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The future of medicine is decidedly digital. That presents phenomenal opportunities for computational science, and the physics, chemistry, mathematics and computer science that underpins it. I shall illustrate the potential in terms of two different personalised medicine scenarios. The first is at the level of organ physiology and shows how high fidelity modelling and simulation of whole brain blood flow can be used in conjunction with imaging technology to provide the basis for a clinical decision support system for use by interventional neuroradiologists needing to make life-or-death decisions in short order when presented with patients exhibiting a range of neuropathologies. The second example is drawn from patient specify drug targeting and therapy.Despite impressions given to the contrary, most drugs in use today are effective on only limited subsets of the human population and point at the need for stratification and increasingly personalised treatments. Based on genome analysis, I show how it is now becoming possible to build patient specific molecular models which can determine the efficiency of a drug on a specific patient, which leads in turn to opportunities to enhance clinical decision support systems across a range of disease cases (examples are given from cancer and HIV), as well as in assisting pharmaceutical companies with a new tool for use in drug development.
Finally, I will mention a new initiative within the European Union Centre in support of high performance computing for health and well being. This should provide a focal point for the development and sustainability of software (codes, programmes, packages, etc.) which are capable of high fidelity modelling and simulation of all aspects of the human body, from the molecular level to the whole human and beyond, in health and disease. The accuracy, reliability and reproducibility of these models, and therefore of the underpinning software, is essential for their intended role in personalised medicine. In the nearer term, such approaches should have an impact inter alia on drug discovery, of direct relevance to the pharmaceutical industry; and to provide added value to medical device measurement data, for example as acquired by various imaging modalities. Thus the initiative is expected to involve major industry participation, furthering the direction, uptake and exploitation of high performance computing within academia, industry and healthcare sectors.
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