Precision health requires success in two intertwined aspects: precision therapy and personalized medicine. Precision therapy is being able to effectively treat the right disease; to have therapies that target for the correct pathological pathways. Personalized medicine requires diagnosing a specific individual’s disease based on accurate assessment their complex health and pathological status. Our underlying premise is that an individual’s baseline proteome reflects their past and present and thus, will dictate their future health and disease. We have combined tracking citrullinated proteins, an irreversible post-translational modification that can drive disease dysfunction as well as induce autoantibodies. The ability to quantify citrullinated peptides by mass spectrometry has been improved by combing searches against a library comprised of the maximal number of citrullinated peptides, data independent acquisition and downstream analytes. We have been able to identification and precise quantification of proteins and their modified forms in 5 targets organs in 4 different diseases. As well, we are determining which are also acting as autoantigens which could compound their role in disease over time. This work has led us to consider the need for continuous patent-centric health screening. We have developed technical pipelines for patient screening. This will/has required development of microsampling device, point of service devices, pathways for client data return and specific clinical grade assays. We have begun down this path with production of system suitability and quality control measures, assays and volumetric sampling device and will discuss the remaining challenges involved and requirement.