Encouraging for them and all of us because these practices not only help Climate Change but produce more food and make and they make themselves more resilient against drought so its one of these amazing winwinwin but very few of us really appreciate it. Thats what anna is so good at getting across and we hope that our new book can help too. Thank you for that great question. [ applause ] tonight, our Washington Journal Program focusing on community policing. Well reair yesterday mornings entire program from richmond, virginia with your cools and comments, the Richmond Police chief and head of the Police Training academy and richmond mayor dwight jones. It starts at 9 00 p. M. Eastern on cspan. Former president jimmy carter held a News Conference this morning in atlanta and briefed reporters about treatments for brain and liver cancer. Well show you the event on cspan. Heres some of what president carter had to say. Spots on the liver and the operation and that same afternoon, we had an mri of my head and neck and showed up it was already in four places in my brain. I would say that night and the next day until i came back up to emery, i thought i had a few weeks left but i was surprisingly at ease. You know, ive had a wonderful life and friends and exciting and adventurous existence. So i was surprisingly at ease, much more so than my wife was. But now i feel you know, its in the hands of god and my and ill be prepared for anything that comes. Former president jimmy carter from earlier today. You can see all of his atlanta News Conference tonight at 8 00 p. M. Eastern. 5 00 p. M. Pacific on cspan. National institutes of Health Director dr. Francis collins updates the Senate Committee on president obamas Precision Medicine initiative. The Initiative Funded through the 2016 budget is a Research Effort designed to improve treatments for diseases like cancer and leukemia by tailering health care to the individual not a one size fits all approach. The Senate Committee on Health Education will come to order. This morning were holding a hearing on continuing americas leadership realizing the promise of Precision Medicine for patients. Well have have an Opening Statement and introduce our panel of witnesses who are getting to be very familiar to us. Were grateful for you for coming. After that well have time to ask five minute rounds of questions or two, depending how many senators are here. Were here to discuss the exciting new direction in our health care called Precision Medicine. What does that mean . Those of us in the room are a good representation of the United States population, centers for Disease Control and prevention estimates nearly one in 10 of us would have diabetes. If doctors could use Precision Medicine, that is if they could look at our individual dna and genetic makeup of our disease, perhaps they could potentially tailor treatments to each individual than to a general category of diabetes. I was visited this morning by the head of philadelphia Childrens Hospital who talked about their work in identifying a defective gene or mutated genetic defect that causes blindness and how they have developed a therapy that restores the sight in a child because of therapy directed for that specific genetic defect. This is happening with cancer treatment, doctors can look at the mutations of the cancer cells and it says how to treat it. This week reports that genetic testing on tumors is already starting to become the norm in the big cancer hospitals. Like sloan kettering, all incoming patients automatically have tumors sequencesed. This is possible because of extraordinary achievement by a great many individuals on sequencing the human genome. None more important that dr. Collins, here today. Today we want to discuss what the National Institutes of health and industry are doing in Precision Medicine and how the food and Drug Administration will regulate those innovations and electronic hgt records can affect the ability for the patient and Health Care System. Its one of the exciting new frontiers in medicine. Senator murray and i are working on a initiative to ensure our federal agencies are equipped to review the medical products and processes produced by this kind of cutting edge medicine so an american patients arent waiting on sidelines. Our Innovation Initiative is not just about Precision Medicine, but Precision Medicine is an important part of our initiative. President obama announced a Precision Medicine initiative in the state of the union this year. Detailed his plans and an event at the white house. I attended that to demonstrate my support for it. The president proposed as part of the plan mapping genomes of 1 million individuals and making the Information Available across the country. We look forward to hearing more about that from our witnesses and similar private efforts under way and imed in hearing about the competition and possible collaboration with Childrens Hospital of philadelphia that i mentioned as 215,000 individual children genome sequenced there. I wonder how useful that would be to the 1 million that dr. Colins is putting together and how this scientific entrepreneurs and philadelphia, other places, how that relates to the president s proposal for a million individuals. I look forward to hearing about the potential cost of Precision Medicine. We know that cost to sequence the human genome have been reduced significantly in the last two decades. Dr. Collins testified, i believe he said 15 years ago it cost us about 400 million to sequence the first human genome and today about 1,000. Very often in Health Care Innovation initially increases our cost, that doesnt mean we shouldnt innovate. Innovative new products can increase costs but in the long term actually decrease Health Care Costs. Take alz zimers which according to the Alzheimers Association cost 226 billion along about other dementias. If we can use Precision Medicine to delay onset or cure that disease, we can save precious dollars in our Health Care Systems and alleviate some of the grief and pain associated with it. The committees also spent some time and spend more on improving the Electronic Health records. The federal government has spent 28 billion to drive the adoption of these record systems and the result is that doctors dont like the systems and many say they disrupt work flow and interrupt the doctor patient relsship. Senator murray and i have begun working to identify the five or six things we can do to help make the failed promise of Electronic Health records something that positions and providers look forward to instead of something they endure. We look forward to working with you on that and with secretary burwell and being able to report maybe early next year some resul results. We have to get to a place where the systems can talk to one another and where doctors particularly smaller physicians offices want to adopt the systems, cant afford the cost, can be confident they are investment will be a value. Dr. Collins has told us and i heard from many others, that a properlily functioning Electronic Medical records system is tremendously important to the president s Precision Medicine initiative. Number one, can help to assemble the genomes of 1 million individuals and if we want to make it useful, this is complex stuff. Its going to take computers that operate easily and with a click of the mouse to help make it possible for doctors to prescribe prescriptions for individual patients. We would like to hear if we know dr. Disalvo, how the 11 billion effort by the Defense Department would relate to the 28 billion we already spent and whether those are compatible. Theres a lot to talk about today. This is a tremendously interesting and important effort and i look forward to the witnesss comments. Thank you, mr. Chairman, thank you to all of our witnesses for being here today. Each of your agencies plays a Critical Role in the topic were going to be talking about. Im grateful to have you all here to share your expertise. Focused on one question, what can congress do to help all patients and families get the safest, most effective treatment and cures more quickly . Our conversation today is the promise of Precision Medicine and it is a crucial and truly exciting piece of the puzzle. Theres no question we are at a critical moment in the medical field. Researchers in medical experts are increasingly finding ways to treat patients not just as the average patient but instead based on their own unique characteristics in history. This is like the difference between getting eyeglasses based on the average prescription and getting eyeglasses based on your own prescription. Its huge. Especially for patients and families across the country who are waiting and hoping for better treatments and cures. Im proud that my home state of washington is home to several institutions that have been pioneers in this area, includes Fred HutchisonCancer Research center and university of washington using this Precision Medicine technology to tackle Breast Cancer and eye disease and alzheimers disease among others. Im glad we have the opportunity to discuss the ways in which Precision Medicine is changing and improving lives and how congress can help advance this new frontier in biomedical innovation for patients and families. The president proposed making significant investments in Precision Medicine. Fiscal year 2016 budget supports a Bold New Initiative to exploit the advances in Data Management to support the shift away from this one size fits all medicine and towards treatment tailorred to specific individuals. This proposal can do an enormous amount to accelerate the advancement of Precision Medicine. As i discussed with dr. Collins in our appropriations hearing last week, im deeply troubled by the steady erosion of nihs purchasing power over the last decade. Last Congress Democrats and republicans were able to come together to replace the harmful sequestration cuts to the investments in nih and fda and other critical priorities like education and infrastructure and defense. Im really hopeful this year despite the budget proposals put forward by our republican colleagues, we will be able to work across the aisle and find a way to prevent these shortsided cuts from kicking in again. This is absolutely critical to the kinds of investments we need to keep make our families help our families and grow our economy, including Precision Medicine. One of my Top Priorities on this committee is looking for ways to continue improving the quality of care patients receive and supporting Precision Medicine is essential to that goal. By offering patients and providers more and much Better Health information, patients and consultation with their doctors will be empowered to make informed decisions about their care and our Health Care System will be better equipped to put their needs first. I do want to note the protecting privacy will be an important challenge throughout this process, just in the last few months we have seen serious Security Breaches impacting families, personal Health Information. That is unacceptable. As researchers and providers and patients gather and use more Health Information, we need to be aware data is being created that cyber criminals will want to exploit. That means well need to develop stra strategies to protect privacy that meet todays challenges. Were investigating the certainty state of Cyber Security in the Health Sector and it is clear this needs to be an all hands on deck effort with providers and insurers and government working together. Thank you to all witnesses for being here today and i want to thank chairman alexander for holding this hearing for patients and families in my state and every state across the country. I look forward to working together, mr. Chairman with you and other members of this committee to support this important initiative. Thanks, senator murray. To underscore what senator murray said, this specific topic is a initiative of the president in which the committee and bipartisan way is very interested. We expect to get a result. We have three witnesses now, i ask senator cassidy if he would like to introduce the first. Dr. Karen disalvo know each other from way back. In her honor we made the spread tulane green today so anyway and dr. Disalvo for Health Information technology at the office of the National Coordinator of information technology. The lead Agency Charged with formulating the government i. T. Strategy and coordinating policy standards and programs and investment. Ive been impressed she has come to me personally and theres a friend back home having a lot of problems with her electronic record and she called her and they spoke at length. She clearly recognizes int interoperability as key. She was Health Commissioner for city of new orleans, including and after hurricane katrina. We expect to get to know you pretty well because the Electronic Medical records system and youre on point for that according to secretary burwell so we look forward to that. The other two witnesses are here about every other day. Dr. Collins of the National Institutes of health, largest supporter of Biomedical Research in the world. Been director since 2009. Of course, hes known among other things for his leadership of the International Human genome project, completely sequencing the human genome in 2003. The director of the center for devices and radio logical health and food and Drug Administration more than five years. They are responsible for ensuring the safety and effectiveness and quality of medical devices and sharing saflt of radiation emitting products fostering innovation. In one year that has been detamed to this committee as part of kennedys staff. We welcome him back. If the witnesses would summarize their remarks, in about five minutes, we would appreciate it. We have senators here who want to have a conversation with you. Good afternoon, distinguished committee members, its an honor to appear before you to discuss how to advance Americas Health towards a new era of Precision Medicine. Earlier this year the administration unveiled a Precision Medicine initiative, a bold new Research Effort to revolutionize how we diagnose and treat disease. We believe the time is right for this initiative and nih and fda and onc will work hard to achieve this mission. Historically physicians had to make most recommendations based on the expected response of the average patient. This one size fits all approach works for some patients and some conditions but not others. Precision medicine is an innovative approach that takes into account individual differences in patients genes and environments and lifestyles. The concept is not entirely new. Blood typing for example has been used to guide blood transfusions for almost a center are you. The identification of the b rca 1 and 2 genes made it possible to provide options for women at high risk of breast or ovarian cancer. The gene implicated in cystic fib rose sis discovered in my own laboratory, has led to widespread availability of targeted therapeutics. By the development of powerful and affordable methods for characterizing personal biological information, that includes genomics, the Widespread Adoption of Electronic Health records and r