Chapter 23 - Systems Medicine and the Emergence of Proactive P4 Medicine: Predictive, Preventive, Personalized and Participatory

Abstract

Systems biology and the digital revolution are transforming healthcare into a proactive P4 medicine that is predictive, preventive, personalized and participatory. Systems biology – holistic, global and integrative in approach – has given rise to systems medicine, a systems approach to health and disease. Systems medicine promises to (1) provide deep insights into disease mechanisms, (2) make blood a diagnostic window for viewing health and disease for the individual, (3) stratify complex diseases into their distinct subtypes for an impedance match against proper drug treatments, (4) provide new approaches to drug target discovery, and (5) generate metrics for assessing wellness. P4 medicine, the clinical face of systems medicine, has two major objectives: to quantify wellness and to demystify disease. Patients and consumers will be major drivers in the realization of P4 medicine through their participation in social networks directed at improving their own healthcare. P4 medicine has striking implications for society – including the ability to turn around the ever-escalating costs of healthcare. The challenge in bringing P4 medicine to patients and consumers is twofold: first, inventing the strategies and technologies that will enable P4 medicine, and second, dealing with the impact of P4 medicine on society, including key ethical, social, legal, regulatory, and economic issues. Managing the societal problems will pose the most significant challenges. Strategic partnerships of a variety of types will be necessary to bring P4 medicine to patients.