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If you missed the first three, you might wanna check those out. There's the, uh, the innovators episode. There's the clinicians episode, and then there's the CIO's episode. Um, you can check those out on iTunes. You can check 'em out on the, this week@healthit.com website. You can check 'em out on Google Play as well.

Um, this podcast is brought to you by Health Lyrics. Be a market leader. We help you to clarify your health IT plan, eliminate confusion, align your work experience breakthroughs. Visit health lyrics.com to schedule your free consultation. My name is Bill Russell, recovering healthcare, c i o, writer and advisor with the previously mentioned health lyrics.

Well, here we are, uh, the, uh, the last episode of this series, which is the top 10 episode. And, uh, you know, this is a fun and a dangerous episode. It's fun because I get to go back and listen to all the great content and, uh, just remember the great conversations that we had this year and just soak it in one more time.

Um, I, I'm guessing that no one is sitting around their, their, uh, podcast listening device right now and gonna be hurt that I, I did not select their, uh, their two or three minute video. To be on here, but. On the off chance that I did, I just wanna make sure that all of my guests, uh, recognize that. Uh, I really appreciate everybody coming on the show.

It really has been an honor to have them on the show, and we've had a, a great time, uh, recording this year. Um, you know, for those of you who, uh, have been on the show, you know this, but for our listeners, Uh, you know, I just, I, for a lot of these people, I just send 'em emails and say, you know, will you lend your voice to this community?

Uh, this community, which is about, uh, helping to train the next generation of health IT leaders. And so many of 'em just jumped at the chance and, um, I. And I'm, I'm thrilled to be able to bring this show every week, and I'm thrilled that you're listening to it. The numbers just keep going up every week, uh, since we've started.

So, uh, while there is a little bit of risk of, of selecting the top 10, I don't think anyone's gonna be offended. So we're just gonna, we're just gonna get to it.

So coming in at number 10 is Jason Joseph, c i o, for Spectrum Health. Jason was gracious enough to sit down with us following his panel discussion at the Becker's conference in Chicago this past fall, and uh, I was really impressed with his perspective. He's a newly minted c I o. I asked him the question of what opportunities exist for health it and, uh, this was his answer, check it out.

So what's the biggest opportunities for health it right now? You're talking to a whole bunch of CIOs, potentially. What's the biggest opportunity that you see out there? Yeah, I think you could answer that question in two, two fronts. Um, one, I think that we, uh, have a huge opportunity to leverage some of our core in, uh, infrastructure and simplify it so that we are more digital ready.

Um, I mean, I. I'm a big believer in having a few core systems that you really invest heavily in, but the pace of change is such in our business that you're still going to need to adapt and you're gonna need to flex into those strategic opportunities. And it's incredibly hard to do that if you've got, um, complexity under the hood.

And so I would say do not underestimate how much that complexity will. Hurt you in the long run if you're not ruthless and rooting it out super, not only for the cost, but also for the agility that it's gonna provide you. And so that's kind of philosophically, I would say, our opportunities to get more simple so that we can be more agile, so that we can innovate.

And I think the innovation's gonna come in two main areas. You've already touched on 'em. Digital and how we transform our healthcare system. Digitally, some of which will be, you know, very common types of capabilities that we're all gonna have in our, in our toolbox. And then there's going to be those things that are true, truly differentiating.

And the second is how well we use the data that we actually have in our systems to come up with new answers and new outcomes. And that's where our business and our clinical competitive advantage is gonna come in with advanced analytics and some of these tools, if we can apply those well, we will actually see significant changes in the core

Of business, of healthcare. There's other things that we do every day that just helps us kind of make the core a little better. The things that I look for are the things that actually change the core, the things that say you no longer need that diagnostic process. Um, you know, I'm looking forward to . A point in time, and this may be way out there where you could actually go in and have some medical imaging done, and when you walk out, you're going to get a report because it's so protocolized and the AI engine has become so strong that you're gonna get a 99.6% accurate report out.

Same thing with low acuity, uh, primary cares. These, um, the, the engines, the intelligence and machine learning is going to quickly make it so that these are, these are realities in the near future, and we have to be ready to capitalize on. You gotta love that answer. Root out complexity. Uh, use the data to really change the core business of healthcare.

I love how pragmatic his answer is, but I also love the visionary aspect of it.

So at number nine, we have a two time guest of the show, uh, Sarah Richardson, who is the c i o for the California Nevada Markets for Healthcare Partners, a DaVita Medical Group. Sarah is a, a amazing leader and a great voice for women in leadership within healthcare. I was able to catch up with Sarah at the Chime fall forum down in San Diego, and this is what you had to say about soft skills.

The pace of change has been so dramatic in it itself. How do you prepare your IT staff? But one of the things we've been talking about is the, the, the role within health. It's the roles are really changing from technology roles to people, roles, people, and, uh, understanding culture and communication. And these are all areas where if we have a, as they were talking about, you know, a 75, 25 or 80 20 male to female ratio, this is areas where we can really make that transition and start adding a lot of

Um, 'cause you know, STEM is underrepresented today. Mm-hmm. , but that's not what we're hiring you. No, we're, we're hiring. So, um, what does it look like? I mean, what are we looking, what are we looking to do, uh, with that staff to help them make the, those transitions? What I feel like people forget about or what they say is that people are focusing on the soft skills.

It's the soft skills that, that women are better. It's the soft skills that are important. These aren't soft skills. This stuff is hard. Oh, when you need to have a thoughtful conversation, you need to be articulate. You need to know what you're talking about. You need to have the education, you need to have the background.

Those are not soft skills, so leadership and communication and the ability to affect and drive change within an organization. To be a, a role model and beacon for others to have a crucial conversation, but do so with respect. Those are tough skills. Those are the things that everybody needs to bring to the table.

And so whether you're in STEM or operations or wherever you come from, from an educational perspective, it's having the ability to embed those capabilities into your organization, into your teammates, and create an environment where they can practice those types of skills. And it's not always gonna be at the bar at 10 o'clock at night.

I'm always fascinated when I come to conferences. Everyone's, you know, at the bar and people excited to go out and party. I'm like, you are never gonna see me having too many drinks or staying out past 10 o'clock, because that's not where you're gonna create that momentum and create an example for others to follow.

Yeah, absolutely. I guess what you're saying is we should start calling hard skills and soft skills. Soft skills should be the things where we just sit behind a computer and create spreadsheets and Yeah, do all that stuff and you do not have to interact with other people. That is a soft skill. Yeah. . Yeah, you just have to love that answer.

And the, the wisdom that Sarah brings to the show when you, when you have to interact with people, those are the hard skills when you have to actually lead people to rally them, to get them excited and to, uh, point them in a direction and get them, uh, motivated to do things. Those are the hard skills.

Sitting behind the computer, not interacting with people. Those are soft skills. Uh, I really appreciate Sarah's insights and her willingness to, uh, take time out. Uh, to come on this, the show. Uh, thank you very much Sarah and I look forward to coming on your SoCal HIMSS podcast, uh, early this, uh, early this spring, and uh, also look forward to seeing your new Apple Watch.

At number eight, we have Daniel Barchi, C I o, for New York Presbyterian. Uh, in my research for the show, I was struck by the number of times that, uh, Daniel referred to history. He referred to history in his talks, in his interviews. And, uh, I thought that was interesting. So I thought I'd just ask him why, why that was So give this a listen.

I, I, I read a bunch of stuff on the internet in, uh, preparation. Um, and you, you appear to be a big fan of history. You made, you made reference to, um, Lincoln Grant, the Wright Brothers, Alexander Fleming, uh, And you even studied the history of the Chrysler building, uh, as you know, that you, uh, referred to in a story, which I, I found interesting.

The foundations that they put into place are important to recognize. And whether you look at your local history in your town or village, or you look at a national or global history, we can look back to fantastic people who are inspirational and what they did and learn a lot of lessons from them. So I think when I look at history, I try to see what challenges people face and what lessons I might draw from them.

Now, thinking about going forward, I think that we wanna invest our time and our energy and our resources in. Creative foundation more and more as we've run into a problem, I've thought not, oh, what do we need to do this week? But if we could really change things, how would we want this to look five years from now?

How would we want it to look at 20 years from now? And if that's where we wanna end up five or 20 years from now. What changes do we need to put in place right now that will get us on that right glide slope to get there? Even if it's hard, it's worth doing, but there's no point in putting in a quick fix and then two years going in and do the hard work later.

Wow. What, what? Great wisdom from a, from a great leader and um, You know, just, I mean, think of some of the things. I mean, we're standing on the, on the shoulders of the giants that went before us. Um, we lead today with an eye on the future. Uh, we are setting the foundation for what is to come. I love the wisdom of Daniel's answer.

Appreciate those who have come before you and create things with an eye on those who will come after you.

So throughout the year, people come out to me and they say, Hey, there's someone you should meet, or there's someone you should have on your show. And I really appreciate those conversations. And this next guest is someone who I didn't know starting this year. And Sue Shade, one of our other guests on the show introduced me to Amy Maner.

And Amy is a former C I C M I O for a children's hospital and now with Starbridge Advisors. And Amy and I started talking about the Arts Collaborative. She, uh, introduced me to what the Arts Collaborative does, uh, around E H R effectiveness. And, uh, it was a really fascinating conversation. So here's Amy at number seven, sharing some of those insights.

Okay. So I think one of the hottest topics, both for me personally and across the industry and I suspect is how do we address the E M R, whatever brand you're on's, role in provider efficiency and satisfaction. So, you know, people say physicians are burned out. I was at a social event the other night and the neurosurgeon next to me kind of heard what I did and immediately started complaining about clicks.

To me, no joke doesn't even work at. Where I've, um, but I hear about the clicks and so I think we're really trying to, we're beginning to adjust that and one of the most helpful tools. Did a project on that at my last organization, but IS class is doing this arch collaborative and I think we're getting some really good, fascinating data.

And so what class is doing is they're asking, I think they're probably close to 120 organizations, and they basically say, Hey, to all the users. Does your, do you agree? How do you feel about, does your E H R enable you to deliver high quality care? Then kind of like when we do population health, you look for the bright spots.

So what are the characteristics of places that, where everyone says, yeah, it's pretty good here, the emr. So it's not what you think. So you ready for the big surprises? Sure. Love it. Uh, so you're gonna share some of the things that Arch Collaborative, uh, found Yep. With their initial, uh, findings and that I've had, and I've also, um, had personal similar experience, but I think it's more powerful to talk about.

This national data. Absolutely. So they found, I'm gonna give the big surprises first that it spend doesn't correlate, voice recognition doesn't correlate. And, um, scribes doesn't correlate with improved user satisfaction. That's, that's wild. That's hard to believe actually. Uh, 'cause you hear that a lot if.

You know, if I didn't have to do the data entry, this, this whole thing would be fine. That, that's an interesting finding. So, and in fact this week, um, JAMA had an article about scribes and satisfaction in, um, 18 P C P practices. I. Which shows the opposite. So then, now that I've kind of reigned up, you know, everyone's assumptions, what are successful organizations and, and what they found, and I've personally found is it's really about how do you help support the users to use the E M R.

And it's, it's, It's robust, high quality, or at least the perception of really good training at first. It's ongoing support and the ability to personalize, which I tie to ongoing support. And one of the things that I really think, and it hasn't been borne out yet in the, they haven't gotten is granular.

It's ongoing ownership and engagement of the physicians. They need to have some ownership and engagement. Not each and every one, but like someone in each specialty needs to own the content and understand the software, and that's what really makes a difference. One more thing is the organizations that haven't had good data have keep trying to, it looks like they throw money and technology at it.

Well, the organizations with high user satisfaction seem to have a more of a culture of, of support and relationship with it. And the other thing is that everyone complains about entering the data. This is my concern about the JAM articles. No one talks about getting the data out, which is as important as entering the data.

I think Amy captures the, the spirit of so many of our guests on the show that we know we can do better and we want to do better for our clinicians and for our patients. And, uh, we continue to work diligently to find ways to ease the burden and, uh, and really to move technology into the background so it's not, uh, at the forefront, but really is in the background, just serving the needs of the people who, uh, need it most and really restoring that u human interaction back into healthcare.

So Ken Lewan is c i o for Sharp Healthcare in San Diego. Ken and I became friends when he moved here. Um, . Ken Lewan is the c i o for Sharp Healthcare in San Diego. Ken and I became friends when he, uh, moved to Southern California to replace longtime c i o for Sharp, uh, bill Spooner, who was also on the show this fall during the, the Chime series that we did.

Um, so Ken and I decided to discuss an article that talked about these disruptive forces that are impacting healthcare, and they identified eight disruptive forces. And Ken and I decided to go in depth on those. So, coming in at number six, here's a short soundbite from Ken Luan, C I O, for Sharp Healthcare.

The three more are millennials as consumers, internet of things, and non-traditional entrance into the market such as Amazon, Berkshire, jp, p m. I think we talked about that last one a bit, but yeah. So, uh, what would you tell your peers about those last three things? You know, consumers, i o t and non-traditional entrant.

I'd say, you know, consumers kind of goes along with what we talked about on the retail side. They, they talked really about the millennials and, and, you know, they don't want to go through the traditional process. So I think you, you have to start thinking about, you know, how do I serve, uh, a different kind of population.

It's really about transforming what we've grown up as kind of a, an operational automation of points of care. And, and and removing the complexity internally, and we've shifted the complexity to our customers, and we really have to switch that model around and think about how do we take the complexity out of the interactions that we have with patients and consumers?

And if we have to move a little complexity back inside, then how do we work on, you know, on automating and, and, and streamlining that. But you really have to shift your thinking as an organization from a. What I'd call a process and operational driven company to a consumer or retail type company. And, and, uh, and as part of that, you know, the Internet of Things is all this information that can be collected and the patients are on their own.

What's the plan for incorporating that? You know, how are you working with Apple or whoever to bring that data in to make it relevant to providers? So I think it just, it causes us at, for me it's really shifting and everything has to be thought of as more of a patient, consumer focused, uh, thinking not about how can I make this part of my operation more efficient, but how can I make that interaction?

Because as you said, You don't wanna lose the, you don't wanna lose the, the relationship. Yeah. So the consumerization of healthcare came up an awful lot this year. Uh, it seems to be a trend that is not going away. And you have all these disruptive forces and companies coming in from the outside, uh, to try to impact healthcare.

I think Ken really captured it well when he said, shift your thinking from a process and automation company to a consumer-based company.

Our next guest is so gracious. I've mispronounced her name so many times. I half expect her family to start picketing right back here, uh, behind me. Uh, Anne Weiler is the c e o and co-founder of Well Pepper. She is so smart and so excited about what technology can do, uh, within healthcare and to change healthcare in the healthcare experience.

In this clip, we discussed the move from point solutions to the platform. At number five, here's Ann Weiler. What area would you focus on right now? You're on patient engagement. Yeah, patient enablement. What, is there another area that you're looking at going that's a great area? Well, you know what's really interesting is just in the time that we've been doing this, which on the one hand seems like a long time in, in healthcare is really not a long time at all.

Um, we've gone from . Point solutions to platform solutions. So the, you know, a point solution for each type of patient or each type of intervention, whether that's like, here's a cardiac rehab solution, here's a total joint solution to like what, basically what we do and what we've always done, which is we can support any type of patient experience.

So interestingly, we went from people saying to us, you're trying to do too much, and now they're telling us we're trying to do too little. Because of this, the ones who see this overall digital patient experience, so they're asking us, how do I attract more patients? How do I, you know, you do, you do a great job of retaining them and recalling them, but how do I find them to begin with?

How do I do some basic triage of them when they're just starting to think that they might need care? And so I think what, what we would do if we were doing today is we'd actually do something even bigger because our customers are asking us for, for that something bigger and the market is ready. I think if I'd come out with like, we're doing a, you know, all of these things that a patient needs to do outside the clinic, we're gonna do them.

If I'd done that like four years ago, people were just like, you're crazy. Um, I don't understand what this is. So I think we would do. Similar, you know, a similar thing, but even bigger . Yeah. Platforms really have changed every other industry. Our EHRs really haven't taken that next step. They haven't filled that void.

Yeah, who owns the medical record is a, uh, pretty simple question that you would think would have a very simple answer, but, uh, sometimes we get wrapped around the axle with this one. Uh, Dr. Rod Hockman is the c e o for Providence, St. Joseph Health, uh, one of the, I think, believe the third largest health system in the country.

Um, and he is one of the, the leaders that I appreciate that has the courage to state the answer to that question very simply. At number four, we have Rod Hockman answering the question of who owns the medical record. I apologize in advance. The audio was a little rough on this video. I wanted to, uh, cover one last topic, and that's data with you.

And there's, there's a handful of ways I wanna talk about this. Um, you've talked about the power of data in healthcare, um, and how it can have a meaningful impact on, on outcomes and, and many other things. Uh, we, uh, Uh, we really have a ton of data within healthcare already. Uh, so let's talk about ownership of that data, scope of that data and privacy.

So let's start with the first question, which is, um, uh, who do you, who do you think owns the medical record or who should own the medical record and how will that change the way we view data and use data, uh, moving forward? So, I.

Given the question is, who do they get to and who do they trust? And uh, unfortunately we've had some bad examples out in the social media, uh, venue. You know, I think in healthcare we've always considered the, you know, the sanctity of data and, you know, we're, we're regulated to do that. So.

Over their data, but I hope they'll trust their health organization to be that trusted partner with them, to then figure out how that gets used and where, and I would not be as afraid, say, just trust of the other organizations out there that are now trying. I just think that one of the advantages that we have in the sector where we're, is that I think our, our patients and our families still trust us and we have a relationship with them.

So that's the way I would see that, uh, that working. And then the question is, is how do we use that patients benefit? Advance how we do care and in a way that, uh, you know, as, as you know, we're, we're a 5 0 1 company. Our interest is the health of our patients and communities, but we see ourselves being able to use that data advance, that not necessarily share.

There you have it. Simple answer. Data is there to serve the patient, not necessarily to build shareholder value. Really appreciate Rod Hockman coming in on the show.

And here we are. And now down to our top three. Um, most weeks we discuss the news, but some weeks there are, um, topics that I really wanna know more about. And artificial intelligence is one of those topics. And I decided to do a deep dive episode where I would find an expert and just, uh, really talk about artificial intelligence in depth.

Dr. Anthony Chang is Chief Intelligence and Innovation Officer for, for CHOC Children's Hospital of Orange County, as well as the Sharon Disney Lund. Medical Institute. He leads the AI med conference around the world, uh, the most recent one in December down here in Laguna Beach. And, uh, we had a fascinating conversation around, uh, artificial intelligence in medicine.

Here's a short story that he shared with me about human machine interaction. So that's a great story about the Alpha Go software program from, uh, Google being the human contestant and go, uh, so handily actually, um, But, and everyone publicized the second game, 31st move because it seemed like the computer made a move that it had not learned from any human based on hundreds of thousands or millions of games before.

It was like a move out of nowhere. And then, but yet that move was instrumental in winning the second game. What's not publicized is in the fourth game, uh, one of the moves the human champion made. Was sort of in the category of that really creative move. So some eerie moments there, right? Because maybe the computer thought or was creative for the first time and now the man, the human champion is learning from the computer.

But I think it's a wonderful, I. Uh, example how man and machine can learn from each other, right? I love Dr. Chang's, uh, vision for the Future where, uh, machines and intelligence working in the background, providing that information to the care providers and even to the patients. Uh, he made the point in our interview that, you know, we really don't think twice about taking, um, directions from

Uh, computers anymore. It's really becoming more and more commonplace. You don't think twice about, uh, following your g p s when it tells you to make a right turn and you don't really think twice about the information that comes back from Alexa when you ask, uh, Alexa or, um, or sir a question and you get that information back.

We do check it. We do filter it, but we are doing it every day. And, uh, I'm, I'm also just thrilled that Dr. Chang, uh, agreed to come on the show and I really appreciate his time.

As you guys know, we share a lot of videos on social media platforms, and this video got far and away the most attention of any of the videos that we shared this year. Dr. John Halamka is the c i O for Beth Israel Deaconess Medical Center in uh, Boston, Massachusetts. And John and I got into a discussion on the role of the c I O.

And I think John really captured this massive change that's going on in the role of the c I O and, uh, you know, only John can really address it because, you know, he is a prac practicing physician. He's an M I T trained engineer and he's been a c I O for, uh, for a very long time. So take a listen to John Halamka talking about the role of the c I O, that the role of the C I O has changed Totally.

And that is, uh, helping people to understand the vision for, hey, here's what's possible, and then bringing them together to have a conversation of, okay, if these are all the things that are possible, what should we be doing? Should we be doing something different in the Boston market than, than they're doing in Southern California?

Probably, I mean, our. Our environments are very different and our communities are different, and there are things that are probably a priority here than that aren't there, but we're we're people that lead those conversations. It's really fascinating to me. The other thing that's fascinating is I had a fair number of conversations at the, uh, CHIME forum and a whole bunch of the CIOs, the, that have been pushed into this operational role.

And then you've seen these other roles sort of elevate Chief Digital Officer, chief Innovation Officer, and uh, And, and I'm not sure the c i o, the chief information officer knows what to do now other than, okay, well, my job now is to keep the E M R running to make sure the data center runs to have DR capabilities and even security somewhat, I mean, not the implementation, but the oversight of, of security has been taken away from them as well.

And they're, they're saying, okay, my job, they really have become more of a director of infrastructure and technology than, than a traditional c i o. I mean, what do you say to, to someone who's saying, I want to get out of that trap. How do I get out of that trap and, and how do I. I don't know, differentiate myself in in that space.

I mean, the ones we just enumerated, because that's the nature of how the work has to be done these days. So fine. Tell a C I O, you're a sociologist, it's a change management activity, and you're a convener and you have these experts working for you. At these individual domains, you can't do it all yourself.

It takes a village. I love having John on the show agree with John, disagree with John. That's not really the point. The point is John, uh, puts ideas out there that we have to think about ideas that we have to discuss, uh, agree with, disagree with. Really, uh, come to grips with. And, uh, I think that's what, that's what I really like about him.

Uh, the other thing is he really has a passion for training the next generation of health IT leaders. And that's what this show is about. So, um, thank you John for coming on the show. I.

Um, one of the ones I didn't use was, your technology has no soul. Uh, it's a great story of, uh, Todd presenting to a Silicon Valley investor. It was some funding round. He was showing him his technology and, uh, the, the gentleman looked at him and said, you know what, Todd, the problem with your technology is it has no soul.

Uh, and it was, it was a transformative event for him. Uh, it caused him to change how he thought about, uh, developing the technology around the user experience. And he now talks very significantly about, uh, building empathy into the applications that he's putting out there into the marketplace. Uh, you'll wanna look that one up because that's not the number one, uh, video, even though I'm excited about it.

Um, the, uh, the minute I heard this clip, I asked him a question, and the minute I heard this clip, I thought, That is one of the top things I've heard in a long time. It just resonated very deeply within me, and I believe it'll resonate with you as well. So, uh, without further ado, here's the number one soundbite from this year.

Todd Johnson, c e o of Health Loop. Alright, so this is a a selfish question. Let's talk about implementation from, from a digital entrepreneur standpoint. What are the characteristics or activities that organizations that have successful implementations, what, what do they have in common? Yeah, I mean, It is conviction, right?

System. Have conviction around a thesis, and really work to identify the right partner and treat them like a partner, um, and make the, make real investments to achieve those outcomes, right? Find ways to really, really go strong. I think it, it is almost that simple. And clearly when there's the right economic incentives and organizational objectives, that we can align those incentives together.

It works. You know, we've seen, and you've seen this, um, you know, the emergence of the, the pilot, right? There's so many damn pilots, and now we have innovation centers that just, you know, they're pilot. Um, uh, wood chipper factories. And on the one hand it's great that you know, health systems get to take a test run for digital innovations and digital innova innovators get some test runs with hospitals, but more often than not, it results in failure and it results in failure.

'cause it gives everybody an in out right a chance to. Take the exit ramp as opposed to just saying, look, we're committed to this one way or the other, we'll make this succeed. This is where we're going and we're going to go big. And, um, I think that's really the critical, like when a, when a health system has conviction and is committed to achieving real outcomes and is willing to expend the energy to get the change management inside, the sky's the limit, right?

You can do amazing things without that conviction. You can sputter. Yeah, and I actually, I think the conviction, I, I think that's a great answer by the way. I think the conviction starts with what problems are we trying to solve? I think too many health systems are trying to solve a hundred problems, and, uh, you can't solve a hundred or or more problems every year.

You almost have to say, these are the 15 to 20 problems we are going to solve this year, and we're gonna focus our energy, our resources, our investments on these 15 to 20 problems, depends on the size of the organization, but I, I just find that. Uh, the focus of the organization is spread so wide, so there's a sort of a conviction that these 20 problems are the most relevant to our community.

That we serve right now. I feel like it's a little bit of the Jerry McGuire at the end. Uh, you know, you had me at conviction and if all he had said was conviction, this would be a great clip. But then he gave us this visual picture of the, uh, pilot wood chipper. And I just think that's, uh, so indicative of what's going on.

We just, we just keep trying things and trying things instead of. Really sitting down and figuring out what are we trying to build, what are we trying to establish? Uh, are we trying to do experience for the clinicians? Are we trying to do experience for the patients? And really setting the direction for our partners, uh, for our system, for our staff.

Um, your voice has had an impact this year and it will for many generations. And, uh, that's what I believe and I really appreciate you, uh, being a part of the show. Uh, if you enjoyed the show, please share it with a friend or colleague. . Uh, if not, please drop us a line. Let us know what we can do better. Uh, bill at this weekend, health it.com.