 So, what I wanted to do, basically, I actually would probably go a step below Pearl's knowledge of genetics. I guess I have a first degree relative. My father is a biochemist and sits in the world of genetics, but my own training is around organizational behavior, organizational change and how do we actually try and improve the healthcare system in which way we can. So I think there are two major things. If I thought about the first slide, I think we're still missing the boat to some degree. We're still seeing research and clinical care as these completely separate entities, and I think that hasn't worked very well. The barriers between research and practice in some sense are a function of identifying these as completely separate endeavors when, in a sense, we're trying to get the best possible information toward improvement of health. So I think the ideal world that at least I'd like to see is where research and clinical care become much more the same, that there's an acknowledgement that the same level of rigor, the same quality of data is what goes into making decisions about any individual patient as that, which makes decisions about the broader knowledge base. And I know it's not something with all of the barriers that is a simple flip of a switch, but it's something that at least we're aspiring to. So I think about it in two different ways, one of which is what's been discussed a lot about translating research into practice and thinking about the fit between the innovations that we're creating and then the practices given the constraints, given the challenges, but also given the opportunities, thinking about the salience of the outcomes that people within practice are looking for compared to the outcomes that we're generating through research. And really, it's come up a lot thinking about to what degree there's a strength of evidence, to what degree on the practice side are we able to support clinical practice change. But certainly we've seen doesn't work is assuming that the publication or the lecture, the individual training as a standalone thing is going to do much to change practice. Now thankfully at this point, we do have a growing science around dissemination and implementation research. We have a knowledge base that's developing an NIH, though this isn't as well known to some, has been at least trying to increase the size of this portfolio and the quality of this portfolio over time. So just to anchor you around these questions that are coming up out of these demo projects and potentially thinking not just about best practices for implementation, but studying them within clinical practice within a whole range of practice settings. We have RO1s, we have RO3s, we have R21 announcements that are standing that have now 14 and hopefully more to come, 14 institutes that have signed on to this. NIH and the National Cancer Institute have been more vocal than some, but there's an increasing number. There's also, as Mark had mentioned, a dedicated annual meeting where, as he said, maybe a practice group of experts around implementation science could come together with some of you. Well, there's 1,200 of those folks who are coming to the North Bethesda Marriott in March 19th and 20th. I think some of you will be there as representatives, but it would be nice to see more of that crosstalk because ultimately, you know, discoveries that sit on the shelf don't really benefit many people. So in addition to that, just there's often a concern about the review needing to be much different. Well, we've been at least pleased to see that the Center for Scientific Review at NIH has convened a special panel. So people who are studying in this space, actually trying to advance knowledge around dissemination implementation, have an expert panel to go to. So that's actually progress that we've made. And it turns what before was an afterthought in terms of research, much more in terms of this is part of the research enterprise, that if we can't figure out that last link of how to get widespread benefit, then we're certainly falling short of our task. And it's not certainly in mental health we're doing that. We're falling short, but broader within healthcare, we know that we're falling short. We can average that any evidence-based practice is being accessed by a minority of the population. And those are of those who actually access care. So if you take out care, then you lose a lot of people, maybe half. If you take out those who are accessing care, but not getting best care, you take out another quarter. So you're down to maybe a quarter, maybe less, who are actually getting effective practices. So I'd love to hear more, even though I have to run, I'd love to hear more from you with your ideas around these demo projects of how do we take them in larger scales. As was said, implementation decisions may be local, but in other cases, they're state, they're national. There's opportunities to do something about it. The other side, I think, really is, again, around that idea of fusing research and clinical care in a much more directive way. Certainly, at least from what I've gleaned in terms of genomic research, there's a continual need for large samples. There's a continued need to at least position this in terms of how does it maximally become relevant to health systems. And certainly checking the broader validity of findings. We know the limits of any individual study. So trying to figure out a way that we continue to check validity over time within health care settings seems to be quite useful. Again, NIH is at least trying to move into the space. Those of you who work, at least with the HMO research network, have seen that over recent years there's been a number of institute-specific efforts. The Cancer Research Network, the Cardiovascular Research Network emerge, as well as our mental health research network that is trying to use existing health care networks where there are researchers and clinical care settings potentially together with information system to try and narrow that gap to make it actually reality that we're doing more research within clinical practice and that in turn is feeding back to make sure that we've got the right answers and that we're even answering the right questions. So NIH's common fund initiative has been focused on this HMO collaboratory of seeing to what degree can these integrated health systems research and practice go together in a much more formalized way. We've heard from the VA already today of nice models in which health care dollars are actually going toward research development. This is something that I think we could at least explore in a much greater way. And when we think on the federal side of some of our practice agency colleagues, HRSA, SAMHSA, et cetera, as well as the VA and Indian Health Service, we ought to do a better job of seeing that where there's opportunity for shared resources, we can get further than we are. So I'm basically going to stop there, but it's sort of a plea to not get too bogged down in this idea of these silos will and potentially should always exist, but rather thinking about breaking them down. So that's my thoughts. Thanks. Since David has to leave, any specific questions for David? That's just a bit more. If there were a group or a subgroup of this group that were to attend the meeting, would it be possible to set aside or develop a little sidebar meeting in the context of the larger meeting to maybe discuss some very specific issues? Yes, so I think it's a good point. There's certainly to be a sort of directed, invited session around the interface of genomic medicine and practice. But in addition to that, yes, there are a number of networking opportunities, people in the past, from outside HHS entirely and outside health entirely, education and child welfare and justice have come together in this kind of a thing. So there's no reason why we wouldn't have space and opportunity to do that here. So yeah. Your thoughts on a whole different model of changing clinical practice, which doesn't involve this paradigm, and that is we know from the pharmaceutical companies with DTC advertising that changes practice. Why not have this all come up through consumers and the public to drive it rather than trying to get the medical community that is basically ossified to change anything? Yeah, I think it's a great point. And actually, whether you call it patient activation or increasing consumer demand, it's absolutely something that we don't look to enough. I mean, some of the challenges at least happen to be money. There's certainly a lot of money going into the enterprise that gets the information directly in the hands of consumers where we're thinking about pharmaceuticals. But yes, I mean, one of the challenges is we're only often focusing on the supply. How do we make a particular thing available within a clinical setting or within insurance and we're not thinking about how do we increase demand? The autism folks have done a really nice job of galvanizing around, here's what we need in terms of to advance care for our kids or care for the population and have done a nice job of figuring out, how do we turn that both into research and clinical advances? And I think, yes, there's tremendous opportunities in the same. Patients like me is another place, if people have seen that particular website, but where you have, it's entirely patients going on and saying, here's what clinical care I'm experiencing, here's the symptomatology, here's what I'm, so there's an activated group that we're not usually looking to. So I think it's absolutely a great point. But the flip side of that is that DTC advertising resulted in bad prescribing. And practically bankrupting our country because of inappropriate use of prescription drugs. And the autism community has also been perpetuating the notion that vaccines cause autism. There was a front page article in the Memphis newspaper last week titled vaccines, yes or no? I mean, so consumers can also drive us in the wrong direction. And that's why it's our responsibility to come to a consensus. Yeah, like any powerful tool, it can be misused entirely. And yeah, I mean, it's not to say that there's been the cure all on any side where what's resulted is the best possible practice. But it would be unfortunate not to look to that as an opportunity. Yeah, just to come back, I think DTC advertising should be banned. I'm not supporting it. I'm just saying it's remarkably effective. And the other thing, yeah, I just want to be clear. The other thing that I think is not being appreciated is that there's ability to move people more than ever before. And whether it's Arab Spring or Occupied Wall Street, there's a way to do that in an effective way. That is, where there is the appropriate evidence. So it doesn't have to be the evil pharma. And going, you know. Occupied genome, go! I think going to Target, too. I mean, the director of consumer advertising did exactly what it needed to do in terms of improving market share for these different products. If it was predicated on trying to optimize and improve clinical practice directly, the actual advertising might have looked a little different. I think on the advertising thing, you know, the ads got milk with a thing. We had this great billboard in Boston that has this person. It says, got plague. And it shows, you know, some dead rats. And it says, no, because of research. Which I thought was incredibly effective. It only lasted a day and a half, though. So, I mean, it clearly was not politically correct. Irwin, would you like to go next? Or Dave, or do we have a volunteer?