 So, thank you. This is my first genomic meeting here, so just to back up, there's been a lot of references to the VA. I think it is the best example to the NHS or anything. It's a wonderful system. There are about 23 million veterans alive with seven millions who are expected to receive care this year. So, it's a very large healthcare system, over 60 million yearly visits. There are 153 medical centers, and then there are a lot of outpatient clinics. So over 1,400 total sites of care. All systems do use the same electronic medical record system, but actually they're not integrated across. We can finally get remote access to other ones, but there are about 180 separate servers involved, so that's a different issue. From my point of view as a clinical geneticist, the VA kind of lagged in delivery of genetic care behind a lot of other health provider organizations, because we didn't have pediatrics, and I did a pediatric genetic fellowship, and 20, 30 years ago, dysmorphology was a very big piece of genetic care, and then it evolved into something very different, and so an academic center is now obviously involved in oncology and neurology, but the VA kind of lagged. Back in 2006, then Secretary Peake really established the first genetic medicine program advisory committee with the goal of using genetic information to optimize clinical care, but also recommending processes and goals for the development of a VA genetic medicine program. So two years later, the committee was formed. There was genetic care in the VA. There are 120 and round numbers of the VA's have academic affiliates. Obviously there are high class providers in all of these places, and they were providing care, one off in a neurology clinic, in a cardiology clinic, in an oncology clinic. There were four actual board certified clinical molecular, clinical geneticists delivering care, and Los Angeles developed a center, but really we only started capturing genetic workload. The VA didn't even use the workload to capture systems. This was integrated into research very quickly within the VA after this was announced. Sarah and I will be talking as soon as I finish as fast as I can here. I think describe a lot of the HSR&D programs as well as the MVP, and those are incredibly large research programs, but the clinical program really lagged. So I was hired in I think 2009 as the national director, and I quickly realized there was no service. So you know, it's a little, it sounds great until you realize that you have nothing to do. I hired the first actual clinical provider as a clinical geneticist in 2010, excuse me in 2011, and one of the key points in providing a centralized integrated genomic service within the VA was an agreement between the VA and well an understanding with the Joint Commission that we could cross credential people across all of the 153 medical centers. So that's at least possible getting it done through the bureaucratic web was interesting. So we hired our first counselor in 2011, and in March 2011 we got the first memorandum of understanding between two facilities. And then there was, there are now 29 stop points that we've identified in the process of delivering care. Telehealth has really made this possible. The VA bought into telehealth in a very big way. The goal is to have 50% of all patient encounters done by telehealth. A lot of these are between the local VA medical center and what are called the community based outpatient clinics or CBOX, there are about 1,000 of those. And so the images of the mothership and then the little outpatient clinics, it keeps the veterans from driving 150 miles, they don't have to drive 20 miles, great place. They can get specialty care there. A lot of it is telemental health. But I think the idea of genetic counseling where you're using a specialist as the primary care physician and then a genetic counselor and a backup medical geneticist really works well and is integrated well into that potential model. Another program, I mean I'm really surprised, there's a big ICU program with TELA ICU where rural hospitals have an ICU, but they can get support from, with a little robotic interface from an intensivist at a much higher acuity hospital. So we really built a centralized service in Salt Lake City. This is where we were one year ago and here is where we are now. So we're delivering care in, actively I think in 47 or 48 places. We have over 60 memoranda of understanding signed to deliver care. But the IT infrastructure lags. You have to get permission from each hospital and get integrated into their system. My counselors have to log on to each medical center every 30 days to maintain their passwords. We have an encrypted log. So if you can imagine trying to keep track of 153 user IDs and log-ins just to be able to deliver care, there's got to be a better way. We're going to work on that. Here's the setup. These are actually two counselors talking to each other. But it's just done through a nice setup. And here's the way the workload has increased through the first quarter of this year. So we're just, we're exponentially increasing, which is really fun. And here's the agreements with TSAs. A lot of this has been through the telemedicine capacity over a third of it. About a third of it is e-consults. And a lot of the driver of that is from pathology. We get consults from, I think well over half of the e-consults are from pathology saying is this test appropriate? How do we handle this? The pathologists in question a lot of times are not certified molecular pathologists. There are more than a handful of excellent certified molecular pathologists within the VA. But a lot of these go to the regional lab. They're just saying in the VA if you've seen one VA, you've seen one VA. They're kind of entrenched. And so the test lands at a local VA medical center that may not have anybody skilled in molecular pathology. So we handle those. We also just do a lot by telephone. As soon as we have the memorandum of understanding signed, we can get in there and legitimately contact the veteran. And then we're emailing encrypted notes, but it does work. We have gotten referrals from every department and division within the VA with the sole exception of the emergency room. And I imagine that's going to happen one of these days. So we've really made inroads into every place. Usually when we get into a site, we give an in-service. The big users are oncology, women's clinic, which also includes breast cancer, obviously, GI. So the needs and gaps, I'm trying to close here, everything that we've heard today is I think there's a tremendous consensus in the room about what the needs are. Clearly integration with EMR is the big one. The one thing that hasn't been mentioned yet is the structured family history. And if you're looking at Amsterdam or Bethesda Criteria, you're looking at BRACA Pro, you want to, if you're going to computerize that for decision support for some busy primary care physician at the point of care, you really need to have a structured family history. I know there's a conference a little later this week that might address some of that. I'm going to the conference in San Francisco on disparities of care. But building computerized decision support all the way through and making this seamless has got to happen. There's no way that any of us who are, no matter how good we are and how long we've been doing this can keep track of all the polymorphisms. I think the processes, this was just eluded, the idea that there should not be a genetic exceptionalism either in the ways we order the test or anything, it's just another test. And it's just more medical information. How can we use that? How are we going to run this into, how are we going to build this in the large scale? There are 3,000, I think, or very close to 3,000 individual genetic tests performed commercially in the United States right now. And then as we approach whole genome sequencing or exome sequencing or Regulome or whatever it is, how are we going to divide that? There are also, so these are sort of the more external issues. I think the internal issues, building a service within the VA, I was at a meeting in DC a little less than a year ago, and they were suggesting words that describe the VA as flexible and responsive. And those of us from the field were saying glacial, monolithic, bureaucratic and working this through so that we can get access to the high-quality molecular labs and centralizing those so that we can work with IT, which is a local issue, work between all the medical centers, all of those are issues. But I think, you know, I can just go back to that trajectory slide. So I also work in research, and so I'll turn over now to my colleague from ORD, but thank you.