Ten years ago, a handful of genomic pioneers realized something was missing. The main meeting of Advances in Genome Biology and Technology (AGBT) celebrated technical progress and showcased the most dazzling sequencing innovations. But when it came to the messy, real-world complexities of using those tools in medicine, there was no forum. The clinicians, the payers, the regulators, the health systems—the people who had to actually make precision medicine work—weren’t in the room.

So, Michael Talkowski, PhD, a leading figure at Massachusetts General Hospital and the Broad Institute, along with Eric Green, MD, PhD, who at the time was just a few years into his tenure as director of the National Human Genome Research Institute (NHGRI), and a few other colleagues at The Genome Partnership, a not-for-profit organization that hosts the AGBT meetings, founded the Precision Health Meeting in 2015. The inaugural Organizing Committee included Eric Green, MD, PhD, Elaine Mardis, PhD, Heidi Rehm, PhD, Len Pennacchio, PhD, Michael Talkowski, PhD, Geoffrey Ginsburg, MD, PhD, and Howard McLeod, PharmD, among others, who helped establish its distinctive format and culture.

“We thought there needed to be a meeting fully dedicated to genomics and precision medicine that brought together the interface of the technologies and genomic science, as well as the perspectives of the clinicians, payers, and providers,” Talkowski told Inside Precision Medicine. “That’s how the meeting started. It was very small to begin with. Now it has grown, but it still maintains a tightly organized structure similar to that of a small Gordon Research Conference, where discussions focus on the biggest challenges in genomic medicine and their implementation.

The AGBT Precision Health Conference has since grown into a distinct ecosystem of its own. Ten years on, it continues to cultivate the candid debates, cross-disciplinary encounters, and practical discussions needed to move genomic medicine from possibility to practice. As the 2025 meeting approaches, which will take place in San Diego, California, from September 8-10, both Talkowski and Green are reflecting on the arc of the past decade—and what lies ahead for a conference that has become the beating heart of implementation science in genomics.

From panels versus exomes to real-world implementation

The first meetings were dominated by existential questions. Should diagnostic companies focus on narrow gene panels or on whole exomes, or should they take the leap to whole genomes? Was sequencing clinically valuable at all when karyotyping and microarrays still reigned as first-tier tests for developmental disorders? Fierce arguments ensued.

“The debates then were really about major genome centers. Could they scale genomics to bring it to healthcare? And was that even a value?” Talkowski said. “Should we be doing gene panels? Should we be doing exome, or should we be doing genome? And what should these major diagnostic companies be moving towards, which would build on guidelines and really push for implementation? The debate was actually pretty fierce.”

Eric Green remembers this period from the perspective of a funder. “It was really when NHGRI was pushing the accelerator and trying to push other NIH institutes, the best we could, to invest in genomic medicine implementation,” Green told Inside Precision Medicine. “What we were seeing as a funder was the complexity. There’s the classic genomics ecosystem, but all of a sudden, when genomics really started touching medicine, it then took on a broader ecosystem of people that had to think about regulation and payment and all these things that are the big healthcare challenges. We were amazed at how important it was to stimulate the discussions between the frontline genomic innovators and the people who are the frontline healthcare implementers.”

That interplay—between technological innovators and healthcare practitioners—was precisely what AGBT Precision Health was designed to enable. In Green’s words, the meeting offered “a forum to have those discussions and to have it be a mixture.”

Fast forward to 2025, and the central questions are no longer about whether genomics can shape healthcare. That has been answered. “The question then was, could genomics really impact healthcare? And to me now the question is, how do we do that?” Talkowski said. “How do we actually take a genome and put it in a medical record and then interpret it at every stage of your life when it’s impactful? What do we return? It’s very hard. But it’s becoming more tractable.”

One of the enduring traditions of the meeting is the “Great Debate.” No one remembers exactly how the name was coined, but the spirit is unmistakable: acknowledgment that some of the biggest questions in genomic medicine are still unsolved and may remain unsolved for years. And that’s okay—what matters is to wrestle with them openly.

“I would also say we readily admit that some of the issues are really hard and are not solved and are worthy of debate,” Green said. “There’s never a shortage of them. Ten years ago, this was before AI got big and before a lot of other things. Now AI will be another slice of that general challenge.”

In the early years, debates often hinged on technologies: panels versus exomes versus genomes. Today, they revolve around implementation: What does it mean to put genomic information into every patient’s medical record? How do clinicians interpret variants quickly enough to impact care? How do we balance equity, cost, and speed?

At the 2025 meeting, debates will focus on the role of AI in healthcare. “Everybody is saying we need to bring AI to healthcare, but how are we actually doing that?” Talkowski said. “Can we have debates and panels around how to make that happen and not just say it? Where’s the data, what are the results, how do they affect patients, and what stories can we tell?

The 2025 agenda: Rare disease, AI, therapeutics, and nutrition

Another distinctive feature of AGBT Precision Health is its investment in training. Each year, the meeting opens with workshops designed to bring participants—regardless of their expertise—up to speed. “No stupid questions. You could be as low on the learning curve as you want. We’ll try to help you get up on that learning curve,” Green said. Senior scientists and clinicians volunteer their time to make the meeting accessible, a tradition that reinforces its role as a bridge for newcomers.

For trainees, the intimacy of the meeting is unparalleled. “If you’re a trainee there, you will probably interact with every single speaker,” Talkowski said. “It’s like camp. I think that’s just a really special opportunity.”

The program, developed by Green, Talkowski, and co-chair Wendy Chung, MD, PhD, chair of the Department of Pediatrics at Boston Children’s Hospital and on the faculty at Harvard Medical School, also emphasizes storytelling, bringing in not just leading-edge science but compelling narratives that excite and inspire. “Part of this is also to stimulate the field by showing, you know, having great speakers who will attract good trainees and get people excited,” Green said.

The 2025 agenda features some particularly high-profile storytellers: Mary-Claire King, PhD, a legend in human genetics, will deliver a landscape talk. Later, Green himself will conduct an on-stage interview with Jay Flatley, the longtime Illumina CEO who helped usher in the era of affordable sequencing. “It’s not too intimidating in reality because Jay is such a personable guy,” Green said. “But to have someone like him come and really engage with a small group, that’s pretty special.”

Every year, the agenda evolves to reflect what’s most pressing in the field. “We start almost the year before, like what’s hot, what’s out there that we want to get there, who are the great storytellers,” Green explains. “We think about new emerging stories in precision medicine and genomic medicine.”

This year’s agenda highlights include rare disease genomics, artificial intelligence, precision therapeutics, and nutrition and precision health. This eclectic mix reflects a deliberate effort to push into new frontiers while staying grounded in areas where genomics has already proven its value.

Genomics is currently having its greatest clinical impact in rare diseases. The GREGoR Consortium (Genomics Research to Elucidate the Genetics of Rare diseases), which has driven discoveries of countless rare disease genes, will anchor a major session. “One of our key themes was rare disease genomics,” Talkowski said. “Those programs have really penetrated the rare disease space in a way that no other program really has.”

AI will be a central thread running through the meeting. The goal is not hype but reality: real-world data, validated results, and tangible patient outcomes. “It’s the right time to do what Precision Health is trying to do,” Talkowski said. “AI is a wonderful buzzword, but how are we actually doing that?”

Another highlight is the future of bespoke therapies. Ben Kleinstiver will describe a case where he and Kiran Musunuru developed the first in vivo gene-editing therapy tailored for a specific patient—work that unfolded just months ago. For Talkowski, this marks “the 10-year arc on the next phase of what’s really going to be differentiating precision health in 2030 and 2040.”

For the first time, the meeting will showcase nutrition, bringing together investigators like Neil Hanchard, MBBS, PhD; Meghan Azad, PhD; and NIH scientists from the Nutrition for Precision Health program. Azad, a world expert on the omics of human breast milk, exemplifies how the meeting seeks out fresh voices. “She gives a great talk,” Green said. “She’s fascinating, and she would love to get even more genomic medicine-oriented. I think she’ll benefit tremendously from coming to this meeting.”

The 2025 program will also pause to honor a member of the community lost this year, Atul Butte, MD, PhD, weaving tribute into science. “We’re sort of trying to quickly honor him by bringing people who work with him,” Green said. These moments of remembrance reflect the close-knit, personal character of the meeting.

Looking ahead: The next decade

Not everything has been smooth. The COVID-19 pandemic disrupted momentum just as the meeting was gaining recognition. One year was fully virtual; another was hybrid. Attendance dropped. “It hurt,” Green said. “The pandemic slowed down progress, and I actually think the current climate in science is not wonderful right now. Every professional meeting is nervous.”

Yet optimism endures. Both Green and Talkowski want to see the meeting grow—not to thousands, but to a scale where subspecialists in fields like cardiology or ophthalmology come naturally, without needing an invitation. “I would like to see more of the folks from subspecialties who are starting to use genomics feeling comfortable enough to come to our meetings,” Green said. “I hope they will start to submit on their own.”

Talkowski agrees. “The representatives of the hospitals and the departments and the subspecialties should be there out of their own desires, the way the genome institutes were at the very beginning,” Talkowski said. “And the genomicists and fundamental researchers, when they bring topics to precision health, they should do so understanding what it will take to deliver that to the healthcare system.”

One possible approach, Green suggests, is to spotlight one specialty each year—ophthalmology one year, cardiovascular medicine the next, and neonatology after that—potentially in partnership with specialty societies. “It would require work, but it could be a way to start,” he said.

As the meeting enters its second decade, its role feels even more urgent. Genomics is no longer a field on the cusp of clinical relevance—it is embedded in cancer care, rare disease diagnosis, and emerging therapeutic platforms. The challenge now is to ensure those tools are implemented effectively, equitably, and sustainably across healthcare.

In Talkowski’s words: “I think that will come when we show the demonstration that genomics has really infiltrated all of healthcare and invaded all facets of it. To me, that would be wonderful if everybody started speaking the same language and thought about genomics from the perspective of the patients.”

For Green, the hope is that the meeting continues to nurture that vision while staying true to its spirit: small, candid, and unafraid of hard debates. “What we really have tried to do in ten meetings is to just create an annual forum where we could showcase the successes of genomic medicine, showcase the cutting edge, and not be scared to showcase the challenges,” he said.

Ten years ago, AGBT Precision Health was an experiment, a spinout from the glitzier Florida meeting. Today, it is one of the few places where genomics meets medicine head-on, where hard questions are not only asked but argued over, and where the next generation of scientists and clinicians find their footing.

The 2025 meeting, with its themes of rare disease, AI, precision therapeutics, and nutrition, promises to be both a celebration and a challenge. It will look back at the progress of a decade and look forward to the daunting, exhilarating task of bringing genomics into every corner of healthcare.

If the first decade was about proving genomics could impact medicine, the next decade will be about making sure it does—responsibly, broadly, and for all. And as Green and Talkowski know, there is no better place to hammer out that future than in the intimate, debate-filled rooms of the 2025 AGBT Precision Health Conference.