 So, Ebony had asked me to give an overview of our genomic medicine portfolio. As you're probably aware, thank you. As you're probably aware, we have two major program divisions in the institute, the Division of Genomic Sciences, which is the basic science division, and then the Division of Genomic Medicine, which is the one dedicated to clinical applications. And within the Division of Genomic Medicine, we also have a number of programs that are not per se applications of genomic approaches in clinical care. We also have a third division, Division of Genomics and Society, which is also relevant to the ethical and legal social issues involved in implementation. And this, there we go. I'd like to start off by pointing out that when we embarked on the effort to apply genomics in clinical care, this was based on our strategic plan that was published in February of 2011. We also established a working group of our council, and many of them are here today, and here are the names of that group, Eric and Laura and I serve as sort of ex-officio members of that group. And we came up with a definition of genomic medicine because there had been a little bit of confusion, I think, in terms of what we were referring to when we applied the term. And we use it in a fairly narrow sense as an emerging discipline that involves using genomic information about an individual in that person's care. So there's a lot of work that goes on that involved in relating genomic variation to disease. That's important work, and it's very foundational for the work that we do in applying it to individual care, but this is a fairly narrow definition. One of the first things we did after establishing the working group was to call a meeting much like this one, except in the middle of the country, we held it at O'Hare Airport and just invited everybody that we knew of who was doing genomics in clinical care to come at their own expense on very short notice, and we were delighted that many of them were able to attend. And from that, we identified a number of common barriers, common problems that people were encountering, and in fact, solutions that they were developing much in isolation and not really in collaboration with each other. So this was a report published from that group. We found much more going on than we had expected, and as I noted, a lot of it was going on in isolated efforts. Since then, we have held nine genomic medicine meetings. This was the first one in June of 2011. About six months later, we held an effort to really begin to develop collaborations because we saw the isolation as being a major problem. And so that was the forming collaborations in December of 2011. Our third meeting looked at stakeholders and trying to address what kinds of things would be needed to encourage payers and insurers and hospital systems to adopt genomics in clinical care. We had a fourth meeting on physician education, a fifth on working with federal partners, a sixth on sort of a global effort, very much like our first effort in June of 2011 to really find out what was going on across the world. Seventh one on genomic clinical decision support, an eighth one about a year ago on sort of an overview of all of our programs, trying to identify where the holes were and what kinds of things we might move forward with. And one of the things we identified from that meeting was that there seemed to be a bottleneck in bringing things learned in the clinic back into the laboratory and then in sort of encouraging that free flow of information between those two groups. And so our ninth meeting just a few months ago was focused on sort of bedside back to bench. And we actually from that learned that one of the important things to do was to encourage basic science collaborators to be involved in meetings like this one. And so we do have some of those folks here today. All of these meetings, except the first, were video cast, much like this meeting is being video cast. They're archived on our genomic medicine website and all of the presentations and the meeting summaries, et cetera, are available. So if you just Google NHGRI Genomic Medicine, you should be able to find them. To give you an overview of our programs, there are six of them that we consider to be firmly in the genomic medicine space. There are RAID here in order of sort of the depth of patient characterization and the breadth of kind of implementation strategy. So the Undiagnosed Diseases Network, which actually is a common fund project. It's funded by all of the NIH institutes, which contribute to a common fund as it's called. But it grew out of NHGRI's Undiagnosed Diseases Program in our intramural program that was in collaboration with the Office of Rare Diseases Research. It's now expanded to be a national network. And in fact, there are international sites that are beginning to collaborate with them. The NSITE Newborn Sequencing Program is exploring the uses of genomic sequence information in the newborn period. You can see the sizes of these programs. They vary quite a bit and the fiscal years that they've been funded. The Clinical Sequencing Exploratory Research Program, or CSER, is looking at infrastructure methods and issues for integrating genomic sequence information into clinical care. Emerge is our longest standing one. Began as a program to use bio-repositories with access to electronic medical records for genomic research. And the third phase is looking at the penetrance of about 100 clinically relevant genes. And I'll talk about each of these in a little more detail in a moment. And then we have Ignite. Ebony is going to tell you much more about Ignite. But as you heard from Eric, the goal here is to develop and disseminate methods for incorporating genomic medicine into clinical care, particularly in sites that are not perhaps on the sophisticated cutting edge level of this but much more routine care that mostly you and I receive. And then the ClinGen Program, the Clinical Genomics Resource, actually grew out of our first meeting back in Chicago where we recognized that many sites were trying to determine which variants to report and to whom to report them to and what actions to take on them. And again, each of them was reviewing the same literature, largely coming up with the same conclusions. And we recognized that a central resource for doing that would be a useful thing. And so their goal is to develop and disseminate consensus information on these genes and variants. And just to kind of give you, we like matrices in the government. So looking at a kind of a matrix view of our programs kind of right across the top and then the various emphases that they have, you can see shown here as sort of the primary emphasis of these programs. The ClinGen Resource is really focused on variant curation. Emerge in its third phase, looking at estimating prevalence. Caesar II is establishing, this is going into its second phase, establishing the clinical utility of sequencing and clinical care. Ignite is firmly in the dissemination and clinical decision support area. Clinical evaluation and deep phenotyping is the goal of the UDN. And the end site is obviously focused on prenatal newborn and pediatric care. But each of these programs actually addresses almost all of these goals in varying degree. And so shown here, you can see that for Ignite, for example, it also is heavily involved in clinical evaluation and deep phenotyping. And you'll hear a little bit more about that today. And also has some lighter involvement in some of these other areas. And then you can see how the others kind of line up. To kind of give you an overview of each of them very, very briefly, this is the Undiagnosed Diseases Program, focusing on puzzling medical cases and trying to come up with a diagnosis. These are Dr. Bill Gaul and Cindy Tift on rounds with a young patient. And they have a whole crew of people who join them. These rounds are open to anyone in the clinical center or in the NIH. And they are heavily attended. And as I mentioned, this has now been opened up to a national network. So there are six other sites that are collaborating with the NIH site, as well as several sites internationally that are working in this area. The NSITE program comprises four different grants. You can see them here. And they are all relatively small focus on newborns, both very ill and healthy newborns and looking at primarily the newborn screening panels and their relationship to sequencing. So how does sequencing sort of augment or complement what might be done in standard newborn screening panels? The CSER program, which has moved into its second phase or is moving, it's currently under review, is looking at applying sequence data to clinical care, including, you know, such mundane things as implementing a clinical workflow, which is very important in the implementation area and has to be done in a variety of different ways, depending on the local setting, interpreting and translating data for clinicians and communicating findings to patients, also developing best practices for whole genome and whole exome sequencing and developing an evidence base for implementation. In its second phase, it will be moving forward with these efforts. And you can see here the nine programs that make it up, three of them are co-funded by the National Cancer Institute. Emerge is the longest running and probably most complex of our programs to date. Multiple sites, as you can see, nine clinical sites, a coordinating center, two sequencing centers. And it has a variety of components. It began as a GWAS discovery study in 2007. It also involved electronic phenotyping and has proven through the efforts of many who are here in this room, the value of electronic phenotyping using electronic medical records. There's also a methodology for consent developed, community consultation, data privacy efforts, there's a pediatrics component, pharmacogenomics component, clinician and patient education is a large part of it as well and clinical decision support in addition. So its current aims are to continue discovery and implementation research using large biorepositories linked to electronic medical records. As I mentioned, it will be looking at sequencing about 100 clinically relevant genes, assessing phenotypic implications of the variants found by leveraging the well-validated EMR phenotypes and possibly re-contacting and re-examining participants using appropriate consent and education reporting these variants to patients or their families and their families and clinicians and then assessing the impact, not only on patients and clinicians but also on the medical care system. And then Ignite, you'll hear much more about, I just list the goals of it here, expanding and linking existing projects, developing new collaborative projects and contributing to the evidence base, defining and sharing the less well-resourced settings. And you'll see this map again, I'm sure, several times. These are the various sites of Ignite. Lastly, the clinical genome resource or ClinGen is that program to curate variants and provide information to clinicians as to what to report, how to report it and what to do once you've found them. The goals here are creating a centralized resource of annotated genes and variants, including standardizing the assessment of variants and depositing them into ClinVar, the database of clinical variation that is led by our partners at the National Center for Biotechnology Information, developing a consensus process, curating genes and variants, developing machine learning algorithms to improve speed and accuracy and disseminating that information, exploring integration of it into the electronic health records. And several of the ClinGen investigators are at this meeting as well. And one of the things that they have recently produced are guidelines for clinical actionability, developing clear and robust criteria to guide these decisions based on a variety of components, severity, likelihood of disease, efficacy of an intervention, nature of the intervention, how invasive it is and the level of evidence supporting it. And this was recently published in Genetics and Medicine with Jessica Hunter-Katrina. You'll notice this is here as well. So I think at that point I will stop. I'd like to thank all of the program investigators, as I said, many of whom are here and particularly their research participants. All of my colleagues at NHGRI who are working in this and of course our Genomic Medicine Working Group. Thank you very much.