Immunotherapy that helps kids fight cancer without chemo. Automated cars that reduce accidents and hospitalizations. Virtual reality systems that help surgeons carry out procedures more safely. These are some of the medical innovations that could transform health care in 2017, according to the Cleveland Clinic, a large nonprofit hospital system.

Cleveland doesn’t arrive at its list lightly, says chief wellness officer Michael Roizen. It surveys 156 multi-specialty physicians, who come up with 500-plus ideas. It consults venture capitalists and clinical researchers. It forms committees that argue for four or five hours at a time. It goes through a multi-stage balloting process. And so on. Sometimes, the debates get heated. The list, though, is nothing but inspiring, and, most positively, it’s pegged to the coming 15 months (by the end of 2017), not some distant point in future. The Clinic says these ideas could start saving and changing lives more or less immediately.

The trillions of microbes in our gut–collectively, the “microbiome”–are thought to have major importance to our health. And this importance was poorly understood until recently. Now, researchers are confident they can make sense of the microbiome to predict how we’ll respond to drug treatments, what diseases we might pick up in the future, and how we digest our food. “Biotech companies once focused on the genomic market are pivoting to the potential of the microbiome to develop new diagnostics, new therapies, and ‘probiotic’ products to prevent dangerous microbe imbalances,” Cleveland writes in its report. Roizen says diagnostics is likely to be most fruitful area of innovation around the microbiome in 2017.

Up to one in eight Americans now has type 2 diabetes, one of the world’s fastest-growing diseases. But Cleveland says good news is coming in the form of drugs like empaglifozin and liraglutide that, in trials, not only blunted diabetes but also reduced “comorbidities” such as heart disease. “Experts predict 2017 will mark a complete shift in the lineup of medicines prescribed for diabetes patients, as well as a new wave of research,” the report says.

More good news: cellular immunotherapies that could help fight, or even cure, leukemia and Non-Hodgkin lymphomas. These involve removing immune system T-cells, and genetically “reprogramming” the cells, and then introducing them back into the body where they target tumor cells. Regulators will consider the treatments in 2017 and Cleveland says they could one day “replace chemotherapy and its lifetime of side effects.”

Emerging diagnostic techniques known as “liquid biopsies” could lead to earlier detection of liver and other cancers. The tests take blood samples and look for “cell-free circulating tumor DNA (ctDNA)” that are more numerous than tumor cells themselves. “It’s being hailed as a flagship technology of the federal government’s Cancer Moonshot Initiative. Experts believe it’s only a matter of time before catching and treating cancer is as routine as your annual checkup,” the report says.

Car crashes are a major cause of injury and death, costing $23 billion in medical expenses. But automation could help, reducing the incidence of human error. “Safety and legal questions remain, but 2017 is expected to be the year that driverless cars take a spin into the mainstream,” the report says. Accidents won’t stop happening overnight, but next year could see the beginning of a trend, Cleveland says.