The positive impact of a fully wired system would be profound. "Gaps in care," largely the result of medications that are underprescribed, misprescribed or not taken as directed by a physician, lead to unnecessary hospitalization, emergency room visits, and extended illnesses. A fully wired system, Snow argued, ensures the most appropriate, targeted information is available to both physicians and patientsThe results of such enhanced physician and patient insight would be substantial: significantly increased safety, improved outcomes and hundreds of billions in annual savings. Indeed, the poor management of chronic and complex disease alone costs the U.S. an estimated $350 billion a year. Snow pointed out that in combination with other reforms – including medical malpractice reform; restoring the financial solvency of Medicare; and the systematic promotion and incentivizing of healthy lifestyles – the U.S. could achieve as much as $1 trillion a year in healthcare cost reduction. Snow, who has more than 30 years of experience managing hospitals and healthcare systems and himself comes from a family of physicians, went on to make a detailed case that integrating all facets of medical/scientific knowledge through a wired platform could finally realize the oft-cited healthcare ideal: getting the right treatment to the right patient at the right time – all the time. Medco's specialized expertise in the practice of pharmacy, combined with evidence-based research gathered through its Medco Research Institute, provides the knowledge, precision and efficiency that, applied system-wide, could move U.S. healthcare practice from what amounts to "shotgun medicine" today to precision medicine tomorrow, improving patient outcomes and bending down the cost curve. However, ultimate success will hinge, Snow cautioned, on the extent to which the effort is underpinned by an enlightened public-private partnership in which the government drives strategic foundational policies and regulations and the private sector, fueled by fair competition, is motivated to innovate.