Fighting Disparities with Home Health

Webinar

Featuring

Renown Health

Description

COVID-19 forced healthcare into a whirlwind of innovation. Healthcare leaders had to make tough, but quick calls on addressing patient needs remotely.


Were these one-off moves, or have we found new ways to address challenges to access and affordability?


Dr. Tony Slonim, CEO of Renown Health in Nevada, led the nation in one of the first transitions to home health. Dr. Slonim’s focus rooting out inequity means there are great learnings on moving healthcare forward:


  • Why Renown Health invested in these efforts early
  • The impact of home health on patient experiences and inequities
  • How to drive strategic change with lasting impact

Dr. Tony Slonim

Tony Slonim

President & CEO
Renown Health

Renown Health

Chris Hemphill

VP, Applied AI & Growth
Actium Health

1

Transcript

Chris Hemphill (00:02):
Hello Healthcare. We are excited. Well, we're alive, and we are excited to have this conversation with you with a very, very special guest. I just had the pleasure of talking to Tony for a few minutes before, and I'm really excited for what you're going to be able to hear and learn about home health and its role in the future of healthcare, the future of care pathways and how it's being used to address needs and address and combat disparities in healthcare right now. Before we get into it, I just wanted to give you a quick introduction to Dr. Tony Slonim, who is currently the CEO of Renown Health, Tony. Anything you want to say before we start getting into this?

Dr. Tony Slonim (00:48):
Chris, thank you for allowing me to be here with you guys. I'm excited about the conversation we're going to have. It's so important for all of us.

Chris Hemphill (00:57):
Excellent. And folks, I'm excited for you. While we're talking I just want to let you know that if this is your first time attending one of these Hello Healthcare sessions, say hello, let us know where you're from, because what we're doing here isn't just for Tony to come up with a two hour PowerPoint and talk you to that. The idea here is with a lot of the innovation that Renown Health has been leading in-home health, and I'll get into that in a second. We know that a lot of people on here are focused on driving similar change, driving similar success within your own organizations. So if you have stories, if you have questions, the reason why Tony is right here is to be able to answer that, to be able to coach you the right way while we can on this call.

Chris Hemphill (01:51):
So feel free, let us know how you're doing, who you are and if there're any questions or stories that you'd like to share. And look, we got one coming in. Terry, I'm happy to have you join us again, too. So everybody feel free to get into it, you saw the title, you saw the subject matter that's being addressed, fighting home health to fight disparities in healthcare. One thing that's been coming up is we had a whirlwind of innovation in the middle of last year based on the fact that we needed some way to respond very quickly to one of the most overwhelming and enormous challenges within healthcare with COVID-19. With a lot of those that Tony and I were just talking about that. That was basically a giant experimentation process. There's a lot of different changes that we can expect to stick long term with the patient experience and a lot of things that didn't work well.

Chris Hemphill (02:47):
So one thing we want to explore is the lasting impact of a lot of these innovations. A lot of these changes are where we see those impacting the journey moving forward. So I just wanted to frame that up and talk about the fact that Renown is one of the first within that home health experience. So that's just a bit of context before we start getting into it. Oh, and Hey, Dr. Hillary Heinz, appreciate you logging in and speaking with us today. Thank you. So Tony, before we get into home health, It's like to take it personally. There's a personal motivation behind the way that you're you and your team are running Renown Health. So what would you say is the driving purpose behind your journey as a physician and now as an executive in healthcare leadership?

Dr. Tony Slonim (03:41):
Well, you know Chris it's funny because it hasn't really changed before I've had an amazing career. I'm so blessed to have been a nurse before I went to medical school, to have been a doctor caring for our most precious resource children who were critically ill and now as a healthcare leader, but over the course of the 30 years of my career, it's all about how today can we improve people's health and leave them with something that might be better than they had yesterday. And that's why I come to work every morning. I think the work that we do and the thinking that we do and the creativity that we bring to the problems we're facing is all about making people healthier. And whether I was an ER nurse or an ICU doctor, or a CEO, or a medical director, the journey has been the same as we focus on improving people's health.

Chris Hemphill (04:42):
Excellent Tony and I love the way that you phrased that. Especially there's two components that really caught my ear there, which was I want people to emerge healthier today than they were before. And also the fact that you acknowledge the creativity that's required and needed when it comes to all these diverse conditions and different things that are unexpected, we need to be able to be adaptable to keep delivering on that promise of making someone healthier than they were before they came in.

Dr. Tony Slonim (05:16):
It seems to me that we spend too much of our lives in healthcare thinking about hospitalization. And the hospitalization is such a very small segment. If you're a hospital leader, health system leader, you spend a lot of time thinking about the hospitalization for people, but if you are the person being hospitalized, it represents three days of your life, four days of your life, maybe two or three times throughout your lifetime. You got your appendix out when you were seven, you fell off your bike when you were 15, you had a baby when you were 28 and you broke your hip when you were 65.

Dr. Tony Slonim (05:53):
And in total, you spent 10 days in the hospital and you lived your life intersected by hospitalizations. The healthcare leaders in the country tend to think about hospitalization without a focus on how people live their life. And the only reason for the hospitalization is to restore people to health. That's what our job is. So, people that had fallen ill may have chronic conditions that get out of whack and our job is to make sure we restore the preserve health and restore them to health, that's our focus.

Chris Hemphill (06:32):
I think another good way to focus on that is that there is a whole world, a whole life that's going on that often isn't being addressed and isn't being considered at some of these levels that you're talking about. So I think that in a previous conference, I think you drove a division, there's healthcare versus health. So healthcare being, I'll just see if I remember it correctly, but healthcare is the what's happening while you're in the four walls, the actual delivery of care, whereas a health system focused on health is focused on that holistic experience, right?

Dr. Tony Slonim (07:07):
Yeah, exactly. You remember a lot, Chris, from that talk, that's awesome. The way we think that we've divided it in our heads, just so we have a working definition and a working model is that healthcare is what we do for people when they're sick or injured. And health is how we create an environment of wellbeing mentally, physically, and spiritually, so that they can be the best that they can be as an individual. And was is so valuable about at it is it integrates the person and their family into the conversation. We each individually have our own goals about how we want to live our lives, and that approach on health allows people to be in a partnership that lets them live their best life mentally, and physically, and spiritually.

Chris Hemphill (08:00):
So I think that there's some glue between how you're framing this whole total life experience with health and what some of the innovations that we're here to discuss around remote patient monitoring and home health. Could you talk about where home health aligns with what we're discussing in terms of that total health experience and your mission as a physician and caregiver?

Dr. Tony Slonim (08:26):
Absolutely. So at Renown Health, we're an integrated health system. And for a long, long time, we've had not only hospitals, but we have an integrated health plan, a medical group with 500 providers. We've just now newly integrated the University of Nevada's medical school into the Renown Health operations in a way that's meaningful. And we've had a home health enterprise for a while, but the way that we've tried to approach the work, and I think there's a historical element here. People have typically thought about rehabilitation hospitals or physical therapy home health as non-healthcare, they call it post-acute services usually.

Dr. Tony Slonim (09:10):
Well, we've tried to change the model years ago, we went and said, why are you saying it's only after hospitalization? Why can't it be before? Why can't we tap into these alternate settings as a way of keeping people and sustaining people's health? Imagine that we could come into your house before you deteriorated in the hospital that props you up. Imagine that you could go to rehabilitation if you were getting weak or had a condition before you went to the hospital, we might actually avert the hospitalization. And so we've tried to take a systems' lens to how we design and build our services for this new technology.

Chris Hemphill (09:57):
Excellent. So when we're thinking about that systems' lens, then a big concern here is on the long-term viability of some of these new types of experiences that have been introduced, but you're thinking about this in a systematic way it sounds like. So it's integrated. Do you see it replacing parts of that care journey for the long-term?

Dr. Tony Slonim (10:22):
I would hope so, and here's why. And I think the healthcare industry has struggled for a long time and you can go back historically in segments and identify this, we won't do that now, but needless to say, we still have for the amount of money that we spend on healthcare as a nation outcomes that are insufficient for that investment. And it's not about cutting people out or reducing services, it's the fact that we have a little bit of a flawed model. You would never design it the way it ended up, you would do it differently. And there's been tremendous progress over years trying to improve the health system. And we should not minimize those impacts, right? I mean, the patient safety act, we know about patient safety and quality and the value that's come really in the 99, 2000 timeframe.

Dr. Tony Slonim (11:19):
We know about President Bush's patient safety act. We know about President Obama's work that we did on investments in infrastructure and electronic medical records. We know famously about the affordable care act, and we certainly know about the pandemic and the influences that has had on our communities and our lives more broadly. And so I think we find ourselves in a new place where I ask the question about whether the way we looked before and all of the things we were doing, looked the same now after the pandemic. So I want to give folks a metaphor if you will, and we've all heard about the long haul syndrome. There are people who have been affected by COVID, who for some reasons are not as healthy as they were before they got COVID. Well, they look exactly the same.

Dr. Tony Slonim (12:23):
Here's one person before COVID and here's a person after COVID, they look the same, but there's something different about their endurance, about the way they were able to think, about the way that they were able to exercise about the way they were able to enjoy eating. COVID effects, even though you look the same, your mental status, your respiratory system, your cardiovascular and GI system. And so the people that look the same after COVID, we call them long haul COVID syndrome. They look the same as they did before, but they know they're different. And I think there's a metaphor there for the health system. We think that the health system has just had a pandemic. Well, yeah, but we're different. We may look the same, but are we the same and do the same metrics and do the same rubrics hold up? Even though we look the same and I'm questioning that, I'm questioning that for us, and I'm questioning that for others.

Dr. Tony Slonim (13:24):
Because until you ask the question, you'll never be able to find the opportunities and the solution sets to innovate around. Who knows? A fundamental principle in the world of healthcare, as you're managing hospitals, is the length of stay, how long you stay in the hospital. And for all of us, that's how we get paid. Right? The GRG based length of stay. In the aftermath, the pandemic with a long whole syndrome, is that the right measure? I don't know, maybe it is. Maybe it's not, but the whole system over the last two years has been completely turned on its head. What makes us think we're smart enough to know that what we used in the past is going to be successful in the future, and that's the spirit of inquiry and thinking that I think we should all bring to the table as we try to evaluate how best to care for people.

Chris Hemphill (14:27):
We absolutely should. And I've actually been seeing some exciting conversations coming in. I'm not sure if you know him, Dale Sanders, with regards to doing the quality measures, do the things that we've been using to measure care in the past. Do they hold up to what this modern scenario is?

Dr. Tony Slonim (14:51):
I'm pausing because yes, I want to jump on that. You're absolutely right. No matter what the domain, whether it's quality, whether it's service excellence, whether it's finance, whether it's picking your domain that you're passionate about. And I believe in some ways it's all of them. Again, why should we believe that the way we're going forward is just a repeat of the way we experience life in the past. It's inconsistent that we would not have learned things through the pandemic or need to teach people with the massive exposure we've had as a result of the virus. And so I don't have the solution Chris, by any means, but I am asking the question about spending enough time thinking about fundamental issues. How are we dealing with employee engagement? How are we dealing with things like patient engagement? Engagement is a two-way street.

Dr. Tony Slonim (15:52):
I can reach out all day long to patients and families and employees, and that's one-sided. And we know now the reciprocal of that, is in some ways challenged. People are tired in healthcare and around the nation. People are generally just from the burden of dealing with the pandemic. So what does that reciprocal engagement side look like? Frankly, it's a lot of disengagements and it's a lot of lack of trust, and it's a lot of scrutinizing and criticizing everybody around us. And well, wait a minute, let's reduce some love into this conversation and figure out how together we might be successful moving forward with a different mindset and design.

Chris Hemphill (16:42):
So to speak to that, when we talk about and when we think about the engagement and investment in remote patient monitoring and this home health experience, it sounds like that was something that had to coalesce and drive a lot of folks who might not have otherwise been unified to then unify around that experience. So I'm curious, and I want to help everybody watching to learn through the lens of what you've learned at Renown Health. So would you be able to talk a little bit about the launch of that program and some of the results that you've seen?

Dr. Tony Slonim (17:17):
Absolutely. And I'm happy to talk about it. And I want to add a little bit of a personal lens in this because I think it's important. It frames how my lens into the team's ideas helps to frame the conversation. So many people know, and it's not public information. My father died of COVID in April 2020 and the lead up to my father's death, ultimately after a two-week hospitalization, he had chronic illnesses for many, many years. And on the morning he called that he was sick, it was early-late March, early April, very early in the pandemic. I think six, eight weeks after the conversation really took hold in February 2020. Dad called me, it was very early in the morning, he woke me up and said, I'm not feeling well. I can't catch my breath. And he had a number of chronic illnesses, and I knew, intellectually knew, that as a physician, that a hospital would not be a good place for him.

Dr. Tony Slonim (18:24):
So I spent the next couple of hours saying, how could we put in the place care for him at home? He doesn't live in our community. He lives back home in New Jersey. And so I spent the time, I picked up the phone and I called his doctor and remember where we were very early in the pandemic. People didn't even know what we were thinking, what we were doing, how to treat this. And we've tried to arrange home care for him. He already had home healthcare workers. How do we get a nurse in the home? How do we do the lab testing in the home? How can we get him home oxygen so as to prevent hospitalization, because if he goes to the hospital with this pandemic and this heavily transmissible virus, that will be the end? And the short story Chris was that we could not arrange those things.

Dr. Tony Slonim (19:11):
When I spoke to his doctor on the phone, he said, well, I can't order oxygen. I'm like, of course you can. Paramedics give oxygen, EMTs give oxygen, let's just get oxygen. He said, well, we're not set up for that. And you know, I said, let's get a nurse in the house, let's get somebody to go there and test him. And they couldn't find a nurse to get it done. Ultimately, 72 hours, when we knew that he had progressed in his illness, it was about calling the paramedics and getting him to the hospital where he ultimately died two weeks later. The problem with the story is that it's not just about that, it's how emblematically dad's illness and the care that he could not receive in his home helped to frame what we needed to do for our community 3000 miles away.

Dr. Tony Slonim (20:04):
And so when the team brought to us ideas about, hey, what to do when the community's capabilities or resources get outstripped, we had to be creative in the mindset, and we supported the thinking. When the opportunity said, hey, could we do this differently with home monitoring or home oxygen, that resonated with me on a very personal level? Imagine that you could not only have home testing, but home monitoring home oxygen, you could care for people surrounded by their loved ones, eating their own food, sitting on their couch, not being exposed to viruses and other bad things in the hospital where transmissibilities is going up, up, up with the Delta variant and other things. Yeah, this actually might be the solution set that we could use. And we have been more than pleased with the results. We put this on people as they go home, we monitor their vital signs remotely.

Dr. Tony Slonim (21:06):
We monitor their pulse oxymetry levels. We monitor their heart rate through temperature and their body position. We have it integrated through artificial intelligence algorithms. We have nurses and technicians and doctors at the elbow if they need help, we're fully integrated. We transmit an ambulance to their home to bring them in if the data suggests that they are needed. So throughout the pandemic, we defaulted to a place of innovation in the context of science and data. Don't go with innuendo, follow the data and science. And now if the data don't exist, we're held open to creating the data streams so that everyone can learn about these new knowledge opportunities we have moving forward. It's been a great journey. I want to share with the audience that it comes out of a very personal experience.

Chris Hemphill (22:04):
And Tony, there's nothing more powerful than that as a motivator, but gosh, that was extremely gripping. And I'm really sorry to hear about your loss and what that's led to for you. But I appreciate you sharing that personal lens. And it drove your thinking behind the science and the technology to pursue.

Dr. Tony Slonim (22:33):
Yeah. You know, it's interesting, Chris. People give those too much credit. At the end of the day, we're just people, we're just people who have experiences and journeys of our own and try each day to figure out a different approach. And we're fortunate, as a CEO I'm lucky that I get a very broad lens. I may only know an inch deep on some things, but it's a very broad lens and it expands from home care to politics, to environmental issues, to other things. And because we are given the gift of that lens, we have a responsibility to use it in a way that can help to continue to advance in my case, the health and wellbeing of those that we serve.

Chris Hemphill (23:21):
So when we take it to that lens as well, like when we look at the wide view that you're able to have, and kind of the capabilities that you talked about in acting such as identifying when people have needs, being able to deliver certain aspects of care remotely that wouldn't be in the safest environment. One thing that we're curious about learning from the Renown experiences, has this is a major pin in the battle against healthcare inequities and disparities in healthcare for underserved people?

Dr. Tony Slonim (23:59):
You know, it's interesting. We as a nation, struggle with inequities and disparities in healthcare, and if we could do one thing in our lives, it's about how we focus on that opportunity because the reality of the situation is people don't get the same kind of care. And that depends on the color of their skin, depends on their ethnicity. It depends on a whole host of factors perhaps to even their gender or orientation. And again, as a CEO, I think you're informed, you get to be informed not only by your education, but your experiences. And so I want to give you and the audience another experience because it is intimately related to that conversation. I had cancer myself 20 years ago as a young person. And I've actually written papers on this issue. What really brought the issue of disparities to me as an opportunity that could be addressed was, when I was sitting in the waiting room waiting to see my cancer guy.

Dr. Tony Slonim (25:07):
And there were people across the waiting room who clearly came to care long after their tumor had arisen. And in part, it was because of the way that they were either insured or had access. In contrast to me, who was young health and knowledgeable educated, and a young and evolving healthcare leader at that time in my career. And I had the simple answers. I had opportunities that those people across the way from the room for me simply didn't have. And I vowed to myself at that point that if I was able to ever get past my cancer, and here I am 20 years later, I would try to make a contribution to breaking down those barriers to access because they're real. And frankly, the difference between me being here today and that person who was anonymous to me, I don't even know who was probably not alive today.

Dr. Tony Slonim (26:08):
And that is the heart of the issues around disparities and equity and inclusion. And to the extent that we use technology, which has a frame of being more cost affected. For me, that means opening up to more and more people, but because it's less expensive. And so the beauty of technology is you can democratize it and you can democratize it at a cost that's lower than most, and thereby make it available more and improve the access conversation regardless of their ability to pay, regardless of the color of their skin or their nationality or ethnicity.

Dr. Tony Slonim (26:51):
And that my friend is the key. We're not going to do it in the pre-COVID mindset because we would never build a system of care that way again. And all we've done is try to say, where can we disrupt and fail forward in a safe way and don't put anybody at risk. You have to test the technology. You have to default, I'm a scientist. I have to default to the science and the data, but don't let the rigor of the scientific methods stand in the way of letting a simple easy doesn't hurt new technology, get rolled out to the masses because you might save lives in the process.

Chris Hemphill (27:35):
The way that you framed that up, I mean, understanding like a new path, but identifying a new path to be able to deliver care in a much more affordable way. Does that sound like a tremendous step to what we're trying to accomplish and focusing on how do we have healthcare equity? How do we have addressing disparities as the north star? And what happens from that though, there was a question that I wanted to ask, which was how remote patient monitoring and how home health fits into your framework or your idea of how the next three years should go. But the focus on experimentation and the focus on not being too rigorous about some certain roadmap, I just want to broaden that question instead, rather where does home health fit over the next three years?

Chris Hemphill (28:31):
Because you made it very clear in the beginning of the conversation that this is a long-term investment. This is not just a one-off from COVID-19. So what do you see as the framework? For the people out there that want to make sure that they're designing and allowing these new technologies to come to fruition, what do you see as the path over the next three years for this type of innovation?

Dr. Tony Slonim (28:58):
Yeah. The short answer, Chris, is that I don't know. So let me tell you how life works as a CEO, right? You get incoming emails from around the nation, and I'm pretty active on social. So on LinkedIn, people contact me and on Twitter they contact me. And there are endless opportunities with people who are doing really good work and want to make a difference. And the reality of it is, I couldn't possibly even evaluate or understand where things are. So I always say to the team, our journey is about us being thoughtful. There are a bunch of smart people on my team who are just so wonderful, amazing healthcare leaders who have their hearts in the right place. And together, we help to craft what we know our community needs.

Dr. Tony Slonim (29:48):
And if there's a technology that fits in there that enables it, we go after it, we can't tackle the waterfront and you can't follow somebody else's dream. You have to create your own dream and then figure out where people fit into that. And that's been a major issue for us. If I come to work wondering what the composition is doing, I never get to my work. So define your work and go about executing it. But for one of those places where once we've designed our approach in the home health space and in others, we got contacted and here's the technology. I keep it on my desk because it's really simple and it costs less than a hundred bucks. And I can democratize this by sticking it on your chest and sending you home and making sure you don't get worse in your illness.

Dr. Tony Slonim (30:41):
And the good news about that is that you can with some levels of success, compliment current standards of care, I'm all about innovation. And as a scientist, you want to make sure that you're true to the experimental method, your biases play in, et cetera, the data has to solve. And so when you're adding a technology like this on to the usual standard of care, it's complimentary, it's additive. You're not putting anybody at risk and you can start to learn and understand as you go. We're very rigorous about how we approach the conversation, but while we're observing with the use to the technology, we're learning.

Dr. Tony Slonim (31:24):
We're learning in a fast forward kind of a way that allows us to say, hey, of all the people we monitored who we kept in the hospital for the extra day, they really didn't need to be there. They could have gone home and we could have monitored just the same, because very, very few of them decompensated based on the data we have seen with this diagnosis, and you get the idea, you learn things. You're better tomorrow than you were the day before. So innovating in a fast forward direction with a cycle time that matters is important for the way we do our work. And it's not just the use of technology, it's just the way we do our work at Renown Health in a variety of ways in context.

Chris Hemphill (32:07):
Well, Tony, if I was taking notes, it would be way too loud, but there was a lot that I hope people got out of that. And one thing that really struck early on was the focus on, I had a question kind of around technology, what that landscape looks like, but really what the focus is, is still having the strategy, the patient experience that you're looking for, addressing those disparities as that north star. And as your teams are coalescing and working together, so long as they see say they see that vision, everybody's getting these hundreds of emails, but you can only focus in on what matters at the time and what's appropriate at the time. So the technology strategy shouldn't just be technology-led. It should be strategy-led, patient-led, experience-led, and then there're different capabilities that we can start looking into that fit into what you're trying to accomplish.

Dr. Tony Slonim (33:04):
Yeah, Chris, it's funny. People tend to make healthcare really complicated, and I don't think it's as complicated, which is important. So I've been fortunate to be informed by a variety of lenses, some of which we've talked about. I've been a nurse, I've been a doctor. I have a doctor in public health and administration and all the rest of it. And I came up through the world of healthcare quality, where I really learned about how to measure things. And I've done the research for years. And with those lenses, here's the way I would define what we want both as a provider and a leader, and as a patient in healthcare. And we have a big sign on our campus that reminds us of this every single day and it is very simple. I love art and it's a piece of art that was donated to us and it says love, L-O-V-E in eight for it letters on the front lawn of our campus.

Dr. Tony Slonim (34:03):
And it reminds us and our providers every day to love those who they care for and to make sure that sometimes all you can do is hold a hand, but you will engage with an individual who is experienced in life and maybe a crisis in life different from you can appreciate today. And it's important to be there, to be that kind of back up for them that gives them confidence and hope and determination to be able to move through. And we put that out there in a prominent position on our front lawn because we want our providers and our community and our patients to know that's how we live our lives. The technology is an add-on, but it goes to the heart of how we provide love in the home. It goes to the heart of how we wrap around you with a big hug and let you know you're cared for in a way, even if we're not there giving you your medications in your home, but you've got one of our monitoring devices on you making sure that we got your back.

Chris Hemphill (35:02):
You know, Tony, this conversation I think is giving people so much to think about. There's so many different things, so many different avenues that somebody could come away with this from and really be focusing on. We talked about your personal journey around as a clinician and then going in into the administrative world. And then we talked about science and its relationship to the love that you're still focusing on still having as a north star at the end of the day. But as we move into the holidays and hopefully many of us have a little bit of time to be able to sit back and reflect and not have to be involved in the hustle and bustle this whole time. Are there any final thoughts or any takeaways that you want people to be able to focus on or what would you say? Like there's a reason, hey, you got the email from me, and fortunately, you opened that one. What would you say is the reason that you came here and that you'd love for people to be able to just take away from?

Dr. Tony Slonim (36:02):
Yeah, I think anytime, and I want to thank you, Chris, for the amazing platform and for all of those folks who have joined us today for a conversation. When you have an offer to share some thoughts, they may not all be the right thoughts. People may have different opinions, but when you have an offer to share how you think about certain issues and people perhaps can learn from that and apply it in different contexts around the nation. I spend most of my time being a teacher. That's what I do, I teach every day. And if I re-think back years ago, early in my career as a fellowship director and I taught young doctors how to be intensive care doctors for children. And there are hundreds of them over the course of time, who I taught how to care for sick kids.

Dr. Tony Slonim (36:56):
And they are now all over the country, caring for sick kids. And it's an opportunity to give and carry on in a much broader frame how you go about thinking of the world. Because I shared when I was teaching those young doctors and nurses, my values for caring for kids and their families. And hopefully, there's a nugget you remember, hopefully, there's an opportunity or there's a thought in your mind, that is huh, Tony's context is not exactly like my context, but what he said has relevance and here's how I would apply it. That's the key learning that we hope to get. And I think that this platform is a great opportunity and I really appreciate our conversation this morning. Hopefully, people have gotten another two out of it and that's why I was willing to share my time.

Chris Hemphill (37:48):
Excellent. Well, we appreciate that. And it's rare for everybody to be able to gather around and get these types of perspectives. But I believe that a lot of people attend these talks because there're certain types of change or certain types of innovation that they want to take to their own organizations. And I think along with the overall perspective that you drove, people got to get into your head a little bit, see a little bit of your decision-making process because they have their CEOs or leadership boards that they need to appeal to and it was just excellent to hear your side of the story.

Dr. Tony Slonim (38:27):
Well, Chris, I'm a little scared. It's crazy up there. I hope we didn't scare people off too much, but hopefully, well, if it accomplished that, that's what it was intended to do is to give people an inside look into the way that you can think about problems and hopefully solve them over time.

Chris Hemphill (38:46):
Well, thank you very much, Terry. Thank you, Dr. Hillary, thank you, Tony. For the folks out there watching, again as Hello Healthcare, we also have the podcast, so you can listen in on these types of conversations. Our most recent one actually came out a little bit earlier this week and focuses on the relationship between health IT and the customer examines is the customer within the health system, or is the customer of the physician, the customer or the patient. So it's a really good listen for the folks out there. If you want to come with us next week, our final Hello Healthcare session of the week is on Friday, next Friday, on the 17th, then we'll be taking back for the holidays and then starting a new season next year. But next week, we'll be talking to Dr. Alice Jacobs of converge.ai, and we'll be digging into her story on patient engagement. Chad, I appreciate you as well. And for everybody else, I hope you've got a lot of good things to think about for the weekend based on this conversation.

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