Towards a “4I” approach to personalized healthcare

The objective of personalized healthcare is to ensure that each patient has the best clinical outcome by tailoring both preventative measures and treatments to meet their unique needs and characteristics. Achieving such a vision requires not only the collection and application of the best possible data, information, and knowledge during each patient encounter, but also, learning from each encounter and engaging patients and their families in the healthcare process. This vision of a learning health care system can improve the outcomes and quality of care for the individual patient, their family, and their community.An innovative and paradigm-shifting approach to conceptualizing personalized healthcare has been described by Weston and Hood using the moniker of “P4 Medicine” - where it was proposed that our fundamental approach to disease prevention, diagnosis, and treatment must transition from being a primarily reactive model to one that is predictive, personalized, preventive and participatory [1]. In this model, it is envisioned that our fundamental approach to the delivery of healthcare will be shifted from an emphasis on treating illness to the early and continuous prevention of disease and the promotion of wellness. Furthermore, under this paradigm, the patient becomes an integral part of the healthcare delivery ecosystem, taking an active role in the identification and modification of disease related risk factors, while also assuming responsibility for critical aspects of their ongoing care (moving from being a passive consumer of clinical care to an active member of the overall healthcare team). Unfortunately, it is widely noted that the current healthcare delivery workflows (including essential data, information, and knowledge management methods) are not well aligned with the P4 paradigm, thus impeding the implementation of the model [2-6].The scientific discipline of Biomedical Informatics emerged over the last several decades as a catalyst for the discovery