Germany’s genomics-guided precision medicine pilot, genomeDE’s Model Project for Comprehensive Diagnostics and Therapy Selection by Means of Genome Sequencing, has gained momentum with near-term plans to expand enrollment and open data access. Organizers said the project has already enrolled almost 15,000 patients and is preparing to recruit more than 100,000 by 2029. Project leaders attributed progress to building reimbursement infrastructure and secure data storage before enabling clinicians and researchers to access genomic and clinical datasets. The program is funded with up to €700 million from Germany’s public health insurance system and will evaluate clinical utility and cost-effectiveness at project end. The scale-up is notable for precision medicine operations because it targets the hard parts—governance, data handling, and payment alignment—needed to move genomic testing into routine care.