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September 9, 2022: Healthcare is looking for a robust, integrated, person-centered record that can operate across multiple care delivery environments and bring efficiency and less friction across the patient and consumer health experience. MEDITECH Expanse rated 82.9 in the latest KLAS report on EHRs. The EHR has always been the system of record. Where does it go from here? What is the future? Helen Waters, Executive VP and COO for MEDITECH joins us today. Where is the market taking MEDITECH? What is their approach to usability and preventing burnout? What about interoperability? Can MEDITECH offer sustainability amongst the rising cost burdens on healthcare organizations? What is their approach to patient-centered care? How will MEDITECH continue to challenge the market moving forward?

Key Points:

  • It took a lot of courage to hit a pause button while meaningful use was going
  • on to develop Expanse
  • The evolution of value based care will continue to place demands on electronic health records that MEDITECH is very prepared to meet
  • Our goal is always to make technology affordable and scalable
  • MEDITECH WEBSITE
  • MEDITECH BLOG
  • MEDITECH PODCAST

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Transcript

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Today on This Week Health.

Healthcare is looking for a robust integrated person-centered record that can operate across multiple care delivery environment and bring with efficiency and less friction, the patient and consumer health experience.

Thanks for joining us on This Week Health Keynote. 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 our Keynote show sponsors Sirius Healthcare, VMware, Transcarent, Press Ganey, Semperis and Veritas for choosing to invest in our mission to develop the next generation of health 📍 leaders.

All right. Today we're joined by Helen Waters, Executive VP and COO for MEDITECH. Helen welcome to the show.

Good morning, bill. Great to be with you.

Yeah, I'm looking forward to the conversation. we got together the last time at the hymns conference and it's been a little while. Back then, we were talking about the Google. Partnership and you guys were doing some interesting things there. Today I wanna focus on the EHR world and the EHR market and really get your take on what's going on. But I'll start with this. The class report on Meditech is really impressive. Congratulations on that.

Thank you so much. We have been busy these last several years, rebuilding our company in particular, the platform for the future of healthcare it, and in particular, the EHR space. And we've been really pleased with how our customers have viewed the integration, the usability, the personalization of the platform, and are thrilled with the results.

And as we often say, The job is never done, right? The goal is continue to listen and learn and understand what would be most pleasing for our customers and how to deliver on it for them. So thank you. We're happy with them as well.

I hear conversations all the time where people are, they, they consider the EHR a two, two horse race, really? And these numbers paint a very different picture. It's almost like Meditech is the insurgent startup challenging the status quo. You you've really been around since the start of the industry.

years we were founded back in:

There was many in the market. I, the question that was at that C and standing, we knew and never self doubted back then, but many did. And I think the class scores have proven out both the 10. And the ability for the company to reinvent itself with all of its vast experience and passion and pride for what we do, which is desiring to really impact he in the broad sense. And also obviously didn't do that through it. We've come roaring back and I think the message to the market is not to presume a legacy view of this company or what we sell or what we do, but to assume that our staying power and the tenacity is. Actually rebirth the company that is very much well positioned given the platform.

And I think the numbers show that we have come in a very close second in the overall scores, our eighth year being best in class for a number of categories. I think the notable difference in distinction this year is just the growth in each of the categories, including market share gains adding new hospitals, retaining more customers, given the strains of the platform.

And I think that the biggest misconception probably doesn't exist is just that we're a small community based rural hospital system. Very much not the case. And we can talk more about why I believe that. And the examples of where I think we've shown the depth and diversity in our base in terms of size and scale.

let's look at some of those numbers in a little more depth here. So class rating, epic 87.7, Meditech expands 82.9, Cerner 72, Allscripts 66.5 closer to epic than I think most would've imagined and significant distance from Cerner. Do you think this represents a change in what healthcare is looking for from an EHR partner?

I do. I think that there's a really fundamental difference between all of our orientations in terms of where we came from. But healthcare is looking for a robust integrated person-centered record that can operate across multiple care delivery environment and bring with efficiency and less friction, the patient and consumer health experience through whatever digital front door they wanna walk through and certainly help from a clinical perspective, release all the cognitive burden and load that physicians and nurses in particular feeling. And I think fundamentally people wanna do that with an integrated record. But they're looking in a partner for continued progressive ways to deliver the user experience.

Continued progressive ways to embrace innovation and augment the electronic health record as not the be all end all, but a very significant component that should be allowed to exist, but also coexist with a platform perspective a more innovation coming from a broad spectrum of partners. And that's an exciting piece that I think we brought to the equation.

I think today in time as has always been fundamental to our. Healthcare organizations are under a lot of pressure from a cost perspective, a labor shortage supply chain cost increases a burnt out workforce. And so they wanna do all that needs to be done in focus on the value of the system.

They have. Expansion to consider they have hiring to consider we deliver a whole lot of value in this platform. And I think those numbers show that in terms of sophistication, relative to epic or any other system that's out there.

It's interesting more from the class report it's number two best overall software suite number one, acute care EMR for community hospital, number two for large IDN.

And I think the thing that's interesting to me about that is cloud based. Solution, you guys wrote a cloud-based solution as opposed to just hosting it in the cloud as as a lot of people do. And I think that's one of the differentiators. The second is in that large IDN space, I think if you look at feature functionality and whatnot, and you compared the cost, not only of acquisition, but the cost of running. that's the thing as a CIO, as a former customer of Meditech when I was CIO the overall cost, cause I looked at it versus the competitors to operate, it was a significant annual amount, less than operating the competitors in this space.

I would attribute that so great points on the class report and the highlights, but our goal is always to make technology affordable and scalable. We don't sell a scale down solution. In fact, we sell a very scalable solution. You noted that the acknowledgement of us in the larger IDN space but we've always focused on the fact that being cost effective was important to healthcare. I think the goal of meaningful use and the enormous spend that went on was to drive down the percentage of GDP and improve the efficiency of healthcare.

It wasn't to dummy it down. It wasn't to necessarily give less capable software. The software capability should be expounded upon. From our perspective, we always thought that we could deliver a very value based and value driven system to both acquire it and then to own and operate it. And there's a lot of reasons that go into that.

But our cost of ownership has always been significantly less than the competi. Which by the way, from a software perspective technology should go down and cost over time. There's much about the HR invest. That's been around for decades. Instead of it scaling up, technically in concept in dynamics of business, it should have been coming down over time.

We've stayed, tried and true to the fact that we want to. Be successful. Obviously we live in a capitalistic society. We wanna make money, but we never intended to burden the industry with the cost of ownership in a manner in which I think a lot of the HR system did and that has just expound and grown.

So I think our staying true to our roots on affordability has been critical. We don't believe in compromising the quality of the system or the EHR or the depth of sophistication. When you talk about advanced capabilities like surveillance and delivering proactive care and understanding populations of patients and significant registries and advanced analytics.

All of that is in our system, which is reflective in those class scores. We just have figured out how to stay in true lockstep with the industry, with regard to delivering a whole lot of value at a price point that is both affordable to acquire, but also maintain. And I think the industry's turning its attention back to that. We've been very successful. And replacing competitor systems based on that, on that.

Yeah I hear the word sustainable costs being used more and more by CIOs. I was talking to a CIO the other day and they, it wasn't the EHR, but they were replacing another system and it was one of the top tier systems they were replacing.

And I was like, why would you replace that? It's a great system. He's like, it's not sustainable. We can't afford it. Right. they keep increasing the cost. They keep increasing functionality that we're not using. And so he said we actually went back and looked at it not only from a sustainability standpoint, but the features we're actually using and using effectively.

And he is like what we found is we bought this thing and we aren't using a third of it, if not two thirds of it. And the things we actually needed to do, the system that we're implementing, which is much more sustainable in cost is just gonna be a better fit for us. And we've just entered a different time in healthcare where the low Mar I mean, there's been a lot of things this year. It's labor, shortages, competition, escalating costs lower reimbursements, supply chain challenges. There's a lot of challenges for healthcare. They need the money to not be going to software.

They need the money to be going to towards really focusing in on what they do best, which is providing care for that community.

I couldn't agree with you more one of the, Largest customers we have, and we have several right that are larger IDNs with facilities that are 10 and up to 40 facilities using the Meditech system under the umbrella.

Health is one and Stuart is another one. The biggest customer we have is HCA and HCA who technically could afford whatever system they has decided to move forward with the expand platform. And they operate today multiple markets through acquisition with the Cerner system. And they operate the epic system in a rather substantial market in Utah.

They've been doing that for over a decade. They're a value based customer. They don't sacrifice quality, but they don't chase shiny objects either. And we're really excited that they have decided elected to move forward with Meditech for their facilities, which go from 50 beds to 800 beds. Based on the fact that the software has a depth and capacity, it require.

It's got advanced capabilities that are absolutely important and critical in today's modern healthcare delivery system. And that's called a smart system. It's got the mega suite that Gartner would to addressing analytics and pop health and the components of even a genomics element. And we wonder about parents wear in terms of a bakeoff.

And I think that that speaks to the fact that you've gotta have central components that are modern today and. But you can deliver all of that in an affordable price point and partner with the industry. Keep focus margins, where they belong, as you said, it shouldn't be all consumed at six and seven and 8% of a operating budget in an EHR should be distributed to other investments.

And by the way, new innovations that will come about it should be augmenting the EHR, expanding the facilities strong recruitment and investment in training and capacity of your staff and employees not wrapped up in technology.

So take me back, take me back a couple years you've been there for a while. so expanse is sort of a glimmer in people's eyes. There's a lot of courageous decisions that are made there. In terms of building the ambulatory from the ground up building it as a cloud platform from a design standpoint and there's gonna be a couple of years where you're really gonna be heads down, have to build this thing out.

take us back to that time. what were the conversations around that? What were you looking at in the industry? In trying to get ahead of the curve that was happen?

Yeah. So you mentioned courage. It took a lot of courage. I think, to hit a pause button while meaningful use was going on, we had a existing legacy platform that were very deep.

We had a market that was beginning its migration towards consolidation at massive levels that were unforeseen larger academic medical centers and urban medical centers buying up all kinds of community and rural hospital. The promise of. Approach was lower cost, more efficiency, happier physicians and patients, and arguably that's been debated well in the industry.

And I think continues to be we decided that we were thinking about Meditech for the next decades and beyond. We had had a 50 year history of impact in healthcare. By the way we went. That no one else cared to. We didn't go to the most glamorous market. We took technology and clinical systems to areas across north America and the world that made a difference in how care was delivered and delivered modern tools in the hands of people who were working hard to care for patients, we decided that the ambulatory component would be central obviously to the future healthcare.

So we hit a pause button and instead of partnering with a standalone ambulatory vendor, which. One of the approaches we could have taken. We said that we would stay true to ourselves in terms of building tools that would be naturally integrated off of a core technology and platform, but we would take the enormous step of moving to a web-based platform, which was critical for the future.

We would set ourselves up to be able to operate in the cloud. We would build to cloud native applications to really modernize the solution. And we would focus on the usability factor first and foremost, to release from the clinical perspective being tethered to cows for nurses, or to desktops for physicians and put more mobility in their hands with a better user interface than previous legacy systems had done.

And so we pioneered really the web based component. I think from a clinical perspective we decided that workflows were number one. We would deliver more content in this system than we had previously. We would transition our whole development approach to agile. And we would fundamentally reinvent ourselves, which is what we did.

We took everything that was known and respect about Meditech, but we brought it into an era that was now changing rapidly and positioned ourselves to be an electronic health. But also to be a significant player in terms of the user experience and creating a platform for the future growth and evolution of healthcare, which will be more open and will engage more innovators, which we think is a good thing for healthcare.

We took the right path and it took a while to get there, but fundamentally as the scores would reflect from the. Ratings, we've done a great job. And what we love is that the job continues, the work continues and our passion for what we do. When GE was in the market in Siemens and McKesson, And IBM and many others over time.

A lot of people said you'll, you'll never be able to keep up Allscripts as well, who bought really strong companies and absorbed them all under an umbrella. Bigger was presumed to be better. Bigger was presumed to be more innovative and agile and well resourced. What we have proven is that what really matters in success and in.

For us. And for many companies is a passion and a commitment and a love for what you do. And our passion and commitment is as deep for healthcare and having a widespread impact through the use of digital technology and tools. That's gonna make a difference to ultimately a person in a bed and their outcomes and how they're treated.

And that's fundamentally been in our DNA for decades. It exists today and it's been evolved to address the modern customer and the modern market needs in terms of platform and the.

📍 📍 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. 📍 📍

Helen. I love, I love your passion around this. It's really exciting to see. How long have you been at Meditech? Just out of outta curiosity,

I was hoping was the one wouldn't Medi in I, another company for just shy of five years and had lived through a bit of a merger at that company. Didn't wanna relocate came here with the expectation that I would stop in and see. Software looked like from another angle and fell in love with the software industry, which is where I come from, but also the merging of healthcare and technology.

I had worked in hospitals. I have a lot of family members that were clinicians and caregivers, and I, I found a home that I was deeply passionate and connected with and a terrific community of strong. Good people who cared about what we did and focused on having an impact. Maybe not always thinking we would to biggest company and do everything for everyone, but we would widespread impact their success. I really job in that regard.

All right. Let's talk about the future a little bit. The EHR has always been the system of record. How do you see it evolving into a platform of really a platform for innovation, I guess?

So I think innovation is one of those words that's highly utilized today and means a lot of different things. I think for us, we see and envision a more open ecosystem looking. forward We desire to be a fully fire client and server enabled healthcare data platform. So we are, if somebody once eloquently stated we're the pilings underneath the water, upon which the stanchions were built to connect all these bridges in healthcare.

And we're proud of that history and it's deep in important work to. But we wanna transition now to continue to do that work, but also elevate the discussion and dialogue around being a data platform whose tools will actually enable nationwide healthcare data exchange. And it doesn't all have to be in a Meditech system.

There's a difference. We will have products that have streamlined workflows that support. Data offered within Meditech, but that also supports the same data authored by outside sources and that we will integrate into the true altruistic goal that we have had as a nation forever. My data goes with me of my choosing as a person and in order for me to get the very best care.

possible And the mandate that's gone on in our country, that that must all be on a single system, or you can get care everywhere. Provided us on one technology is dated. And so our belief is that we will lean in to what is the right direction for our country and for the general concept of strong and good patient care and ease a burden of clinicians by creating an ecosystem that absolutely supports that.

And we're excited and supportive in addition to the fact. that We also believe consumers should have choice in healthcare provider organizations of consumers, of tools. We don't wanna build a CRM system for customers. There are really good companies that do that and do that well. So we wanna provide the ecosystem and the platform that says you choose a CRM from another vendor.

We embrace and welcome and open that capacity up for our system to exchange information. We don't believe in this day and age with this much innovation and talent going around in the tech world, in the digital space that we can be all things to all people. So how do we further healthcare's option to achieve and utilize tools that they so choose you open up and become a more open platform to do that. And that's, I think the decided difference between us and other companies right now.

Yeah. that is a. Distinct difference. Being able to utilize the platforms you already have for things like CRM and whatnot, and not be tied into something that the EHR provider is bringing along. Let me ask you this. We talked talking about this ecosystem and allowing other organizations to come in. We talked about Google health partnership for how is that? Progressing at this point

incredibly well. Right. We elected, it's a great example of us leaning into change. We elected to work with Google because they are a powerhouse at some very deep capabilities that would merge with our assets. We thought we'd deliver a better user experience. So our concept with them is to really. Embed search capacity in our system, which is something that they Excel at exceedingly better than anyone else in the universe.

And to leverage some of their tool. To also help summarize a record. Right? So if we can search deeply, not just off of a live expands database with some converted information, we wanna bring the benefit of all the legacy information on a patient that might have been generated from a Meditech legacy tool, or quite honestly, from another vendor source, because we can data map that and the summarization capability brings to the forefront insights about that patient.

As the physician determines it would be helpful in their decision making. So we are searching deeply and we're summarizing based on legacy data on that person based on interoperable data on that person. And based on a set of database that might be existing in another vendor system. So our goal is to really take the assets and the significant skills that Google does really well and merge them with the experience and need knowledge that we have a healthcare and provide a better user experience.

Physicians wanna see as much as they can on a patient as easily as they can often to make the right decision. But these records are big and they are difficult sometimes to comb through the advanced capabilities that Google will bring in terms of some of their machine learning and AI capabilities and their extremely talented algorithms for searching and summarizing will make a difference when blended with expense electronic health records for nurses and.

doctors

Yeah, it's a pretty interesting technology. So you guys listen to the industry extremely well. I mean, you're constantly having groups come in, you have conversations, you host conference, bring, bring people in to have conversations that this is probably the last future leaning question, but where are they taking you and where do you think you can continue to, to challenge the status quo within the EHR space and really unlock the potential of the caregivers and potentially health of the communities that they serve.

Yeah. So I, I still think there's plenty of work for all of us to continue to do in the sense that there are significant drivers in healthcare and you've alluded to a few of them.

First of all, the whole patient and consumer health experience and how we can continue to support a left friction oriented encounter. Right. And so. We've done that through a number of advanced tools that allow patients to ly engaging and confirming appointments and enrolled in specific programs for their diseases.

And there's there's work to be done. I talked about interoperability, I think care coordination and the evolution of value based care will continue to place demands on the electronic health records that. Very prepared to meet. I think one of the things we haven't talked about yet is just the whole concept of where healthcare heads next, which is into a more personalized healthcare experience.

And I don't mean from the standpoint of the health system, knowing me, I meant personalized in the sense of what's happening for me. And that really gets down to the concept of genomics and embedding genomic testing. Capabilities in a more digitalized fashion than has been done before today in time, any kind genetic data that is ordered for a patient and sent out typically comes back on a piece of paper and that gets scanned into record and it gets put somewhere what we've done already.

And we intend to take significantly farther is embedded the electronic ordering capacity. And then the consumption of that genetic profile back into electronic health records so that it is actionable. So when we think about a patient in a real world experience, which is happening today, who has a certain genomic set of results, and we're gonna do some ordering of a specific medication, our ability to take their lab information from that genetic set of.

And combine it with some evidence around certain medication alternatives for. And the processing of really pharmacogenomics so that the patient can be looked at as an individual. We're not just gonna give them a class of drugs. We're gonna look at them as an individual and decide which class of drugs would potentially be best for them.

Whereas the matching of that patient's genomic sequence and metabolism. Against what medications could be ordered for them. So we're getting down to a specific med for a specific person that we think will provide a much better outcome. So I think personalized healthcare is the future. I think our ability to integrate that in a more electronic way has made a fundamental difference for our customers.

And I think at the end of the day, what inspires us most is that if we can identify and know an individual and what will work best for them in this case, we're talking medication, but there's so much future potential in genomic medicine and precision medicine. We're excited about the fact that we're making a difference.

It impacts cost. It impacts the outcome, and it impacts the experience of that individual to to get better, faster and quicker with the right meds. So genomic medicine and personalized healthcare, I think is the future for us. I think that's an area that we will explore a lot more deeply. We're excited about where we are with it today, but fundamentally the data sets and doing more with them.

Now we've been collecting medical record data for years. So the question is how do we take it and have it be more meaningfully absorbed and utilized in the actual treatment. And I think genomic medicine does that, but I also think doing more analytics on a larger scale to understand populations of patients what it means, what it's doing in terms of chronic condition management and advancement, lots of opportunity for EHR is there.

So I still think it's a vibrant industry. I think we'll be competing effectively on a number of different fronts with new innovator. I think you have to know what you do well and focus on what you do well, but I still think there's a lot of elasticity left for electronic health records to deliver real value and efficiency to healthcare.

one of the reasons we shot away from genomics in storing that genomic data, the results is one thing, cuz it's just a paper document and discrete data fields, pretty easy. It's just. It's unruly. It's big. It's huge. It's unruly. It's hard to search and whatnot. Have we gotten past that from a technical standpoint?

I, I think so. I mean, if we're consuming it as discrete results, then we're getting past that to be able to find the data, which is what wasn't happening. So when you get hundreds of pages of a test that was done, and as I mentioned, most of it would've been scanned and dumped in somewhere. I think our focus initially on making.

Genomic information valuable is very targeted to the pharmacogenomic part, right? So we're specifically looking at that gene sequencing and understanding deeply the whole pharmaco aspect of it to decide how do we treat this person with the right medication? But I do think over time there'll be much broader potential use cases and it, and not too wide, too fast.

Right. There's a lot, that's controversial about genomics that, but I think if you. A certain level of condition if you're in treatment for a certain form of disease, that, that, that genomic information will continue to be one of the most valuable things that can be enhanced in determining treatment in determining the right regimens in determining the right cadence of medications that can be given. I think people will continue to embrace it over time as it's about me and not about the person next to me who might metabolize and be treated very differently based on the genomic.

I'm not sure this last thing is a question more than a statement. I was doing some research prior to this and I, I hit the Meditech site and looked at the leadership team and a health tech company with a leadership team that has a CEO, CFO, COO general counsel a significant portion of your leadership team is women, which is which is fantastic.

It's a conversation we have. A lot on this show. Just about the the disparity between the number of of men in tech positions versus women, and you guys appear to be a women led organization. I don't know if there's a question there I'm just how is that evolved as a culture?

So I would say it evolved under the the direction of. Bright and talented men who thought that obviously this workforce would be well served by female. We have lived and worked in a culture that was very accepting of talent versus just what the gender was very aware of. The policies and the Benefits that helped working women stay in the workforce.

Always gracious about changes in life and lifestyle as females would be off. Perhaps starting a family working part-time telecommuting way before pandemic years, where there was just a lot of flexibility and consideration given to where you were in your life. And the fact that you could balance a really strong career and have a life at the same.

And I think a lot of females came here and stayed here. I also think that the culture of the company. Was just very accepting of people that worked hard and did a great job. There was never really any gender bias that we had in our company. And I think we had a degree of humility about men that just said, we put the right person in the right job for the right reason, doesn't matter who they are.

And it doesn't matter what their gender is. And we've all been really fortunate in that sense. So there are I. A number of officers that are women. And then we have an associate vice president level underneath that. That's about 50 50. And by the way, we have incredibly talented men that work here.

So we continue to be gender, not biased, but just aware of the kind of people that can help drive this company forward, successfully carry on the passion and commitment that we. But drive forward in terms of growth and that will be a combination of men and women, but you, something that a lot of people do bring, give all that credit to. Our Larry Paulino and Howard met, worked really hard to the right in the seat.

Well, talk about the tenure as well. I mean, cuz the tenure there is is pretty impressive as well. I mean the longevity of the people who work there is, is pretty impressive.

Right. Agreed. I think there was a strong connection that many of us made to the mission of what Meditech was here to do, which I keep saying. And I'll just say one more time was have a broad impact on healthcare, the delivery of healthcare and the vehicle by which we would do that with technology. So for most of us, while we're not laying hands on a patient, For most of us, we consume healthcare. Every person on the planet does, and we could connect with the mission of how to.

Organizations of all sizes and shapes be able to deliver healthcare with efficiency and with the idea of the best possible outcome for the person in that bed and in that exam room. And so I think we had a deep connection to what our company was originally founded on, which was to make a difference.

We had a deep connection to the pride that we have and how well we do. I believe that our, our founders also instilled in us just a great sense of community. A lot of us. Worked with people here as much as we absolutely promote from within, we have welcomed a number of different generations in this company.

And we spend a lot of time today thinking about the future leaders of the company. So I think that the tenure has been a little bit unusual rooted in our deep belief that we're making a difference from many, many people on the planet. And. I think that our our humility with regard to where we do that and how we do that has, has been something that kind of connected us all over the years.

the people that are most in need of digital tools in healthcare are not always in the biggest cities. They're the biggest institutions. They're everywhere in, in our country and in Canada and across the globe. And we've gone to those places very proudly because we believe we're making a fundamental difference in care in the way it's delivered. And that's, what's kept us founded together.

Fantastic, Helen. It is always a pleasure to catch up with you. I love your passion for what you're doing, and I love the the work that your team is doing at Meditech. Thank you again for your time.

Great to see you, bill. Appreciate. Thanks.

What a great discussion. If you know someone that might benefit from a channel like this, from these kinds of discussions, go ahead and forward them a note. I know if I were a CIO today, I would have every one of my team members listening to a show like this one. It's conference level value every week. They can subscribe on our website thisweekhealth.com or wherever you listen to podcasts. Apple, Google, Overcast, everywhere. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our Keynote sponsors who are investing in our mission to develop the next generation of health leaders. Those are Sirius Healthcare. VMware, Transcarent, Press Ganey, Semperis and Veritas. Thanks for listening. That's all for now.

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