1 00:00:00,240 --> 00:00:01,919 Hi, everyone. This is Lucas Voss with the 2 00:00:01,919 --> 00:00:04,400 Becker's Healthcare Podcast. Thanks so much for tuning 3 00:00:04,400 --> 00:00:07,219 in to this episode. An exciting topic today, 4 00:00:07,440 --> 00:00:11,119 building trust through innovation, technology and patient care 5 00:00:11,119 --> 00:00:13,884 in modern health care. And I'm very excited 6 00:00:13,884 --> 00:00:15,964 to be joined by doctor Ryan Fulton. He's 7 00:00:15,964 --> 00:00:19,184 the section chief at Carilion Children's General Pediatrics 8 00:00:19,324 --> 00:00:20,704 and an assistant professor 9 00:00:21,005 --> 00:00:24,045 both at the Virginia Tech Carilion School of 10 00:00:24,045 --> 00:00:24,545 Medicine 11 00:00:24,845 --> 00:00:27,024 and Edward Via College of Osteopathic 12 00:00:27,980 --> 00:00:30,059 Medicine. Doctor Fulton, thanks so much for being 13 00:00:30,059 --> 00:00:30,719 here today. 14 00:00:31,179 --> 00:00:32,880 Great to be here. Thanks for having me. 15 00:00:33,179 --> 00:00:36,059 Absolutely. Great to have you on. Well, for 16 00:00:36,059 --> 00:00:38,559 us to get started, making sure our audience 17 00:00:38,700 --> 00:00:40,634 knows who you are, Could you just give 18 00:00:40,634 --> 00:00:43,034 us a a brief introduction to yourself and 19 00:00:43,034 --> 00:00:45,034 your overview of your work and career in 20 00:00:45,034 --> 00:00:45,774 health care? 21 00:00:46,554 --> 00:00:47,934 Absolutely. Yeah. So 22 00:00:48,234 --> 00:00:49,534 I started my career, 23 00:00:50,314 --> 00:00:52,254 obviously, in med school at BCom, 24 00:00:52,890 --> 00:00:54,109 in Blacksburg, Virginia 25 00:00:54,490 --> 00:00:57,710 and ended up doing residency at, Carilion Clinic, 26 00:00:58,329 --> 00:01:01,070 as well following that and then maintained, 27 00:01:01,850 --> 00:01:03,230 my career through Carilion, 28 00:01:03,850 --> 00:01:05,770 rising up to be section g for the 29 00:01:05,770 --> 00:01:07,230 past, two years, 30 00:01:07,795 --> 00:01:08,694 for outpatient, 31 00:01:09,474 --> 00:01:10,454 pediatric medicine. 32 00:01:11,474 --> 00:01:14,534 I've have a passion in both advocacy 33 00:01:15,155 --> 00:01:15,814 and technology 34 00:01:16,274 --> 00:01:18,435 and all kinds of things that are associated 35 00:01:18,435 --> 00:01:20,194 with medicine, so it's a nice place to 36 00:01:20,194 --> 00:01:20,694 be, 37 00:01:21,155 --> 00:01:21,894 to really 38 00:01:22,489 --> 00:01:25,290 hone my skills and develop the section in 39 00:01:25,290 --> 00:01:26,269 a way that, 40 00:01:26,729 --> 00:01:27,469 is most 41 00:01:27,930 --> 00:01:29,390 advantageous to our patients, 42 00:01:30,009 --> 00:01:31,950 as well as benefiting our physicians 43 00:01:32,250 --> 00:01:33,609 as we move forward with, 44 00:01:34,090 --> 00:01:36,509 the new technology and things that we've encountered 45 00:01:36,729 --> 00:01:37,629 along the way. 46 00:01:38,224 --> 00:01:39,984 And I love that you're an educator as 47 00:01:39,984 --> 00:01:40,484 well. 48 00:01:40,944 --> 00:01:42,644 That's that's that is fantastic. 49 00:01:43,584 --> 00:01:45,924 And I again, you have so much clinical 50 00:01:46,465 --> 00:01:46,965 experience 51 00:01:47,265 --> 00:01:48,165 over a decade. 52 00:01:49,025 --> 00:01:50,805 When we talk about technology 53 00:01:51,265 --> 00:01:51,765 specifically, 54 00:01:52,799 --> 00:01:55,519 it's evolved significantly. It continues to evolve. I 55 00:01:55,519 --> 00:01:57,439 feel like every month there's something new that 56 00:01:57,439 --> 00:01:58,579 we need to talk about. 57 00:01:59,680 --> 00:02:01,920 What do you see as the major benefits 58 00:02:01,920 --> 00:02:02,659 and challenges 59 00:02:03,040 --> 00:02:04,500 of integrating new technologies 60 00:02:05,439 --> 00:02:07,379 into medical practice today? 61 00:02:08,354 --> 00:02:11,395 I think the biggest benefit is improving patient 62 00:02:11,395 --> 00:02:11,895 care. 63 00:02:12,275 --> 00:02:14,915 That's that's the goal of improving technology. Right? 64 00:02:14,915 --> 00:02:16,915 So I I remember being the first to 65 00:02:16,915 --> 00:02:19,555 use the digital stethoscope in my practice. I 66 00:02:19,555 --> 00:02:20,055 remember 67 00:02:20,435 --> 00:02:23,870 being, on the research team looking at putting 68 00:02:24,650 --> 00:02:25,310 these devices 69 00:02:26,169 --> 00:02:27,790 in Far Southwest Virginia 70 00:02:28,569 --> 00:02:31,550 to allow us to do a full exam 71 00:02:31,610 --> 00:02:32,110 remotely, 72 00:02:33,290 --> 00:02:36,909 and allowing us, especially during COVID, to implement 73 00:02:36,969 --> 00:02:37,710 those strategies 74 00:02:38,155 --> 00:02:41,055 to improve patient care, not only for those 75 00:02:41,194 --> 00:02:43,114 that can't get in, but for those that 76 00:02:43,114 --> 00:02:46,155 don't have access at all. You know, many 77 00:02:46,155 --> 00:02:47,294 of our states are 78 00:02:48,074 --> 00:02:50,875 are very large much larger than Virginia. If 79 00:02:50,875 --> 00:02:53,159 you think about places like Texas or California, 80 00:02:53,219 --> 00:02:55,219 there are regions that don't have access to 81 00:02:55,219 --> 00:02:58,099 health care at all. So that's the direction 82 00:02:58,099 --> 00:03:00,340 that, you know, I really wanted to see 83 00:03:00,340 --> 00:03:03,639 most benefit from the technologies that we have. 84 00:03:03,939 --> 00:03:06,519 We off also have better diagnostics, 85 00:03:07,314 --> 00:03:10,055 enhanced communication within health care teams, 86 00:03:10,754 --> 00:03:12,694 and more personalized care, 87 00:03:13,394 --> 00:03:16,775 that we're seeing. The movement of concierge medicine 88 00:03:16,834 --> 00:03:19,014 and things like that would never happen without 89 00:03:19,314 --> 00:03:20,614 improvement in technology. 90 00:03:21,719 --> 00:03:23,639 Yeah. Absolutely. And you mentioned some of the, 91 00:03:24,039 --> 00:03:26,840 advancements that you've sort of personally witnessed in 92 00:03:26,840 --> 00:03:28,439 your own career, and this is this is 93 00:03:28,439 --> 00:03:30,379 something that I was really interested in. 94 00:03:30,919 --> 00:03:33,739 For you personally, what's the one technological 95 00:03:34,120 --> 00:03:37,555 advancement that has really impacted your career the 96 00:03:37,555 --> 00:03:39,474 most and your daily work when you think 97 00:03:39,474 --> 00:03:41,254 back through this evolution? 98 00:03:42,594 --> 00:03:44,754 I mean, I think that everyone's answer would 99 00:03:44,754 --> 00:03:46,534 be the electronic medical record. 100 00:03:47,474 --> 00:03:50,534 It's the most impactful and most all encompassing. 101 00:03:51,389 --> 00:03:52,769 You know, when you think about, 102 00:03:53,229 --> 00:03:55,949 the development of anything, whether it be the 103 00:03:55,949 --> 00:03:58,129 machines that help us do remote 104 00:03:58,590 --> 00:03:59,090 medicine 105 00:03:59,629 --> 00:04:00,849 or whether it be, 106 00:04:01,389 --> 00:04:02,289 you know, utilizing 107 00:04:02,669 --> 00:04:05,775 AI and health care, Epic, You know, the 108 00:04:05,914 --> 00:04:08,094 the Epic is what we use for EMR, 109 00:04:08,235 --> 00:04:11,134 but any electronic medical record is the backbone 110 00:04:11,514 --> 00:04:12,735 of how that technology 111 00:04:13,514 --> 00:04:16,235 is put from our hands into the patient 112 00:04:16,235 --> 00:04:19,514 hands, and that has really, really impacted health 113 00:04:19,514 --> 00:04:20,014 care. 114 00:04:20,829 --> 00:04:23,169 There are pros and cons to it, obviously, 115 00:04:23,629 --> 00:04:25,550 but that is that's has had the biggest 116 00:04:25,550 --> 00:04:26,449 impact overall. 117 00:04:27,069 --> 00:04:27,889 Yeah. Absolutely. 118 00:04:28,269 --> 00:04:30,430 Now with these advancements, there's a lot of 119 00:04:30,430 --> 00:04:33,264 happening. A lot of folks touch these technologies 120 00:04:33,485 --> 00:04:35,404 that that have certainly been in this space 121 00:04:35,404 --> 00:04:37,404 for a while, and and AI has really 122 00:04:37,404 --> 00:04:37,904 impacted 123 00:04:38,365 --> 00:04:41,004 health care as well. And there there's a 124 00:04:41,004 --> 00:04:43,884 survey from last year from 2024 that identified 125 00:04:43,884 --> 00:04:46,899 that nurses still have a have significant doubts 126 00:04:46,899 --> 00:04:48,599 over using AI driven technology, 127 00:04:49,220 --> 00:04:51,800 specifically in regards to accuracy and cybersecurity. 128 00:04:52,899 --> 00:04:55,139 How can leaders foster more trust, and and 129 00:04:55,139 --> 00:04:56,979 where do you see AI making the biggest 130 00:04:56,979 --> 00:04:59,319 difference for clinicians and patient care? 131 00:05:00,334 --> 00:05:02,894 Yeah. I think I think any anyone any 132 00:05:02,894 --> 00:05:05,074 advancement in technology or science 133 00:05:05,774 --> 00:05:08,194 has its reservations and trust. 134 00:05:08,894 --> 00:05:11,134 And this comes from even when we talk 135 00:05:11,134 --> 00:05:13,794 about early inter early adoption of electronic 136 00:05:14,495 --> 00:05:15,394 medical record. 137 00:05:16,069 --> 00:05:16,569 And, 138 00:05:17,110 --> 00:05:18,949 really, what it comes down to is that 139 00:05:18,949 --> 00:05:21,610 the direction that we're moving in health care, 140 00:05:21,829 --> 00:05:24,709 whether it be for AI or any other 141 00:05:24,709 --> 00:05:25,209 technology, 142 00:05:26,069 --> 00:05:28,310 is is the direction that we will be 143 00:05:28,310 --> 00:05:29,529 going. So 144 00:05:30,115 --> 00:05:31,555 I I always like to say that, 145 00:05:32,675 --> 00:05:36,595 when when, ChattiBT and all the new age, 146 00:05:36,915 --> 00:05:39,495 artificial intelligence started to come out, 147 00:05:40,435 --> 00:05:43,189 they were worried about AI taking jobs. 148 00:05:43,569 --> 00:05:45,730 And, one of my favorite quotes, and I 149 00:05:45,730 --> 00:05:47,970 forget who said it, but it was that, 150 00:05:48,529 --> 00:05:51,009 AI is not gonna take your job. Someone 151 00:05:51,009 --> 00:05:53,170 who knows how to utilize AI is going 152 00:05:53,170 --> 00:05:55,035 to take your job. And so, 153 00:05:55,335 --> 00:05:57,574 it's kind of get on the train or 154 00:05:57,574 --> 00:05:59,675 not leave the station sort of thing. So 155 00:05:59,895 --> 00:06:01,975 how do we affect how do we affect 156 00:06:01,975 --> 00:06:02,475 that? 157 00:06:03,014 --> 00:06:05,175 It's really talking about it in less of 158 00:06:05,175 --> 00:06:07,654 a scary way. As with anything, when you 159 00:06:07,654 --> 00:06:08,875 adopt something new, 160 00:06:09,479 --> 00:06:11,419 there are gonna be growing pains. 161 00:06:11,720 --> 00:06:14,680 And so trying to discuss those growing pains 162 00:06:14,680 --> 00:06:16,839 in a in a way that doesn't seem 163 00:06:16,839 --> 00:06:17,500 like you're 164 00:06:18,360 --> 00:06:18,860 preventing 165 00:06:19,160 --> 00:06:20,860 information from being shared, 166 00:06:21,399 --> 00:06:23,259 in a very transparent way, 167 00:06:23,720 --> 00:06:24,459 will help, 168 00:06:24,894 --> 00:06:28,334 both patients and nurses and and everyone that 169 00:06:28,334 --> 00:06:31,154 is involved really get on board with things. 170 00:06:32,254 --> 00:06:34,254 Yeah. And and you talked about the patient 171 00:06:34,254 --> 00:06:36,115 piece as being 172 00:06:36,415 --> 00:06:38,670 very important in in this space as well. 173 00:06:38,830 --> 00:06:41,790 And, again, you have extensive experience specifically in 174 00:06:41,790 --> 00:06:44,430 the pediatric space. When you work with younger 175 00:06:44,430 --> 00:06:46,670 patients and their families, how have you seen 176 00:06:46,670 --> 00:06:47,170 technology 177 00:06:47,710 --> 00:06:50,270 change the doctor patient relationship there over the 178 00:06:50,270 --> 00:06:52,350 years, and and what's important for health care 179 00:06:52,350 --> 00:06:54,050 organizations to keep in mind? 180 00:06:55,264 --> 00:06:56,485 The wonderful thing about 181 00:06:56,785 --> 00:06:59,985 working with kids is that kids have almost 182 00:06:59,985 --> 00:07:00,725 no biases. 183 00:07:01,264 --> 00:07:02,324 Mhmm. And so 184 00:07:02,704 --> 00:07:06,305 when they engage with new technology, it's more 185 00:07:06,305 --> 00:07:07,204 of a curiosity 186 00:07:07,665 --> 00:07:08,165 thing 187 00:07:08,600 --> 00:07:11,180 rather than a fear thing. 188 00:07:11,560 --> 00:07:13,480 So when I talk you know, when we 189 00:07:13,480 --> 00:07:13,980 utilize, 190 00:07:14,600 --> 00:07:16,379 DAX Copilot in in, 191 00:07:16,919 --> 00:07:19,240 our work in the in the office, we 192 00:07:19,240 --> 00:07:21,560 were initially, like, worried that there's gonna be 193 00:07:21,560 --> 00:07:24,235 people that deny access because of the fear 194 00:07:24,235 --> 00:07:25,535 of artificial intelligence. 195 00:07:26,074 --> 00:07:28,555 And what what I have have been doing 196 00:07:28,555 --> 00:07:31,914 is introducing it, explaining it, you know, asking 197 00:07:31,914 --> 00:07:34,875 permission, but also kind of telling the telling 198 00:07:34,875 --> 00:07:37,435 the patients that I have this little man 199 00:07:37,435 --> 00:07:39,580 in my in my phone that's gonna help 200 00:07:39,580 --> 00:07:42,060 me write my notes so I can sit 201 00:07:42,060 --> 00:07:43,120 and play with them 202 00:07:44,139 --> 00:07:44,879 and draw 203 00:07:45,180 --> 00:07:47,980 and do trucks and cars and talk to 204 00:07:47,980 --> 00:07:49,500 mom and dad instead of sitting on my 205 00:07:49,500 --> 00:07:50,000 computer. 206 00:07:50,460 --> 00:07:52,400 So I used to sit on my computer 207 00:07:53,154 --> 00:07:55,794 ten, fifteen feet away from my patient until 208 00:07:55,794 --> 00:07:57,794 the physical exam. Now I get to be 209 00:07:57,794 --> 00:07:59,095 right up with my patient, 210 00:07:59,475 --> 00:08:01,654 hanging out with my patient, building that patient, 211 00:08:02,274 --> 00:08:03,175 doctor relationship 212 00:08:03,634 --> 00:08:06,055 rather than being divided by a screen. 213 00:08:06,810 --> 00:08:09,389 So technology, in this case, is really enabling 214 00:08:09,610 --> 00:08:11,470 that that patient that relationship 215 00:08:11,930 --> 00:08:13,610 and being able to focus more on the 216 00:08:13,610 --> 00:08:16,430 relationship. Is that right? Absolutely. And I tell 217 00:08:16,490 --> 00:08:18,569 patients all the time, you know, even with 218 00:08:18,569 --> 00:08:20,514 older kids, I'm like, I would, you know, 219 00:08:20,514 --> 00:08:22,774 I'd like your permission to utilize this technology 220 00:08:23,634 --> 00:08:25,154 so I don't have to stare at a 221 00:08:25,154 --> 00:08:27,074 screen, and I can look at you and 222 00:08:27,074 --> 00:08:30,035 talk to you. And that immediately I've not 223 00:08:30,035 --> 00:08:32,514 not had anyone say no, though, as far 224 00:08:32,514 --> 00:08:34,375 as giving their consent because, 225 00:08:35,159 --> 00:08:36,379 one, they trust me, 226 00:08:36,839 --> 00:08:39,179 and they trust the process. And and 227 00:08:39,639 --> 00:08:41,659 and really establishing that relationship 228 00:08:42,360 --> 00:08:45,159 is so much of what people are looking 229 00:08:45,159 --> 00:08:47,480 for in health care. And if we look 230 00:08:47,480 --> 00:08:49,320 even more than that, if we look at 231 00:08:49,320 --> 00:08:50,539 a global perspective 232 00:08:50,894 --> 00:08:51,394 of 233 00:08:51,934 --> 00:08:54,894 how do we change people's, you know, overall 234 00:08:54,894 --> 00:08:56,975 trust of the medical community, how do we 235 00:08:56,975 --> 00:08:57,475 change, 236 00:08:58,575 --> 00:09:01,375 their interaction with the medical community, it's about 237 00:09:01,375 --> 00:09:02,595 building that relationship. 238 00:09:03,669 --> 00:09:05,750 Yeah. And with that, again, comes then trust 239 00:09:05,750 --> 00:09:08,309 in the technology that's being used to be 240 00:09:08,309 --> 00:09:10,309 able to advance patient care, which is was 241 00:09:10,309 --> 00:09:12,730 the key it was the key here, really. 242 00:09:13,190 --> 00:09:16,710 Looking looking ahead, obviously, 2025, but beyond that 243 00:09:16,710 --> 00:09:17,210 too, 244 00:09:17,644 --> 00:09:19,245 what do you think are some of the 245 00:09:19,245 --> 00:09:21,804 aspects or the technologies that you think will 246 00:09:21,804 --> 00:09:23,345 redefine family medicine, 247 00:09:23,725 --> 00:09:25,965 and what advice do you have for other 248 00:09:25,965 --> 00:09:28,125 providers who are looking to say, okay. We 249 00:09:28,125 --> 00:09:30,684 want more technology. We want to implement more 250 00:09:30,684 --> 00:09:33,200 AI and really leverage these new 251 00:09:34,379 --> 00:09:36,299 tools. So I think as far as the 252 00:09:36,299 --> 00:09:36,799 impact, 253 00:09:37,899 --> 00:09:39,840 for health care as a whole, 254 00:09:40,460 --> 00:09:43,899 you know, the possibilities are endless. My my 255 00:09:43,899 --> 00:09:44,399 suspicion 256 00:09:44,860 --> 00:09:47,615 is that, eventually, you will walk into a 257 00:09:47,615 --> 00:09:48,115 clinic, 258 00:09:48,575 --> 00:09:50,595 and you will be able to 259 00:09:51,455 --> 00:09:53,534 be recorded. Obviously, you would have to have 260 00:09:53,534 --> 00:09:55,714 your permission, but the the protected, 261 00:09:56,815 --> 00:09:57,315 information 262 00:09:57,695 --> 00:09:59,899 would get would check you in, get all 263 00:09:59,899 --> 00:10:02,879 your information. They would take your history. And 264 00:10:03,500 --> 00:10:06,940 while there's concerns about, you know, AI taking 265 00:10:06,940 --> 00:10:08,559 over the diagnostic steps, 266 00:10:08,940 --> 00:10:10,559 again, it's about the relationship. 267 00:10:11,205 --> 00:10:13,524 So you want one person wants to talk 268 00:10:13,524 --> 00:10:16,085 to another person. And so if you are 269 00:10:16,085 --> 00:10:18,745 able to gather that information in an expeditious 270 00:10:18,965 --> 00:10:21,045 way and then come in and have a 271 00:10:21,045 --> 00:10:21,545 conversation 272 00:10:22,325 --> 00:10:25,045 and talk with that patient meaningfully face to 273 00:10:25,045 --> 00:10:25,545 face, 274 00:10:26,139 --> 00:10:28,220 you're saving a lot of time that on 275 00:10:28,220 --> 00:10:30,779 the back end is what is causing burnout 276 00:10:30,779 --> 00:10:31,519 in physicians. 277 00:10:32,059 --> 00:10:34,159 So the logistics of, 278 00:10:34,940 --> 00:10:37,500 writing the note, of making the order, of 279 00:10:37,500 --> 00:10:40,355 dealing with the health insurance. All of those 280 00:10:40,355 --> 00:10:42,615 logistics is where AI needs to focus 281 00:10:43,315 --> 00:10:45,154 as we move into the future because the 282 00:10:45,154 --> 00:10:45,654 relationship, 283 00:10:46,034 --> 00:10:48,615 person to person, is what we have. 284 00:10:49,154 --> 00:10:52,674 But the burnout rate for physicians is why 285 00:10:52,674 --> 00:10:55,240 we would is gonna be taken hopefully taken 286 00:10:55,240 --> 00:10:56,139 care of by 287 00:10:56,440 --> 00:10:56,940 AI. 288 00:10:58,519 --> 00:11:00,759 And then in terms of the the provider 289 00:11:00,759 --> 00:11:02,459 perspective too, as you've mentioned, 290 00:11:03,000 --> 00:11:05,159 it's that trust, right, that's really important in 291 00:11:05,159 --> 00:11:07,720 the technology, being able to have conversations with 292 00:11:07,720 --> 00:11:10,575 everybody to say, okay. Hey. This is what 293 00:11:10,575 --> 00:11:12,495 what the tools do. Here's how it can 294 00:11:12,495 --> 00:11:14,894 help you. Are these conversations crucial for leaders 295 00:11:14,894 --> 00:11:16,335 to have to be able to say, okay. 296 00:11:16,335 --> 00:11:18,434 Here's how we're going to move this forward? 297 00:11:19,134 --> 00:11:19,634 Absolutely. 298 00:11:20,174 --> 00:11:23,779 I think that from the technology company 299 00:11:24,160 --> 00:11:25,779 side of things or corporation, 300 00:11:26,160 --> 00:11:28,820 there needs to be a significant focus on 301 00:11:29,120 --> 00:11:31,460 how to keep patient information protected, 302 00:11:31,919 --> 00:11:32,820 how to keep 303 00:11:33,200 --> 00:11:34,660 the artificial intelligence 304 00:11:35,075 --> 00:11:37,235 on track, which means that we're gonna have 305 00:11:37,235 --> 00:11:39,154 lots of software updates. We're gonna have lots 306 00:11:39,154 --> 00:11:41,254 of changes and and adaptations. 307 00:11:42,035 --> 00:11:44,434 But a %, you have to explain to 308 00:11:44,434 --> 00:11:46,855 the patient and their parent what this means, 309 00:11:47,000 --> 00:11:49,320 you know, how the encryption works, why the 310 00:11:49,399 --> 00:11:51,179 why I feel safe with this data, 311 00:11:51,559 --> 00:11:52,839 or at least have it in your back 312 00:11:52,839 --> 00:11:55,159 pocket if there's lots of concerns from the 313 00:11:55,159 --> 00:11:55,659 parent. 314 00:11:56,440 --> 00:11:58,934 Right. Absolutely. And that's why partnership is so 315 00:11:58,934 --> 00:12:01,174 important with with these companies being able with 316 00:12:01,174 --> 00:12:02,855 the vendors being able to do that, building 317 00:12:02,855 --> 00:12:04,315 a good partnership as well. 318 00:12:04,774 --> 00:12:06,855 Doctor Fulton, thank you so much for taking 319 00:12:06,855 --> 00:12:08,375 the time. I feel like we could, keep 320 00:12:08,375 --> 00:12:09,894 going on here with all of the great 321 00:12:09,894 --> 00:12:11,674 things that are happening in this space. 322 00:12:13,169 --> 00:12:15,889 Oh, yes. Absolutely. There's all always a change. 323 00:12:15,889 --> 00:12:17,889 Every every new day has a new thing 324 00:12:17,889 --> 00:12:18,710 to look into. 325 00:12:19,169 --> 00:12:21,409 Absolutely. Thank you, doctor Fulton, for taking the 326 00:12:21,409 --> 00:12:22,850 time, and we also want to thank our 327 00:12:22,850 --> 00:12:24,470 podcast sponsor, Microsoft. 328 00:12:24,850 --> 00:12:26,529 You can tune in to more podcasts from 329 00:12:26,529 --> 00:12:29,328 Becker's Healthcare by visiting our podcast page at 330 00:12:29,328 --> 00:12:32,148 beckershospitalreview.com.