Three of the most important forces driving medical care are: patient specificity, treatment specificity and the move from discovery to design. Engineers while trained in specificity, efficiency, and design are often not trained in either biology or medical processes. Yet they are increasing critical to medical care. For example, modern medical imaging at US hospitals generates 1 exabyte (10^18 bytes) of data per year clearly beyond unassisted human analysis. It is not desirable to involve engineers in the acquisition, storage and analysis of this data, it is essential. While in the past we have nibbled around the edges of medical care, it is time and perhaps past time to insert ourselves more squarely into medical processes, making them more efficient, more specific and more robust. This requires engineers who understand biology and physicians who are willing to step away from classic medical thinking to try new approaches. But once the idea is proven in a laboratory, it must move into use and then into common practice. This requires additional engineering to make the process robust to noisy data and imprecise practices as well as workflow analysis to get the new technique into operating and treatment rooms. True innovation and true translation will require physicians, engineers, other medical stakeholders and even corporate involvement to take a new, important idea and move it not just to a patient but to all patients.