1 00:00:00,080 --> 00:00:02,319 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,319 --> 00:00:04,480 podcast. I'm thrilled today to be joined by 3 00:00:04,480 --> 00:00:06,799 doctor Samuel Jones, who is the director of 4 00:00:06,799 --> 00:00:09,839 inpatient EP services at the Chattanooga Heart Institute 5 00:00:09,839 --> 00:00:12,240 Memorial Hospital. Doctor Jones, it's a pleasure to 6 00:00:12,240 --> 00:00:14,000 have you on the podcast today. Thank you, 7 00:00:14,000 --> 00:00:16,614 Laura. Looking forward to it. Absolutely. Now I'm 8 00:00:16,614 --> 00:00:18,295 excited for our discussion to dig a little 9 00:00:18,295 --> 00:00:20,315 bit deeper into some of the cool things 10 00:00:20,454 --> 00:00:22,375 that you're doing at the Heart Institute. I 11 00:00:22,375 --> 00:00:24,695 think certainly it's such an important time and 12 00:00:24,695 --> 00:00:27,255 interesting and innovative time for heart care. But 13 00:00:27,255 --> 00:00:29,175 before we do that, can you introduce yourself 14 00:00:29,175 --> 00:00:30,539 and tell us just a little bit more 15 00:00:30,539 --> 00:00:31,359 about your background? 16 00:00:32,140 --> 00:00:34,780 Yes. I'm Sam Jones. I am a clinical 17 00:00:34,780 --> 00:00:35,280 electrophysiologist 18 00:00:35,899 --> 00:00:38,539 here at the Chattanooga Heart Institute with Memorial 19 00:00:38,539 --> 00:00:39,039 Hospital, 20 00:00:39,579 --> 00:00:41,179 and I've had a few roles over the 21 00:00:41,179 --> 00:00:42,320 years. I've been, 22 00:00:42,745 --> 00:00:44,664 in the service line, 23 00:00:45,065 --> 00:00:47,965 EP for common spirit health for several years. 24 00:00:48,104 --> 00:00:49,865 And then I've had various roles within the 25 00:00:49,865 --> 00:00:51,164 American College of Cardiology 26 00:00:51,945 --> 00:00:55,085 focusing on some of our registries, quality improvement, 27 00:00:55,625 --> 00:00:57,725 advocacy, as well as strategy. 28 00:00:58,520 --> 00:01:00,759 Overall, it really kinda fits into the niche 29 00:01:00,759 --> 00:01:02,619 and things I'm interested in, including 30 00:01:03,559 --> 00:01:05,420 how we're going to transform care. 31 00:01:06,040 --> 00:01:08,040 ASCs are something that we've been looking at 32 00:01:08,040 --> 00:01:09,799 very carefully that we may talk about more 33 00:01:09,799 --> 00:01:12,454 today. Certainly, how we're gonna adopt AI is 34 00:01:12,454 --> 00:01:14,875 something I've been following. And then just overall, 35 00:01:15,015 --> 00:01:16,314 the future of our specialty. 36 00:01:17,575 --> 00:01:19,895 Absolutely. You know, and that's a lot a 37 00:01:19,895 --> 00:01:21,734 lot to cover, but I think we'll dive 38 00:01:21,734 --> 00:01:23,334 right in here. So what are the top 39 00:01:23,334 --> 00:01:25,334 three trends that you're focused on right now 40 00:01:25,334 --> 00:01:26,900 in health health care as well as heart 41 00:01:26,900 --> 00:01:29,380 care, thinking about ASCs? We just love to 42 00:01:29,380 --> 00:01:31,140 hear some of the big things that are 43 00:01:31,140 --> 00:01:32,200 on your mind today. 44 00:01:32,900 --> 00:01:35,060 I would say the first one that I 45 00:01:35,060 --> 00:01:38,260 think everyone in medicine is really worried about, 46 00:01:38,260 --> 00:01:40,760 especially in cardiology, is workforce, 47 00:01:41,255 --> 00:01:43,355 which really means access for patients. 48 00:01:43,814 --> 00:01:46,935 Because right now, we have the epitome of 49 00:01:46,935 --> 00:01:49,895 a supply demand mismatch, meaning that we've got 50 00:01:49,895 --> 00:01:51,415 a lot of patients who wanna see us. 51 00:01:51,415 --> 00:01:54,234 We've got patients that are getting older, and 52 00:01:54,329 --> 00:01:56,650 they're just sicker. We've never seen patients quite 53 00:01:56,650 --> 00:01:58,810 like this before. They've got more chronic diseases, 54 00:01:58,810 --> 00:02:00,090 so they take up a lot of time. 55 00:02:00,090 --> 00:02:02,569 There's a lot of complexity there. And with 56 00:02:02,569 --> 00:02:03,630 all of this supply, 57 00:02:04,490 --> 00:02:06,409 with all this demand that we're having of 58 00:02:06,409 --> 00:02:08,830 these patients coming, how are we gonna actually 59 00:02:08,889 --> 00:02:09,949 address it? Because 60 00:02:10,275 --> 00:02:12,114 we may just not have enough clinicians, at 61 00:02:12,114 --> 00:02:13,794 least in our current model, to take care 62 00:02:13,794 --> 00:02:16,914 of it. They talk about within cardiology right 63 00:02:16,914 --> 00:02:19,495 now that we're kinda shifting older. 64 00:02:20,034 --> 00:02:22,034 We've got a gray tsunami. In other words, 65 00:02:22,034 --> 00:02:24,114 all the gray hairs may not be around. 66 00:02:24,114 --> 00:02:25,254 In 2019, 67 00:02:25,314 --> 00:02:27,849 they said twenty seven percent of cardiologists 68 00:02:28,550 --> 00:02:30,650 were over the age of 61. 69 00:02:30,870 --> 00:02:32,490 And so you've got a lot of cardiologists 70 00:02:32,629 --> 00:02:34,730 that are getting ready to retire, unfortunately. 71 00:02:35,430 --> 00:02:37,110 Now that would be okay if we had 72 00:02:37,110 --> 00:02:40,175 the training pipeline to accommodate for that. But 73 00:02:40,175 --> 00:02:42,415 every year, we don't have enough coming out 74 00:02:42,415 --> 00:02:43,155 of training 75 00:02:43,534 --> 00:02:45,314 than we do that are gonna be leaving. 76 00:02:45,534 --> 00:02:46,514 And the pathway 77 00:02:46,895 --> 00:02:48,655 to get to being a cardiologist or to 78 00:02:48,655 --> 00:02:51,215 be and being other subspecialists within cardiology is 79 00:02:51,215 --> 00:02:53,294 just so long. It takes a while for 80 00:02:53,294 --> 00:02:55,989 us to even, address that. Right now, they're 81 00:02:55,989 --> 00:02:59,269 saying that we're probably gonna lose about 547 82 00:02:59,269 --> 00:03:01,509 cardiologist every year just because those that are 83 00:03:01,509 --> 00:03:03,829 leaving and those that are coming in. So 84 00:03:03,829 --> 00:03:04,949 I think that's a big thing that we're 85 00:03:04,949 --> 00:03:06,389 gonna have to we're gonna have to really 86 00:03:06,389 --> 00:03:08,409 think about how do we address this problem. 87 00:03:09,205 --> 00:03:12,025 The second thing I would say is is 88 00:03:12,165 --> 00:03:12,665 AI. 89 00:03:13,205 --> 00:03:15,944 Probably, there's not a a talk that you, 90 00:03:16,485 --> 00:03:18,805 hear right now that AI isn't part of 91 00:03:18,805 --> 00:03:21,444 that. But I think AI is not just 92 00:03:21,444 --> 00:03:23,223 the the image acquisition. This is one of 93 00:03:23,223 --> 00:03:24,930 the things in cardiology that we have it 94 00:03:24,930 --> 00:03:27,010 doing so much for us in the imaging 95 00:03:27,010 --> 00:03:28,849 space. But, really, it's gonna be how can 96 00:03:28,849 --> 00:03:30,610 we use it in other things? How can 97 00:03:30,610 --> 00:03:32,129 we use it to address some of these 98 00:03:32,129 --> 00:03:34,210 workforce issues? And that could be with some 99 00:03:34,210 --> 00:03:36,550 of our documentation, whether that's with ambient 100 00:03:36,849 --> 00:03:37,990 AI scribes, 101 00:03:38,844 --> 00:03:39,665 care navigation. 102 00:03:40,125 --> 00:03:42,365 I think scheduling is something that can really 103 00:03:42,365 --> 00:03:43,504 be used for, 104 00:03:43,965 --> 00:03:46,384 triage. And so there's a lot of administrative 105 00:03:46,604 --> 00:03:48,685 type functions for AI that we're gonna be 106 00:03:48,685 --> 00:03:50,764 able to use as well as just clinical 107 00:03:50,764 --> 00:03:51,665 decision support. 108 00:03:52,439 --> 00:03:52,939 And, 109 00:03:53,319 --> 00:03:54,919 if we do that right, then maybe we 110 00:03:54,919 --> 00:03:55,419 can 111 00:03:55,800 --> 00:03:59,000 help with some of the workforce issues just 112 00:03:59,000 --> 00:04:01,479 by getting everyone to really focus at the 113 00:04:01,479 --> 00:04:02,840 top of their license as part of the 114 00:04:02,840 --> 00:04:05,159 cardiovascular care team. So that's gonna be a 115 00:04:05,159 --> 00:04:07,465 big thing, but making sure that we're also 116 00:04:07,465 --> 00:04:09,164 watching AI very carefully. 117 00:04:10,025 --> 00:04:11,805 And I think the third thing is just 118 00:04:12,185 --> 00:04:14,764 a transformation that we're seeing across all medicine. 119 00:04:15,144 --> 00:04:17,625 One time, especially in cardiology, we were tied 120 00:04:17,625 --> 00:04:19,865 to the hospital, and everything happened within those 121 00:04:19,865 --> 00:04:21,720 walls of the hospital. But But that's no 122 00:04:21,720 --> 00:04:23,660 longer gonna be the case, and we're seeing 123 00:04:23,720 --> 00:04:25,899 sort of a transformation and a translocation 124 00:04:26,279 --> 00:04:28,759 of care that's gonna go out. We mentioned 125 00:04:28,759 --> 00:04:32,120 ASCs already, ambulatory surgery centers. We've seen that 126 00:04:32,120 --> 00:04:35,019 happen in other specialties, whether it's with, 127 00:04:35,824 --> 00:04:36,324 gastroenterology 128 00:04:36,785 --> 00:04:39,444 and orthopedics and all of those same things, 129 00:04:39,584 --> 00:04:40,564 those same principles 130 00:04:41,024 --> 00:04:42,964 for why things are moving out of hospital 131 00:04:43,024 --> 00:04:45,665 will happen in cardiology as well. So how 132 00:04:45,665 --> 00:04:46,865 do we do that? How do we make 133 00:04:46,865 --> 00:04:49,024 sure we're doing that in a in a 134 00:04:49,024 --> 00:04:51,365 safe way? Because it can't just be about 135 00:04:51,800 --> 00:04:54,439 making sure that we're we're saving money across 136 00:04:54,439 --> 00:04:55,879 the board, although that is a big part 137 00:04:55,879 --> 00:04:58,139 of it. But how are we actually expanding 138 00:04:58,199 --> 00:04:58,699 access 139 00:04:59,079 --> 00:05:00,860 and the experience for the patient? 140 00:05:01,240 --> 00:05:03,660 And in that same area of care transformation, 141 00:05:04,199 --> 00:05:06,220 it's gonna be more use of telehealth. 142 00:05:06,634 --> 00:05:10,074 It's gonna be using more diagnostic rhythm and 143 00:05:10,074 --> 00:05:12,475 device care to help us really get to 144 00:05:12,475 --> 00:05:14,954 patients really where they are rather than have 145 00:05:14,954 --> 00:05:15,935 them come to us. 146 00:05:17,115 --> 00:05:18,634 I love that. I think all of three 147 00:05:18,634 --> 00:05:21,035 things you talked about are critical, whether it's 148 00:05:21,035 --> 00:05:23,399 in the workforce transformation and access to care 149 00:05:23,399 --> 00:05:25,180 for patients, thinking through how 150 00:05:25,480 --> 00:05:27,800 AI can help address some of those issues, 151 00:05:27,800 --> 00:05:28,860 but also understanding 152 00:05:29,560 --> 00:05:31,639 what it the risks are involved and how 153 00:05:31,639 --> 00:05:34,439 you can smartly integrate that more broadly into 154 00:05:34,439 --> 00:05:34,939 cardiovascular 155 00:05:35,319 --> 00:05:36,268 care teams. And then finally, looking at that 156 00:05:36,268 --> 00:05:36,405 transformation across all medicine going into the outpatient 157 00:05:36,405 --> 00:05:37,420 setting, I think it's 158 00:05:45,055 --> 00:05:47,375 cases into that space, it seems like, 159 00:05:47,774 --> 00:05:49,055 you know, you're not meeting some of the 160 00:05:49,055 --> 00:05:51,295 goals in terms of quality and value and 161 00:05:51,295 --> 00:05:52,990 and bending the cost curve in health health 162 00:05:52,990 --> 00:05:54,990 care and more, and then really working smartly 163 00:05:54,990 --> 00:05:56,829 with the the teams that you have. And 164 00:05:56,829 --> 00:05:58,430 so I I think that's a really interesting 165 00:05:58,430 --> 00:06:00,750 analysis and overview. And, you know, if we 166 00:06:00,750 --> 00:06:02,990 were to, dig just a little bit into 167 00:06:02,990 --> 00:06:03,729 the workforce, 168 00:06:04,189 --> 00:06:05,250 trend you mentioned, 169 00:06:05,634 --> 00:06:06,535 How do you see, 170 00:06:07,154 --> 00:06:09,875 realistically, the impact of losing that five hundred 171 00:06:09,875 --> 00:06:11,095 to seven hundred cardiologist, 172 00:06:11,714 --> 00:06:12,375 you know, 173 00:06:12,915 --> 00:06:14,214 coming through to retirement, 174 00:06:14,834 --> 00:06:17,415 you know, over the next several years? Like, 175 00:06:17,649 --> 00:06:20,050 how are you proactively thinking about that, and 176 00:06:20,050 --> 00:06:21,490 what does the field need to do in 177 00:06:21,490 --> 00:06:23,729 order to, make sure that, you know, you're 178 00:06:23,729 --> 00:06:25,810 in a place where people can still get 179 00:06:25,810 --> 00:06:27,829 the the care that they deserve? 180 00:06:28,689 --> 00:06:30,129 Yeah. This is gonna be a big thing 181 00:06:30,129 --> 00:06:32,685 that cardiology has to address, and I think 182 00:06:32,685 --> 00:06:35,165 it's gonna be a multi pronged approach because 183 00:06:35,165 --> 00:06:36,524 you might just look at it and say, 184 00:06:36,524 --> 00:06:38,285 let's just train more. Let's just open up 185 00:06:38,285 --> 00:06:40,044 a lot of spots. Well, that's not really 186 00:06:40,044 --> 00:06:41,964 how it works, and that's not how how 187 00:06:41,964 --> 00:06:43,644 GME works. While there are some things that 188 00:06:43,644 --> 00:06:46,329 we can probably do, as I mentioned, because 189 00:06:46,329 --> 00:06:48,569 the pathway to become a cardiologist is so 190 00:06:48,569 --> 00:06:50,889 long for training, that that's gonna take a 191 00:06:50,889 --> 00:06:52,490 long time if we can even do that 192 00:06:52,490 --> 00:06:54,009 at all. So there may be some things 193 00:06:54,009 --> 00:06:55,849 within education. Are there ways in which we 194 00:06:55,849 --> 00:06:57,930 can shorten some of that training? Can we 195 00:06:57,930 --> 00:06:59,875 remove some of the barriers so that we 196 00:06:59,875 --> 00:07:02,035 can do that? So that's one thing. But 197 00:07:02,035 --> 00:07:03,555 I think it's important to know it's not 198 00:07:03,555 --> 00:07:06,214 just about the physician. It's about the entire 199 00:07:06,274 --> 00:07:09,475 care team. And I think in cardiology, we're 200 00:07:09,475 --> 00:07:11,555 really blessed more more than any other specialty 201 00:07:11,555 --> 00:07:13,930 that we have really embraced that idea 202 00:07:14,470 --> 00:07:16,470 of how do we use everyone working at 203 00:07:16,470 --> 00:07:18,389 the top of their license. And this is 204 00:07:18,389 --> 00:07:20,709 gonna be critical because without that, we really 205 00:07:20,709 --> 00:07:22,870 have no hope for it. Even within that 206 00:07:22,870 --> 00:07:23,370 cardiovascular 207 00:07:23,750 --> 00:07:26,149 care team, though, we need to redesign some 208 00:07:26,149 --> 00:07:27,814 things, and we need to make sure that 209 00:07:27,814 --> 00:07:29,754 we understand what are the care pathways 210 00:07:30,214 --> 00:07:32,535 that we can utilize to really become more 211 00:07:32,535 --> 00:07:34,694 efficient in the care that we're given. How 212 00:07:34,694 --> 00:07:36,074 can we use the technology 213 00:07:36,454 --> 00:07:39,300 that's coming on board so that that's helping 214 00:07:39,300 --> 00:07:41,300 patients as well? How can we get to 215 00:07:41,300 --> 00:07:44,600 more virtual diagnosis with patients with telehealth 216 00:07:45,060 --> 00:07:46,980 and some of the other things that are 217 00:07:46,980 --> 00:07:50,259 becoming available with technology? So it's gonna have 218 00:07:50,259 --> 00:07:52,324 to be a multi pronged approach, 219 00:07:52,865 --> 00:07:55,104 definitely looking at the training pathway itself for 220 00:07:55,104 --> 00:07:55,604 cardiologists, 221 00:07:56,305 --> 00:07:58,224 using the cardiovascular care team to the top 222 00:07:58,224 --> 00:07:58,964 of the license, 223 00:07:59,425 --> 00:08:01,985 instituting the technology and AI in other ways 224 00:08:01,985 --> 00:08:03,365 that we haven't done before. 225 00:08:04,509 --> 00:08:06,029 I love that. That makes a lot of 226 00:08:06,029 --> 00:08:07,790 sense. You know, it is really helpful to 227 00:08:07,790 --> 00:08:09,709 understand the big picture problem and then some 228 00:08:09,709 --> 00:08:11,790 of the things that you're doing in in 229 00:08:11,790 --> 00:08:13,550 in the field is doing in order to 230 00:08:13,550 --> 00:08:15,649 prepare for the future. Now 231 00:08:15,949 --> 00:08:16,990 speaking of, 232 00:08:17,464 --> 00:08:19,064 just kind of some of those activities, what 233 00:08:19,064 --> 00:08:20,985 are you most excited about right now? What's 234 00:08:20,985 --> 00:08:21,485 really, 235 00:08:22,025 --> 00:08:23,785 exciting for you as you think about what 236 00:08:23,785 --> 00:08:25,225 we're able to do today in in the 237 00:08:25,225 --> 00:08:25,725 cardiovascular 238 00:08:26,105 --> 00:08:27,725 space and what's ahead? 239 00:08:28,345 --> 00:08:29,545 Yeah. I think there's a lot to be 240 00:08:29,545 --> 00:08:31,705 excited about, and you don't always get that 241 00:08:31,705 --> 00:08:33,860 message from people, but it really is. 242 00:08:34,160 --> 00:08:36,879 Right now, we're living in a phenomenal time, 243 00:08:36,879 --> 00:08:37,620 and there's, 244 00:08:38,160 --> 00:08:41,600 while there's the the burden is great, I 245 00:08:41,600 --> 00:08:44,000 think that the opportunities then just are gonna 246 00:08:44,000 --> 00:08:46,799 keep showing themselves more and more. Part of 247 00:08:46,799 --> 00:08:47,779 that's just innovation, 248 00:08:48,225 --> 00:08:50,225 and what we're seeing across the care pathways, 249 00:08:50,225 --> 00:08:52,565 how we're able to do things in cardiology 250 00:08:52,704 --> 00:08:53,524 with our procedures 251 00:08:54,225 --> 00:08:54,725 quicker, 252 00:08:55,105 --> 00:08:58,644 safer, and not always requiring the, the same 253 00:08:58,944 --> 00:09:00,625 need to be in the hospital and ship 254 00:09:00,625 --> 00:09:02,784 those out. So that innovation itself is gonna 255 00:09:02,784 --> 00:09:03,444 be phenomenal. 256 00:09:03,779 --> 00:09:06,980 I think the entire artificial intelligence, though, is 257 00:09:06,980 --> 00:09:09,139 gonna showcase things that we haven't even dreamed 258 00:09:09,139 --> 00:09:10,899 of about how that's going to do. Now 259 00:09:10,899 --> 00:09:12,820 we're gonna have to monitor that carefully. So 260 00:09:12,820 --> 00:09:14,740 while I'm excited about it, I have to 261 00:09:14,740 --> 00:09:17,399 admit that I'm also a little bit concerned 262 00:09:17,725 --> 00:09:19,804 to make sure that we understand what that 263 00:09:19,804 --> 00:09:21,264 AI is gonna do for us. 264 00:09:21,725 --> 00:09:23,424 And then just looking at 265 00:09:23,804 --> 00:09:24,945 the efficiency 266 00:09:25,644 --> 00:09:28,284 and the experience that we're delivering to patients. 267 00:09:28,284 --> 00:09:29,804 I think this is something that people are 268 00:09:29,804 --> 00:09:30,784 starting to realize. 269 00:09:31,485 --> 00:09:33,264 We have to do this better for patients, 270 00:09:34,019 --> 00:09:36,100 And we're gonna find that with some of 271 00:09:36,100 --> 00:09:38,980 the translocation of care outside the hospital, this 272 00:09:38,980 --> 00:09:40,820 has become a premium on making sure we're 273 00:09:40,820 --> 00:09:42,980 providing that service to patients. In the end, 274 00:09:42,980 --> 00:09:45,139 patients can definitely be served better with all 275 00:09:45,139 --> 00:09:47,154 of those things. So the main thing I'm 276 00:09:47,154 --> 00:09:49,475 excited about is just the innovation, whether that's 277 00:09:49,475 --> 00:09:51,315 not just from the technology, but just from 278 00:09:51,315 --> 00:09:54,035 the overall care delivery of pathways. How do 279 00:09:54,035 --> 00:09:56,274 we institute our cardiovascular care team? How do 280 00:09:56,274 --> 00:09:59,075 we institute telehealth to really transform this into 281 00:09:59,075 --> 00:10:01,154 something that's gonna be a better system for 282 00:10:01,154 --> 00:10:01,654 patients? 283 00:10:02,860 --> 00:10:04,779 I love that. And that's certainly an inspiring 284 00:10:04,779 --> 00:10:06,860 message when you think about how you can 285 00:10:06,860 --> 00:10:09,200 do things that you've never thought of before, 286 00:10:09,500 --> 00:10:10,320 and truly 287 00:10:10,700 --> 00:10:13,100 make that experience and the patient journey, 288 00:10:13,500 --> 00:10:15,935 much better. And two, some of the outcomes 289 00:10:15,935 --> 00:10:18,095 and quality of care, I can imagine, are 290 00:10:18,095 --> 00:10:20,254 ways that you can improve some of that 291 00:10:20,335 --> 00:10:22,335 those things with AI too. Is there anything 292 00:10:22,335 --> 00:10:24,735 you're doing at the Heart Institute right now 293 00:10:24,735 --> 00:10:27,935 that, you've been just overcome by some of 294 00:10:27,935 --> 00:10:29,774 the results or have been really excited by 295 00:10:29,774 --> 00:10:30,595 some of the results? 296 00:10:31,590 --> 00:10:32,549 Well, we do, 297 00:10:33,029 --> 00:10:35,029 have a lot in the imaging space that's 298 00:10:35,029 --> 00:10:36,950 going on, and I think that this is 299 00:10:36,950 --> 00:10:39,129 something where we're seeing by 300 00:10:39,750 --> 00:10:40,250 leveraging 301 00:10:40,629 --> 00:10:42,950 some of the technologies that's come out, we're 302 00:10:42,950 --> 00:10:44,945 able to get the right patient to the 303 00:10:44,945 --> 00:10:46,464 right place at the right time. And and 304 00:10:46,464 --> 00:10:48,464 what I mean by that is really in 305 00:10:48,464 --> 00:10:50,084 the world of interventional cardiology. 306 00:10:50,464 --> 00:10:51,824 You know, before, we would have a lot 307 00:10:51,824 --> 00:10:53,345 of patients that would come to the cath 308 00:10:53,345 --> 00:10:55,204 lab and get a diagnostic catheterization, 309 00:10:55,824 --> 00:10:57,105 and it turns out they did not need 310 00:10:57,105 --> 00:10:59,264 a stent. We didn't know that until they 311 00:10:59,264 --> 00:11:00,299 had a heart catheterization. 312 00:11:01,160 --> 00:11:03,820 But because of some of our CT workforce 313 00:11:03,879 --> 00:11:06,059 issue, we've been able to actually have patients 314 00:11:06,120 --> 00:11:07,899 get a noninvasive test. 315 00:11:08,360 --> 00:11:10,600 And what's what we found with this is 316 00:11:10,600 --> 00:11:12,440 that by doing this in a in a 317 00:11:12,440 --> 00:11:15,065 very designated way, we have a champion who 318 00:11:15,065 --> 00:11:16,985 watches carefully how we're doing with all these, 319 00:11:16,985 --> 00:11:18,985 are we putting the right patients into the 320 00:11:18,985 --> 00:11:21,964 CT scanner? How are we adjusting our flows? 321 00:11:22,345 --> 00:11:24,345 And with all of that, we're actually having 322 00:11:24,345 --> 00:11:25,085 less patients 323 00:11:25,464 --> 00:11:27,485 go to the heart catheterization laboratory. 324 00:11:27,830 --> 00:11:30,230 But that's okay because a greater percentage of 325 00:11:30,230 --> 00:11:32,950 them actually get an intervention. They get a 326 00:11:32,950 --> 00:11:35,990 stent. And so I think that's where we 327 00:11:35,990 --> 00:11:37,750 need to go overall as a field. We're 328 00:11:37,750 --> 00:11:39,610 trying to find out how do we get 329 00:11:39,669 --> 00:11:42,230 the patient the right procedure at the right 330 00:11:42,230 --> 00:11:44,315 time. And by leveraging that technology, 331 00:11:44,774 --> 00:11:46,855 we're absolutely doing that. And so I think 332 00:11:46,855 --> 00:11:48,695 that's gonna be one of many things that 333 00:11:48,695 --> 00:11:50,934 we find that we can we can continue 334 00:11:50,934 --> 00:11:51,595 to do. 335 00:11:52,134 --> 00:11:54,054 Overall, like a lot of people, we're also 336 00:11:54,054 --> 00:11:56,419 looking at how do we get more continuous 337 00:11:56,480 --> 00:11:58,399 care going on, what do we do with 338 00:11:58,399 --> 00:11:59,459 hypertension management, 339 00:11:59,839 --> 00:12:01,779 lipid management, rhythm management, 340 00:12:02,559 --> 00:12:04,639 all of those things that patients now have 341 00:12:04,639 --> 00:12:06,879 access to at their home. We're not having 342 00:12:06,879 --> 00:12:08,424 to wait for them to come in. We 343 00:12:08,424 --> 00:12:10,345 actually can get some of that data sent 344 00:12:10,345 --> 00:12:12,105 for us so that they're getting a more 345 00:12:12,105 --> 00:12:14,285 continuous pathway of of care delivery. 346 00:12:15,144 --> 00:12:17,065 That's helpful to understand, and thank you so 347 00:12:17,065 --> 00:12:19,625 much for, digging deeper into that example. Before 348 00:12:19,625 --> 00:12:20,845 we wrap up our conversation, 349 00:12:21,304 --> 00:12:23,144 are you thinking about growth over the next 350 00:12:23,144 --> 00:12:24,240 twelve months or so? 351 00:12:24,959 --> 00:12:27,039 I think for everyone, it's it's a big, 352 00:12:27,360 --> 00:12:27,860 issue. 353 00:12:28,480 --> 00:12:30,480 Growth, though, can't just be about how many 354 00:12:30,480 --> 00:12:32,399 more procedures are we doing, all that, but, 355 00:12:32,399 --> 00:12:34,959 again, smarter pathways. And I've I've mentioned that 356 00:12:34,959 --> 00:12:36,320 a few times, but I really think that 357 00:12:36,320 --> 00:12:37,539 that's critical because 358 00:12:38,159 --> 00:12:39,620 the new center of excellence 359 00:12:40,004 --> 00:12:42,085 can't just be, what it used to be. 360 00:12:42,085 --> 00:12:43,684 I think it's gonna have to be efficiency 361 00:12:43,684 --> 00:12:46,024 of care to really make sure we're getting 362 00:12:46,085 --> 00:12:47,845 the right thing for for the patient at 363 00:12:47,845 --> 00:12:48,745 the right time. 364 00:12:49,125 --> 00:12:51,065 So that comes down to access, 365 00:12:52,164 --> 00:12:54,404 shifting care where it belongs at all times, 366 00:12:54,404 --> 00:12:56,659 and making sure it always stays patient 367 00:12:57,279 --> 00:12:58,500 centered. We're gonna continue 368 00:12:59,279 --> 00:13:01,379 to use a lot of the new technology 369 00:13:01,440 --> 00:13:03,279 and AI to do it, but we have 370 00:13:03,279 --> 00:13:05,279 to make sure that when we do that, 371 00:13:05,279 --> 00:13:07,934 we're still keeping the clinician front and center 372 00:13:08,095 --> 00:13:10,595 with all of those things, that we're not 373 00:13:10,654 --> 00:13:12,115 outsourcing this to, 374 00:13:12,975 --> 00:13:16,095 artificial intelligence that is making the decisions for 375 00:13:16,095 --> 00:13:17,794 us. You have to know who is responsible, 376 00:13:18,335 --> 00:13:20,495 and we can't be dependent upon it. We 377 00:13:20,495 --> 00:13:21,934 still have to drive that. And I think 378 00:13:21,934 --> 00:13:23,940 that's what's gonna be really critical for us 379 00:13:23,940 --> 00:13:25,320 as part of our growth strategy. 380 00:13:26,419 --> 00:13:28,100 I love that. Doctor Jones, thank you so 381 00:13:28,100 --> 00:13:29,699 much for joining us on the podcast today. 382 00:13:29,699 --> 00:13:32,259 This has been a really fantastic conversation. I've 383 00:13:32,259 --> 00:13:33,699 learned a lot, and I look forward to 384 00:13:33,699 --> 00:13:36,100 connecting with you again soon. Sounds great, Laura. 385 00:13:36,100 --> 00:13:37,159 Thank you for the time.