Latest / Becker’s Healthcare Digital Health + Health IT / Joshua Wilda, MPA, Associate Vice President for Information Systems and Chief Information Digital Officer at University of Iowa Health Care

Transcript

Joshua Wilda, MPA, Associate Vice President for Information Systems and Chief Information Digital Officer at University of Iowa Health Care · Becker’s Healthcare Digital Health + Health IT

• 0:00
  This is Laura Dierda with the Becker's Healthcare
• 0:02
  Podcast. I'm thrilled today to be joined by
• 0:04
  Joshua Wilda, associate vice president for information systems
• 0:07
  and chief information digital officer at the University
• 0:10
  of Iowa Healthcare. Joshua, it's a pleasure to
• 0:12
  have you on the podcast today. Thank you,
• 0:13
  Laura. I'm excited to be here today,
• 0:15
  especially representing University of Iowa Health Care.
• 0:19
  Absolutely. Now, you know, I love University of
• 0:21
  Iowa. I haven't grown up right near there,
• 0:23
  a a big Hawkeye fan. And so just
• 0:25
  we'll be excited to learn more about some
• 0:27
  of the things you're doing and,
• 0:29
  what you're thinking about for the future. But
• 0:31
  before we dive in, can you tell us
• 0:32
  a little bit more about yourself, your background?
• 0:34
  I know you recently,
• 0:36
  joined the University of Iowa, and so love
• 0:38
  to hear a little bit more about,
• 0:40
  you know, some of the things that you've
• 0:41
  done throughout your career and what you're bringing
• 0:43
  to the new, new place.
• 0:44
  Yeah. For sure. So,
• 0:47
  I've been in health care IT for about
• 0:49
  twenty years now in various different roles. I
• 0:51
  actually started
• 0:53
  as an Epic implementer working at Epic,
• 0:56
  which gave me a really good opportunity to
• 0:59
  understand the relationship
• 1:00
  between,
• 1:02
  patient provider and technology,
• 1:04
  with how forward folk forward facing and forward,
• 1:08
  thinking that they are as an organization.
• 1:11
  After that, I got that opportunity to go
• 1:13
  work for
• 1:14
  a health system in the Michigan market, University
• 1:16
  of Michigan Health West, where I really had
• 1:18
  that opportunity to combine talents of how do
• 1:21
  we connect patients and providers,
• 1:23
  how do we use technology as that vehicle
• 1:26
  to allow the whole organization
• 1:29
  to work at the top of their license.
• 1:30
  I talk a lot about about that,
• 1:32
  and really get myself to to hone in
• 1:34
  on my own leadership style, leadership abilities.
• 1:37
  Five years ago,
• 1:39
  University of Michigan Health West joined
• 1:42
  into the University of Michigan Health Regional Network
• 1:44
  where I got to be able the the
• 1:46
  opportunity to to lead a much larger team
• 1:48
  across a network of community health organizations
• 1:52
  and get the opportunity to really partner with
• 1:54
  academic medical centers. You see this now happening
• 1:57
  these days where academic medical centers and community
• 1:59
  health medicine
• 2:01
  are really combining forces and bringing more power
• 2:03
  to what they can do. And then, you
• 2:05
  know, I had the opportunity to expand in
• 2:07
  my own career.
• 2:09
  The mission that happens at Iowa, the fact
• 2:11
  that Iowa is is, the
• 2:14
  the only academic medical center here. We're a
• 2:17
  quaternary
• 2:18
  organization for the state, and we truly serve
• 2:20
  the Iowan community.
• 2:22
  And I love the mission and passion around,
• 2:25
  again, how can we extend technology,
• 2:27
  especially now, you know, Laura, you've probably seen
• 2:29
  and heard about rural health.
• 2:31
  We'll talk probably a little bit about that.
• 2:33
  And Iowa is right for how can we
• 2:35
  use technology to connect patients,
• 2:38
  to for them to stay in their communities,
• 2:39
  but still get the health care that they
• 2:41
  lead. So, my career has gone full circle
• 2:44
  up and down,
• 2:45
  allowing me to use a lot of my
• 2:47
  own past experiences to now bring a breadth
• 2:50
  of expertise in digital health,
• 2:52
  in digital transformation, in project management, in leadership
• 2:56
  to the already great foundation that was here
• 2:59
  at UIHC
• 3:00
  and be able to to really push us
• 3:03
  forward. As you, can imagine our mission and
• 3:06
  vision, changing medicine, changing lives. How can you
• 3:08
  not get behind that?
• 3:10
  And so that's it's very exciting to be
• 3:12
  a part of it now.
• 3:14
  Absolutely. No. That's amazing. And what a a
• 3:16
  great way to come into the health care
• 3:18
  space to understand the technology side, really, being
• 3:21
  able to then move into the provider side,
• 3:24
  and see some of the big challenges as
• 3:25
  well as come up with solutions and develop
• 3:27
  network and relationships that can make a big
• 3:29
  difference. So, you know, I'm curious when you
• 3:31
  think about where we're at today, what are
• 3:33
  some of the opportunities and headwinds that you
• 3:35
  have your eye on right now? What are
• 3:36
  you, thinking most about?
• 3:38
  Yeah. Laura, I think for for me and
• 3:40
  and I'll see talk specifically here at University
• 3:43
  of Iowa.
• 3:44
  One of the major things that I'm still
• 3:46
  hyper focused on is patient experience
• 3:48
  and how do we connect our patients
• 3:51
  to us when they're not here. This is
• 3:53
  a perfect opportunity and perfect
• 3:55
  ecosystem
• 3:56
  for that.
• 3:57
  You know, many out there I I'm from
• 3:59
  Wisconsin. I'm a Midwesterner, so I understand
• 4:02
  communities in the Midwest, but some might say,
• 4:04
  you know, Iowa, they don't use IT. They
• 4:07
  don't use technology.
• 4:09
  You know, I beg to differ coming from
• 4:10
  the Midwest of, you know, farmers and those
• 4:13
  that are in these industries.
• 4:14
  They actually rely heavy on technology.
• 4:17
  And how can we then bridge that gap
• 4:19
  to give them that care that they need
• 4:21
  so you can still focus on on their
• 4:22
  families and where they're going and where they
• 4:24
  are, but get the care. So patient experience,
• 4:27
  I think, is something that we can lead,
• 4:30
  definitely the state in, but also expand on
• 4:32
  nationally.
• 4:34
  The other thing that is hyper focused is,
• 4:36
  for me,
• 4:37
  is connecting the dots between
• 4:40
  the health care, the research, and the academic
• 4:43
  side of our tripartite mission.
• 4:46
  Often I see in some other,
• 4:48
  organizations
• 4:49
  that while they're part of the mission, they're
• 4:51
  not coalescing together.
• 4:53
  The research isn't driving the health care, isn't
• 4:55
  driving the education within the organization itself. Usually,
• 4:59
  it kinda permeates out and then comes back
• 5:00
  in another ways. And so I'm focusing on
• 5:03
  how do our teams connect those dots even
• 5:05
  more so that we can bring some of
• 5:08
  that research to the bedside as quick as
• 5:10
  possible for our patients in in care from
• 5:12
  that standpoint.
• 5:14
  I hate to always talk about this. I
• 5:16
  think every CIO, CIO, CIDO does
• 5:20
  cybersecurity.
• 5:21
  You know, those two missions of how do
• 5:22
  we extend ourselves
• 5:24
  not only in, the community that we're in,
• 5:27
  but to the rest of the state, then
• 5:28
  there's big risk there too from a cybersecurity
• 5:31
  standpoint. I do feel
• 5:33
  that's our biggest risk these days. Although you're
• 5:35
  starting to see some of the cloud technologies,
• 5:37
  starting to get a knock on resiliency,
• 5:39
  but I think it's still cybersecurity
• 5:42
  is one of the most
• 5:44
  impactful things that can happen at any given
• 5:46
  moment. And how are we prepared now to
• 5:48
  use technologies like cloud
• 5:50
  and others to maintain services
• 5:53
  while we deal with those high impacting events?
• 5:57
  Last but not least, when we talk about
• 5:59
  headwinds,
• 6:00
  it definitely is
• 6:01
  this push and pull of technology can be
• 6:04
  an enabler,
• 6:05
  but technology has cost behind it. And how
• 6:08
  do those costs affect the cost of health
• 6:10
  care? How do we drive down those costs?
• 6:12
  What's happening at the federal and state levels
• 6:14
  around our reimbursement?
• 6:16
  You know? And it is interesting that I
• 6:18
  have these conversations of, hey. You know, we're
• 6:20
  reducing your reimbursement, but use technology to make
• 6:23
  yourself more efficient.
• 6:24
  Well, that comes with cost.
• 6:26
  That comes with the understanding of how do
• 6:28
  we become intentional with how we're using technologies.
• 6:31
  Rural health care, I mentioned that with some
• 6:33
  of the federal funding that's coming our way
• 6:34
  here in short order. The conversation is, yes,
• 6:37
  we wanna use that to stand it up,
• 6:39
  but it also needs to be sustainable and
• 6:41
  make the impact of the mission and care
• 6:43
  there so it is sustainable cost. So Dan
• 6:46
  Dan that that that dance of innovation,
• 6:49
  cybersecurity,
• 6:50
  how much you you know, how innovative can
• 6:53
  you be when you're always concerned about those
• 6:55
  security and resiliency pieces of it, and then
• 6:57
  the funding. And how do we continue to
• 7:00
  flow that
• 7:01
  to allow technology to help drive health care
• 7:04
  from a vehicle standpoint? We're still in it
• 7:06
  for patients and providers. I never want anyone
• 7:09
  to ever think that, especially in our world,
• 7:12
  that it's not health care first. I talk
• 7:14
  about that we're an organization.
• 7:16
  Our leadership style is we're health care professionals
• 7:19
  in the IT space. I say that often.
• 7:22
  And that's where the goal is of how
• 7:23
  do we balance cost,
• 7:25
  risk, and innovation
• 7:27
  to push forward where health care can go.
• 7:30
  I love that. I think that's such a
• 7:32
  sums up sums up so well,
• 7:34
  some of the different challenges, but then also
• 7:36
  opportunities that you have with the technology, with
• 7:38
  AI, and, what it really takes in order
• 7:41
  to transform the organization, not just bringing technology
• 7:44
  in, but
• 7:45
  knowing how to implement it and incorporate into
• 7:47
  the daily workflows to solve some of these
• 7:49
  big problems and really tackle,
• 7:52
  you know, the challenges that we're having head
• 7:54
  on. So Yeah. When you think about,
• 7:56
  yeah, I guess, are there any specific examples
• 7:58
  you're looking at in the next year or
• 8:00
  two?
• 8:01
  Yeah. Some things that we're doing for innovative
• 8:03
  wise, we're we're one, it's not innovative. It's
• 8:06
  it's actually
• 8:07
  assuring that the block and tackling of some
• 8:09
  technologies that are table stakes are out there,
• 8:11
  like telemedicine and teledelivery.
• 8:14
  Those are some things that we're we're looking
• 8:16
  at. We're definitely looking at the cyber,
• 8:19
  security framework. And, again, using infrastructure
• 8:22
  and technology. How can we
• 8:24
  bridge the gap in resiliency and really make
• 8:27
  sure it's at control cost? So we're talking
• 8:29
  about being a cloud smart organization
• 8:32
  using cloud technologies not as the primary deliverer,
• 8:35
  but to to to stand up our resiliency.
• 8:38
  I'm really excited for where the hospital of
• 8:40
  the future and I always say that and
• 8:42
  I go, it is here and now. How
• 8:44
  can we use our four walls and bricks
• 8:46
  and mortar with sensors, with AI, with tele
• 8:49
  nursing, and some other things that we're doing
• 8:51
  to really encapsulate that patient care and and
• 8:54
  deliver more of that patient provider intimacy but
• 8:57
  through our technology. So we're definitely looking at
• 9:00
  products that allow us to expand our services
• 9:03
  and telly,
• 9:04
  expand our services in patient education.
• 9:07
  There are also some things that are fun
• 9:08
  things, which is interesting that,
• 9:11
  as I came here, it's a very large
• 9:13
  institution.
• 9:14
  You know, I came from Michigan Medicine, same
• 9:17
  thing there. It's something that you you experience
• 9:19
  every day here, and you see it are
• 9:21
  those patients that are coming here. And for
• 9:23
  the most part, they don't wanna be here.
• 9:25
  You know, there are some life changing fun
• 9:27
  events why you would be at health care.
• 9:29
  But when they come here,
• 9:31
  you should really be focused on how can
• 9:33
  they come in and be well and and
• 9:35
  and engage. But the first thing they gotta
• 9:37
  figure out is how do I get to
• 9:38
  where I need to be? Where do I
• 9:40
  need to park? So digital wayfinding and that
• 9:42
  experience
• 9:44
  of helping folks relieve some of the pressures
• 9:46
  of what it takes to engage with health
• 9:48
  care,
• 9:49
  so they can focus on the relationship, what
• 9:52
  they need to do to be better, what
• 9:53
  they need to do to heal. That's something
• 9:56
  that's fun to to look at, and we're
• 9:57
  talking about that as an organization of how
• 9:59
  can we give a a great internal experience
• 10:01
  when they're here so they can focus on
• 10:03
  engaging with us and not focus on how
• 10:06
  are they gonna wander around and get to
• 10:07
  where they need to be. So those are
• 10:09
  some fun things that we're continuing to work
• 10:11
  on. And I didn't touch on AI just
• 10:13
  because everyone else does.
• 10:15
  But it is in there in our conversations
• 10:18
  around how do we get how do we
• 10:19
  utilize it everywhere in our organization for everyone
• 10:23
  to work at the top of their license,
• 10:26
  in facilities, in HR, in supply chain. You
• 10:29
  know, it's not just about those clinical,
• 10:32
  AI tools for ambient voice. Those are very
• 10:35
  important. Clinical decision for AI, that's very important.
• 10:38
  But we're also looking holistically of how do
• 10:40
  we raise all boats
• 10:42
  using AI and raise all of our capabilities
• 10:44
  as
• 10:45
  health care professionals. So those are some some
• 10:47
  of the exciting things that we're working on
• 10:49
  in short order.
• 10:51
  I love that. I I think that's, so
• 10:53
  cool that your capability,
• 10:55
  to do all of those things and the
• 10:56
  precipice of really,
• 10:58
  strong transformation there at Iowa. Now I think
• 11:00
  we've talked a little bit about growth and
• 11:02
  some of the ways that you see these
• 11:04
  changes occurring, but I am curious. What does
• 11:07
  it look like, that balance when you think
• 11:08
  about adding value to the organization? I think
• 11:10
  especially with technology and AI, you know, it
• 11:13
  is expensive as we've talked about in a
• 11:15
  big event. So how do you know, that
• 11:18
  some of the things you're doing are are
• 11:19
  actually adding that value and really what do
• 11:22
  you do to measure that? What are some
• 11:23
  of the metrics and things you take into
• 11:25
  consideration as you're piloting and testing and then
• 11:28
  rolling out?
• 11:29
  Yeah. I always love the conversation around, is
• 11:31
  IT an expense center or a value center?
• 11:35
  You know, we're expense center when you're looking
• 11:36
  at budgets and you're going, hey. We're in
• 11:38
  high health care, and why are you one
• 11:39
  of the largest
• 11:40
  budgets?
• 11:42
  But it is about value, and it is
• 11:44
  about what are we bringing to the table
• 11:46
  and pushing to the forefront here at Iowa.
• 11:49
  One of our goals is to be ahead
• 11:50
  of the business, but doing it in an
• 11:53
  intentional sort of way. We all know that,
• 11:56
  that money is tight or it is small
• 11:59
  margins around,
• 12:01
  health care, and our focus is intentionality.
• 12:04
  Our focus is how do we reinvest in
• 12:06
  ourselves
• 12:07
  by really focusing on,
• 12:10
  eliminating
• 12:11
  legacy technologies, overlapping technologies,
• 12:15
  and then
• 12:16
  driving new innovations in intentional ways. I've been
• 12:18
  a part of other organizations where they do
• 12:20
  a lot of pilots all over the place.
• 12:22
  And they really don't know what they're trying
• 12:24
  to solve for. It might be the new
• 12:25
  cool big thing
• 12:27
  to do and that's out there, but they
• 12:28
  really haven't engaged with the organization of what
• 12:31
  true problems are we trying to solve? What
• 12:34
  problems that if we solve them are gonna
• 12:36
  be the most impactful?
• 12:37
  And like you said, Laura, what are those
• 12:39
  metrics to show that?
• 12:41
  We're bringing that discipline
• 12:44
  to our institution and having those conversations around
• 12:47
  technologies.
• 12:48
  Perfect example that I give you is when
• 12:50
  I talk about tele nursing.
• 12:52
  You know, there's point solutions that are out
• 12:55
  there for that. But can we get more
• 12:57
  value out of that being a a platform
• 12:59
  based technology?
• 13:00
  So we can maximize our resources,
• 13:03
  teach them a platform, and expand on that
• 13:06
  platform.
• 13:07
  Also, our end users are now not, dealing
• 13:10
  with different systems.
• 13:11
  They're now more focused on how the technology
• 13:14
  is driving care instead of being a wedge.
• 13:16
  So when providing that value, it is about
• 13:19
  what's the what are we trying to solve
• 13:21
  and getting to the root of that? What
• 13:23
  are we trying to to deliver as far
• 13:25
  as our experience in getting to that? Talk
• 13:28
  about those measurements of what it means to
• 13:30
  bring that value.
• 13:31
  And then with that intentionality,
• 13:34
  and this is something that, you know, I'm
• 13:36
  learning
• 13:36
  as I have grown into the larger scale
• 13:39
  organizations.
• 13:40
  How can we move in an agile sort
• 13:42
  of way so there's speed to delivery
• 13:45
  in that innovation, in that intentionality?
• 13:48
  So we're working on how are we assessing
• 13:50
  those things in short order, how are we
• 13:52
  bringing them to bear in front of our
• 13:53
  organization,
• 13:55
  as well
• 13:56
  as being using our telescope in strategic planning
• 13:59
  going, what is the next two to three
• 14:00
  years look like, and how can we
• 14:03
  maybe deprecate some old technologies
• 14:06
  so we can invest in the future and
• 14:08
  be in an investment front fund of ourselves?
• 14:12
  Absolutely. I love that. And, you know, that
• 14:14
  that's such a a great philosophy to have.
• 14:16
  And when you think about becoming an investment
• 14:18
  fund into yourself, when you become how you,
• 14:21
  think about, you know, where the value is
• 14:24
  and how you're contributing,
• 14:25
  overall,
• 14:26
  it'll just become even more critical over the
• 14:28
  next couple of years because I know so
• 14:30
  many hospitals and systems have tight budgets or
• 14:33
  looking at, you know, tight margins,
• 14:35
  probably,
• 14:36
  in the coming years given just the current
• 14:39
  environment, health care landscape, etcetera. So,
• 14:42
  I I think when you actually take that
• 14:44
  mindset and put it into practice, what does
• 14:45
  that look like? Are there any other, I
• 14:47
  guess, investments that you still think are important
• 14:49
  to make knowing that it's going to be
• 14:51
  challenging in the next couple of years? Yeah.
• 14:53
  You know, the the other thing, Laura, that
• 14:55
  that I think is helpful is now the
• 14:57
  partnerships that you form in the communities that
• 14:59
  you're in. Right?
• 15:01
  Every market has
• 15:03
  competition, some sort of competition or a community
• 15:07
  arm, especially in Iowa. There's a lot of
• 15:09
  community and critical access hospitals.
• 15:12
  And I think another way to bring that
• 15:13
  value is how do we pool our resources
• 15:16
  together,
• 15:16
  not from a command and control standpoint, but
• 15:19
  from a leveraging all of our experiences. You
• 15:22
  know, we're all competing for talent.
• 15:24
  We're all competing for patient focus. We're all
• 15:27
  competing for the best quality of care that
• 15:29
  we can do. Now how can we do
• 15:31
  that in such a way that we get
• 15:33
  economies of scale, especially from a technology standpoint?
• 15:36
  That's something I'm excited about that's happening in
• 15:38
  Iowa.
• 15:39
  For those that are are listeners might know
• 15:42
  Epic's Community Connect program, allowing
• 15:44
  organizations like Iowa who,
• 15:47
  have direct connections and contacts to Epic to
• 15:49
  extend ourselves out into the community areas.
• 15:52
  So those folks can leverage the technologies at
• 15:55
  a lower cost sort of way because of
• 15:57
  the scale that we're able to provide it.
• 15:59
  And then looking to how do we build
• 16:01
  upon that,
• 16:02
  something I've been so excited about coming into
• 16:04
  the Iowa market has been the community connect
• 16:07
  program that we have at Iowa. I've been
• 16:09
  thoroughly impressed with the partnerships that we have
• 16:12
  made
• 16:13
  through our community connect program. But the secret
• 16:15
  sauce is actually
• 16:17
  then those critical access hospitals that we're extending
• 16:20
  to, especially in Iowa, how they've come together.
• 16:23
  And they've talked as a community now on
• 16:25
  how they leverage the tools.
• 16:27
  And that's where you're gonna get the investments,
• 16:29
  the returns on these.
• 16:31
  You know, if we're all going out and
• 16:32
  buying the same systems and putting the same
• 16:35
  technologies,
• 16:36
  there's no economies and scales of that. How
• 16:38
  do we leverage our skill sets and our
• 16:40
  talents and our scale
• 16:42
  to really drive what can happen in a
• 16:44
  community and across the state?
• 16:47
  So I think that organizations need to hyper
• 16:49
  focus on that. Michigan market, there was a
• 16:51
  lot of competition, and we would call coopetition.
• 16:54
  Here in the state of Iowa, I'm seeing
• 16:56
  that it is more of that community focus.
• 16:59
  It's less about competition and more how do
• 17:01
  we raise all boats.
• 17:03
  And that's something that I'm excited for. And
• 17:05
  Iowa is a key partner in that conversation,
• 17:08
  especially with the scale,
• 17:10
  especially what we provide,
• 17:12
  with the skill sets, the talents of our
• 17:13
  providers,
• 17:14
  of our nurses, of our administration,
• 17:16
  and definitely our IT shops. So I think
• 17:19
  that that's another area that folks should should
• 17:21
  look at at is how do you partner
• 17:22
  in technologies
• 17:24
  versus going out and doing them on your
• 17:25
  own.
• 17:27
  I love it. I I think that idea
• 17:29
  of partnership and being, so ingrained with those
• 17:31
  collaborative collaborators,
• 17:33
  within the community,
• 17:34
  in in the companies that are willing to,
• 17:36
  be part of that and part of that
• 17:38
  solution and partner with you to know what
• 17:40
  you need and build something that makes sense
• 17:42
  for the institution is so helpful. I I
• 17:44
  think I've heard more than ever over the
• 17:46
  last year that, partnerships are critical in the
• 17:49
  health care space, more than ever. So it's
• 17:51
  it's a team sport, and that's great to
• 17:53
  hear.
• 17:54
  Before we wrap up, I wanted to ask,
• 17:55
  where do you see some of the best
• 17:56
  opportunities for growth in the future? Yeah. Good
• 17:59
  question.
• 18:00
  There's definitely more growth to be had around
• 18:02
  how we can extend our services both internal
• 18:05
  to our organization
• 18:06
  and then thinking about how do they how
• 18:08
  do they grow to the community. I think
• 18:10
  another area of growth is
• 18:12
  our talent,
• 18:13
  and how do we invest even more in
• 18:15
  our talent, taking advantage of of especially local
• 18:18
  talent, but also expanding ourselves. I think that
• 18:21
  as the community of IT changes, you know,
• 18:24
  the the the now the technology changes into
• 18:27
  AI or the ability to be remote,
• 18:30
  it really has changed the framework of how
• 18:31
  we utilize our talent and deploy them.
• 18:34
  So growth and maximizing
• 18:36
  our talent to the point of how are
• 18:38
  they involved, how are they getting into the
• 18:40
  passion of the mission, how are they bringing
• 18:42
  new technologies to the forefront
• 18:44
  are gonna help us grow. I think the
• 18:46
  most part for for me, growth is truly
• 18:49
  going to be how do we control costs
• 18:51
  but bring those innovations to the table.
• 18:54
  AI and automation is definitely going to allow
• 18:56
  us to be more efficient.
• 18:57
  But it is gonna be that hyper focus
• 18:59
  on how do we make sure the technologies
• 19:01
  enhance the patient provider intimacy
• 19:04
  and not just decrease it. And I think
• 19:06
  as we start seeing AI being a layer
• 19:08
  on top of some of the technologies that
• 19:10
  we've had, you know, that we've had EHR
• 19:12
  for years, and now a e AI is
• 19:14
  allowing us to interact with big data and
• 19:18
  EHRs
• 19:19
  in a more efficient way so we can
• 19:20
  focus on patient care. I think that is
• 19:23
  gonna drive
• 19:24
  more of the benefits of what we can
• 19:26
  get out of the collective data in EMR
• 19:29
  in our infrastructure and technology. So I'm excited
• 19:32
  for the growth and possibility
• 19:34
  of how can we be more efficient, but
• 19:37
  come at it with a all new light
• 19:38
  of innovation,
• 19:40
  connection,
• 19:41
  partnerships, and collaboration.
• 19:43
  I love it. Joshua, thank you so much
• 19:45
  for joining us on the podcast today. This
• 19:47
  is such an inspiring and and fun conversation
• 19:49
  to have, and I look forward to connecting
• 19:51
  with you in the future.
• 19:52
  Thank you for having me, Laura. Always always
• 19:54
  love participating in these.