In the past several years, we have taken advantage of a number of opportunities to advance the intersection of next generation high-performance computing AI and big data technologies through partnerships in precision medicine. Today we are in the throes of piecing together what is likely the most unique convergence of medical data and computer technologies. But more deeply, we observe that the traditional paradigm of computer simulation and prediction needs fundamental revision. This is the time for a number of reasons. We will review what the drivers are, why now, how this has been approached over the past several years, and where we are heading.