Personomics and Precision Medicine

The importance of knowing patients as individuals has been highlighted throughout the history of medicine. However, shorter visits, electronic documentation, reliance on technology, and increasing linguistic and cultural differences between patients and physicians create more challenges to effective communication than ever before. Perhaps more concerning is the greater emphasis on aspects of care considered more precisely measurable and quantifiable, the sum of which is sometimes felt to represent the patient better than knowledge of the patient himself. While genomics, proteomics, pharmacogenomics, metabolomics, and epigenomics promise enhanced diagnostics and therapeutics, understanding the unique circumstances of the person - what may be called personomics - is at least as critical to patient care. Such an understanding can only be developed when the relevant psychological, social, cultural, behavioral, and economic factors are obtained. Personomics determines how a disease reveals itself phenotypically and the way that disease and the individual with the disease respond to treatment.