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

 Thanks for joining us on this week in Health IT Influence. My name is Bill Russell, former Healthcare CIO for 16 Hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged. Today we have a phenomenal conversation with Theresa Meadow. She's the CIO for Cook Children's Healthcare System out of Fort Worth, Texas, not to be confused with Chicago, Illinois.

There's two great ways you could help out the podcast. One is just shoot a note to a friend and, and tell them that you're getting a lot of benefit outta the show and that they should really subscribe to it, but another way you can can really help us out. I. Is by, you know, whatever app you are listening to the podcast on, go ahead and click and give us a review.

Tell people about the, the value that you're getting from the show. We would really appreciate it. It helps us, it moves us up in the rankings in, uh, apple and in Google and in in the other services as well, and, and doesn't take that long and we really appreciate it. Special thanks to our Influence show sponsors Sirius Healthcare and Health lyrics for choosing to invest in our mission to develop the next generation of health IT leaders.

If you want to be a part of our mission, you can become a show sponsor. The first step is to send an email to partner at this week in health it.com. Now onto today's show. Alright. Today we are joined by CIO for Cook Children's Healthcare System. Theresa Meadows, rn. Good morning Theresa. Welcome to the show.

Hey, good morning. I am really excited to be here. This is a great opportunity. Yeah. I'm looking forward to this. And, uh, so you're working outta the office? We can, I, I want people to know that it's your, your, your work office in case they're watching the video and they see all those . You know, all the disheveled books and stuff behind you.

Yeah, yeah. The mess is definitely how my work environment looks on a regular basis. . Well, I, I remember when I became CIO, uh, for the health system and the, the gentleman who was before me goes, okay, everything's on this shelf, and there was binders that were the thickest things you've ever seen. He is like, I'm like, do I have to read that?

So you've pointed out that I probably need to do some spring cleaning . Well, yeah, that's, yeah, that's, that's what happened to me after a while. I, I, I'm like, okay, I haven't opened those yet. And it's five years later, I should probably move them somewhere. That's, yeah, that's, that's, I think, I can't recall the last time I touched anything on that bottom shelf.

So you're first time guest. It's not the first time we've talked. We did a webinar together. I hosted a webinar on . Cost reduction strategies. You did that in the fall last year was, uh, a lot of it was good conversation, but since this is the first time on the show, tell us, tell us about Cook Children's a little bit.

Sure. Cook Children's is a pediatric integrated delivery system, and our, our primary location is right in the heart of Fort Worth. Every time I present, people say, oh, you're in Chicago. I'm like. Real South Chicago, like this accent is not a, I don't think this is a Chicago accent, but Right. In Fort Worth.

The, the cool thing about Cook Children's is, and that a lot of people don't know, is we're actually, uh, made up of nine different companies. And so when people hear about Cook Children's, they think primarily of our, our medical center, which is right in the heart of Fort Worth, 400 plus beds a hundred. You know, room, private room nicu, so pretty typical pediatric hospital that you would think about.

But we also have a physician network where we employ, you know, 450, probably close to 500 physicians today. It continues to grow. We continue to acquire, um, and bring physicians into our physician network. That physician network has locations throughout the state of Texas. We're probably at about 90 locations.

Providing primary care, specialty care, and urgent care throughout the state of Texas. So even as far as, you know, west as San Angelo and our, our coverage area, if you looked at it on a map, is about the same size as the state of New Mexico. Of course, Texas is huge. So if you, if you looked at where we were covering, you would see that from our, our physician practices and we continue to acquire.

We have a ho home health business where we see kids directly in their homes and we do a durable medical equipment, infusion therapies and and skilled nursing to kiddos homes. And we also are a Medicaid health plan, so we administer Medicaid and ship and star for the state of Texas for about 150,000 members, give or take.

So. A couple of joint ventures that we have, and then of course our health system and our foundation. So very diverse set of, you know, activities, but also a lot of diverse technology, which makes this role really exciting because there's a lot of variety and a lot of challenges and opportunities there.

Pediatric, IDN, so do you have like, like retail locations that are just for children out in the community? That's. Yeah, we do. And so we don't, we don't. The other thing is we're not affiliated with any medical school. So most, a lot of pediatric facilities have some medical school or academic medical center affiliation, and we're total standalone.

So if you looked at the, the po, you know, the, our global business we're about, we're almost a $2 billion business overall, just with all of our different things that we do. Wow. Gosh, I have a, I have a lot of different directions I want to go with you. That, that's fascinating to me. By the way, a pediatric IDN is, you know, I don't wanna show my ignorance here, but that's a first for me.

I mean, I've talked to a lot of, of, a lot of, um, children's hospitals and those kind of things, but this concept of IDN, a lot of 'em build out their networks with partnerships throughout the community. But to have that many physicians on staff to have that kind remote capabilities. Yeah, I mean, is that pretty common or is that, is that distinct?

Do you know? No, I don't think that's common. I, you know, and we've been doing this as long as I've been here, so well before I even got here, and so we were a very early adopter. And I do think we're unique. I mean, I think we're one of the unique pediatric entities. We participate in Children's Hospital Association, so you know, I have visibility into what other children's facilities look like, and there's.

Maybe a couple, maybe a handful that kind of look like us, but for the most part, they're affiliated with bigger institutions. If they look more like us, well talk about look like us. So you have the RN title . Um, how many, how many, how many CIO RNs do we have out there? You know, uh, it's very few. I think that may be growing.

Uh, I know about, I know of about five. Um, well, how, so tell us about your role. How did you end up as ACIO going that, that track? Yeah, it's really interesting because if I, if I thought about what I was gonna be when I grow up, this would not have been where I would've even remotely placed myself. So I started my career in pediatric or not in pediatric, in.

Interventional cardiology, cardiology, transplant. As a nurse, that was really where my passion was. I always wanted to be in healthcare. I grew up, my best friend when I grew up, she, her dad was a nurse anesthetist, and so I originally thought that's what I wanted to do is I wanted to, you know, be a nursing anesthetist.

And the way they chose to do it is they said, you know, we're gonna take nurses from each area, 35 nurses, and they are gonna be the physician trainers. They're gonna do the building, we're gonna train them on how to build systems and they're gonna be that support for those physicians. And at that time, we didn't really, we had a dumb terminal, you know, on the, on the nurses station.

We didn't really have computers. And my nurse manager said, Hey Theresa, you're pretty good with physicians. Would you like to do this? It's a two year project. You'll do this for a couple years and then you'll go back to your nursing job. And at that time, all I heard was no weekends, no nights, no holidays,

I'm like, sure, sign me up. So I, you know, it's sometimes in life if you take, you just sometimes do things that you don't really a hundred percent know what it is. And what I learned through that was, first of all, IT projects are never over. They really are . Living, breathing entities that last forever. And I realized that I liked it and I saw the value in taking technology and improving outcomes and improving clinical care.

So from that point, I decided I would get a master's in informatics. I. I worked at Ernst Young in consulting. I worked@webmdinthe.com era. Worked at McKesson for a while, but my true heart is really, and passions is in the acute care space. And so that's kind of how I circled back. I was at Ascension prior to here and then, you know, this opportunity came up and I'm like, you know, I wanna.

I've always wanted to do that. And so I I you, you know, Theresa, as you tell that, as you tell that story, I, I think of two things. One is you have to be about 80 years old with that number of careers, and then the, I feel like it . The second thing is no nights, no weekends, and, and has that played out exactly how you thought that was gonna play out?

It has not , especially the first go live. Back, you know, when we were implementing TDS for any of you old timers, who knew what TDS was? Yeah. The first shift was a night shift and I'm like, what the heck? How did this happen? , how did this happen? I was supposed to, no weekends, no nights, no holidays. Right. So, but you know, it's all worth it.

It's definitely all worth it. That's fantastic. So I wanna hit, I hit

priorities. Uh, price transfer. Just a bunch of, bunch of different things. Okay, let's, let's start with remote work. 'cause you know, culture, productivity. These have been interesting topics coming into this year. We just came out of the JP Morgan conference and I didn't hear any CEO even intimate that we were gonna go back to the way we were before, where everybody works out of the office.

Everyone saying changed.

But what I, I, I really want to do before we go to what's next is, you know, the team is now, you know, a percent which. You know, how have you done with regard to productivity? Let's, let's start there. Well, first of all, what have you done? And then how have you sort of, uh, have you been productive? How has that gone so far?

Yeah, it, it's interesting because we, we already had a semi remote culture prior, at least in it, prior to the pandemic, we were, we had people who worked from home one day a week-ish. So it wasn't extreme. So we went from one day a week to . Everybody at home five days a week. So I think initially we struggled a little bit with productivity just because people were getting used to, well, how do I manage remote workers?

How do I know, uh, things are getting done? And you know, we don't really have a detailed productivity measurement system. The way we measure productivity is we have 140 IT projects plus . About 20 pandemic related projects. And the way we measure productivity is really based on delivery and customer satisfaction.

And so our delivery has not slowed down. We continue to deliver, you know, solutions we've had even through the pandemic. We w we took our health plan live on epic tapestry. Doing fully remote support. So we've been doing, so our measurement right now has been okay, are we still delivering at the same rate and the level that the expectation was prior?

Yeah. So how, how have you had to change your, your personal communication style and management style as we have moved through the pandemic? Yeah, it's, it's interesting. I hate. Video probably because I get, I don't like seeing myself on video MO mostly, but we do a lot more video. I have kind of instituted in our organization, our IT organization, you have to be on video this hiding behind your, you know, your beautiful picture that you have for your Zoom client.

We need that, we need that social interaction. So one is we, we . Pretty much require that people be on video for eight, for a couple reasons. One, to keep that social interaction, but two, just you can tell how people are doing and that's a huge concern of mine that people's wellbeing is, is being watched. I write a lot more communications than I used to because I was used to getting a group together and us just talking about it.

But now with everybody having scheduled so packed with video conferences and those types of things. A lot more written communication. What, which proves to be difficult sometimes. 'cause you're like, I, I sent out this communication, nobody read it. So I think people are getting overwhelmed there. We've taped, we've done like two minute video messages that we send out, uh, via email so people can refer back and look at those two minute video messages.

Just a lot of different techniques. I think we're still, you know, working through what the best. Thing is, yeah. You know, the, the management by walking around, that's how I was taught early on in my career. And so when I became A-C-I-O-I, I, I get it. I get in pretty early, so I'd get in around six o'clock, I'd get a bunch of stuff done before 8, 8 30 or so, and about nine o'clock I just started walking around.

A lot of teams were doing their huddles and whatnot. I got to listen in on a bunch huddles and I would pop into people's offices and. I'm not sure what I would be doing today as ACIO. You know, how do people pop in and talk to you? How do they, you know, initiate that sort of, that conversation of I have an idea.

Yeah, so we actually do that a couple ways. I. Through Skype. A lot of times you'll see the Skype window pop up and when people will say, Hey, I've got this thing going on, or I have this idea. So we've been using Skype, we've also been using teams. We're in a transition. We haven't gotten to 365 yet, so we're in that.

I. In between stage where we're making a transition to Office 365. So we've been using some of the team's functionality to, you know, do that pop in type of mentality. But I agree with you, that's the one thing I miss the most because I was a walk around leader to, but now walk around and I look at empty cubicles that are still have Easter decorations from March.

You know, so well, they'll, they'll be appropriate in a, in a month or so, they'll, so by the time we get back to what we're doing, you know, everybody's, we're all decorated for Easter. But, yeah, so that, it's been a struggle for me and it's been a struggle for our culture in general. 'cause we are a, we're a walk around collaborative in-person culture.

So it's not just an it. At Cook Children's, it's a, it's a global issue that we're all struggling with. 'cause we are very collaborative and we'd like to see each other in person. And so it's been a challenge to work through. Yeah. Have you guys, have you guys started conversation, and I think this is gonna be, uh, health system specific.

I think it's gonna be geography specific. Um, have you started. Post Covid work looks like we have, and so we've gone through a process where we've actually took, taken our employees and we've kind kind of categorized them. We actually have already determined 500 plus employees who will just stay at home permanently.

And now we're working through what we're considering hybrid workers, which we're, you know, that definition is sometimes in the office. Sometimes at home, and then we have the, of course, the people who are at work a hundred percent of the time. And so it's that hybrid part in the middle. That's the hard part because, so we've kind of said, okay, if you're less than 50% at time at home, then we're gonna provide you an office and a parking space and you know all the things you need.

On campus. But if you're greater than 50% at home, then we're going to assume your home office, your primary office is your home. And now we're looking at space reallocation and how, what do we do to reallocate space and parking and, and those types of things. The un, the unfortunate part for us is we don't lease space very often, so we own all of our physical space so we could clear it out, but we don't know what we'll do with it.

Sometimes people, some people look at me like, Hey, you know, we have a June fiscal year, in which case they're already halfway through and Yeah, we're in our second quarter. Yeah. Second quarter of 21. So, I mean, do you, uh, I mean you were, when you were planning this, we were mid pandemic. So what, what, what are the technology priorities for 21?

What do they look like? Yeah, mobile and digital for sure. I think that has been. We had that as a priority prior to the pandemic, but we've escalated that priority because of the amount of remote work and because even through a pandemic, we're building another hospital, . In North Dallas, in a, in an area where the expectation, um, from our consumers is, I wanna do it on my phone and I want to do it as rapidly and as quickly as possible.

So we really have two paths. One, to enable our patients to be more mobile, and the second is for our employees. How do we enable 'em to be more mobile and be more agile in their work? The second priority is really around data. And, you know, data has proven hard through covid and, and sharing the data specifically around vaccines and, you know, testing and those types of things.

So we've learned a lot about how we wanna structure our data plan going forward because data is going to be and has been king. I think people just didn't realize it until we've kind of gone through this. Change in how we work each day. So we're asking a lot more questions and using a lot more data than we have, you know, in the 10 years that I've been here, um, which is pretty interesting.

So just outta curiosity, do you rely on your EHR, do you have like a third party thing, like health Catalyst or something to that effect? Or do you have your own homegrown type data solutions? Yeah, we have a combination of homegrown and the epic. Data repository type tools. And then we use third party visualization.

So we have a data warehousing structure for all our data that's not in Epic. 'cause we've only been live on Epic for three years. So we have, we had a huge data infrastructure that was somewhat homegrown prior, uh, to going to Epic. So we kind of have a hybrid model where we use, you know, products like Tableau or to bring those data elements together visually.

We have a pretty strong data integration team, which has been very, extremely helpful during Covid in this, this time period. Well, that's a, you know, I mean that takes us to interoperability and, you know, I, children's hospitals are unique in that their interoperability strategy, it has to, has to be really good because you know, you, you're connecting with so many people and you're handing off your patients.

Very few people have to plan for handing off. Point, they're not pediatric anymore and they, they move. They move on. So what does that look, what does an interoperability strategy look like for Children's Hospital? Yeah, it has a couple of legs. Um. The interesting thing about the, uh, Dallas Fort Worth area, almost everyone's on Epic.

We were the last pretty much Methodist and then us, we were the last holdout. And so a big part of our strategy is care everywhere just because of the amount of patients who move around between all the different entities in the Dallas Fort Worth area. The second thing is, is we really . You know, share data a lot with other children's hospitals.

So our second strategy is how do we connect at the most efficiently with other children's hospital? 'cause we do share patients back and forth depending on, you know, what specialties and what things we have. And so how do we connect to those, you know, those other children's hospitals efficiently. And then the third leg is really around API development, because what we're seeing is that.

A lot of our families and kiddos are using technologies like apps to track their health. They're using things like Fitbit and Apple watches and smart scales, and. All of these things. And so we have a strategy to use APIs to connect to those devices and really start to, you know, have, have kids really be part of their care at home.

So our strategy is really how do we integrate to those kids at home through interoperability. And then we get tons of data requests through research. And so we have started sharing, you know, data with research networks and those types of things. So it's, it's a lot of different things. Our goal is to share as much as possible 'cause we think that is really important, not only for our organization, but for the ecosystem as a whole, uh, to be able to do that.

Yeah, it's interesting. The digital strategies are increasing the number of touchpoints. So you're interacting a lot more with your patients and it's increasing the data points. So we have this Internet of Health things out there now. Yeah. How are you? How are you helping your physicians? I mean, obviously we start collecting all that information.

I remember the pushback I got was the clinicians were like, I don't want it. And I'm like, all right, why don't you want it? And they're like, two reasons. It was very clear. It's like, two reasons I don't want it. One is it's a lot of information and, and you know, you, you're just messing up the, the record.

There's just too much information for me to review. And the second is, if it's in the record, I become liable for it. So they were worried about liability and they were worried about the amount of information. Are you doing something to, to address those two things? Yeah, we are. And so it's interesting because what's kind of changed, and I think it's 'cause of the pandemic.

Our physicians now are wanting to get data from kids at home. They don't want 'em to come here. So there's kind of been a shift about, okay, we want that data, but we don't want everything to go into the record. So we have a process where they can actually accept the things they want and reject the things they don't.

Yeah. Which has has proven very valuable because some physicians like a lot of data and other physicians like almost none . And so it, they have the ability and then we have just some mandatory requirements where we say, look, we're these kind of things will come into the record because you need those from a liability perspective to, to make sure that you're protected and the patient's protected.

Um, in the event there was something negative occur. And so we work closely with legal on this and with our health information management group on how do we, how do we, you know, define the medical record and what's included in the medical record versus what's great data for research that we're gonna bring in.

But we're gonna exclude that if somebody require, if somebody requested the medical record, we'll exclude that. But we'll use it for research purposes and other . Other things. That's cool. I, so, no, I haven't asked, I haven't, I can't remember asking a children's, uh, hospital about this, but, you know, what kind of regulatory things are you looking at?

Are you looking at 21st Century cures? Are you looking at, uh, price transparency? What, what regulatory things are on your plate? We're, um, it's interesting. We went live with our shoppable services on January 1st, and so we actually, if you went to cook children's dot org, you could get estimates on 400. The 400 procedures that we're required to do also in our patient portal, my Cook Children's is what we call it, MyChart.

You can actually do pricing estimates in MyChart today, where you actually can put in I'm, I'm having this procedure and we'll provide the pricing estimate, and we also have the machine readable files that we've produced. We felt that it was important that we start providing that information to our patients.

Other facilities have decided that they'll just wait it out and see if they get fined and, and those types of things. But we, we decided we would go the more conservative route and just, just go ahead and bite the bullet there and start providing that information to patients, which I think is, I think it's the right thing to do.

Is it easy to understand? Sorry, my lights just went out. , that happens periodically when you don't move around. Oh yeah, I've, I've had that in other interviews by the way. I did, I did in-person interviews and the lights went out on us. Yeah, it's, we, we have motion since slides, so if you don't move quite a bit, you, it goes out.

So we've, we've been doing that since the 1st of January, which I. You know, I wish I don't have really a lot of data about how, how many people have used it, but we'll be looking at that to see how that, how that's going. And the 21st Century Cures Act absolutely applies to us. So we've been work, we were thankful the, for the little delay from November to April as far as providing, you know, real-time access to your medical record and being very transparent with your data.

Because in peds there's a lot of sensitive data that we wanted to be able to go through more and more thoroughly and not just have to release everything automatically to families and patients. 'cause some of that requires, you know, education and discussion to those particular patients. And there's some unique issues there.

'cause each state, depending on their, their laws, some kids own their. Their patient record at age 13, 12, and 13. Yeah. And so what's the, you know, what's the risk of, you know, sending a negative result or something that's, you know, could change a life of a kid to a 13 year old, just automatically? So we're actively working through the information blocking provisions and the, the, the API provisions to be able to, you know, provide data to other applications if asked.

Pretty much most of the things apply to us. If you looked back to meaningful use, that was a little bit different because of of Medicaid, and that was really the state dependent. So like in our state, we just had to say we implemented something and we received meaningful use dollars. It wasn't as, we weren't judged, you know, we weren't reviewed on, on metrics, but that's gonna change over time, I think for peds.

It's, it's gonna be interesting, the, the regulatory path. I, I'm gonna be following the price transparency rule pretty closely. I think I'm gonna ask every CIO who comes on the show about how they've implemented. One of the things I, I was, I was talking to Rob Deha about this, who's a former CFO for UPMC, where we, we were just discussing that, that there's some problems with the, the rule and one of the biggest problems with the rule is they didn't tell health systems where.

So we have to go find it. We go to their website, we have to find it. And, and some of are like incomplete compliance, but it's buried. You just have to, you know, do a lot of search to find it. Yeah, and I could, I, I definitely see that in more competitive markets, right? The more competitive your market is, the deeper you have to go to FI to find the information.

You know, we had a lot of discussions about that because it is about competition. Somewhat about where we would do it, right? No, it's, it's, yeah, I mean it, I would imagine those conversations were interesting. Uh, let's, let's hit two more technology topics and then we'll, we'll close out. And any plans around ai, machine learning, RPA, anything like that?

Yeah, we're actually looking at all of those right now. . We had ARPA project slotted to start right before uh, covid hit. So it kind of got delayed a little bit just because of the amount of work that it was going to take. But we're definitely looking at RPA in our, in our finance and some of our supply chain areas 'cause there's a lot of opportunity there.

Okay. Can, can you share, have you a heading in direction. We've narrowed it down. There's not a ton of vendors for RPA, so we're it down to the final two. And if you thinking through my vault here of, I can't think of the top two names, but yes, we've, we've narrowed it down to two and our team, and we worked with a consulting firm to at least help us set up some RPA governance structure.

Right. Because you know, everything's not RPA worthy , but you, you know, people could think of a thousand ideas that you could use RPA for. And then we're also looking at artificial intelligence for things like some of the chat bot functionality that's proven very useful during Covid, where we're using some chat bot.

Technology for frequently asked questions about, you know, do I need to be tested mostly internally with employees, not with patients so much because you know, with Covid the interesting thing in PEDS is we're dealing with adults. 'cause all of our employees are at risk for covid. And then we're also dealing with our patients.

So we really, we had lots and lots of internal questions from employees about what to do. So we used some. Of that chatbot functionality to kind of help alleviate the phone calling. Yeah. It'll, it'll be interesting to see what we do with chatbots moving forward because it's now been sort of introduced into our Yeah.

Vernacular. I, I was talking and I think AI's just gonna continue to, and machine learning, we were using some predictive modeling and, and different things and some of our research studies that we're doing. So I, I, I expect that just to grow over time. I was talking with Lee Milligan, who's the CIO at Asante about RPA and you know, one of the, one of the areas he said that they would love to have RPAs and testing around the EHR for EEHR.

Updates and those kind of things. He was talking about beaker and how they have to test everything. He's like, man, if we could just pop RPA in there somehow to do the testing. He goes, because we have to test every single aspect of that, and it would be a great tool for that. Yeah, there's a lot of it use cases, so I was.

I was, I was a huge proponent for it. If nobody used it but us . Yeah. It would be a win because there are a lot of repetitive things that we do in it that RP a's perfect for. Yeah. You know, password creation. Yeah. Um, you know, password termination. Yeah. Yeah. That that whole user provisioning process could really use RPA.

Yeah, so there's a ton of use cases just in IT operations that I think where RPA could be extremely valuable are, are you guys leveraging the cloud at all? You know, we have a mixed strategy around cloud. We use cloud where cloud makes sense. That's kind of our, our strategy. So . We have a lot of third party applications in the cloud.

Our ERP is going is pro. We're in a ep ERP uh, selection process right now, and it will go to the cloud regardless of the choice, so that that will be moving in the near future. And of course, our Office 365 implementation will take us more. We have not taken any of our electronic medical record. To the cloud.

We were a previous cloud medical record when we were with Athena Health. So we've had that experience and we have a lot of lessons learned there that we, if we do that again, we would not repeat . What, so I think it, it, it's gonna be interesting with Epic. 'cause I think this Irish move is part of the journey to really see Epic become a cloud provider.

I think so too. And you know, I always, I always joke we've kind of all been cloud for a while, so, you know, we've had 95% virtualization in our data center for five plus years. So technically we've had our own little cloud environment over there with how we've chosen to deploy applications and, you know, work our remote work activity.

So it'll be interesting to see how it evolves. But I, I think we'll see more and more, especially with remote work. So, Theresa, I, I guess, I guess action items from this call are to clean out that bottom row of binders. Absolutely. Yep. That's number one. . Unfortunately, the top rows. I still like a physical book.

I try to read books online, but, and I do that, but I love, I love the physical books. I don't know if I'll be able to get away from that , you know, I, we, we just moved into a house and we, we gave a lot of our books before we moved to the, uh, local public library. But I've found myself already amassing books.

I, I'm the same as you. I, I, I like taking notes. I like, I like the feel of it in, in my hands. I like taking it to beach. I don't, I, I don't know how you, uh, I don't know if that's just gonna be a preference, uh, forever. Well, another interesting thing that I've started doing, my husband does this a lot too, is I'll listen to the book and read it at the same time.

And so sometimes, you know, so I can make notes in the, I do some similar things where I can listen to it and then also follow along. So, we'll, it'll be interesting to see if I can get away from it, but I, I love a good. Piece of paper. Book . Paper. Paper. Well, Theresa, thanks for doing this. I know we're on different time zone, so you did this pretty early and I, I really appreciate it.

You're welcome. Thank you for having me on the, on the show. Yeah. We'll have to do it again. Yes, we will. What a great discussion. If you know of someone that might benefit from our channel, from these kinds of discussions, please forward them a note. They can subscribe on our website this week, health.com, or you can go to wherever you listen to podcasts.

Apple, Google Overcast. That's what I use, Spotify, Stitcher. We're out there. You can find us. Go ahead and subscribe today or send a note to someone and have them subscribe. We wanna thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware.

Hillrom and Starbridge Advisors. Thanks for listening. That's all for now.