Compared with personalised, predictive, and preventive health care, participatory medicine is relatively well developed for several reasons. First, participatory health care aims to empower patients in the process of care and this has a long history. The importance of patients as partners in care is articulated in the definition of evidence based medicine and health, the current paradigm of medical/health care (cite definition of ebm, Sackett).  Second, in 2009, Donald Berwick stated,  "
“Patient-centeredness” is a dimension of health care quality in its own right, not just because of its connection with other desired aims, like safety and effectiveness. Its proper incorporation into new health care designs will involve some radical, unfamiliar, and disruptive shifts in control and power, out of the hands of those who give care and into the hands of those who receive it.  \cite{berwick2009patient}
Patient-centredness as a dimension of health care quality has gained acceptance and is an accepted norm of good practice. But participatory health care goes a step farther and accepts the role of the patient as an equal partner in the care process itself.  Third, shifting health care from being "hospital/clinic centric" to more "patient home/workplace centric", which is one of the conditions of participatory health care, is reasonable from the perspective of cost-effective care. In order for this to happen, patients or health consumers must have the tools and knowledge to organise care in their own settings, in turn is helped if they have easy access to information sources & support systems available round the clock. Access to social media and easy access to always-on internet service on their handheld devices and home computers (those who can access them) facilitate such practices. As increasing number of people are accessing the broadband Internet in their homes, this facilitates the flow of information from practitioners to patients  and prepares the ground for adoption of participatory model of care.  Fourth, wellness industry is ready to provide handheld apps and wearable units that connect patients with hospitals and help to put data on the internet so that these are made accessible to the caregivers at all time (citation XXX) -- these factors facilitate the development and advancement of participatory aspect of the care in P4 health care paradigm ahead of the other three concepts. Hence we focus on participatory aspect of P4 health care in this paper.