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Today on This Week Health.

It's now a standard. Every new employee that comes into is they have to go on clinical routes in their first 90 days. Cause I want them to see the business that we're serving. Yeah. Not the business. We think we're running 

 Thanks for joining us on this keynote episode, a this week health conference show. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health, A set of channels dedicated to keeping health IT staff current and engaged. For five years, we've been making podcasts that amplify great thinking to propel healthcare forward. Special thanks to our keynote show. CDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders. Now onto our show.

📍 Trigger warning. This video discusses suicide and mental health issues, which may be difficult or triggering for some viewers. If you are struggling with suicidal thoughts or other mental health concerns, please seek support from a mental health professional or crisis hotline Viewer discretion is advised.

 All right. Today we're joined by Ed Kopetsky, retired Stanford Children's cio. Ed, appreciate you coming on the show.

Hey, thanks, bill. Great to do it and great to know y'all all these years.

One of the benefits of our small industry, we get to know a lot of people.

Well, I'm looking forward to it. I wasn't gonna let Sue Schade have all the fun. She did an interview with you recently. We'll dance around some of those topics because I like some of the topics.

Maybe we'll go a little deeper. But we could start with uh, retired in a suit jacket. So is that just like your normal look or for those not watching, it looks like you're in an office, you have your suit jacket, it looks like you're at work. So is this what retirement looks like?

Well, I wasn't planning this by any stretch.

I'm only gone two weeks now. And but we had a major storm again, come through the Bay area and our power is knocked out. So I had to call my friends at Stanford and let me in the office, take a shower and I guess it's just a habit if I'm coming in to be, have a jacket on, plus I'm trying to stay warm.

Well, this is gonna be one of the conversations I have with you cuz I think one of the things that's impressive is you have a planned post-retirement. There's a lot of things that your life has been about, even over and above being a cio, and that's going to be an extension of what you do.

And I wanna talk a little bit about that, cuz I think sometimes people retire and they're not sure what they're gonna do next. And we can talk about some of the people that have retired. I've talked to some of the CIOs, some of 'em have like mobile homes and they just wanted a quiet life after being a cio.

But it doesn't sound like you're going after the quiet life. What are some of the things that you're gonna be doing?

Well, Billy and I came into this from engineering systems engineering and healthcare 40 some years ago, and my goal was to improve health. And I had no idea what it was at the time, and it exploded.

And I was there in timing on all that. So my contributions in healthcare have been from better systems, better workflows, better automation better intelligence. And I think after 40, 41 some years I decided the CIO role is all consuming and I wanted handed off. We've developed a number of successors here.

At least three people can take the job, and I know they're doing a search. But one of the missions that found me was mental health and addiction and you don't choose everything in life, but that's certainly now a new passion of mine. And I helped co-found and co-chair the chime opioid task force.

We're still going strong and actually continuing to contribute. And I'm working in that space locally, Santa Clara County, overdose prevention and other things. So it's really a gift that I can contribute in that space. Also I've gotten involved with mentoring startup companies and I actually just joined the board of one that we

funded the seed round on and we're bringing it to the us. So I think combination of continuing to mentor and advise others continuing to stay active and improving healthcare problems. Mental health is clearly one that we're all a deficit on in this country, and I have a passion around now.

I appreciate you taking up that banner. Obviously it's very personal for you with your son and all the things that have gone on there, and I love the progress that has been made. In terms of what we're doing at the hospitals and the healthcare systems and the new protocols we're putting in the playbooks, we've made so much progress there, but we're not making progress on the opioid crisis.

Where do you think the next major push will be in the next couple of years?

Well, let me just disagree with you a little there. I actually think we made significant progress. In the last five years, especially in the management of opioids in hospitals and healthcare systems.

Yeah, and I agree, and that's what I was trying to say is that we've made tons of progress there, but just overall, when the pandemic hit, we solve

just that problem exacerbated significantly due to access and isolation issues associated with that disease.

And. Secondarily, we've had an influx of fentanyl that is now laced in almost every street drug people are thinks they're buying out there. And we have a crisis in adolescent mortality right now. And frankly I'm really excited to be working with Santa Clara County. They're doing amazing stuff to address that problem.

We now have distributed free Naloxone in every high school in Santa Clara County. So basically Bill, we're moving more to harm reduction. We've gotta get people into recovery. We've got, and it's a long-term issue, but immediately we've gotta implement harm reduction measures.

For example, safe injection sites where you're supervised secondarily testing of meds. Thirdly. The state of California has a free Naloxone program, and all healthcare systems are eligible to distribute. Anybody on opiates, whether it's prescribed or not, should have naloxone in their presence and with people around them because overdoses are extremely likely.

So that's how we're tackling it now, but there's serious policy issues. That have to be addressed. Number one, funding for mental health has gotta change. Secondarily, I think sharing of information that's critical on chronically ill patients has gotta be changed. We cannot isolate patient care to silos when we're dealing with a chronic long-term condition where the patient will go to multiple healthcare providers.

So we've actually advanced that quite a bit. Even at Stanford Children's Bill, I'm a sponsor. I've gotten others to sponsor. We have a teen van that goes out and serves homeless and underserved children. And I've been on it multiple times. It's alarming how many people are out there without homes, without shelter, without food.

And we are a lifeline now for those patients. We will connect them with needed services. We'll even transport 'em. But we go around to very high risk communities and just, watch the kids coming outta the woods or out of the schools, they're coming because they know we're there to help and they don't charge a penny.

It's all donor sponsored. But we really have serious issues in our community. Yeah,

I love the work that the task force has done on the playbooks, and I love the work that we've done in the health systems to reduce the access to those drugs over-prescribing them and the access. And I think we've done a lot in that healthcare.

What you're describing is really us going outside of our four walls now. It's really engaging the community, it's engaging our policy makers, it's engaging it's, is that something that you're encouraging CIOs to look at as part of their work or identifying a team of people that's gonna do that for a health system?

Yes, definitely. And frankly, I'm carrying on that mission with Stanford Children's. I was just on a call that I orchestrated between Santa Clara County experts and Stanford pediatric specialists yesterday to develop an addiction clinic for teenagers at Stanford. They've had one at Santa Clara County for two years.

It's extremely successful. And we live in an area where we need to do this. It's, the problem is everywhere. So we're learning from those that are advancing. And yeah, bill, it takes more than just providing a care treatment center. You've gotta draw the people in. You've gotta encourage the community to refer people.

The other thing we gotta do is change the stigma. And I've done an advocate on that. I've had a couple podcasts in that the stigma around mental health and addiction is holding us back and the heaviest load is on the patient, but it's also on policy where we think mental health shouldn't be funded at equal levels.

It's ingrained in institutional policies. It's also shared by families who, like ours went through trauma. And, we were carrying a lot of uncertainty and guilt for years until we opened up about it. So I'd say, bill, we gotta change the rhetoric. We gotta change the dialogue to where this is a acceptable illness that people have.

And my God, it's like one in three almost now. It's coming out more as we talk about it. And I think that's the other thing CIOs can do. I know. We don't have a lot of time on our hand, but we can be spokespersons for those who are in need and create a safe environment for them to talk about it.

We did a lot in my department over the last three years around this issue. Even in our team huddles people talked about issues and challenges and they never thought they could before. I don't know how many people came to me and said ed, thank you for opening up the discussion. And they were just embarrassed, but here they were on the brink of disaster and depression, but trying to come into work and function, et cetera.

And I think we just gotta recognize it. Just like, you injure yourself or you get another virus. It's the same thing. Only it's chronic.

Yeah, my experience with this is interesting because in my family, my daughter has struggled with depression. And so she went out and got a service dog and trained that service dog and we thought, oh, what's she getting a dog for?

That's crazy. It's gonna be hard, she's gonna travel how? All that stuff, and we just weren't thinking about it. Right? I mean, the dog truly is a service dog. I mean, it comforts her. It calms her as, and we're not having the dialogue. So we had no idea how important and the life changed, it might sound silly to some people if they're listening to this, but the life change that dog brought about, The comfort and the ability to take that dog into situations where she was uncomfortable has really helped her to grapple with a lot of things that she wasn't able to. It's just having the dialogue, talking about it more I think will help.

Absolutely. And just accepting it that people have this Right. Anxiety, depression, bipolar, whatever. It's been definitely exacerbated over the last couple years with all the uncertainty in society and isolation and covid and, inability to really connect with others.

So the hats off and I think we all need to start, pushing the needle on That's one of the purposes of the opioid task force is not just to look at how we can leverage technology, but to change the discourse on this and talk about it transparently on what we're doing and what we should be doing.

I'm wondering how you create that environment in the workforce and, this is a pretty heavy conversation, but when I was a cio, we actually had a suicide in our IT team. And the number one thing I heard from the people as we got together and started talking about it, I worked with that person every day and I had no idea this stuff was going on.

I had no idea it was this bad. I had no idea. How do you create that environment? Do you have any success in creating an environment where people feel they can talk about these things?

Well, yeah, I do. I'll just speak from my own experience. Talking about our family experience with my son's

addiction and then passing five years ago, I don't know how many people came to me and said, Ed, I've kept it inside all the years. My brother passed away, or My sister has it. And we, it goes on. I mean it, once you open up the dialogue as a leader, others will take the bait. Secondly, we implemented, we have a lean management system here at Packard and Issn that involves daily huddles with tiered huddling all the way up, 10 minutes every day with all the executives.

And on our huddles, on our team huddles in is we started bringing up mental health topics and opening up the dialogue . People felt safe to do it and others wanna help each other. Like you said, people didn't know about it all these years. Right. We had a similar issue. Someone relapsed, one of the most intelligent Microsoft engineers we've ever had, and we never knew he was in recovery.

But when Covid hit, he relapsed and unfortunately passed away within a week. It was unreal. How fast So it was before we opened up these channels to talk about things. But that certainly created an impetus for us as in the department to talk about it more and be more aware of things. And bill, we have something called Schwartz Rounds in healthcare and we practice it in Stanford Children's.

It's really about the care teams and them. Releasing things they've held inside for years, like medical mistakes or patients that didn't make it or whatever. We're humans and when something traumatic happens, we care more about others than ourselves. And a lot of clinicians carry a lot of guilt and a lot of trauma and Schwartz round.

It's an opportunity to open that up in a group setting so on that I did one on stigma on mental health one time a couple years ago, and I had like eight people from my department come to it. Well, why did they? Because the topic was relevant to them, and people came afterwards and talked to me.

One person was suffering from PTSD from Afghanistan, was a veteran. And these things aren't encouraged until now. We just gotta change it, I think. And that's what I'm up to.

Yeah, absolutely. If people haven't heard the interview with you and Sue, I would highly encourage them to listen to it cuz Sue got you to talk about lean and lean processes, bringing it into Stanford.

We're not gonna touch on that subject only. You guys had a great discussion on it. I'll just point people over there. But you know, now that you're not in the chair, now that you're not in the CIO chair, we could probably talk about some things that we weren't able to talk about. I often joke the five minutes before the interview and the 10 minutes after the interview, a lot of times, Sitting CIOs are the best part because they say all the things that they can't say on the air.

Well, yeah, I mean, within reason I, so you tell

me by now,

what's, yeah, well, I want to ask you, I want to sort of look out at first of all, I wanna look at what's going on in healthcare right now. And then I wanna look out at, where it's potentially going. So right now we do have some clinical staffing shortages.

We have financial pressures due to wage inflation and other things. We have burnout and those kinds of things that people are concerned about. A lot of pressure on health systems right now. How is healthcare going to get to the other side of this, do you think? What are some areas or some ways that they're going to get from this point of being under pressure all the time to getting I don't know, ahead of it and really serving in a less pressure-filled environment?

I'm not sure that's Ever possible, but I'm curious what your thoughts are,

although that's a big question and not a simple answer at all. I think the last few years have brought to light a number of really troubling concerns. I don't have a particular order on this, so let me just wing it.

But number one, we've advanced the EMR presence to an almost a hundred percent level in our acute institutions. We have almost no interoperability between acute and post acute.. So when you look at most illnesses, it's very rare you're in the hospital, but your care is given outside the hospital. And so there's a still a need to do better automation on the continuum of care around the patient, not just the acute episode.

Secondly, our systems that we implemented are transaction based.

So we're putting in a lot of data, but we're at the early stage of leveraging that data for intelligence, and I think that may be one of the breakthroughs is that we finally start using the data, both our historical and our current and combined with other organizations with life data.

We're very much into that in the pediatric world. Because it's a smaller subsection of the population, at least 6% of the population. So, I think that's a big deal. The issue today is I think the, our systems have not improved productivity. I think they have, but all the load and all the entry of data and all the policies we've implement, Have added burden on the front line and we gotta take that off somehow.

And I think one of the answers on that is digital transformation. And I know that's the new buzzword. My title was even changed a couple months ago when they realized I was leaving him now information and digital officer. But we need to take waste out and I would say, It starts with basically the administrative loads of staff, right?

Budgeting and getting things procured and staff hired and recruited. All those things were still very much archaic on. And secondly, then when you get to the caregivers, we've gotta take load off somehow. We've either gotta capture data electronically instead of manually or we gotta develop better algorithms.

And we're doing that here to say, Hey, the data is indicating these high risks. Hone in on that clinicians instead of the whole field. And we are doing a lot of that with Stanford. We have unique skills in biomedical and data sciences here, and we're combining that. We've got a clinical informatics program that's world class

but we're unique built. We're one of the, those top entities that maybe is 5% of healthcare in the country, right? Most community hospitals can't afford all that. So we've gotta develop it and then clone it and transfer it is my view on all that.

Well, Let's go back and forth a little bit on digital transformation.

I'm glad you brought that up. Yes. And what I'd like to do is follow the patient journey. And talk about the digital transformation that can occur. And we'll start with the patient. The patient before they're a patient the consumer that we don't necessarily know about and engaging that person. So this is almost greenfield.

It's like they're not in our EMR yet, but they've just moved into our community. How do health systems think about digitally engaging that patient before they even enter the hospital.

Well, our first space is our consumer portal where, I mean, we definitely are in that space because our market is young families and we have to compete for those right against Kaisers and Sutters and others. So we actually re-engineering our consumer site after 10 years. It's gonna go live this year

but basically it's to make Packard available to them. All our resources, our clinicians, it helps them set up an appointment. It helps define the services we're in, the locations we're in. So that's one area that we put quite a bit of emphasis on and are now re-engineering that we have also, Automated tools for our patients, like mobile apps that have way finding, appointment scheduling et cetera, that we've advanced.

So we make it easier for the patient once they once they move from consumer to customer. Once they become our patient, we equip them with tools. MyChart, we have a mobile app that's out on out there for free. And so when they come on site, they can do wayfinding to find the location of their clinic, et cetera, et cetera.

They communicate with their clinicians. We also bill last year, implemented a. Patient communication systems. We had about 30 different methods and all unique, but we put in one system that's integrated with our emr and now we can send out select communications to, for instance, all our pediatric patients at school season get a notice about flu vaccine.

Or if we have diabetic patients and we wanna send out and announce we, we can do that automated wise. And it's really improved our communications between our caregivers and our care units and our patients. Yes. Those are some of the things we're doing.

Yeah. That's, exceptional, I mean, setting up those lines of communication,

I applaud you guys just for thinking about it, right? We're going to engage the consumer in our community, but you're in a very competitive marketplace.

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Let's move into the acute care center for a minute. I love talking to children's hospitals because you guys have the coolest buildings and the coolest stuff.

What are some of the digital tools that you've implemented inside the Acute care center for patients and their families?

Yeah. Well, that's a great time. I was just, we, in 2017, we tripled the size of our hospital. We are only 31 years old and we're now top 10 in the country, three years in a row.

And we expanded our acute building 200%. In 2017. We put 23. new Technologies in that facility, and I won't go through 'em all, but some of the highlights were rtls and we created a standard with the adult hospital because we're very connected and physically, but we're separate in care. But we share emergency room and supply chain and other things.

So we, we had to create one standard for real time location services. We track all our assets like our biomed equipment et cetera, and it's really cut down on lost equipment time to find critical equipment when you're treating patients. We also can track our staff. We can track any asset. And we never refer to our people as assets, but they're our greatest assets.

But on our badges, are tracking devices, and when we can turn it on to see how long they've spent in the patient room, did they respond in an appropriate manner. So that was a big advance. Another thing we created on our own was a little, looks like a little iPad. It sits outside on the wall of every patient room.

And critical indicators like diet restrictions, tests needed, are on that board. So when nurses walk down the floor, they can see that patient is in need of a follow up right now where they're coming up. And then, so it was like a decision support tool, but a visually, instead of having to go to the computer, And look up every patient individually while they're doing the rounds.

It's already giving them advice. So I, those were a couple of the cool things we did. Another thing that we implemented where we were one of the first to develop telesurgery and in our ORs, we now video in high level specialists from around the country, like a Texas children's, and they consult. During the surgery on the patient.

So instead of flying that physician, out here with four hours of flight time and everything else we can save them time and video them in and they're doing literally consults to our surgeons live during our surgery. So one of the things Bill here, we advanced a long time ago was integration of biomed.

We were like, 5% of the hospitals in the country when we did it. And it has been such a boom for us we're the highest acuity children's hospital in the country. And to have the clinical technology secured and fully integrated with our EMR and realtime is a major advance. And I think, I don't know why we don't do it across the country in every hospital

because I mean, as you were saying that, I was thinking you might still be in the top 5%. I mean, there, there's, that is so expensive.

Oh, we're in the top 10. I already put a

number. I know, but it's so expensive to do. I remember looking at it going, oh my gosh, we have so many biomed devices across 16 hospitals and the standard, we weren't really standardized across 16 hospitals, and there was just so many aspects of it.

I'm like, okay, why don't we just start. And, set standards and buy all this equipment. And I think we, we ended up setting a program up, but it was gonna be like a five year program to replace all the equip, like just one line of that equipment. And it's just, it was just very expensive.

I wanna take you one step further though, on the digital transformation. And this one's a little harder. And this is the post-acute, and we talked about. You have high acuity care for children, you're gonna see them for probably many years, potentially. And you're gonna have a lot of touchpoints remotely and whatnot.

What's some of the digital transformation either that you see or you would like to see in that post-acute care continuum?

Well, I'll give you an example and I'll highlight in an advance we did here. We have oral leading congenital heart repair for kids here, and those procedures require three surgeries.

And our patients are, we're on a national referral level, so they don't stay necessarily local. These patients are referred to us and go back to their community, so we have to develop tight integration. With the clinicians in their community. The other thing we did for these patients, because historically they would come for visits and there would be a batch process of data and then analysis, we actually developed tools that track their data real time.

Send them to our clinicians, and we can see the indicators now of when they're leading up to the need for the second and third procedures. And it's really advanced. Our leading edge, we've done similar stuff for diabetic patients where we're tracking their glucose and instead of a batch meeting once a month, the data's coming in and the clinicians can check.

Are they falling off at certain levels during the day we can adjust their meds. So that's actually two things. We innovated here already at Stanford joints with patients that, are maybe unique to us or we see a lot of problems. We've done similar things in Billy Rubin and stuff in the NICU on predicting how much radiation people need.

And, kids are super sensitive. The lower doses you have, the better. And so we're doing a lot with the data, but we're not waiting for traditional methods of reporting. We're building automation on data automation tools and capture tools so that our clinicians can be ahead of the patient.

And there's so much variability when you leave it on the patient, the self report you're dealing with a lot of different levels and. Of education level language levels, et cetera, et cetera. So this just creates extension tools for us and it allows our patients, again, to stay connected with data flowing in that we can act on actionable data.

I'm gonna go larger on your career here as you look over your career. You've seen a lot, so you've been around when the EHRs were just coming in, I would imagine. Is that pretty accurate?

Yeah, I actually, I cut my teeth in the VA when we first developed D H C P. And then I went to the private sector and that was before EMRs were out there.

So yeah, I've seen a lot, quite frankly.

Well, how do you talk to me about longevity? Because the the CIO role was very difficult for me. I mean, it I joke that, I was never at a loss to find someone in the health system that wanted to tell me how bad I was at my job.

It's because a lot of stuff gets stumped on our plate. It's like, the documentation, they're like, why do we have to document so much? I'm like, it's regulatory. I didn't come up. But yes, we can look at maybe there are some things in this that somehow was not implemented correctly.

What do you attribute your longevity to?

Hell of a persistence if you want. You gotta be persistent. Bill I, I've had a couple weeks to think about it, and I look back. In 1998 I was chair of CHIME. It was only six years old at the time, and I said to everyone for my fall forum, I said, look, we're never gonna make it if we don't partner with the clinicians.

There's no way. And so we invited our physician partners in 1998 for the first time before they were called CMIOs and from there in my career, wherever I went, it was never acting alone. It was always in partnership with others. I created governance that was inclusive and participative so that finance and surgery and we were all in one room planning our IS priorities every year.

And I think the C M I O role has been a. I would say that was one of the major differentiators in our trajectory when we in healthcare, created that partnership role of the cio, CMIO and then eventually C N I O and others. It became that we're just part of the same problems. We're not different. And we need to learn a lot.

You need to tell us how to automate things. We can do anything with technology, including screw it up. We really need the impact on the front line to understand that and to improve adoption. There's no way a technologist is gonna shove it down anybody's throat in terms of adoption. No way. I don't care what the rules are.

It's all. Clinicians saying this is what we need and we partner with them to develop it. I think strategic partnerships and collaboration are the answer. Not being an expert. I being an expert, the technology partnerships you're innovating the business.

Well, It's interesting cuz we now have CIOs that are, that have the MD.

Credentials and you

know, quite a few. Why are you doing growing?

Yeah, quite a few but I still think that advice is valid for them because it's not about them being the expert, it's about them being able to rally people, get people to the table, put the right governance and structure together.

Even the lean stuff you talk about, People involved in the ongoing improvement culture, if you will of making things better on a daily basis.

Right. And Bill, that's one of the reasons when I came here, I changed our name from it to information services. I felt extremely strong. I went out on clinical rounds and I saw the problem.

Here we were buried behind computer terminal. And 50% of our cows weren't dysfunctional. The day I rounded and I went, what's going on here? Right. Yeah. We were very proud, but the basics were broken and so we turned it around. We changed our name to services and every person in is that year went on clinical rounds.

It's now a standard. Every new employee that comes into is they have to go on clinical routes in their first 90 days. Cause I want them to see the business that we're serving. Yeah. Not the business. We think we're running. Well, I'm, yeah, I'm curious. It's very

different. I'm curious about Lean, cuz Lean has this whole concept of not the gemba and being there and rounding and that kinda stuff.

So we've gone remote. A lot of organizations have gone. How do you keep that going? How do you maintain that

hard? It's very hard and it kind of broke down because when you can't come on site, you don't really know what's going on. And secondly, you lose your relationships. There is nothing better than people going to where the real value is produced.

That's called gem. And caring. I want to emphasize that because you can't just show up in a suit. You gotta care. And the caring means you ask people what they need and you follow through. That's key. Lot of people try to fake it and they go, okay we're checking off the boxes we're going on.

But if it's not authentic, you lose everything. When people know you care, you don't need to show up. They'll call you, but you've gotta show it. And I think when Bill, when we came back from Covid, the first thing we did was back on clinical rounds, starting with the exec team, but also my department. And it's magic and people.

We're out there to help them. And you also gotta follow up, like I said, and if they know you're gonna do that they'll partner with you forever. And I think we have some of the highest engagement scores in the country in this department and it's because they feel we're doing good stuff and they are valued.

And I think when you look at Lean, there's kind of two principles that are dominant number. You're here as a servant leader, get rid of the org chart. You're here to serve the people on the front line and all the issues you have to help get over it. And you can't do that without going to Giba. You don't learn that in a conference room.

And you certainly can't see it from a conference room. But people, like, even during Covid we actually had a strike last. And there was a lot of turmoil that, that is such a difficult issue when you have clinicians by, polarized and some walking out. And when we had to come back on recovery, one of the ways was presence was going back out, building that trust again, showing up and, respecting what happened.

But also, again, we're all in this together. We have to be a we. And so you're just not gonna do that issuing edict, memos are showing up in conference rooms you gotta go to. Yep. Absolutely.

Absolutely. Ed, I appreciate you putting a suit on. Going back in the office. One more time to join us. I will see you this Sunday.

That'll give people an idea for when we're recording this pre ViVE and CHIME I'll see you on Sunday at the opioid taskforce golf event. Look forward to that. We all know who's gonna win before we even get there, but we'll go compete anyway,

just that. Oh, that's alright. No, thank you, bill. I really appreciate it.

And I've been honored to be in this industry. I don't plan on leaving it completely ever, and wherever I can contribute I want to keep doing that. Thank you for your service here today. I think it's great. Well,

I appreciate all that you've done. Appreciate you coming on the show.

Thanks, ed. (Main) I love the chance to have these conversations. I think If I were a CIO today, I would have every team member listen to a show like this one. I believe it's conference level value every week. If you wanna support this week health, tell someone about our channels that would really benefit us. We have a mission of getting our content into as many hands as possible, and if you're listening to it, hopefully you find value and if you could tell somebody else about it, it helps us to achieve our mission. We have two channels. We have the conference channel, which you're listening. And this week, health Newsroom. Check them out today. You can find them wherever you listen to podcasts. Apple, Google, overcast. You get the picture. We are everywhere. We wanna thank our keynote partners, CDW, Rubrik, Sectra and Trellix, who invest in 📍 our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.