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The Future of Healthcare and the Four P's: Preventive, Predictive, Personalized, Participatory

Posted Aug 26 2010 12:00am

I have posted a number of previous notes on the topics of preventive, predictive, personalized, and participatory medicine (see: Preventive and Predictive Medicine as Components of the Healthcare Continuum ; Some Encouraging News About New Federal Funding for Preventive Medicine Initiatives ; Wellness, Preventive Medicine, and the Classic Disease Model ; The Need for a Preventive Medicine Infrastructure in the U.S. ; A Key Link Between Predictive and Preventive Medicine ; Further Consideration of the Definition for Personalized Medicine ; Recruiting Office Patients into a Participatory Model of Healthcare Delivery ; "Participatory Medicine" and Its Relationship to Clinical Lab Testing ). There are more but you get the idea.

Putting it all together, they together constitute a blueprint for the healthcare development arc in the near term. Tony Killeen, who blogs over at iPathology, makes reference to a recent lecture by Leroy Hood about P4 Medicine (see: P4 Medicine: Predictive Preventive Personalized and Participator y). Below is an excerpt from his note:

One of the best talks at the recent AACC Annual Meeting was given by Leroy Hood from the Institute for Systems Biology. His topic was P4 Medicine , a term he coined for "predictive, preventive, personalized, and participatory". What he's describing will, I believe, have significant and exciting implications for Laboratory Medicine because the concepts are based on the idea of clinical laboratory genomic analysis for identification of disease risk alleles, blood analysis for early detection of disease by measurement of disease specific biomarkers, and interpretation of data by knowledgeable experts. With the prospect of a $1000 genome sequence in the not-too-distant future, and rapid advances in protein analysis by mass spectrometry, it seems realistic to think that many of the technical limitations are surmountable. The question in my mind is how does one deal with the enormous amount of data from these analyses and distill it into something intelligible to physicians and patients alike?  And will patients really take an interest in modifying their lifestyle in response to new risk factors when it's so difficult for many people to adjust to well known disease risk factors today, such as smoking, diet, lack of exercise, and so on? But back to Laboratory Medicine. What is being described as P4 Medicine is obviously very reliant on clinical laboratory analysis, and could bring about a new era for advanced Lab Medicine in specialized centers that can offer such testing.

One "deals" with the enormous amount of data that will be accessible to us using information technology, but Tony already knows this. I think the question that he is really asking here is how the IT tools that will be at the disposal of both physicians and patients will be integrated into healthcare delivery. What's most revolutionary about the Four P's is the last one -- participatory. The truly unique aspect of this formula will be the nearly unfettered access by patients to the same information about their health status as the healthcare professionals (see: Should Patients Be "Allowed" to Read Their Medical Records? ; Paging Dr. Google! We Are Waiting for a Second Opinion. ; Teaching Consumers to Say "No" to Physicians' Recommendations ). The most engaged of them will become key partners in the quest for continuing wellness.

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