Podcasts about CMS

This week I talk about Preparing For The Holidays! [powerpress]

Health Affairs' Marianne Amoss and Rob Lott explore the impact of Medicaid unwinding on children's health.Read Milkie Vu's article from the upcoming "Tackling Structural Racism in Health" issue.Related Link: We cut child poverty to historic lows, then let it rebound faster than ever before (Vox) Federal Health Policy Requires Child Health Investment Focus (Health Affairs Forefront) Medicaid (KFF) Racism and Health Resource Page (Health Affairs)

In this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice talks with orthopedic surgeon and ASCA Board member David Weinstein, MD, about performing outpatient total shoulder surgeries in both hospitals and ASCs.Tens of thousands of patients with commercial insurance undergo safe, effective total shoulder surgeries in ASCs each year, saving themselves and their insurers millions of dollars. Yet the Centers for Medicare & Medicaid Services (CMS) has refused to extend its insurance coverage to ASCs—the less costly site of care and the one that most patients prefer. Dr. Weinstein discusses several clinical studies that include findings that support making this change, as well as his own experience performing thousands of shoulder surgeries, in this compelling case for finally allowing Medicare patients the same choice that private pay patients enjoy today.Dr. Weinstein is a graduate of the University of Colorado School of Medicine, where he completed his residency in orthopedic surgery, as well as an associate clinical professor at the University of Colorado Department of Orthopedics in Denver.

  Sarah interviews Alyson Seighman, Compliance & Risk Management Lead for Ritter Insurance Marketing. Join them as they discuss the recent compliance regulation updates from CMS. If you're an agent selling Medicare Advantage and Medicare Part D, you don't want to miss this episode.   Mentioned in This Episode: Ritter Compliance Program*: https://docs.ritterim.com/compliance/compliance-at-ritter/ Email our compliance team at complianceofficer@ritterim.com with your compliance questions!   TPMO Disclaimer for agents that DO NOT represent all MA/Part D plans within a service area: “We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”   TPMO Disclaimer for agents that represent ALL MA/Part D plans within a service area: “Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.” *Must be registered and logged into ritterim.com for access.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim Twitter, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Resources: Are Your Medicare Marketing Materials Compliant? https://agentsurvivalguide.podbean.com/e/are-your-medicare-marketing-materials-compliant-2023/ CMS' 2024 MA and Part D Final Rule Changes for Agents: https://agentsurvivalguide.podbean.com/e/cms-2024-ma-and-part-d-final-rule-changes-for-agents/ CMS' New Definition of Marketing & How it Affects Agents Selling Medicare Plans: https://agentsurvivalguide.podbean.com/e/cms-new-definition-of-marketing-how-it-affects-agents-selling-medicare-plans/   References: 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F): https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-final-rule-cms-4201-f CMS 2024 Final Rule for Medicare Advantage and Part D: https://public-inspection.federalregister.gov/2023-07115.pdf Medicare Advantage Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-V Medicare Communications and Marketing Guidelines: https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines Part D Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-V

Part II. Sam and Michael L. Powe (vice president of reimbursement and professional advocacy for the American Academy of Physician Assistants) continue their conversation on PA practice and reimbursement. This episode they cover the CMS changes to coding and billing.

The Charlotte-Mecklenburg Schools district is continuing its efforts to revamp long-term academic goals for students over the next few years. Every five years, CMS centers itself around new goals and guardrails that can range from increasing literacy among elementary school students to increasing the number of students post-graduation who get a job.  Experts say the hallmark of a good goal needs a few things. It needs to be specific, measurable, achievable, timely, and realistic. These attributes were at the center of the discussion around the goals and guardrails conversation on Tuesday night.  CMS Board Member Melissa Easley immediately expressed frustration with the first recommended CMS goal.  “There is absolutely no way we can require our staff to have 97% in anything, we're just setting them up to fail," Easley said. READ MORE: https://www.wcnc.com/article/news/education/cms-school-board-achievable-realistic-district-goals/275-da8b6dd4-3294-4571-a7ac-753a2965fcd7

American healthcare is at risk of collapse as one-fifth of nurses intend to leave the profession by 2027. Jennifer Thietz outlines her vision of a new model for nursing and healthcare to Jim Cagliostro.     Episode Introduction  Jennifer highlights the soaring post-pandemic levels of burnout and high turnover among nursing staff, why the four primary nursing models are no longer effective, and shares her vision of building on a one-to-five patient-nurse ratio. She also explains why rebuilding connections helps nurses and patients to thrive, why nurses need to unite and use their voice, and reminds us that all nurses are heroes.    Show Topics   US healthcare is in a state of crisis Nurses are the bridge between healthcare providers and patients Healthcare requires a new model of nursing  Building on a one-to-five nurse-patient ratio Healthcare comes down to human connection  All nurses are heroes     04:12 US healthcare is in a state of crisis  Jennifer said that nurses represent 50% of the workforce but almost one-fifth intend to leave.  ‘'….this is a news release in April this year, and it's from the National Council of State Boards of Nursing, and they gave some really scary facts. We know that over 100,000 nurses left during COVID. They're saying by 2027, 900,000, or almost one fifth of the 4.5 million nurses, intend to leave the workforce. So that's a really frightening stat. We know that 189,000 nurses under the age of 40 want to leave nursing by 2027, 50% of nurses report being emotionally drained and burnt out, and this is the worst burnout in nurses that we've ever seen. So we really are in a real crisis, and we are losing our nurses daily. And without nurses, considering that nurses are 50% of the workforce, and actually touch 90% of patients. So you can imagine, if we don't have nurses, we can't nurse. We can't work in healthcare as it currently is. And I believe there will be a collapse in healthcare if we don't make some changes now.''   07:42 Nurses are the bridge between healthcare providers and patients.  Jennifer said 90% of hands-on care comes from nurses, who are essential to provide a safe and happy environment for patients.  ‘'Well, nurses are fundamental to healthcare. As I've just said, 90% of the hands-on care comes from nurses. We're a huge, huge percentage of the caregivers in healthcare. And if we as nurses can provide care in a safe and happy environment, we can turn healthcare around. We're the bridge between the physicians, between the other healthcare providers, we are the bridge with patients. We are the ones who are there 24 hours a day, 365 days a year. We are the ones who are speaking with the patient, spending up to eight or 12 hours a day with individual patients, so we really are the front-runners. We understand what's going on, and we are the ones who are hurting. Everybody in healthcare is paying a price, but I believe that nurses are paying the biggest price at this stage. And the reason is that they don't... Many of them do not have sufficient help in the units.''   11:21 Healthcare requires a new model of nursing Jennifer said nurses are no longer able to provide care as they want to.  ‘'Now, obviously, we are in unprecedented times in healthcare with this hemorrhaging of nurses, with the costs that are associated with care at the moment. And having been on the floors and seen how nurses work, I think the main issue with many of the nurses who I've been speaking with and who I've worked with, is that they don't have sufficient time to nurse the way they would like to. And the reason I think is related in some way to cost cuttings, where organizations are losing staff in order to stay afloat. And what's happening is nurses are now literally wearing two hats. They are doing their nursing specific tasks, which as the acuity of patients goes up, become more and more complex, more and more difficult, and then they're also asked to do care, for example, handing out food trays, or finding patients who are lost, and transport has got a patient and they're supposed to go to Dr. Smith's office, but he's now lost somewhere and they're making calls, they're doing ordering, they're doing billing, they're doing bathroom breaks, all of this work, which is obviously essential, because that's how a hospital turns around, and that's how nursing care is provided, but I think if we had staff, auxiliary staff, to help the nurses, just to take that load off them so they have the time to do their nursing specific roles, I think that for me would be the way to go.''   12:46 Building on a one-to-five nurse-patient ratio Jennifer explained how using the one-to-five nurse-patient ratio can transform patient care by combining the benefits of two models.  ‘'And so I've looked at nursing, and I've used the benefits of two models. The one is the individual approach where obviously the nurse is involved with the care of the patient, and then a team approach where multiple people are involved, but I've shortened it or honed in on a ratio if possible of one to five, which is what CMS actually recommends. They don't mandate it, obviously, but the CMS is recommending a ratio, patient nurse ratio, one to five, and then involving in that team a nurse assistant that just works with that RN. So you would have one nurse, you would have one nurse assistant, you would have five patients, and then you have two sets of eyes on those patients all day. You have the auxiliary tasks, like handing out food trays, et cetera, taken care of, and the nurse then can go ahead and fully concentrate on their nursing roles. And I would add to this, Jim, which I think is extremely important, is a ward secretary, or a ward clerk we call them, whereby they are at the nurses' station, and they allow the charge nurse time to leave the nurses' station because they're going to be doing the directing of patients, they're answering the phones, maybe the ordering of meals, et cetera, and then charge nurse will then have the opportunity to be on the floor with the nurses where she's really needed, or he's really needed. So that's what I see as the hybrid individual team approach…. this one to one to five would be in units like telemetry, med-surg, oncology, the specialty units, obviously our ICUs, our step-downs, et cetera, have a totally different way of working.‘'   20:31 Healthcare comes down to human connection  Jennifer said the crisis in nursing is affected by the break in connection between patients and nurses, and between colleagues.  ‘'….I think nursing and healthcare in general boils down to the connection we have with our patients and with each other, with our nurses. And our connection with patients, and I'm saying our, but I'm talking about specific nurses, there are other nurses who are working in wonderful work conditions who have the time. I spoke to a nurse last week who said, "Hey, I'm very happy. We have this incredible organization and I'm working in a great team. I have help." Absolutely. And this particular nurse has the nurse assistant with her. So there are many organizations who are doing it right. I don't want to give the wrong impression, but yes, I believe that the crisis in nursing now is happening due to the break in our connection with our patients and our nurses. With each other, colleagues. We need to have that human connection in order to thrive, in order to heal, in order to work to our best ability. And many of us are going into our workplaces every day, and we are given an assignment, and we look down and we see the tasks that we have, and we put our head down and we just plow through those tasks. And we don't have the time to necessarily sit with patients, with each other, to connect.''   27:16 All nurses are heroes Jennifer said in some ways nursing is more difficult now than during Covid and encouraged all nurses to use their voices and speak.   ‘'… I think the most important thing that I'd like to share is my deep respect for nurses, and to really... I'm hoping to empower nurses who are sitting in jobs that are very, very, very challenging. I also worked during the COVID pandemic on the floor, and we as nurses were held up as heroes during COVID, and we were, and we are, and I think we remain those heroes. I think what nurses are doing now is maybe in some instances more difficult than during the COVID pandemic, because then we had the support of everybody. Now, each nurse that walks into a facility remains a hero because many of you are working very, very challenging conditions. And you are highly intelligent, highly skilled, highly motivated, your compassionate heart, you have a right to raise your voice and speak. And speak as much as you can and share with your leaders, if you have ideas on what can happen in your units to help your job, make your job easier, then go ahead and share that information. I think communication is vital. We need the connection. So keep connecting. Keep connecting with each other, pay it forward with each other, look after each other, look after your nursing managers, and your nursing leaders as well. And let's come together and change healthcare, because we are millions strong. We can do it. And we just need to get our voices out there.''   Connect with Lisa Miller on LinkedIn Connect with Jim Cagliostro on LinkedIn Connect with Jennifer Thietz on LinkedIn Check out VIE Healthcare and SpendMend    You'll also hear:  From South Africa and a heart transplant first, to Mexico, via America. Jennifer's 20 years of experience at the patient's bedside. ‘'And I think for that reason, I can really speak to this topic today, because I've been there, I've worked with these nurses, I've been on the floor with patients, and I have a great understanding of what is happening in healthcare.''   Why the nursing world as we know it is unsustainable: ‘'… I'm passionate about this situation as a long time nurse… And I'm hearing stories all the time about working conditions, which are extremely difficult.''   Why the four primary nursing models are no longer effective for modern healthcare. ''… these approaches are, as I say, World War II up to the 1980s. They're old. They are nursing approaches that have been around for a long time, and I don't think they speak to what is happening in healthcare at this point.''   Offsetting the initial cost of a new model of healthcare against higher staff retention levels. ‘'In the long term, the cost savings would be huge. …. And I believe that then the patient satisfaction would go up, because they would have this interaction.''   What To Do Next:   Subscribe to The Economics of Healthcare and receive a special report on 15 Effective Cost Savings Strategies.   There are three ways to work with VIE Healthcare:   Benchmark a vendor contract – either an existing contract or a new agreement. We can support your team with their cost savings initiatives to add resources and expertise. We set a bold cost savings goal and work together to achieve it.  VIE can perform a cost savings opportunity assessment. We dig deep into all of your spend and uncover unique areas of cost savings.  If you are interested in learning more, the quickest way to get your questions answered is to speak with Lisa Miller at lmiller@spendmend.com or directly at 732-319-5700.  

It's a Photon Media crossover episode! Accelerators co-hosts Drs. Matt Spraker and Simul Parikh team up with Dr. Jason Beckta, host of the Out Of The Basement podcast, to talk about billing. We are joined by Shawna Stacey, ROCC, MBA, Coding and Billing Specialist at Radformation. The episode kicks off with a discussion about why you should care about billing and coding. Matt, Simul, and Jason discuss their (lack of training) training and experiences trying to learn on the job. Simply learning about billing and coding doesn't make you greedy, it helps you understand how you are paid for your work. A transparent and well funded clinic offers the best chance of optimizing care for your patients! Feeling overwhelmed by billing and wish you could just stick to patient care? Us too. Later in the episode, we discuss resources that help you not care, especially Radformation's QuickCode. You already know how AutoContour and ClearCheck have automated your clinic, QuickCode does it for billing and coding. Don't believe us? We close the episode by asking Jason and Simul to "break" QuickCode with a complicated billing and coding scenario that is sure to frighten even the experts. Here are some things we discussed during the show:"What is a MAC?", from CMS"What's an LCD?", from Medicare.govACROInsights Newsletter from the Goverment Relations/Economics Committee (membership required)Editor's Note: While our love for their products is genuine, The Accelerators were compensated for this episode and Radformation participated in planning the content. The discussions in this episode are the opinions of the participants and are not billing and coding advice. Please see our website for complete information on our past and current sponsors. The Accelerators Podcast is a Photon Media production. 

There's a new ICD-10 code presenting a new challenge for facilities, physicians, clinical documentation integrity specialists (CDISs), and coders: E88.A, muscle wasting due to underlying conditions.This new code represents an opportunity to identify, document, and report the frequent and too-often unrecognized undernutrition, sarcopenia, and cachexia disorders associated with muscle wasting, along with their underlying causes. During the next live edition of Talk Ten Tuesdays, James S. Kennedy, MD, president of CDIMD near Nashville, Tenn., will address the clinical criteria inherent to these conditions. He will also discuss recent Coding Clinic advice affecting E88.A reporting, and proactive CDI approaches that facilitate expert identification and management of these debilitating conditions. And to help you gain more value from this exclusive broadcast, Dr. Kennedy has offered the following references on muscle wasting (https://society-scwd.org/muscle-wasting/), sarcopenia (https://society-scwd.org/sarcopenia/), cachexia (https://society-scwd.org/cachexia/), and malnutrition (https://www.tinyurl.com/malnutrition2012).Following the broadcast, you should be prepared to implement these concepts.All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will have the latest coding news.SDoH Report: Juliet Ugarte Hopkins, president of the American College of Physician Advisors, will substitute for Tiffany Ferguson, and will report on the news that's happening at the intersection of coding and the social determinants of health (SDoH).News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Pour cet épisode en partenariat avec Shopify, Laurent Kretz reçoit Bastien Borget, directeur e-commerce d'Eden Park. Il lui explique pourquoi il a fait le choix de migrer sur Shopify et comment il s'est appuyé sur les outils du CMS pour booster son chiffre d'affaires. Ensemble, ils parlent également d'image de marque pour une Legacy Brand, d'automatisation de l'emailing et de conquête du marché nord-américain. Dans ce nouvel épisode du Panier, vous trouverez des clés pour : Faire le choix de la migration vers Shopify après un Black Friday catastrophique et pour simplifier le travail de ses équipes [12”40] ; Tester quotidiennement son nouveau site Shopify pour mieux préparer son lancement[26”10] ; Faire confiance à son outil et ne pas chercher à le customiser à tout prix [41”30] ; Améliorer son expérience client et augmenter son panier moyen de 30 euros [49”25] ; Faire d'un challenge (régénérer un mot de passe) une opportunité pour booster son trafic [52”30] ; Travailler son marketing automation et inverser le ratio paid/organique [58”00] ; Unifier sa donnée clients quand on vient du physique [1”04”30] ; Se développer à l'international sans effort avec les outils Shopify (synchronisation des stocks, taxes, etc.) [1”13”40]. Pour en savoir plus sur les références abordées dans l'épisode : #237 - ShopiShopa : Les bons tuyaux pour faire décoller son e-commerce sur Shopify Catch-up #26 - Black Friday, Cyber Monday, ventes de Noël : cartonner au Q4 grâce à l'email Matrixify pour faire la migration de ses données Flow pour créer et gérer des scénarios Nosto pour personnaliser la navigation du client “La règle : pas de règle”, le livre du fondateur de Netflix Syncio pour synchroniser ses stocks à l'international Suivez l'actualité du Panier sur notre compte Instagram, lepanier.podcast ! Inscrivez-vous à la newsletter sur lepanier.io pour ne rater aucun conseil des invités du Panier et cartonner en e-comm ! Pour découvrir tout ça, c'est par ici si vous préférez Apple Podcasts, par là si vous préférez Spotify ou encore ici si vous préférez Podcast Addict. Et n'oubliez pas de laisser 5 étoiles et un commentaire sympa sur Apple Podcasts si l'épisode vous a plu. Le Panier est un podcast produit par CosaVostra, du label Orso Media.

Imagine a world where diseases are not just treated but predicted, where access to healthcare is democratized, and where patients are empowered like never before. This isn't science fiction; it's the potential of healthcare innovation. The possibilities are boundless, and the potential for positive change is immense. In today's episode, Shawn Nason is joined by Dr. Karen Murphy, the Executive Vice President and Chief Innovation Officer at Geisinger Health. They discuss Dr. Murphy's career in healthcare, her passion for driving change, and the importance of collaboration and problem-solving in the industry. They also touch on the challenges and misconceptions surrounding healthcare innovation and share examples of successful transformations. In This Episode [00:51] Introduction to Dr. Karen Murphy  [02:22] Dr. Karen Murphy's career path [04:18] The importance of collaboration and avoiding silos in healthcare [07:14] The Importance of purposeful innovation in healthcare [09:36] The Influence of culture and experience on success in healthcare and the film institute [10:39] What made Dr. Karen an effective healthcare innovator [13:39] Common misconceptions and challenges in health care innovation. [16:47] Human-centered design in healthcare leadership [21:56] How might we statements [23:26] Payment transformation [23:41] The combustion questions What We Learned From Dr. Karen Murphy Collaboration and breaking down silos are essential for fostering innovation in healthcare. Innovation should have a purpose and aim to solve real problems with measurable outcomes. Balancing patient care with the need for experimentation and iteration is a challenge in the healthcare industry. Successful healthcare transformations include an AI-based colon cancer detection program and a remote patient monitoring system for complex hypertension. Human-centred design plays a crucial role in healthcare innovation, from empathy to implementation. Notable Quotes [04:21] -“Our philosophy is we work with the willing.” [04:38] - “We define innovation as a fundamentally different approach to solving problems that have quantifiable outcomes.” [08:19] - “We use virtual nurses to admit and discharge patients from the hospital.” [11:04] - “During my time at the hospital, I worked with so many that wanted to change, were willing to change, and just didn't have the way to change.” [11:43] - “I'd like to change the world as long as nobody changes me.”  [22:28] - “We have got to get to a payment transformation that promotes wellness, promotes prevention, and does not incentivize.” Our Guest Dr. Karen Murphy is the EVP and Chief Innovation Officer at Geisinger Health's Steel Institute for Health Innovation, serving rural and urban Pennsylvania. With a career spanning public and private sectors, she's been a driving force in healthcare transformation. Former Pennsylvania Secretary of Health, Dr. Murphy tackled pressing issues like the opioid crisis. As the head of the State Innovation Model Initiative at CMS, she led a $990 million investment in nationwide healthcare innovation. An accomplished author and sought-after national speaker on health policy and innovation. Resources & Links Dr. Karen Murphy LinkedIn: https://www.linkedin.com/in/karen-murphy-58094638/ Shawn Nason LinkedIn: https://www.linkedin.com/in/nasonshawn/ Instagram: https://www.instagram.com/manonfiresocial/ Twitter: https://twitter.com/manonfiresocial Website: https://shawnnason.com/ MOFI: https://www.mofi.co/ The Combustion Chronicles Podcast Website: https://shawnnason.com/combustion-chronicles-episodes/ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Greg and Rob are joined by healthcare attorney Jeff Davis, to discuss how the Medicare drug pricing provisions in the IRA will impact 340B providers.  They'll go over CMS billing modifier requirements (15:27), share opinions on the financial impact covered entities might experience (38:02), and how various legal challenges to the IRA by the pharma industry may play out (56:29).  They also add some insights around CMS's proposed Part B payment remedy (1:01:03). In the intro, Rob catches Greg up on new manufacturer restrictions, and some recent HRSA audit experience related to interpreting data request list (DRL) revisions, and shares some commentary on the current House E&C subcommittee hearing on proposed drug shortage legislation. Email us questions, thoughts, and ideas for podcast topics at 340BUnscripted@spendmend.com!

This week I recap the past 500 Episodes! [powerpress]

On the local news roundup…a compromise in Raleigh on the budget. CMS bans another book. And Charlotte airport workers march for better wages, better benefits and better working conditions. Mike Collins and local journalists will have those stories and more.

The Biden Administration announces it will again send free COVID tests to US households. CMS says parts of the No Surprises Act dispute resolution process can resume. And, the FTC sues US Anesthesia Partners and private equity firm Welsh Carson, alleging they formed a monopoly to drive up prices for services in Texas. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

On this episode of "The Dish on Health IT," hosted by Ken Kleinberg and Jocelyn Keegan from Point-of-Care Partners (POCP), healthcare technology enthusiasts were treated to an engaging discussion with a special guest, Alice O'Carroll, Interoperability Product Manager at Florida Blue.  Ken Kleinberg, the senior consultant and innovation lead at POCP, kickstarted the episode by extending a warm welcome to listeners, emphasizing POCP's pivotal role as trusted and independent health IT consultants. He expressed their unwavering dedication to uncovering the latest healthcare technology news and milestones.The episode promised an illuminating exploration of some of healthcare's most significant challenges and opportunities from a payer perspective including:• CMS MANDATES IN HEALTH IT: Ken introduced the episode by shedding light on the far-reaching impact of CMS mandates and other policy initiatives within the healthcare technology space. The hosts emphasized that merely adhering to regulations falls short; healthcare stakeholders must aspire to achieve more.• ARTIFICIAL INTELLIGENCE (AI) IN HEALTHCARE IT: The episode delved into the transformative potential of AI in healthcare but perhaps used in a more mundane way than expected.  • ENHANCING DATA QUALITY IN HEALTHCARE: The hosts underlined the paramount importance of elevating data quality standards within healthcare. They highlighted how this mission not only benefits healthcare providers and payers but also empowers patients and enhances overall healthcare outcomes.• PATIENT CONSENT MANAGEMENT IN DIGITAL HEALTH: Among the critical issues discussed was the management of patient consent not only across the ecosystem but also the need for the patient to be able to grant access to pieces of information and not their full record. Most importantly, patients need a way to revoke consent at any time. Consent is a challenge demanding immediate attention within healthcare technology.Alice O'Carroll's introduction was met with enthusiasm as she joined the podcast as a distinguished guest. She donned multiple hats, including her role as the Interoperability Product Manager at Florida Blue and her status as one of the champions of the HL7 Da Vinci Project—a remarkable collaborative initiative.  Alice passionately shared her personal dedication to healthcare interoperability, tracing her journey into the realm of interoperability mandates and their profound impact. She underscored the unique role of these mandates in reshaping the entire business model of health IT. She explained that she had a deep belief that interoperability can usher in meaningful change, benefiting not only patients but also all stakeholders in the healthcare ecosystem.At Florida Blue, Alice and her team stood at the forefront of CMS mandate compliance, actively participating in industry workgroups like Da Vinci to ensure alignment with industry standards and drive positive transformation.The discussion swiftly transitioned to the impact of policy developments, particularly CMS mandates, on payers in the healthcare technology landscape. Alice offered her perspective, tracing the lineage of mandates back to CMS's Meaningful Use initiative. She painted a vivid picture of a rapidly evolving regulatory landscape, touching upon mandates such as the transparency and coverage mandate and the no-surprises act. Alice emphasized the vital role of industry involvement in effectively influencing and navigating these transformative regulations.Ken questioned the philosophy of merely checking the regulatory box and explored why organizations, including Florida Blue, should invest additional time and resources in healthcare technology. Alice passionately responded, underlining that the healthcare technology industry's business model is undergoing a profound shift. She explained that compliance with mandates like USCDI creates opportunities, such as payer-to-payer data exchange, but real value emerges from leveraging data to benefit members, lower costs, and enhance quality.The trio ventured into the thrilling domain of artificial intelligence (AI) in healthcare technology. Ken and Jocelyn recognized the potential and challenges AI presents. Alice joined in, envisioning AI's role in transforming unstructured data into structured data, thus enhancing data quality and interoperability in healthcare technology.Alice and Jocelyn delved deeper into the pivotal topic of data quality, acknowledging the healthcare technology industry's historical shortcomings. Alice stressed the need for a universal standard and the challenges posed by unstructured data. She discussed how regulations accelerated data exchange but also emphasized the significance of data stewardship and accountability in healthcare technology.This dynamic conversation encapsulated these crucial healthcare technology themes, painting a vivid picture of an industry undergoing unprecedented transformation. As Ken, Jocelyn, and Alice shared their insights, they collectively illuminated a path forward—one where interoperability, data quality, AI and consent management converge to progress healthcare towards a more patient-centered approach.  The podcast culminated with a valuable reminder from Alice and Jocelyn for healthcare technology professionals to actively engage in industry workgroups and partake in the ongoing transformation of healthcare data sharing and interoperability. They championed a collaborative approach, where both business and IT partners collaborate effectively to navigate the evolving healthcare technology landscape.In closing, Ken expressed his gratitude to his guests, Jocelyn Keegan and Alice O'Carroll, for their passionate insights and engagement in the healthcare technology discussion. He also extended his thanks to the audience for tuning in and invited them to stay updated with future podcast episodes across various platforms as the dynamic field of health IT and healthcare technology continues to evolve.    

SEO (Search Engine Optimization) is how websites prepare and portray themselves to search engines like Google and Bing. The goal of SEO is to generate as much traffic (ideally organic traffic) as possible from the right people - namely prospective customers. The problem with SEO is that many industries and specific keywords are very competitive and require a lot of effort by someone that knows what the search engines want. In order for them to operate effectively they'll need to work with a developer and/or CMS to ensure good technical SEO and be given control over at least some of the website's content (ie blog posts) so that they can try and rank in as many relevant keywords as possible. For small businesses, having someone do their SEO for them seems like a massive gamble, so its a hard sell. If the small business tries to do their own SEO, they may find that their efforts aren't yielding any leads because SEO is not only time consuming, but can also get complex. In this episode, Matt and Mike discuss how to deliver the best possible SEO service to a small business that is on a tight budget, with minimal free time to dedicate to content and keyword research. Show Notes: https://www.htmlallthethings.com/podcasts/seo-for-small-businesses Scrimba Discount: https://tinyurl.com/ScrimbaHATT

Part 1: PA Advocacy Updates This episode, Sam talks with Michael L. Powe who is vice president of reimbursement and professional advocacy for the American Academy of Physician Assistants. They discuss PA and NP Medicare payments, the ABSA or (the American Board of Surgical Assistance) and how it might potentially affect PA practice, the CMS fee schedule and CMS interest in post-op visits, and what the implications are for PAs, as well as the hot topic of the provider nondiscrimination provision.

Friends, The central role that Medicare, and CMS, play in our healthcare system can not be overstated. There are approximately 64 million Americans in the Medicare program, with annual payments ...

New analysis finds that more than 80% of nursing homes currently fall short of staffing levels being proposed by CMS. An FDA panel finds that the active ingredient in many over-the-counter decongestants is ineffective. And, Oracle announces it will add generative AI to its EHRs to help physicians reduce their workload. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Ceribell's rapid seizure triage product for critical care received FDA's Breakthrough Designation with an exclusive New Technology Add-on Payment (NTAP) from CMS. Everything about the ClarityPro product—from the innovative EEG headband to the EEG recorder and physician portal has been engineered to enable quick detection and response to non-convulsive seizure in a critical care or ED setting. In this episode of the Medtech Talk podcast, host Geoff Pardo speaks with Jane Chao, CEO of Ceribell, about the path to develop an innovative new product and her personal journey as well.  Chao's own story started with a love of numbers, a highly exclusive spot earned in a prestigious chemistry program in Beijing, a Ph.D. in biophysics, a stint in documentary film making, and roles at McKinsey, Novartis, and Genentech. For Ceribell's genesis, Chao took lessons from all of those experiences—empathy sharpened while filming a documentary on migrant workers in China, business knowledge gained at McKinsey, and a rich, interdisciplinary scientific background—to launch a new medtech business and engineer a new device to meet a critical, unmet medical need.  Medtech Talk Links:  Cambridge Healthtech Institute   Medtech Talk Gilde Healthcare  

Artificial intelligence (AI) is what many in healthcare will come to remember about the closing years of this decade in healthcare – a decade of unprecedented technological changes, ranging from telehealth to algorithms.And now AI is becoming an accepted technology for evaluation and management (E&M) coding. The results appear to be dramatic in terms of remarkable speed and extraordinary accuracy.Join us during the next live edition of Talk Ten Tuesdays, when Angela Jordan, executive vice president of Chart Pal, the documentation service of Calm Waters, AI, Inc., reports on the latest validation research on E&M leveling and explains how AI can bring a renewed sense of confidence to coders who work tirelessly on E&M coding.All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will be on board with the latest coding news.SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.Point of View: Lidiya Ter-Markarova, president-elect of the California Health Information Association (CHIA), will serve as guest cohost of Talk Ten Tuesdays, reporting on a subject that has caught her attention.

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT What if you could use AI to make digital signage screen content relentlessly relevant? That's the premise and promise of what Korbyt calls Machine Learning Broadcast, new capabilities in the Dallas-based software firm's CMS platform. Using computer vision and machine learning, the idea is that if the platform can get a sense of what's making people stop and watch in a defined environment, then content can be optimized based on that interest. The system finds and schedules content to push to screens based on engagement metrics. How it all technically works is a bit over my shiny head, but I had a good chat with Korbyt CTO George Clopp about what's going on and its implications. We also get into what the future looks like for AI in digital signage. Subscribe from wherever you pick up new podcasts. TRANSCRIPT Geroge, thank you for joining me. We've chatted in the past. For those who don't know Korbyt, can you give me a rundown of what the company's all about?  George Clopp: Hi, Dave. It's a pleasure to speak with you again. Yeah, Korbyt is at its root an employee engagement company. So we've got roots in digital signage, but our typical use case is using digital signage at corporate campuses and to communicate to employees, to increase employee engagement as well as to communicate real-time mission-critical stats as well.  Is that pretty much the core vertical that you guys chase, workplace?  George Clopp: It is. We are heavily into the workplace, meeting rooms as well. We do a lot with retail banks, a little bit into the retail space, but it's primarily corporate campuses. For those who don't know the company, it actually goes back a long way to Symon Communications days, right? You guys were doing workplace communications long before the digital signage industry discovered that.  George Clopp: Yeah, exactly right, Dave. It precedes me. I've been here for seven years now. I can't even believe it, but that's how much I enjoy this space and the industry. I enjoy the company so much, but we had Target Vision, Symon Communications, and we've just evolved. I joined at the tail end of 2016 to develop the Korbyt platform, and obviously, we have to meet the needs of the digital signage industry, but we've had a really heavy focus on employee engagement as well. Is it interesting to see all these other companies who have more general offers, find their way into the workplace because they see that as an opportune vertical?  George Clopp: Yeah, I view it as exciting. I think it's definitely a macroeconomic trend with the pandemic, post-pandemic, the modern workplace, everything is reimagining and reinventing and re-everything these days. I think it's good. It's a legitimate macro problem that everyone's looking to provide solutions to. So, I'm really excited. I love the industry myself.  In some respects, you guys have been doing back-of-house, a lot longer than most companies would have. I mean, you're not just working in the offices, you're working in production areas and so on.  George Clopp: That's correct. Heavy in manufacturing and heavy in the contact centers, anytime where you're doing mission-critical real-time data, you're connecting to an ERP (Enterprise Resource Planning), or yard management system, and you want to change or orchestrate the display and the surroundings based on data changing, we've got a deep background in that.  Yeah, for contact centers, if I recall, years ago pre-arrival with the company, you were doing low-resolution LED readouts that were just telling people in the contact center about the average wait time on calls and things like that.  George Clopp: Exactly, and that's matured over the years and now we're doing that on the desktop and on the mobile device as well. We still have some supply chains and some yard management systems in a warehouse, where we'll do the little blinky boards over the dock doors themselves. We range from the dock doors all the way to your mobile device now.  The PR that came out about a new piece of functionality, your marketing talks about a million endpoints, 250 cloud migrations, and 100+ native integrations.  A million endpoints, that's like a lot. George Clopp: It is. Yeah, scalability and being able to expand out to touch desktops, normal, typical digital science screens, and mobile endpoints. It's been a real focus on us for the last four or five years. So we're really proud to announce that, and then the back end, like you were talking about those native data integrations, I think that's really what sets us aside from a lot of our competition is making those really hardcore authentications and then that real-time pipe between us and the source systems.  I know a lot of other software in our space that we run into, they talk about integrations. A lot of times it's really just a file, they're taking data from a source system. They're putting it into a CSV format or any kind of other format and then they're pulling that in. So that's really where we shine with that real-time data integration.  Is that important in terms of a distinction when solutions providers and users are looking at data integration and they see that a CMS says, yeah we do data integration, we can integrate with your platform? It sounds like you're saying there are different tiers of that, and there's real integration and there's just like a baseline.  George Clopp: Yeah, exactly. That's the right way to pick up on that day, for sure. When you need to orchestrate and change things in a 911 center or in a manufacturing-type environment and definitely in a contact center, speed is really the key there. So having something on a five-minute loop that's pulling a file, it's just not fast enough. So you need that real-time data, you need that high availability so that something was to break that you've got a backup in place and you can make sure that contact center, that supply chain, that 911 center is rolling smoothly. They're not just getting their data, but they're changing the experience of the data. That's another thing that we do, we pull in stats, but we also augment those stats and do value-added calculations on the stats, and then we trigger on those values to change the screen, or change the mobile device or change the desktop. So if you've got too many calls in the queue or you're running behind on this loading dock here, we'll change the entire experience for you based on that value-added stat that we do.  I also assume that when companies talk about integrations, for very logical reasons, they're going to go to the most used platforms out there, whether it's Teams or God knows what. But if you have a hundred plus native integrations you're probably talking about some pretty exotic things that nobody's ever heard of, and if a company went in and said, we can integrate with their systems and they say, what those systems are, their eyebrows are going up, because they're thinking, I have never heard of that. George Clopp: Absolutely, Dave. There are some low-level protocols where we just integrate at a TCP level with a very proprietary protocol, but I would say the bulk of it is more modern, JSON-based RESTful interfaces, for sure and we like to distinguish between data integrations, business application integrations, and SSO integrations, in three categories there. So, like a Power BI or a Tableau or something like that would be more of a business application integration, and when we're talking data integration, we're talking more low level, running SQL against a data store, running web services, running SOAP-based web services, and to that extent. And again, that's why we call it out in our marketing because we do think that's a core differentiator for us.  So just to go back to something, when you talk about a million endpoints, you're including desktops..  George Clopp: That's correct. Desktops and mobile devices, basically all of the endpoints that we talk to. Good. Back at the start of summer, you guys introduced something called, Machine Learning Broadcast. What is that? George Clopp: Yeah, fantastic question. We were involved with machine learning, and AI before it was really cool, so this was actually something we developed in 2018. We've been honing the model, and then we re-released it this year. But machine learning is a subset of AI, and we all know AI is a super big buzzword these days and when you peel that onion, there's levels of accuracy involved there, and there's a lot of hype around the world. But the reason why we called the feature machine learning broadcast is really to focus on the ML aspects of it, and it's a great business problem to solve because, at the end of the day, what we're really creating is a recommendation engine. And I think everybody's familiar with the Amazon recommendation engine, Instagram, and other social media platforms that are just, they're recommending content for you. That's essentially what we're doing here. We're using KNN Analysis, which is supervised machine learning to look at content that has some engagement with it, and that engagement could be measured by computer vision on a digital signage screen, it could be measured by interactivity with it on a desktop or interactivity with that content on the mobile device and then behind the scenes, all we're doing is we're finding out second, third, fourth-degree order content, that's related to the content that was engaging and then it's a feedback loop. We go ahead and automatically schedule that content and see how that content is engaged with so it's a self-learning feedback loop there and the whole purpose of it is to find content that's engaging and show more of that content to your employees. Could you give me a real-world kind of example of how that might work? George Clopp: Yeah, absolutely, Dave. Let's say a company's opening up a brand new office in Buenos Aires and for whatever reason, people really gravitate to that content. They look at it on the signage screen, on the fifth-floor break room, they're engaging with it on their desktop, they're looking at it on the mobile device. We learn from that engagement and say, okay, let's go ahead and find similar related content there. Let's find content related to office openings in Buenos Aires, and then let's go ahead and go further out and look at second, third-order tags. So that would be content related to South America as well. And then we automatically play that content, inject it back into the playlist, and our customers have complete control over whether it's automatic and which players actually get this content and which devices get it and then, we learn based on that content. So it's a feedback loop, and you might find in that case that your employees are really more interested in the geographic region than they are in the new office opening. So it's relentlessly relevant.  George Clopp: Exactly right, Dave, and solving a real-world business problem because one of the challenges our customers have is, it's really arduous to constantly schedule new relevant content.  The first couple of times you do it, you create a scheduled playlist. Yeah, it's okay, but it takes a long time and then, with Attention Deficit Disorder in today's modern world, people grow immune, and they tune out that same content over and over again. So, you need that fresh content injected to keep the employee's attention.  I'm guessing that somebody's going to be listening to this and thinking, that's cool, but where on earth do I get, or how do I develop all this content so that I do have this somewhat bottomless hyper-relevant content available? George Clopp: Yeah, fantastic question. Right now, in its current stance with our ML broadcast, you need to have that content in your media library. We're not automatically going out to like copyright-free areas and pulling in content. But with our release coming out next year, it's called our AI employee engagement. With that, we'll automatically be creating and sourcing content for you on your behalf.  Yeah, I saw a demo of something like that over in Germany a little while back with another company who, I'm sure you'll be happy if I don't name them, that was all about using what was available through an intranet and an extranet, and other resources to auto-generate content for screens. George Clopp: Yeah, it's opening up the whole world of generative AI. We're actually looking at both. Whether there are generative images, generative video, or generative text. Obviously, in our space, images and videos mean a lot, and there are different systems out there. There's DALI 2, there's stable diffusion. They've all got their strengths and their weaknesses. But we're combining that with templated-based content as well.  So automatically generating content that's relevant based off of a text prompt is super useful. But in some cases, it might not be the right content that's generated. So we also will have a mixture of templated content as well.  Yeah, I think templates are a big part of that. I've farted around with things like Mid Journey and so on, and you could see how it could go sideways on you really quickly if you left too much up to the machine.  George Clopp: Exactly. It gets into that whole thing of prompt engineering. You got to be really good with your prompts, and they've all got issues like generating hands and things of that nature right now. But we want to be on the leading edge of this, use it where it makes sense. An area where we think it really makes a lot of sense, a preview into our AI Employee Engagement, is on mission values and goals. We feel like that's an area where our customers just don't communicate enough to their employees, like, there's cake in the break room, let's recognize employees.  That's all part of it, but really just reinforcing, Hey, your goal in the finance department this week is to close your books three days earlier. And so, mix that text in with some great video or some great images that are created in the background using this generative AI. Yeah, I saw something on LinkedIn last night, and I commented on it because I thought it is great that there's a company that's using KPIs and messaging right on the production floor, and the person who posted about it said, this is not very sexy, but it goes to what's needed on the floor for those workers. But the problem was, it looked like hell.  It was just black and white, and they were slapping up a whole bunch of Excel charts, like a stock of them and you'd need binoculars to even see them. So it's important to think about the presentation.  George Clopp: Yeah, totally agree, Dave. I say this at all my speaking events: content is king, content is queen, and that still rules the day. When we're intermixing real-time data with content, it has to be visually appealing. You can't have 20 different stats on the screen; all of those rules of graphic design, I still think, hold true here.  Do you see a day when things like scheduling and trafficking of content are largely automated and handed off to machine learning or some variant of AI?  George Clopp: That's exactly what we're trying to build, Dave, with a release next year. With the ability, of course, to intervene, the ability for the communicator to come in and approve the content or really go ahead and bias the content and say, okay, I've got these 30 categories of content I see that I really want to bias, what the content areas could be.  “Hey, I'm a new enroll. I'm a new first-time line manager. I'm a new director. I'm a new VP, and there's content associated with that new enroll.” They might want to bias that and increase the weight on it, decrease the weight on it, or take it out altogether. So there's still going to be that human touch involved in the ability to approve content, but the AI itself will take care of making sure that content is fresh and relevant. And the big problem we're solving there is just that, again, attention deficit disorder people have, if they see the same thing on the screen, week after week, they tend to tune out. So how can we think of innovative ways to display KPIs, display goals, display things that are really important to the company and give it a great background, give it a great video so that it gets employees' attention again? We're going to talk about machine learning. You reference AI-driven camera optics. Is that basically a computer vision? George Clopp:  It is. Absolutely is, yes. Did you guys write your own, or are you using something like Intel's OpenVINO?  George Clopp: Yeah, the two big ones out there, we've used OpenCV, that is, Open Computer Vision, and TensorFlow, and they both have their strengths and weaknesses, but there are higher order problems we're trying to solve here, and not reinvent computer vision so we're using some libraries for that.  Is that just part of the mix of doing this sort of thing? Are there other technologies you can use to get a sense of dynamics in a venue? George Clopp: Yeah, I think so. Infrared detectors, pressure sensors that kind of tell you who's in that immediate vicinity. You're basically correlating that to human beings in the vicinity, how many human beings are there, and what was playing on the screen at that time. Yeah, so there are less technological ways to do this and still get some good results.  AI is being talked about a lot as you've gone through about its potential to automate presentations. Are there other aspects to a digital signage company, the way your company operates, that you can use AI to help with marketing, help with customer contact, that sort of thing? George Clopp: Yeah, without a doubt. I'm sure you're reading everything. It's revolutionizing all traditional roles, right? Not just engineers writing code. You got a chat with a ChatGPT engineer. With Microsoft's Copilot, it's going to revolutionize the way we all use Excel and Word and PowerPoint and things of that nature. It's definitely revolutionizing marketing. Building product brochures for you automatically, things of that nature, and then, that naturally progresses into, is AI going to take all of our jobs, which I don't think so, going to help us all become more productive. The employees that really change and adopt the AI, I think they're going to be even more valuable than they are today. It's just the employees that just say, I'm not going to do this, and they refuse to allow their cheese to be moved, those are the ones that I think you have to watch out for.  There's an increasing number of companies. I just wrote about one today that has gone down the path of headless CMS. The idea that you can leave the final presentation later, the interactive element, whatever it is to software developers at a large company or who works with a large company as a services company and the digital signage CMS is just the infrastructure, the foundational platform that does device management, scheduling, trafficking, all that sort of stuff. Are you seeing that demand in the marketplace?  George Clopp: We're seeing the opposite. What you're saying absolutely makes sense, especially with my background and the way we've architected our product with microservices. What we're seeing, especially with our large enterprise customers is, they want a little more white glove service. Taking on the arduous task of piecing everything together, even with a microservices framework, is putting a lot of ownership on them. But that is not to say that there's not a need out there. We just really haven't found it. We've actually gone the opposite direction on our side, which has really served us well because we've gone from zero revenue in the cloud to 2 million. We brought on a new CEO, and we quickly ramped up to 20 million. I think it's working for us so far.  Yeah, you're a very different company than maybe prior to you joining RMG Networks, that was a weird little side trip into digital out of home.  George Clopp: It was. We see the artifacts and all that, but I think it's a great group of people here now. There's not a leftover where people have bad attitudes or anything like that. So really proud of where the company's been, the talent we've acquired. We've acquired people from all over the industry. Really love working with the current team and cross-functionally, not just engineering and support, which is what I run, but in sales and marketing as well.  Yeah, it's interesting when you mentioned you've gone in the opposite direction of headless. I've heard that as well, particularly when you get into, like Fortune 500, Fortune 100 kinds of enterprise-grade customers. They want to outsource digital signage, by and large, in the same way that they've outsourced a lot of IT services. George Clopp: Yeah, absolutely. That's the same trend we're seeing, Dave too. It's a little bit of both, right? Everybody wants their cake and eats it too, right? Like they want you to have the ability to do it, but then when it comes time to actually execute on it, we typically find, Hey, we can help them get faster to market if we help augment their team. How important is security? George Clopp: Oh! It's Huge. We all know that the disaster scenario in digital signage, someone compromises your network and they put up some content images or videos that are not appropriate. Even more so with us being more omni-channel with desktop, mobile devices. We've got a data privacy officer, we're SOC 2 compliant. We do a lot of work in Europe so GDPR comes up a lot as well, data privacy. So I think it's super important.  When I think you look at the different offerings out there and the first tier, we look and sound the same. So I think what you got to do with new prospects or new customers, they just got to peel that onion more. What does that really mean? What does it mean that you encrypt your data? Do you do it at rest? Do you do it in transit? Those kinds of things, and I think that's where you can tell the difference between different offerings.  And are the people in the first and second meetings with prospective customers different than they were 7 years ago when you started? I'm hearing the IT people who used to come to meetings and sit there with their arms crossed, thinking, dear God, how long is this going to go on? They're now tending to lead these meetings.  George Clopp: Yeah, I've seen it in multiple ways. Definitely, IT is still the big persona of the buyer here. But I'm also seeing less and less about speeds and feeds and players and hardware and transmission equipment and scalers and more about the final purpose of what we're trying to do. I'm just starting to see that shift. Seven years ago, I talked to people, and it's the AV integration guy. I don't really care what's on the screen. I just care that it's not dark. I don't want a screen that's down. That's their most important thing, and now I'm seeing that shift a little bit more towards they do care about the content, and they're bringing in more of the HR and the communications group involved and making sure that the platform can grow. I can create content on the platform or I can integrate with Adobe or SharePoint or something along those lines. But I still see it, especially AV/IT as a huge influence in the buying process.  Yeah, certainly going back seven, eight years when I was doing some one-to-one consulting with enterprise level customers, that sort of thing, I would go into a first meeting, and I would say, okay, why do you want to do this? And it was always intriguing to see how often people would lean back in their chairs and say, I hadn't really thought about that. They wanted this thing, but as you say, they didn't really know what they were going to do with this thing. George Clopp: Yeah, exactly. And there's a little bit of power in that too. There's power to putting the latest and greatest screen technology in your office and giving you that modern technology look and feel but then just carry it one more step in the maturity direction and start focusing on the content too. Yeah, you can demonstrate innovation by having a big ass screen in your lobby, but if there's nothing useful on there, you're not really demonstrating a lot of innovation.  George Clopp: Exactly, and I think there's still room for that super wonderful creative experience that's human-curated that graphic designers make, and they spend a lot of time getting just perfect in those high profile areas, like the lobby of a company, and then there's also opportunity for, new content generation automatically for me so that I don't have to necessarily sit here and handle this thing. So I think we're going to live in a world where both will be applicable. So you mentioned you, you're working on new iterations of AI-driven content. Is that the big kind of roadmap item for your company over the next year?  George Clopp: Yes, it really is. Yeah. We've got a huge, large-player ecosystem, all the data integrations, and omni-channel platforms. So where our new development team is focused on is automating the content creation, automating that entire feed, if you will, so that it really takes that arduous process away from our communicator. How many folks do you have in the company now? George Clopp: We're a little under 70 people right now. So still a small company and I love it cause everybody has to wear multiple hats, do multiple roles. You have to bring a lot of energy to the company, and I just love that. I've just grown so fond of it over the last seven years.  And is most of the team in the Dallas Fort Worth area, or are you all over the place? George Clopp: Since COVID, we're mainly in Dallas, but since COVID, a lot of us have moved out a little bit. So I'm actually in Colorado. Some of my engineering leads are in the West Coast, some are in Pennsylvania. So we're really practicing what we preach, the hybrid workforce. All right, George, thank you for spending some time with me. It was good to catch up. George Clopp: Yeah, it's fantastic, Dave. Thank you so much for taking time out.

This week I share information about URL Redirects [powerpress]

The Science of Reading has replaced Guided Reading. Switching to something new can feel hard and frustrating. Tune into this episode and become encouraged and empowered by Linda Rhyne. She talks about what Science of Reading is, why it's replaced Guided Reading and how you can implement it. Tune in now! Quotables *All quotables are from the interviewee  In order to become a proficient reader, children need and require direct, explicit, and systematic instruction.  Educators know, understand and feel to their core a deep understanding of the impact that they have or could have.  I can use what I'm learning now to propel myself forward.  About Linda Linda Rhyne is the owner of Linda Rhyne Consulting, a company focused on helping teachers and leaders connect research to practice in a safe & supportive environment. Linda is an award-winning and National Board Certified educator with 15 years of experience in education with Charlotte-Mecklenburg Schools, one of the nation's 20 largest urban school districts located in Charlotte, NC. She served in multiple positions in CMS: classroom teacher, literacy facilitator, new teacher support coordinator, and Southeast Learning Community coordinator, with 10 years of experience as an instructional coach. In her free time, you can find her playing with her two boys, hanging with her husband, reading, and working out. Resources Mentioned by Linda: The Reading League- The Science of Reading Connect with Linda: IG @lindarhyneconsulting Twitter @lindaschultzie FB LindaRhyneConsulting Website: http://lindarhyneconsulting.com Join the Always A Lesson Newsletter Join here and grab a freebie! Connect with Gretchen Email: gretchen@alwaysalesson.com Blog: Always A Lesson Facebook: Always A Lesson Twitter: @gschultek Instagram: Always.A.Lesson Linkedin: Gretchen Schultek Bridgers Book: Elementary EDUC 101: What They Didn't Teach You in College Leave a Rating and Review: This helps my show remain active in order to continue to help other educators remain empowered in a career that has a long-lasting effect on our future.

The system for coordinating organ donations and transplants in the United States is broken, according to experts who have testified over the course of many years to Congress. In this episode, hear their testimony about what is wrong with the current system and then we'll examine the bill that aims to fix the problems. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources August 3, 2022. Senate Finance Committee. Lenny Bernstein and Todd C. Frankel. August 3, 2022. The Washington Post. February 10, 2020. Senate Finance Committee. The Bill Audio Sources July 20, 2023 Senate Committee on Finance, Subcommittee on Health Care Witnesses: LaQuayia Goldring, Patient Molly J. McCarthy, Vice Chair & Region 6 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Matthew Wadsworth, President and CEO, Life Connection of Ohio Raymond J. Lynch, MD, MS, FACS, Professor of Surgery and Director of Transplantation Quality and Outcomes, Penn State Health Milton S. Hershey Medical Center Donna R. Cryer, JD, Founder and CEO, Global Liver Institute Clips 30:40 Sen. Ron Wyden (D-OR): HRSA, the Health Resources Agency, is on track to begin the contract process this fall and we're just going to be working here to complement their effort. 36:30 Sen. Chuck Grassley (R-IA): In 2005, I started the investigation of the deadly failures of UNOS, the monopoly tasked with managing the US organ donation system. Since then, more than 200,000 patients have needlessly died on the organ waiting list. There's a reason that I call UNOS the fox guarding the hen house. For nearly two decades, UNOS has concealed serious problems [at] the nation's organ procurement organizations, known as OPOs, instead of working to uncover and correct the corruption. This human tragedy is even more horrific because many of these deaths were preventable. They were the result of [a] corrupt, unaccountable monopoly that operates more like a cartel than a public servant. 44:45 LaQuayia Goldring: As a toddler, at the age of three, I was diagnosed with a rare kidney cancer that took the function of my left kidney. And when I was 17, I went back into complete renal failure and I received a first kidney transplant at that time. Unfortunately, in 2015, I went back into kidney failure. And at that time, I wasn't ready for another transplant, but I didn't have a choice but to go back on dialysis. I've been waiting nine agonizing years for a transplant, dependent upon a dialysis machine five days a week, just to be able to live. I was told that I would receive a kidney transplant within three to five years. But yet I am still waiting. I am undergoing monthly surgeries just to be able to get my dialysis access to work so that I can continue to live until I get a transplant. The UNOS waitlist is not like one to 100, where everybody thinks you get a number. I'm never notified on where I stand on the list or when I will get the call. I have to depend on an algorithm to make the decision of what my fate will be. 47:55 LaQuayia Goldring: Just a few weeks ago, a donor family reached out to me to be a directed kidney donor, meaning they chose me specifically for a kidney transplant. But unfortunately, due to the errors in the UNOS technology, I was listed as inactive and this was a clerical error. And all that they told me was this was a clerical error, and they could not figure out why I was inactive. But when it came down to it, I'm actually active on the transplant list. 51:45 Molly McCarthy: The Federal monopoly contractor managing the organ donation system, UNOS, is an unmitigated failure. And its leadership spends more time attacking critics than it does taking steps to fix the system. I've seen this firsthand in my five years as a patient volunteer with the OPTN and three years ago, I stepped into the role of Vice Chair of the Patient Affairs Committee, or PAC. 53:45 Molly McCarthy: Further, I have been called by a board member telling me to stop focusing on system outage and downtime of the UNOS tech system. He told me that having downtime wasn't a big deal at all, "the donors are dead anyway." That comment speaks volumes to me about the lack of empathy and respect UNOS has for donor families. 55:00 Molly McCarthy: Congress needs to break up the UNOS monopoly by passing 1668, ensuring that HHS uses its authority to replace UNOS as its contractor. 1:00:15 Matt Wadsworth: Break up the OPTN contract and allow for competition. 1:00:40 Matt Wadsworth: I commend this committee for introducing legislation to finally break up this monopoly and I stand ready to work with you in any way possible to ensure that this bill passes. It's the only way this industry will be able to save more patients' lives. 1:02:10 Dr. Raymond Lynch: I want to differentiate between organ donation, which is the altruistic decision of the donor patient and their family, and organ procurement, which is the clinical care provided by OPO staff. This is what turns the gift of donation into the usable organs for transplant. Organ procurement is a clinical specialty. It's the last medical care that many patients will ever receive. It's reimbursed by the federal government and it's administered by OPOs that are each the only provider in the territory to which they hold federal contracts. Right now patient care delivered by OPOs is some of the least visible in American healthcare. I can't tell you how many patients were evaluated by OPO workers in the US in 2022. I can't tell you how many patients were examined, or how many families were given information about donation, or how many times an OPO worker even showed up to a hospital to do this clinical duty. This lack of information about what OPO providers actually do for patients is a root cause of the variability in rates of organ procurement around the country. My research has shown that what we call OPO performance is a measurable restriction on the supply of organs that results in the unnecessary deaths of patients with organ failure. For example, if the lowest performing OPOs from around the country had just reached the national median over a recent seven year period, there would have been 4957 more organ donors, yielding an estimated 11,707 additional organs for transplant. Because many OPOs operate in a low quality data environment and without appropriate oversight, almost 5,000 patients did not get adequate organ procurement care, and nearly 12,000 other patients did not receive life saving transplants. 1:03:55 Dr. Raymond Lynch: OPO clinical work is currently not visible, it's not benchmarkable, and it's not able to be adequately evaluated, analyzed, or compared. However, much of the hidden data about how OPOs provide care to patients is known to one entity and that entity is UNOS. 1:05:20 Dr. Raymond Lynch: We need a new network of highly skilled specialist organizations, each attending to areas of expertise in the management of the OPTN contract. 1:21:15 Sen. Marsha Blackburn (R-TN): When we look at OPTN, and look at the Securing Organ Procurement Act, the bill would strip the nonprofit requirement for the manager of the Organ Procurement and Transplantation Network, which would open the door for profiting from organ procurement and donation. And to me, this is something that I think many people really fear, especially people that are on a waitlist. And so what I would like for you to do is to address that and address those concerns. And why or why not you think the Act has it right. Dr. Raymond Lynch: Thank you, Senator. I think it's unfortunate that people would be afraid of that and it needs to be changed. Many of the patients that you referenced are waitlisted at for-profit hospitals. For-profit is a part of American healthcare. And I can tell you that our not-for-profit entity doesn't work. And there are for-profit hospitals and for-profit transplant centers that do work. So patients don't need to be afraid of that. They do need to be afraid of the status quo. 1:28:30 Sen. Ben Cardin (D-MD): Ms. Cryer, do you have any views as to why it's much lower percentage chances for a racial minority to be able to have a transplant? Donna Cryer: Yes. And it really does come down to UNOS not doing its job of overseeing the organ procurement organizations. We know from many studies that black and brown communities donate organs in the same percentage they are the population. So it is not a problem of willingness to donate. It is a problem, as Miss Goldring was starting to discuss, about UNOS not ensuring that OPOs go out into the communities, develop relationships far before that horrible decision is needed to [be] made to donate the organs of a family member. 1:56:45 Sen. Elizabeth Warren (D-MA): And among the many reforms the legislation would support HRSA's proposal to break up the OPTN monopoly contract into multiple smaller contracts, which would allow some competition and allow the best vendors in the business to manage different parts of the transplant network operation. That means hiring IT experts to do the IT. It means hiring logistics experts to do logistics, and so on. 1:57:15 Sen. Elizabeth Warren (D-MA): UNOS does not want to lose control, so they're pushing to have the government limit eligibility only to nonprofit vendors that have worked in the past on organ donation, meaning, for instance, that the IT company that is hired to run OPTNs computers systems would have had to have worked on an organ transplant network in the past and be a nonprofit. So Ms. McCarthy, the requirement UNOS wants would seem to make it so that only one organization could apply for the new contract: UNOS. 1:58:35 Sen. Elizabeth Warren (D-MA): Right now, Congress has an opportunity to root out corruption in this system, but if we don't act before the current contract expires we won't have another shot for years. August 3, 2022 Senate Committee on Finance Witnesses: Brian Shepard, CEO, United Network for Organ Sharing (UNOS) Diane Brockmeier, RN, President and CEO, Mid-America Transplant Barry Friedman, RN, Executive Director, AdventHealth Transplant Institute Calvin Henry, Region 3 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Jayme Locke, M.D., MPH, Director, Division of Transplantation, Heersink School of Medicine, University of Alabama at Birmingham Clips 36:15 Sen. Ron Wyden (D-OR): A 1984 law created the first computerized system to match sick patients with the organs they need. It was named the Organ Procurement and Transplantation Network. Someone needed to manage that system for the whole country, so the government sought to contract an organization to run it. UNOS was the only bidder for that first contract in 1986. The contract has come up for bid seven other times, UNOS has won all seven. Today, the network UNOS overseas is made up of nearly 400 members, including 252 transplant centers, and 57 regional organizations known as Organ Procurement Organizations, or OPOs. Each OPO is a defined geographic service network. Families sitting in a hospital room thinking about donating a loved one's organs does not have a choice of OPOs. 37:40 Sen. Ron Wyden (D-OR): Between 2010 and 2020, more than 1,100 complaints were filed by patients and families, staff, transplant centers, and others. The nature of these complaints runs the gamut. For example, in a number of cases, OPOs had failed to complete critical mandatory tests for matters like blood types, diseases, and infection. Our investigation found one patient died after being transplanted with lungs that a South Carolina OPO marked with the wrong blood type. Similar blood type errors happened elsewhere and patients developed serious illness. Some had to have organs removed after transplant. Another patient was told he would likely die within three years after an OPO in Ohio supplied him with a heart from a donor who had died of a malignant brain tumor. UNOS did not pursue any disciplinary action. In a case from Florida, another patient contracted cancer from transplanted organs and the OPO sat on the evidence for months. In total, our investigation found that between 2008 and 2015, and 249 transplant recipients developed a disease from transplanted organs. More than a quarter of them died. 38:55 Sen. Ron Wyden (D-OR): Delivering organs has been another source of life threatening errors. We found 53 such complaints between 2010 and 2020, as well as evidence that this was just the tip of the iceberg. In some cases, couriers missed a flight. In others, the organs were abandoned at airports. Some organs were never picked up. Many of these failures resulted in organs being discarded. 39:20 Sen. Ron Wyden (D-OR): It's reasonable to assume that many more errors are going unreported. Why? Because filing official complaints with UNOS appears to accomplish zero productive oversight or reform. Organ transplant professionals repeatedly told the Finance Committee that the complaint process was, and I quote here, "a black hole." Complaints went in, UNOS went quiet. In interviews with the Committee UNOS leaders have dragged their feet, dodged tough questions, and shifted responsibility onto others. investigations and disciplinary measures rarely amount to much more than a slap on the wrist. Only one time -- just once -- has UNOS recommended that an OPO lose their certification. 55:05 Diane Brockmeier: We must update the archaic technology system at UNOS. As OPOs, we are required to work with UNOS technology DonorNet every day. DonorNet is outdated, difficult to us,e and often slow to function when every minute counts. Manual entry subjects it to error and OPO and Transplant Center staff are not empowered with the right information when time is critical. I did serve in leadership roles on the OPO Committee from 2017 to 2022. Committee members and industry leaders voiced repeated requests to improve DonorNet. The consistent response was UNOS IT did not have the bandwidth to address this work. The limitations of the UNOS technology are delaying and denying transplants to patients that are dying on the waitlist. Poor technology impacts the disturbingly high kidney discard rate in the United States, where one in four kidneys never make it to a patient for transplantation. Critical time is lost due to the inefficiency of DonorNet, wasting time on offers that will not be accepted. Of course an available organ should be offered to the patient in this sequence. However, far too much of the matching, particularly on older donors and organs that are difficult to place, are left to the individual OPOs and transplant centers to find each other despite, rather than facilitated by, UNOS technology. Mid-America Transplant intentionally identifies surgeons who accept kidneys that have been repeatedly turned down many times. These are life saving options for those patients. In May of 2022, one of these patients was number 18,193 on the list. Relying on DonorNet alone, that kidney would never had been placed and the chance to save a life would have been wasted. 55:20 Diane Brockmeier: UNOS lacks urgency and accountability around identifying and remediating this preventable loss of organs, and they are not required to publicly report adverse events when patients are harmed, organs are lost, or the quality of patient care is deemed unsafe. UNOS does not require clinical training, licensure, or certification standards for OPO staff delivering critical patient care. In this environment, who's looking out for the patient? Who's being held accountable for poor patient care? No OPO has ever actually been decertified, regardless of its performance or its safety record. 57:55 Diane Brockmeier: When an OPO goes out of sequence to place an organ that would otherwise be thrown away, UNOS requires an explanation; however, when organs are recovered and discarded, you must remain silent. 58:05 Diane Brockmeier: We must remove conflicts to ensure effective governance. From 2018 to 2020, I served as a board member for the OPTN. Serving on the board of the OPTN automatically assigns membership to the UNOS board. My board experience revealed that at times UNOS actions are not aligned with its fundamental vision of a life saving transplant for everyone in need. How can you fairly represent the country's interest and a contractor's interest at the same time? 58:35 Diane Brockmeier: Board members are often kept in the dark about critical matters and are marginalized, particularly if they express views that differ from UNOS leadership. Preparatory small group calls are conducted prior to board meetings to explore voting intentions, and if the board member was not aligned with the opinion of UNOS leadership, follow up calls are initiated. Fellow board members report feeling pressured to vote in accordance with UNOS leadership. 59:10 Diane Brockmeier: To protect patients, I urge Congress and the administration to separate the OPTN functions into different contracts so that patients can be served by best-in-class vendors, to immediately separate the boards of the OPTN and OPTN contractors, and to ensure that patients are safeguarded through open data from both the OPTN and OPOs. 1:00:45 Barry Friedman: Approximately 23% of kidneys procured from deceased donors are not used and discarded, resulting in preventable deaths 1:00:55 Barry Friedman: Organ transportation is a process left to federally designated Organ Procurement Organizations, OPOs. Currently, they develop their own relationships with couriers, rely on airlines, charter flights, ground transportation, and federal agencies to facilitate transportation. In many cases, organs must connect from one flight to another, leaving airline personnel responsible for transfers. While anyone can track their Amazon or FedEx package, there is currently no consistent way of tracking these life saving organs. 1:01:45 Barry Friedman: Currently there is no requirement for OPOs to use tracking systems. 1:02:20 Barry Friedman: I also believe there's a conflict of interest related to the management of IT functions by UNOS, as the IT tools they offer transplant centers come with additional costs, despite these being essential for the safety and management of organs. 1:02:35 Barry Friedman: UNOS is not effectively screening organ donors so that they can be quickly directed to transplant programs. UNOS asks centers to voluntarily opt out of certain organs via a filtering process. As a result, OPOs waste valuable time making organ offers to centers that will never accept them. Time wasted equates to prolonged cold ischemic time and organs not placed, resulting in lost organ transplant opportunities. 1:03:10 Barry Friedman: Due to the limited expertise that UNOS has in the placement of organs, it would be best if they were no longer responsible for the development of organ placement practices. The UNOS policy making [process] lacks transparency. Currently OPTN board members concurrently serve as the board members of UNOS, which creates a conflict of interest that contributes to this lack of transparency. UNOS committees are formed in a vacuum. There is no call for nominations and no data shared with the transplant community to explain the rationale behind decisions that create policy change. 1:11:35 Dr. Jayme Locke: The most powerful thing to know about this is that every organ represents a life. We can never forget that. Imagine having a medication you need to live being thrown away simply because someone took too long to get it to you. Your life quite literally in a trash can. Organs are no different. They too have shelf lives and they are measured in hours. Discarded organs and transportation errors may sound abstract, but let me make this negligence real for you. In 2014, I received a kidney that arrived frozen, it was an ice cube you could put in your drink. The intended recipient was sensitized, meaning difficult to match. The only thing we could do was tell the waiting patient that due to the lack of transportation safeguard, the kidney had to be thrown in the trash, the final generous act of a donor in Maryland. In 2017, I received a kidney that arrived in a box that appeared to have tire marks on it. The box was squished and the container inside had been ruptured. We were lucky and were able to salvage the kidney for transplant. But why should luck even play a role? 1:12:45 Dr. Jayme Locke: In one week, I received four kidneys from four different OPOs, each with basic errors that led to the need to throw away those life saving organs. One due to a botched kidney biopsy into the kidneys collecting system, another because of a lower pole artery that had been cut during procurement that could have been fixed if someone involved had assessed the kidney for damage and flushed it before packing, but that didn't happen. Two others arrived to me blue, meaning they hadn't been flushed either. 1:13:15 Dr. Jayme Locke: Opacity at UNOS means that we have no idea how often basic mistakes happen across the country, nor can we have any confidence that anything is being done to redress such errors so they don't keep happening. 1:13:40 Dr. Jayme Locke: Women who have been pregnant, especially multiple times, are harder to match, contributing to both gender and racial disparities in access to transplant. This is a very real example of how a constrained pool of organs and high discards disproportionately hurt women and women of color, who are more likely to have multiple pregnancies. 1:14:25 Dr. Jayme Locke: Number one, immediately separate the OPTN board from any of the boards of any contractors. Number two, bring in real experts to ensure our patients are served by the best of the best in each field, separating out key functions of the OPTN, including policy, technology, and logistics. And number three, ensure that patients are safer by holding all contractors accountable through public adverse event reporting and immediate redressing of problems. 1:22:00 Sen. Chuck Grassley (R-IA): The system doesn't seem to be fair to racial minorities or people living in rural communities. So what are your efforts underway to understand the root causes and help make the system fairer to patients on the waiting list to explain the factors that result in the disparity for minorities in rural populations in the process? And how can the federal government address a problem if we have to be involved in addressing it? Dr. Jayme Locke: One of the most important things that we don't currently do is we don't actually account for disease burden in terms of examining our waiting lists. So we have no way of knowing if we're actually serving the correct people, if the correct people are actually making it to the waiting list. Disease burden is super important because it not only identifies the individuals who are in need of transplantation, but it also speaks to supply. So areas with high rates of end stage kidney disease burden, like the southeastern United States are going to have much lower supply. And those waiting lists predominantly consist of African American or Black individuals. So if you want to make a truly equitable organ system, you have to essentially get more organs to those areas where there are higher disease burdens. I think the other thing is that we have to have more focus on how we approach donor families and make sure that we have cultural competence as a part of our OPOs, and how they approach families to ensure that we're not marginalizing minority families with regard to the organ donation process. 1:30:00 Brian Shepard: The OPTN IT system that UNOS operates has 99.99% uptime. It is a highly reliable system. We are audited annually by HRSA.... Sen. Ben Cardin (D-MD): My information shows it's had 17 days down since I think 1999. That's not correct? Brian Shepard: In 23 years, yes, sir. Sen. Ben Cardin (D-MD): Okay, well, every day there's a loss of life, isn't it? Brian Shepard: That's the total amount of time over the couse of -- Sen. Ben Cardin (D-MD): I hope our national event system isn't down 17 days a year. Brian Shepard: The system has never been down for a day. And to my knowledge, and I have not been at UNOS since 1999, there's been maybe one event that was longer than an hour, and that was three hours. But the total amount of time since 1999 -- Sen. Ben Cardin (D-MD): So you're satisfied with your technology? You think you have the right technology? You're satisfied with your tracking systems now? You think everything is okay? Brian Shepard: We constantly improve our technology. We're subjected to 3 million attempts a day to hack into the patient database and we successfully repelled them all. So we are never satisfied with our technology, but we do maintain 99.99% uptime. We disagree with the USDS analysis of our systems. 1:37:25 Brian Shepard: If you're asking whether UNOS can prevent an OPO from operating or for being an OPO -- Sen. Rob Portman (R-OH: Well not prevent them, but require them to do something .You don't have the ability to require them...? Brian Shepard: The peer review process has significant persuasive authority, but all the payment authority and all the certification and decertification authority live at CMS. 1:39:00 Sen. Rob Portman (R-OH: Do you think there should be tracking of organs in transit? Brian Shepard: I think that's a very beneficial thing. UNOS provides an optional service that a quarter of OPOs use. Many OPOs also use other commercially available trackers to do that. There is not a single requirement to use a particular system. 1:41:55 Sen. Elizabeth Warren (D-MA): Mr. Shepherd, you are the CEO of UNOS. We have documented these problems and you've received more than 1000 complaints in the last decade alone. So tell me, in the 36 years that UNOS has had the contract to run our national organ system, how many times has UNOS declared its OPO Members, any OPO members, not in good standing. Brian Shepard: Two times, Senator. 1:43:20 Sen. Elizabeth Warren (D-MA): How many times has UNOS put an OPO on probation? Brian Shepard: I don't know that number off the top of my head, but it's not a large number. Sen. Elizabeth Warren (D-MA): It's not large, in fact it's three. 1:45:20 Brian Shepard: Approximately 10% of the budget of this contract is taxpayer funded. The rest of that is paid by hospitals when they list patients. 1:49:30 Sen. Todd Young (R-IN): Once an OPO is designated not in good standing, Senator Warren referred to this as toothless. It does seem toothless to me. I'll give you an opportunity, Mr. Shepherd, to disabuse me of that notion and indicate for me what penalties or sanctions are actually placed on an OPO when they are designated not in good standing. Brian Shepard: The statute does not give UNOS any authority to offer sanctions like that. The certification, decertification, payment authorities belong entirely to CMS. UNOS's statute doesn't give us the ability -- Sen. Todd Young (R-IN): So it is toothless in that sense. Brian Shepard: It is designed to be, by regulation and contract, a quality improvement process, in contrast to the oversight process operated by a federal agency. 1:51:15 Sen. Todd Young (R-IN): To what extent is UNOS currently tracking the status of all the organs in transit at any given time? Brian Shepard: UNOS does not coordinate transportation or track organs in transit. We do provide a service that OPOs can use to use GPS trackers. Some of the OPOs use ours and some use other commercially available products. Sen. Todd Young (R-IN): So why is it, and how does UNOS plan to optimize organ delivery if you don't have 100% visibility into where they are at any given time? Brian Shepard: I think that the GPS products that we offer and that other people offer are valuable, they do help in the delivery of kidneys. Only kidneys travel unaccompanied, so this is a kidney issue. But I do think that GPS trackers are valuable and I think that's why you've seen more and more OPOs use them. 1:52:50 Sen. Ron Wyden (D-OR): Mr. Shepherd has said twice, with respect to this whole question of the power to decertify an OPO, that CMS has the power to do it. UNOS also has the power to refer an OPO for decertification under the OPTN final rule. That has been done exactly once. So I just wanted it understood with respect to making sure the committee has got what's really going on with respect to decertifying OPOs. 2:00:15 Dr. Jayme Locke: Obviously people have described that we have about a 25% kidney discard, so one in four. So if you look at numbers last year, these are rough numbers, but that'd be about 8000 kidneys. And really, I think, in some ways, these are kind of a victim of an entrenched and cumbersome allocation algorithms that are very ordinal, you have to go sort of in order, when data clearly have shown that introduction of multiple simultaneous expiring offers would result in more efficient placement of kidneys and this would decrease our cold ischemia time. 2:00:50 Dr. Jayme Locke: So if you take UNOS's organ center, they have a very rigid system, for example, for finding flights and lack either an ability or interest in thinking outside the box. So, for example, if there are no direct flights from California to Birmingham, Alabama, instead of looking for a flight from San Francisco to Atlanta, understanding that a courier could then pick it up in Atlanta and drive it the two hours, they'll instead put on a flight from SFO to Atlanta and allow it to go to cargo hold overnight, where it literally is rotting, if you will, and we're putting extra time on it. Sen. Ron Wyden (D-OR): Just to make sure everybody gets this. You're saying you've seen instances of something being put in cargo hold when it is very likely to rot? Dr. Jayme Locke: That is correct. So if the kidney arrives after 10pm at the Atlanta airport, it goes to cargo hold. We discovered that and made calls to the airlines ourselves and after several calls to the airlines, of course they were mortified, not understanding that that was what was happening and actually had their manager meet our courier and we were able to get the kidney out of cargo hold, but this went on before we figured out what was happening because essentially they fly it in, it sits in cargo hold, it comes out the next morning to catch the next flight. Instead of thinking outside the box: if we just get it to Atlanta, it's drivable to Birmingham. And those hours make a difference. Sen. Ron Wyden (D-OR): That sounds way too logical for what UNOS has been up to. 2:03:05 Sen. Ron Wyden (D-OR): Miss Brockmeier, UNOS has developed this organ tracking system. Do you all use it? I'm curious what you think of it. Diane Brockmeier: Thank you for the question, Senator. We did use and participate in the beta pilot through UNOS and made the decision to not move forward using their product, and have sought a commercial alternative. Sen. Ron Wyden (D-OR): And why was that? Diane Brockmeier: Part of the issues were some service related issues, the lack of the interconnectivity that we wanted to be able to facilitate a more expedited visual tracking of where the organ was. Sen. Ron Wyden (D-OR): Was the tracking technology low quality? Diane Brockmeier: Yes, sir. 2:11:25 Sen. Ron Wyden (D-OR): All right, let's talk for a moment about the boards that are supposed to be overseeing these, because it looks to me like there's a serious conflict of interest here and I'll send this to Ms. Brockmeier, and perhaps you'd like to get to it as well, Mr. Friedman. The Organ Procurement and Transplantation Network, which is the formal title of the organ network that operates under federal contract administered by HHS, and UNOS, which is the contractor that operates the network and controls information about the network, have the same boards of directors, despite efforts by the government to separate them. That means the people who look out for the best interests of UNOS, the multimillion dollar nonprofit, are the same people who look out for the interests of the entire organ transplant network. Sure sounds like a conflict to me. 2:12:55 Diane Brockmeier: I think there should be an independent board. I think the division of the responsibilities of the board and by the inherent way that they're structured, do pose conflicts. It would be like if you had an organization that was a supporting organization, you'd want to hold it accountable for its performance. And the current structure really limits that opportunity. 2:19:50 Dr. Jayme Locke: And if you think about IT, something as simple as having a system where we can more easily put in unacceptable antigens, this was a debate for many years. So for context, we list unacceptable antigens in the system that allows us to better match kidneys so that when someone comes up on the match run, we have a high probability that there'll be a good tissue match. Well, that took forever and we couldn't really get our unacceptable antigens in, so routinely people get offered kidneys that aren't going to be a match, and you have to get through all of those before you can get to the person that they really should go to. Those are simple examples. But if we could really have transparency and accountability around those kinds of things, we could save more lives. 2:23:10 Sen. Ron Wyden (D-OR): Mr. Shepherd told Senator Warren that only 10% of UNOS funds come from taxpayer money and the rest comes from fees paid by transplant centers who add patients to the list. But the fact is, Medicare is the largest payer of the fees, for example, for kidneys. So we're talking about inefficiency, inefficiency that puts patients at risk. And certainly, taxpayer dollars are used to cover some of these practices. May 4, 2021 House Committee on Oversight and Reform, Subcommittee on Economic and Consumer Policy Witnesses: Tonya Ingram, Patient Waiting for a Transplant Dr. Dara Kass, Living Donor and Mother of Transplant Recipient LaQuayia Goldring, Patient Waiting for a Transplant Steve Miller, CEO, Association for Organ Procurement Organizations Joe Ferreira, President, Association for Organ Procurement Organizations Matt Wadsworth, President and CEO, Life Connection of Ohio Dr. Seth Karp, Director, Vanderbilt Transplant Center Donna Cryer, President and CEO, Global Liver Institute Clips 5:15 Tonya Ingram: The Organ Procurement Organization that serves Los Angeles, where I live, is failing according to the federal government. In fact, it's one of the worst in the country. One analysis showed it only recovered 31% of potential organ donors. Audits in previous years found that LA's OPO has misspent taxpayer dollars on retreats to five star hotels and Rose Bowl tickets. The CEO makes more than $900,000. Even still, the LA OPO has not lost its government contract and it has five more years to go. 30:00 Rep. Raja Krishnamoorthi (D-IL): Unusual among Medicare programs, their costs are 100% reimbursed, even costs unrelated to care. So, extravagant executive compensation and luxury perks may be passed off onto the taxpayer. 46:55 Dr. Seth Karp: We have 10 hours to get a liver from the donor to the recipient, and about one hour to sew it in. For heart, we have about six hours. Time matters. 47:55 Dr. Seth Karp: Last year, I had the opportunity to co-write a viewpoint in one of the journals of the American Medical Association with TJ Patel, former Chief Data Scientist of the United States. In that article, we provided evidence that the metrics used to judge the performance of organ procurement organizations are basically useless. Until the recent OPO Final Rule, performance was self-reported, and OPO employees admitted to having gamed the system. When threatened with decertification, one of the OPOs themselves successfully argued that because the performance data were self reported and unaudited, they failed to meet a reasonable standard and the OPO should not be held accountable. In other words for decades, the metrics supposed to measure performance didn't measure performance, and the results have been disastrous, as you have heard. 49:45 Dr. Seth Karp: Whenever I, and quite frankly most everyone else in the field, gives a talk on transplantation, we usually make two points. The first is that organ transplantation is a miracle of modern medicine. The second is the tragedy that there are not enough organs for everyone who needs one. I no longer use the second point, because I don't believe it. Based on my work, I believe that there are enough organs for patients who require hearts, lungs, and probably livers, and we can make a huge improvement in the number of kidneys available. In addition to improving OPO performance, new technologies already exist to dramatically increase the organ supply. We need a structure to drive rapid improvement in our system. 54:00 Joe Ferreira: One common misconception is that OPOs are solely responsible for the entire donation and transplantation system, when, in fact, OPOs are the intermediary entity and their success is highly dependent on collaborations with hospitals and transplant programs. At the start of the donation process, hospitals are responsible for notifying any OPO in a timely manner when a patient is on a ventilator and meets medical criteria to be an organ donor. Additionally, transplant centers must make the decision whether to accept or decline the organs offered by OPOs. 57:55 Matt Wadsworth: As geographic monopolies, OPOs are not subject to any competitive pressure to provide high service. As the only major program in all of health care 100% reimbursed for all costs, we do not face financial pressures to allocate resources intelligently. 1:02:10 Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, I'd like to turn to you. You run the OPO called the Nevada Donor Network. I have your OPO's 2019 financial statement filed with the CMS. It appears that your OPO spent roughly $6 million in 2019 on administrative and general expenses. Interestingly, in 2019, I see your OPO spent approximately $146,000 on travel meetings and seminars alone. And your itemization of Administrative and General has an interesting line item for $576,000 for "ANG". It took me a minute but that means you have an "Administrative and General" subcategory in your "Administrative and General" category. Very vague. Now Mr. Ferreira, I was informed by Mr. Wadsworth, a former executive of yours at the Nevada Donor Network, that your OPO has season tickets to the NHL's Las Vegas Golden Knights, isn't that correct? Joe Ferreira: That is correct, Mr. Chairman. Rep. Raja Krishnamoorthi (D-IL): And you also have season tickets to the Las Vegas Raiders too, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And according to Mr. Wadsworth and others, your OPO took a board retreat to Napa Valley in 2018. Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And Sonoma in 2019, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, what you're spending on the Raiders, the Golden Knights, Napa Valley and Sonoma have one thing in common: they have nothing to do with recovering organs. 1:10:30 Dr. Seth Karp: In 2019, there were six heart transplants that were performed using donors after circulatory determination of death. And I don't want to get into the technical aspects of that. But in 2019, that number was six. In 2020, that number was 126. This is a new technology. This is a way that we can increase the number of heart transplants done in United States dramatically. And if we think that there were 500 patients in the United States waiting for a heart in 2020, 500 patients that either died or were delisted because they were too sick, and you think in one year, using a technology, we got another 100 transplants, if we could get another 500 transplants out of that technology, we could almost eliminate deaths on the on the heart transplant waiting list. That technology exists. It exists today. But we don't have a mechanism for getting it out to everybody that could use it and it's going to run itself through the system, it's going to take too much time. 1:24:05 Rep. Andrew Clyde (R-GA): You know, I'm a little disappointed that we're discussing race as a factor in organ transplant. We're all one race in my opinion; color makes no difference to me. We're the human race. And to me, the interjection of race into this discussion is very concerning. Discrimination based on race was outlawed almost 60 years ago through the Civil Rights Act of 1964. Now, I'm not a medical doctor, and I have very little knowledge of medicine. But last year, there was an article that came out in LifeSource and it says, "Does my race and ethnicity matter in organ donation?" And so my question here is for Dr. Karp. In your experience, would you agree that a donor's organs are more likely to be a clinical match for a recipient of the same ethnicity? Could you comment on that? Is that actually a factor, or not? I mean, we're all human beings, we all, you know, have similar bodies. Dr. Seth Karp: Yes. So there definitely are certain HLA types that are more common. That is race-based. So the answer to that question is yes. Rep. Andrew Clyde (R-GA): Okay. All right. And so if you have more of one particular race, more donations of one particular race, then naturally you would have more actual matches of that particular race. Is that correct? Dr. Seth Karp: That would tend to be the case. Rep. Andrew Clyde (R-GA): Okay. All right. All right. Okay, that's just a question that I wanted to clear up here. 1:34:20 Donna Cryer: We'd like to see investments in languages that are spoken by the community. Educational resources should be, as required by law, for those with limited English proficiency. They should be in the languages spoken by the community. They should be hiring diverse staff to have those most crucial conversations with families. The data shows, and certainly experience and common sense shows as well, that having people of color approaching families of color results in more donations. Executive Producer Recommended Sources Music by Editing Production Assistance

Today, we're excited to get to know Dr. Karen Murphy, EVP, Chief Innovation Officer and founding director of the Steele Institute for Health Innovation of Geisinger. Karen has worked to improve and transform healthcare delivery throughout her career in both the public and private sectors. Before joining Geisinger, she served as Pennsylvania's secretary of health addressing the most significant health issues facing the state, including the opioid epidemic. Prior to her role as secretary, Dr. Murphy served as director of the State Innovation Models Initiative at the Centers for Medicare and Medicaid Services leading a $990 million CMS investment designed to accelerate health care innovation across the US. She previously served as president and CEO of the Moses Taylor Health Care System, and as founder and CEO of Physicians Health Alliance. Karen has a PhD, MBA and RN degree!  Founded in 1995, Geisinger is an integrated healthcare system that includes 13 hospital campuses, two research centers, the Geisinger Commonwealth School of Medicine, and a health plan that serves approximately 600,000 members. Geisinger's more than 30,000 employees, 2,500 providers, nearly 500 residents and fellows, and 360 medical students serve and care for the three million residents in Pennsylvania. In this episode, Karen shares her wealth of experiences from RN to CEO of a health system, Geisinger's exciting merger with Kaiser to form Risante Health, and key characteristics of a successful partnership between system and startup, her approach on working with startups as an innovative health system.

On this episode of the Healthcare Education Transformation Podcast, Dr. Carmen Cooper Oguz shares her non-traditional journey in healthcare and how she has managed to juggle multiple roles and responsibilities. She emphasizes the importance of having a supportive network and being proactive in seeking opportunities. Dr. Oguz encourages individuals to show up, socialize, and express their interests in order to get involved and make a difference in their profession. She also highlights the value of recognizing and uplifting others in their achievements.Dr. Carmen Cooper Oguz is a highly accomplished physical therapist and healthcare administrator. With a background in business and a passion for healthcare, she has held various positions in the field, including hospital outpatient CMS, grants reviewer for the Health Resources Services Administration, and medical expert witness. Dr. Oguz is also actively involved in professional organizations such as the American Physical Therapy Association and the American College of Healthcare Executives.Key Takeaways:- Show up, socialize, and express your interests to get involved in professional organizations.- Recognize the opportunities that others see in you and be proactive in offering your help and resources.- Surround yourself with a supportive network of family, friends, and colleagues.- Be open to learning and never underestimate the power of kind words and gratitude.- Strive to be a clinical leader and advocate for the profession in various settings.Reach out to Dr. Oguz:Email: carmencooperoguz@gmail.comhttps://www.instagram.com/oguzcarmen/https://twitter.com/oguz_carmenhttps://www.facebook.com/carmen.c.oguzhttps://www.linkedin.com/in/carmencooperoguzSpecial thanks to both our sponsors, The NPTE Final Frontier, and Varela Financial! If you are taking the NPTE or are teaching those about to take the NPTE, visit the NPTE FInal Frontier at www.NPTEFF.com and use code "HET" for 10% off all purchases at the website...and BREAKING NEWS!!!! They now have an OCS review option as well... You're welcome! You can also reach out to them on Instagram @npteff If you're a PT and you have student loan debt, you gotta talk to these guys. What makes them unique is that they view financial planning as like running hurdles on a track. And for PTs, the first hurdle many of us run into is student loan debt. Varela Financial will help you get over that hurdle. They not only take the time to explain to you which plans you individually qualify for and how those plans work, but they ALSO take the time to show you what YOUR individual case looks like mapped out within each option. So if you're looking for help on your student loan debt, or any area of your personal finances, we highly recommend working with them. You can check out Varela Financial out at varelafinancial.com. Feel free to reach out to us at: http://healthcareeducationtransformationpodcast.com/ https://www.facebook.com/HETPodcast https://twitter.com/HETpodcast Instagram: @hetpodcast @dawnbrown_pt @pteducator @dawnmagnusson31 @farleyschweighart @mail.in.stew.art @ujima_institute For more information on how we can optimize and standardize healthcare education and delivery, subscribe to the Healthcare Education Transformation Podcast on Apple Podcasts or wherever you listen to podcasts.

In a proposed rule issued earlier this summer, the Centers for Medicare & Medicaid Services (CMS) suggested expanding the scope of combining, or stacking, discounts when determining best price. Meanwhile, the Inflation Reduction Act amended the statutory best price definition to include maximum fair prices negotiated under CMS's new Medicare price negotiation authority. In this episode of Connected with Latham, partner Chris Schott and associate Danny Machado explain how CMS's proposed rule on best price stacking differs from past interpretations, and discuss possible ways CMS could implement the Inflation Reduction Act's statutory change to the best price definition.   This podcast is provided as a service of Latham & Watkins LLP. Listening to this podcast does not create an attorney client relationship between you and Latham & Watkins LLP, and you should not send confidential information to Latham & Watkins LLP. While we make every effort to assure that the content of this podcast is accurate, comprehensive, and current, we do not warrant or guarantee any of those things and you may not rely on this podcast as a substitute for legal research and/or consulting a qualified attorney. Listening to this podcast is not a substitute for engaging a lawyer to advise on your individual needs. Should you require legal advice on the issues covered in this podcast, please consult a qualified attorney. Under New York's Code of Professional Responsibility, portions of this communication contain attorney advertising. Prior results do not guarantee a similar outcome. Results depend upon a variety of factors unique to each representation. Please direct all inquiries regarding the conduct of Latham and Watkins attorneys under New York's Disciplinary Rules to Latham & Watkins LLP, 1271 Avenue of the Americas, New York, NY 10020, Phone: 1.212.906.1200

Health Affairs' Ellen Bayer and Rob Lott break down CMS's new funding opportunity for states to create an all-payer model.Listen to the second Research and Justice For All episode, sponsored by CVS Health.Related Link: Three Outstanding Questions About CMS's Ambitious New AHEAD Model (Health Affairs Forefront) Maryland Hospital All-Payer Model: Can It Be Emulated? (Health Affairs Forefront) Maryland's All-Payer Model - Achievements, Challenges, and Next Steps (Health Affairs Forefront) Hospital Rate Setting: Successful in Maryland but Challenging to Replicate (Healthcare Value Hub)

What's Ahead for CMS' New AHEAD Demo? David Johnson and Julie Murchinson explain how CMS' new AHEAD demonstration project will impact the transition to value-based care and the speed of market-based healthcare innovation on the new episode of the 4sight Health Roundup podcast moderated by David Burda. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

In this episode of "Tit Talk," Rosalina explores the challenge posed by the federal government agency CMS, and the significant development in 2019 that affected one of the most popular breast reconstruction surgery options, the DIEP Flap Reconstruction. She examines how this surgery was no longer 100% covered by insurance due to changes in policy, creating challenges for patients and surgeons alike and potentially resulting in financial difficulties, particularly for underserved communities who would be burdened with out-of-pocket costs. Rosalina addresses the financial hardships faced by individuals diagnosed with breast cancer and emphasizes the critical need for equitable access to appropriate treatment options.The episode wraps up by highlighting the efforts of the Community Breast Reconstruction Alliance (CBR), Dr. Elizabeth Potter, various patient-driven advocacy organizations, and individuals who tirelessly advocated for the reversal of the billing code changes. Their successful initiatives led to CMS reversing its decision by August 2023. Rosalina encourages listeners to reflect on the broader implications of this issue and stresses the importance of ensuring fair access to breast reconstruction choices for all cancer patients.Resources:https://cbralliance.org/https://www.lbbc.org/news/women-who-rebuild-both-breasts-with-diep-flap-surgery-see-more-issueshttps://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/whcra_factsheethttps://www.lbbc.org/news/stop-new-limits-on-breast-reconstructionhttps://www.healthcentral.com/condition/breast-cancer/cost-of-breast-cancer-treatmenthttps://www.breastcancer.org/news/diep-flap-surgery-cms-code-changehttps://canceradvocacy.org/wp-content/uploads/Group-letter-to-CMS-re-DIEP-flap-surgery-code-4-3-23.pdfTRAM Flap: https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/autologous-flap/tramCPT Billing Codes For DIEP Flap:S2066, S2067, and S2068If you enjoy this episode, please share it with your friends. Help us reach more women by subscribing and rating us on Apple Podcast, Spotify, and YouTube.You can follow us on Instagram @TYFTSpodcast and email us at tyftspodcast@gmail.com

  Sit down with Sarah and Tina as they review CMS compliance rules and guidelines for marketing. Learn all about the resources available to agents. Keep listening until the end to hear a special opportunity for Ritter agents! Read the text version   Ask the ASG!   Questions about selling insurance? Not sure how to market your insurance business? Stuck when it comes to social media? Fill out the form and ask the Agent Survival Guide team! We're here to help you survive today and thrive tomorrow. Remember… the only bad question is the one you don't ask. Reach out and let us help!   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim Twitter, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Resources: 2024 Medicare Advantage and Part D Certification Info: https://agentsurvivalguide.podbean.com/e/2024-medicare-advantage-and-part-d-certification-info/ Insurance Agents as TPMOs: What 2023 CMS Compliance Regulations Mean for You: https://www.ritterim.com/blog/insurance-agents-as-tpmos-what-cms-compliance-regulations-mean-for-you/ Major Compliance Changes Coming to Medicare Advantage & Part D for 2024:  https://agentsurvivalguide.podbean.com/e/major-compliance-changes-coming-to-medicare-advantage-part-d-for-2024/ Modern Medicare Marketing for Today's Agents FREE eBook: https://www.ritterim.com/blog/dos-and-donts-of-medicare-compliance/ Register for Free with Ritter: https://app.ritterim.com/public/registration/ Social Media Marketing for Insurance Agents FREE eBook: https://www.ritterim.com/social-media-ebook The Ritter Certification Center: https://docs.ritterim.com/products/certification/ What Does ‘Ready-to-Sell Mean for Medicare Agents? https://agentsurvivalguide.podbean.com/e/what-does-ready-to-sell-mean-for-medicare-agents-2023/   References: Compilation Of The Social Security Laws: https://www.ssa.gov/OP_Home/ssact/title11/1140.htm Medicare Advantage Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-V Part D Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-V

How will the new all-payer, global-budget demonstration project from CMS impact the push for more healthcare value and innovation? David Johnson and Julie Murchinson explain how AHEAD will impact the transition to value-based care and the speed of market-based healthcare innovation on the new episode of the 4sight Health Roundup podcast, “What's Ahead for CMS' New AHEAD Demo?” moderated by David Burda. @‌CMSGov #VBC #healthcareinnovation David W. Johnson is CEO of 4sight Health. Julie Vaughan Murchinson is Partner of Transformation Capital and former CEO of Health Evolution. David Burda is News Editor and Columnist of 4sight Health. To bring your own revolutionary ideas to life, sponsor this podcast. Email ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@4sighthealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more. Listen on your podcast app or on the ⁠⁠⁠⁠⁠⁠⁠⁠⁠4sight Health YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠. Subscribe on ⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Google Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠ and ⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠.

On this episode, my guest is Lynette Didur (@lynettedancefitness) who won the Best New Lifter award at the Riddlestruck 2023 and hit CMS! She is a woman of many talents, and we dive in on her background and how it influenced her ability to perform in kettlebell sport. Enjoy! This episode is presented by our friends CK Maceworks. They're back for the 3rd year as sponsor of the 2023 WKSF Open North American Championship, and they want YOU to Swing Heavy SH*T! They're adding 2 of their custom plate loadable maces or Indian clubs to the prize hoard for the 2023 World Kettlebell Sport Federation Open North American Championship, hosted by the Twin Cities Kettlebell Club. Lifters from all over will compete for the 2023 North American Championship AND qualify to compete internationally representing your country in the 2024 WKSF World Championship! You can compete in person on August 14th in Little Canada, MN OR online via video submission the week prior to the in person event! It will still be on Saturday October 14th, 2023 in Little Canada, MN! We have over $2,500 worth of prizes to raffle off and a $500 cash purse to top performers in the competition thanks to our amazing sponsors, Take advantage of this amazing opportunity and ⁠⁠⁠⁠⁠⁠register today for only $100!!!⁠⁠⁠⁠⁠⁠ Raffle Prizes: CK Maceworks - 2 plate loadable mace or club Bearfoot Shoes - 6 gift cards of $100 each Kettlebell Kings - $150 Gift card Morpheus Training - 3 M7 heart rate monitors ProKettlebell - 2 bells, 1 pair each of 1 kg, 2kg plates Sorenson Strong - 1 pair of 1.5# Indian clubs A $500 Cash Purse Sponsored by Living.Fit & Twin Cities Kettlebell Club $150 top raw total KG lifted $150 top Male coefficient $150 top Female coefficient $50 best new lifter Registration costs $100 and is open until 23:59 Central Time on 10/11/23, and we will be accepting video submissions beginning Saturday October 7th until  10:00 AM central time Saturday October 14th. All classic lifts will be available in 5' and 10' set lengths, as well as 30' half marathon sets! And if you want help reaching your goals please ⁠⁠⁠⁠⁠⁠Apply for Coaching⁠⁠⁠⁠⁠⁠ If you enjoy the content please leave a 5 star rating & review, subscribe, share on social media, and support my work by supporting my affiliates: ⁠⁠⁠⁠⁠⁠Pro Kettlebell⁠⁠⁠⁠⁠⁠, use code TCKB to get 10% off to get your MADE IN THE USA Kettlebells ⁠⁠⁠⁠⁠⁠Kettlebell Kings⁠⁠⁠⁠⁠⁠, use code TCKB to get 10% off ⁠⁠⁠⁠⁠⁠Bearfoot Athletics⁠⁠⁠⁠⁠⁠, use code TWINCITIESKETTL to get 10% off ⁠⁠⁠⁠⁠⁠Driven Nutrition⁠⁠⁠⁠⁠⁠, use code TCKB to get 15% off ⁠⁠⁠⁠⁠⁠Revive Supplements⁠⁠⁠⁠⁠⁠, use code TCKB for 10% off,

The Charlotte-Mecklenburg Schools district is working to revamp its district goals and guardrails for the next four years. These goals and guardrails range from increasing literacy in elementary school students to improving discipline disparities. For the last six years, CMS has used a list of goals and guard rails to guide policy and how schools run. For example, one of its goals in the past few years is to increase the number of Black and Hispanic students reading at an advanced level. The past state testing scores showed schools in the district saw progress and an increase in testing scores in both math and reading scores, although the gains they made fell short of the academic goals and guardrails the district has set for itself.  One example of a goal for CMS is the district's goal of wanting 36% of Black and Hispanic students to be college and career-ready based on English test scores by the end of the 2022 school year. Data showed the district fell short and only hit 15.9% of Black and Hispanic students being college and career-ready based on English test scores. READ MORE: https://www.wcnc.com/article/news/education/cms-goals-guardrails-reflect-past-years/275-a4403c05-d96d-4445-906d-8a81bac6a8d3 Watch Wake Up Charlotte each weekday morning from 4:30 to 7 a.m. on WCNC Charlotte, and as always, join the conversation on social media using #WakeUpCLT! 

In the picturesque landscape of Prince Edward Island, Canada, a growing problem has emerged involving 10 Acciona turbines, installed back in 2014. These once-reliable turbines now have significant main bearing issues, necessitating extensive overhauls. This development has created tension, given that these turbines come equipped with a robust 15-year warranty, yet power production has plummeted by a staggering 70%. In the most recent edition of PES Wind Magazine, Eleven-I takes center stage to shed light on the advantages of in-blade accelerometers and CMS monitors. Rosemary and Phil join forces to dissect the engineering intricacies, delving into both the benefits and associated costs of augmenting blade sensors. The burning question of whether flow batteries can make a meaningful contribution to the energy grid is also on the table. Notably, the US Department of Energy (DOE) is extending a generous offer of nearly $400 million in loans to EOS Energy Enterprises, with the aim of establishing a state-of-the-art factory in Pennsylvania, capable of churning out a staggering 8GWh of flow batteries annually. Rosemary, our resident expert, takes the reins to elucidate the physics underpinning flow batteries, while Phil introduces Allen to the myriad potential applications these innovations hold for the power grid. And, as the cherry on top, we shine the spotlight on the Timbermill Wind Project in scenic North Carolina, our Wind Farm of the Week! Sign up now for Uptime Tech News, our weekly email update on all things wind technology. This episode is sponsored by Weather Guard Lightning Tech. Learn more about Weather Guard's StrikeTape Wind Turbine LPS retrofit. Follow the show on Facebook, YouTube, Twitter, Linkedin and visit Weather Guard on the web. And subscribe to Rosemary Barnes' YouTube channel here. Have a question we can answer on the show? Email us!  PES Wind - www.peswind.comPardalote Consulting - https://www.pardaloteconsulting.comWeather Guard Lightning Tech - www.weatherguardwind.comIntelstor - https://www.intelstor.com Uptime 182 Allen Hall: Well, Phil, did you get a new helmet for that crazy electric scooter that you have?  Phil Totaro: Oh, I, I've got a helmet. Don't worry. It's a fancy, it's a fancy one. And it's very aero. It's I, I won't give, give them shameless product placement, but it's, you know, if, if you've watched the Tour de France or you're watching the Vuelta España right now cycling race. You, you will see them wearing the same ones in the individual time trial.  Allen Hall: Well, we were just at a NASCAR race and one of the things I was paying attention to was the helmets that they wear. And recently there was an accident in NASCAR. This car literally just spun end on end for about 10 rotations and then hit the dirt. And the guy walked out of it and I thought, my gosh, helmets have really improved over the last couple of years. I'm not sure several years ago to be able to walk away from that as well. And hopefully they're using the same technology in your helmet, Phil, because. You're going really fast. You're like probably going too fast. Phil Totaro: No, I'm actually, it's, it is for, for where I live, which is Santa Barbara, California, it's a fantastic way of getting around town and any place that actually has the infrastructure with a lot of bicycle lanes and, and you know, just good infrastructure for being able to do this, it's a, it's a much better way for me to be able to get around town than a car and it's faster. Less time and less money parking, et cetera. So it's it, it works  out all right.  Allen Hall: See Phil saving the planet one scooter at a time. So up at the Hermanville wind farm in Eastern Prince Edward Island, Canada, they're having a big problem with wind their wind farm, which is only producing about 10 percent of the power that it's supposed to, the farm opened up in 2014 and despite having a 15 year warranty.

A reported 700,000 suicides worldwide annually are the impetus for the World Health Organization (WHO) to recognize what it has called a major public health problem ahead of World Suicide Prevention Day on Sept. 10. In recognition of this global issue, during its next edition, Talk Ten Tuesdays will feature world-renowned psychiatrist and award-winning author H. Steven Moffic as the program's special guest. Dr. Moffic will report on how to detect early-warning signs of potential self-harm. Dr. Moffic first appeared on the long-running broadcast following the suicide of famed actor and comedian Robin Williams, whose death in July 2014 shook the world's collective conscience.All this and more will be covered during the next edition of the weekly broadcast, which will also feature these outstanding segments and thought leaders:RegWatch: Stanley Nachimson, longtime editorial contributor to ICD10monitor and former career professional at the Centers for Medicare & Medicaid Services (CMS), now an IT consultant, will return to the broadcast to report on the latest regulatory news coming out of Washington.Coding Report: Senior healthcare consultant Gloryanne Bryant will substitute for Laurie Johnson to deliver the latest coding news.SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT A lot of technology companies have bolted digital signage capabilities on to their core software platform. Often, that means the end-products don't do a whole lot beyond playing out some files on a screen. I'm a bit guilty of making that assumption about Ditto, a wireless screen sharing platform that also works as a digital signage CMS. In chatting with the company that develops and markets Ditto, and now in this podcast with co-founder Andrew Gould, I've learned Ditto is much more than an add-on. Some customers get Ditto licenses for the signage functions, and then don't even use the screen mirroring. Based in Ohio, the company spent its first dozen or so years selling screen sharing into the education and workplace verticals. But it started getting a lot of requests from end-users about adding functionality that made screens useful during downtimes. They wanted to get more bang from their hardware buck. So the parent company, Squirrels, spun up the digital signage component in 2020, and Ditto is now a tandem offer. Gould concedes there are maybe some things a pure-play, enterprise-grade digital signage CMS can offer that Ditto can't, but there's an awfully big user base out there that's never going to need or use a lot of those more exotic and elaborate functions. Subscribe from wherever you pick up new podcasts. TRANSCRIPT Andrew, thank you for joining me. Can you give me a rundown of the company? Is it Squirrels, the company, or is Ditto the company or is Ditto the product?  Andrew Gould: Ditto is the product. Squirrels is the company. We founded the company in 2008, and we've been mainly focused on wireless collaboration in classrooms, and huddle spaces in higher education and then, in 2020, we expanded our Ditto offering to include digital signage and emergency alerts, which is something a lot of our K-12 customers were requesting.  So when you started the company back in 2008, was digital signage on the roadmap way back then, or is it purely one of these situations where you had the K12 people asking you about it and eventually realized okay, we should do this? Andrew Gould: Yeah, it was a situation where we were focused on the collaboration, and then in the feedback channels we had with the customers, they started asking or suggesting, It'd be really great if we could show things when we really weren't showing things. When the teachers weren't mirroring their screens and sharing things, it'd be nice if we could say, here's what today's homework is, or here's what's going on at the school or for higher ed, here's upcoming events, things like that.  So we saw it as a natural evolution of, “We're already on that screen. It makes sense to allow users to utilize that screen when it's not being used for the primary function of collaboration.”  That primary function, could you walk through how that would work in a typical scenario? Andrew Gould: Yeah, so we have an application that runs on a device connected to the screen or TV in the front of a room. Be it a projector, a flat screen, doesn't really matter. It runs on Apple TVs as well as Windows devices so there's some flexibility there of whatever device they wanna have connected to that main screen. There's just a piece of software called Ditto Receiver and that handles all of the functionality of showing what's being shared by students and teachers in the classroom. It handles displaying the digital signage and it also handles displaying critical emergency alerts, if they're fired and all of those things connect back to the cloud.  The IT staff manages that from a central cloud portal, and then it periodically checks for updated settings, digital signage, configurations, et cetera, pulls those down, and caches them locally, so if you do have a little blip in the network or the internet goes down temporarily that functionality can continue to run even if it's not connected to the internet for a moment. So, in essence, whether it's a teacher or a student or in a working environment, whether it's the person leading the meeting or somebody who's a participant, they could pull up their phone, their tablet, whatever it may be, and if they have the Ditto app, they can push their screen to the main screen in that room? Andrew Gould: Exactly, and our big focus with the collaboration part of Ditto is that device agnostic approach. So we want any kind of device that's coming into a space to be able to share, not just if you have an Apple device, it'll work to this Apple TV, or if you have a Google device that'll work to this Chromecast. We really push hard to make sure that each device that comes in, whether it's from a browser or from a native app on a platform, can connect and quickly share.  And that's important in a number of ways. A, it doesn't slow down the meeting, but it removes a lot of IT support and AV/IT support within an organization, whether it's a school or a business. Because I've been in those meetings where somebody says here, I'll just share my screen, and then 15 minutes later, it's still being sorted out. Andrew Gould: Yes, and we've all gone into those rooms that have the laminated sheet of instructions of, “If you're using this device, it's these seven steps, and if you're using this device, you have to be on this network. Then you have to do these three steps, et cetera, et cetera.” All of that goes away with Ditto which means far fewer support calls for the IT staff, and just a more pleasant experience is that we have people come into our offices, accountants, lawyers, just general non-technical people, and they're blown away at how easy and fast it is to get their content up on the screen, which is all anybody wants. We don't care about how fast or how crisp it is or how cool it looks once it's up there if it takes you 10 minutes to get it connected. So quick, fast, easy is always our guiding light as we mature the product and move it along.  On the digital signage side of this, the way it's marketed from what I can see is, it's a tandem product, as opposed to, we are a collaboration product that, oh, by the way, we can also do this. You seem to be saying, “It's a full-fledged product on its own. If you wanted, you could just use it for digital signage.” Is that a fair statement?  Andrew Gould: Oh yeah, for sure. We have customers that turn off the mirroring capabilities and they just use it for digital signage. Menus in the fast dining have TVs over the counter where people order. We have customers that are just using it for that, that don't even care about what the original purpose of Ditto was, which was the screen mirroring stuff, and then we have customers that only use it for screen mirroring and we haven't got them up and running on digital signage ye. They haven't realized what the value add is.  But there are more customers doing both. They are mirroring, and then when it's not mirroring, they are showing important information to the users. Whether it's connection information, things going on at the organization, stocks, or just the kind of stuff to keep it feeling more fresh, utilizing those screens. But yeah, it's definitely a product that can just be utilized as a standalone digital signage solution. I'm guessing that you and particularly your customer-facing folks fight a perception problem in that there are other products out in the marketplace that were started as one thing and added digital signage on, and generally speaking, the perception I have and the feedback I've somewhat heard is that, “Yeah, it can do digital signage too, but we're not talking about robust digital signage. We're talking like we can run a set of files on a screen in an order and that's about where it begins and ends.”  Andrew Gould: We are not an industry-leading digital signage solution when it comes to features. There are incumbents that are far more feature-heavy than we are, but what we've tried to focus on are the things that the customers truly need to have a good digital signage experience. So it's being able to create signage lists, as we call them, which are basically playlists of media, ease of use of setting all of that up in the configuration portal, so that it doesn't feel like an add-on or a thing etucked into a corner. A lot of time and energy is spent on the part that actually the end user never sees, which is configuration managing of all the media files and also providing templates for people who don't want to or don't have the resources to create their own digital signage assets. Providing some really easy turnkey solutions as well to say, hey, if you just need to get some basic information shown and you don't want to have to pay a designer or something like that to create something, here are some really cool templates that we've put together for you and they're just WYSIWYG, change this line, change the subject, change the body, upload an image, add a video, and you're ready to go with really nice looking digital signage.  So I wouldn't say we are innovating digital signage by any means, but we're trying to create a package that doesn't feel like we just bolted something onto the side of it. That really feels like a first-class digital signage solution. In a lot of cases, while there are certainly feature-rich software options out there, I suspect a hell of a lot of end users don't ever use more than 15% of what's available to them with those platforms.  Andrew Gould: Yeah, absolutely. We poll our users frequently about, “Hey, what do you like about the product? What don't you like about the product?” That's the most important part. We wanna make that better, and we ask, “Hey, here's a whole list of different things. How much would you use this?”  The feedback nears that there is 10-15% of features we don't have that people say they might use, and most of the people say that they probably would never use synchronized digital signage across eight different screens or things that kind of fall into the more high-end solutions for digital signage. They just want ease of use, things that look nice and reliable. Those are what they care about the most. Yeah. So if somebody comes to you and says, “We're putting a huge LED video wall in the lobby. Can you drive that?” You might say, I suppose we could maybe do that, but that's not what we're here for.  Andrew Gould: We've certainly had those requests and we've said, “Hey, here's how you would do that if you are ready to do it. But, to be honest, there are better solutions for that problem.”  Digital signage is not a one-size-fits-all problem. There is very high-end hardware that drives large billboards and there's our end where we're just trying to drive it on a 70'' screen in a room. So we don't have to solve everyone's problems. We're fine saying, that sounds really cool. We wished Ditto was designed to do things like that. You might be better served with something that's from the ground up built to power stuff like that.  You can stay in your lane, and it's a pretty decent-sized lane.  Andrew Gould: Correct. Yeah, it's a huge market. So there's plenty of room for lots of people to all be swimming, doing different things, and not really stepping on each other. One of the problems I find with some entry-level, and I'm not saying yours is, but just in broad strokes, entry-level platforms don't have much in the way if they have anything at all in terms of device management, and I gather that your device management is done through third-party device management modules, like the Jamf and so on. Andrew Gould: Yeah. So early on, we explored building Ditto with MDM capabilities. But what we experienced in talking with our customers is that most of them already had a solution to do those sorts of things. So we would have to convince them to switch to our device management platform and 90% of what MDM does has nothing to do with what we would need to do with it. So we'd be building out this whole lump on the side of Ditto just to be able to replicate the service they were already using so they would switch to ours.  So we ultimately looked at that and said, this isn't the right fit for us, rather than trying to fight upstream and convince all of these customers that already have solutions to switch to ours. Let's just partner with all of these solutions and make it work really well. So we've partnered with the various Apple TV MDM vendors to make it really turnkey to mass deploy Ditto to hundreds of Apple TVs with literally just pushing a couple of buttons. So that's been our approach to it and that seems to be what the customer's like with us.  Yeah, if they're already using it, why would they go to something that's just dedicated to your application?  Andrew Gould: No matter what I do, I will always be inferior to a Jamf. They're a huge publicly traded company focused solely on MDM. I'm never gonna make an MDM as good as theirs, so why try?  What is your footprint, and what would you say are your core vertical markets?  Andrew Gould: The core vertical markets definitely K-12 and higher education in the United States. We have a footprint all around the world. We're in Europe, Asia, Australia, South America. We have a lot of business users as well, whether that's in office space or co-working spaces have been a big business for us lately, as people are working from home but wanna get out of the house occasionally and go somewhere else. Those office spaces are looking for easy mirroring as people come in and out. But we're really focused on the K-12 and higher education market because this solution just fits so nicely into that environment. It works great in business. It works great in fast casual dining and all these other places that people use Ditto. But what's cool about Ditto is that it is so universal as a tool. It can plug in all kinds of places. We have churches that use it to show the lyrics to songs as people are singing along. There are all kinds of really interesting applications that we set out to get into flexible and adaptable tools and put into a lot of interesting environments.  When it comes to education, how is it being used in classrooms?  Andrew Gould: So you've typically got it running on the screen at the front of the room, whether that's an interactive whiteboard or just a TV mounted on the wall or projector, whatever. It's usually connected to that, and then primarily, the teacher is using it to push her screen from a laptop device up to the screen, and then we can support up to four devices sharing at the same time. So then students will connect and we have an add-on application for Windows and iOS where the teacher can manage who's allowed to be sharing. She can approve or deny connections to hide somebody if she wants to emphasize on her screen and not the other students who are connected to that. Then typically, when nothing is being shared, there's digital signage that's usually managed at the school level, but we do have some schools that allow the teachers to set up their own digital signage per classroom. So you're seeing that digital signage there and then it's spilling out into the hallways. They're putting TVs into hallways of even K-12 schools, higher ed common areas. They're running mainly just digital signage in those areas versus the hybrids that they're running in the classrooms.  Are school districts mostly using Apple TVs?  Andrew Gould: It's about two-thirds Apple TVs and one-third Windows devices, that's how our users break down. So it's not quite 50-50. I think it's trending more towards that 50-50 blend. Early on, it was very Apple TV heavy, and we're seeing a bit more of a skewback towards Windows devices.  I'm not sure exactly what's behind that trend, maybe it's the drive down of cheaper and cheaper Windows devices that can actually run 4k video and kind of stuff, the nooks, and the likes But yeah. So right now, the blend is really two-thirds Apple TVs.  What about collaboration displays that have systems on chips embedded in them, can you work with those?  Andrew Gould: So we've looked at the Android TVs and Samsung's OS and those sorts of things. The feedback that we've got from customers is that they are not really interested in that capability. The limitation of that is usually given the horsepower on those devices; we can usually only show one or two screens at a time. It ends up making Ditto, a hobbled product for it, and most of the time when people come to us, they've already got Apple TVs purchased or they've got a Windows device, they're already looking to use, and they're coming from the, “I picked my device, now I'm looking for the solution” approach, and the Smart TVs don't come up in the conversations that much. We're not opposed to it. If that's the way the market wants to go, we can surely adapt to that. All our technology is really flexible, so it's quick for us to repurpose a new platform, but just not what the customers are asking these days.  Yeah, and it's not like an Apple TV is expensive.  Andrew Gould: It's $150, and it'll run for probably 10 years before you have to worry about replacing it. They're really rock solid.  When you're selling into K12 in particular, are you selling district-wide or do you have to sell down to the school level?  Andrew Gould: It's typically district-wide. It's usually the IT coordinator or applicable semi-related role there that's looking to roll out an agnostic solution, and that's another place where we really shine is that schools are not one-to-one all the same type of device. You're typically seeing iPads in the lower grades, and then you're seeing Windows surfaces or Chromebooks as you get more into typing and writing papers and those sorts of things. So they want one solution that's going to work across the board for all of those things, and that's what Ditto's bread and butter is. So that starts the conversation off right away: one solution, you're supporting one product across, whether you have three schools or a hundred schools in the district, it's all the same solution, and then we can start the conversations if you realize digital signage, you've got all these screens in the cafeteria or the hallways, how are you putting information up there? And a lot of times it's, oh, there's a USB drive, and we go around and collect them, and we update them once a month. Somebody's job is to update the USB with the media and plug it back into all the TVs, and there is a much better way to do that. With a lot of schools using Chrome devices, is that problematic at all, or does it work with your system just fine? Andrew Gould: No, it works great with Chrome. So Chrome  OS used to have applications; they called them Chrome Apps. So we originally had a Chrome app that did all of this. That was in the store. And then Google wound down Chrome apps just because they weren't really being utilized all that much on the platform. So we went to a pure browser experience. So you just go to our goditto.com website, and you enter the room code that's being shown on the teacher screen, and then we just use the web RTC built-in technology to capture the screen and send it over to Ditto receiver and show it so you can actually share without installing anything on a device, and that works on all platforms that support the browser capture technology.  There are other options out there for certainly higher ed. You've got companies like Rise Vision that's particularly strong in K to 12 in churches and things like that, and some others How do I describe them, CMS software companies that are focused on that market, and then you've got the companies like Zoom that have video collaboration that have added on some digital signage capabilities and the Air Teams, where people who do similar screen mirroring. How do you match up against them and how do you sell against them? Andrew Gould: Yeah, so the Air Team and Immersive, they're selling proprietary hardware with a subscription service on top of it. So if you're looking for, “Hey, just give me a turnkey solution, give me everything. I'm not really worried about the price, I just want it to work.” Those are great solutions. But what we see in schools is they care very much about the cost and the pricing, and some of them have already made investments into hardware with Apple TVs or Windows devices, and they're saying, look, this is just extra cost that I don't need to do the same thing. So how we position against those is just, “Hey, you can use whatever hardware you want. We're happy to run on either of those platforms and if you've already got them, cool, just buy our subscription, and you're ready to go. You don't have to worry about buying a five, six or eight hundred dollar hardware device, deploying it, or managing it differently than how you manage other things.” So that's how we match up against those.  The more CMS type things that are focused on, digital signage in those very specific things. Again, those are the incumbents, those are the people that have been doing this; some of them have been there for decades doing this type of stuff. So we're not here to try and outcompete those companies. We just see that there are certain niches that maybe those companies don't fill as well, and we're content to come along and fill those in and keep improving our product, and one day, maybe we'll compete with them. Maybe we'll have a platform that we've decided, hey, we should just make it do everything for everybody and look at going after competitors like those.  But like I said, the market is big enough that they can have that niche. We can have this niche, and it's a very healthy business for us, and we're happy to keep doing that. There are a couple of things that we know how to do really well versus, maybe, trying to get too big too fast, trying to do everything all at once.  Was having the digital signage component added to it pretty important because you've got companies like Google that have Chromecast that costs 35 bucks or something like that, that can do some degree of screen sharing, and it would be people who are really cost conscious, they could just go down that path? Andrew Gould: Yeah, for sure. We don't really see many Chromecast in school-type approaches. For whatever reason, they still don't have basic security like onscreen code or passwords. They've only recently rolled out the ability to remotely manage those types of things. Adding digital signage wasn't really about competing with any particular thing.  The customers that we have and the ones that we're trying to get all value this functionality, and we saw it as a natural fit. It wasn't like we had to completely reinvent the product and take it in some radical new direction. It just seemed like a natural complement to what we were already doing and we talked with some customers. We're running two different solutions on an Apple TV, and they were trying to use Ditto for screen mirroring, and they were trying to use a different Apple TV application for digital signage, and they were trying to do crazy MDM scheduling, based on the class schedule, lock this app for Ditto, so it's open, and then when it's time in between class, walk the digital assignment solution, and we said, there people really want it that bad, maybe we can just be all of that in one and not force our customers to have to run two things like that. So that was the natural genesis of it versus we need to protect our position or something like that. It just made it evolutionary to move in a new direction. So, how seamless and intuitive is it?  Let's say, it is running in digital signage mode, the screen is, and the teacher decides, I want to push something to the screen from my laptop or my phone or whatever, and launches that session, does its thing. To then go back to digital signage, what's involved? Andrew Gould: You just start sharing your screen and stop sharing your screen. So it's directed from the device that wants to share their screen. So, when you open the app, you enter the room code. We make them fun, easy to enter, like red apples, big pineapple things that are easy, not like random numbers and digits that are hard for kids to type in. And they push ‘Start sharing' and boom, their screen's up there, digital signage fades out, screen sharing fades in. It's an instantaneous switchover, and then as soon as the last person stops sharing their screen, if you've got multiple people connected, it goes right back to the digital signage slide it was on when the person first connected. So it's very easy. There's no mode, nothing you have to tinker with on the screen itself.  So the management, whether it's the school, the district, or the individual teacher, they're using a browser to plan out their digital signage side of what the screen's doing? Andrew Gould: Yeah. It's all a cloud-based portal. So you can be in the same building, or you can be in a different state. We have businesses that are deployed with Ditto in offices around the world, and there are a couple of people that sit in California and they manage all the digital signage worldwide. So it's super easy right from the portal. And what's the commercial side of it? What are you paying? Is it a SaaS?  Andrew Gould: Yeah, it's a SaaS model. It's a yearly subscription. We offer a monthly if people are using this in bursts, but obviously, you save money by purchasing for an annual versus monthly. And it's per screen that's running Ditto.  So the other thing that we allow is, if you have multiple screens in a classroom, obviously, you can show digital signage on those, but we actually allow one device to push their content to multiple screens. So we're seeing, especially in some classrooms, you've maybe got a screen in the front or to the side or behind as they set up classes less like when I was in school where it was just rows, everybody facing the front now that these little pods of kids are sitting at tables and not everybody's facing the same direction, so they've actually got multiple screens in the rooms. So we just charge per screen that runs the software, and that's it. What's the fee?  Andrew Gould: So, it's $12.50 per month annually. So it's $125 per month if you're at 10 or more receivers in a school. Is that just for the screen mirroring, or is that for the functionality, including the digital signage? Andrew Gould: Yeah. That's for everything. That's one price for everything. We don't charge more for that. We view it as, “Hey, we took this thing that we charge this price for. It made it even better by giving you all the stuff, and it's the same price.”  And that includes the emergency alerts as well. So that ties into a protocol called CAP, which is how the National Weather Service and School Alert Systems all can send alerts. So we have a CAP server capability, where we can receive alerts from other servers, whether it's the National Weather Service, an alert system that, unfortunately, a lot of schools are having to deploy now, where it can push one button and text the parents and send a push notification and send all the alerts out to Ditto and Ditto immediately takes over and shows that alert. You get all of that for that one price.  Yeah, it sounds very much like this isn't a constrained compromise limited solution for the K to 12 market, it's gonna do pretty much what an average classroom and what an average school is going to need.  Andrew Gould: Yeah, we really tried to put everything in there because, again, we don't want people having to be like, “Well, Ditto almost does everything. It'd be great if it just did this one other thing, and then we wouldn't need this other solution.” The hope is that we can provide that one solution that everybody needs.  Tell me more about the company. It's been around since 2008. Is it privately held, or are you listed?  Andrew Gould: We're privately held. I'm one of the co-founders of the company, started it back in 2008 with my business partner. When we first started out, we weren't doing collaboration. We were doing iOS app development. We had one of the first 50 apps in the iOS app store. We could actually get to the bottom of the list. It was a TV guide app where you could put in the code and see what was on TV. It sounds like an archaic technology today but it was pretty cool back in the day, and then we got into the collaboration space in about 2012 when we released our first collaboration app, and then we've been focused on collaboration ever since.  Where's the company based?  Andrew Gould: North Canton, Ohio, about an hour south of Cleveland but we have a diversified team present in a lot of states all around the country, but all the within the United States.  Is the majority of your business in the US?  Andrew Gould: Yes. That's where mainly our outbound sales are focused on. But, like I said, we have a really big following actually in Australia. A lot of ditto customers there, and we are working on expanding into Europe this year and into next year to really go after that. There's a lot more regulation and requirements, and apps have to work certain ways and those sorts of things that we want to make sure that we're compliant and respectful to those things and come into that market appropriately, but it's a big focus for us because we think the same needs exist there as they do everywhere else. Yeah, it's interesting. A lot of US and Canadian companies think they can just make the jump over, and then they get asked about things like GDPR and they're looking at the other person, “What?”  Andrew Gould: Yeah, or even just common things like in France, everything has to be localized into the French language. If you have one string in your application that's in English, they typically won't purchase. They value that. So we want to be respectful to those things, and they're not hard things for us to comply with. It just requires us to pay somebody who knows French to translate a list of strings, and then we can sell into those markets as well. Are you selling direct, or do you have channel partners?  Andrew Gould: Mainly direct. We have some channel partners that we started with right before the pandemic, and so we've seen a lot of that market move around, and so some of the channel partners that we originally partnered were more business-focused and the world has changed for business where people just aren't going to the office as much anymore, and those channel partners just didn't make sense.  So we're actually working through a sort of reset of that channel partner program to be more education-focused with the channel partners. But we have some really great channel partners in the US that we work with, whether they're distributors or they're resellers, whether they're just purchasing on behalf of the school and passing that through, or taking our solution and bundling it up with, “Hey, here's the screen you need and here's the speakers and the WiFi and everything,” and including us as a full technology rollout. We like to work with both of those.  If people want to know more, where do they find you online? Andrew Gould: Our website is goditto.com. You can sign up for a free 30-day trial there. You can set up as many screens as you want, and play with digital signage as much as you want for 30 days, and then, as I said, it starts at $150 per receiver for a single license, and then we have volume pricing above 10 and it scale scales down from there.  Great. Thank you very much for spending some time with me.  Andrew Gould: Yeah, thanks, Dave. Appreciate it.