In order to translate the promise of discovery into the reality of personalized medicine, the biomedical enterprise needs to embrace a new, 21^st century, systems-based approach. Such a system—which is a self-sustaining "ecosystem"—blends the research and health care delivery sectors and is centered comprehensively around consumers. It realigns incentives. It reduces costs. It becomes a rapid learning system.

The use of information is key to achieving this new biomedical ecosystem. Information binds the individual components and connects the community. The vast volume and complexity of information requires the ubiquitous adoption of state-of-the-art information technology throughout biomedicine.

A new 21^st biomedical system will not emerge fully formed. It requires progressive steps of iterative and incremental development that can be assembled into a whole. Successive cycles of prototyping and development will reach larger communities and broader market penetration. The National Cancer Institute (NCI) and the cancer community represent an ideal test-bed for the development and deployment of this paradigm. Its standing platforms provide unique opportunities for experimentation.

NCI has begun the process of creating a 21^st century biomedical system. It has developed the cancer Biomedical Informatics Grid (caBIG^®), the pre-requisite information technology platform necessary to realize the new paradigm. The caBIG^® platform connects consumers, the care delivery system, and the research community. Close to 60 NCI-designated Cancer Centers are deploying caBIG^® infrastructure and tools, as are 16 Community Cancer Centers that in the aggregate touch 20 million lives.

There are, to date, over 100 grid nodes currently online at a wide spectrum of U.S. government, academic and commercial organizations, linking those entities in a data-sharing network. caBIG^® tools and infrastructure are also reaching beyond cancer as the information technology backbone for other disease research communities; are being applied internationally; and are being utilized to support electronic healthcare transactions in the Nationwide Health Information Network.

Building on that foundation, the NCI has launched the BIG Health Consortium^™. This broader ecosystem is leveraging the caBIG^® connectivity platform and joins government, academic, non-profit, and industry efforts to realize a new 21^st century model for biomedicine.