TR: How do you see the future of personalized medicine?

LH: I think personalized medicine is too narrow a view of what's coming. I think we'll see a shift from reactive medicine to proactive medicine. I define it as "P4" medicine--powerfully predictive, personalized, preventative.

TR: What new technologies will drive the revolution in medicine?

LH: Individual genomes will become a standard of medical records in 10 years or so, and we will have the power to make inferences [about an individual's health] when combined with phenotypic information. Then we can begin to plan strategies for individual health care in ways we have never done before.

The final driver is going to be what I generally call computational and mathematical tools, the ability to deal with data dimensionality that is utterly staggering. If we have patients in 10 years with billions of data points, being able to compare that with individual genotype-phenotype correlations will give us deep and fundamental new insights into predictive medicine. But the challenge is, where will we get the cycles to make those computations and where will we get storage for all this data?

TR: So IT has a major role to play in personalized medicine?

LH: Medicine is going to become an information science. The whole health-care system requires a level of IT that goes beyond mere digitization of medical records, which is what most people are talking about now. In 10 years or so, we may have billions of data points on each individual, and the real challenge will be to develop information technology that can reduce that to real hypotheses about that individual.

TR: Will there be consequences beyond medicine?

LH: I think the P4 medicine revolution has two enormous societal consequences. It will absolutely transform the business plans of every sector of health care. Which will adapt and which will become dinosaurs? That's an interesting question, but it will mean enormous opportunities for companies.

I also think it will lead to digitization of medicine, the ability to get relevant data on a patient from a single molecule, a single cell. I think this digitization in the long run will have exactly the same consequences it has had for the digitization of information technology. In time, the costs of health care will drop to the point where we can export it to the developing world. That concept, which was utterly inconceivable a few years ago, is an exciting one.

TR: What will be the challenges in implementing this vision of medicine?

LH: I think the biggest challenges will be societal acceptance of the revolution. We are putting together something we call the P4 Medical Institute. The idea is to bring in industrial partners as part of this consortium to help us transfer P4 medicine to the patient population at Ohio State University, which is both the payer and provider for its employees. We plan to announce further details of this project in two or three months.

http://www.technologyreview.com/biomedicine/24703/