Today we are on the brink of a much-needed transformative moment for health care.

The U.S. health care system is designed to be reactive instead of preventive. The result is diagnoses that are too late and outcomes that are far worse than our level of spending should deliver. In recent years, U.S. life expectancy has been declining.

Fundamental to realizing better health, and a more effective health care system, is advancing the disruptive thinking that has spawned innovation in Silicon Valley and throughout the world. That's exactly what Stanford Medicine has done by proposing a new vision for health and health care. InDiscovering Precision Health,Lloyd Minor andMatthew Rees describe a holistic approach that will set health care on the right track: keep people healthy by preventing disease before it starts and personalize the treatment of individuals precisely, based on their specific profile.

With descriptions of the pioneering work undertaken at Stanford Medicine, complemented by fascinating case studies of innovations from entities including the Chan Zuckerberg Biohub, GRAIL, and Impossible Foods, Minor and Rees present a dynamic vision for the future of individual health and health care. Youll see how tools from smartphone technology to genome sequencing to routine blood tests are helping avert illness and promote health. And you'll learn about the promising progress already underway in bringing greater precision to the process of predicting, preventing, and treating a range of conditions, including allergies, mental illness, preterm birth, cancer, stroke, and autism.

The book highlights how biomedical advances are dramatically improving our ability to treat and cure complex diseases, while emphasizing the need to devote more attention to social, behavioral, and environmental factors that are often the primary determinants of health.

LLOYD MINOR, MD, is the Carl and Elizabeth Naumann Dean of the Stanford University School of Medicine as well as a professor of otolaryngology–head and neck surgery and a professor of bioengineering and of neurobiology, by courtesy, at Stanford University.

MATTHEW REES is the president of Geonomica, an editorial consulting firm in McLean, Virginia, and a senior fellow at Dartmouth's Tuck School of Business. He has worked as a speechwriter at the White House and a journalist for theWall Street Journal and the Economist.

About the Authors ix

Acknowledgments xi

Introduction The Power of Precision Health 1

Chapter 1 The State of U.S. Health and Health Care Delivery 15

Chapter 2 Theres More to Health Than Health Care 33

Chapter 3 The Innovation and Disruption Powering Progress in Health 43

Chapter 4 Fundamental, DiscoveryFocused Research: The Foundation of Biomedical Breakthroughs 111

Chapter 5 Peering into the Future: Leveraging The Powers of Prediction to Help Prevent Illness 147

Chapter 6 Prevention as a Pathway to Health and Wellness 177

Chapter 7 Curing Disease with More Precise Medical Therapies 207

Conclusion Achieving Precision Health: The Opportunitiesand ChallengesAhead 237

Notes 243

Index 259