NYCKidSeq seeks to advance use of genomic medicine for underserved NYC children and assess improved management of childhood disease. As we rapidly scale genomic testing in health care, we will need to leverage technology, and engage with providers and community members, to overcome critical barriers to access and adoption of genomic medicine in underserved populations. Our mission is to (a) introduce genome sequencing into standard clinical care of sick children from Harlem and the Bronx, (b) work with patients, families, communities, doctors and hospital administrators to fully realize potential clinical benefits, and (c) support patients, providers and health systems to adopt genomic medicine with interactive and educational health system technologies and webbased tools.