. He argues that P4 medicine (predictive, preventive, personalised, and participatory) medicine that will help to model transition from health to disease state and therefore enable earlier detection of diseases and their halting will lead to emergence of scientific wellness. Predictive here indicates that the genetic risk for diseases can be estimated for most diseases and these would enable model the transition of a healthy person to a diseased person and if that would be known early enough, then it would be possible to generate therapy or approaches that would prevent the emergence of disease from wellness (prevention); personalised medicine refers to the idea that individuals and diseases can be stratified to identify finer subtypes of diseases than what exists now and therefore instead of assuming that individuals are homogeneous as is the norm in large trials now, it would be possible to finely stratify diseases and humans into disease subtypes and clusters based on their personal data clouds and therefore better characterise disease pathologies and subtypes and specific remedies. Participatory medicine refers to the idea that each individual would be able to take care of his or her own wellness guided by wellness coaches and using social networking so that more people would be able to lead healthy lives. He described that four technologies converged to make this happen: emergence of systems medicine where study of genes and networks of genes, molecules, cells, tissues, organs, and humans themselves were layered one over another; digital technology has developed so that each human can have millions of data points that form a cloud around them that can be harnessed to generate new patterns of knowledge; big data science is maturing so that large data sets can be analysed to improve on signal:noise ratio than what exists now, and social networking and social media will enable more efficient and effective sharing of knowledge. As a result more people will live healthy lives into their 90s. Hood etal initiated studies with 108 indivdiuals and preliminary results are being published in leading journals. His research institute ISB has teamed up with healthcare provider organisations to deeply reearch "scientific wellness" and this programme will shift the focus to wellness as opposed to diseases that is the current paradigm. Final conclusion. -- Scientific wellness will be the future of health care and P4 healthcare is the new paradigm where the focus is on wellness. Reasons. -- Four ideas converge and make this possible + early studies show the potential + Evidence. -- 108 pioneer based studies and early results ; critique. -- Many of these statements are speculative but it is also feasible as it brings many technologies and ideas together to generate new knowledge; questions. -- What would be the relationship between P4 wellness and the achievement of health status? How would we know? Who will deliver the approaches? What will be the role of primary health physicians? Quotes. -- 
Models of Participatory Health care
What would Dr Morris do?
Conclusion
A search of the participatory health care suggests that there are several channels, processes and athw
e-patients
P4 medicine (participatory, predictive, preventive, and personalised medicine)
How these are different from traditional medical practices
Methods of search and selection of studies
Findings
Discussion
Studies have differeed in what works best for fostering patient centric care. XXX (yyyy) has ....

Methods

We searched Pubmed/Medline, Univesity of Canterbury's library site, Google Scholar with the following keywords .... The years we retricted were bw between 20-7 and now (las t ten years).
Results
Table 1 shows ....

Discussion

Notes
Susannah Fox (2007) in  "the engaged e-patient population"
75-80% Americans search for online information. Two major drivers are availability of broadband and personal motivation.  Availability of home broadband is a determinant for Internet access. Those with chronic conditions are more likely to search for internet based health information. those with recent diagnoses are more likely to engage with their doctors on the information they identified on the net.  Pew's 2007 Internet Life project found that despite wide availability of health related information, doctors were stil main source of information for the patients. Only three percent reported that they were harmed by information they received online \cite{fox2008engaged}
This review or recapitulation of the Pew Internet Project on the life of  Americans present a partial but somewhat dated view of the actual picture but this is the only record we have. Since then, the situations have changed.  
Shmuel Giveon et.al. (2009) thought that due to wide access to internet and internet based information on health, the nature of doctor-patient relationships have changed to a more participatory type of relationship. The team wanted to know how did doctors themselves feel about it? How satisfied are they about it? They conducted a self-reported survey of xxx doctors in Israel and found that. One time cross sectional survey of 100 family practice doctors. These doctors were enrolled in a CME activity. they were phoned. They found that the physicians reponded favourably when they were asked about their attitudes towards their patients brining in information from the Internet to them  \cite{giveon2009patient}
Not peer-reviewed (for introduction/discussion)
Dave deBronkert (e-patient Dave, 2013) narrated a personal experience. When he first wrote about his comments about medical record  in a blog, Boston Globe, a newpaper in the US questioned his authority or right to write about something he was not supposed to know. He had renal cell carcinoma with multiple metastases and fractured femur in 2009. He underwent nephrectomy. He has argued what is value in the context of medicine from a patient's perspective.  Awareness of status (he did not know at the time of his diagnosis that he had cancer, a "spot" in his Xray was the diagnostic marker); accuracy of diagnosis - his doctors used both radiological findings and biopsy to confirm the diagnosis;  he received state of the art treatment that are denied to most people he knows; his surgical & clinical care was excellent. Among the system varialbles, he has listed access to care, access to information, choice of provider. Beyond systemic and instutitional issues, he listed that his being informed and engaged helped him. These were taking action to get examined, his advanced planning, his information seeking about choosing providers. He accessed ACOR.org, which is an online community of cancer patients who provide information and share information with each other.  He was direxcted to him by his GP, and he found messages for him within two hours of starting to use ACOR.org website. 
If peer review is the only true path to reliability, how can a patient community have better facts?