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This is Laura Duda with the Becker's Healthcare

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Podcast. I'm thrilled today to be joined by

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Nylene Flores, administrator and chief operating officer at

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Lake Oconee Orthopedics. Nylene, it's a pleasure to

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have you on the podcast today. Hi, Laura.

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Thank you.

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Now I'm excited for our discussion because I

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know there's so much happening in health care

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and particularly a lot of transformation in orthopaedics.

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And so I'm looking forward to getting a

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sense from you of how what you're thinking

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about, how you're looking at the future, and

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where growth might come from. But before we

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dive in, can you introduce yourself and just

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toss a little bit more about your background?

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Sure. So my name is Nylene Flores, as

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you mentioned. I'm currently,

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based out of Georgia.

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And like you said, I I've been running,

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orthopedic practice

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now here for the last couple years and

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also,

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own and operate a company called MedElevate Solutions

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where we streamline,

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health care processes,

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for ASCs and,

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practices

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throughout The United States.

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So I am having,

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a lot of fun,

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exploring and growing orthopedics in many different areas.

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And I have over about eighteen years in

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health care overall.

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That's amazing to hear. And and thank you

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so much for, you know, digging in. I

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know it can be a huge responsibility to

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run my practice and have none of the

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elevator solutions and just continue to work within

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the ASC industry. So with that in mind,

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what are the top three trends that you're

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following right now in health care and ASCs

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today?

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So

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this is gonna be really interesting because

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we have

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a continued shift really towards paperless

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operations,

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including a broader implementation of EHRs,

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and electronic logging systems

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and digital documentation

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systems overall.

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I think that as our generation,

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younger generations

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come up in leadership,

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this will hopefully in increase in trend.

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Also,

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I'm watching the decline of independently

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owned ASCs, unfortunately.

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Consolidation with larger health systems and private equity

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is really continuing

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as our health care shift,

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kinda continues to happen to more employed physicians.

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And then also

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a heightened focus on quality metrics and transparency,

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which is driving accountability and patient centered care.

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And, honestly,

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with this,

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I love the openness

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and platforms,

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social media and different platforms being utilized to

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empower physicians

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to basically say what is wrong with the

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health care system.

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And, hopefully,

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that will lead to a revolution

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in,

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in health care overall with, watching reimbursements

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and the way that payers

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help us continue to be able to treat

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patients in the ambulatory space. And so this

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is all something really exciting that, I'm watching.

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Absolutely. No. That's definitely fascinating. And I think

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especially when you look at, the trend, as

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you mentioned, the consolidation in the industry,

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new, you know,

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people coming in, new organizations, private equity, health

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systems, trying to figure out their operational strategy.

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It seems like,

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there's so much possibility of potential in outpatient,

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that I can imagine, you know, transformation is

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happening quickly. But I'm curious too. You know,

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when you look at, physicians and the tide

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as it seems to be turning a little

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bit here with both physicians as well as

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payers,

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you know, where do you see some of

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the big

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opportunities? What do you see as being the

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spaces that,

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will, you know, change the most over the

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next few years?

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Well, hopefully,

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the growth of the ASC industry overall, bringing

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patients outpatient.

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Most recently,

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we're we're also increasing acute, you know, acuity

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of cases,

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and we're seeing higher acuity cases being performed

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outpatient. So in general, it much better care

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for the patient is being provided outpatient so

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that they can recover at home. But

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what's really interesting is in my last couple

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of authorization

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requests,

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where we are here is rural Georgia. So

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we don't and we also are subject to

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certificate of need law here in Georgia. So

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it limits a little bit access to surgery

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centers for a small practice,

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or an independent physician

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that's not part of a large group or

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a healthcare system. In any case,

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I've seen several authorization

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requests come through

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specifically asking

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why we cannot perform, for example, a knee

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scope

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at a surgery center. So we've actually had

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to justify with payers

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as to why we're performing

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this type of case in a

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in a hospital versus a surgery center. And

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and then in our case, it's simple. It's

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just lack of access.

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But, you know, if the payers are starting

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to put this as part of the prior

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authorizations,

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may not be such a bad thing to

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have physicians

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move more of their cases

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outpatient with the backing now or kind of

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a little bit of a push from the

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payers to make this happen and ultimately, obviously,

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save money for the patients

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and look for opportunities for physicians to have,

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an other source of of income.

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And then just overall increasing the openness and

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discussion of hard health care truths from safety

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concerns to systemic inefficiencies

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that there's, you know, real potential for these

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conversations

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to lead to true tangible improvements

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in care, of quality and equity,

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of care.

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That's amazing to hear. And I I can

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imagine, you know, a really, positive trend as

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you're looking at outpatient, looking at,

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you know, figuring out ways that

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the patients and physicians can have more access

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to that setting,

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and I know it can make a really

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big difference. What are you most excited about

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right now?

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Most excited is focusing on expanding service lines

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to meet growing demand while optimizing operational efficiency

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through

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implementing

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something I believe very deeply in, which is

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a complete digital transformation,

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moving away from paper,

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streamlining compliance,

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and improving data accessibility. This is what I,

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push to my clients, and I tell them

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we've got to grow. We've got to optimize

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all of our digital solutions

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to work efficiently,

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smarter.

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And so I'm really excited about that and

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particularly growing service lines

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to include,

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you know, the higher acuity cases in the

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outpatient space. So I'm really, really excited about

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that.

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Absolutely. And I think that's such a great

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point you brought up because, you know, having

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that digital transformation,

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having the data,

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makes such a big difference, for a variety

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of reasons, whether it's trying to be more

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efficient

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or,

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figuring out how you can, you know,

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better have conversation with payers and improve your

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values. So, you know, when you look realistically

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at surgery centers, there's a variety of types

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of centers, large, small, independent.

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How possible do you see that digital transformation?

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What are some of the roadblocks that you

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see surgery centers running up against, and how

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are the best navigating them?

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Well, roadblocks is people. People are the roadblocks.

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You can and then also, it it could

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be financial as well. Platforms,

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can

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be expensive

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to begin to implement,

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to start out because you have to not

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only pay for the software, but you've got

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to pay your staff to get trained to

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use it until you can actually see the

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return on investment

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as you actually begin to use the product.

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So that is the biggest hurdle is

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they're just used to doing things their way,

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and change is hard. So unless you have

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that strong figure

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pushing and champion

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in your surgery center, And it it doesn't

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even have to be the administrator. It doesn't

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have to be the clinical leader. It has

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to be a champion

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in the center that's willing to say, okay.

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I'm gonna take the lead in clinical.

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I'm gonna take the lead in the business

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office to make sure that they are on

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board with this transformation.

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So that is the biggest hurdle.

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I think that

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when you do a cost benefit analysis truly,

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honestly,

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and just get over that initial hump,

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you realize that the benefits way outweigh

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any cost.

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So

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that is the biggest hurdle as people.

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That makes a lot of sense. And, you

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know, I I appreciate that, kind of forward

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looking

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nature of it because, you know, as you're

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you're right, it's an investment, but definitely investment

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in the future that if done right, will

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make a big difference and have that ROI

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that you're looking for.

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When you think about Lake Orochi Orthopedics in

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general, how are you looking at growth in

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the next twelve months? Can you tell us

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a little bit more about, additional procedures and

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and services that you'll be bringing in?

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Yes. So really excited.

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We're looking to grow,

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add another practitioner here at our practice. Like

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I said, we moved from a very busy

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practice in Florida,

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kinda opened it here.

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But most exciting is,

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my main orthopedic surgeon is performing

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a thumb

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replacement surgery with BioPro.

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It is a, full joint replacement

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of the CMC joints, and so the patients

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are doing amazing. We've even he's the only

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practitioner currently doing that in the state of

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Georgia.

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We, unfortunately, can only perform it at a

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hospital because we don't have a surgery center

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here.

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So really excited to just increase different new

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service lines and offer,

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new procedures.

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Not as early it's not really that new.

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It's just that not many doctors are doing

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it. But it's a great procedure that's allowing

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for patients to regain and not have to

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do

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a traditional procedure that would actually shorten their

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thumb. This allows them to keep their full

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thumb and have,

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great use. We've even done one on a

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person only on one hand. So we we

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and now we're we're doing our second

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patient who's doing both joints. So we've done

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both

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both hands.

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Recovery has been great. So are we looking

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to continue to do

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innovative,

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great procedures

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to help patients

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in in general? So we're excited about that.

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Well, that's fascinating to hear. And what a

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cool evolution in technology and medicine and just

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being able to, perform really needed procedures.

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But also I know the complexity, especially of

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the hand and and thumb, you know, is

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something that,

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it takes a real expertise to do. Nylene,

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thank you so much for joining us on

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the podcast today. This has been a fun

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conversation, and I look forward to connecting with

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you again soon.

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Great. Thank you so much. I appreciate your

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time.