 Well good morning everyone, let me start out by of course thanking all of you for coming to Bethesda, some cases traveling from far away and spending a day with us to really help us think through strategically where we should be in this important area that we're going to be discussing based on experience so far with the CSER program, but really as the title implies really thinking about it beyond what's next. And that's at a critical time for us to sort of get that kind of feedback. So as always we appreciate people giving their time to help us think through the best use of our resources, especially in exciting areas like this where there are many things to do and we need to figure out exactly the best way to do them. It is an interesting week actually and besides this workshop taking place this week there were two other things greatly on my mind, one not so great in terms of the potential of what it would do to some of us and the other I think is worth pointing out. It was obviously of great concern to many of us that we might potentially be facing another shutdown this week. The good news that seems to be coming out of the news is that we may have averted a shutdown because of some political maneuvering that's gone on so hopefully we will stay open this week after Thursday. I would just, people have already asked me about this, all we've really done is dodged a bullet for now. This from what I understand what's going to happen is we will be on a continuing resolution until December or so and probably face the same circumstance again at that time but maybe more rational heads will come into play and we'll actually get a budget at some point. But at least it seems we're going to be open beyond Thursday. But Thursday actually moving to a more positive thought, Thursday actually I think is a very significant day for all of us and for all the people involved in genomics. If you're not keeping track of this, Thursday will be October 1st, 2015, which will be precisely the 25th anniversary since the launch of the Human Genome Project. And on the one hand it is just an odometer moment and it really is, it's just a launch, 25 years. On the other hand maybe it's my advancing age or something, I can't help but sort of think back as somebody who got involved in the Genome Project on day one and basically decided to dedicate my career to this new field, what was then a new field. And I just got to say that 25 years ago you would have come up to me and said that within 25 years you're going to be having major meetings to figure out exactly how genome sequencing is going to become part of the mainstream of clinical medicine. I would have said not a chance in 25 years, I said maybe 40 or 50. I don't know how the rest of you feel and various of you got involved in genomics at various stages, but I just find it sort of breathtaking to think that we've gone in 25 years from just saying we're going to sequence the human genome, not really knowing how we were going to actually do that, but just saying we were going to do it, to actually now operationalizing this in a fashion that allows us to actually use this as part of medicine. I just think that is phenomenal. So I'm taking the odometer moment fairly seriously because I just think it's a tribute to the community of scientists that have made genomics such a robust discipline and bring us to meetings like this where we really are thinking about truly impactful things that can come out of genomic advances with respect to how we practice medicine. So I think in some ways the 25th anniversary is very inspirational for this workshop and what we're trying to accomplish today, which is why I wanted to sort of point it out to you. Okay, so besides those three things happening this week, let's talk about the third one, which is today's meeting. What I was asked to do is to just briefly orient you to what really we're asking in terms of for the discussion where we want this to go. I sort of thought there's three things going on at NHGRI that sort of all come together. You're going to, and I'm going to introduce two of them, and Teri Manolio is going to introduce the third. You know, one is everything we do in our extramural and intramural program, but in particular extramural program is framed around our strategic plan that we published back in 2011. So that has to be considered. The origins of this program, the CSER program, were within our genome sequencing program, which is now in the midst of a renewal and has some important contextual things to think about with respect to the CSER program. So I want to review that briefly. And then everything we're talking about here relates to genomic medicine and our growing genomic medicine portfolio. And so that's what Teri Manolio is going to describe, and really where our discussion today is right in the middle of this Venn diagram, the intersection, at least from a historical point of view, of these three major areas. So let me start with the strategic plan, which we think actually is still pretty darn good even though it's four years old. And introduced, as all of you I'm sure are quite familiar, this notion of organizing our thinking around genomics and the programs that NHGRI does as to these five really overlapping domains of activities progressing on the left side from more basic pursuits to the right side of far more clinical pursuits and everything in between. The thing that for the institute that was significant in this strategic plan compared to previous ones was the overt reference to genomic medicine as sort of an important goal of where the institute is heading in addition to everything it's been doing traditionally. And in particular, these two areas were ones that where we were sort of moving towards expanding our portfolio beyond more basic genomics and inclusion of the use of genomics to understand disease, but now embracing clinical applications as well. So that's the context of our strategic plan. When it came time to consider how we were going to start to operationalize genome sequencing and think about clinical applications, the obvious home for it at that time was within our very well-known genome sequencing program which I think from the beginning of the institute and really from the beginning of the genome project in some ways just represents the cutting edge of genomic analysis. If you sort of go through time what our genome sequencing program has been affiliated with, it has matured starting with its origins in the genome project, moving to comparative genomics and then genomic variations such as 1000 genomes, a program that is wrapping up after being highly successful, most recently looking at cancer genomics and then at the far right end is in its most also in its most recent iteration addressing rare and common diseases and as part of the CSER program clinical care. So this has sort of been the progression over time. In its most recent iteration, the genome sequencing program which is in its phase will end at the end of this year consisted of four components. The largest component associated with the three very large centers under a program that has been in total large-scale genome sequencing analysis centers. All of you are quite familiar with their work, but I would say the major focus of what they've been doing in the last four years has been refining the implementation of next-generation sequencing platforms strategically figuring out how to use prodigious amount of sequence data that can be generated for a studying human disease, heavy emphasis on cancer with things like the cancer genome atlas and also starting to address big projects of common diseases such as Alzheimer's disease, diabetes and so forth. When we renewed the program back in 2012, we dedicated a separate program just looking at rare diseases and launched our centers for Mendelian genomics, a highly successful program that is now in the midst of being renewed. We also had a component that tried to develop computational tools for the common researcher, if you will, basically trying to refine very sophisticated tools that specialists could use and make them available to a broader audience of researchers, an ICIC tools program, again, a successful program that actually in many ways I think set the stage for other similar initiatives even at the NIH level such as the big data to knowledge program or BD2K program and in fact those sorts of, we are not continuing ICIC tools the way it is, but rather it's going to sort of merge and synergize in a broader way with other activities going on both at the institute and at the NIH holistically. And then of course the fourth component was the CSER program which all of you are quite familiar with and we're here to discuss. Now follow, where I would sort of regard the CSER program, merging it now with the concept of our strategic plan is firmly right there in the fourth domain of the five domain progression, advancing the science of medicine. That's really what it is in a test mode. In fact, I often refer to this program as a test drive program. We were test driving genome sequencing in the clinic and learning for the first time what we needed to know to make this a more robust approach. I sometimes refer to sort of sticking our toe in the water in terms of clinical sequencing. This really was some of the first applications NHGRI was supporting for clinical applications of genome sequencing. But then when it came time to renew our sequencing program, which we're in the midst of doing now for funding that will begin mostly next year and then beyond, we made a number of strategic decisions. One decision was to basically have the CSER program butt out formally from this having been successfully incubated within the genome sequencing program and rather seen it much more a natural home within the genomic medicine program and also there were some issues about funding years and so forth. So it essentially has butted out from that. The genome sequencing program as it is currently now going to be renewed will consist of no longer just large-scale centers, but rather the centers that are being, they will be large, but they're being renamed with a focus on common disease, so centers for common disease genomics. As I told you, renewal of our centers for Mendelian genomics, again two programs, one on common diseases, one on rare diseases. The introduction of a new coordinating center to provide overarching coordination across these two other programs. And then these are all by the way programs will be announcing and funding that actually just the decisions were brought to our council a week ago and in the coming weeks we will be announcing exactly what the funding is going to look like in a public forum. And then two other components that are in the midst of going through the maturation towards applications and review and funding. One related to setting up some centers to just look at analysis and also program to try to look at human and non-human primate genome sequences at very high quality. And there will be other components of well that are coming down the pipe. But this is the main components of what will be our renewed genome sequencing program. So that's what I wanted to describe to you, how the strategic plan brought us to where we wanted to look at clinical applications, how it was incubated into fashion through our genome sequencing program and the last reiteration and how this now fits very nicely into the genomic medicine portfolio that Terry is about to tell you about. But the last thing I was asked to just briefly summarize really doesn't fit on this slide per se because it's not just NHGRI and all these things are just about our institute. But rather there is sort of another dimension that I think is relevant and it will probably come up for discussion today. Not that it is exactly what CSER does by any stretch of the imagination but is certainly going to be something of big potential influence and we will be learning a lot from and we want to be thinking about at the NHGRI level how our programs would synergize with a larger government program not even just NIH around precision medicine. And a lot of attention has been paid to this since the announcement by President Obama and the State of the Union address on January 20th and then his formal announcement on January 30th of his desire to launch a U.S. Precision Medicine Initiative. I assume most of you have looked at the one thing in the scientific literature describing the initiative that Collins and Varmas co-authored on January 30th in the New England Journal of Medicine. More specifically the initiative has two major components one around cancer genomics which the Cancer Institute is basically running with and run around the construction of a U.S. national cohort. For those of you who aren't familiar with us or want to learn more there is a lot of stuff that has happened over the last six or eight months about five or six workshops lots of documents written lots of video has been recorded from these workshops lots of summaries and and all of this is I think very nicely cataloged on this landing page at NIH about the initiative I would strongly urge you to continue to look here this is where all information will be put forth. Of particular interest I think for NHGRI I think certainly for the discussion today is going to be this notion that there hopefully will be the assembly of a U.S. national research cohort of upwards of a million people or probably more where there'll be a lot of integration of medical data genomic data and various other physiological and social data providing a resource for probably some unprecedented studies of scope and scale and how that might influence what we should be doing as an institute in thinking about genomic applications of into medicine I think is certainly worthwhile worth our consideration. It is significant that on September 17th so it really just not even a couple weeks ago under that was the release of a working group report shown on the left accompanied by a lot of press release and a lot of press attention shown on the right where a working group of the advisory committee to the NIH director that deliberated for about six months put together a very detailed report of what this cohort program should look like and I would send you again to that landing page to look at that report and to see what exactly that when magicians this is going to look like and there's a lot of implementation activities going on now both at NIH and actually other parts of the federal government that to try to make this thing a reality beginning potentially in fiscal 16 because this will involve new money it requires congress giving new money for this hopefully that will be forthcoming at some point and we are assuming it will be there and therefore are planning accordingly so again i think this is worth keeping in mind as the discussion goes on as well so what we are asking for this program review meeting as we call it to look critically at what the CSER program has done and in particular looking forward the and beyond part is to really go through these objectives and these are listed at the top of your agenda i don't need to read them but i really would tell you to routinely throughout the day look at them because this is the focus of what we're trying to get at and in particular i would emphasize they're all important but but number three is the thing that's going to lead to action for us is to really think about organizationally if we're going to have a follow-on program organizationally what should it look like we have a little bit of a clean slate we're hitting the reset button we could do it a lot of different ways and i'm going to be asking very hard questions of staff about exactly if we do something how should it be structured especially in the 2016 context which is very different than where we were in a 2012 context i assure you we are listening to you this is not just a foreshow i have no idea what the recommendations or what the discussion is going to be today i have no idea what the synthesis is going to look like we really are here to listen not only are we going to listen to all of you and we absolutely will be listening to all of you you know i would also point out that we have a heavy dose of of our advisors here and i was just actually i was given the list of both for recent former members of our council current members of our council and even incoming members of our council who start officially in at the february meeting coming up just so you know who they are you know eric borewinkle carlos carlos bustamato i think it's going to be on the phone laun cardin rex chism jim evans gal henderson shanita hues halbert amy maguire howard mcleod rob bob nespom lucilla onamachada and dan rodin so you can see we stacked the deck heavily by our advisors past current and future because we know this is very important and it'll be things that will be clearly discussed at our upcoming council meeting and will be deliberated by council i will also tell you that we're not alone it's not just n h g r i the caesar program has been affiliated like many of our programs with collaborative partnerships with other institutes and centers at nih and we have at least a half dozen represented here throughout the day and we will be talking to them and looking to them for partnerships coming out of this because there's a lot of things that will be discussed and they'll be very interested in and it's finally the broader community is listening in that's why we're spending the extra resources to video cast this live and to video archive it because we will ultimately be interested to hear what the community has to say as well we really do want a broader input even beyond the people in this room so that's what i wanted to do to set the context i think i've done this successfully on time if i if i know that the schedule although if there's any immediate questions i'm also told that there's a little bit of time for questions so thank you have a couple minutes for questions if there are any for eric we're good oh and i guess the last thing i should say i do have to apologize i've said this is an incredibly valuable meeting it really is and and unfortunately a headquarters of an nih wide meeting got scheduled on top of this that i have to go to in the middle part of the day so i'll be here for a while i have to disappear for the middle part of the day to go to campus for a meeting but i will be back here during the last session especially the summary wrap-up session so with that i will turn back over to you great thank you eric and now i'd like to introduce terry manilio the director of the division of genomic medicine and hgri to talk to us about hgri's genomic medicine portfolio terry