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established to advance the future of personalized medicine
by connecting the scientists, clinicians, the media and the
general community in a common goal). We will discuss
below only our own efforts to bring P4 medicine to patients.
At the Institute for Systems Biology, in conjunction
with Ohio State Medical School and PeaceHealth clinics,
we have created the P4 Medicine Institute (P4MI), a non-
profit organization that is committed to creating a network
of six or so clinical centers with the ISB to employ the
strategies and tools of P4 medicine in pilot projects to prove
the power of P4 medicine. Pilot project success will be
critical in convincing conservative physicians, a skeptical
medical community and an often bureaucratic and herd-
driven healthcare industry as to the potential of P4 medi-
cine. P4MI is also interested in bringing relevant industrial
partners to this clinical network. In addition, P4MI has
established a Fellows Program to begin delving into some
of the societal challenges of P4 medicine, eventually
expressing these issues through 'white papers' on
economics, the 'gold standard of healthcare information',
ethics, regulations, etc. Strategic partnerships are a critical
component for bringing P4 to patients worldwide and
gaining its widespread acceptance in the national and
international medical communities.
As the P4MI pilot programs become successful and
begin demonstrating the power of P4 medicine, we would
like next to persuade a small country to build a P4
medicine/healthcare system. This country could play a key
leadership role in pioneering the new medicine of the 21st
century, just as Johns Hopkins Medical School in the early
1900s adopted some recommendations of the Flexner
Report on the future of medicine (sponsored by the Car-
negie Foundation), which included the recommendation
that medicine should integrate basic research and clinical
medicine. Thus Johns Hopkins propelled itself from
a mediocre medical trade school into a world leader in US
and world medicine. Now there is now a similar oppor-
tunity for institutions (and countries) that pioneer P4
medicine/healthcare to become world leaders. It will take
courage, leadership, resources and an effective commu-
nication of the vision to the stakeholders to catalyze the
revolution in P4 medicine/healthcare. It goes without
saying that any nation that assumes a leading-edge lead-
ership role in catalyzing the emergence of P4 healthcare
will be in a unique position to transform the healthcare of
its citizens, to revolutionize its medical research agenda
and to take advantage of the associated economic oppor-
tunities associated with the newly emerging world of P4
medicine.
of a deep understanding of neurodegeneration to avoid
the personal and societal tragedies of diseases such as
Alzheimer's and Parkinson's.
4.
P4 medicine, through its driving of the emergence of new
technologies and computational techniques, is pioneering
the digitization of medicine. The 'quantified self' will
provide the data that will enable each individual to opti-
mize his or her own health. This will also provide the data
to empower P4 medicine to revolutionize healthcare
through consumer-driven social networks (
Figure 23.1
).
The digitization of medicine through the generation of big
data sets for each individual
allowing one to sculpt with
exquisite specificity wellness and appropriate responses
to emerging diseases
e
is one of the transforming aspects
of P4 medicine. Another important implication arising
from the digitization of medicine is the fact that personal
data will become incredibly inexpensive (e.g., it is esti-
mated the first human genome sequence finished in 2003
cost about $1 billion; today it costs a few thousand dollars,
and in a few years genome sequences will cost perhaps
$100)
e
thus digital technologies and their exponentially
declining costs will contributing significantly to reversing
the escalating costs of healthcare.
5.
P4 medicine will bring increased wealth to the health-
care systems, communities and nations that practice it.
The decreasing costs of healthcare have been mentioned
above. Many economic opportunities will evolve from
the knowledge of P4 medicine through the trans-
formation of the healthcare industry. We predict that
there will be a 'wellness industry' that will emerge over
the next 10
e
15 years that will in time far exceed the
size of the healthcare industry. P4 medicine is an area
replete with economic opportunities for those who are
practicing it at the leading edge.
6.
The patient (consumer), through social networks, will
drive the emergence of P4 medicine. Because of
intrinsic conservatism and sclerotic bureaucratic
systems, physicians, healthcare specialists and the
healthcare industry will take a back seat to the power of
patient-driven social networks in bringing change to the
healthcare system. Indeed, patients may be the only
driving force capable of truly changing our contempo-
rary healthcare system to the proactive P4 mode.
e
HOW TO BRING P4 MEDICINE
TO PATIENTS
The challenges of bringing P4 medicine to patients and
consumers have two critical dimensions, technological and
societal. The latter is far more complex. A variety of efforts
are focused on bringing personalized medicine to healthcare
and to dealing with some of the societal issues of this new
medicine (including the Personalized Medicine Coalition,
ACKNOWLEDGMENTS
Thanks to Lee Rowen for advice and counsel in preparing this paper
and Jaeyun Sung for help with
Figure 23.9
. This paper was in part
