 All right, so thank you for the opportunity to present on behalf of Ignite. So there was a group of individuals listed here who theoretically worked on this group of slides. In reality, this is really the result of our last face-to-face meeting and our dinner turned into really sort of a forward-thinking exercise in where we believed the network had great opportunities in the future. So it really, I think, is a broad representation of where the network is thinking. So I think you've heard earlier, particularly in the first two presentations from Carol and Josh, that over the last two or three years, depending on when the groups came into the network, we in many ways have documented the feasibility of doing genomic medicine implementation. We have not necessarily solved all of the challenges, but across many, many different types of settings. Academic Medical Center, urban, rural, private practice, the VA, VA may be being the most complicated of all those, unfortunately. Inpatient, outpatient settings, we have effectively, across many different kinds of study, been able to implement genomic medicine. We've identified barriers and challenges, and in many ways I would argue that we have overcome many of those. There are still problems to solve, but in many ways those are sort of logistical challenges, and we have discovered many of those. I leaned over to Jonathan when he sat down, and I said, once I get through with my talk, it will look like we sat down side-by-side and presented or prepared our presentations, because I think we as a network believe that in the end, sustainability and widespread adoption of genomic medicine is going to require a much stronger evidence base. The reality is I think we've proven in this phase of the network that we can do it, but without the evidence base, clinicians won't adopt it and payers won't pay it for it. So we really need to be thinking hard, just like the previous two speakers have mentioned, about building the evidence that documents the clinical utility, including the impact on clinical outcomes, as well as the economic impact. So you saw this slide earlier, and I'd like to use this as an example of a single site versus a network effort. And so we implemented the CYP-2C-19 genotype guided anti-platelet therapy in our institution as part of our program at University of Florida. Then we, after the fact, then looked at outcomes, clinical outcomes. And so these data were presented last year at the American Heart Association meeting. And so we were really testing where clopidogrel was a standard of care therapy. And those who have a loss of function genotype and cannot bioactivate the drug, we recommended alternative therapy. When that alternative therapy was not adopted, the patients had significantly worse outcomes. The outcome of being death stroke, myocardial infarction. So outcomes that I think we all agree matter. Whereas if they had a loss of function and got alternative therapy or did not have loss of function but continued on clopidogrel, they had very good outcomes. You'll also note that many of these events occur in the first month of therapy. This is a diagnosis for which Medicare doesn't pay for a 30-day readmission. So we think that economic implications are significant. However, this is one site, 400 patients, maybe you just got lucky. So the level that people will sort of believe that and change practice nationwide is limited. And so we said, is there an opportunity within Ignite, both within the funded groups in the network but also through our affiliate membership to document this in a much more broad-based manner. And so the Ignite from the Code Genetics interest group is one of the interest groups and in your workbook describes all of the activities ongoing. Josh Peterson described another project of the group. But our first major project was to look at Ceptusin-19 Genotype Guided Antiplatelet Therapy, not just at the University of Florida, but at nine sites. And we ended up with 4,477 patients in our data cohort. We'll say right here that Vanderbilt University has a significant portion of that cohort and I think their data are represented for you in the handout as well. So we have done this collaborative effort, developed a common data tool. Seven of the sites did manual data extraction from the EHR. The other two sites did electronic data extraction. We presented, prepared the data, submitted to the American Heart Association and their late breaker abstract submission and we're selected for what they're calling a hot clinical science session which is, as we're understanding it, at the same level as the late breakers. It's just that all of the things in that session are not sort of true randomized controlled clinical trials. So we can't share the data with you because they're embargoed. Our goal is to publish these data in a simultaneous publication with a presentation in a high impact journal. So we'll let you guess what the data look like. So we think that our bottom line is that we have positive outcomes data with 400 patients but that wasn't likely to change practice. But with nearly 5,000 patients maybe we have the opportunity to change practice as it relates to antiplatelet therapy post-PCI. There are also economic opportunities and so side by side we have an economic analysis that is ongoing and in-homes from IU and Nita Limdi, both who are here, Nita's from UAB, affiliate member. Again, I think just to point out we've really created a lot of power in the network by engaging affiliate members. So we have an analysis ongoing of the outcomes data as it relates to the economic implications and then you heard earlier today about the broader economic study that IU is doing with their pharmacogenomic based program. So just to again highlight, all of us were funded, six groups, three of us are focused in pharmacogenetics, three in disease genetics and really the root of our programs are focused on documenting the approaches to clinical implementation, the barriers and the challenges that we face with that. Nonetheless, all of us are developing some clinical evidence and just so to run through these in the monogenic diabetes project at University of Maryland, their goal is to, from a clinical evidence perspective, to document changes in diagnosis, treatment, glycemic control, hypoglycemic episodes, hospitalizations, et cetera. They also have a very strong economic element. The APOL-1 story in Hypertensive African Americans, you heard a lot about that this morning. They also have a clinical outcome which is blood pressure control and then the Family History Project at Duke, looking at whether that family history information changes a variety of clinical factors including lifestyle and risk factor management, changes in their clinical care course, et cetera. We would argue that all of these things could more powerfully answer outcomes if there were more than one site, more than one project focusing on them. Even though all of us have multiple settings where we're implementing this, we believe the power to document these kinds of outcomes would be much greater just like we saw with the Clopidogrel CIP 2019 story where we were able to accrue much, much larger numbers. We believe that the barrier, the greatest barrier moving forward is the clinical evidence gap and we can solve all of these other problems. We can figure out all the informatics stuff but if the clinical evidence isn't there, it probably won't matter because we have to have the clinical evidence in order for clinicians to actually adopt into clinical practice and for the payers to pay. We believe that moving forward, the network should have more focus on clinical evidence generation and I think as Mouine mentioned earlier in his talk, we can continue to look at the implementation elements but we need to make sure that the clinical evidence generation is sitting right beside that. Again, using the Clopidogrel example as a project as an example, we believe the power to accomplish that would be much greater with network-wide efforts as opposed to a single site. In terms of our summary and recommendations, we believe that the network has documented across a lot of clinical settings the feasibility of implementing genomic medicine into clinical practice. However, in order for this to be sustained and adopted when you don't have grant funding to fund the genotyping, when you don't have grant funding to sort of make these things happen, that we have to have sufficient clinical evidence. As a suggestion, a recommendation would be to think about structuring Ignite II in a way that looks more like traditional NIH networks where we work on common projects and can build evidence in a manner that's sufficiently powered and sufficiently robust to actually change practice. Thank you.