P4 medicine: how systems medicine will transform the healthcare sector and society

Abstract

Ten years ago, the proposition that healthcare is evolving from reactive disease care to care that is predictive, preventive, personalized and participatory was regarded as highly speculative. Today, the core elements of that vision are widely accepted and have been articulated in a series of recent reports by the US Institute of Medicine. Systems approaches to biology and medicine are now beginning to provide patients, consumers and physicians with personalized information about each individual's unique health experience of both health and disease at the molecular, cellular and organ levels. This information will make disease care radically more cost effective by personalizing care to each person's unique biology and by treating the causes rather than the symptoms of disease. It will also provide the basis for concrete action by consumers to improve their health as they observe the impact of lifestyle decisions. Working together in digitally powered familial and affinity networks, consumers will be able to reduce the incidence of the complex chronic diseases that currently account for 75% of disease-care costs in the USA.

Keywords: P4 medicine; big data; knowledge network; learning healthcare; new taxonomy of disease; omics studies; personal data clouds; systems biology; systems medicine; wellness industry.

Conflict of interest statement

Competing interests disclosure

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1. Three converging megatrends driving the transformation of healthcare

P4 healthcare is emerging at the intersection of these megatrends. P4: Predictive, preventive, personalized and participatory.

Figure 2. The evolution of data regimes

Healthcare’s data needs can be characterized by two variables: the number of people measured and the number of measurements taken. We are moving from a limited-data regime of few measurements of few people to vastly increased measurements of few people. The future points to a regime of billions of data points for all members of the population. P4: Predictive, preventive, personalized and participatory.