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Imagine this, you're at the Hyatt Regency Chicago

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surrounded by the top minds in the ambulatory

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surgery center industry.

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Welcome to the Becker's 30th annual meeting, the

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business and operations of ASCs from October 30th

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to November 2, 2024.

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Picture the excitement as you collect business cards

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from over a 1000 executive level attendees forging

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priceless connections.

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Feel the buzz of conversations as you participate

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in more than 60 sessions led by over

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225 elite ASC speakers.

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Envision yourself gaining actionable insights on topics like

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private equity strategies,

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ASC business growth, and innovations in spine, orthopedics,

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GI, ophthalmology, and cardiology.

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Now imagine yourself listening to inspiring keynotes from

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hall of fame boxing world champion, Lila Ali,

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and professional basketball player, Caitlin Clark. Their stories

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will motivate you to take your business to

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new heights. You'll leave with a wealth of

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knowledge and a network of connections to help

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lead your ASC into the next year. Don't

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miss out. Get registered today. Visit beckershospitalreviewdot

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com and click on the events page to

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find the conference website. That's the beckershospitalreview.com

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events page. See you in Chicago.

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This is Alan Conlon with the Becker's podcast,

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and I'm thrilled to be joined today by

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Noelle DeFeld,

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vice president of perioperative

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services at HonorHealth.

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Noelle, delighted to have you make your debut

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appearance on the Beckers Podcast.

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Before we dive into some questions, I'd love

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to turn the floor over to you to

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hear a little bit more about your role

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and your background at HonorHealth.

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Fantastic. Well, thank you for having me today.

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Yes. I am presently the vice president of

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perioperative services

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for the HonorHealth Network.

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Previous to that role, I was the senior

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director of perioperative

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services

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at the Scottsdale Shea location in the HonorHealth

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Network, which logically is in Scottsdale, Arizona.

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But with this recent move, I have network

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oversight over the HonorHealth perioperative

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services department,

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and that does include

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outpatient services.

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So I'm very excited to be here today

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and talk to you a little bit about

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trends in the ASC space.

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Yeah. Absolutely. Pleasure is all ours. So without

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further ado, let's let's dive right in. I'd

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love to hear obviously, there's so much going

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on in health care at any one point

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in time. But could you give us a

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little bit of a breakdown? What are 2

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or 3 key trends that you're really following

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in health care, paying close attention to, and

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why?

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Yes. You know, I had the good fortune

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of being able to live in both spaces,

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being able to live in the inpatient environment,

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and then also be able to live in

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the outpatient environment.

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And so, you know, we've all probably experienced

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it where a lot of the inpatient hospital

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stuff is migrating to the outpatient world.

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And right now, there's an interesting development

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in

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screening colonoscopies.

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The US Preventative Services Task Force has

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lowered the age of screening colonoscopies

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to 45

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from the age of 50.

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And, yeah, that doesn't sound like a big

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swing. But what that does is it affects

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19,000,000

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lives across the U. S. And that is

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huge for our outpatient space.

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And along with that,

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one of the things that I'm watching closely

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is AI.

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We're all talking about AI and how do

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we effectively

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use AI when we have these massive changes

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like an age of screening colonoscopies

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to get our patient population

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into our centers

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so that we can optimize

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what the US feels is best for preventative

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care while filling our centers.

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Yeah. I'd love to hear a little bit

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more on the first thing you mentioned. I

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know we can touch a little bit on

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AI afterwards. But in terms of that,

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screening colonoscopy is, obviously, like you said, the

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age has been lowered 245

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from 50,

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affects 19,000,000 lives. Can you talk a little

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bit more about the significance of that ruling

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and kinda how you're preparing for it?

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Yeah. So, you know, I will say that

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we still have opportunity even with our 50

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plus age group to make it just more

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matter of fact. You know, mammography as matter

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of fact, PSA screenings as matter of fact,

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gynecological

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screenings are matter of fact. But a lot

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of people still are very hesitant to get

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a colonoscopy.

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You know, we've done a lot of community

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based outreach

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for screening colonoscopies.

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We have a big footprint,

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here in Metro Phoenix for the HonorHealth System

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in our primary cares

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and having a lot of employed primary cares

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and really measuring,

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you know, our compliance rate with getting people

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in for their screening colonoscopies.

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You know, for us also, you know, as

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we determine, like, people maybe have, you know,

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something that is suspicious

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with colonoscopies, we have a nice framework to

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get them into the hospital or get them

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into the next level of care. We also

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are doing and I actually highlighted this at

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a previous Becker's forum where we have a

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program where women

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are helping women

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get into the screening colonoscopy

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because we have found that women

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are less likely

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to seek that care.

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And so we have a model where we

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can do all female teams

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to make women feel more comfortable

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when they have their screening colonoscopies.

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Mhmm. Yeah. What why why do you think

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it is that women are less likely to

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seek that care? And can you any any

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early results that you can share about this

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initiative that you've implemented?

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You know, I wish I had better results

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or more results that I could share with

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you. I unfortunately don't have that in front

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of me now. You know, I think it's

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kind of back to basics with women. Right?

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We

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often are juggling a lot, whether it's our

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families,

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our work,

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aging parents,

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all of the above where

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the likelihood of us to add this to

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our list is fairly low. And we have

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other things that we put as a priority

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because it's more commonplace

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and more kind of socially accepted, You know,

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gynecological

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screening,

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mammography,

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those are easier. But the colonoscopy

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seemed to still be a barrier.

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And I did kind of touch on AI.

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And I know we'll probably get a little

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bit more to that. But

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with our AI platforms that we are using,

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we can focus on any given population. And

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if we take women

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between the ages of 45 and whatever, set

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an end date, our AI platforms

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can send text messages.

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They can call people. They can do a

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lot of different things

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to make it it like, almost like advertising.

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Right? You know, why did I buy that

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dress off of my social media platform? Or

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why did I, go to that restaurant?

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A lot of it's advertising or some sort

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of a ping that's stuck in my mind.

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And so we are using AI for just

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that purpose,

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to try to find the opportunities

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for better health care so we can do

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better preventative

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and then

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reduce risk, of course.

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Mhmm. Yeah. I mean, it's it's as someone

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who's a bit of a tech geek myself,

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I often kind of geek out of here.

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And just the the potential, the opportunities

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of of AI in many walks of life,

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where it's in health care, media, like myself

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or whatnot. But I'm curious to hear, is

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there anything else that you're working on on

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our health, whether in the perioperative services department

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or maybe more system wide in terms of

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AI initiatives and how you see that benefiting

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provider?

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Yes. So

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AI is playing a big role in our

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perioperative space.

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We are using a platform that will find

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open OR time for our physician

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partners.

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It's all about ease of use right now.

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And if we don't figure it out, my

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competitor will. So we're using a platform where

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our schedulers

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can go in and they can find open

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time much like you'd find an open time

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for reservations at a restaurant.

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And so we have had fantastic

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results with that in our physician partners being

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able to find time

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outside of their block.

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Or perhaps they're a practice that doesn't

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yet warrant blocks, but they still need access

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to the schedule. And, again,

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if we can make it easier,

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they will come to us.

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Mhmm. Yeah. It sounds when you think about

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kind of streamlining the whole process, maybe reducing

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revenue leakage, filling that block time, and ultimately

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keeping those positions happy, it sounds like certainly

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a a great initiative there too. AI, like

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you mentioned, super exciting exciting time in health

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care. You talked a little bit about the

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benefits there. I'm curious, Noelle, is there anything

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else? When you think about the future of

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health care, what else excites you?

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Yeah. I'm really excited about robotics.

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We do have robots in our freestanding centers.

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And

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robotics

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was originally for cardiac surgery or kind of

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entered into the market with a different

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trajectory than it is today.

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And robotics has really proven to get people

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back to regular life quicker.

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And our surgeons are now coming out of

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their residency and their training programs

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using robots in that and really expecting that

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in whatever type of setting they're going to

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be operating in, whether it's an inpatient OR

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or an outpatient center. So I'm really excited

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about the administrative

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teams

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embracing that as an offering in the lowest

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level of settings.

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Mhmm. Yeah. Is it is it a case

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where, like you said, residents, fellowships are coming

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out, having trained on the the latest and

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greatest technologies, having used these robots?

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Is that the case, especially when you think

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about ASCs,

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maybe that, you know, when you're looking to

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recruit the the top talent, the next generation

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of physicians, it's a simply must have, not

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a nice have in terms of having these

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robots?

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Absolutely.

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I was at a survey the other day,

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and they were asking about robotics and

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can you do it 7 days a week,

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all hours of the day? And I said

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absolutely.

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It is simply another instrument.

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And the public is asking for it. They

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are doing their research.

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They have that type of information at their

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fingertips.

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And what they're really looking for is, you

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know, what's going to give them the best

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recovery

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and the shortest downtime in their personal lives.

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And, you know, when we're looking at the

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ASC space, you know,

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so many different procedures can be done there,

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and they can be done safely. And it

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also helps kinda decant

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those procedures

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out of the main ORs

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so the so that the access in the

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main OR is appropriate for

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cases that really need to be done in

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that setting. So it seems like a win

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win

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for everybody, administration,

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our surgeons, and most importantly, our patients.

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Yeah. And interestingly said, I guess, robotics you

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know, the next generation of surgeons are seeking

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these out. They're joining health systems, hospitals, practices

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with these technologies. But also interesting to hear

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what you said, the patients are also doing

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the research and seeking out,

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practices which also supply these robotic technologies as

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well.

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Yes. Patients are very savvy these days. I

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remember my mother-in-law at 93 learned how to

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use FaceTime to do a televisit, and she

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did it all by herself. And she was

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so proud of herself. And so patients of

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all ages are very tech savvy,

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And so they do go on to various

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websites. They do do their research.

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And it makes sense to them that this

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will allow them to get back to normal

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life quicker.

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I figured your your mother-in-law

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using FaceTime at 93 years old. My niece

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at 3 years old just, figured out how

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to FaceTime during the day. So wondering what

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the next generation is gonna be like.

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Well Yeah. We'll be in those flying cars.

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So, well, last question before I let you

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go. Fascinating conversation so far, but how are

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you thinking about growth over the next 12

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to 24 months? What are you most focused

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on? Yeah. I hate to sound like a

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broken record, But in our growth strategy, it's

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really about optimization of everything. We'll be talking

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about key performance indicators forever.

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How do we run an efficient OR?

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And our AI partners are helping us. And

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I think from

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leadership perspective,

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I've mentioned that we'll be doing KPI and

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key performance indicators

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for the rest of my career.

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But it is different when we start using

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AI.

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We've been looking at case averaging.

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And, you know, our normal platforms do an

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okay job.

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But AI is taking okay to, oh my

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goodness, this is amazing.

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I can build in different patient factors

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to determine

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the length of time of a hysterectomy

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or the length of time

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of a hysterectomy

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versus

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an oncology

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hysterectomy.

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And that is helping our administrative team

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optimize the OR time better and have a

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more predictable schedule. And greater predictability

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allows for more case volume.

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And at the end of the day, the

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surgeon leaves and they've been on time all

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day. The patient leaves. They didn't have to

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wait, you know,

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extra time in preop. They got everyone did

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what they needed to do in the time

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that was allotted,

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and it really is a nice feeling. And

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any type of technology we can incorporate

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that helps that

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along really helps us optimize our operating rooms.

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Yeah. Absolutely. I mean, well, fascinating discussion and

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great to kind of get the inside scoop

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on everything you're working on, the great initiatives

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that HonorHealth at the moment. Really look forward

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to connect with you again down the line.

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Thank you so much.

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Thank you.