This Week Health 5 Years

December 12, 2023: Christine Parent, Associate Vice President at MEDITECH joins Bill for the news. MEDITECH and Google Health collaborate to advance clinical search and discovery in Expanse EHR. Healthcare consumers have always taken the time to research and explore their health options but today digital patient experience now plays a huge role in their selection. Providers focus on EHR optimization to improve cross-solution interoperability. And KLAS reports that health system-affiliated home health agencies are migrating to enterprise EHRs.

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This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Today on This Week Health.

What we're seeing a lot with our customer base and what we are hearing when we go out there to the various conferences, et cetera. It's almost a tale of two cities a little bit. We have some people that are continuing on to spend with innovation. We have some people with the clinician shortages and the concern on wage inflation. We're seeing spending in security, we're seeing them spend in r and d, some AI even some supply chain items. So what we're seeing for those other group of folks they're really looking at making sure that their investment dollars are where they need to be.

It's Newsday. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a channel dedicated to keeping health IT staff current and engaged. Special thanks to CrowdStrike, Proofpoint, Clearsense, MEDITECH, Cedars-Sinai Accelerator, Talkdesk and DrFirst who are our Newsday show sponsors for investing in our mission to develop the next generation of health šŸ“ leaders.

All right. It is Newsday, and today we are joined by Christine Parent Associate Vice President for Meditech. And welcome. Welcome back to the show. It's been a while.

It has been a wild bill. Nice to see you. It's nice seeing you at Chime in the fall. I know that you were there and getting some recordings in, so hopefully your listeners got a good of content in interviews from those sessions, both at Chime and, and Health.

it was great to see you. It was great to see people just to get together. It's always fantastic. We don't take that for granted anymore. I

don't. No, it's nice to see everyone back. And it was a full, it was a full group at Chime. Lots of good conversations, and I think many of them are a lot of the same themes that we're gonna be talking about today.

Yeah, absolutely. So you're up in the northeast, is there snow on the ground where you're at?

Not where I'm at yet, knock on wood. But we do have folks in Minnesota and they already have snow there, so some of our buildings and some of our staff they're shoveling out, but not yet in the Boston area, and I'm, I'm thankful for that. If I can be thankful for anything right now.

I was excited at the health conference. We got to interview Google there, that they've, you guys did a partnership with them and integrated the search bar into Meditech Expanse. Really cool. I mean, the search is really cool, how it delivers the results and whatnot. it's pretty exciting. exciting.

Thank you. And, and yes, we're very excited about that. If you've not seen it, there's a small snippet that we are sharing on social, it's also on meditech.com. But as you, as you pointed, we actually put it into our ehr. So I know I've mentioned a couple of times that we opened our toolkit and put a lot of their tools within Rehr, but who better to have a search bar that says, Meditech powered by Google for our searches.

So yeah, no, we, we are very excited about that. A lot of good press. We just announced our early adopters, so what we announced in the springtime at hymns we've moved forward with the next milestone of the early adopters and we're really looking forward to bringing. To fruition in 2023.

And so more to come. You'll hear more at hymns and at vi in the springtime. But we are really excited and it's been a great partnership.

Yeah, I mean, this is Newsday. We talk about news. That, to me was one of the. And we, there's a lot of really neat startups doing really neat things. But today we're gonna talk about the patient experience. We're gonna talk about optimization and some of the work that's going on in health systems. And so much of that data is trapped in the ehr. No matter how good you are, a program in the ehr, there's so much data in there. And this is sort of like the easy button to boom. Here, here it all is. So I, I think that's a phenomenal move forward.

All right, first story, digital patient experience in healthcare. A necessary game changer and this we got from Forbes. So yes. Healthcare consumers have always taken the time to research and explore their options for finding and scheduling medical services. However, time and technology have changed how consumers make their care decisions today.

Digital patient experience now plays a bigger role in their selection. A new provider or care. To stand out and market practitioners have no choice but to deliver healthcare access in accordance with consumers changing preferences. Those who fall behind in enhancing their digital care experiences, risk losing patients to their more up to date competitors.

So, I mean, alright, so that's the backdrop of the. Are we at that point now where we really feel like we're starting to see differentiation in terms of how we engage patients? We already know that patients absolutely want convenience. They want the, the best care they can possibly receive at the lowest price in a convenient fashion at the time they want it.

I mean, we make this sound like rocket science, but that's what they want. Exactly. It, it's pretty, pretty straightforward. So when we get to that point of. How do we find that out? How do we determine that? And then how do we schedule that? Is that where the, is that the, the area of competition we're looking at?

So, first of all, I think that it mentions in the title a necessary game changer. And I think one of the things that was a game changer was the pandemic and how people had to interact with their healthcare. And a lot of it was done digitally. I don't know about you, but you know, those, those tests that you could actually do digitally instead of scheduling your CVS test and doing the drive through.

A lot of people took advantage of that, myself included. So as you start to pivot back to what we consider post covid times, you have this very kind of an accelerated patient education in digital healthcare through that. Three year period. So I do think that this is a time that if, if you have some of these traditional health systems that are not competing in this area, they will be left behind as says the, the title and kind of the suggestion in that opening paragraph.

I will say that for organizations these days, and we heard about it, there was an entire track dedicated to. At Chime about the consumer experience in digital healthcare, but you have these traditional and local competitors. You have local hospitals, you have some of these large national chains like Kaiser.

You have new disruptors in the market like CVS and Walgreens, or Doctors on Demand. So how do you start to attract and retain consumers in this very competitive market? So, First and foremost, you have to make sure you have a beginning to end strategy on the digital journey. And so I know that as we go through and you and I can talk about it, I'd like to talk about that cuz I think there's so much focused on the patient entry.

And the patient access and sometimes they're not taking it to the very end game. And to this point some of what this alludes to is also looking at some of the revenue cycle and some of the other areas that may not traditionally be seen as that patient engagement journey. So I do think that this is the time, and this is at the time for people to start to formulate their.

Yeah, so there's a lot of different ways that people have gone digital, and I'm just thinking through some of the interviews that I've done over the past year. Obviously access is important, right? So it's do you take my insurance? Who's the best provider? That kinda stuff. All that stuff is part of the convenience factor.

Once you get through there, offering a way to access clinicians. Via telehealth and whatnot. We had to stand all that stuff up. That's really important. Pay your, you mentioned revenue cycle, pay your bill is one of the things I'm not sure people are asking for, but we're giving it to 'em. I mean, are they asking for it?

I, I guess they are.

Well, I think that we're seeing a lot more people wanting to have exposure to the portal process and be able to see their where is it from a transparency, price perspective. Did they have their authorizations? Where is it in that process? And also have the ability to pay.

I know that there's text, text payment options that are readily available, but making sure. Seem seamless in the portal. That's easy to see as you're accessing it. That's not a another place for you to go. It does go to the whole, the whole total experience. And so I do think it's a, a beginning to end and where they can probably learn, I think a little bit from the marketing component is make sure that each of those touch points is cataloged in that entire digital experience. And so, to your point the online scheduling, that's been big. If you don't already have that, most people were doing that during the pandemic. Anyways, even for the vaccination shots.

The telehealth many people stood that up during the pandemic, and a lot of their go forward strategy on the digital side continues to enhance that. The, the virtual, the virtual care, including on demand care. So that urgent. Type of on demand care to see your physician or like physician within their practice.

So to that point being able to access your results and having lab results in an easy, easy to read manner on their portal when they check in. A lot of folks are going to the internet ever before to learn about their diseases. So having access to health libraries really stepping up the game on the digital side.

And making that interaction seamless, making sure that those digital experiences and journeys are from beginning to end, and making sure that that portal, that app that's, that's on their mobile device, regardless if it's a tablet or a smartphone, really meets their needs. It's simple. It follows the easy user interface and really pushes forth the relevant data that they need that they're looking for.

gosh, I'm taking through some other things. One is the conversation I had with one cio. He talked about the fact that the digital experience starts before they hit our digital assets. So it starts in seo, it starts in search engine optimization. Yes. Because so many people just go to search engines and say, Hey, I'm feeling this, or, Hey, I've got a cough, or whatever.

So being relevant in those spaces is important. We've talked about digital therapeutics this year. That's a different category altogether, but needs to be stitched into that experience across the board. And it's almost like you need marketing expertise at the table because they've understood. This whole idea of connecting these disparate experiences into almost sounds like a cliche now to say journey, but, but it is, it's, it's like, it's a journey. Yep. Yeah. It's, it's like when it's a discreet experience, that's when it becomes a problem. Cuz people's expectation is just what we're experiencing every day with other digital.

Engagement in, in other industries and like it or not, that has become the expectation. So online scheduling, we can, you and I can talk about hard. It is, we know how hard it is. You gotta it's specialties. You still really can't do that cuz you need a referral and, and people don't like to open up their schedules and so you have cultural work you have to do.

All those things are true, but it doesn't change the fact that the expectation for the consumer continues. To evolve each year. And even if it's only a little bit, it's evolving to the point where they just sort of shake their head and go, why can't I get this in healthcare? I get it everywhere else.

And even dental, I, that's one of the interest, I had a interview with a dental cio, a DSO dental service organization, and it was interesting to me because he talked about experiences and he said, look, I mean, we're, we're retail. I mean, picking your dentist isn't nearly as locked in as a doctor. He's like, we have to be really conscious of losing people into search, losing people in the experience from end to end. I mean, it's so important to knit all that stuff.

Exactly. And so it was interesting how they ended this article of where to start, right? So not just the different components and features as you were saying. We talked about telehealth, we talked about online scheduling, online bill pay, but to your point, the pre-process.

So having that online presence, making sure that your website is up and running, that you're using the SEOs that it goes onto to. Making sure it's accessible. And there's, there's packages and tools right now that goes through websites to make sure that it's accessible to everyone. Are there certain things that you could be enhancing from a digital perspective to make it much more easy to navigate and much more easier to find information?

Are you hiding it in too many clicks? So there is, there is a lot of 1, 2, 3 steps on here and practical guidance. But it's not just the website either. Making sure that care is, is not just on a website and accessible through an seo, although they are very clear to say that most people before they actually sign on with a provider.

So this is your physician office will check out the provider via the website. So that still becomes top of mind for that selection. But going into online appointments and cancellations to your point on the. I guess dentist example is, I think I get about four texts of reminders leading up to that dentist appointment to make sure that I, I don't miss it.

So are we putting in the same workflow processes on the appointment side? Are we making sure that if, if I haven't confirmed that someone's, someone's doing some sort of followup. Or sending out information on your portal about Uber or other car services that you may need to get you to that appointment.

So they definitely need to be a little bit more creative, but create that experience. Make sure it's not just the website, but obviously that still needs to be an extension. Make sure it is a portal or an app and, make sure that you're really following through and creating that.

I could call it beginning to end journey of that digital experience with the consumer and that you're documenting and guiding the consumer through that journey. So you can also find out and do some, some mapping even beyond that with that consumer, how they want to interoperate, because a lot of it's gonna end up being personalization, bill.

And so I don't know what you think about that, but right now I think that we've only started to scratch the surface on some of this, where we're putting together journeys, but we really haven't like personalized that journey based on how Christine or Bill wants to interact with their healthcare digitally.

Yeah. And I think that's gonna be an important distinction. We are way away from that at this point. First of all, we have to underst. Who our consumer is, right? We have to understand their preferences. Are they a full time worker? Are they stay at home? Are they remote worker? Some of that information.

We don't really have anywhere to store it at this point. I mean, I mean, we're getting there. We're getting better at it, but it requires us to know them. One of the areas I'm keeping an eye on is this. I mean, just a lot of chatter right now around these AI chatbots. Now we've had chatbots, which were programmable and we'd put some stuff in it, and in the back end it would just be a bunch of branch statements, like if they asked this or if the word, if this word is in it, present these things.

And they were kind of dumb cuz you could ask some questions and you'd get some answers. And as a human, you'd sit there and go. You have no idea what I just said, . But what's interesting now with these, these AI chat bots, I've, I've been talking to some people who have been playing around with 'em and they're like, nah, these things are getting like smart, like very interestingly smart.

Like and our team's actually working with it a little bit and they've, what they've done is taken our transcripts and given it to an AI engine and said, write an. And very interesting, and they are writing articles and I, I wouldn't say they're, they're not something we would publish yet, but they're good crappy first drafts.

Mm-hmm. , that's a concept we use in our company. I'm like, look, I want something today and I just want a crappy first draft. Well, now they're just throwing it through the AI engine and they're saying, here's the crappy first draft, and I. Yeah, that's a good, that's a good crappy first draft. I mean, we can actually build an article off of that foundation and plus these AI agents now have , according to the marketing, have consumed 25% of the internet, which is essentially my articles, my stuff, all the things I've done.

And so when they say, Hey, tell me about the nurse staffing challenges, Out of the 25% of the internet I've consumed, 1% of the information right now is on, on nurse crisis staffing charges. Let me, let me see if any of the keywords, it's, it's eerie actually, but it's very fascinating.

It is just one other thing about chat bots, which I think is interesting. And, we've done a lot of research in that, in this area specifically, but even around sometimes it's hard to tell your provider everything when you're online or do your you do your questionnaire about how often do you smoke this, that, and the other thing, or what is your ails or complaints.

But there's, there's been a couple studies where they've used chat box to actually input. That information and there doesn't seem to be the stigma. It's almost like they're speaking to a little cartoon or something. So I do think that there's the way to, to incorporate, I love the AI example that you gave.

I'm gonna have to look into this after we get off this podcast because that's, that's completely interesting to me. But also utilizing it as form input h and p input and stepping people through certain processes where you're trying to collect information. There definitely is some use, use cases there.

Yeah, absolutely. šŸ“ šŸ“ We'll get back to our show in just a minute. I'm excited to have Meditech as a partner of this week health. They were a great partner of mine when I was CIO at St. Joe's and we ran 16 hospitals on their platform, and I love their vision for the future. EHRs, have the power to transform care. And with Meditech expanse, you're gonna have all the tools you need to monitor at risk patients. Use genetic data for better decision making. And deliver prompt, personalized care on the go Cy expands quickly ascended the class rankings to become one of healthcare's top two overall software suites. Visit ehr.meditech.com to learn more. All right, back to our show. šŸ“ šŸ“

The next one comes from Bain and Company. There's an article I actually could click through to the report. The Bain Company report 2022 Healthcare Provider It report Post pandemic investment Priorities. Here, they, the nice thing about this report is they have just the bullet points, so it's not hard for me to. Pull these out. So here we go. As healthcare providers emerge from the global pandemic, they are doubling down on software investments, even in the face of macroeconomic turbulence. That's one of the things I was concerned about, is that we were going to retreat from some of our investments and belief that technology and some innovation could go a long way in addressing some of our challenges.

So that's the first point. Second providers are focusing investments on revenue cycle management, patient intake, and cyber security. Third providers are increasingly streamlining bloated tech stacks and looking to their EMR providers and other existing vendors for new solutions before evaluating new vendor offerings.

So use the stuff you have as becoming a mantra competition in the provider. IT space shows no science of abating, early stage capital, big tech and scale. EMR players continue crowding into more segments. So the EMR providers at scale haven't have a. An advantage, I guess is what they would say. And then finally, this has significant implications for providers as they transition into a new disruptive period for software players, as they fine tune, go to market models for the current environment and for private equity investors as they look to invest behind winning themes.

Those were just some of the bullet points that they. Pulled out. One of the headlines here is interesting to me, from disruption to disruption, how provider IT priorities are evolving. as you read this article, talk to me a little bit about what you took away from the article.

So first of all, this mirrors , what we're seeing a lot with our customer base and what we are hearing when we go out there to the various conferences, et cetera. It's almost a tale of two cities a little bit. We have some people that are continuing on to spend with innovation. We have some people with the clinician shortages and the concern on wage inflation, which you mentioned that are being a little bit more careful with their investments. So in many cases, the ones that are spending, we're seeing spending in security, we're seeing them spend in r and d, we're seeing them go out and look at innovation or innovative areas that really does.

Deal with staffing shortages. So that could be some AI that they're incorporating some into their processes, even some supply chain items. So what we're seeing for those other group of folks they're really looking at making sure that their investment dollars are where they need to be.

They are looking at their EHR to see if they can extend. They're kind of a tried and true. Entity. I know that we tend to be looked at as a legacy system, but many of us have actually started to build out at least Meditech, the digital platform. So in many cases it may not necessarily, when we talk about investments or optimization, it may not be a new product that the EHRs are even putting out there in the market.

But it could also be some of these new partnerships that I, we were just talking about with the Google Health that we're leaning into, and we are opening up and we are having an extension of our platform, but we're, we're doing a lot of the legwork with the workflow so that it's not something that's so risk oriented that. They're going up to a booth at a vibe and wanting to do some work with them. Now they, they can go to their EHR vendor and work with their EHR vendor really to, to bring forth some of this innovation or bring forth some of these areas. I will say to you, I had a nice conversation with one of our ED physicians.

Who said over the past three years, the, for us anyways, I know that this is Meditech specifically, but I, I imagine all EHR vendors have been sending out a lot of changes to our customers to help them during the pandemic. So the, the number of telehealth. Changes and some workflow changes and some new technology that we would help them to make sure that they could get through these three years.

It's been a lot, it's been a lot of code changes. So they also during this timeframe, didn't have the luxury to stop everything, create process process improvement. Initiatives to make sure that they were doing the workflow assessment. So in many cases, a lot of these changes were put in overnight.

So when we talk about optimization, I do think that many of these institutions, these health systems, are really going back and saying, Let's, let's go ahead and see what we've had delivered. Let's make sure that we are maximizing everything with this investment. This is a great time to just hit the hit the slow button in some cases and really make sure that we have all of our processes defined.

Telehealth in a perfect example in some cases you had institutions doing three different telehealth solutions, and now that we're seeing the tide change a little bit. Volume change in certain specialty areas. They can really go back and make meaningful changes, identify where they wanna place their investment.

And in many cases specifically, I know in telehealth they're moving more to affiliated. Does the EHR have a telehealth solution? They might be moving to a telehealth solution. So, Lots here, bill. But I do see that this reflects a lot of what we're seeing at these conferences and hearing from these conferences.

And they're, they're being very pragmatic because they have some very big challenges with inflation and with staffing shortages that, that they need to deal with. That is the here and now.

Yeah, that is here Now, there's, there's a couple interesting phrases from this report. One is COVID 19 led to the bifurcation and providers approaches to their software investments, larger urban organizations with more orientation innovation. Accelerated H C I T investments during the pandemic setting. The challenges posed by Covid 19, they focused on telehealth, clinical systems, so forth, and they say small rural health systems with tighter budgets tapped the brakes during the pandemic and thus fell a little bit further behind.

Let's see. Nearly 45% of providers claim that they spent more on software over the past year. Another one, 40% of providers. A top let's see. Healthcare, it is a top three strategic priority for almost 40% of providers and top five priority for nearly 80%. Be curious what, what the top priorities are for the others.

A third of the providers expect to make significant software investments, but the effect of macro conditions on spending varies, right? So some are gonna make significant investments continue but you know, it feels like there's gonna be a little bit of a retreat here. Just because of the severity of the financial turn that we've seen in some of the reports that we've seen.

So a lot of focus there on the financials, I think, and consolidation. I think this bodes well for the players who are already there. They're trying to figure out how do we do more with the software that we do have? How do we do more with the. Things that we do have. But I think the, the crazy thing about this is we have this financial challenge going on and normally we would deal with this financial challenge cuz it's a single challenge.

Then we're still coming out of the pandemic and there's still, there's still reminisce, there's still RC and other things. I mean, so there's still remnants of that that are going on. And then you have cultural change that's going on as well. You have an uneasiness around clinicians. I think they're, they're.

A little bit exasperated that they can't impact more change. They want to make it better for their patients and they struggle, and some of that's the regulatory environment. Some of that's pre-authorizations and the model they live in, and they, they get frustrated. And so there's, there's. The pandemic, there's that frustration.

And there's that burnout. And so we have this, this shortage right now, even during this shortage, we have an inflation inflationary period. And so there's so many things going on that it's like, okay. I think people have to step back and say, do we really believe technology is going to provide us not the answer or the path, but a path. To greater efficiency A return of, of joy to the practice of medicine to better healthcare experience for the consumers. I think people are gonna have to sit step back and say, do I believe that? And if they do, then they're gonna have to make that bold move of saying, even though times are tight, we still have to continue in, in our investments in this area. Maybe get better at it. Continue to, to push forward knowing that there's, there's something on the other.

I, I agree. And, and to, to that point, we are seeing pockets of it. We ourselves just had our, our customer go live with our genomics product in six months and that's now interfacing with four genomics labs and that's a community hospital that had some great visionary leadership.

And really, really move that forward. Google Health, another one that I think from a physician's standpoint and trust factor, if we can get that right and get that off and running that's, that's something that we're working with them. We're kind of at the forefront.

But that's some technology that's available that's out there in the market by them that I do think is, is potentially a big game changer, especially around frustration. Fatigue, being able to get the information when you need it et cetera. So to your point I do think that we need to bring back that humanity to some of this.

And I know that these are incredibly tough times and it's been an incredibly tough year, I think, for many of the health systems financially. So I'm hopeful that as we turn the corner to 2023, that we get back on track. We. The, the investment in those new innovations, cuz I think that's solely needed, especially on the digital side. And on the consumer side , and let's move forward.

šŸ“ šŸ“ All right. We're gonna be doing webinars a little different this year. I've talked to you a little bit about this. We got together with our advisors. They told us, Hey, you gotta do 'em different. They're just not serving the community well. And we said, what do you want? They said, community generated topics. Great contributors. Not product driven. They want a more honest and open discussion. And they said what we want is not no on-demand webinars. We want once and done type webinars on a consistent date and time. So every first Thursday of the month. Our first one being January 5th first Thursday a month, one o'clock Eastern time. We are gonna be doing a webinar. You can count on it. Put it on your calendar every first Thursday of the month at one o'clock Eastern time. We're gonna do a webinar. The topics are gonna be generated by the community, and we would love to have you there. Our first one, January 5th, priorities for 2023. A CIO discussion with Integrated Delivery Networks, February 2nd, we're gonna come back with Academic Medical Center CIOs talking about their priorities. And then we're gonna hit some of the other great topics that they've given us for the year, and we would love to have you join us again this week, health.com, top right hand corner, it'll have our current webinar and our upcoming webinars. You can sign up right there. And if you miss it, it's not on demand anymore, so. We would love to have you there. Make sure somebody from your team is there taking notes and bringing stuff back to your staff. So we hope that this works out. Any feedback? Go ahead and send us a note. We would love to hear about it. šŸ“ šŸ“

All right. We only have a couple more minutes, so let, let's just touch on this last one. So class reports on shifts in home health, EHR market, and this is really an interview. Between Healthcare Innovation group, who did the article and let's see, class.

Paul Hess from class, senior director of research. And interesting article talking about the requirements for home health and how they're different than really the acute side. Definitely. But even the physical location, ambulatory different As you read this article, what are some of the things that that jumps out?

So I love this article by the way, because we're hearing more and more about home health as part of the population health strategy with health systems. And I do think, again the themes of the pandemic and what has come out of it that has been one of the areas that a lot of these health systems have started to refocus on.

So I think I've told you previously in a, in a different episode that I was very much involved with our home care. Operations out of Atlanta for about three years. And so I lived this life and their, home health, the workflow is completely unique. the scheduling down to the scheduling is, is very unique.

You have the the nurse that's going in their car, driving out with their vehicles to the various locations, they're taking care of their patient. They're doing their documentation and then they're going on to the next house. So one of the things that you're looking for, and this is where I think a lot of the workflow and where the if you're gonna go with an EHR system such as like a Meditech or an Epic or whoever.

You're going to want to make sure that your health system can deal with those workflows, that the scheduling component is not out of an EHR scheduling. They're taking in the nuances of understanding how far you need to drive. So making sure that all the schedules are within a particular area for efficiency.

They're matching who the care provider with the patient, so you have the right person, whether it's language or whatnot. You're making sure. Your home care agency, not everyone has the depending on if you're a rural or even a, a high skyscraper in a urban city, they're not gonna always have the connection to the internet.

And so can you be in a disconnected state? And then can you, when you get to one of those things that you have access points, you can reconnect to the ehr. So you can do your visit documentation and come back. A lot goes into this and talk about regulatory. This is a highly regulatory area. And I know that there's some opportunities right now with hospice as well.

So many of our customers. Anyways, when they're looking at our platform, they're looking at our home health and hospice offerings as well as part of those solution areas. Fantastic.

Christine, I want to thank you for joining us. Hope. Hope you have a great holiday. Living up there, you probably will see nothing but Norman Rockwell photos as you leave your house is my guess.

Yes, it's, it. Sometimes I feel like it does feel like you're in a little bit of a snow globe up here in New England, but we enjoy it. It gets us our sense of humor. So by the time that spring rolls around and we get our mud season, that's what we call it up here in the springtime we usually have some very happy people because we, we've gone through a long couple of months, but looking forward to the holidays and honestly, bill, it was great seeing you.

At the Chime event in the fall. And it was great seeing everyone that showed up because it just feels, it feels like it's the right time to get everyone back together. And we have some really incredible challenges ahead of us, but some really thoughtful and smart people that are dedicated to this and passionate to really make a difference.

Yeah, I, I agree. And by the way, the mud season, when I lived in New Hampshire, mud season was only one of them. My other favorite was black fly season. It was actually a black fly season. It just cracked me up.

Absolutely .

Love it. look forward to catching up next year.

Thank you, šŸ“ bill.

What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to show just like this one. It's conference level value every week. They can subscribe on our website thisweekhealth.com. They can also subscribe wherever they listen to podcasts. Apple, Google, Overcast. You get the picture. We are everywhere. Go ahead. Subscribe today. We want to thank our news day sponsors who are investing in our mission to develop the next generation of health leaders. Those are CrowdStrike, Proofpoint, šŸ“ Clearsense, MEDITECH, Cedars-Sinai Accelerator, Talkdesk and DrFirst. Thanks for listening. That's all for now.

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