Good afternoon, I'm Ellie Huff and I want to formally welcome you to an engaging discussion we plan to have with you today around how do you sell quality to the senior executive suite. The premise today is simple. We believe that each year someone in your organization has to defend the costs associated with participation with registries and accreditation. Given the growth, the explosive growth, quite frankly, in this space, plus the unprecedented pressures we face with cost containment, thank you COVID, we believe it's a paramount time for us to be prepared and confident going into these conversations to protect the future investment into quality and outcomes. So with that and setting the stage for us all today, I would like to jump right in and introduce our first panelist and my distinguished colleague, Dr. Jeffrey Michael. Dr. Jeffrey Michael is the vice president of cardiovascular services at Baylor Scott and White Health. Dr. Michael. Well, thanks, Ellie. I think you raised a very important question that we're seeking to answer in this session today, which is we're all asked by leadership to justify every expense we bring to the table as we provide cardiovascular care. We're constantly looking at ways to improve costs and savings for patients. And I think, you know, my portion of today's talk, I'd like to go back to some basics on why data is important. And I think one of the important points we can make to leaders is that data is really no different than the CT scanner, the antibiotics, the ventilator, everything else. It's part of the way we treat and manage disease today. And to understand that, I think we need to go back in history. And I think I want to go back to the 19th century. I want to go back to a time when we didn't have data in medicine to understand what that looked like. And if I don't know how many people recognize this individual, probably not many. This is John Snow. And John Snow is not the same John Snow, you know, from Game of Thrones. He was a physician in the mid 19th century in London. And John Snow was interested in what caused cholera, which was an interesting question because Hippocrates had answered that question in 400 BCE. Everybody knew and everybody was taught that cholera was caused by bad air. Everybody knew this. But John Snow, having an inquiring mind and not being sure that was correct, decided to collect data. He collected data on cholera by actually taking cases of cholera and putting them on a map. And this is his actual map. And you can notice in this map that when he looked at cases of cholera, they seemed to be bunched up around one of the water pumps on Broad Street in London. To understand this, at that time in London, to get water, you had to go to a pump outside of your house. The pumps were connected to the River Thames, which also served as the sewer. Some pumps got water from upstream. Other pumps, like the Broad Street pump, just connected to the nearest part of the river, which was polluted. So what he recognized was that there was a correlation between where people were getting their water, not so much where people were getting their air. The old idea that this was an airborne disease, it didn't look like that was true when you looked at where the water pumps were. What's interesting is he also looked in this area and found that there were some workers at a brewery who were not getting cholera. Interestingly, they were not drinking the water from the pump because they got free beer at work. So he actually had a control in Broad Street area who were breathing the air that these people were breathing who were getting cholera, but who were not getting cholera, and they were not drinking from the water pump. It's a famous story. The local officials removed the pump from the water pump, and the cases dropped off and the epidemic resolved in that area. So he very nicely proved that this was a waterborne disease, even though for 2,500 years, medicine had taught that it was an airborne disease. And data was critical to figuring this out. He was recognized for his work by having a pub named after him. You can imagine that in the 1850s, when he reported that drinking beer from this brewer, that the people were not getting cholera, it was good for business, and the brewer actually named a pub in his honor. So this is one case study. I think another case study that is maybe more familiar to people is the case of this individual who may be more recognizable. This is Florence Nightingale. Now Florence Nightingale is well known for being the mother of modern nursing, but she was also a statistician and a scientist. And there aren't very many of us that remember the Korean War, the Crimean War. The Crimean War is one of those wars of the 19th century that had to do with religion. It involved Russia invading the Ottoman Empire, Britain and France coming to the aid of the Ottomans. What's interesting about this is that there was a public outrage about the mortality rate in the Crimean War. And it wasn't mortality associated with bullets and guns. It was mortality associated with disease. And Florence Nightingale went to the Crimean area to see if she could institute some basic hygiene measures. Now I don't know how many of you, I think the one memory I have of the Crimean War, I wasn't alive, Dr. Dahmer may have been, but I wasn't alive during the Crimean War, is the Charge of the Light Brigade by Alfred Lord Tennyson. I think we've all heard it, you know, into the valley of death rode the 600. It's very interesting because a light brigade of cavalry in the British military is 1500. So the reason that 600 people rode into the valley of death were 900 of them were sick and laid up. What Florence Nightingale hypothesized and was able to advocate for was that the officials there institute some basic hygiene, that they do hand washing, that they dig latrines separate from the water sources, that they have clean sheets and clean food. And basically what she did when she reported her results was show that there was this huge outbreak of disease in the Crimean Peninsula. When they instituted her reforms, there was a marked reduction. And it was proof that hygienic measures worked. It didn't prove what was causing the disease. We now know that bacteria was responsible. But back when John Snow and Florence Nightingale were working, we had no idea about the existence of bacteria. That wouldn't come for another 20 years. So why is this important to medical leaders today now that we know everything? Well, the problem is that we don't know everything. And that as healthcare systems, we face complex chronic diseases that we have to manage, that we know that there are factors involving biology, social determinants, and we have to treat these disease processes in real time, without being able to wait for all the science to be worked out. In other words, we need constant ongoing data on the populations we care for, and the patients we care for, in order to make good decisions. As Winston Churchill said, those who fail to learn from history are doomed to repeat it. So an argument to the senior leadership is, if we don't have data, we can't practice medicine, in the same way that if we don't have a CT scanner in the year 2021, we can't practice medicine. And this was brought as a grim reminder in 2010 in Haiti, when both the lessons from John Snow and from Florence Nightingale were forgotten. After the earthquake in Haiti in 2010, the United Nations sent in troops. These troops did not follow the hygienic standards of Florence Nightingale. They also came from the Himalayas, where cholera is endemic, and they brought it with them. So the unfortunate people of Haiti not only suffered an earthquake, but thousands died afterwards from cholera brought in because we didn't have, we weren't tracking data, and we forgot the lessons. So the message here is that data is essential. We learned this from John Snow around cholera. It doesn't matter if everybody agrees to something. If the data shows that it isn't true, we need to follow the data. We also find from Florence Nightingale that trusted data is necessary. Where do you go to get data? Do you go to the people that have been doing the same thing for 2,500 years? Or do you go to an independent source for the truth? One of the great things with these registries we're going to discuss and that Dr. Dahmer is going to discuss is that these registries provide benchmarks and trusted data. And we need longitudinal data. If you simply stop measuring things after you see success, you're in danger of having repeats. So the leadership remains key. We've got to keep our leaders engaged, and we've got to keep them informed and make the case that data is an essential tool in the practice of medicine in the 21st century. It's now my pleasure to introduce Dr. Greg Dahmer, who is the medical director of quality and outcomes for the Cardiovascular Institute at the Carilion Clinic. He's been a mentor of mine. He's my predecessor in my current role. And welcome, Greg. Thank you, Jeff, for that introduction, despite implicating me as being older than dirt. My pleasure to speak with you is why you should continue to participate in an NCDR registry. I have no financial disclosures to this talk, but as you see, I've been a past member of the NCDR management board for about eight years. I'm currently the chair of the public reporting advisory group for the NCDR. I guess that qualifies me as an NCDR groupie. So obviously I've had a long history with the NCDR, and I think very favorably of the NCDR. So why participate in an NCDR registry? As I was putting this together, I thought perhaps of three major benefits, and they're seen on this slide, benchmarking, maintenance, and public reporting and rankings, and we're going to go through briefly each of these three. So what about benchmarking? Well, I actually happen to live between the Allegheny Mountains and the Blue Ridge Mountains. Lots of wonderful hiking in that area, and perhaps you've never actually seen a real benchmark, which is shown on this slide. This is actually a benchmark placed by the U.S. Geological Survey. It marks the height and elevation above sea level. But when we talk about benchmarking in our areas, we're talking about more the verb form, which is to measure the performance of an item relative to another similar item in an impartial scientific manner. Now, benchmarks are everywhere. You probably don't stop to think about this all the time, but there's benchmarks for the airline industry, things like on-time arrival, lost luggage, things like that. There's benchmarks in the entertainment and hotel injury. There's lots of benchmarks about school functions, other academic things. So benchmarks are really everywhere. We don't think about them all the time, but they're everywhere. And that also includes benchmarks in the healthcare arena. These are just a minority of some that exist. Probably some of you are familiar with the Vizient database or the Premier database. Both provide clinical benchmarking based largely on billing or administrative data. The Commonwealth Fund benchmarks our U.S. healthcare system against that in other developed countries. So benchmarks are really fairly ubiquitous throughout the healthcare industry. So why benchmark and why should you be using the NCDR? Well, you need to benchmark if you want to know how your facility is performing, if you want to know your strengths and weaknesses, you want to know how you compare with others, and if you want risk-adjusted outcomes. And I think more and more we're increasingly being asked not just if we are any good, but to prove that we're any good or prove that we're good at doing what we do. And those requests come from payers, legislators, all sorts of regulators, auditors, litigators, and I could go on with a very long list here, but how else are we going to prove that we are doing a good job if we don't have some kind of benchmarks? And this quote here comes from an article by Douglas and Brindis and I think is especially important. If all we ever did was use our own data as the basis for improvement, we would only be better than what we used to be. That's why we really need national benchmarking because national benchmarking really sets a higher bar. So I'm sure many, many individuals who are listening to this are quite familiar with the NCDR. Not all benchmarking is equal. You need to have standardized data collection and certainly the NCDR provides that with their data collection forms which are under continual revision for improvement. You need standardized definitions as come from the NCDR data dictionary. You have to have data checking and you're all familiar with the little green circles that you get where there's data checking to make sure your data is internally consistent. There is an NCDR auditing program. It's not as robust as we would like to have it, but it certainly is there. And finally, the modeling that occurs in the NCDR is a little bit unique in that it contains these hierarchical risk models. That's something that a lot of people kind of stumble over a little bit. Risk models can be very simple and they can be very complex. So a simple risk model is based entirely on patient characteristics, risk factors and other things and it assumes that all patients are equal across all hospitals. Well, I think all of us would sit back and think for a second and realize that not all patients are equal across all hospitals. There's different size hospitals, tertiary care, quaternary care hospitals and things are not really the same. So hierarchical risk modeling introduces another factor and that's the hospital factor in terms of which hospital is providing care and adjusts for all that as well. So the NCDR provides all of these things. It's a comprehensive suite of 10 registries. The clinical data, this is very important, it's clinical data rather than administrative or billing data. Now administrative data has a lot of problems. I'm not here to claim that clinical data is absolutely perfect. It's not. But it is far superior than using administrative data for these kinds of things. There's quarterly risk adjusted benchmark reports that compare your institution with similar groups and national trends and then there's very convenient to use executive summaries that provide the opportunity to drill down into the data. So why participate and what does maintenance mean? I said we have benchmarking, well, what about maintenance? Well, I'm sure most of us drive an automobile and I think of it in terms of a well-maintained car that you do your regular oil changes, tire rotation and so forth and then there's, I'm not sure this is really a word, but the unmaintained car where you really don't do anything to fix it until it breaks and then you might be looking at a very huge repair bill. It turns out I actually have a dental appointment coming up and that got me thinking about kind of the patient environment and what's the well-maintained dental patient? Well, it's daily brushing, daily flossing and hopefully you do a better job than the fellow in the cartoon off to the right there. It's preventative care, getting your fluoride treatments and basically trying to identify and correct problems early before they become too severe. In contrast, there's the unmaintained dental patient. You really don't do anything that you're supposed to do until you have a terrible toothache and are trying to get in touch with your dentist at 7 o'clock on Friday evening. You have huge bills that are possible and the worst thing is it may be too late to actually save the tooth. Well, maintenance of your facility's data is equally important to all that. A well-maintained facility data, regular reviews data on a timely basis, you identify worrisome trends and then have the opportunity to correct problems before it's too late. All too often I've been on site visits at various hospitals and they'll proudly show off their NCDR data in three-ring binders up on some shelf and it's organized terribly well but it's also very dusty because they're really not using the data to help improve their own facility. That's in contrast to the unmaintained facility data where you really don't do anything until others start to report your data, either the state or the federal government or some other agency is reporting your data and at that point it's too late to correct your data when others start to report it and I think we all realize that can certainly have a profound effect on your institution's reputation and possible revenue. Last thing to talk about in why you should participate is because of public reporting and rankings. I think everybody should be familiar with these big three. There's Hospital Compare, that's the CMS run comparison of hospitals. There's the Watson top 50 cardiovascular programs, probably not as well recognized as Hospital Compare and then there's really the one that always commands a lot of attention when it comes out as it did about two months ago and that's the Best Hospitals report from U.S. News and World Report. I would emphasize that all three of these use Medicare administrative data that's about two years old to generate their reports and if you can adequately and diligently follow your NCDR data metrics, it can keep you out in front of what others will eventually report about you and give you the chance to correct things before they wind up in the public domain. So in summary, why participate in an NCDR registry? Well, I gave you three overlapping reasons, benchmarking, maintenance and public reporting and rankings. So with that, it's my pleasure to introduce Mr. Tucker Bing. Tucker is Director of Regional Cardiology at the Billings Clinic in Billings, Montana. Thanks, Dr. Dahmer for your introduction and your explanation on the importance of registries and thanks, Dr. Michael, for that background. As mentioned, I'm here in Billings, Montana and I will be discussing some of the market considerations and ways to use this registry data in a real-world context as we try to build market share, as we try to reach our patients. And I also have no financial disclosure related to this talk. So as Dr. Dahmer mentioned, there's a lot of external rankings, awards, accreditations that community members, that people in the community see. Some patients are savvy enough to understand some of the quality metrics, but a lot of times the information they see comes in this way, it comes in a marketing release and they see different things that happen. And so here's just a few examples for here at Billings Clinic, some of the awards that we've been able to participate in or accreditations we've received, but I want to emphasize that this has been done through the use of some of this data and to Dr. Dahmer's point, data that's more real-time than waiting two years to find out that we missed something. And so through some of that data, we've been able to really build a reputation for Northern Wyoming, for the Western Dakotas and Montana as the best place to receive cardiovascular care. And so I'll touch a little bit more on that. So Billings Clinic, as you can see here, we service a pretty wide geography. We're here in Billings, we have some cardiologists, and then I'll touch a little bit on our cardiology group out in Missoula. But we provide outreach to communities across the state into the Western Dakotas and Northern Wyoming. And in my role as the director of regional cardiology, I spend a lot of time on the road talking to referring physicians, administrators, community members in these small critical access hospitals, discussing why Billings Clinic, why if you have a patient you can't take care of in your town of 2000 people, why you should come to Billings Clinic for your cardiovascular needs. And there's a lot of reasons why I can share, but the most powerful is the objective data that comes from registries. Obviously as a Billings Clinic employee, I'm going to be biased and I'm going to say, well, you should send them here for these reasons. But rather than say, well, because I think we're the best or because I think you'll have a better outcome, to be able to point to actual objective data is really powerful. And it shows that we're tracking this and it's something that's important to us, rather than we're just trying to take care of patients and we don't really understand what's happening to them. And so tracking that data and having that objective information relevant and handy is really important. As we go out into the region, we refer to the region as anything outside of Billings and talk to some of these community members. And so here just shows some additional sites outside of just physical outreach, where we're continually reached out to and asked to provide some diagnostic reads, provide different things. But one of the questions that always comes up is, what is your quality like? How can you demonstrate your actual quality? And this registry data is really important. One other thing to comment on this, a couple of months ago, we were giving a presentation to a facility in another part of the state that wants to add some cardiovascular services and was looking to us to potentially provide those. And so we went through our presentation, gave some information, and then we had a Q&A session. And one of the most important questions that we were asked by a physician was, which registries do you participate in and how are you doing? And I was taken aback a little bit, but we were able to provide the answer and talk about all the different registries, which were participants, and gloss over, and we can go into more detail with him later, how we're doing. But that was really important and really powerful to be able to say, here's what we're doing and how quality is important to us, so that as they were seeking a partner, they would know that if they were to choose us to partner for some of their patients, we would make sure that we were giving them the best outcomes possible. And then if we were to deviate from that, we would have data that would be able to inform our decisions on how to improve that. So related to that, quality can lead to increased referrals. So as I mentioned, having that objective data is really important and showing that this isn't what I think, this isn't what someone who's biased thinks, but here's some objective data that shows why, if you have a patient who needs to be seen for some complex intervention that can't be done in rural Montana, here's a reason why you should send them to our facility. And we've seen that time and time again be the reason why we stand out and why we're able to continue to grow our market share. I was in a facility talking to a cardiologist down in Wyoming the other day, and he brought that up. I said, what is the main reason or thing we can continue to do to drive, to make sure we can continue to work with you? And the thing that was brought up by this physician was your commitment to quality is the most important thing. I can send my patient elsewhere, but I know that I send my patient to you, he or she will have a good outcome. And we're able to back that up with the objective data. The other thing that was brought up, I think when Dr. Dahmer was speaking, was having data points from across the country against which we can benchmark. Montana is a pretty rural state. We only have nine PCI centers across the entire state. And so even if we were to benchmark across the entire state, the entire region, it's still a pretty small sample size. And our commitment is to provide the same level of care where appropriate as you could get in a larger market. And so by being able to see what is being done in the, you know, Texas and Virginia and see what's being done there, we can benchmark against them and try to make sure that we're performing at an adequate level. And so that benchmarking data is even more important, in my opinion, for a smaller facility because we don't have that internal data that we would have in a larger system. So a couple case studies or examples that show how this works. A few years ago, because of our commitment to quality, a community medical center, which is a hospital out in Missoula in the western side of Montana, approached Billings Clinic and asked for us to partner with them on their cardiovascular service side. They had had a pretty small group with just a single interventional cardiologist and wanted to grow that, but looked to us for our help. So this is a facility that's 300 miles or so to the west, but our commitment to quality and the understanding that we're tracking, we're using these registries to make sure we're doing a good job, carried to that community and they wanted to partner with us. And so we were asked to work with them and we started to do so. As we've continued to focus on quality, we've seen some pretty good results and I'll touch on those here. So one example of how we've been able to use quality to drive improvement is through our chest pain accreditation. Before we were part of this joint venture, not a joint venture, but this partnership, they had a pretty small volume in their cath lab. And so in the last four years, since we started this partnership, we've been able to see 140% increase in our volume in the cath lab. In January of this year, we started and we received the first accreditation for a chest pain center in Western Montana, which is different than our competitor. Our competitor does not have that in this community. And we're on track to have a further increase, about 35% in our cath lab volume. So this morning I was having a discussion trying to get some resources. And in this case, it was a people resource for our quality team, which is always a challenge. We're adding a physician that doesn't generate revenue. Why is that needed? And so we had this discussion and I was able to point to this and say, because of this, we've been able to see some growth in our cath lab volume. And because of that, the administrator with whom I was speaking said, okay, that makes sense. Let's do an analysis, but gave me the green light to go ahead. And so by having this data, by showing how we go from tracking this quality, how it's seen in the community, we've been able to get some additional resources. One more point on this, as I've been traveling throughout the community, I've been asking different entities why we've seen this growth and what we can do to continue to see this growth. And something that was brought up to me by one of the EMS agencies was because we have this chest pain center accreditation, it's something that has been, the community's educated on this to some extent. And when they're choosing where to go, they come see us for their acute cardiac events because they know that we're following certain standards and we have certain quality benchmarks and things we're doing to receive this accreditation. And so it's been a great way to justify additional resources by really drawing that correlation between an investment in quality has led to improvement in the bottom line. And so then we can go back and ask for additional resources within quality. So the last thing I'll comment on here is, as I commented on, for referring entities want to see how we're doing with quality. Another really important aspect is what payers are doing. So as we all know, the payers are creating networks that are becoming more and more narrow and we're trying to find ways to continue to participate in those networks because often payers can influence where patients choose to receive their care. As you can see on this slide, one of the important aspects that payers are looking at is how we're tracking our quality data and how we're performing. And it makes sense. If you're a payer, you want your patients to go to the best place where they're going to receive the best outcomes so they don't have to receive any further care where it's inappropriate, where it could have been avoided. And so as we continue to work with payers, it's important that we have this data to point to so that we continue to become a center of excellence and have patients come see us rather than our competitors. And this is just another important consideration as we look to sell quality by showing that it's something that the people who are paying for this really want to see. So with that, I'll turn the time back over to Ellie for a wrap up. Okay. Thank you, Tucker. Well, this concludes the major presentation portion of our session today. I want to think back to when Dr. Michael was presenting, he was talking about learning from our history and not repeating it, but also how do we become a data-driven organization? And I would argue that registries and accreditations is the pathway forward for that. Number two, we heard from Dr. Dahmer who talked about the importance of benchmarking public reporting rankings, but also I think it's important to talk about the risk adjustment, the level of sophistication in the analysis that we're getting back for participation. That's really critical. And the fourth thing being what we heard from Tucker about the market growth, whether that's through reputation and building a brand with your referring physicians, but also with EMS and with our payers. So all in all, we hope that these succinct bullet points are going to help you be thoughtful going into conversations in the elevator with your CFO and ready to defend the quality agenda. Okay. I have two questions today for our panel that I think is important to help build up our tool set as we prepare for these conversations. So Dr. Michael, can you give us an example of a time in your career where maybe a quality project has led to a change in an executive mindset about participation or any insights thereof? Well, I mean, I think one of the things our system has done is to try to get the data to the practicing physicians in a helpful way that allows them to improve their practice. And one of the areas that we've worked on has been TAVR. And in TAVR, we have a number of different centers that do TAVR. We have developed scorecards based on the data that allow both leaders and physicians to look at the data in a fairly simple, understandable way and compare themselves both to national and to each other. And I think where that's been really powerful is that when everybody looked at their data, there were areas where everybody had room for improvement. And what was really interesting is they were different at the different sites. And it stimulated a discussion of, you know what, we should talk to each other. How is it that your vascular complications are less than ours? But wait a minute, we're having more issues with this other thing. What are you guys doing? And what it's fostered is a very collaborative environment that brings people together in meetings where they're meaningful meetings. They're not just meetings because we're having a meeting. They're meeting where people are coming in to learn something from their colleagues. And what's been really exciting is you can demonstrate that as a result of these, the overall outcomes have improved over time. And that's really the meaningful outcome. So I would say that's the most exciting thing that I've seen recently in our system of taking data that may be, as Dr. Dahmer said, used to live in a binder and figuring out a way to visually represent it and push it down to the physicians who are actually doing the work in a helpful way to allow them to improve care. And we've seen that work. Great. Thank you so much, Dr. Michael. Dr. Dahmer, a question for you. I would love to know where you think registries are going. What's next? What are they tackling? What's the future for us here? Well, I mean, I think the, you know, the NCDR has been in existence for quite some time has had, has shown steady growth. There's now, you know, in addition to the collaborative effort with the Society of Thoracic Surgeons on TAVR and MitraClips, now there's also now a left atrial occlusion registry and other registries. So I think, you know, as new procedures come along, they will be added either to an existing registry or there'll be the need to, you know, perhaps even start a new registry. I mean, one of your initial slides that you showed is that, you know, registries really show you what you're doing and you need to have the ability to understand what you're doing. I mean, nobody would think about walking around in their house with absolutely no lights on because you really wouldn't know where you were going and you'd probably stumble and fall down. And without that kind of data that you get from things like NCDR, that's kind of where you are in terms of knowing where you are, knowing what's good, knowing what's bad, and knowing where you need to improve. So I think, you know, you're going to see continued growth and investment in the NCDR over time. Thank you. And Tucker, lastly, you represent some of our more rural hospitals. What are your thoughts about, you know, participation with NCDR, the accreditation, the registries? What would you say to a CEO that's making the decision to join or not join? Yeah, I think one of our big commitments here is we want to keep care local. And so we need to show patients, we need to show our community members that they can receive the same quality of care here in Montana, and they don't have to travel to a Denver, to a Salt Lake, to a Seattle. And it's important to not just say that, but to be able to show that. And so I think in the rural setting, I think that's where that's important. And also to show where there may be times when it's not appropriate to stay local, where there's, you know, we can't achieve the same level of quality because we don't have certain equipment, we don't have the level of volume that we would need for certain types of programs. And so that's what I would say in a rural setting is we want to make sure that we're delivering care in the most appropriate place possible. And we need to make sure that we're doing that. And if we see where for some reason that's changed, where before we had, you know, the same level of quality that you get in a bigger market, and that's changed, why has that changed? Maybe we need to change the way we're doing things. Or is there something we can do to keep patients close to home? Because that's really what we try to do in the more rural setting. We don't want people driving hundreds and hundreds of miles in a snowstorm in the middle of January in Montana to go get care if they don't have to. And so that's where it really becomes kind of that patient focus. I think sometimes with quality and with registries, we get very focused on some numbers and some colors on a scorecard, which is important. But how do we get it back to that patient who lives in your community? You're, you know, in a rural hospital, you know, everyone in your town, how does this really influence that person? And I think when you can get to that point, it becomes a lot more powerful than just some numbers on a screen. So that's what I would talk to is just how this can really independently affect people and understand how those numbers really affect people's lives and the way they receive care. Excellent. Well said. Well, I want to wrap up this session by thanking the esteemed panel for sharing their perspectives and expertise. I think we're all going to walk away from this with some, you know, a purposeful pause to be ready for those elevator conversations or those drive-by meeting conversations and continue to make the investment into a quality agenda. Thank you.

data in medicine

managing diseases

registries

quality data

market growth

improve outcomes

data-driven decision-making