The All of Us Research Program (AoURP), which started enrolling participants in 2017, is an ambitious, forward-looking and futuristic national endeavor to create and sustain a research data platform unique in the world, with the ultimate objective of advancing effective health care approaches and interventions that are exquisitely and precisely tailored to individual patients. Known as “Precision Medicine” or “Precision Health” in which preventive measures, diagnoses and treatments are designed specifically for an individual based on their genetics, exposures, biomarkers and circumstances, the AoURP was envisioned as a mechanism for overcoming a number of significant research challenges in order to accelerate the achievement of this revolutionary goal. The AoURP is specifically designed to address current issues that plague precision medicine/health research efforts, including small sample sizes of cases and population sampling frames, population homogeneity, limited breadth of data, gaps in patient follow-up, incompatible data platforms, restricted data access, challenges in obtaining IRB approvals and cost. The research platform of core participants (which includes those participants with uploaded electronic health records, genetics, physical measurements and survey data) is already approaching that of the successful UK biobank, but is a far better depiction of America. Over 5400 researchers are already registered on the platform. Investigators from six health care delivery networks spanning six states (MA, MI, MN, ND, TX, WI) of the Health Care Systems Research Network or HCSRN (Henry Ford Health and Corewell Health in Michigan, Baylor Scott & White in Texas, Essentia Health and Health Partners in Minnesota and North Dakota, and the Reliant Medical Group in Massachusetts) established The American Consortium for the HCSRN (TACH) to support the mission of the AoURP. Funded in 2016, TACH shares the undergirding philosophy of the AoURP and has demonstrated this through our work during the last 6+ years. We continue to have the scientists and staff, resources and experience to contribute to growing and sustaining the program and to using the AoURP research platform. In this new award period, the TACH network proposes to expand geographically, including adding two new health care systems, SSM Health and Kaiser-Permanente Northwest, which equates to eight more states (OH, IN, SD, NH, MO, OK, OR, WA) without current AoURP health care provider organization coverage.