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Welcome to this week in Health. It. It's Tuesday Newsday, where we look at the news, which will impact health it today. Epic takes heat from employees and adjusts their course. Uh, HIMSS announces new dates, patient id, chaos in compliance, and telehealth is here to stay. I think my name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health it a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

This episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare. Now we're exiting the series and Sirius has stepped out to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts during the crisis and beyond.

If you haven't signed up for three X Directs yet, you are missing out text. Drex, DREX to 4 8 4 8 4 8 and receive three texts every week with stories that will help you to stay current. Uh, it helps me prepare for the show. This is a service of Drex to Ford, a frequent. Contributor of the show now onto the news.

Uh, I wanna do something in the first 10 minutes of the show before I jump to the news that I haven't done before. I'm gonna go through the headlines in Modern Healthcare and just riff a little off the headlines themselves. Uh, just trying something out to see how it goes, and then we'll jump into the stories that I have selected.

So, you know, this idea came 'cause I was just . Shocked. I, you know, I'm sitting here looking at the modern healthcare, uh, website, and by the way, all this stuff is behind a paywall. And unless you work for a health system, in which case just walk around, you'll find a copy of Modern Healthcare sitting around somewhere.

There were so many great headlines that, uh, I didn't, I I just, I thought this is, it would be interesting just to, just to riff now, I haven't read these stories. I am just going . Off the headline. Okay, so, so cut me a little slack here. I'm trying something new. The first story here is Kaiser Permanente posts 4.5 billion in Q two net income.

Couple things jump out at me, uh, with this. One of the things we did when I was ACIO is we created a thing called it university and part of the IT university was we had, uh, . Uh, people from my team and my direct reports and myself each had to lead a class. So we had to teach a class had to be at least, uh, you know, four hours in duration.

And the CFO for my group decided to teach a class on understanding healthcare finance and understanding how to create a budget for within health It. And it was interesting when he created the class. It was a, it was a really well, uh, attended and received class. As you can imagine, uh, a lot of people don't understand healthcare, finance and how healthcare, healthcare organizations make money and, you know, all the money they give to public good and how they, you know, all those things.

So that was an interesting conversation in and of itself. But he, he covered a lot of things like operating income. And what that means and how we look at those things. And we, we looked at, uh, I don't think the word is endowments, but the investments that healthcare organizations have. And when I'm reading this, this, uh, headline, the first thing that pops out at me is Kaiser posted a four, four and a half billion dollars net income in Q two.

Okay. So the first thing you have to ask is how much of that is operating income? And I don't know, I haven't read the story, but I would imagine a fair amount of that's operating income. They probably used the crisis as an opportunity to reduce costs. Uh, so they probably had a, uh, percentage or two drop in costs.

They had an increase in revenue because Kaiser is a. Payer and a provider. So anytime somebody tries to compare your health system with Kaiser, you have to ask how much of the percentage of your bus overall business is, is as a payer. Right? So that's not always a good a, a good comparison. So the reason I I, I look at this story is to say, understand what you're reading.

When you read these things, understand the comparisons that are being made. 'cause you could just go down on the same page. Down to the bottom here, and it says, mass General Brigham reports 12% loss, uh, in margin amid patient care drought. And so what they're, you have to look at the timelines. and you have to look at, uh, what they're actually talking about.

The, the first was talking about, uh, net income. The bottom one's talking about a margin drop and margin drops happen when profitable business, when you're doing less profitable business and some of your profitable businesses dropped out. So when we stopped doing elective procedures, that was very profitable business and we started doing more covid that maybe wasn't as profitable of a type of business.

So I cover that to say, you know, as healthcare IT leaders, uh, within the organization, part of our job is to help our, our organization and our people to understand the, the, the finance of healthcare. The finance of healthcare, it, where the money's coming from and how that money, uh, should get allocated to drive what's best for the community, not only best for the community, but also is good for the business to keep it going.

Okay. Uh, next story was he nine. Healthcare policies at Stake If Congress, uh, c Ovid 19 package stalls. You know, I am actually gonna pull this up. Just see what the nine are. More provider relief fund money, uh, could be at risk relaxing, Medicare loan terms, liability protections, telehealth, policy extension, uh, COVID 19 testing funds, state and local funding.

You know, it's interesting as I read that article as I just hit those headlines real quick. This is an alarmist article. How I read this is, you know, first of all, there is gonna be something passed, right? So this is one of those things that you ratchet up the pressure by writing these kind of articles, getting people, uh, concerned about things so that they push this thing forward.

And, uh, that's. Generally speaking, how I read this article, I don't think, first of all, I think telehealth is gonna continue. I think this package is going to pass. We're not gonna have to worry about additional funding coming down to hospitals. They're the largest employers in all these states. There's an election going on, no party wants to tick off the electorate during an election.

Uh, so that's how I read that. Uh. Let's see, epic Systems makes return to, in-person work voluntary. I'm gonna come back to that story because uh, it's actually one of the stories we're covering. 'cause I, uh, when I picked the stories, it was that the epic, uh, employees had responded unfavorably. The reason I pulled that article out is because I think we're all gonna have to face that.

How are we gonna bring our employees back? Is it gonna be a voluntary thing? Is it not gonna be a voluntary thing? Uh, and what are we gonna do when people just refuse to come back? And so I wanna talk about that a little bit, a little bit in the, uh, so what, in that story, when we take a look at it, I'm not taking a look at it to say, Hey, epic did this right or this wrong.

I'm really looking at it to say, what can we learn from that? Because we're gonna have to do something similar, uh, in the not too distant future. I. Then there's, uh, of course Trump orders to defund Medicare social securities and, uh, social security encroaches on Congress's power to invite challenges.

Again, another one of those stories that's written mostly to, uh, to agitate people and get them, uh, excited For the most part, the, the executive order that he signed. Doesn't really do much. , I think if, if you read into it, it, it, it authorizes people to go in directions, but it, it doesn't, in and of itself doesn't appear to do much from what I'm reading.

But it does do the, it does do what it is intended to do. Which it takes the ground away from the opponents so that they are forced to, uh, the negotiating table and it moves it forward in a little fashion. And at least that's the political maneuvering that's going on. Again, not a political show. I'm not commenting on it, I'm just saying that's how I read this as a, as ACIO I'm sort of reading this going, Hey, there's really nothing I need to

Worry about here because this is gonna be, this is gonna play out. Like all of these things play out, which is eventually, uh, there's enough pressure, a deal gets done and all that stuff gets, gets taken care of. The, the funding, the telehealth and all that other stuff gets taken care of. So there's nothing for me to really function from.

I can get agitated by these stories 'cause that's why they're written. But it, it doesn't really do anyone any good. Uh, I think there's two stories here that are really fascinating and relevant for us. One is emergency department visits continue to lag, uh, post covid. Right? I, again, I haven't, I'm just reading the, the article.

This is not surprising to me. We did a good job of moving, I've said this before, we did a good job of, of telling people, Hey, stop coming into the emergency department, uh, because we need to do social distancing and we need to create a safe environment. Well, we went, went ahead and . Created those safe environments and now people aren't coming back because people generally are still making a lot of decisions out of fear.

And so it's our job to help them to overcome that fear. But we have to present the compelling case. Why should they come back to the emergency department? And uh, a lot of them are choosing to use telehealth, which is good. Right. And a lot of them are, are, are trying to use, uh, different avenues to get care, which is interesting 'cause the very next article is rethinking Ed Waiting Rooms in Response to C Ovid 19.

And I think that is where we need to go. This is a very relevant conversation for healthcare and healthcare. it right. Emergency department visits continue to lag and rethinking the ED waiting rooms in response to c Ovid 19. No one, uh, I don't sit in a waiting room now to get my hair cut. Why would I sit in a waiting room full of sick people to go see a doctor?

Right? That's, we've changed the, we've changed how people think about waiting rooms, and we need to think about how we have designed our hospitals and maybe how we have to redesign our hospitals. You know, I know for me, going to get my haircut, I make an appointment, I show up, I stay outside, they come out and get me.

I go in, get my hair cut with a mask on, and. The whole thing and I get outta there. I think I'm outta there in 15 minutes, so I'm only exposed to someone else for like 15 minutes. You know, it doesn't reduce my risk down to zero, but I, I use that story to say there is probably an opportunity for us to sit down and rethink waiting rooms, and technology will have a role in that for sure.

Let's see. Healthcare industry. Uh, forged new supply chains in the fight against c Ovid 19. There's definitely a technology play there. Next story, I, I see how Mercy Hospitals closure could hobble Chicago South Side Healthcare, roughly 300 fewer beds on Chicago South side where residents have long been disproportionately affected by chronic conditions.

And now, c Ovid 19, we're going to continue to, this is one of the things we expected out of Covid, that if you did not have a well-funded hospital, if you did not have an, uh, a hospital that was potentially . Well funded and op and, and operating at a high efficiency that those hospitals were gonna be hobbled so much that they may not recover.

And we're starting to see that. And so there are gonna be gaps that are created in uh, uh, certain areas, rural areas. Some as they say, disproportionately affected. Areas and, and that is gonna be, you know, something that needs to be addressed. Something that from a health IT perspective, I read that and I say, yeah, there's gonna be a bunch of these.

And if I'm with a larger health system, I'm thinking, you know, there's gonna be a bunch of expansion that we're gonna do. Either fill these gaps or through m and a, that is gonna be coming down the pike. That's how I read that story. Um. Let's see, blue Cross claims returning to pre c Ovid 19 levels. Uh, that's not surprising to me.

We, we saw the claims data bounce back to about 85%. That was back in April, may, we saw back at, uh, 85%. It doesn't surprise me that it's almost back up, uh, to a hundred percent. Uh, here's an interesting health it story. VA resumes rollout of $16 billion. Cerner, EHR project. I don't think there's any project in the country that has more scrutiny.

Then this project in terms of an EHR rollout, and, uh, it's gonna have, uh, you know, again, it's $16 billion in its implementation. So it has a lot of interests, let's say it that way. There's a lot of interests fighting around this, and there are some that would like to see it fail. I. So that it might go to a different EHR uh, vendor.

There are, you know, there's ways to make political points by pointing out some of the deficiencies and things that are going on. So again, this is a, if I were the CIO for this project, this is a extremely challenging project. I would, uh, you know, I would cross my t's, dot my i's, I would make sure that we were doing, you know, piloted projects, ensure minimizing the risk.

I. And make sure that that goes well. So that's my, this is the first time I'm trying this. I think it's, I, you know, I think it's interesting you guys can tell me, bill it this week in health it.com. Is it interesting? Is it not interesting? We will find out. All right, so we are taking a look at, uh, a bunch of stories this week that have come down the pike.

Let's start with, let's start with the Epic story. Right. So you wanna hear about that Epic Faces employee backlash. This is healthcare IT news. And because we only report out on Tuesday, this was from last week, and it said essentially that frustrated staffers at the Verona campus alleged indifference from upper management to the health risks and say there have been efforts to quash descent.

Some say they're looking to U unionize in response. Okay, so Epic, CEO Judy Faulkner wrote in a July company-wide email. It's hard, actually, it's impossible to retain our culture when we are working from our homes. She added, uh, creativity, innovation, and serendipity suffer, which can be fatal to a company like ours that is constantly needing to create new products and new features.

But employees are wary of returning to work in Wisconsin, where the, uh, coronavirus spread is currently described as uncontrolled. According to a Covid 19 exit strategy with 6.1 positivity rate. And then it goes on to talk about the World Health Organization. Uh, a couple other things. Uh, and so letting people work from home during the pandemic is, uh, one-sided trade off.

The company loses almost nothing. Cultural culture hardly counts and gains quite a bit in the way that an employee Goodwill, morale and public health wrote another. So these are employee responses. So they're saying, Hey, look, . You know, the company gained so much 'cause we are such happier employees and there's, there's no downside 'cause we're just as productive as we were.

Another one, . Wrote The response to Covid 19 has been a disaster. Management doesn't care about the safety and wellbeing of the employees during the pandemic. Another one said, slow to roll out. Working from home when Covid to 19 Pandemic started then rushing to get 9,000 people back on campus. Despite high success for working from home, wrote another instead of fearing work from home.

Learn to manage when your employees aren't on campus. They were your strongest assets, but are now leaving. I doubt they're leaving. But a lot of times, again, this is at the peak, right? So when you read these things, it's the emotions are at their peak and management's trying to, posture and employees are trying to, trying to posture.

So you, again, I'm, I'm morally outraged in our I at our response when anonymous epic employee said on CBS news, I don't want us to be the epicenter or the next breakout. Uh, again, these concerns are not unfounded. I mean, my baseball team, the St. Louis Cardinals and you know, we can point fingers and say, oh, they didn't follow protocol, whatever.

We have no idea if they followed protocol or not. This virus is not a Democrat or a Republican. This virus is not a Midwestern or big city. This virus is not rural or, or urban. It's not this virus. It doesn't it, it's not National League or American League. It doesn't root for the Cubs and not for the Cardinals.

This virus is a virus and it acts like a virus. And so, uh, it doesn't matter if your intentions are good or bad, it will act like a virus. And, you know, it's, it's, it's, it's interesting to read all these things. So anyway, we should probably go to the other story. And the other story is Epic responded hopefully in the right way.

So let's take a look at this. Epic Systems makes return to, in-person work voluntary, and this is what a lot of you are doing, right? Epic employees, about 10,000 people, 4,200 have already returned to work last week. So let me comment on that. That seems to be the approach that a lot of people are, are, are using.

People that that choose to return to work may choose to return to work. By the way, Epic's facility is probably one of the safest facilities in the country to work in. I mean, Judy Faulkner went out of her way to, to make a, I mean, it, it's a interesting place, but I mean, it has HEPA filters, almost all individual offices, plenty of space.

It's a wide open facility. You could practice social distancing. Uh, you could wear a mask. It's probably one of the safest facilities out there. Right. But it's still, how is it gonna be perceived by your employees? Uh, make them come back, voluntarily come back. I think this is a different conversation if vaccines in place herd immunity has happened.

Uh, I think this is a case study for us in healthcare to say, how are we going to bring our employees back? There will be a time where we sit back and go, look, we're we, we've now done the real analysis, not this, Hey, we're doing a good job working from home, but we've actually done the analysis to say, have we lost anything?

And if we haven't lost anything, then by all means, employees work from home. Everybody's happy. But if we've lost some things, let's have that discussion and say, you know, how, how do we bring people back? What do the hybrid models look like? This is gonna be a conversation I'm looking forward to having in the fall with, with CIOs as I have them on, on the show.

And just to say, you know, how are we thinking about this? How are we bringing them back? You know, my so what on this is . right now, the ball's in the, in the employee's court, I don't think we should force them to do anything. I don't think we have answers to an awful lot of things. We don't have enough testing still in some cases.

I know that the Cardinals, I, you know, again, I'm following that because I'm a huge St. Louis Cardinals fan. And one of the things I'm seeing is they're, they're literally taking tests every day to try to get back on the field. And I don't think we can offer that level of, you know, are we gonna do that level of testing?

If there is a breakout, are we gonna do contact tracing to ensure that the people who were at work are monitored in, in the right way? And so this is gonna be a conversation if you're planning on coming on the show this fall. And some of you have accepted the invitations and I'm looking forward to it.

You know, this is, this is gonna be one of those topics I think people want to hear about. All right. Next story. Let's go to patient id. So good news, the house voted to remove the federal ban on the unique patient identifier. It's good news because HIMSS has been pushing this. Chime has been pushing this, and they're not the only ones.

So there's others who have been pushing this. I seem to be the only one in the opposite camp, by the way. But generally speaking, this story says that, you know, they, they've removed. The block to funding anything around this. So there used to be a block in some bill, section five 10 of Labor HHS bill prohibiting federal funds for the promulgation or adoption of a unique patient identifier.

I. Love those words. And so you had bipartisan support on this. It was supported, as I said, it's supported by him, supported by Chime, supported by others. You know, just real briefly, you know, why, why am I not a huge proponent of this? There's a handful of reasons. One is we even solved this within our, within our four walls or our health system.

There's still, you know, in, in many health systems, there's still a, a two to something percent . Two to two plus percent duplicate rates. Now some of the well run hospitals have gotten that percentage way, way down. And the reason is because it's a people problem, right? It's, it's not necessarily a technology problem, although technology helps.

We used to initiate and there's other technologies that are out there that allow you to put alerts up as people are checking in. We also had a significant population of people that were . Uh, what do you call 'em? Aliases, I guess, that people weren't giving us their real information. So you're, you're bound to have duplicates and, and other, uh, kinds of information like that.

We also had a different EHR for our ambulatory in our acute that also led to, uh, duplicates. And so when I say that, I say. You know, we haven't solved the problem within and we had the ability to do all sorts of things and, and it didn't really solve it. So I'm not sure that a patient identifier on a national basis is gonna give us the ability to pull everything in.

That's number one. Number two, we have, let's just call it the ACLU concerns, and the ACLU concerns are that there could be a breach of, uh, patient privacy that they're concerned about. The third I would say is security. and from a security standpoint, if I have the ability to go into a, let's say, a weak cybersecurity posture, health system and get in there and then link up to the other records and get a complete medical record from that, let's just say vulnerable health system, you know, we have not proved our ability to keep breaches from happening.

And now we've given a, uh, a sophisticated hacker, a way to piece together the entire medical record. Uh, from across the board. So, you know, that's another reason I'm not a huge fan, and actually my primary reason all those things are really secondary to me. But the primary reason I'm not a fan is I believe that the patient identifier should be

Uh, I think the patient should be the center of the identifier, so it should be a pat patient-centric data sharing model, not a hospital-centric data sharing model and not a health system, a centric pat, uh, data sharing model. And so, uh, I've talked about this on the show before, so I won't go into too much detail, but suffice it to say I'm more of a fan of having my phone number.

Be my, uh, pa unique patient identifier, and the record comes to me and I'm the data steward, and I can find fiduciaries, I can find data stewards, I can find others who are gonna help me in my healthcare. This is a very healthcare centric way of thinking about this problem and really pursuing I. A solution to this problem.

So that, those are my, that's my 2 cents on this. You know, what's the, what's the so what for you? Uh, the, so what for you is, this is probably gonna be the direction that we go. Unique patient identifier. Just keep an eye on it. It's gonna move slow. Uh, all they did was lift the, uh, funding ban. It's gonna, uh, it's gonna open up funding.

It's still gonna take them. . Yeah. I dunno. It, it'll take probably a couple years before we're really doing anything in health. It, that's my 2 cents on it. I hope it moves faster and I hope it, it, it gets us to a longitudinal, accurate, longitudinal patient record at the point of care. That's their goal. I believe that their, their intentions are good and I believe that their goal is noble.

And I hope we, uh, get there. I, I'm an advocate for a different approach, so. Neither here nor there on that one. Let's see, what else did I say? I was gonna talk about patient id, chaos in compliance. This is an interesting story. Uh, quick pivot to new HHSC. Ovid 19 reporting rules meant chaos for hospitals generally.

I, I read this article, I wasn't a huge fan of the article. And the reason I wasn't a huge fan is 'cause the hospital associations and whatnot speak for health. It. And they, they make us sound like the keystone cops. The reality is, while this pivot, if you, if you don't remember the, the CDC, oh, well, you're living it.

So the CDC, we used to send our reports either to the state or to the CDC directly. And now HHS is now the, the target they added about, uh, six. I think it's about six, six to eight data fields out of, uh, 31. I think it's 90 some odd data elements that we have to collect. But you know, the data elements really fall into two categories.

They fall into the basic blocking and tackling of healthcare. These are things that we had reports and dashboards on for decades, literally. I mean, we know how many beds we have. We know who's in the beds. Uh, the challenge with some of this stuff is it's in multiple systems, right? It's not just, Hey, go do your EHR, run a report, and here we go.

Some of it's in TeleTracking. Some of it's, it just, it's spread out. It can be in your, uh, pharmacy system. That might be in your EHR. It might not be in your EHR. So there's a. There, there is some work here to get the extracts right, and so my so what on this is, yeah, there is some work here, but they, they make it sound like it's an impossible lift.

The reality is the first 25 some odd data fields should be a relatively easy lift because we lifted it a decade ago. Right? It's the new data fields that probably need, need a little bit of time to get right. And so there's two ways to report this, either directly to HHS or to the state. Um, and what I'm advocating for you, if you're doing this, is take the time, get it right, send it in, but also don't stand behind these hospital associations that are calling this out.

Don't stand behind. Oh, it's too hard. It's impossible. If that's the case, then we really have significant analytics problems within our organizations. I understand we have to stand up some new things for some of these new . Data fields that we're collecting. But all in all, this should be a, uh, core competency for every health system.

The ability to pull fields, even new fields that they're asking us for, to validate those fields, to get the extract right, and to create the feed that goes out. If I were a governor, I don't know if I have any governors listening to this or anybody in government. . That should be the, the method for everyone to report.

It shouldn't be directly to the HHS. It should be to report through the state governments. And the reason I say that is because there, if I'm a governor, I want this information. I don't want it to like go through HHS and then come back to me. I want it at the state so that I can build the right responses.

We're responding locally to this, right? So I need as much data as I can get. It doesn't make sense for me to have it go to HHS. Now I understand it's underfunded. A lot of public health is underfunded in most states, but there should be a repository. And if you are struggling to set that up, by all means give me a call.

There's a lot of ways you can set up that repository in a open source platform that is not overly expensive. Uh, a lot of health systems have done it in the past. Build your own kind of thing. Uh, very inexpensive. Take in those data feeds and massage that data and get it right and then send it over to HHS.

So that's the so what, so what if you're a state? Get the data to yourself. If you're a health system, uh, don't stand behind. It's too hard. 'cause it's not too hard. This is basic blocking and tackling in analytics. Get the extract, get it right. Take the time if it, if it takes a week and you're not reporting on time and those kind, take your time, get it right.

Because you don't wanna report incorrect information. 'cause you're just gonna have to go back and correct it anyway. So get it right, but then send it over. Uh, you know, and again, is this, this, this is what we do. This is our business. It's, uh, it information technologies moving information around, and this is what they expect from us.

Let's see, one more story. That's chaos and compliance. What'd I say? Oh, HIMSS announces new dates. I don't know if I wanna talk about this one. This is an interesting hot potato, and I've seen some posts out on social media on this. You know, the question people are asking is, is there a better way to do this?

Right. I've, I remember the first time I went to HIMSS and I said to somebody, is this a big deal? And they said, no, it's not a big deal. Then I went and there's like a, a bajillion people there and I'm like, how could you say this isn't a big deal? There's so many people here. And, uh, their point was that not a whole heck of lot gets done there.

I don't think that that analysis was true. I, I've been able to utilize HIMSS pretty effectively to, to meet with vendors. They're all in one place. I got a lot of . You know, as ACIO, one of the things that happens is you start to elevate above the technology, start to work with the business more, but you start to get away from the technology.

And one of the things that enabled me to do, uh, you know, as ACIO, I liked walking the floor. I. I could get a lot of demos very quickly so I could see what my EHR provider was doing. I could see what other EHR providers were doing in a very low key way. I was able to see, uh, what was going on between VMware and Citrix.

I was able to see what was going on in identity and access management and look at the different solutions around that I was able to sit in. I didn't sit in on a lot of the presentations, to be honest with you. I would've liked to have done more. But for ACIO, that was a, there was a, there was value in all the vendor partners coming together and, and having the chime event sort of connected with it.

I don't think this is gonna go away. There's a lot of bad, uh, bad taste in how HIMSS handled this. They're holding onto the money. They do have, they have not given, uh, refunds the way they should. They're essentially saying, Hey, we're waiting to see how our insurance, uh, claim comes through before we . Give any kind of money back.

And I've, I've heard from vendors that they're not overly happy. I've heard from some health systems, there's some different things that people signed up for that they didn't get money back for. There's, there's a lot of bad blood around this, but I don't, I don't suspect, I, I think HIMSS is gonna take a black eye.

I think the, the August date will not be overly well attended for a couple reasons. One is, you know, August, I don't know. I don't know where we'll be in August. I don't know what it'll look like. I do know that budgets will still be constrained, so travel will still be constrained. So it'll be, it'll be tight from that perspective.

I think there's gonna be some bad blood. There's gonna be some empty, empty booths for that reason. But here's my So what if there's value? There's value. So if I were ACIO. And, um, you know, I'd probably go to that August conference to take a look, see if there's value. There's still the, the networking opportunity with your, uh, peers.

There's still an opportunity to meet with, uh, strategic vendors. 'cause you can rest assured that, uh, your EHR vendor will be there. And some of the key, uh, players, whether they're angry or not, is gonna be re Irregardless. They're gonna be going next year just to see . What sort of transpires. Others are gonna see this as an opportunity to step up and say, Hey, our conference is the next conference.

To be honest with you, I've, I've gone to a lot of these conferences. There's none quite like this one. There's none quite like himss I've gone to the health conference. It's a different crowd. It's a, you know, it's the innovation crowd and it's mostly, it's mostly around, you know, venture capital. It's mostly around private equity.

It's mostly around investments and, and that whole crowd. And it's, it's, it's not the same now, I think you'll, you'll see those vendors start to show up there and that might be the protest vote. The protest vote might be the health conference. But again, it's very different conference. So we'll have to see.

I I, I don't have a definitive, I'm not falling down either side of this. You know, I, I do remember the quote from Hunt for red. October Ramus, the commander of the Soviet sub at the end, the Alec Baldwin character, Jack Ryan, is essentially saying, Hey, you know, there's gonna be held to pay in, in, in Russia for, for the ship going down.

And he looks at 'em and says, you know, a little revolution from time to time is a good thing. and, you know, healthcare Revolution from time to time might be a good thing. Well, you know, that's all for this week. Uh, don't forget to sign up for CliffNotes. Send an email, hit the website. Uh, we wanna make sure that your system is more productive and CliffNotes is one of the ways that we're trying to do that.

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