Chapter II - Personalised Healthcare

Summary

Introduction – Enabled by the patient's changing role, the technological possibilities, and pushed by population changes, healthcare is more and more relying on e-health tools and becoming personalised. Key to the success of personalised healthcare is the availability of data, data on the patient's lifestyle, environment, family history and health. As the famous quote of John Naisbitt – observer and analyst of global trends – says, “[t]he new source of power is not money in the hands of a few, but information in the hands of many”. The same is true for modern healthcare models. Leroy Hood and Mauricio Flores argue, “[t]he digital revolution has given scientists the ability to generate and analyse previously inconceivably large quantities of digital data”. Emerging technologies permit exploring new dimensions of patient data and biological information to provide disease-relevant information for the individual. The mapping of the human genome has been a crucial outcome of this evolution. New approaches to medicine began to emerge.

Outlook – In the following paragraphs, a short exploration of the ideas expressed under the denominators ‘systems biology’, ‘personalised medicine’ and ‘disease management’ are provided. While their definitions are often still unclear – or different versions circulate – they reflect general, but essential changes in healthcare providers’ and patients’ attitude. Additionally, the approach to medicine, known as P4 Medicine, is briefly discussed. Although this approach is quite specific and primarily focussed on genomics, many of its characteristics affected different healthcare fields.

SECTION 1. SYSTEMS BIOLOGY

Understanding interactions – Systems biology is a holistic global and integrative approach to health and disease. Organisms are approached as an integrated, collaborating network of genes, proteins and biochemical reactions. Computational power enables the analysis of relationships between elements in a system and their response to genetic or environmental perturbations. The goal of systems biology is to understand the complex interactions behind the individual components of an organism. Hood and Flores emphasise that the outcome of a systems approach to medicine is “an exponentially increasing ability to generate enormous amounts of digitalised personal data, big data”. Subsequently, new analytical tools to capture, validate, store, mine, integrate and model data sets, must translate data into knowledge.