To propel change forward we need not just a good sense of direction but also a sense of the prize, for patients and the health system, if we are successful. A wide range of new technologies, from technologies now coming into our hands, from gene editing to machine learning, have the potential to empower precision medicine to overcome some of mankind’s most intractable challenges: cancer, inherited diseases, aging, dementia—among many others. Taken together, the changes we propose to the innovation process could bring at least an order of magnitude greater net patient benefit over the lifetime of products, as a result of faster development, better targeting, more consistent reimbursement, swifter adoption, and better utilization.