Is personalized health care. In a compelling presentation, Dr. Ralph Snyderman at Duke University lays out the case for moving from the current “find it, fix it” model of care to a “predict it, personalize it” model – a journey from understanding disease in the 20th century to understanding health, disease and complexity in the 21st.

This moves from the science of reductionism to the science of emergence: establishing baseline risk and environmental factors, using new tools (genomics, proteomics, systems biology, informatics) to predict and personalize potential problems, and intervene with wellness and disease management strategies before late-stage development and expensive treatment.

Not in the current fragmented “non-system” of care, however. Personalized health care will occur in the context of community-wide teams and an integrated care model. Some aspects of the current health reform law – medical homes, changes in reimbursement, health education and personal empowerment – may form the basis for a responsive, effective and efficient “system” in the future.

That’s the vision, at least. Those who continue to profit from the current state of affairs will look for ways to resist it.