The purpose of this review is to review the state of the art knowledge on patient-centric care and what programmes are effective in primary care for patient-centric care?

Introduction

Dr Morris is a general practitioner at a university based practice. One of her patients is a university lecturer, and attended her clinic for consultation about his recent "blood report". This patient is a 50-year old male university lecturer, diagnosed with hypertension and Type II diabetes, both conditions for about ten years. He is currently stabilised with  daily doses of metformin, "statins", and ACE-inhibitors; he has no other significant illness, he is a non-smoker, and does not drink alcohol. He has family history of diabetes & heart disease in his family.  His father had diabetes and died due to "heart attack" 15 years ago), mother has hypertension and is alive. 
Dr Morris reviewed the earlier records of this patient and found that he had glycosylated haemoglobin of 55 mmol/mol  (IFCC) six months ago, and  a week earliter, his glycosylated haemoglobin level "went up" to 70 mmol/mol (IFCC). All other blood parameters were within normal limits. The patient reported that he "tried" to maintain a healthy lifestyle (he turned "vegetarian" a month ago, and since then, began jogging three miles twice a week). 
Dr Morris considered if she should change her patient's antidiabetic medication but decided to discuss with the patient first. Her patient asked for another "three months' trial" to see the effects of change in his lifestyle. The patient said that he subscribes to WebMD, an online health information portal, and discussed his health status in a disease based social network named patientslikeme that he subscribes. He said that several of his "online friends" benefited from buying exercise wrist bands and logging their data on the portal. He showed Dr Morris that his cell phone logged his running distance, time, his water, and calorie intake; he said he never missed his "pills" as he paired his "smart pill box" with his cellphone he bought from Singapore, and that, he would bring his glucometer readings, exercise and diet data on the next consultation if Dr Morris would like to review them. He asked Dr Morris if he could incorporate these data in the electronic medical record he used. 
Dr Morris wondered how she could use this new information that the patient has generated and is about to offer her; wondered what would that mean for care planning for this patient. She wondered if her decision was to be based on her patient's information about his lifestyle, would that be viewed as "participatory heath care" and how would he interpret the situation.
The term "Participatory health care" refers to a health care setting where patients are considered as equal partners with their providers in their care management; this concept forms the cornerstone of an emergent paradigm of medical care referred to as "P4 health care" (cite hood). "P4 healthcare" refers to a concept of health care delivery and practice consisting of four related themes, each starting with the letter "P". These are: "personalised, predictive, preventive, and participatory" health care. In "personalised health care",  care is tailored to the context and need of the individual patient or the consumer based on his genomic information; predictive care extends this based on genomic, environmental and clinical data, the health provider uses big data algorithms to predict possible needs and patterns of utilisation and tailor the provision of care based on the predicted patterns of health services utilisation; preventive care indicates that health care provision will be focused to keep people free of disease as long as possible and delay emergence of diseases in individuals to the maximum extent possible, and participatory health care refers to the situation where patients share their personal data, and make use of the "personal cloud" of health information that drives their anticipated or assessed need for health care and share information with each other, support each other and thus enhance the value of health care information (cite??).
These themes are based on systems medicine -- an application of the concepts of systems biology to the context of diseases (cite Hood). These are based on understanding the patterns of emergence and progression of diseases based on study of gene networks, molecular signatures and networks, networks of cells, tissues, and organs. In addition to considering how individual genes, molecules, cells, through human beings network and are interconnected, systems medicine also layer networks over networks and refer these as "network of networks" (cite).
We argue in this paper that the fourth concept -- that of participatory health care -- forms the basis of delivery of health care in the P4 health care model and hence we discuss this further in this paper. This is because personalised and the predictive care are dependent on availablity of data and archival and analyses of complex data to identify subsets of disease conditions, causes, stratification of patients, and based on the stratification and clustering, matching of interventions and disease conditions; the preventive aspect of P4 depends on the compliance of the individual patient and the provider advice, but the aspect of partiicpatory health care forms the "bulwark" of this concept: the quality of the data and their subsequent analyses to drive the decision making process and discovery of novel patterns for classification, clustering, stratification, and prediction will depend on the quantity and quality of the data the patients and consumers of health care would willingly share; besides, for participatory health care to be functional, the patients and consumers of the health care would need to be in a social network or utilise a network of care or their own information sharing network that would also be transparent to the providers and other players of the system: if that does not work, then the process of P4 healthcare falls through.