The starting point for an interaction between a patient and a clinician is almost always a set of clinical facts (aka a phenotype). Phenotype-first medicine is the standard way in which the practice of medicine has traditionally proceeded. In fact, phenotype-first medicine has been the routine approach applied to genetics in medicine. For example, when a woman with a strong family history of breast or ovarian cancer is evaluated, and the potential use of DNA sequencing of the BRCA1 and BRCA2 genes is considered, it is the clinical fact that drives the decision of whether or not to obtain that genomic sequence information. GenomeFIRST™ Medicine (a subset of precision medicine) turns this process around by building systems that can be activated before "the problem" arises. This is care that is based on an individual's DNA sequence and it will be applied in some important settings without waiting for the emergence of a clinical phenotype. Our GenomeFIRST™ Medicine program takes a comprehensive approach to care that includes:

1. Genomic screening.
2. Interpretation of DNA sequence variants.
3. Communication of interpretations to patients and providers.
4. Support of patients and providers in the process of translating and clinically managing these results.

This 21^st Century medicine approach takes advantage of new DNA-sequencing technologies that are making DNA testing more accurate, less expensive and faster. We believe that this change will quickly lead us to a time when most of us will have our genome sequenced and available to inform our care.

GenomeFIRST™ Medicine is rooted in a learning healthcare system approach (as defined by the Institute of Medicine) that is focused on "...the collaborative healthcare choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety and value in healthcare."