Through the inimitable combination of defined clinical and educational goals, a unique systems-medicine focus and a statewide commitment to implement a program for molecularly-informed therapeutic decisions, the Arizona Clinical and Translational Science Award will forge a uniquely transformative, novel and integrative academic home for clinical and translational science. Arizona's current population is a microcosm of the US as a whole: a growing aging population, large uninsured populations with predisposition to specific diseases and a clustered but geographically-dispersed populous. We propose to organize our CTSA program so that novel clinical and translational programs and education and career development programs will successfully tackle these complex health problems. The CTSA program provides a logical framework to integrate nationally-recognized efforts by the Battelle Memorial Institute to develop a statewide roadmap for Arizona's biomedical research and capitalizes on the complementary strengths in research and clinical expertise of research-oriented biomedical and clinical organizations across Arizona, including universities and research institutes, hospitals and healthcare institutions, the NIDDK and the IMS. A large statewide patient base is a tremendous resource for application of clinical, translational and outcomes research that will derive from our statewide clinical research efforts. We have assembled a cadre of clinicians and scientists who represent highest quality clinical care and research, an ongoing commitment to translational research and an unequivocal commitment to work together as a team. The Arizona CTSA team has specific goals it will address and will do so by working across the continuum of applied, clinical, and outcomes research ensuring that projects have complementary strengths that will allow translation and implementation of new findings to clinical therapies and screening procedures. Recognizing the geographic dispersment of our team, we have developed effective methods of communication and will use new generation technology for web-based multi-center telemedicine to strengthen communication during the planning period so that all investigators and institutions can contribute significantly to the generated joint research efforts. The CTSA represents the integrated efforts of institutions with a unique and remarkably collaborative track record, formally joining forces to improve outcomes for patients across Arizona and the entire medical community. ? ? ?