Forming a Precision Center of Excellence: There is an urgent need for developing a Precision Center of Excellence for COPD research to catapult our patient care and prevention effort for reducing hospitalization and improve treatment and prevention of the disease. In absence of a center, there is lack of coordination between infrastructure and the research and clinical activities occur in silos, limiting our forward progress.   Individual inter-departmental research collaborations exist but lack the larger mission which only a center can foster.  COPD is ideal for precision medicine, as it is a complex syndrome representing several disorders with a range of clinical susceptibilities, phenotypes, severity, progression, exacerbation and responses to current therapeutic agents. A NHLBI 2014 consensus statement raised the importance of identifying subphenotypes of COPD.  The formation of a Precision Center of Excellence can forge the way to identify and categorize patients into clinically relevant subgroups by detailed acquisition of clinical data and outcomes and relevant characteristics over time.  These clinical phenotypic data can be coupled to radiographic and biomarker data using collected biospecimens, and leveraged to study the biological underpinnings of COPD heterogeneity and progression. The clinical activity in the area of COPD at Johns Hopkins includes a dedicated Obstructive Lung Disease outpatient clinic with a significant out-of-state draw, as well as a substantial patient volume in general medicine and general pulmonary clinics.  There are 800 admissions per year to Bayview and Johns Hopkins Hospitals combined with the primary diagnosis of COPD.  Characterizing clinical subgroups, based on electronic medical record (EMR) analysis with biobanking for multiomic studies, biomarker identification, and basic pathways investigation, will allow us to identify new therapeutics for COPD.