1. Market Creation of Personalized Whole
Genome Sequencing
Solution to developing patient-centric Healthcare
Hee Gun Eom

2. The Problem and Opportunity
Introduction: Genome Sequencing Cost
One of the prerequisite when talking about genomics and source of excitement in our
contemporary is summarized by figure 1.
Since the completion of the Human Genome Project in 2003, which cost approximately 3 billion
dollars, the cost of sequencing the human genome has been plummeting. This has allowed
abundance in genomic data and any modern biological research lab, access to sequencing; not
only of the human genome, but every living organism. This development has often been
compared to Moore’s Law* a driving force that keeps the information technology industry
innovating and highly productive. As indicated in figure 1 since January 2008, genetic
sequencing has been out-pacing Moore’s Law by a large margin. Most recently an offshoot of
the Personal Genome Project, the brainchild of George Church, Veritas Genetics has started to
offer the $999 genome, a price point that will allow faster consumer** adoption of human
genomics. (Nanalyze, 2016) The cost of sequencing is speculated to keep dropping and allow
more individuals to get their genome sequenced. The cost of genome sequencing is no longer
the rate-limiting step. However, diffusion of genome sequencing to healthcare has been slow
and disappointing. Once promised as the catalyst to create a more innovative healthcare
industry, genomics has been stuck in laboratories, providing little economic benefit to average
Figure 1 Costper Genome in function of time
and compared to rate of Moore’s Law.
Courtesy of (NGRI, 2016)

3. consumers. Genome sequencing does not offer economical value yet, because there is not a
defined market for personalized medicine or a value network that can deliver the care the
consumers need. This paper will outline the current landscape of healthcare and personal
genomics to speculate its potentiality. Using innovation theories, this paper will aim to provide
a clear strategy in creating a new market of patient-centric whole genome sequencing; a new
paradigm that has the potential to disrupt current healthcare industry and improve health and
wellness of patients.
*Observationmade byGordonMoore,co-founderof Intel,thatthe numberof transistorspersquare
inchon integratedcircuitshaddoubledeveryyearsince the integratedcircuitwasinvented
**Consumersandpatientswill be usedinterchangeablytoexpressthatnature of patient-centric
healthcare where,patientsbecomeactive consumersintheirownhealth&wellness.
Personalized, Preventative, Precision, and Participatory
What is the goal of commercializing genomic data? As of now genetic sequencing has
yielded significant scientific insight and has propelled biological research to a quantitative
discipline. However, it has yet to produce economical value in reducing healthcare cost, drug
development, personalize care; economic benefits that effects the general consumer
population. In our contemporary, immense advances in basic scientific knowledge in biology
and new biomedical technology are being gained and developed, however the healthcare
industry has been unable to translate these technologies to innovative solutions that benefits
the patients. The value that genetic data can offer society is best summarized by Leroy Hood’s
P4 medicine model. P4 standing for: predictive, preventive, personalized, and participatory.
With patient’s entire genomes sequenced, it will provide crucial insights into optimizing
wellness, and allow us to detect many diseases before symptoms appear allowing predictive
capability to medicine. Instead of medicine focusing on disease as it does today, the focus will
be on wellness and the patient taking active preventive measures from getting ill. Every
individual is differentiated by his or her genomic deposition and micro and macro environment
that demands a personalized approach in maintaining health and curing diseases. Genomics
can provide a stratified model according to genetic make-up of the individual and allow

4. treatments to be individually optimized. Finally, patient-driven networks will drive this
revolution in medicine, as patients become active participant in their well-being. (Hood)
Table 1 isprovidedcourtesyof (Hood,2013)
Adoption of P4 medicine will shift medicine from reactive medicine to patient-centric
healthcare. In our contemporary healthcare services are only used after a patient falls ill. There
is little emphasize in preventative medicine, and the healthcare industry plays little role in
keeping people healthy. In the current system, there is more economic incentive for patients to
fall ill, because he/she consumes more products and services. However, in the new paradigm,
disease-centric model will be replaced by wellness maintenance system, in which economic
incentive drives consumers to be healthy and healthcare industry sell product and service that
complements this model. Different elements from table 1 will be continually referenced to gain
a complete understanding of this new paradigm.
Complementary to P4 medicine, the NIH (National Institutes of Health) uses, Precision
medicine defined as: a groundbreaking approach to disease prevention and treatment based on
people’s individual differences in environment, genes and lifestyle. (NIH, 2016) This definition

5. overlaps with the P4 medicine model proposed by Hood. Precision medicine will be better
utilized in this paper to describe a rule-based medicine proposed by Clayton Christensen.
Intuitive to Precision Medicine (Rules-based medicine)
The human body has a very limited vocabulary from which it can draw when it needs to
declare the presence of disease. When we cannot properly diagnose the underlying disease or
the context in which the patient may or may not be able to respond to treatment, effective care
generally could only be provided through intuition and experience of highly trained (and
expensive) doctors. (Christensen, Grossman, & Hwang, 2009) The intuitive nature and
unpredictability of diseases have historically kept patients, consumers with no prior medical
knowledge, to rely on expert doctors to make consumer decision on their health and wellness.
Effectively, patients receive the care, but play little role in preventing or participating in their
health. This has promoted reactive medicine, treating the patient only after they get sick, and
little emphasize, in proactive wellness maintenance. Medical information and records were
never diffused to the patients, in argument of patient protection, creating an asymmetry of
information leading to where patients have no market influence.
However, investment in basic research have developed technologies and scientific basis
that enable precision care. Biotechnology advances in diagnosis and better understanding of
disease’s molecular pathways; more diseases are moving from the realm of intuitive medicine
to precision medicine. Provision of care for diseases that can be precisely diagnosed, whose
causes are understood, consequently can be treated with rules-based therapies that are
predictably effective. The end goal of rules-based therapies is the conversion of complex,
intuitive process into simple, rules-based medicine allowing handoff of the work from
expensive highly trained experts to less costly technicians. (Christensen, Grossman, & Hwang,
2009) Rules-based medicine is vital in reducing healthcare cost and making healthcare more
accessible. When a product and service is predictable and the value of the product/service can
be easily evaluated, it creates a more competitive market driving the cost down and value up.
Accessibility is increased as nature of healthcare delivery is not only limited by doctors or
traditional healthcare providers, it can come from various sources. Contemporary healthcare

6. system has been allergic to innovation, because of the dogma that healthcare must come from
safe and reliable sources. However, as it will be explained later in whole genome innovation,
the need to harness disruptive innovation strategy is vital in creating a healthcare system that is
affordable and accessible.
Of course intuitive and precision medicine are not binary states; there is a broad domain
in the middle that we term empirical medicine. Practice of empirical medicine occurs when a
field has progressed into an era of “pattern recognition”. (Christensen, Grossman, & Hwang,
2009) Disease states are shown in spectrum from intuitive to precision medicine, with varying
levels of predictability. Figure 2 shows the spectrum of common diseases.
The x-axisrepresentsthe mechanismof the disease,whetheritisthe molecularpathwaysunderlying
the disease ordiagnosticcapabilitytoidentifythe disease thisdefinesunderstandingandidentifyingthe
problem.The y-axisrepresentsthe treatmentefficacywhichcancome from drugs,therapeutics,or
lifestyle changes.(Graphcourtesyof TheInnovator’sPrescription a DisruptiveSolution forHealthcareby
Clayton M.Christensen)

7. There is no magic technology that will allow all these diseases to move from intuitive to rules-
based medicine. Research will have to be conducted disease by disease, to slowly move up the
spectrum, where diagnosis and treatment can be routinized. (Christensen, Grossman, & Hwang,
2009) However, genomics can serve as a technological enabler to fasten the pace of research to
bringing disease states to intuition to precision.
When large patient population have their genomes sequence, it allows stratification of
patients, that allow drug development to move from, population-based blockbuster drug model
to personalized, disease-specificdrug development process. Clinical studies, one of the costliest
portion of drug development can change to a stratified model, in which drugs and therapeutics
are developed to specific genomic-based, patient population. Furthermore, chronic disease
such as: heart disease, stroke, type 2 diabetes, and obesity can be managed through
personalized preventative measure. Empowering the patient with their genomic data, and
providing a point of care that prevents, or manages the chronic illness; will be a major step
toward alleviating these diseases. However, for this to become a reality, it is important to shift
the paradigm of medicine from, paternalistic care where patients received care, playing no
participatory role in their health; to where patients are active participants in health and
wellness of their own body.
Asymmetry of Information
Healthcare is a non-consumer market. On a consumer level, the customer or patient
that gets the end benefit of the product or service are non-consumers, in that they do not drive
the market or have an active purchasing power. In reality, there are three customers, each
making independent decisions for selection, purchasing, and utilization of most healthcare
products. One customer is the decision-maker who decides which product should be used
(doctors), another customer makes an independent decision whether or not to pay for the
product (payer), and a totally different customer uses the product (patient). (Shimasaki, 2014)
This segmentation of the consumers naturally has developed as medicine is an intuitive science;
needed professionals (doctors) to make expert decision and diagnosis for the patient’s safety
and benefit.

8. The disconnect between what consumers can learn and how they can use what they
learn, results in this inability for them to truly be the drivers in their own healthcare decisions.
Information asymmetry, defined as a gap in knowledge between consumers and professionals
regarding price and quality, is one of the major factors that makes healthcare delivery
inefficient. (D'Cruz & Kini, 2007) Healthcare is characterized by extremely high level of
uncertainty and the consumers’ uncertainty about the consequences of purchasing healthcare
services. Patients as consumer have an inherent inability to fully understand the effectiveness
of medical treatments. Under these conditions of uncertainty, correct information becomes a
valuable commodity. (Arrow, 1963) The need to develop a coherent platform in which provides
consumers with actionable, coherent personalized healthcare data is vital in making an
effective healthcare industry.
As intuitive medicine moves up the spectrum to precision medicine, the uncertainty that
drove information asymmetry will be less elusive and patients will be able to assess the
effectiveness and value of the care they receive. The information asymmetry gap is closing in,
disease by disease, however healthcare will never be truly personalized until the patients have
access to their healthcare data, and become active consumers in assessing the quality and value
of care.
Electronic health record is a prime example of how information is being generated, but
are balkanized, and does not benefit the patient. In the United States, health data live in a
plethora of places, from electronic health record (EHR) systems, insurance claims databases,
siloes of personal health apps, research and clinical trial databases imagining files and lots of
paper; resemblance of an overarching organization or standardization of medical data are
lacking. Disorganization and balkanization contribute to poor outcomes and death. The US
Department of Health and Human Services, estimates 20% of preventable medical errors are
due to lack of immediate access to health information. Of the estimated 400,000 preventable
medical errors leading to death in the United States annually, we can project 80,000 people die
every year because of the lack of needed access to medical information. (Topol & Kish, 2015) In
the decentralized and fragmented nature of the health care delivery systemor “non-system”,
patients see multiple providers in different settings, none of whom has access to complete

9. information, it becomes easier for things to go wrong. (Kohn, Corrigan, & Donaldson, 1999) The
only solution is a patient-centric model, where patients own their data and healthcare
providers utilize this information to deliver effective care. Patient ownership of their healthcare
data is the first step in making a personalized point of care. It promotes patients to be actively
engaged in their healthcare and preventative measures.
Technical Limitation (Needs to be more technical)
Genetic sequencing and the science of genome is a knowledge base innovation, where
scientific knowledge is the enabling product of economical productivity. Reduced cost in
sequencing enables reading of the genome, however the sequence in itself does not provide
economic benefit. Only when the sequenced genome is annotated, analyzed, and is translated
to actionable clinical decision is when the genome is finally of productive use. However, the
human genome is not as simple as it seems. When the human genome project was completed
in 2001, it was discovered that over 98 per cent of the DNA in a human cell is junk. (Carey,
2015) The conventional knowledge is that DNA is transcribed to RNA and translated to proteins,
which have functional biological activity that enables cellular activity. However only 2 per cent
of the DNA codes for functional proteins; this seems like an excess waste of 98 per cent of the
genome. In the last few years, it has been recognized, a major role of junk DNA is to regulate
gene expression. (Carey, 2015)
(More research ENCODE) Can we make genetic research more rule-based?
Only using genomic data to precisely diagnose complex disease is not the end goal. It is actually
impossible. Diabetes, have polygenetic markers that make it complex to diagnosis through
genetic sequence, but relatively simple through blood test. The role of genetic testing is not to
replace traditional diagnostic methods, but to complement it. The patient’s genome combined
with electronic health records, family history, diagnostic tests, and any patient generated data
can add to creating a clear picture of a personalized map of a patient’s health status. More
importantly in should be the technology that shifts the paradigm from reactive medicine to a
proactive patient-centric health care by making it accessible to non-consumers.

10. HAPMAP Project
GWAS: how population level genomics can move medicine to an empirical to rule-based
(GWAS is promising, but using the wrong technology, using SNP because of cost effectiveness
and accessibility; whole human genome GWAS will be the next step)
After whole genome sequence has been performed the patient’s genome can be stored for
future evaluation. As new medical questions arise the genomic data can be reanalyzed.
(Chrystoja & Diamandis, 2014) The human genome is a static dataset in which, in changes little
over the course of the patients life. Genomes can be re-sequence to improve accuracy of the
genome sequence. However, the genome, once sequenced will continually add value to the
patient as more genes are discovered to further our understanding of our health. There are
efforts to commercialize SNP and whole exome sequencing, however it is my belief that whole
genome sequencing will drop in price rapidly and will far out-pace the cost, data ratio making it
the standard in personalized medicine.
Because everyone has a risk for developing at least one disease and whole genome sequencing
can expand the accuracy of family history, whole genome sequencing is economical in
preventative care. Every genome sequenced offers value, as it provides a reference for an
individual’s family, as well as for the general population. In our opinion, as medical genomic
information becomes better integrate, the combined dataset will be an even greater value to
the patient, their family and society. (Jacob, Abrams, & Bick, 2013)
The promise of patient-centric whole genome sequencing is immense. It has the
potential to create a new paradigm in how healthcare is delivered and practiced. No matter the
limitation, promotion of personalized systemwill dramatically reduce healthcare cost, increase
patient safety, and health. However, the importance in a patient-centric healthcare is the
accessibility and ownership of data. The enabling technology that will allow patients,
conventionally non-consumers, to be active participations in their well-being. Innovative
approaches in adapting whole genome sequencing is required to make genome sequencing
available for all consumer population in cost effective way.

11. Market Creation
Nature of Innovation
To ask the right questions we need to first understand the nature of innovation. More
specifically knowledge based innovation where scientific knowledge is the underlying driver to
innovation. Knowledge-based innovation requires careful analysis of all the necessary factors,
whether knowledge itself, or social, economic, or perceptual factors. The analysis must identify
what factors are not yet available so that the entrepreneur can decide whether these missing
factors can be produced. (Drucker, 1985) Genetic sequencing has been plummeting in cost and
the cost of sequencing will soon reach a point where it will be available for any patient and
consumer. However, sequencing the genome is only the first step, the genome must be
contextualized and specific genes must be identified that can provide accurate diagnostics of
the patient’s health. As of now, our knowledge of the human genome is sparse, limiting
widespread adoption of human genome in clinical settings. The dilemma is that even through
patients get their genome sequenced, doctors are limited in what they can do with this
information, because there is only a small amount of biomarkers that are clinical actionable.
Furthermore, doctors have traditional diagnostic tools, such as blood test, that are proven to
work and less expensive.
However, the irony is that more genomes must be sequenced to contextualize and gain
a better understanding of the genome. Similar to the GWAS (Genomic Wide association study)
approach, the quality and quantity of genetic information is vital to creating a population wide
study that can produce novel knowledge about out genome.
Job-to-be Done
In the frenzy of new technology and attempt to market it, people involved in developing
these innovative products lose sight of the end goal. Majority of the consumers are not buying
the new technology. They are buying it because it gets a job done. Introduced by Clayton
Christensen, the Job-to-be Done framework simplifies consumer behavior. Jobs arise in
consumers lives that they need to be done, they hire products or services to do these jobs, the

12. job and not the customer or the product, should be the fundamental unit of marketing analysis.
(Christensen) The job-to-be done is a flexible unit of marketing analysis as the same product
can do multiple jobs or might appeal to multiple customer segments. We will continually go
back to this frame of thinking to re-analyze the market and elucidate what job genomics can do
for consumers.
Disruptive Innovation
A disruptive innovation is not a breakthrough improvement. Instead of sustaining the
traditional trajectory of improvement in the original plane of competition, the disruptor brings
to market a product or service that is actually not as good as those that the leading companies
have been selling in their market. However, though they don't perform as well as the original
products or services, disruptive innovations are simpler and more affordable. This allows them
to take root in a simple, undemanding application, targeting customers who were previously
non-consumers because they had lacked the money or skill to buy and use the products sold in
the original plane of competition. (Christensen)

13. Figure X summarized disruptive innovation in planes of time, performance and non-consumers.
Applying this idea to whole genome sequencing, we begin to envision how to create a patient-
centric healthcare market. The sustaining innovation spectrum, is the traditional healthcare
system in which it has been moving up the pace of performance over time. Sustaining
innovation has created products and services that are nothing short of miracles, MRI
machine, …., and it has far crossed the performance improvement that customers can utilize.
An important caveat to this domain, is that the customers, are doctors or healthcare providers.
The patient receives the care, but the active consumer with purchasing power are the doctors
and healthcare providers. Moving up the z-axis the non-consumers are the patients or general
consumers that play little role in the current healthcare industry. Now the question is, what
form of disruptive innovation, a product that is simpler and more affordable, will allow
healthcare to move up the non-consumer axis to target the general consumers. To understand
this, we need to introduce another concept: crossing the chasm and the technology adoption
lifecycle.
Value Network
A key contributor to this costliness, however, is that the primary business models being used to
care for these patients— physicians' practices and hospitals— were primarily set up to deal
with acute diseases. They make money when people are sick, not by keeping them well. There
are more than 9,000 billing codes for individual procedures and units of care. But there is not a
single billing code for patient adherence or improvement, or for helping patients stay well.
(Christensen, Grossman, & Hwang, 2009)

14. Crossing the Genome Chasm
The Chasmwas introduced by Geoffrey Moore in his book “Crossing the Chasm: Marketing and
Selling High-Tech Products to Mainstream Customers” to explain the technology adoption
lifecycle and the chasmthat divides the early adopters from the early majority. Although
originally developed with the information technology industry in mind, this model is highly
applicable in all areas of high technology, and the human genome in this instant. However,
because healthcare is not a traditional consumer market we need to redefine the market
segments to define the customer at each market and the willingness to adopt new technology.
Innovators are defined by technology enthusiasts that are first in line to get the newest
technology, even if the product is expensive and lack functionality.
However, at this market segment, the product is still un-tested and at the early stage of
adoption. It provides little value to the individual with their genome sequenced. These
individuals with their genome sequenced is not in it for the value it provides, but the
excitement and opportunity that the technology can buy. These are the few consumers that
buy for the sake of buying the technology. In genetic sequencing the innovator can be
described as individuals that have already had their genomes sequenced as part of a research
effort led by government or universities.

15. Early Adopters are visionaries that see the potentiality of the technology as a business
goal and see how it can radical change how the industry operates. This can include anyone from
innovative doctors that what to try out new technologies, or entrepreneurs that believe
genome sequencing have the potential to redefine healthcare. It can be said that in our
contemporary, human genome sequencing is about to cross onto the early adopter market
segment. There are a few start-up companies that aim to commercialized whole genome
sequencing. However, these products /services still only appeal to early adopters. Whole
genomics sequencing has potential but provides little value to appeal to the early majority
market segment. It is how these companies cross the chasmto provide a product/service that
appeals to the early majority consumer market is vital to success of commercializing whole
human genomics.
Contemporary early adopter companies run the risk of, not being able to cross the
chasm, unable to cross to the early majority market where most of the consumers lie. The
chasm is the dividing line between the early start-up period to creation of mainstream markets.
This is where most high-technology fortunes are made or lost. (Moore, 1991) The companies
that are successfully able to cross the chasmand grab the mainstream market customers, set
the de facto standard and have the ability to define the market. Two main strategies in crossing
the chasm defined in Moore’s book is: find niche market with intractable problem and commit
to provide the whole product. Finding a niche market is important as it defines it customer, and
commits the company in developing a whole product that satisfies the consumers need. A
whole product, is defined as spectrum of products that meet all the customers need, and gets
the job-done. For example, a personal computer is a single product, but without software,
mouse, keyboard, and peripherals, the personal computer has little value to the customer. Only
when the PC is provided to the customer with the whole product (software, mouse, keyboard…)
does it have value to consumers. In context of genomics, companies need to start thinking
about the which niche market to target. Genomics has the potential to disrupt many industries:
healthcare, hospital, wellness, agriculture, and food. However, by targeting a niche market it
provides focused product development that has the ability to win over early majority

16. consumers. After winning over a market segment this provide opportunity, to disrupt other
markets.
In context of human genomics, the early market will be segmented, at first, by
healthcare industry and wellness industry. There will be niche markets that will sell whole
genome sequencing to doctors as customers who will use it to diagnose their patients. Genome
sequencing has already been used in clinical settings for personalized cancer diagnosis.
However, one of the limitation of genome sequencing through this market is that it does not
inherently create a new value network. It still will advocate disease-centric model, and genomic
information will likely not be patient-owned. Another niche market will come from the wellness
industry where consumers will get their genome sequenced through DTC (Direct to Consumer)
whole genome sequencing services. This market provides the best opportunity for patients to
own their own genetic information. Companies that are able to provide whole products based
on niche market demand, have the potentiality to confer with the P4 medicine model.
The late majority market will be captured when whole human genomics become the
standard for all health and wellness product and services. It will permeate through all aspects of
healthcare and wellness industry. Also it has the potentiality to disrupt the agriculture, food,
pharmaceutical industry as how we eat, and the drugs will change dramatically.
The laggards are the very end of the technology adoption lifecycle, and are closer to
technology luddites. They will only adopt new technology as it become the basis of modern life.
Market Creation
***Having doctor approval genome sequencing significantly reduces the number of innovator
and early majority that are willing to experiment. Argument for DTC genetic testing
The only way whole genome sequencing can be patient centric is to apply the theory of
disruptive technology and move up market until it is a predictable, whole-product that doctors
will be willing to use. Companies need to target the innovators and early adopter market
segment, that are willing to test out new technology and is not in immediate need of whole
products. The market will have to start from preventative medicine, where instead of medicine
focusing on disease, focus will be on wellness. (Hood) It needs to garner the health and

17. wellness industry where active consumers are buying healthy products and services to enhance
their health. This customer base can be called the “health innovators”. They are willing to try
different diet and exercise regiment, and heavily invest it health and wellness. Their job to be
done is to maintain or improve their healthy lifestyle. Companies that offer a whole product
using genomics and scientific method in giving personalized information to maintain their
customers’ health and wellness will win this market segment. Centered around driving the
health and wellness outcomes that are critical for long-term economic sustainability. And
positive catalysts abound, including advances in science, the evolution and availability of
genomic, health, and lifestyle data, and the abundance of technology solutions coming to the
market every day to help us monitor, measure, and adjust our habits to improve our health and
the outcomes of treatment. (Elton & O'Riordan, 2016)
Adoption of this market segment lays the groundwork for sustaining innovation in whole
human genome sequencing. Sustaining innovation will come in forms of GWAS and added
knowledge as more disease move from intuitive to precision medicine. The best companies will
create an innovative business model where consumer genomes added to the wealth of
genomic database can be used by researchers to discover new knowledge and clinical insights
into intuitive diseases. The more contextualized the human genome becomes, the technology
will have the ability to move up market to the early majority. Especially in an information based
value proposition, wealth of data generated and active customers are more important than
revenue at the inception of the market. Revenue streams will follow after the user base has
been established. In the digitization of healthcare, it is useful to look at information technology
business models. Facebook, Google
Scale of Disruption
PC disrupted several industries
Genomics should aim to do the same
Preventative medicine is traditionally harder to see outcome because its results were indirect
***Only the innovators are buying the technology, they are buying a dream

18. When developing a market that is patient-centric, companies should not aim for the
higher tier, risk adverse market segment. The chronically ill, doctors, hospitals, or what we call
the healthcare industry. Applying technology such as the whole human genome sequencing,
with little actionable clinical data, and unpredictability; these established market will not be
willing to adopt a new technology. For this market they have a better and more conventional
alternative (blood test). Going back to the job-to-be done frame of thinking, their job is not to
try and test new technology, their job is to diagnose patients accurately and treat them with no
error and as cost effectively as possible. Only when whole human genome sequencing has
proven to be an accurate source of diagnostic information, will it be adopted in the healthcare
industry. This creates an opportunity for whole genome sequencing to be first marketed at the
lower end of the market, the health and wellness industry. Conventionally the wellness industry
and healthcare industry has been largely independent. The wellness industry, relatively
unregulated and lacking real medical backing; but characterized by highly consumer oriented
and competitive because of general consumer access to these product and services. The
healthcare industry on the other hand is defined by non-consumerism and the gatekeepers of
the product and services where professionals that had adequate knowledge to use it. However,
in the 4P medicine paradigm, these two industry will converge to deliver a whole-product
health system. The lower-end of the market will be defined by preventative measures to keep
patient from getting sick, utilizing wellness products personalized through their genomic and
health data. The higher-end of the spectrum will be delivery of precision care where, when the
consumer gets sick, he/she will receive care that is personalized to their genomic deposition.
Application vs. Platform
Creating a paradigm where “everyone” participate in scientific research
For actual chasm crossing application have a huge advantage, because disruptive
innovations are more likely to be championed by end users than by the technology
professionals that operate the current infrastructure. Application are what an end user sees.
(Moore, 1991) Technology professionals are the doctors, researchers and healthcare
professionals that utilize genomics to treat patients. The platform is the wealth of personalized

19. human genomics data that will be generated, along with analytical tools to contextualize the
genome. Using the wealth of genomics data as a platform, companies need to find their niche
market in developing an application that benefits the consumer in a personalized, preventative,
participatory, and precision manner. There is no doubt in the coming years, there will be many
applications suited for consumers, based on their genomic profile. But before this can happen,
it is essential that a patient-centric platform is developed, where patients become consumers,
rather than the passive role they have been playing in the past. The platform as its basis,
several applications will be personally made to specific patient population. Application can
range from: drugs, medical devices, medical service, wellness products and services, the list is
infinite.
Developing a platform to disrupt healthcare is no easy task. We need to look at
healthcare, not as: hospitals, doctors, insurers, but ask the question what does the consumer
want? What is each patient and consumer’s job-to-be done? In the traditional reactive
medicine model, patients will be segmented according to their diseases and age. However, in
the new preventative medicine model, it is about wellness and empowering patients to take
control of their health. In a broader view, all human beings are different, we all have different
genomic profiles, metabolism, health condition, the list goes on. However, all humans have to:
eat, exercise to maintain health, and most importantly, their job-to-be done is to have a
lifestyle where health is not a deterrent to each individual’s pursuit of life’s purpose. Build a
platform using whole genome sequencing that promotes preventative medicine, it will create
an application that empowers consumers to play a participatory role in their healthcare.
Genomic will serve as a starting point. Adding on to this will be application that are patient
specific and disease specific.
This market entry aligns with disruptive innovation theory mentioned earlier. It gives
non-consumers the power to participate in their own wellness and healthcare. It will not be as
sophisticated as what the hospitals and doctors have to offer, it shouldn’t be. However as
patient generated data increases and more disease states move from empirical to precision
medicine, this platform will move up market in form of sustaining innovation to eventually
disrupt the latter half of the healthcare industry. In the future, sustaining innovations will

20. combine: electronic health records, family history, proteomics, metabolomics, microbiome, and
biosensors to create a complete picture of a patient’s health status.
Additional Topics
 EHR and Genome example translation and diffusion topatient is faster
 Regulation and Innovation
 Reimbursement
 Role of Doctor in the NEW healthcare paradigm
o They will move up the supply chain, curing more intuitive disease that are
harder, finding new ways to treat patients
Conclusion
The personalization of medicine is beyond the interest of profits and revenue.
Innovation in P4 medicine, commercialization of human genome and quantification of
healthcare is vital in making medicine an abundant resource rather than a resource intensive
industry that it is today.
We borrow clues from the technology industry. Mainframe computers were limited to
research labs. Personal computers democratized computing power to the offices and personal
users. Now smartphone has democratized computing power to the world. Smartphones has the
highest adoption rate globally and you can see consumers with it whether you are in US,
Vietnam, Kenya, or Egypt. This continual innovation in information technology allowed
democratization of information. Once limited to a select few, now information is abundant, and
a child in Tanzania with a smartphone and Internet has access to the world’s information and
has the ability to educate oneself.
Biotechnology seems to be following a similar trend. Once a multi-billion-dollar project,
the human genome, has been making its way down market where today most academic labs
have access to sequencing technology. Soon we will be entering a time where human genome
sequencing will be making its way to clinical settings and soon to the general consumers. When
genetic sequencing becomes so cheap it can be implemented anywhere; any country will have
access to sequencing technology. (Oxford Nanopore) With cloud computing; only access to the

21. internet is required to conduct data intensive genomic data analysis. The result is, advance
genomic diagnostics is democratized without the need of expensive healthcare infrastructure.
Emerging diagnostic devices and other Omics technology will follow suit to complete the P4
medicine. This is beyond the aspiration of the short-term future, rather a long-term vision. A
long-term vision where healthcare is abundant.
Healthcare and wellness of one’s health is a basic need of life to have a productive life.
Everyone deserves adequate healthcare that will enable them to pursuit their life’s passion and
become a productive member of society. However, the current healthcare systemis resource
intensive and is not a system that can be emulated by many countries. The United-States,
Japan, European countries are blessed with economic resources to build multi-million dollar
hospitals with doctors and nurses that are highly trained. However, to export such model to
countries with less economic resource is impossible. Furthermore, training healthcare
professionals do not happen overnight, it takes decades of education and the infrastructure to
do so. The only solution is to apply emerging technology to reduce the resource that healthcare
needs to deliver care. Genomics is the first step in creating a healthcare system that can be
adopted world-wide. Human beings may different in culture, language, race, appearance, but
we all share a common code, the human genome. Genomics provides a platform where
healthcare can be digitized. We live in a world where information is abundant and free, when
healthcare becomes an information technology, through sustaining innovation, we have the
opportunity to make healthcare an abundant resource.

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