Podcasts about CMS

This week I review another e-commerce alternative: Gumroad [powerpress]

What wonderful ways is God moving in Africa? Join guest speaker, Rabbi Alex Yelanga of Zambia Messianic Fellowship, as he shares with us incredible stories from doing ministry in Africa and reminds us of God's promises that will certainly uplift and empower you. You do not want to miss it! https://www.bible.com/bible/314/jhn.14.1 (John 14.1); https://www.bible.com/bible/314/mrk.13.7 (Mark 13.7); https://www.bible.com/bible/314/2ti.1.7 (2 Tim. 1.7); https://www.bible.com/bible/314/rom.8.28 (Rom. 8.28); https://www.bible.com/bible/314/mat.5.16 (Matt. 5.16); https://www.bible.com/bible/314/rom.10.17 (Rom. 10.17); https://www.bible.com/bible/314/heb.13.5 (Heb. 13.5); https://www.bible.com/bible/314/jhn.14.27 (John 14:27); https://www.bible.com/bible/314/php.1.6 (Phil. 1.6) http://www.bethhallel.org/CMS/programs/prayer/prayer-requests/ (Prayer Requests) or send an email to info@bethhallel.org http://www.bethhallel.org/CMS/ (CBH Website) https://www.paypal.com/donate/?cmd=_s-xclick&hosted_button_id=FBVL4JZH8HVS4&fbclid=IwAR2MB7yq6Zkq-ZNvwnw8Yz6z0crcMmGPpKhqIDD4w3sr5fXDBE0qOr1C5cM (Donate) https://www.youtube.com/channel/UC7EfRTmLFyvapAVb7q64PoA (YouTube Channel) Support this podcast

This week we nerd out about our new website. While things look mostly the same, we rewrote all of the code and are now using a CMS to make posting episodes easier.Follow Up Austin Guevara spotted a few visual differences in our websiteShow Notes Our websiteNext.jsDatoCMSRecommendations Elgato Wave Mic Arm LPSuccessionNo Time To DieShang-Chi and the Legend of the Ten Rings Hosts Kevin Clark (@vernalkick) Rafael Conde (@rafahari)

With the December 5 COVID-19 vaccine deadline approaching, Montana’s health care facilities could lose their Medicare and Medicaid funding from the CMS if they don’t comply and nurses across the state are ready to let their objections be heard through […]

With their heads still not clear from a Layover in Mistport, the Line Bulls of the Pride of Duskwall agree to meet on the train early and investigate the Office Car. The mists of the Dagger Isles are unable to conceal the secrets of Mr. Walker, who's true nature is finally made clear to the Line Bulls. Drix busts this whole thing wide open. Pippin is cornered and frightened. Andrel is told she is pretty. Follow https://twitter.com/EryliaPod (@EryliaPod) on Twitter and learn more about Adventures in Erylia on their website https://www.adventuresinerylia.com/ (here) Ghost Lines by John Harper. Music by Sebastian Black. Art by Yoshiko Agresta. https://secure.actblue.com/donate/bail_funds_george_floyd?refcode=cwg&fbclid=IwAR26tAnbuOt9SDjt7F6wDEbEqeZ183QAITXTm8R-rrLM-9JrrEr3zthzIDQ (https://secure.actblue.com/donate/bail_funds_george_floyd?refcode=cwg) https://www.joincampaignzero.org/?fbclid=IwAR1RI-kn0ukkY0BPTh3pO6BAHMop3funxm6-zy8z6cRmghpcojVhbU3_hKU (https://www.joincampaignzero.org) https://www.napawf.org/donate (https://www.napawf.org/donate ) https://www.navajowaterproject.org/ (https://www.navajowaterproject.org/) https://l.facebook.com/l.php?u=https%3A%2F%2Factionnetwork.org%2Ffundraising%2Fcontribute-to-the-atlanta-solidarity-fund%3Ffbclid%3DIwAR3FMa9F34YB6K73zsYHtcfNosNwf0mwYHjtRzSm0SvoXeMcd_8vi9s-CMs&h=AT1j_pUV7Bmk5xLa4UliXieo2G3tzcPvL62jRR0ExRB8l9C8_TMedB2vkKwNg8wRwSXhMyiydkNVtvta6eaQcKju2_YSQp6-rc6pFzhpM6Xrfp9xSDC45MfBv11h-wdUWvc (https://actionnetwork.org/fundraising/contribute-to-the-atlanta-solidarity-fund) https://nymag.com/strategist/article/where-to-donate-to-help-asian-communities-2021.html (https://nymag.com/strategist/article/where-to-donate-to-help-asian-communities-2021.html) Follow us on https://twitter.com/ghosts_train (Twitter @ghosts_train), and if you have questions or suggestions for the train email them to ghosttrainpod@gmail.com or leave a voice message at https://anchor.fm/ghosts-on-a-train/message (https://anchor.fm/ghosts-on-a-train/message) and you might hear yourself on the show We are a proud member of the https://www.faustiannonsense.com/ (Faustian Nonsense Network) of podcasts! Join the Faustian Nonsense Network discord https://discord.gg/7wyS37xXRX (here), and support us by joining the https://www.patreon.com/faustiannonsense (FN Patreon)! Help the Show by Rating and Reviewing on https://podcasts.apple.com/us/podcast/ghosts-on-a-train/id1507682855 (Apple Podcasts)

Today's guest is Leyna Belcher, MSN, RN, CCDS, CCDS-O, enterprise system CDI educator for WVU Medicine in West Virginia. Today's show is co-hosted to Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, the CDI education director at HCPro/ACDIS in Middleton, Massachusetts. Today's show is supported by 3M Health Information Systems. 3M Health Information Systems, now with M*Modal, delivers innovative software and consulting services designed for a wide range of healthcare environments. From closing the loop between clinical care and revenue integrity, to computer-assisted coding, clinical documentation integrity and performance monitoring, 3M can help you reduce cost and provide more informed care. Featured solution: Today's featured ACDIS solution is ACDIS Pro. Just like the printed ACDIS Pocket Guide, this online portal provides all of the detail, explanation, and content you have come to trust and expect from the ACDIS team but is updated in real-time to keep you at the forefront of the CDI industry! Easily access all the query, coding, and documentation resources you love and need every day – anywhere, any time! This new, fully customizable, easy to navigate online portal can be accessed on any device – pull it up on your phone in a meeting to make sure you have the right code, access it on the go while talking to a physician, or from your office! With the ability to add your own personal notes directly into conditions for easy reference, ACDIS PRO will become your favorite reference. Click here to learn more or purchase access.  (http://ow.ly/Q5m830s1BMn)   In the News: “Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS” from the Office of the Inspector General (http://ow.ly/MJQ530s1BO8) ACDIS update: CDI Week 2021 Q&A: Ordering takeout | Outpatient CDI with Leyna Belcher (http://ow.ly/Uv9q30s1BN0)   Send us a picture of your ACDIS Pocket Guide in the wild! (http://ow.ly/jMCH30s1BOj)

Today we're digging into what is on a lot of hoteliers' minds, 2022 and the big projects you're planning for in the upcoming year. One of those bigger capital expenses many are planning on is a new website. Well, if that's you, you've brought your ears to the right place since we're going to be discussing how to choose the right CMS for your hotel website. SHOW NOTES AND MORE! https://www.TravelBoomMarketing.com/podcast

Your medical records don't make pleasant bedtime reading. And not only are they inscrutable—they're often mutually (and deliberately) incompatible, meaning different hospitals and doctor's offices can't share them across institutional boundaries. Harry's guest this week, Ardy Arianpour, is trying to fix all that. He's the co-founder and CEO of Seqster, a San Diego company that's spent the last five years working on ways to pull patient data from all the places where it lives, smooth out all the formatting differences, and create a unified picture that patients themselves can understand and use.The way Ardy explains it, Seqster “smashes the data siloes.” Meaning, the company can combine EMR data, gene sequence data, wearable device data, pharmacy data, and insurance claims data all in one place. The big goal guiding Seqster, he says, is to put the patient back at the center of healthcare.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show, the interview podcast that explores how technology is changing everything we know about healthcare. Artificial intelligence. Big data. Predictive analytics. In fields like these, breakthroughs are happening way faster than most people realize. If you want to be proactive about your own health and the health of your loved ones, you'll need to learn everything you can about how medicine is changing and how you can take advantage of all the new options.Explaining this approaching world is the mission of my new book, The Future You. And it's also our theme here on the show, where we bring you conversations with the innovators, caregivers, and patient advocates who are transforming the healthcare system and working to push it in positive directions.If you've ever gotten a copy of your medical files from your doctor or hospital, you probably know these records don't make pleasant bedtime reading. They aren't designed to be clear or user-friendly for patients. In fact, it's usually just the opposite.The data itself is highly technical. And on top of that, there's the inscrutable formatting, which is dictated by whatever electronic medical record or “EMR” system your provider happens to use. But the problem isn't just that EMR data is incomprehensible.It's also that different EMRs are often incompatible with each other.So if you're being treated by multiple providers, it can be really tricky to share your data across institutional boundaries. That's why medicine is one of the last industries that still uses old-fashioned fax machines. Because sometimes a fax is the only way to send the data back and forth.But my guest today is trying to fix all that.His name is Ardy Arianpour, and he's the co-founder and CEO of Seqster.It's a company in San Diego that's spent the last five years working on ways to pull patient data from all the places where it lives, smooth out all the formatting differences, and create a unified picture that patients themselves can understand and use.The way Ardy explains it, Seqster quote-unquote “smashes the data siloes.” Meaning, the company can combine EMR data, gene sequence data, wearable device data, pharmacy data, and insurance claims data all in one place.The big goal guiding Seqster, according to Ardy, is to put the patient back at the center of healthcare.At the moment, however, consumers can't sign up for the service directly. Seqster's actual customers are players from inside the healthcare industry. For example, a life science companies might hire Seqster to help them make the experience of participating in a clinical trial more user friendly for patients.Or a health plan might use a Seqster dashboard to get patients more involved in their own care.Seqster did let me do a test run on my own medical data as part of my research for this interview. And I was impressed by how quickly it pulled in data that normally lives in a bunch of separate places. I'm hoping Seqster and other companies in this space will continue to make progress.Because, frankly, I think poor patient access to health data and the lack of interoperability between EMRs are two of the biggest factors holding back improvements in healthcare quality.If we can finally get those two things right, I think it can help unlock the data-driven healthcare revolution that I describe in my new book, The Future You. Which, by the way, is out now in paperback and ebook format at Barnes & Noble and Amazon.When we spoke back in September, Ardy and I talked about better EMRs and many other things. And now here's our conversation.Harry Glorikian: Ardy, welcome to the show. So, it's good to have you here, and you know, for everybody who doesn't know your story and the story of the company, I'd love to, you know, start covering some basics like, you know, the when, the what, the how, the why. What's the founding story of Seqster and what was the problems that you were really trying to go out there and solve when you started the company in 2016?Ardy Arianpour: Thanks so much, Harry. Always been a fan. I think we've known each other for quite some time, but it's been a long time since we've ran into each other since the genomic and precision medicine days. So great to see you. I hope you and your family are well and yeah, look, Seqster is super special and there's a secret story, I guess, that never has been told. It really starts way beyond 2016 when I founded the company. So I spent 15 plus years in DNA sequencing, next gen sequencing genomic market. And during that time in the 2000s to early 2010s, I was fortunate enough of being part of some amazing endeavors and organizations that allowed my team and I to take some risk. And when you take risk, when you're in biotech, pharma, precision medicine, genomics, bioinformatics, you learn new things that most people don't learn because you're you're you're, you know, trailblazing, I guess you could say. And we were able to do that back with one of my old companies where we were able to launch the first clinical exome test, launch the first BRCA cancer panels, launch the first next gen sequencing panels in a CLIA lab. Ardy Arianpour: And then, you know, it wasn't about the testing. It was all about the data, and we didn't realize that till later and we kept on seeing that wow genome data is really only one set of all the other data pieces, right? I think the genomics folks, me being a genomics guy, I guess you could say, for a decade and a half, we're so forward thinking that we forget about the simple things within science, and we never really thought, Oh, collect your medical data and pair it with your genomic data. We never really thought there would be a wearable out there. That data was going to be siloed, too. We never thought there was going to be, you know, many different medical devices and instruments that would be Bluetooth and sensor enabled, where there would be data that would be siloed. Claims data, pharmacy data. Never even crossed our minds. So, you know, when you put this all together, my inspiration with Seqster was actually really simple. And when I founded the company, I wanted to combine the genomic data with your EMR medical data as well as your wearable data, because in 2016, the tailwinds of those other, you know, services was really taken off.Harry Glorikian: Right. Totally understand it. And you know, as we were talking about before I hit record, it's like it was funny because I was just talking to another company that's working on NLP and they're able to look at, you know, papers and see drugs being used in different, you know, medical conditions. And then they figured out, well, they needed to tap into the unstructured data of a medical record to really, like, add the next layer of value to it. So, you know, there's a lot of activity going on about there. But how do you guys, how do you, how do your co-founders, you know, Zhang and Dana play into like the science, the technology and what's the sort of angle that you guys have taken to solve this problem? Or what's your idea on how to fix it? I'm not saying it's been solved yet, because that would be a Herculean task in and of itself. But how are you guys approaching it that? Is a little different than the. You know, maybe any any of your other you would you would consider anybody else out there, the working on this?Ardy Arianpour: Yeah, look for us we spent a lot of time understanding the power of data. But how what makes Seqster different is no one knows the power of the patient better than us. We've spent time with our platform with, you know, tens of thousands of patients: rare disease patients, oncology patients, parents, autoimmune disease patients, patients that have that are seeing functional medicine folks. Patients that were having issues sharing data through telemedicine, clinical trial patients. All these sorts of patients are very different. At Seqster we focused on putting the patient at the center of health care in order to smash all the data silos from their medical institutions to their wearable technology that they wear to the DNA testing that they get and even maybe a COVID test or a vaccine. How do you bring a 360-degree patient view? And you know, you tried the system, so I think you got a small teaser of how we can do that and we've really cracked this large problem. It is Herculean, I believe, and a lot of people believe because it's interoperability, it is the number one problem in all of health care.Harry Glorikian: Yeah, I mean, I had the pleasure of trying it and imported my data and was able to see, you know, individual pieces. I mean, I made some suggestions on what might make it easier for me to hone in in different areas, right, and have the system highlighting different things. But I guess each data stream is being brought in separately and then at some point you're going to create a master dashboard above it, because now each one is separate from when I go into each record, right, When I go into my medical record, it gives me one set of data with my lab results and everything else and the notes, and then it pulls in my wearable data separately that I have to look at, right? So you've got to look at it separately. It doesn't. Then I guess the next step would be creating a master sort of view of how everything would look in a sort of I don't want to say integrated, but at least a timeline view of the world. But. You know, following up on the the sort of the what question, you know, how do you sort of combine data from different EMRs, tests, apps, devices in a sort of scalable, repeatable way? I mean, it seems like to date, that's been a hugely manual process, and I can imagine you could figure out every provider's ontology and then create a table that shows what's equivalent to. And but you know, there's got to be sort of a translation scheme that would be required that that provides some constant readjustment as the main providers tweak and evolve their own systems, right? Because if the provider is tweaking their system, your system has then got to adapt to changes that are happening in that end. So how are you guys managing all that craziness?Ardy Arianpour: Yeah. So I think it all and you hit on so many points, I'll try and cover them if I remember them all. Look, the number one thing for us is we can connect to any data source. It doesn't matter. And you saw it. And just before I continue, just tell the audience how fast, how fast, how long did it take for your data to be populated after you connected it?Harry Glorikian: Oh, it was. I mean, yeah, as soon as I created it, I could see that it was, you know, it was digesting and then populating. And, you know, I was just I was watching it as a matter of fact, when I was on the phone with your person, that was helping me. Yeah. At first I said, Oh, it's not there. And then a couple of seconds later, I'm like, Oh no, it's showing up, right? So it was happening in, I don't want to say real time, but it was happening as as we were watching it evolve, right? It was sort of it was. It was almost like watching time lapse.Ardy Arianpour: And that's actually a great way. That's a great way to actually describe it. We created the time lapse of all your health data. Now let's get to the what and the how. So we connect to any health data source. The patient is fully in control. You own your data, you control it. It's all consented by you. We don't own your data and we connect to every single medical record. And that's huge that we've achieved nationwide coverage. We didn't know what data you have, but we're you're able to connect to it. Why? Because our team, which our engineering team gets all the credit for six years now, almost since founding of the company we have written, I don't know, seven million lines of code, that standardizes and harmonizes all of the ICD 9, ICD 10, SNOMED codes and every single lab result to every single wearable terminology, from biking to cycling to, you know, you name it, VitaminDB, you know, characterized in 40 different ways. You know, we're harnessing data to improve patient lives at scale. We built it for scale because you can't do it by the traditional method of just faxes and PDFs. Now, you know, being able to do that is not a bad thing.Ardy Arianpour: We can bring that service into our platform as well. It's already integrated, but that type of service takes 30 to 60 days and it's static data. It's not real time right now. If Harry goes, I don't know, you go on a bike ride and you fall and you go to the E.R. and you had whatever data connected automatically in your sister portal, it'll be populated without you even touching Seqster. That's how our real time data works and another way that we're totally differentiated than anything else in the marketplace. I was never a fan of API businesses because they're just data in data out. I truly wanted us to create a patient engagement platform, a PEP right, or a patient relationship management system, what I call a PRM instead of a CRM. And that's what we created with Seqster. So that is beyond an API, beyond just data. We're visualizing the data, as you saw. We really nailed the longitudinal health record or the individualized health record. And I think it's, I always say this, health data is medicine. The reason why it's medicine is because our platform has saved patient lives.Harry Glorikian: Ardy, how do you, how are you handling the free form notes, right, because I noticed that I could look at all my notes, but they weren't necessarily, it wasn't pulling from the note and sort of making sense of it. I mean, I could look at all of it and it was all in one place. But the the system wasn't necessarily processing it, sort of. I was talking to Jeff Felton from ConcertAI and they do a lot of sort of, their big thing is the NLP that sort of tries to choose chew through that, which is not trivial, you know, yesterday today, context matters in health care.Ardy Arianpour: Yeah. Look, if we created the the the Tesla of health care, let's just say, right, we're we're changing the game. From static data to real time data. Ok. Well, you're talking about is, are you going to create a helicopter as well? Right, OK. And all right. So, no, we're not going to go create the helicopter. Is there going to be an electric helicopter by Tesla? There's no market for that, right? So that's why they're not doing it now. I'm not saying there's not a market for NLP. It's just the fact that we'll go ahead and partner with a third party NLP provider. And we already have we have like four of them and they all have their strengths and weaknesses because it's not a one size fits all thing. And you know, we can already run OCR, you know, over the free text and pull certain ontology information out. And then, you know, when you partner with an NLP company, once you have a system that can capture data, you could do anything. So people always ask me, Are you going to get into AI? It's just the buzzword. There's a million A.I. companies. What have they really done right in health care? It's not really there. Maybe for imaging they've done some things, but it's more of a buzzword. AI only becomes valuable if you have a system, Harry, that can instantly populate data, then you can run some great artificial intelligence things on it. So NLP, AI, OCR, all those things are just many tools that can add. Now, in your experience, you only got to see about 5 percent of the power of Seqster, and that probably blew you away, even though it was five percent of the power. Because you probably never -- I don't know, you tell me, have you ever been able to collect your data that quickly? It took, what, less than a minute or two?Harry Glorikian: Yeah, well, thank God, I don't have a lot of data. So, you know, just when I tap into my my health care provider, you know, my data is there and it's funny, I always tell people, being a not exciting patient is a really good thing in one way, and it's a really bad thing because you can't play with all the data. But you know, like even when I did my genome, it's an extremely boring genome.Ardy Arianpour: My question is it's not about it being exciting or not, because thankfully you're not a chronically ill patients. But imagine if you were and how this helps, but take a step back. I'm just asking the speed, yes, and the quality of the presentation of the data that seeks to you. It was less than what hundred seconds?Harry Glorikian: Yeah. Well, it was very quick. And I've already it's funny because I texted my doctor and I was like, I need to talk to you about a couple of these lab results that look out of out of norm, right? And they weren't anything crazy. But I'm just curious like, you know, how do I get them in norm? I'm just I'm always trying to be in in the normal band, if I can be.Ardy Arianpour: So it's interesting you say that because as a healthy individual. You know, and even a chronically ill patient, it doesn't matter. The best way to actually QC data is through visualization, and this is what this is. That's foundational to interoperability. So we hit on semantic and structural interoperability with our, you know, backend engine that we've created to harmonize and standardize the data. We built many different types of retrievers and then we parse that data and then it's standardized and harmonizes it. But that visualization, which some people call the Tableau of health data, you know that we've created when they see it, is really, we got to give the credit to the patients. We had so many patients, healthy ones and unhealthy ones that told us exactly how they want it to look. We did this on the genomic data, we did this on the wearable data. We did this on the medical device data and we have some great new features that can superimpose your clinical data with your fitness data on our integrated view and timeline.Harry Glorikian: Oh, that? See, now that would be, you know, another level of value, even for a healthy patient, right to be able to see that in an integrated way. I made a suggestion, I think that when a panel shows up is. You know, highlight the ones that are out of Norm very quickly, as opposed to having to look at, you know, the panel of 20 to find the one that's out of whack, just either color them differently or reorient them so that they're easier to find. But those are simple changes just from a UI perspective. But so. How would you describe that that Seqster creates value and say translates that into revenue, right? I'm just trying to figure out like, what's the revenue model for you guys? I know that you're I can actually, I'm not even sure if I can sign up for it myself. I would probably have to do it through a system if I remember your revenue model correctly. But how do you guys generate revenue from what you're doing?Ardy Arianpour: Yeah, I'll share another secret on your show here from the founding of Seqster. My dream was to empower seven billion people on our little mothership here called Earth to have all their health data in one place. And I had a direct to consumer model in 2016. The market wasn't really ready for it, number one. Number two, it was going to cost $500 million worth of marketing to just get the message out for people to know that it exists. So long story short, in 2016, you know, when I founded the company, not that many people wanted to talk to us. They thought we were just like nuts to go after this problem. 2017, we got some calls from some investors, we raised some great seed funding after I personally put in some money in in 2016 to get the company going. And then in 2018, I got a call from Bill Gates and that was when everything changed. Bill called and wanted to meet in person, I was supposed to get 30 minutes with him. And the reason why he called is because our first beachhead was with Alzheimer's patients. My grandmother, both my grandmothers, passed away due to Alzheimer's disease. Both my maternal and paternal grandmothers and being a caregiver for my mom's mom and being very close to her since she raised me, I learned a lot about a multigenerational health record, so I actually filed patents in 2016 on a multigenerational health record because I wanted to have my grandma's data, my mom's data, my data, and be able to pass it on to research as well as to generations down my family.Ardy Arianpour: Long story short there, Bill gets all the credit for telling me after I showed him our platform, "You got to take this enterprise. You guys built something that Google Health failed at and Microsoft Vault Health Vault failed at." And it's funny we're talking about this. Look, Google just dismantled their health division again. Why? Because tech companies just don't get it. They have a lot of money. They have a lot of power. They've got a lot of smart people. But they they they don't know where, I'll give you an example. It's like a tourist with a lot of money coming into a city. You don't know where the really good local bar is, right? Why is that? You don't know where the really good, you know, slice of pizza is. You're going to go to the regular joints that everyone finds on TripAdvisor and whatever. You know your friends told you, but if you're a local, you know where to get the authentic cocktails and the authentic, you know, drinks and food. Why? Because you've lived and breathed it in the city. So we've lived and breathed it right. And so we know what not to do. It's not about knowing what to do in health care or in genomics or in biotech. It's actually knowing what you shouldn't be doing. Yeah.Harry Glorikian: And knowing I got to tell you, there's some problems where I'm like, OK, I know exactly who to call for that problem, because there aren't, you know, they're not falling off trees in that particular problem. There's a small handful of people that understand that problem well enough that they can come in and sort of surgically help you solve that problem. And you can have all the money in the world and have all the smart people you want. Doesn't mean they're going to be able to solve that particular problem, especially in health care, because it's so arcane.Ardy Arianpour: And it's getting, you know, this is a problem that is growing like cancer, interoperability. Just on this 20 minute conversation with you it has grown by hundreds of millions of dollars. Do you know why? Because data is being siloed.Harry Glorikian: Yeah. And I think, look, I've always I've said this on, you know, whatever show or and I've actually I've written letters to Congress. You know, I think this this needs to be mandated because expecting the large EMR companies to do anything is a waste of time. They're not going to do it on their own if their feet are not put to the fire and it changes. And honestly, I believe that if anything will stop the innovation of health care or slow it down is the EMR systems. You know, if you don't have the data, you can't do the work.Ardy Arianpour: Absolutely. But you know what people don't understand. And not to go off that tangent, but I'll get back to the business model in a second to answer that question because I just recalled in my mind here that I didn't answer that. Look, people don't understand that at least the EMR companies, even though they're like Darth Vader, you know, they needed. They've put some foundation there at least. If that wasn't there, we would be in a much worse situation here, right?Harry Glorikian: Correct, but if Satya Nadella hadn't really changed Microsoft, really redone it right, it wouldn't be the company it is now, and I think they [the EMR companies] are just back in the dark ages.Ardy Arianpour: Of course, I totally agree. I'm surprised, actually. Microsoft, as an example, didn't come up with their own EMR system and launch it to the hospitals to go, compete with the servers and all scripts and Epics of the world. If I was Microsoft, that's what I would do. I would have enough money in power, know exactly what to do. I would take a system like Seqster and I would explode it in a good way and be the good guys and have it completely open source and open network. But that's a whole cocktail conversation if anyone's listening on the on the podcast that wants to talk about that. Give me a call or shoot me an email or find me on LinkedIn.Ardy Arianpour: Let me go back to the business model real quick so people understand. So direct to consumer was what I wanted to do. We built it for the consumer, for the patients. It was the smartest and dumbest thing I ever did. Let's go to why it was the dumbest thing first, because it was really, really hard. It was the smartest because we would not be where we are today. You wouldn't have called me to talk on your podcast and all these other great, you know, amazing people that want to hear about how we're, you know, cracking the code on interoperability now and changing the health care system, changing clinical trials, changing decentralized trials with our system.Ardy Arianpour: Why? Well, it's because our system was built by patients. Right, and so it's a patient centric, real time, real world data platform that layers in engagements for both the providers, the payers, the pharma companies and any other enterprise that white labels our platform. We have both iOS and Android SDK and Web available. It gets fully branded. We're the Intel Inside with the Salesforce.com business model. It's a Software as a Service service that we offer to enterprises. Patients never pay for the service. And we do give VIP codes to chronically ill patients and VIPs, you know, journalists, podcasters and to be honest, anyone who emails me that wants to try it. I've been always giving on that. That costs us time and money, and I'm happy to do it because it's my way of giving back to the community and health care because I know our team and I have built a system that have saved lives. It's been covered by the news multiple times.Harry Glorikian: So, so in essence, a large provider comes, buys the access to the system and then offers it to its patient population to utilize to aggregate all this information, right? How can the platform stay patient centric if the patients aren't directly paying for it?Ardy Arianpour: Ok, very simple. All of these enterprises in health care, whether that's Big Pharma, right, or Big Oayer from Pfizer to Cigna, to United Healthcare group to Humana to even Amazon, right, to other tech companies, they all want to go down a patient centric way. It's just what's happening. You know, I've been talking about this since 2016 because we pioneered patient centric interoperability. That's what we did. That's what Seqster did. That's that's what we set out to do. And we did it. Some, you know, a lot of people say they can do it. Very few actually. Do we fit in that model now, right? And you had the experience yourself. And I think the first time I saw patient centric ads was. 2020. No, sorry. Yeah, 2020, JP Morgan Health Care Conference in January, just three months before the lockdowns and the pandemic started. It was the first time I went to Johnson & Johnson's afterparty in downtown San Francisco. And saw a huge banner saying, you know, blah blah blah, patient centricity. It's the 22nd century, you know, whatever. So they add a bunch of ads that were all patient centric, and I looked to my co-founder, Dana, and I'm like, Look at this, these guys finally caught on. I wonder if they've been, because we've been in discussions with a lot of these folks, long story short, it's not because of Seqster, I think it's just the market was headed that way. We were so far ahead of the market and there was no tailwinds. Now it is all there. And the pandemic afterwards accelerated digital health, as I say, by 7 to 10 years.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you enjoy hearing from the kinds of innovators and entrepreneurs I talk to on the show, I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is out in print and ebook format from Amazon and Barnes & Noble. Just go to either site and search for The Future You by Harry Glorikian. Thanks. And now, back to the show.[musical interlude]Harry Glorikian: So the platform combines EHR, genetic, and fitness data, so. Why did you start with those three?Ardy Arianpour: So we started with those three, and I'll get to that, but we also do pharmacy, social determinants of health, and claims data as well. So we've added three other very large pillars. We can connect to any data source. We've created a universal interoperability platform that's patient centric that brings real time, real world data. And we're just super excited about all the business opportunities and the big pain points that we're solving for enterprise as well as for the patient. Why did we start with genomics, EMR, fitness. Ok. Here's the story. So I named the company Seqster after actually going on a five or six mile run in downtown San Diego, coming back and watching The Italian Job. And in the movie The Italian Job, it's one of my favorite movies, actually. I love that movie. I could just keep watching it over again, the real Napster was in the movie, and I used to be a Napster user where, you know, it was the way of actually pulling all your music and having it kind of in one place. Not really exactly Seqster's model, Seqster's model is is much more legal because it's patient centric. Yes, Napster was kind of stealing the data, right? So long story short, I was trying to think of a company name and I'm like, Oh my God. I don't know what hit me. I'll remember that moment like it was yesterday, Harry. Sequster came up because I had dived into DNA sequencing. We are doing everything that you can on next gen sequencing. And so I was like, Wow! Seqster. S-E-Q-S-T-E-R.Ardy Arianpour: And I went on GoDaddy.com. I bought it for $9.99. And the story started from right then. It was just me and the website. No co-founders, no onee else. I was just thinking, this is a great name. Now, you fast forward to why it's medical data plus genomic data, plus fitness data, to begin with. Well, the genomic data was an easy one because, right, I have 15 years underneath my belt on genomic sequencing technologies and clinical diagnostics and doing a lot of great things for patients in that arena. And I knew that it couldn't just be the genome, right? That's where the medical data came in because we knew and I never knew that we would be able to actually build something that would be able to pull it on together. I knew it was going to be really tough. I didn't think it was going to be this tough. We would have never done it if I knew that it was this tough. It's so great that we did because we solved it. But if you go back and say, "Ardy, would you do it again if you knew it was going to be this tough?" I wouldn't, because it's really, it's not the number two problem, it's the number one problem. And we're just, you know, I'm a peon. I'm a very small dot. I'm not anyone special. I'm just very passionate about solving this problem. That's it. And so is my team, and we got a great team and we've execute on. So great.Ardy Arianpour: And then, you know, it was my idea. I was forcing the wearable and fitness data because I was interested in that. And when the Apple Series One Watch came out, it was very limited, but I saw how it was going to change, you know, just connection of data. And my team being bioinformaticians and from the genomics world were so against bringing it in, I mean, I could show you emails of fights about me saying, get fitness data in here. They were not interested. I forced it on them. And then next thing you knew, clinical trials. One of the biggest things was how do you bring sleeping data and wearable data to x y z data? And that market started taking off. Decentralized trials. You can't even do it if you don't have wearable data. And so everyone started saying, you know, OK, you were right. That was one. I get one big pat on the back. And then we realized we can't be limited to just those three pillars. So what are the next three that we can work on? And that was claims data so we can marry it with the EMR and medical data for payers. And then we ran into pharmacy data. We just signed our first digital pharmacy deal three weeks ago with Paragon Health. And if we didn't have those capabilities, we wouldn't have the business opportunities. And the social determinants of health data being our last integrations comes in very handy for various different use cases.Harry Glorikian: So, three sort of things, right? You know, you combine all this data. What can you learn that wasn't obvious before? How do you translate into better health outcomes for consumers or, say, smarter decision making by consumers, right, so those are two potentially different ways to look at it.Ardy Arianpour: Absolutely. So one word for you: Seqster's longitudinal health record drives health economics, outcomes, research. It drives it.Harry Glorikian: Is that your clients doing that, you doing that, a third party group coming in?Ardy Arianpour: Yeah. We don't do that. We're just the patient engagement and data aggregation operating system that gets implemented for enterprise. And then the enterprise can run the analytics on top of it. They can, you know, take all of the raw data. So we're the only 21 CFR Part 11 compliant platform too. We're fully FDA compliant, Harry. It took us 19 months working with the FDA in order to get our compliance letter in September, October of last year, 2020. So about a year ago. And not only are we HIPAA compliance, not only are we High Trust certified and 256 bit encrypted on all the data that comes in, but having that FDA compliance sets us apart number one. Number two, because we're not an API, we have FHIR fully integrated. We have an API for sharing data, but we're not an API business. We're a SaaS business in health care, in digital health. We can make any company a digital health company. Let's say it's Coca-Cola, and they want to empower their 200,000 employees. They could launch a Coca-Cola Seqster white label in 72 hours to 200,000 employees. That's what we've created. Now, take that and imagine that now within pharma, within precision medicine, within clinical trials, within the payer network, which we're the only platform that's CMS ONC interoperability compliance from the Twenty First Century CURES Act as well.Harry Glorikian: So let me let me see if I... I'm trying to figure out like the angle, right? So I mean, ideally for interoperability, if we talk about the highest level right, you really want to get Epic, Cerner, Kaiser, et cetera, all in a room right? And get them to agree to something. Which is like an act of God.Ardy Arianpour: Some people say, we're doing, you know, it's not my words, but again, a figure of speech, people say, we're doing God's work.Harry Glorikian: But stepping back here for a second, what I see you guys doing is actually giving a platform to the patient and the patient is then connecting the record, not necessarily the systems themselves allowing for interoperability to take place.Ardy Arianpour: So yes, but you're speaking of it because of the direct to consumer experience that you had. The experience we gave you is much different than the experience from the enterprise side. We have a full BI platform built for enterprise as well. Right. And then we have the white label for the enterprise where they launch it to a million patients.Harry Glorikian: That's what, I'm trying to think about that, right? So. Coca-cola says, like, going down your example, Coca-Cola says, "Love to do this. Want to offer it to all of our employees." We make it available to them. But it's the employee that has to push the start button and say, yes, I want my electronic medical record to be integrated into this single platform, right?Ardy Arianpour: But that's that's an example with Coca-Cola. If we're doing something with Big Pharma, they're running a clinical trial for 500,000 COVID patients, as an example. They're getting data collection within one day versus two months, and guess what, we're going to be driving a new possible vaccine. Why? Because of the time it takes for data collection at scale. We empower patients to do that and they get something back. They get to track and monitor all their family health.Harry Glorikian: Right. So so it's sort of, you know, maybe I'm being dense, but sort of the same thing, right? Big Pharma makes it available to the patient. The patient then clicks, Yes, I want to do this and pull in my medical records to make it all everything to be in one place. Yes.Ardy Arianpour: Yes. And I think it's about the fact that we've created a unique data sharing environments. So that's, you know, Harry and Stacey and John and Jennifer and whoever, you know, with whatever use case can share their data and also consent is built with E-consent and digital consent is built within that process. You don't share anything you don't want to share.Harry Glorikian: Right. So let me see if I got this correct. So Seqster is providing a translation and aggregation between systems through a new layer of technology. Not creating true interoperability between systems, right?Ardy Arianpour: Yes. There's a spider web. And. We have untangled the spider beb in the United States of America. We've done all the plumbing and piping to every single health institution, doctor's office clinic, wearable sensor, medical device pharmacy, the list goes on and on, Harry.Harry Glorikian: So let's... Another question. So how does the 21st Century CURES Act of 2016 relate to your business? I think you know you've said something like Seqster has become law, but I'm trying to. I'm trying to understand, what do you mean when you say that?Ardy Arianpour: So when we founded Seqster, we didn't know there was going to be a Twenty First Century CURES Act. We didn't know there was going to be GDPR. We are GDPR compliance before GDPR even came out. Right? Because of our the way that we've structured our business, number one. Number two, how we built the platform by patients for CMS ONC interoperability, you know, final rulings and the Twenty First Century CURES Act, which is, they're synonymous. We worked hand in hand with Don Rucker's team and Seema Verma on the last administration that was doing a lot of the work. Now a wonderful gentleman, Mickey Tripathy has taken the role of ONC, and he understands, you know, the value of Seqster's technology at scale because of his background in interoperability. But what was interesting in the two years that we worked with HHS and CMS was the fact that they used Seqster as the model to build the rules. I was personally part of that, my team was personally part of that, you know, and so we were in private meetings with these folks showing our platform and they were trying to draft certain rules.Ardy Arianpour: We didn't know that they were going to be coming out with rules until they did. And then that's when high level folks in the government told us specifically on calls and also even at Datapalooza when I gave a keynote talk on on Seqster, when Don Rucker did as well right before me. You know, we're sitting in the speaker room and folks are like, "You're going to become law in a month." And this was in February of 2020. March 9th, those rules dropped. I was supposed to give a keynote talk at HL7,  at HIMMS. HIMMS got cancelled in 2020. I just got back from HIMMS 2021 in Vegas just a week and a half ago. It was fantastic. Everyone was masked up. There was only three cases of COVID with 10,000 people there. They did a great job, you know, regulating it. You had to show your vaccine card and all that good stuff. But you know, I would have never thought Seqster becomes law when we were founding the company. And so this is really special now.Harry Glorikian: So what does success look like for Seqster?Ardy Arianpour: It depends how you measure it. So we're in the Olympics. It's a great question. Here's my answer to you. We're in the Olympics just finished, right? So we started out in track and field. We were really good at running the 400 Meters and then somehow we got a use case on the 4x1 and the 4x4. And then we did really well there, too. And then because of our speed, you know, we got some strength and then they wanted us to get into the shot put and the javelin throw and then we started winning there, too. And then somehow, now people are calling us saying, "Are you interested in trying to swim?" We got the 100 meter butterfly. Well, we've never done that. So success for us is based off of use cases. And every use case that we deal with, within clinical trials and pharma, we've define 24 distinct use cases that we're generating business on. Within the payer community now, because of the CMS ONC Twenty First Century Cures Act, there's a major tailwind. Within life insurance for real time underwriting, there's, you know, a plethora of folks that are calling us for our system because of the patient engagement. So this patient centricity for us has been a central pillar, and I've never allowed anyone in our company, whether it's the board or our investors or employees, you know, get sidetracked from that. We've been laser focused on the patients and success at impacting patient lives at scale.Harry Glorikian: So as a venture guide, though, right, like I'm going to, there's only so much money on so much time to tackle, so many different opportunities, right? So it's there is a how do we create a recurring revenue stream and keep plugging along and then generate either enough revenue or raise enough money to do more? And so just trying to think through that for what you guys are trying to do, I get the 4x100 and the swimming. But all of that takes money and resources right to be able to prove out, of course.Ardy Arianpour: And here's another thing we're in a different state. Look, my team and I had a major exit before. We built a billion dollar company out of $3 million. And even though we weren't founders of that company, you know, I was the senior vice president and we we did really well. So, you know, that allowed us to not take salaries that allowed us to take our money and put it into doing something good. And we did that in 2016 to seed it. And then afterwards, I raised, you know, millions of dollars from folks that were interested in, you know, this problem and saw that our team had a track record. And I actually was not interested, Harry, in raising a Series A because of our experience, but we kept on getting calls. And then just six months ago, we announced, you know, our series a funding. Well, we actually announced it in March, I think it was, but we closed our Series A in January of this year and it was led by Takeda Pharma, Anne Wojcicki's 23andMe and United Healthcare Group's Equian folks that created Omniclaim and sold to UnitedHealth Group Omni Health Holdings.Ardy Arianpour: So check this out. Imagine my vision in 2016 of having medical data, genomic data fitness data. Well, if you look at the investors that backed us, it's pretty interesting. What I reflect on is I didn't plan that either. We got amazing genomic investors. I mean, it doesn't get better than getting Anne Wojcicki and 23andMe. Amazing female entrepreneur and, you know, just the just the force. Secondly, Takeda Pharma, a top 10 pharma company. How many digital health startups do you know within Series A that got a top 10 pharma? And then also getting some payer investors from UnitedHealth Group's Omniclaim folks and Equian OmniHealth Holdings. So this is to me, very interesting. But going to focus our focus has been pharma and clinical trials. And so Takeda has been phenomenal for us because of, you know, they they built out the platform and they built it out better for us and they knew exactly what to do with things that we didn't know. And with things that patients didn't know on the enterprise, you know, Takeda did a phenomenal job. And now other pharma companies are utilizing our platform, not just Takeda.Harry Glorikian: Yeah, well, they want their data aggregation. They want as much data on the patient aggregated in one place to make sense of it.Ardy Arianpour: So not necessarily that they actually want to empower patients with a patient centric engagement tool. That's pharma's number one thing right now, the data part, obviously is important, but empowering patient lives at scale is the key, and that's that's our mission. And so, yeah, that's that's a whole 'nother cocktail conversation when I see you soon hopefully in a couple of weeks.Harry Glorikian: Hopefully as life gets, or if it gets back to normal, depending on the variants, you know, we'll hopefully get to meet him in person and have a glass of wine or a cocktail together. So it was great to speak to you. Glad we had this time, and I look forward to, you know, hearing updates on the company and, you know, continually seeing the progress going forward.Ardy Arianpour: Thanks so much, Harry, for having me. Big fan of Moneyball, so thank you to you and your organizers for having me and Seqster on. If anyone wants to get in touch with me personally, you can find me on LinkedIn or you can follow Seqster at @Seqster. And again, thank you so much for. For having a great discussion around, you know, the the insights behind Seqster.Harry Glorikian: Excellent. Thank you.Harry Glorikian: That's it for this week's episode.  You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com, under the tab Podcasts.Don't forget to go to Apple Podcasts to leave a rating and review for the show. You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview. 

The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There's nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS' lead. We believe this change will have a ripple effect across the industry. On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as another example of CMS trying to make Fee-for-Service less “comfy” and expedite the move to value-based payment models. Gail helps us to understand what options exist and we lay out a framework for how to evaluate those options. This is a heavy episode, and there are no clear answers. However, there is a known direction and a viable path forward. We'll try to get you moving in the right direction.   For full show notes and links: https://thehcbiz.com/177-doctors-just-took-a-pay-cut-vbp-in-2022-with-gail-zahtz-part-3/

Hyperbaric oxygen therapy may alleviate symptoms of Alzheimer's Disease Tel Aviv University (Israel) A new Tel Aviv University study reveals that hyperbaric oxygen treatments may ameliorate symptoms experienced by patients with Alzheimer's disease. "This revolutionary treatment for Alzheimer's disease uses a hyperbaric oxygen chamber, which has been shown in the past to be extremely effective in treating wounds that were slow to heal," says Prof. Uri Ashery of TAU's Sagol School of Neuroscience and the Faculty of Life Sciences, who led the research for the study. "We have now shown for the first time that hyperbaric oxygen therapy can actually improve the pathology of Alzheimer's disease and correct behavioral deficits associated with the disease. (NEXT) Scientists discover that CoQ10 can program cancer cells to self-destruct A promising study shows that this nutrient causes cancer cells to self-destruct before they can multiply – giving rise to hopes that it can be utilized as an important integrative therapy for cancer patients.  Let's take a closer look at this wonderful scientific work. CoQ10 “reminds” cancer cells to die Coenzyme Q10 (CoQ10) – which supports many indispensable biochemical reactions – is also called “ubiquinone.”  This is due to its ubiquitous nature – CoQ10 is found in nearly every human cell, with particularly high concentrations in the mitochondria, the powerhouses of the cell. Researchers report that the out-of-control replication characteristic of cancer cells is a result of the cells' lost capacity to respond to programmed cell death, or apoptosis.  (NEXT) Study suggests hot flashes could be precursor to diabetes Analysis of Women's Health Initiative data demonstrates effect of severity and duration of hot flashes on risk of developing diabetes The North American Menopause Society Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests that hot flashes (especially when accompanied by night sweats) also may increase the risk of developing diabetes. Results are being published online today in Menopause, the journal of The North American Menopause Society (NAMS). "This study showed that, after adjustment for obesity and race, women with more severe night sweats, with or without hot flashes, still had a higher risk of diabetes," says Dr. JoAnn Pinkerton, NAMS executive director. "Menopause is a perfect time to encourage behavior changes that reduce menopause symptoms, as well as the risk of diabetes and heart disease. Suggestions include getting regular exercise and adequate sleep, avoiding excess alcohol, stopping smoking, and eating a heart- healthy diet. For symptomatic women, hormone therapy started near menopause improves menopause symptoms and reduces the risk of diabetes." (NEXT) Garlic extract may help obese adults combat inflammation University of Florida Aged garlic extract may help obese people ward off painful inflammation and lower cholesterol levels, a new University of Florida study shows. In the UF/IFAS study, scientists divided 51 obese people who were otherwise healthy into two groups ? those who took the aged garlic extract for six weeks and those who took a placebo. Researchers encouraged participants to continue their regular diet and exercise routine during the experiment. Research showed the garlic extract helped regulate immune-cell distribution and reduced blood LDL ? or "bad" ? cholesterol in the obese adults. Aged garlic extract modified the secretion of inflammatory proteins from immune cells, Percival said. (NEXT) Having children can make women's telomeres seem 11 years older George Mason University A recent study by George Mason University researchers in the Department of Global and Community Health found that women who have given birth have shorter telomeres compared to women who have not given birth. Telomeres are the end caps of DNA on our chromosomes, which help in DNA replication and get shorter over time. The length of telomeres has been associated with morbidity and mortality previously, but this is the first study to examine links with having children. (NEXT) Scientists uncover why sauna bathing is good for your health UNIVERSITY OF EASTERN FINLAND Over the past couple of years, scientists at the University of Eastern Finland have shown that sauna bathing is associated with a variety of health benefits. Using an experimental setting this time, the research group now investigated the physiological mechanisms through which the heat exposure of sauna may influence a person's health. Their latest study with 100 test subjects shows that taking a sauna bath of 30 minutes reduces blood pressure and increases vascular compliance, while also increasing heart rate similarly to medium-intensity exercise. (OTHER NEWS NEXT) Biden's Bounty on Your Life: Hospitals' Incentive Payments for COVID-19 By Elizabeth Lee Vliet, M.D. and Ali Shultz, J.D. – ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS. November 17, 2021 Upon admission to a once-trusted hospital, American patients with COVID-19 become virtual prisoners, subjected to a rigid treatment protocol with roots in Ezekiel Emanuel's “Complete Lives System” for rationing medical care in those over age 50. They have a shockingly high mortality rate. How and why is this happening, and what can be done about it? As exposed in audio recordings, hospital executives in Arizona admitted meeting several times a week to lower standards of care, with coordinated restrictions on visitation rights. Most COVID-19 patients' families are deliberately kept in the dark about what is really being done to their loved ones. The combination that enables this tragic and avoidable loss of hundreds of thousands of lives includes (1) The CARES Act, which provides hospitals with bonus incentive payments for all things related to COVID-19 (testing, diagnosing, admitting to hospital, use of remdesivir and ventilators, reporting COVID-19 deaths, and vaccinations) and (2) waivers of customary and long-standing patient rights by the Centers for Medicare and Medicaid Services (CMS). In 2020, the Texas Hospital Association submitted requests for waivers to  CMS. According to Texas attorney Jerri Ward, “CMS has granted ‘waivers' of federal law regarding patient rights. Specifically, CMS purports to allow hospitals to violate the rights of patients or their surrogates with regard to medical record access, to have patient visitation, and to be free from seclusion.” She notes that “rights do not come from the hospital or CMS and cannot be waived, as that is the antithesis of a ‘right.' The purported waivers are meant to isolate and gain total control over the patient and to deny patient and patient's decision-maker the ability to exercise informed consent.” Creating a “National Pandemic Emergency” provided justification for such sweeping actions that override individual physician medical decision-making and patients' rights. The CARES Act provides incentives for hospitals to use treatments dictated solely by the federal government under the auspices of the NIH. These “bounties” must paid back if not “earned” by making the COVID-19 diagnosis and following the COVID-19 protocol. The hospital payments include: A “free” required PCR test in the Emergency Room or upon admission for every patient, with government-paid fee to hospital. Added bonus payment for each positive COVID-19 diagnosis. Another bonus for a COVID-19 admission to the hospital. A 20 percent “boost” bonus payment from Medicare on the entire hospital bill for use of remdesivir instead of medicines such as Ivermectin. Another and larger bonus payment to the hospital if a COVID-19 patient is mechanically ventilated. More money to the hospital if cause of death is listed as COVID-19, even if patient did not die directly of COVID-19. A COVID-19 diagnosis also provides extra payments to coroners.

ICYMI, Montana's Attorney General discussed the CMS vaccine mandate and his challenge to it.

This week I share what I am thankful for in 2021 [powerpress]

In this Hasty Treat, Wes and Scott talk about their new Apple MacBook Pro's with the M1 Max CPU. Sanity - Sponsor Sanity.io is a real-time headless CMS with a fully customizable Content Studio built in React. Get a Sanity powered site up and running in minutes at sanity.io/create. Get an awesome supercharged free developer plan on sanity.io/syntax. Sentry - Sponsor If you want to know what's happening with your code, track errors and monitor performance with Sentry. Sentry's Application Monitoring platform helps developers see performance issues, fix errors faster, and optimize their code health. Cut your time on error resolution from hours to minutes. It works with any language and integrates with dozens of other services. Syntax listeners new to Sentry can get two months for free by visiting Sentry.io and using the coupon code TASTYTREAT during sign up. Show Notes 04:30 The last time we upgraded 07:05 Initial thoughts on new MacBook Pro Apple MacBook Pro 09:23 How much RAM you might need 11:33 M1 Pro or M1 Max? 12:37 Justification as a business expense Figma Sketch We recently found that the new 2021 M1 MacBooks cut our Android build times in half. VS Code Microsoft releases M1-native Visual Studio Code for developing apps Notion Height Sublime Text 14:52 Shortening the feedback cycle 15:57 Using VS Code 21:20 Video editing on M1 MacBook Pro Mkbhd - M1 Macbook Pro review Synology Syntax.fm Ep220 The Synology Show Recut Davinci Resolve 24:27 Screenflow export comparison Screenflow 29:32 VS Code improvements SWC pnpm 32:57 The tools are no longer the bottleneck 33:37 Hardware upgrades 34:10 The notch Bartender 36:11 macOS icons have more padding 37:03 Charging and battery TS3 Plus 38:32 Fans and heat 39:18 Touch bar is gone 39:36 External displays 41:03 Battery 41:54 LG Display issue 42:51 Touch ID reader in a better spot 43:25 What's happening to your old MacBook Pro? 45:21 Ports and keyboards Tweet us your tasty treats Scott's Instagram LevelUpTutorials Instagram Wes' Instagram Wes' Twitter Wes' Facebook Scott's Twitter Make sure to include @SyntaxFM in your tweets

How can we find rest for our souls? Join Rabbi Kevin Solomon of Congregation Beth Hallel as he describes the step-by-step process offered by Yeshua for how we can lighten our burdens and find rest in Messiah. Find relief in your Savior and listen in today. https://www.bible.com/bible/314/mat.11.28-30 (Matt. 11.28-30); https://www.bible.com/bible/314/jer.6.16 (Jeremiah 6.16) http://www.bethhallel.org/CMS/programs/prayer/prayer-requests/ (Prayer Requests) or send an email to info@bethhallel.org http://www.bethhallel.org/CMS/ (CBH Website) https://www.paypal.com/donate/?cmd=_s-xclick&hosted_button_id=FBVL4JZH8HVS4&fbclid=IwAR2MB7yq6Zkq-ZNvwnw8Yz6z0crcMmGPpKhqIDD4w3sr5fXDBE0qOr1C5cM (Donate) https://www.youtube.com/channel/UC7EfRTmLFyvapAVb7q64PoA (YouTube Channel) Support this podcast

No matter how dominant BJP is, India is a federation of states and it has CMs in only 12. Agriculture is largely a state issue, and most of India doesn't follow it unquestioningly.

Date: November 19, 2021Topics: What is a multi-circuit lottery? How does the process work?6th Circuit Court of Appeals chosen to  hear OSHA vaccina mandate lawsuits. What happens now? Are there lawsuits filed against the mandate put in place for federal workers, contractors and the CMS facilities? John Deere Workers are back on the job this week after reaching an agreement with the company. Qanon shaman sentenced to 41 months in jail. Rapid and good news. Follow Nick on Twitter: https://twitter.com/Blinding_AuraFollow Chris on Twitter: https://twitter.com/c_baker002Follow BBP News on Twitter: https://twitter.com/BBPNewsOfficialNews articles: https://bbpnews.medium.com/

Wahrscheinlich habt Ihr schon gehört, dass das Bundesarbeitsgericht neue Arbeitsverträge für die Zeitarbeit angemahnt hat, in denen der Gleichstellungsgrundsatz besser berücksichtigt wird. Aber wahrscheinlich seid Ihr auch unsicher, was das für Euch und Eure Mitarbeiter bedeutet. Dazu spreche ich heute mit Dr. Alexander Bissels, Fachanwalt für Arbeitsrecht und Partner bei CMS in Köln. Er erklärt uns, worum es genau geht und wie Ihr insbesondere mit Altverträgen umgehen sollt. Echter Mehrwert für alle in der Zeitarbeit. #liebezeitarbeit #arbeitsrecht #mindestlohn

In this healthcare podcast, I speak with Peter Hayes, who is president and CEO at the Healthcare Purchaser Alliance of Maine and a national presence in healthcare strategy, innovation, and a frequent keynote speaker. One thing, among many, that Peter said during our conversation struck me. He said it will take a village to fix what ails the healthcare industry in this country. There are too many interdependencies. This point obviously resonates around these parts because it's the rationale for the Relentless Health Value podcast. We started this show on the recognition that if you want to achieve anything in healthcare, you cannot do it without collaboration/cooperation/grudging acquiescence of other stakeholders in the patient journey or the payment journey. And when I say, “You can't do anything,” I mean you can't sell anything, you can't improve patient care, and, most relevant to this particular episode, you can't contain prices. If we're talking about health systems (for example, hospitals and the like), they are not going to curtail their price hikes or improve the value of care delivered or safety or infection control really unless patients and employers and CMS and others demand that they do—and unless employers and others do some of the five things that Peter Hayes mentions at the end of our conversation. Spoiler alert there. For context to this discussion, let's check in with some of the biggest, most powerful health systems in this country. If I limit this comment to the “nonprofit” ones—and I say “nonprofit” with air quotes because what does that mean exactly?—look, I know there are many health system execs that listen to this show, but there's some inalienable facts here. And let's talk about them with the intent of fixing them because nothing is going to get fixed that isn't talked about. It's not my nature to mince words, so I won't. Many hospitals are, by almost every account, pretty darn inefficient. And they don't do cost accounting, but then they'll scream and claim to be losing money when paid the exact same prices for certain services that other hospitals can get paid and make a fair profit. Crappy workflows cost money. Talk to anybody who has watched even the trailer to a Six Sigma course. Another thing that costs money is when all the burned-out doctors quit and you have to recruit new ones, but that's a topic for a different day. Listen the EP323 with Arshad Rahim, MD.  But there's also inefficiencies in how many health systems purchase supplies. (Listen to EP281 with Rob Austin for more on that.) Further, paying the C-suite millions of dollars but maybe underpaying or understaffing nurses has consequences. There's complaints about Medicare payer mixes, but then somehow there's enough spare shekel to put a waterfall in the lobby. Nonprofit hospitals also don't pay any taxes, keep in mind, which is a huge financial windfall, especially when they provide vanishingly small amounts of charity care compared to revenue. See the top 10 health system hall of shame in this category here.   Here's another point to ponder: Amongst the hundreds, thousands, of requests I get from PR firms pitching guests to come on this show, there are plenty from what appears to be a pretty large cottage industry that I had never heard of before. I'll call it the real estate for nonprofit hospitals cottage industry. From what I can gather by the promo copy, this involves buying up medical office buildings, not paying any real estate taxes, and then leasing out the space. I should have one of these guys come on the show just to shine some light on whatever this apparently pretty common shenanigan is. As Vikas Saini, MD, from the Lown Institute has said, “No margin, no mission” can become an excuse for all kinds of questionable behavior. So bottom line, we have employers, employees, taxpayers, cash-pay patients whose federal and/or state and/or local taxes are going to support these nonprofit hospitals—but then there's this double tax. Because they claim to be losing money on Medicare patients, they justify cost shifting some pretty big bucks onto the commercially insured patients, who are then paying, on average, some wildly inflated prices for healthcare services. This might be considered a double tax if you think about it: tax dollars going to the IRS directly and then after-tax dollars buying that knee replacement for $125,000 that should cost $25,000. Consider that a $100,000 double tax. But why should a hospital with a motive to maximize margins quit it with their questionable and secretive billing practices if employers just pay whatever the bill is no fuss no muss? Short answer: They won't. So, it's going to be up to someone else in the village to make it untenable to continue. It's going to be up to another party to slow that roll. In this conversation, Peter Hayes talks about the RAND Hospital Price Transparency Study.  One last thing that may or may not be relevant here, but I can't resist a good sidebar. New catchphrase I have been hearing lately: the “deconstruction of hospitals.” Have you heard it, too? In fact, I was listening to Zeev Neuwirth's podcast recently that featured Raphael Rakowski. Raphael said that the average fixed cost of any given brick-and-mortar hospital is 65% of revenue. So, just having the building, the physical plant, and paying for all the things you need to pay for to run that physical plant is really high. I heard Jason Wells say in a HealthIMPACT forum the other day that it costs a million dollars to build a bed in California due to all the regulatory requirements. Add to that something Christin Deacon highlighted the other day on LinkedIn about how operating rooms are empty 30% of the time.   So, it makes me wonder whether some of the issues that hospitals have when they claim that they are losing money on Medicaid or Medicare is because their fixed costs are out of whack. This potentially disproportionate situation, however, is one reason why hospitals really have to watch it for hospitals at home or virtual offerings. After all, this is exactly how Amazon ate everybody's lunch. Erase 65% of your costs, or even 50% of your costs, and that cost-plus profit threshold becomes a weapon of mass destruction. At the end of this podcast—the very end, so if you're in a rush, jump to 28 minutes or something [32:45]—Peter gives five ideas for employers to limit the ability for hospitals to take advantage. If you're a hospital exec that's listening, I would urge you to please help your local employers do these things. Let's all get on the same team here to improve the health of our communities with pricing and business models that are reasonable and fair. Don't be like the hospital that Katy Talento is going to talk about in an upcoming episode who won't do direct contracting with employers because the coding is kind of a hassle. Seriously now. You can learn more at purchaseralliance.org. Peter Hayes is president and CEO of the Healthcare Purchaser Alliance of Maine and formerly a principal of Healthcare Solutions and director of associate health and wellness at Hannaford Supermarkets. He has been in innovative, strategic benefit design for the past 20+ years. During the past several years, Hannaford has received numerous national awards in recognition of the company's commitment to working collaboratively with healthcare providers and vendors in delivering health benefits that are focused on value (high-quality efficient care). Hannaford Supermarkets has been successful in this arena by focusing on innovative solutions for patient advocacy, chronic disease management, and health promotion programs. Hannaford was recognized by receiving the National Business Group on Health Platinum Award for the health promotion and wellness programs three years in a row. These programs, along with healthcare delivery strategies, contributed to a flat trend line over five years. Peter has also been involved in healthcare reform leadership roles on both the national and regional levels with organizations like the Center for Health Innovation, Care Focused Purchasing, and Leapfrog. He's also cofounder of the Maine Health Management Coalition (now Healthcare Purchaser Alliance of Maine) and has been appointed by two different Maine Governors to serve on Health Care Reform Commissions to recommend public policies to improve the access and affordability of healthcare for Maine citizens. 07:51 Who are the commercial payers? 08:48 Are hospitals actually losing money on Medicare and Medicaid? 11:26 Is cost inversely connected to quality when it comes to hospital care? 13:46 “A lot of hospitals don't do cost accounting.” 13:59 If hospitals don't know their costs, how does Medicare know their costs? 15:52 “In the hospital financial world … they start the budget upside down.” 18:48 “There's plenty of accountability to spread around for where we are.” 20:30 Do employers have any options in the current health system situation? 21:39 “If this market's going to change, purchasers have to step up and start demanding more accountability, more transparency.” 26:21 How is the new transparency legislation impacting plan sponsors and employers? 29:41 EP342 with Christin Deacon.32:38 “I think the whole dialogue around how we pay for hospital services is going to really change.” 32:45 What is Peter's advice to employers? You can learn more at purchaseralliance.org.   @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth Who are the commercial payers? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth Are hospitals actually losing money on Medicare and Medicaid? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth Is cost inversely connected to quality when it comes to hospital care? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth “A lot of hospitals don't do cost accounting.” @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth If hospitals don't know their costs, how does Medicare know their costs? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth “In the hospital financial world … they start the budget upside down.” @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth “There's plenty of accountability to spread around for where we are.” @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth Do employers have any options in the current health system situation? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth “If this market's going to change, purchasers have to step up and start demanding more accountability, more transparency.” @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth How is the new transparency legislation impacting plan sponsors and employers? @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth “I think the whole dialogue around how we pay for hospital services is going to really change.” @pefhayes of @HPAofMaine discusses #healthsystempricing on our #healthcarepodcast. #healthcare #podcast #digitalhealth Recent past interviews: Click a guest's name for their latest RHV episode! Paul Simms, Dr Steven Quimby, Dr David Carmouche (EP343), Christin Deacon, Gary Campbell, Kristin Begley, David Contorno (AEE17), David Contorno (EP339), Nikki King, Olivia Webb, Brandon Weber, Stacey Richter (INBW30), Brian Klepper (AEE16), Brian Klepper (EP335), Sunita Desai, Care Plans vs Real World (EP333), Dr Tony DiGioia, Al Lewis, John Marchica, Joe Connolly, Marshall Allen, Andrew Eye, Naomi Fried, Dr Rishi Wadhera, Dr Mai Pham, Nicole Bradberry and Kelly Conroy, Lee Lewis, Dr Arshad Rahim

Trump sat down with Mike Lindell for an interview. Do you think we should reference the 2020 election moving forward? Also, AMAC's Andy Mangione joins Mike to discuss CMS's announced Medicare Part B premium increase and it's effect on seniors. See omnystudio.com/listener for privacy information.

The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule outlining vaccine requirements for staff at Medicare- and Medicaid-certified providers and suppliers. Attorney Frank Morris discusses the next steps for health care providers. In addition, covered employers should continue to monitor the recent litigation filed in the Eastern District of Missouri and the Western District of Louisiana seeking to permanently enjoin the CMS interim final rule. Visit our site for this week's Other Highlights and links: https://www.ebglaw.com/eltw234tr2. Subscribe to #WorkforceWednesday - https://www.ebglaw.com/subscribe/. Visit http://www.EmploymentLawThisWeek.com. The EMPLOYMENT LAW THIS WEEK® and DIAGNOSING HEALTH CARE podcasts are presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments.  Such materials are for informational purposes only and may not reflect the most current legal developments.  These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

It's another Potluck! In this episode, Scott and Wes answer your questions about GitHub Copilot, glasses, databases, dealing with stress, self-employment vs employment, design, CORS, and much more! Linode - Sponsor Whether you're working on a personal project or managing enterprise infrastructure, you deserve simple, affordable, and accessible cloud computing solutions that allow you to take your project to the next level. Simplify your cloud infrastructure with Linode's Linux virtual machines and develop, deploy, and scale your modern applications faster and easier. Get started on Linode today with a $100 in free credit for listeners of Syntax. You can find all the details at linode.com/syntax. Linode has 11 global data centers and provides 24/7/365 human support with no tiers or hand-offs regardless of your plan size. In addition to shared and dedicated compute instances, you can use your $100 in credit on S3-compatible object storage, Managed Kubernetes, and more. Visit linode.com/syntax and click on the “Create Free Account” button to get started. Sentry - Sponsor If you want to know what's happening with your code, track errors and monitor performance with Sentry. Sentry's Application Monitoring platform helps developers see performance issues, fix errors faster, and optimize their code health. Cut your time on error resolution from hours to minutes. It works with any language and integrates with dozens of other services. Syntax listeners new to Sentry can get two months for free by visiting Sentry.io and using the coupon code TASTYTREAT during sign up. Freshbooks - Sponsor Get a 30 day free trial of Freshbooks at freshbooks.com/syntax and put SYNTAX in the “How did you hear about us?” section. Show Notes 03:12 - Ders: Has GitHub Copilot become part of your daily workflow, or have you turned it off? 05:50 - Gaston Gmzi: Hey guys you rock!!! I'd like to know if you use eyeglasses and if you have any preference regarding models, design and features like blue-light blocking and anti-reflection. Also, where do you buy them? Do you go to a store to try them out, or do you buy them online? And if ordering online, which specifications do you use besides the doctor's prescription? If you guys have any sick picks about eyeglasses it would be great to hear it too. Thanks for the show and have a great week!!! 11:04 - Hi, I would like to know how the two of you deal with stress? I am a freelancer and sometimes clients can get the worst in me. When they do, I usually take a long walk and listen to a podcast, but I don't always have the time for that. I can actually go into my commit history and show which one was under stress. I think a lot of developers especially freelancers could benefit from that. Thanks. 16:47 - Mike Varela: Question for you guys about dynamic database fields and API requests. How do you let the user store dynamic metadata? Thanks. Love the show, avid listener. 21:04 - Valentine Michael Smith: Can you touch on the use of the word “grok” in the dev world? I know a lot of people who have no idea what this word means. I just happened to have tried to read Stranger in a Strange Land, the novel the word originated from, a few years ago or else I wouldn't have ever heard it before starting dev work. Have either of you read the book? Anyways, why do devs say this? 24:50 - Steve Lewis: If you guys were not self-employed, would you prefer to work for a big company (like FAANG) or go to a smaller agency or startup, etc.? 27:08 - So Many Localhost Errors: This may be a softball, but how do you set up your logging (Sentry and/or LogRocket) so your dev environment isn't firing all the time? I can't seem to find a way to do this well (and it's probably because I'm trying to learn as I go). 31:03 - Josh J from Jersey: Hey guys, loving the podcast, I've been listening for about a month but bingeing through your episodes during my mind-numbing warehouse job, helps me keep my mind on JavaScript and what I have managed to learn in my spare time. I was wondering, when you're sitting down to a new project, how do you design the website? Does it just slowly develop as you code or have you sat down and drawn out what you want it to look like ahead of time? I have heard talk of a remarkable pad. I've seen ads for this on Instagram and YouTube but always assumed it was a very gimmicky thing. Is this a good investment? Also wondering how you both met? Have you worked on any projects together outside of courses and Syntax? Keep the content coming! 38:14 - Andras: Hi Wes and Scott. You have talked a lot on the show about headless CMS's like Sanity, Prismic or even WordPress being used as a headless CMS. I am curious what the setup in a real world project is like. How would you host the CMS? And what will the admin surface look like? Will the button styles, background color etc. be different than the actual website that the end user sees? Is that a problem for the admin users? Does the admin user see all the menu for creating new content types or adding new features? Or do they only see the input fields of all the contents that can be added to a specific page? Thank you! 42:14 - Dave: Hey guys, love the podcast! I understand that CORS prevention is in place in the browser to help improve security/prevent malicious requests across domains, but I don't understand why you can get around this by performing the request server side, for example via cURL? If I were a malicious actor, surely I could just send my cross domain request through a proxy to avoid the CORS issue? I'm sure I'm missing something obvious here, can I please get your thoughts on this? 44:48 - Lemon: How do you implement authentication with GraphQL? Especially in Fastify, I know Scott recently moved over from Meteor to Fastify, so I too was checking Fastify but couldn't find a satisfying auth solution that fits well with GraphQL. 48:08 - Zack Vogel: I love when you play games on the podcast. I'm a high school technology teacher and I play a game with my students called the 5 Second Rule. It's based on a board game, but I have changed the topics to technology-themed questions. The game works like this. One person reads a topic “Name Three VS Code Extensions” and the other person has five seconds to respond with three correct answers. I think this could be a fun game to play on the podcast. Links http://www.seeeyewear.com/ https://www.warbyparker.com/ https://www.costco.com/ MariaDB dynamic columns https://en.wikipedia.org/wiki/Grok https://twitter.com/argyleink https://remarkable.com/ https://figma.com/ https://graphql.org/ https://www.meteor.com/ https://www.fastify.io/ https://docs.google.com/presentation/d/1oRqz1rSUXiLc5pJF2cMygNrodcRrRU77x0KdWGV67Iw/edit?usp=sharing ××× SIIIIICK ××× PIIIICKS ××× Scott: myQ Chamberlain Smart Garage Control Wes: ATOTO Head Unit Shameless Plugs Scott: Level Up Tutorials Pro - Sign up for the year and save 25%! Wes: All Courses - Use the coupon code ‘Syntax' for $10 off! Tweet us your tasty treats! Scott's Instagram LevelUpTutorials Instagram Wes' Instagram Wes' Twitter Wes' Facebook Scott's Twitter Make sure to include @SyntaxFM in your tweets

Rachel Lovinger Many content professionals were first introduced to the practice of content modeling by Rachel Lovinger's 2012 A List Apart article on the subject. Content modeling gives teams of authors, managers, designers, and programmers a shared understanding of a content ecosystem. Before they write a single sentence or line of code, teams align on a common language that keeps their work in sync. Content modeling accounts for everything from the authoring experience to metadata strategy to the end-user experience. It helps team visualize the content landscapes they are creating, and it serves as a conversation starter for any number of important stakeholder interactions. We talked about: her content strategy and content modeling work at Publicis Sapient the content-modeling lessons she learned working on the content and CMS for Entertainment Weekly at Time, Inc. her identification at one point as "a content manager of content management systems" her discovery when she interviewed for her first content strategy job that she was already doing everything in the job description her shift from content strategy to more of a focus on content modeling one of the big benefits of content modeling: its ability to help you visualize the landscape of the content you want to create the importance of accounting for the CMS authors' experience into your content model her work more than 20 years ago with a headless CMS her early work around organizing keywords and other metadata into controlled vocabularies her push for training and guidelines in many of her system implementations how a content model can help streamline documentation creation and author training how content models can serve as a conversation starter for important stakeholder interactions Rachel's bio Rachel Lovinger is a Group Director of Content Strategy at Publicis Sapient in New York City. With over 20 years' experience in online publishing, website development and content management, she's an internationally recognized thought leader in the discipline of Content Strategy. She regularly works on public-facing and enterprise projects, developing content models, metadata strategies, and overall content strategies for clients in a wide range of industries, including automotive, publishing, medical, financial services, travel, and entertainment. Rachel is dedicated to exploring a future in which information is well-structured and well-described, and connections are more easily discovered. Links mentioned in the interview Rachel's Twitter profile The Nimble Report, 2010 First Principle: Disambiguation, March 2012 Content Modelling: A Master Skill, April 2012 Video Here's the video version of our conversation: https://youtu.be/num6SZwnRmM Podcast intro transcript This is the Content Strategy Insights podcast, episode number 109. To build a good system of any kind, like a modern content system, it's important to give everyone involved a clear picture of the system - before you start designing and engineering it. A content model gives authors, managers, designers, and programmers a shared visual understanding of a content ecosystem, before a single word or line of code is written. Rachel Lovinger was one of the first content professionals to develop and teach this important content practice. Interview transcript Larry: Hi, everyone. Welcome to episode number 109 of the content strategy insights podcast. I'm really happy today to have with us Rachel Lovinger. Rachel works now at Publicis Sapient, and welcome Rachel, tell the folks a little bit more about what you do there at Publicis Sapient and how you got into content modeling. Rachel: Hi, Larry. Thanks for having me and sure. So I'm a Group Director of Dontent Strategy at Publicis Sapient, and I've been there, I guess 16 years. Worked on a number of different projects. The company has gone through several name changes since I've been the...

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT Screens in bars, restaurants and all kinds of venues have been part of the mix for decades, and there have been all kinds of different takes on what to put on those screens that not only entertains and occupies guests, but also has  tangible business impacts. Straight-up digital signage solutions give venue operators the ability to fully manage what appears on the screens, but then those operators have to do the work to keep the system running and content fresh. Boxes and software that squeeze a broadcast signal can allow operators to run in-house ads below and on the side of the screen from cable TV feeds, but the legal side of that can be more than a bit shaky. Widely available high-speed internet and over-the-top streaming technology advances have opened up a new way to keep screens fresh and interesting, and a well-funded Austin, Texas spinout company called Atmosphere TV is going hard at the opportunity. Launched in 2019, Atmosphere has more than 50 streaming content  channels that are in 14,000 venues and reach some 25 million sets of eyeballs monthly. There are curated channels full of cute pets and funny misadventures, but there's also a newsroom that produces carefully selected news that manages to straddle the increasingly polarized political divides of the U.S. The particularly interesting kicker is that the service is free to users, with Atmosphere even sending operators free, pre-staged Apple TV boxes that just need to be plugged in and connected to broadband. I had a great chat with Blake Sabatinelli, the company's Chief Operating Officer, about how things work and where Atmosphere is going. TRANSCRIPT Blake. Thank you for joining me. What is Atmosphere TV all about?  Blake Sabatinelli: Atmosphere at its core is a place-based television platform and we think at Atmosphere that we're here to help inform and inspire people who are watching our platform, and we do that through any one of our 54 channels that are on our platform, whether it's Atmosphere News, which we just launched or Chive TV, which is the the engine that built Atmosphere as a whole before we spun it out on its own. But we're everything from entertainment to information to digital signage and really just here to make sure that we're getting people to look up in the venues that they're sitting in, instead of staring down at their phone and engaging with the world around them.  So the simpleton explanation would be that this is something you would use in place of putting TVs in a venue and putting CNN or Fox or whatever on and just letting that run?  Blake Sabatinelli: A hundred percent. We look at our content in a whole different light that I think what you see in the traditional cable space, and if you go back to the genesis of our company, Leo and John, our founders were sitting in a bar, there was ESPN on mute, there was Judge Judy on mute and they were looking around and no one was really paying attention and they realized that no one was really programming television for out-of-home, and that audio is a huge consideration.  In both places, if you go to a sports bar here in the states, you'll see a football game that's usually the primary audio or a baseball game or something, but there's also 15 other TVs in the venue, and all of them are running captions that are really small, that you can't see from 30 feet away on content that's not engaging if you don't have the audio on, on content that honestly isn't engaging even if you have the audio on. And in some cases, especially if you're talking about the news, Fox News or CNN, MSNBC, that's angering half the audience there. So we're coming at television from a totally different perspective.  We programmed it for eyes and not ears, which is not a native thing for anyone coming from television. You have to do both and ensure that it's something that everyone can lean into and enjoy and be engaged with. You mentioned that you've launched a news product among the many channels you already have. When I look at Atmosphere TV, and I've been familiar with it for a while, it's primarily soft content, it's curated social media videos, and that sort of thing. News is a very different animal! Blake Sabatinelli: Yeah, you're telling me. I spent 15 years in the news business before joining Atmosphere and ran a company called Newsy for seven years prior to this, and there's a whole different world from what traditionally is published on Atmosphere to what a news channel is. But if you really break it down, it's really not all that different. On the entertainment side of our business, it's engaging short form videos, programmed in such a way that you want to lean in and really watch, and with news, we're really trying to take the same approach. Keep people informed about what's going on around them. Tell them the things that they need to know, do it all in an audio off capacity, which is a challenge out the gate and also sprinkle in some things that inspire and entertain them along the way, because it's a pretty dark world out there and news can be a dark platform. So we feel like we can come at this a little bit differently. Get people to smile, get people to nod and understand what's happening and not feel bad after watching it at the same time.  Is it a function in certain respects of the political polarization that's out there, particularly in the United States, where you have auto dealer showrooms, where they may have one TV and you get arguments breaking out about the fact that it's on CNN or it's on Fox, and as you said, 50% of the people are unhappy? Blake Sabatinelli: I mean, look, I can tell you now that if you watch our network, there are no opinions. There's no commentary, there's only context and information, and that really does come to the point that you're making that the political environment here in the United States is challenging right now. There's no way to make everyone happy. So our view on the way to make this work is to strip out all the things that make people angry and just report facts and just really hammer home the headlines and straight news. There's plenty that happens in Washington on a daily basis that's factual and incredibly important. There's plenty that happens in Washington DC, if you watch Fox News, CNN, or MSNBC on a daily basis, that's filler, that's conjecture and opinion that people for the most part really don't care about.  So I would imagine with some of the other channels that you have, where it's cute pet videos or extreme sports or whatever it may be that, you've got content curators who are scanning YouTube and whatever for material.  Is it different for the new side where you have a quasi news room?  Blake Sabatinelli: Yeah, we do have a newsroom. So we actually hired Michael Grimes, the former head of social for NBC News to come in and join us and lead our newsroom, and we have a team of producers that sit just out in front of my office and are producing news on a 24/7 basis at this point. So yeah, while it's not our normal curation process, there's a news room out there and it's exciting to see and I like the buzz. How do you gather this news? Do you get feeds from the Associated Press and so on, like everybody else?  Blake Sabatinelli: Yeah, that's correct. So we actually partner with a number of down the middle, highly respectful of these organizations, like the Associated Press, AFP, Reuters, and others to ensure that we're aggregating and collecting the best news that's out there and packaging it in such a way that it can be enjoyed on our platform.  So on the other hand with the softer content, how does that work?  Blake Sabatinelli: Yeah. So we have a team of producers that work on each of our channels. Not all that different than what you mentioned that are out actively seeking out content on the most popular social platforms, whether it's TikTok or YouTube or Facebook and working with these content creators to license their content and get it on our platform to then produce it with a very specific formula that we generate for each channel and get it up on our platform when it's ready to go.  If you use material from YouTube or Facebook or TikTok or whatever it may be, are you talking to those platforms for the rights to that material or do you go right to the content creators?  Blake Sabatinelli: We work directly with the content creators and we work with them in such a capacity that it's a mutually beneficial relationship. Most of these content creators are really looking to extend their reach and ensure they're going to get as many eyeballs on them as a creator as possible to build up their businesses, and we ensure that all of our content creators get a significant amount of showcasing in each of the videos that we air there, so when people see something amazing happening on screen, they're able to look up and say, I want to go to Instagram and follow that guy. So we've built these relationships in such a way that we have an active ongoing discussion with the content creators and when something new pops up in their feed and they're sending it out, they're reaching out to us as well. I guess chasing down certain material from somebody who's in the business or wants to be in the business of creating content that generates income for them that way, they're probably pretty easy to chase down. But on the other hand, you have the serendipitous stuff where somebody took a video of some weird weather event or whatever, I suspect it is probably a lot harder to get them?  Blake Sabatinelli: Yeah, that can be challenging, but we also work with the licenses agencies that those folks work with most predominantly. So whether it's your Stringers or Jukin or others, so wildly large, and when I say large, the vast majority of our content comes from the creators themselves. We also have to work with the licensing agencies as well to ensure that we're gathering all those amazing pieces and putting them in one place.  So technically if I am a restaurant operator, bar operator, and I want to use Atmosphere's one or two or many channels on it, how do I do that?  Blake Sabatinelli: Great question! You generally just give us a call. We have a box delivered to you. It's a self-install. We have everything set up for you. So you call us, we will send you a fully provisioned device. We have onboarding steps delivered with the box so you can plug in and get set up on the internet, and once you turn your TV and the box on, it's up and running.  Everything is managed by us from a cloud capacity. So our IT team and our engineering teams push updates and manage the devices remotely, and if you ever have any issues, you can call our customer service team. They're there 24/7 to make sure that any issue that crops up is able to be taken care of immediately.  So it's pretty much set it and forget it? Blake Sabatinelli: That's right, and that's why we love the platform so much, and that's why our operators that use the platform love it so much. It's robust, it's highly engaging and it's easy to use.  And this is an Apple TV bow? Blake Sabatinelli: It's a provisioned Apple TV box, that's correct.  If you had a smart TV, like a Samsung or an LG Smart TV that has apps and everything else, could you use that instead?  Blake Sabatinelli: So we actually do everything through our own device. We found that our device is far more robust, easier to keep up and running and just decided to go that direction.  Yeah, and the Apple TV boxes, they've got pretty good third-party device management and things like that. So you can remedy things, and as you said, push up new firmware and everything else.  Blake Sabatinelli: Yeah, a hundred percent. The entire Apple ecosystem is robust, and we've found a great deal of success in working with both third-party management platforms and on the Apple TV platform broadly.  I'm thinking five-six years ago, this would have been a lot harder to do. Over the top streaming capabilities have progressed massively in that time space, right? Blake Sabatinelli: A hundred percent. The proliferation of high-speed internet has been a key catalyst in the growth of the business. You couldn't necessarily deliver gigabytes upon gigabytes of information across a slow 128 kilobytes a second DSL line, that was challenging. And the additional infrastructure that's been built along the way to support services like Netflix and Amazon, HBO Max, and others has really benefited our business as well. There's a digital signage component, I guess you could call the whole thing related to digital signage as well, but there's the ability for the owner-operator of a venue that's using this to go in and add advertising, right? Blake Sabatinelli: That's right.  So we give our venue partners the opportunity to add a couple 30s spots every every couple ad breaks into the channel feeds itself. Everything that we hear back from our partners at this point is that it is a great tool for them to be able to advertise specials, upcoming events, you name it for their venue and it's just really helps complete that fortuitous circle of keeping butts in seats longer, bringing them back more frequently, spending more money, etc. How do they do that? Is there an app or a desktop application?  Blake Sabatinelli: Great question. We actually have a portal with a digital signage manager that allows you to either upload your own assets, or we have a tool that allows them to create their own assets on the fly within the ecosystem itself. So if you have an agency and you've been working with them, or you have a creative team and you work with them to create assets, that's great. But if you don't, you're at a small bar or a restaurant, or a dental office and you need to get something done. We have a tool in there to help you build this.  With templates and things like that? Blake Sabatinelli: Yeah, we have templates, both video and still, and a ton of options in there.  Do you work at all with third party digital signage CMS software platforms or is it that either you're going down this path or you go down that path. You can't really merge the two?  Blake Sabatinelli: So primarily we work within our own platform. So all of our tools are built custom for our device and custom for our platform as a whole.  If there is an opportunity for us down the road to work with third-party software operators, whether that's for queuing or for other signage options? A hundred percent, but right now we've been operating and developing all our own software.  Do you get beyond the simple component of throwing ads every three minutes or whatever it may be and enable a venue operator to do things like, ”Hey, we're hiring!” or things like that that get into messaging as opposed to advertising? Blake Sabatinelli: Whatever they want to run in those spots, it's up to them. We're not in the business of policing how businesses operate their own signage option. So if they're looking to post that they're hiring, which I know every restaurant in America is right now, then we would encourage them to use the tool to do that as well. It's a subscription, right?  Blake Sabatinelli: So our platform as a whole is actually free. If you want to use the digital signage option, it's $50 a month.  So you send them a free Apple TV box?  Blake Sabatinelli: That's right. We send people a free Apple TV box and we ask very few questions of them. Our goal is to get people on board and running and streaming and getting people enjoying the content as fast as possible, and while it sounds too good to be true, it's not.  We give you a free Apple TV box. We pay for that Apple TV box by providing advertising. So we're advertising a sport or business, it's a vast majority of our revenue stream, and we find it works for both us and for our partners.  Okay. So there's a programming wheel and there's interruptions in that programming wheel that are both for booked advertising, that your team or the Atmosphere team has sold or is through programmatic platforms of some kind, but if you want to do local on-premise venue specific advertising, that's an opportunity as well, and you pay $50 a month for that?  Blake Sabatinelli: You hit the nail on the head there, and we end up offsetting some of those advertising slots that we normally would sell on a national or local capacity for the venue operators themselves. What's your built-out footprint at this point?  Blake Sabatinelli: We're over 15,000 venues right now, reaching I want to say 48 million unique visits on a monthly basis at this point. Did some of that transfer over from Chive or is that starting from scratch a couple years ago? Blake Sabatinelli: So some of that definitely transferred over from Chive. Chive was an incredible catalyst and test case for us to be able to understand product market fit and the dynamics of the marketplace. We have doubled our footprint over the last year and have seen tremendous growth post COVID. Now if you look back at back in the Chive TV days, we were primarily focused on only bars and restaurants and bars and restaurants are still our bread and butter at this point, they make up 60% of our venue footprint but we've definitely diversified significantly and learned a lot post COVID too.  Now there's any number of Software companies and solutions companies that sell into hospitality, sell into restaurants and bars and all those kinds of venues, as well as clinic waiting rooms and so on. They would sell a software solution that would enable the operators to go in and do all of their on-premise messaging and everything else but they would then have to subscribe to a third party content service, like a ScreenFeed, or one of those kinds of companies to provide the other content for the wheel.  Is that something you sell against or are you finding people are saying, “You know what, I love the ScreenFeed material and everything else, but we just can't keep up with all this. We don't want to manage it. If we could just get something that just shows up, that would be better”?  Blake Sabatinelli: Yeah. So there's a couple of constituencies that we sell against.  Primarily for us as is against the pay television ecosystem. There's not a lot of great options that exist for waiting rooms or public spaces that exist in the pay TV ecosystem. Some of the contents are wonderful with the audio on, but when the audio is off, it's not, and there's also no signage options in there, which clearly is a challenge. There's also the folks that are endemic to the space, to your point, the operators that work with the waiting rooms, especially around point of care and we do hear a lot that people just really want to make sure that the perceived wait times are going down and they can provide signage options, and for us, making sure that our venue operators have higher net promoter scores that proceed wait times are lower in bars or in restaurants, that you're staying for longer is really the key. Beyond that, the additional messaging is a bonus.  I'm going to assume that you guys have done the work to try to develop and highlight some of those metrics, right? Blake Sabatinelli: That's a hundred percent correct. So we've worked with in-market to understand dwell time and other metrics within our restaurant venues, we work closely with our metrics partner Epicenter on how people are engaging and activating with our content, and then a number of case studies along the way to really drive down the funnel, the efficacy of the platform and everything.  So what does happen? Does it increase dwell times if I'm ordering a second round of drinks or another plate of nachos or whatever?  Blake Sabatinelli: Our last study showed that we had 16% longer dwell time in bars and restaurants and 18% higher return frequency amongst customers and a lot of our venue partners who shared back some of their net promoter scores have gone up based on our content being in place.  So really there's no argument against it. If they're going to have flat panel displays, whether they're TVs or commercial displays in their venues anyways, and if they get the Apple TV box free, then you know, I would imagine it's hard to say no? Blake Sabatinelli: Like I said, we've grown really fast the past 18 months post COVID and the business has been booming. So I agree with you. It's hard to say no.  The biggest challenge that we have, and it's really about getting people to understand that this thing that they didn't know existed in a segment that really doesn't have anyone else playing in it. It exists and it's going to be beneficial to their business. Once they understand how this fits into their restaurant experience or their waiting experience, it's an easy close.  So you mentioned how the growth happened in the past 18 months, I keep saying 18 months, it's probably like 20 months now. Blake Sabatinelli: It's been a long time. I've lost count at this point. I think everybody has, as I'm sitting in my home office saying that.  COVID was an interesting thing for our business. Look, I don't think anyone in the media space would say that things didn't go a little haywire in April of 2020 but it did also give us the opportunity to evaluate our business model, our distribution strategy, and to really think about how we could expand and pivot a little bit. So while bars and restaurants were closed, aftermarket auto and doctor's offices, dentists offices, and others still had people coming into them, especially outside of California and New York, so expanding our distribution strategy has allowed us to not only keep up and running through COVID, but to dramatically increase the velocity of our distribution as we've gone out of the initial wave of COVID and into the present day.  Is there a type of a vertical category type of venue that seems to adapt it more so than others? Blake Sabatinelli: I'll be honest with you. We've seen strong growth in that across a number of categories. So everything from traditional bars and restaurants to QSR, we've seen explosive growth in gyms, in aftermarket auto, in point of care. Moving now pretty aggressively into airports and other spaces. We've just seen strong, measured growth across every category and every segment that's been incredibly encouraging.  When you onboard new clients or new venue clients, do you do any work to audit the type of audience that they may have and make recommendations about the channels that suit them best? Because I'm really curious whether a venue puts in a channel that's about cute puppies or whatever, and the audience would be saying, “Why are you showing that?” Or “Why are you showing news? I don't want to see the news.”  Blake Sabatinelli: There's plenty of venues that Chive TV works really well in, but in veterinarian offices, Paws TV plays better and so we make that recommendation. The same goes for news in airports in the doctor's weightings rooms. So we're incredibly thoughtful about how we present our content and where we think it should play, and our customer service and account management teams work closely with our venue partners to ensure that they know new options are available and that options they may not know about that may suit their venue better are available as well. Do you try new content channel formats and try them out with test partners and sometimes just throw them out, cause that doesn't work?  Blake Sabatinelli: We wouldn't be a tech driven platform if we weren't doing a significant amount of AB testing. Our product team and content teams were constantly working within new partners to do tests and learn to better understand product market fit of a channel or a new format and to better understand how we can continue to improve the product. It's a constant process and it's just part of operating in the ecosystem that we do.  Have you learned things about length of material, like duration of material?  Blake Sabatinelli: We actually have and there's a reason that if you look at the content on our platform, it's formatted the way that it is. People want to quickly move from one thing to an X and I think that's partly a by-product of this new world that we live in where short form, highly addictive, highly engaging video is the norm. You're used to looking down and getting that dopamine rush. So fitting that format onto a big screen is important for us. And then just people are really looking for variety too. That's why we have custom playlist features that allow you to compile a number of different options into one because not everyone wants to see the same thing for a long period of time. So we try to keep the format moving, we try to keep the content moving. We try to keep it varied and engaged as much as we possibly can again, to reduce perceived wait times on one end or in some cases to ensure people are sticking around the same. I'm hoping I can get another round of people doing amazing things.  How do you deal with portrait material, stuff shot in portrait mode? Blake Sabatinelli: At this point pretty much everything is shot in a vertical format. So you get pretty used to working with curtains. We've done a good job of being able to cycle back and forth between the vertical and horizontal formats as effectively as possible, and I think people have gotten used to seeing video shot both vertically and horizontally. Ten years ago, I remember you would shoot a video on a cell phone while working in the news business, you would be screaming in the control room. Why didn't they turn their camera sideways? In this instance, everyone's used to this, this is the new normal and it's really not that big of a concern.  And I guess the advancements of camera sensor technology and smartphones has been good news for you guys as well. Like you say, 10 years ago, I remember I had a Blackberry about 10 years ago and that camera was dreadful.  Blake Sabatinelli: 320x240 resolution and if you watch that on my little MacBook that's sitting in front of me right now, I believe the kids would say it looks like it was shot on a potato.  Look, the advancements in camera technology have just really been a boon to businesses like ours. I have one of the crappier iPhones in my pocket and I think it's probably a higher resolution camera than the SLR that's sitting in my closet that I've never used. So it's been fantastic for us.  Yeah, that's exactly right. I've got a mirrorless camera, nice SLR, and I never use it because it's just so much easier to whip out my phone, take a shot, and it's got like a 16 megapixel sensor and it looks great!  Blake Sabatinelli: Yeah. What a time to be alive that I don't have to carry a giant camera or a camera bag around with me anymore. So I'm not going to complain.  You recently announced, I believe that you are expanding Atmosphere TV into Canada, right?  Blake Sabatinelli: That's correct. We're actually moving aggressively there right now.  When I look at your installation map, it throws me off a little bit. It looks like you already have a lot of points of presence in Canada, or is that just the way the map looks? Blake Sabatinelli: So we do have some presence in Canada to start off with, but now we're making a concerted effort to actually come in and take as many shares as we possibly can in the marketplace. But early on we were testing, are we a hundred percent sure that the content is going to work just the same as it does in Canada? It does. Is our distribution and sales model gonna work exactly the same? It will. Is the ad sales model exactly the same? It is, and so at that point, we all sat down and made the decision to make a more concerted effort to move into Canada, to take more share and to really replicate the model that we have down here in the States. Yeah, that would be the easy one. The harder one would be going South.  Blake Sabatinelli: Yeah. Look, our primary target out the gate is English speaking countries. We have Canada, Australia, New Zealand, there's plenty of others that'll be coming down the pipeline. But moving into second languages is definitely going to be a focus for us, especially as we start to understand what the economics look like in each market, how we can program in those markets in such a way that we do here in the United States and in Canada, and then we'll continue spreading in that direction.  How big is the company at this point?  Blake Sabatinelli: The headcount changes every single day. I think we're at 220 people. We've about tripled our head count since I joined in March, I think I was employee number 84.  So there's 110 plus people who you've not met yet because you're working out of your bunker?  Blake Sabatinelli: I go into the office four days a week and I am incredibly thankful that I'm able to go in and actually see people face to face and so we have a large contingency here in Austin, satellite offices now that are popping up in New York and LA, and Chicago is on the roadmap. While we're almost all here, there's a decent chunk of us that are external, and I've had the pleasure of meeting everyone in person. How much of that would be Editorial versus Sales versus IT or Ops, I guess you'd call it?  Blake Sabatinelli: Editorial', probably a quarter of our company. IT and Operations, probably another quarter, and then the rest is spread across Distribution and Ad Sales and GNA, and other. Has it been hard to manage all this largely virtual? Blake Sabatinelli: So we've been back in the office since March at this point. There has been a significant amount of growth with all of us virtual. I'm not going to tell you that there hasn't been a growing pain or two and that it's all easy, and this is a cakewalk, Dave, but our team's incredible, our HR team, our finance folks, recruiters, everyone that works on our team to find, identify and bring and onboard new employees, they're wonderful and so it hasn't been as bad as I'd think as other experiences I've heard across the industry.  My twenties and thirties were spent in newspaper newsrooms and I struggle to wrap my head around the idea that you would have a dispersed newsroom where you're only talking to each other by video meetings and Slack. Blake Sabatinelli: We did it in April of 2020. The entirety of our Newsy at home and we spun up live operations in people's living rooms and it was absolutely bananas, and that was as difficult as you would imagine, and was ripe with challenges, but that team got it done too and made it look easy. I think one thing that I've learned in this new COVID world is to truly expect the unexpected, and so long as you're comfortable with that, and so long as you know that something's going to blow up at some point in time and you're ready for it, then it's not that bad. So what can we expect from Atmosphere TV in the next year, are you going to be launching more products?  Blake Sabatinelli: Yeah. So I think you're going to see a pretty significant expansion in our content offering. We've had the opportunity over the last year to really understand product market fit, to do a significant amount of tests and learn, to gather the data that we need and really prepare ourselves to start running. I feel like we've been at a full sprint, but now it's time to move like Usain Bolt for the next couple of quarters. So a significant expansion in our content offering in the size and scale of our company and our distribution footprint. We have big plans ahead and I expect you'll be able to watch Atmosphere pretty much everywhere you go here soon.  Are you still hiring people?  Blake Sabatinelli: We are hiring like crazy and have plans to continue at a pace like we are now through the next two years.  Great. All right, Blake, thank you so much for spending some time with me. Blake Sabatinelli: It's my pleasure. Thanks for the time Dave.

For the past 18 months, only one trend has impacted the entirety of the HME industry, and of course, that trend has been COVID-19. Joining the podcast to discuss how the pandemic has affected accreditation for HME providers are José Domingos, the president and CEO of the Accreditation Commission for Health Care (ACHC), and Tim Safley, the program director for ACHC. Both guests explain how their company responded to the public health emergency, how that influenced CMS, and explore how they—and the industry—continue to learn and apply ongoing lessons learned during the pandemic.

In this Hasty Treat, Scott and Wes talk about Next.js 12 and all of its hot new goodness and updates! Sanity - Sponsor Sanity.io is a real-time headless CMS with a fully customizable Content Studio built in React. Get a Sanity powered site up and running in minutes at sanity.io/create. Get an awesome supercharged free developer plan on sanity.io/syntax. LogRocket - Sponsor LogRocket lets you replay what users do on your site, helping you reproduce bugs and fix issues faster. It's an exception tracker, a session re-player and a performance monitor. Get 14 days free at logrocket.com/syntax. Show Notes 04:00 - Rust Compiler: ~3x faster Fast Refresh and ~5x faster builds 06:25 - Middleware (beta): Enabling full flexibility in Next.js with code over configuration 08:16 - React 18 Support: Native Next.js APIs are now supported, as well as suspense 09:56 -  AVIF Support: Opt-in for 20% smaller images 11:58 - Bot-aware ISR Fallback: Optimized SEO for web crawlers 13:10 - Native ES Modules Support: Aligning with the standardized module system 14:39 - URL Imports (alpha): Import packages from any URL, no installs required Links https://twitter.com/mattgperry Introducing Middleware Tweet us your tasty treats! Scott's Instagram LevelUpTutorials Instagram Wes' Instagram Wes' Twitter Wes' Facebook Scott's Twitter Make sure to include @SyntaxFM in your tweets

This week I share 5 ways to increase your website load time [powerpress]

Last weekend was Veterans Day. As we honor those who served in the armed forces, defending our country, we should recognize that there is also a spiritual war that continues. Join Rabbi Kevin Solomon as he reflects on the role of the watchman in the Scriptures and how this role also applies to us as followers of Yeshua. Shabbat Shalom! https://www.bible.com/bible/314/EZK.3.16-21.TLV (Ezek. 3.16-21); https://www.bible.com/bible/314/EZK.33.1-3.TLV (Ezek. 33.1-3); https://www.bible.com/bible/314/HEB.13.17.TLV (Heb. 13.17); https://www.bible.com/bible/314/1PE.5.8.TLV (1 Pet. 5.8); https://www.bible.com/bible/314/MAT.7.15.TLV (Matt. 7.15); https://www.bible.com/bible/314/PSA.127.1.TLV (Psalm 127.1) http://www.bethhallel.org/CMS/programs/prayer/prayer-requests/ (Prayer Requests) or send an email to info@bethhallel.org http://www.bethhallel.org/CMS/ (CBH Website) https://www.paypal.com/donate/?cmd=_s-xclick&hosted_button_id=FBVL4JZH8HVS4&fbclid=IwAR2MB7yq6Zkq-ZNvwnw8Yz6z0crcMmGPpKhqIDD4w3sr5fXDBE0qOr1C5cM (Donate) https://www.youtube.com/channel/UC7EfRTmLFyvapAVb7q64PoA (YouTube Channel) Support this podcast

Washington Post columnist Jonathan Capehart speaks with CMS administrator Chiquita Brooks-LaSure, James Perrin, MD & Kawsar Talaat, MD to discuss children's health equity, maternal health and the path forward to ensuring greater health outcomes for children.

As the Pride of Duskwall speeds through the Dagger Isles, the Line Bulls on board must deal with the results of their altercation in the mist. Passengers are often lost, and a locomotive may enter a city a few passengers lighter than they left with. Conversely, stowaways are rare and extra passengers may be viewed with suspicion. The Bulls approach Mistport hoping to put the situation behind them. Pippin is caught in a lie. Andrel makes a promise. Drix makes a friend. Find our sponsor Little Business Library on Twitter https://twitter.com/lilbusinesses (@lilbusinesses), and use our code "listen10" to get your business on their directory https://littlebusinesslibrary.com/ (here)! Ghost Lines by John Harper. Music by Sebastian Black. Art by Yoshiko Agresta. https://secure.actblue.com/donate/bail_funds_george_floyd?refcode=cwg&fbclid=IwAR26tAnbuOt9SDjt7F6wDEbEqeZ183QAITXTm8R-rrLM-9JrrEr3zthzIDQ (https://secure.actblue.com/donate/bail_funds_george_floyd?refcode=cwg) https://www.joincampaignzero.org/?fbclid=IwAR1RI-kn0ukkY0BPTh3pO6BAHMop3funxm6-zy8z6cRmghpcojVhbU3_hKU (https://www.joincampaignzero.org) https://www.napawf.org/donate (https://www.napawf.org/donate ) https://www.navajowaterproject.org/ (https://www.navajowaterproject.org/) https://l.facebook.com/l.php?u=https%3A%2F%2Factionnetwork.org%2Ffundraising%2Fcontribute-to-the-atlanta-solidarity-fund%3Ffbclid%3DIwAR3FMa9F34YB6K73zsYHtcfNosNwf0mwYHjtRzSm0SvoXeMcd_8vi9s-CMs&h=AT1j_pUV7Bmk5xLa4UliXieo2G3tzcPvL62jRR0ExRB8l9C8_TMedB2vkKwNg8wRwSXhMyiydkNVtvta6eaQcKju2_YSQp6-rc6pFzhpM6Xrfp9xSDC45MfBv11h-wdUWvc (https://actionnetwork.org/fundraising/contribute-to-the-atlanta-solidarity-fund) https://nymag.com/strategist/article/where-to-donate-to-help-asian-communities-2021.html (https://nymag.com/strategist/article/where-to-donate-to-help-asian-communities-2021.html) Follow us on https://twitter.com/ghosts_train (Twitter @ghosts_train), and if you have questions or suggestions for the train email them to ghosttrainpod@gmail.com or leave a voice message at https://anchor.fm/ghosts-on-a-train/message (https://anchor.fm/ghosts-on-a-train/message) and you might hear yourself on the show We are a proud member of the https://www.faustiannonsense.com/ (Faustian Nonsense Network) of podcasts! Join the Faustian Nonsense Network discord https://discord.gg/7wyS37xXRX (here), and support us by joining the https://www.patreon.com/faustiannonsense (FN Patreon)! Help the Show by Rating and Reviewing on https://podcasts.apple.com/us/podcast/ghosts-on-a-train/id1507682855 (Apple Podcasts)

On Ep. 60 of iPullRank's Rankable Podcast, Garrett Sussman hosts Kristina Azarenko, SEO Consultant and founder of MarketingSyrup to discuss the topic “The Technical SEO of eCommerce”Kristina Azarenko is an SEO educator and consultant. She runs her boutique consultancy, MarketingSyrup.She's written the book on eCommerce SEO, covering a range of tactics to implement for any online store.She has built and maintained the SEO on-page info chrome extension, SEO Pro Extension.Published on many industry websites, Kristina will explain why technical SEO is the hardest skill to pick up.We also discussed:Learning Technical SEOTechnical SEO challenges unique to eCommerce websitesThe best CMS options for eCommerce stores, depending on their size, resources, and expertise.Black Friday strategies

Tolando77, who reached the Elite Division playing with his feet, joins the podcast along with AirJapes, MattFUTTrading and your host Ben to discuss: How Tolando plays FIFA22 with his feet The gameplay adjustments required His tactics and playstyle Aggressive or Conservative Interceptions? Scoring Longshots Importance of finishing stat Defending Driven Passes  Worth putting CMs on Free Roam or Drift Wide? Some Sulinho and Rulebreakers Machis chat Much more! Get this week's Content Episode, double the podcasts, and keep FUT Weekly going (for just £3 a month) by becoming a Patreon over at bit.ly/morepod. This includes an exclusive supporter podcast this week! Pound For Pound Powerhouses this week Listener suggestions Rulebreakers Corona Review Rulebreakers Verratti thoughts Flashback Mahrez — a better Flashback? First Promo Preview Packs Rulebreakers Gosens First Season Objective — Reece "Rio" Oxford Rulebreakers Suarez and Foden Reviewed TikTok Trading profits Market thoughts Preview Pack Panic Base Icon Pack speculation Much more!

What is the latest on vaccine mandates? In this episode, Husch Blackwell's Meg Pekarske is joined by colleague Tom O'Day to discuss the newly released OSHA and CMS rules. They'll uncover the surprises, discuss how to implement the requirements and analyze the challenges that may be on the horizon for hospices. Tune in to this lively and helpful conversation.

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT The Munich-based digital signage consultancy invidis has been doing an annual yearbook publication for the past decade that is something of an industry bible for the European and Middle Eastern markets, and with each annual edition it gets a little more detailed and broader in its scope. The company does a German version and another one in English to service the rest of the region. There are many, many industry reports out there purporting to have a real understanding and data about the digital signage industry, but most of those reports are expensive and frankly not worth the money.  The invidis yearbook, in contrast, is rich in detail, and full of insights from people who know the business at an expert level. And the best part, it's a free download - with the report bankrolled by sponsor advertisers. I caught up with Florian Rotberg, one of the principals at invidis, to talk about this year's insights, and why the focal point for 2021 was on what they call green signage. Subscribe to this podcast: iTunes * Google Play * RSS TRANSCRIPT Florian. Thank you for joining me. You're just back from Dubai!  Florian Rotberg: Thanks for having me. Yeah, it was very exciting in Dubai at Expo 2020, and we spent a few days there. It was still very hot, but it's fascinating to see how immersive signage can be in today's show. Yeah. There's digital signage all through the Expo site, right?. Florian Rotberg: It's fascinating. It's LED with a lot of projections. During normal times, you don't see that much projection, but in this special country pavilion, there were 180 of them, it's fascinating to see. It's also great to see what works and what doesn't because some of the countries run out of money or never really had a good plan and you feel it immediately. So you enter the room and go, “oh, that's crap, I'm leaving,” and unfortunately, sometimes you have to wait two to three hours at some of the very popular pavilions. So then it's not a good experience, but in general, it's fascinating to see what's the coolest thing. It's not only LED and projection, but it's also how that's really integrated in architecture and not only how it integrated into the room, but also a lot of mirrors. So one of my favorite things, and I've talked about it many times before, it's really how you combine signage, how you combine LED or projection with mirror. You can do fantastic things and you see some really cool pavilions.  Yeah. There was a new observatory that just opened up in New York, overlooking Madison Avenue in Midtown and it's got a big LED wall, but it's also three levels of mirrored ceilings and floors and walls and everything else and reflects like crazy. I was trying to wrap my head around it, but it's that kind of thing where it becomes just an infinite space.  Florian Rotberg: Exactly, and it feels immersive and it can create great experiences there, and we took 1400 photos and 70 hours of video, so we'll put everything together in the next week we would publish it on Invidis Meets World on YouTube where you can watch it and we will show a lot of other stuff also obviously. What is invidisXworld? Florian Rotberg: So invidisXworld is something we started before the pandemic, and we decided because signage is so much about content, so much about the whole room, it's not only the digital canvas, but how people move in front of the screen and what a brand or the vendors really want to achieve.  And so we decided, we have to travel. We have to go there. We have to talk with the people who designed it, and we have to just experience ourselves and then to tell the audience how it really feels. So we just hired the camera team, and we went off to Sweden and to Berlin which is still both in Europe, so it was easier to reach, and we spent a week there and talked with dozens of experts and visited museums. Some of the museums just opened for us because they were all closed because of a lockdown, and we went to Volvo, to H&M, to different places, to headquarters and talk with the guys who are responsible for that. It's a fascinating show and people like it and we get quite good feedback.  So we're working in a visual medium, and you're actually using video?  Florian Rotberg: Yes!  How clever.  Florian Rotberg: To be honest, I always thought photos are so cool, it's so easy, but unfortunately video is so much better, but it's very expensive. It's not just you spending a week somewhere, you have a whole camera team, and almost like a broadcast team, we have a video guy, sound guy, a producer, and you have to feed them and that is sometimes difficult. So you have to manage them almost like kids, but at the end of the day, you get some really good footage afterwards and it's worth the trouble. For people who haven't been to Dubai, as you say, it's fascinating. I find it extremely weird, but the degree of digital signage there, all these projects, and a lot of them are big budget projects, are they instructive or are they one-offs where you look at them and go, that's really cool, but, that's not something that's ever going to scale? Florian Rotberg: It's changing. In the past, it was just about the “wow of the moment” and afterwards, they all forgot about it. Nobody cared about maintenance, and after a year it just looked horrible, because nobody invested in content and nobody cared about it, and to be honest, even till today, the majority of the digital touchpoints are still not really connected to any backend systems or so and there are various reasons for that. One is when they open something and then they forget about it. People change jobs really fast. So even the person who is responsible for that leaves a job after a year or so, and so nobody has ownership anymore, and last but not least, these countries are relatively small, so reaching scale is very difficult, even for big chains, maybe maybe 40 stores or so getting scale is difficult.  And they're interested in the “wow” and unfortunately not so much until four to five or seven year long contracts. But you said it's changing?  Florian Rotberg: Yep. It's changing, getting smarter, getting more connected. To be honest, the region is the most digitally advanced region with a very young population. They have two-three mobile phones, and they're very open to all of this stuff. So it is changing, and we talked, while we were there, to one of the biggest telecommunication companies there, and we were at one of their flagship stores and they now have 170 stores and they have really good connections, and they really think in customer journeys.  We also visited a smart hospital, which was really cool. You identify yourself when you enter the hospital with your ID card and then it takes a photo of you and then you walk through the hospital and it detects you and makes sure that you're in the right room, that the right person is there and everything. So very smart and they're really starting to think about journeys and to improve processes. So at the smart hospital, the process before was three days with all the examinations until you got to stand for your visa renewal, and now it's down to 30 minutes, which is incredible, and this is only possible with digital. So I wanted to chat for a number of reasons, but the principal one was the yearbook that Invidis puts out. Could you explain what that is and how it works?  Florian Rotberg: Some people call it the Bible of the industry. I'm not sure if I would call it that, but yeah, it's an annual book we have been publishing for 11 year now and it's free to download on Invidis.com and it basically gives a yearly update about the latest trends. We have lots of rankings there, especially this year since it was quite interesting. You know, like the largest CMS providers worldwide, and which verticals are most important for digital signage, etc. We just give an analysis of the market, what has happened and also an outlook on what trends are coming up and what to understand, and the main topic this year is Green Signage. I know many of your listeners are based in North America, but over here in Europe, it's a huge topic. During the pandemic, the interest in more sustainable solutions has improved dramatically, and so more and more brands are looking to also operate their signage networks more sustainably, and what's most interesting when we did all the research is that 80% of the carbon footprint of a digital signage project is during operations. So for five-six years, the whole thing is operating. It's not so much the production, it's not so much the shipping. Yes, it's still 10-20%, but 80%, that's the biggest lever, and so it's not only about buying a more sustainable, more conscious signage solution, but it's really about how to improve existing installations. And there are so many things you can improve and you can reduce power consumption with the right content. Turning it off at night, it's so unfortunate that the majority of the signage runs 24/7 even if there are no people around. Kiosks systems, they all run 24.7. There's no reason if a kiosk system is somewhere on a factory floor and the floor is closed or in the evening, or at night, it's still running. In the beginning, especially with LEDs, obviously they consume a lot of power. So there are a lot of levers and ways to be more conscious and more sustainable.  Do you think part of that is simply the early days of the legacy of digital signage software and hardware is that you were afraid to kind of power it down cause it would come back?  Florian Rotberg: Exactly. Yeah, that's the main thing, at least that's what the technical integrators always say. Some, especially on some more recent screens, turn off the sensors, the light sensors and everything because the marketing department wanted the red as close as possible to their official red and obviously that doesn't work if you change the brightness of the screen but things are changing really fast. And what's most interesting now with the pandemic and about sustainability is that signage has become a CEO topic for the first time. In the past years, they never really cared about digital signage, but now they really have to report it to their shareholders: how they could improve operations, where they could reduce the carbon footprint and digital signage plays an important role. Interesting. The yearbook is primarily focused on Europe and the Middle East, right? Florian Rotberg: Yes. That's how we started. We started this in Germany and then we extended it and now it's more or less all over Europe and every year we add a few more countries. Last big thing was the Nordics, and currently we're working on France, Spain and UK, so next year, we will also have rankings for these countries, and yeah, especially in Europe most markets were quite national markets and now some bigger international players are really growing and Europe is seen as one market, and so it's important to have all of them and that includes the UK.  Yeah, despite Brexit. Is what happens in Europe indicative of what is happening globally or is it its own thing?  Florian Rotberg: The whole green stuff is probably the most advanced in Europe. Yeah, you don't hear about it in North America. Honestly, I've never heard anybody bring it up. Florian Rotberg: Yeah, but over here, especially in the Nordics, it's very important, and just for example, electricity is 10 times more expensive in Germany compared to Korea, for example. Even the designers and the engineers who create new solutions, they're not aware of how important power consumption is and life is changing, and I think this whole climate debate we are currently having, I think it will become more important, not only in Europe, but also in the US.  I know that Europe and the Middle East primarily, I've heard other people talk about the real action these days being in China and in India and I wonder how hard it must be, particularly with China, to try to wrap your arms around who the major players are, what activities are going on, any of those things?.  Florian Rotberg: Yeah, China is a very difficult market. There's a lot of potential but it's very difficult as an analyst, really, to look at the market and it's so different. Interestingly enough, there are a few bigger digital signage integrators based in Europe and North America who also have offices in China and they're pretty much doing this stuff for all the big luxury brands and so. So there's some European and then North American guys who really are trying to do stuff in Shanghai and the big cities, but the general market is just huge, and you probably talked to Chris Regal or so, because he's very successful in India and in China, but he's targeting more of the mid market and the European players, they're just looking at how to bring Italian and French brands to China. And those European brands and other brands, would they rather bring familiar companies into the country to do that for them, as opposed to hiring local firms?  Florian Rotberg: At the end of the day, that's the case, but that's also with North America, that's the success of the media to be honest. Media's strength in Europe is that they represent America, the American customers here. So what is happening in terms of the yearbook? Obviously we're hopefully coming out of a rather rough couple of years. I noticed in the report that the countries in Europe, at least that had a particularly rough time were France and the UK versus some of the other countries that were down, but not to the same level. Why did that happen? Florian Rotberg: Because of the lockdown. We had different levels and different lengths of lockdown, and just looking at Australia, they had a three months lockdown. Now that obviously has a huge impact because the stores were closed, and even if it's a brand that's willing to spend money and to upgrade the stores, they couldn't because technicians weren't allowed to enter the stores.  I know, in past discussions around this, that Europe's an interesting market in that dominant players in many respects are dominant by country, as opposed to across the continent?  Florian Rotberg: That has been the case, absolutely. But this is currently changing. So we have, we call them the Top 3, they are the three largest pure play digital signage integrators, and they've all been acquired more or less by private equity and now they're buying competitors in the big markets. All three of them really try to grow into a pan-European or international player.  But in relative terms to the North American guys, AVI, SPL, Diversified and Stratacache, they're tiny, right? Florian Rotberg: They are tiny. They hope to change that but they are very small. But to be honest if you look at AVI, SPL or even Diversified, they're not pure digital signage, they do a lot of Pro AV, IT stuff, so you should compare apples with apples, but still X times larger than the biggest in Europe. AVI, SPL just announced, I think, it's called the Experience Technology Group. So they seem to be recognizing that they need to get more serious about signage and venue based displays. Florian Rotberg: Oh, yeah, and I love what they do. They're really smart in creating this platform to manage different AV solutions and everything. So I think that it's a smart approach, and also now looking out to create more immersive experiences because if you have expertise there, you can really export it throughout the world. So that works quite well.  But in Europe, we still have the problem of 25 different languages and really creating concepts, which you need to understand the culture and yes, there's a big difference between Sweden and Spain or Italy and Ireland also. So really to understand that, and that was a reason why there were large local players and still, if you look how these big three or at least three for European sizes and how they're growing, they all built up little local creative teams and sales teams in each countries because you need to have this local expertise, you need to speak the language of the client, and you need to understand what they really want to achieve.  You've done a ranking of the Top 10 Global CMS software platforms, and I'm making some assumptions that there are some CMS platforms in China that you and I probably have never even heard of and that they are probably huge as well. But were you surprised by who showed up on this list?  Florian Rotberg: Some surprises, yes. I mean there's a small asterisk next to it. So it's just the best of our knowledge, obviously. I'm sure there are many but one big problem is always Samsung. They never report anything, and it's really difficult.  So the largest one is Stratacache. It's a little bit more than 3 million active licenses, and one of the surprises was that the top three players were Navori. I'm not sure if many of your listeners have heard about Navori. They're based in Switzerland. They're pretty big in North America actually.  Florian Rotberg: Yeah, not so much in Europe, funnily enough, even though they came out of Europe and yes, they have more than 1 million active subscribers. So that's quite cool, and then you see some more vertical ones who are growing through acquisitions a lot and socialists like BroadSign, it's great to see. We have followed BroadSign for more than 15 years now, and it's great to see how they have become the standard in the digital out-of-home industry. It's quite impressive. Yeah, they've risen to a level where they pretty much own that vertical and I always try to coach software companies that you really don't want to be a generalist. You want to have a focus on something and they probably more than anybody have done that in digital out-of-home.  Florian Rotberg: Yeah, but the same with Four Winds etc., they all are specialists, or at least they are focusing more and more on certain verticals. Yeah, Four Winds barely calls itself a digital signage company now. They're talking about the workplace and the same with Ops Space.  Florian Rotberg: Yeah, exactly. Yeah. I think there was just an announcement in that space today.  So what are you seeing in terms of trends in the industry? As you mentioned, the shift to, or the interest in green signage is one thing. What else are you seeing happening out there?  Florian Rotberg: The biggest challenge currently across the world is to manage the supply chain shortage. Unfortunately, that won't go away in 2022. If you read the Financial Times, if you talk to all the people, you just read it every day and most people expect that to last at least until the end of next year. And that's pretty bad news because the order books are as full as they were before. There's a lot of demand for signage at the end of the pandemic, and unfortunately 2022 will still be a difficult year. Secondly, we have a shortage of talents and whoever you talk to, I'm sure you also get calls about companies saying, we're desperately looking for a new manager and I get them every day and that's a huge issue and then shortage in diversity, shortages of women, of everything. It's still a very male dominated thing, and today InfoComm opened and I'm sure the majority of them are men, as always, and so we see these three shortages: supply chain, talent and diversity. When I get asked to organize panels particularly with an organization like the AVIXA, which has diversity initiatives and everything else, they really encourage me to make sure that I'm finding women and people of color and so on, and I'm completely supportive of that, but it's hard. Florian Rotberg: It is hard, yeah. It's not easy. I fully understand, but alsowhen you look more in the new work, in the hybrid world, it's all about hybrid and that's very challenging for everyone. It's easy to have everyone at home. It's easy to have everyone on location, but managing these hybrid workspaces is very difficult. How can you create meetings where everything feels included and often you communicate with eyes and with every single one that's very difficult to do when alf of the people are somewhere at home or so. So you need lots of creativity and innovative solutions to manage that. So that's also something which will definitely remain.  And we're seeing gimmicks coming up there, like this idea of the metaverse and using quasi holograms, so that it feels like you're sitting across from a real person when it's not obviously, do you see any potential for that stuff? Florian Rotberg: To be honest, it's a one way road because it's nice for the guys who are in the office, but for the guys who are sitting at home in front of this small screen, it doesn't help them at all, and you need to have both sides and you need to empower both sides, and so I think at the end of the day, it's difficult to solve and we haven't seen any solution. I think the cool part is teleportation stuff, and last week in Dubai, there was also an IT show. It was just the biggest and it was unbelievable how full it was like before the pandemic, and they had these cool mirrors and everything. So it looked like somebody was in the room, when obviously he wasn't. And so it's great to see, but it doesn't help people at home, and so that still remains a challenge.  And I wanted to go to that show. I've seen some videos of some booths from some companies, and it looked insane.  Florian Rotberg: It was, and a lot of booth people were waiting an hour more. Can you imagine that? Just to enter the booth because it was so full, it was unbelievable. We all had to wear a mask, no question about it, but we waited more than an hour just to get in. So yeah, it was amazing, and we produced lots of videos and we will publish that in the next couple of days. It's really cool stuff, especially in regards to retail technology, all the cool stuff, all the fancy things were robots and solar, but also AI and how it really works, and then some simpler solutions in all of these checkout carts and everything, and also these devices which measure you so you don't have to find the right size without using camera technology, because obviously that's something which most people don't like. And it's interesting to see what kind of solutions there are. Much of the stuff, it's really something where you're thinking, oh, it'd be great. If they would roll that out in the future, the majority of them are still in the prototype phase, but hopefully we will see lots of this coming up. Your report coined a term, “Deep Signage” which I had not seen before, but I understand it and this idea of integrating back office systems with other business systems within a company. It sounds like that, particularly in Dubai, is really coming into play.  Florian Rotberg: Yeah, we try to form this term, deep signage, because for us, it's important that you connect as much as possible, as long as digital is just a layout on something existing. It won't really offer the experiences everyone needs and the benefits. So you have to connect it to the back office, and especially when we talk about moving away from just digital signage CMS, all the way to a digital experience platform, then you need to mix everything and then really connect. So deep signage is something we believe is one step towards digital experience.  Yeah, and how do you define digital experience platforms?  Florian Rotberg: Oh, that's difficult. Yeah, when you download our book, we have a little picture there, and it's four stages. We start with a digital poster, which is the most simple one. Then we have digital signage, then we have a digital signage experience platform, and then the ultimate is digital experience platform, because there's a totally different approach to it, and when we talk about DXP, it's not digital signage or mobile or online, which is in focus, but it's really the data, it's the experience which is in focus regardless on which channel you play it out, and it's really orchestration of all of the different channels and different stories and media platforms, and that's what digital experience platform is about. But then many customers ask us who does it and who's good at it, and it's very difficult. There are only very few companies and most of them are totally vertically organized players like Zara,, I'm sure you know them, because they do everything, they own the factory, they own the warehouse, they own the shops, and they own the data and for them, it doesn't matter if you go into a store, try something out and decide to buy it online, because they own the whole value chain and this is one of the few companies who really are able to deliver a DXP and make the most of it, but more will come definitely.  If you're a smaller company, is it something you can even contemplate at a different kind of scale? Florian Rotberg: No, it's not worth it. I think you need to be very large, to be honest, and to really put up a DXP project, you probably need a few million just for setting it up.  You mentioned private equity companies and some of the integrators in Europe, or are you seeing a lot of private equity activity? Florian Rotberg: Yes, it's unbelievable. So much money in the market. That's the reason that conservation is speeding up so fast, it's unbelievable.  Why do you think that is right now? Is it distressed companies?  Florian Rotberg: No. We were surprised not at all, but maybe that's also a European thing because the governments took care of that and so most of them kept their employees, which is a good thing now, because they didn't have to retrain new people so it's not about that.  It's more about that the crisis wasn't really an economic crisis. It was more of a human crisis, and so most companies still have a lot of money, except if you are a Chinese real estate company, then maybe you don't. But in general, they have a lot of money. The private equity companies, they're looking for new ways of spending it, and they all buy into the digitization of stationary retail. They fully understand that times have changed and you can only survive if you're fully digital, and so that's probably why they like it. And then there are also some of the trends like we have the first valuation of more than a hundred million in Europe for an integrator, and this is one of the thresholds where, you know, private equity likes to come into the market. Zeta Display, they were almost at a hundred million valuation and it's not much compared to the top three in the US but for Europe, that's quite big, and that that made it really interesting for many others.  You also, in the report, talk about changing roles of the different companies in the ecosystem and how there are dinosaurs, disruptors and discovers. What do you mean by that?  Florian Rotberg: Ah, that's quite interesting, especially when you look at software companies, some of them are reinventing themselves, and in the past,, there was the value chain and there were clearly defined roles. There was an integrator, the integrator usually owns the lead with the customer and he chose certain software and certain hardware and that was it basically, and then you did some stuff in the back and, but I think Chris Regal was the first one, when he quit Scala, he said “oh, I'm sick of just having 3-5% of the project, I want to have more”, and so he decided to build around software this whole end to end solution. And then other companies, software companies from Sweden and other parts of Europe, they're really also trying to change the way the value chain works. So they really want to be ISV+. So they want to do everything except hardware . Obviously the investors love that because that's every single sale which would have recurring revenue and nobody wants to touch hardware, and Chris Regal always tells us that you need to also to understand how to learn, to manage it. Otherwise the service you mentioned will be really expensive. So it's interesting to see if this ISV+ model will work out for them.  So that sounds like the dinosaurs are those who refused to adjust and adapt, and the disruptors are those that are doing things differently? Florian Rotberg: Yup. We have some smaller, more aggressive players coming into the market and also players like Spector, many people hadn't heard about them and now they have become really relevant  And there are also companies that, in some cases, are very large companies that can come into the market from outside, like consulting companies like Deloitte and so on and disrupt things as well, right? Florian Rotberg: Absolutely. On a different level, but yes, Accenture, Deloitte, all of these guys and they are really close to the big enterprise. So usually they do at least double digits, sometimes triple digit contracts with blue chip companies every year and they're trusted names. So it's an easy one for BMW, Adidas, Nike, or whatever to hire one of them and to ask them to create a new digital concept. Unfortunately, most of them don't know how digital signage works. Yeah. So they always invent this great stuff. It looks fantastic on PowerPoint and everything, but then at the end of the day, they need to subcontract it to the signage contractor to solve the whole thing and make it work, and we have also seen the big four have failed as a digital signage company, and so it's interesting, but eventually they will buy some digital signage companies I think. Or hire smart people, you know? Over here in North America, I think about Gensler and Publicis Sapient, and they have some super smart people working for them now who really get this space and get the technology and everything else. So they're getting there, but it's a very small percentage of people within very large companies..  Florian Rotberg: You mentioned Gensler, it's fascinating, and I'm sure we talked to the same people there and it's really fascinating how with new projects now, they make more money with digital stuff rather than the traditional architectural stuff. So that's fascinating. Not revenue wise, but from the bottom line, and that's interesting to see because if you do digital consulting, obviously your margin is higher than with your standard architectural work. So it's fascinating to see how architectural companies like this are really getting into the digital space and if you don't see it as just a layer really integrated, you need to plan it from day one.  Last question: Is there a piece of technology or an emerging technology that gets you particularly excited?  Florian Rotberg: We are both not the youngest anymore. We have seen many technologies come and go, and I know one thing that never works is 3D. So we were a little bit surprised to see how 3D in this false perspective on this LED wall worked, but I still think it's a hype, to be honest.  Analytics, sensors, and IOT will make a difference, no question about it. But it's not one technology, it's more, I think a mindset of connecting everything and measuring everything and adapting to the audience in the milliseconds. I think that's something we're changing. It's probably a whole range of different technologies.  Yeah, I'm of the same mindset. I tell people that the stuff that excites me would probably bore the pants off of them, and just in terms of its the operational stuff is being able to affect messaging based on what the data is telling you, and it may be really boring saying, go this way instead of that way, because that's too busy over there or whatever, but that's fabulous stuff and it makes a difference or whatever venue it is works.  Florian Rotberg: Exactly. It's more the stuff under the hood, which really gets me excited and that's also where you can really improve processes where you can really add value, and so that's what we are mostly working on, and obviously customers want to pay for the glittery stuff on top of the rest. But no, but that's where we see the biggest changes happening in the future.  So if people want to read the 2021 year book, how do they get it?  Florian Rotberg: It's free to download at invidis.com and I think you also published an article, so you can also find it on your website a link to that, but it's free to download, it's 200 pages and not only this year's edition, but if you also want to read some auditions, please come to our website a and download it there. And you're able to produce it for free because you get advertising sponsors to support it, right?  Florian Rotberg: Yes, but it's still more work than we get from advertisements, I can tell you that It was a pleasure catching up with you as always.  Florian Rotberg: Thanks for having me. 

Is the emergency department (ED) an outpatient CDI priority for your organization? The emergency department is the main source of admissions to a hospital – and the first location patients typically receive care. What should you consider when determining how an outpatient CDI program could support quality patient care, proper payment, and complete and accurate data?   During the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with another installment in her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener's survey during the weekly Internet radio broadcast.The live broadcast will also feature these other segments:Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, wraps up her four-part series on the impact of coding on severe maternal morbidity with a discussion about the intersection of coding and clinical indicators. Conditions specifically in the crossfire are sepsis, acute kidney injury, and coagulation disorders. Pollard will address which data the maternal collaboratives want to track and how you can incorporate these initiatives into existing CDI programs. The Coding Report: Laurie Johnson will report on the outcome of the recent ICD-10 Coordination and Maintenance Committee meeting.  RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the most recent final payment rules released by CMS on Tuesday.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, 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.

There's been plenty of talk about the shortage of nurses in the United States, but is there—or will there be—a shortage of physicians as well? In this episode, Rachel Woods sits down with Advisory Board's Sarah Hostetter and Daniel Kuzmanovich to talk about the misconception that the United States is facing a physician shortage and what the state of the physician workforce actually is. Links: MPFS final rule: CMS cuts physician pay but expands telehealth use Deploying APPs Autonomously The future of primary care The Problem with U.S. Health Care Isn't a Shortage of Doctors

Hello, manufacturing marketers! We're excited to bring you a fresh episode from the Kula Ring vault today with a 2019 interview we conducted with Brittney Zeller, formerly the Marketing Technology and Analytics Manager at American Air Filter. Brittney is now the Director of Marketing and Communications for the Americas, and the lessons she shared are no less relevant today. Learn how AAF chooses marketing technology, how the CRM drives most of their technology selection, not the CMS platform. We'll also dive into the important symbiotic relationship IT and Marketing need to have given that marketing and sales drive some of the most significant technology spends in most modern B2B manufacturing organizations. Please enjoy Brittney's episode, I'm certain you will be able to relate no matter where you are in the marketing tech stack continuum.

This week I share 8 tips to prepare for your Black Friday / Cyber Monday offering. [powerpress]

The Atlanta Braves just won the World Series! This is incredible for our home city, especially considering the odds stacked against us this season. Join Rabbi Kevin Solomon of Congregation Beth Hallel as he shows what we can learn from the Braves' victory and the Scriptures when it comes to finishing the race of life strong.  https://www.bible.com/bible/314/HEB.12.1-3.TLV (Heb 12.1-3); https://www.bible.com/bible/314/1SA.17.43-47.TLV (1 Sam 17.43-47); https://www.bible.com/bible/314/2KI.6.15-17.TLV (2 Kings 6.15-17); https://www.bible.com/bible/314/2TI.4.6-8.TLV (2 Tim. 4.6-8) http://www.bethhallel.org/CMS/programs/prayer/prayer-requests/ (Prayer Requests) or send an email to info@bethhallel.org http://www.bethhallel.org/CMS/ (CBH Website) https://www.paypal.com/donate/?cmd=_s-xclick&hosted_button_id=FBVL4JZH8HVS4&fbclid=IwAR2MB7yq6Zkq-ZNvwnw8Yz6z0crcMmGPpKhqIDD4w3sr5fXDBE0qOr1C5cM (Donate) https://www.youtube.com/channel/UC7EfRTmLFyvapAVb7q64PoA (YouTube Channel) Support this podcast

In the third and final hour of the show, Pete sums up the show conversation about how to fix the problem with guns in CMS schools and talks about the future of CMS Superintendent Earnest Winston.  Support the show: https://www.patreon.com/petekalinershow See omnystudio.com/listener for privacy information.

In the second hour of the show, Pete Kaliner continues to talk about the issue of guns in CMS schools and asks how much blame CMS Superintendent Earnest Winston should shoulder for the problem.  Support the show: https://www.patreon.com/petekalinershow See omnystudio.com/listener for privacy information.

On the Local News Roundup: Mike Collins recaps the lesser-known Mecklenburg County races from this week's election day. Mask mandates get a second look in Mecklenburg. Vaccines for kids 5 to 11 have been approved and are on their way. And guns found at Huntersville's Hopewell High School prompts discussion among CMS leaders about security.

Back in September, HHS released a set of proposed rules dealing with broker compensation disclosure in the individual and short-term limited duration markets, as well as surprise billing requirements for air ambulance providers. As we do with all relevant proposed regulations, NAHU submitted comments to the Administration with our questions and concerns. In addition, CMS and OSHA issued interim final rules regarding national COVID-19 vaccine requirements. On this week's episode of the Healthcare Happy Hour, Marcy M. Buckner discusses what we included in our comments and what is included in the new vaccine mandate guidance.

Tennessee lawmakers try to limit the power of the state's medical board to discipline physicians. CMS boosts outpatient and home health payments, but some physicians will see a pay cut in 2022. And more COVID vaccine mandates go into effect.

There's a lot of unknowns as we head into 2022, but one thing is certain: Health Equity will be a major focus for CMS and CMMI. Gail Zahtz, CEO of PropHealth, tells us that “value-based payment models have failed to deliver on the promise of health equity” and that is a major reason why CMMI paused so many models earlier this year. When the next iteration of value-based payment arrives, you can bet that health equity will be front and center. And for that, we prepare. “Fee-for-service says you get paid to fix a broken arm. Value-based care says everybody's tripping on the sidewalk and breaking their arm – let's fix the sidewalk. Health equity says we're going to fix the sidewalk everywhere.” Gail Zahtz, CEO, PropHealth This is the first episode in a 5-part series: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz. On this episode, we take a deep dive into everything health equity to lay out what is known, what is unknown, and how you can build flexibility into your business operations and systems to ensure that you are ready for whatever comes next. Key topics include: Why have value-based payment models failed to deliver health equity? What is digital equity and why is it important? Why risk is not the solution on its own especially when you're only changing the financial model for those you already serve. Risk scoring. Alignment! Alignment! Alignment! That is… patient, provider, and payer alignment. Serving health nomads. The importance (and lack) of race, ethnicity, and gender data. Health equity and value for the Native American community. The value of Federally Qualified Health Centers (FQHC) and how we can use them as a model to design Gail's “Upside-down ACO”. How to design a community pilot that is effective and sustainable (i.e., good for the patients AND good for the business). How to design your data systems to support health equity initiatives. Quality measures are next in our 5-part series designed to get you ready for value-based payment in 2022. Subscribe and stay tuned! For full show notes: https://thehcbiz.com/175-health-equity-is-population-health-vbp-in-2022-gail-zahtz-part-1/

In this episode of Syntax, Scott and Wes are back with another edition of “Stump'd!” where they try to stump each other with interview questions. Sanity - Sponsor Sanity.io is a real-time headless CMS with a fully customizable Content Studio built in React. Get a Sanity powered site up and running in minutes at sanity.io/create. Get an awesome supercharged free developer plan on sanity.io/syntax. Sentry - Sponsor If you want to know what's happening with your code, track errors and monitor performance with Sentry. Sentry's Application Monitoring platform helps developers see performance issues, fix errors faster, and optimize their code health. Cut your time on error resolution from hours to minutes. It works with any language and integrates with dozens of other services. Syntax listeners new to Sentry can get two months for free by visiting Sentry.io and using the coupon code TASTYTREAT during sign up. Cloudinary - Sponsor Cloudinary is the best way to manage images and videos in the cloud. Edit and transform for any use case, from performance to personalization, using Cloudinary's APIs, SDKs, widgets, and integrations. Show Notes 06:05 - Which property allows you to control the shape or appearance of the marker of a list? 06:33 - What is a pseudo element? What is a pseudo class? 09:15 - What is the difference between block, inline and inline-block elements? 10:15 - What is a combinator selector? 11:12 - What is specificity? How do you calculate specificity? 14:37 - True or False — The translate() function can move the position of an element on the z-axis? 16:44 - What is the difference between “resetting” and “normalizing” CSS? 17:51 - How can you load CSS resources conditionally? 19:45 - Is there any reason you'd want to use translate() instead of absolute positioning, or vice-versa? 22:30 - When to use CSS grid vs flexbox? 25:12 - What are all eight @-rules in CSS? 28:01 - Which property is used to underline, overline, and strikethrough text? 29:52 - What is DOM reflow? 32:14 - How do you serve your pages for feature-constrained browsers? What techniques do you use? 34:00 - What is the property for controlling image-scroll? 36:23 - What are the three different types of CSS gradients? Links https://github.com/sudheerj/javascript-interview-questions https://github.com/learning-zone/css-interview-questions ××× SIIIIICK ××× PIIIICKS ××× Scott: https://height.app/ Wes: Anker Mini Car Charger Shameless Plugs Scott: Astro Course - Sign up for the year and save 25%! Wes: Advanced React Course - Use the coupon code ‘Syntax' for $10 off! Tweet us your tasty treats! Scott's Instagram LevelUpTutorials Instagram Wes' Instagram Wes' Twitter Wes' Facebook Scott's Twitter Make sure to include @SyntaxFM in your tweets

Friends,This episode is about a domain of healthcare delivery that will undergo a fundamental transformation over the next 3 - 5 years. It is the most precarious and fragmented stage of care - post-hospital discharge and post-acute care transitions. It is a side of healthcare that is ripe for disruption, with the potential to greatly reduce readmissions, reduce total costs of care, and dramatically reduce preventable pain and suffering for patients and their families.Our guest today, Yoni Shtein, is a serial entrepreneur who started his journey as a software engineer at Microsoft. Having completed his MBA at Harvard, Yoni joined RPX Corp as a founding member of the insurance business. After RPX went public, Yoni left to co-found and merge a tech fund into Fortress Investment Group, where he spent six years as an investor. Yoni then moved to Israel and launched Laguna Health, a ‘digital recovery assurance company', with his longtime friend and colleague from Microsoft, Yael Peled Adam. They also have recently brought Dr. Alan Spiro on as their President and Chief Medical Officer. In this episode, we'll discover:Why Yoni states that “recovery is everyone's problem and no one's job”, and how Laguna is making it their job!Why and how Laguna is focused on the behavioral and contextual aspects of care, even more than the clinical signs and symptoms.The three platforms that Laguna has created to engage patients and guide providers in optimizing transitions of care: their patient-facing app, the Harmony Case/Care Management Platform, and their Clinical Care EngineHow Laguna is customizing care through a “choose your own adventure” approach.The tremendous outcomes Laguna is achieving in readmission reduction.During the interview Yoni states his fundamental thesis: “Laguna is reframing healthcare in changing the dialogue from readmissions and provider penalties to member ‘recovery journeys' and payer cost drivers.” He points out that the most fundamental problem in transitions of care is the misalignment of incentives. Let's unpack his statement.The reality is that healthcare systems and provider groups are not financially incentivized to optimize patients' health after discharge. While there has been an increased focus over the past few years on reducing readmission rates (driven in large part by CMS readmission penalties); the fact is that hospitals' financials are not aligned to post-hospital care. And, just to be clear, this is not to blame hospital systems. Instead, it's a commentary on how care is paid for in our country. Given that reality, Yoni and his colleagues are targeting their efforts at entities whose business models are aligned with improving post-discharge care: (1) self-insured employers; (2) Medicare Advantage Health Plans; and (3) payers or healthcare systems that are taking financial risk for their populations' total cost of care.A second reframe that Laguna is introducing is instead of focusing on a metric (i.e. 30-day readmission rate); they are focused on the patient's “recovery journey”. They're using decades of published research to identify “recovery barriers”, and are designing their products and services to mitigate and eliminate those barriers. A third reframe that Laguna has introduced is that they have designed their care model to address the behavioral and contextual aspects of care.  They're identifying and solving for the daily barriers that people face in engaging with healthcare and optimizing their health.According to Yoni, over 50% of all readmissions are preventable. That means that the American healthcare system is failing patients and their families one out of every two readmissions. It's been said that our healthcare system is perfectly designed to deliver the results it delivers. But if we understand how wrong those results are, why aren't we changing the system more intentionally and more immediately? Why aren't more healthcare leaders not pushing to create a new healthcare? Far from being discouraged, these questions only strengthen my resolve to seek avenues to create a new and more humanistic healthcare system. And, it also strengthens my belief that we need more leaders like those in Laguna, who are reframing healthcare to be what patients, their families, as well as providers need it to be, and not what ‘the system' dictates it be. Until Next Time, Be Well.Zeev Neuwirth, MD 

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT More and more traditional integrators and IT services companies are finding their way into the digital signage industry, but I can't recall seeing one of them getting seriously into the media side of business ... until now. A well-established IT managed services company based near Toledo, Ohio - called Velocity - is not only providing technical services to digital out of home media companies, it's directly selling media. The company describes its media solutions business unit as being an an end-to-end digital signage provider - doing hardware, software, installation, tech support, media sales and everything in between. Velocity runs and owns digital screen networks in groceries, cinema lobbies and hotels, and is looking to grow its footprint. I had an interesting chat with the company's Senior VP of Digital Media, John McCauley. Subscribe to this podcast: iTunes * Google Play * RSS TRANSCRIPT John, thank you for joining me. I was intrigued when I heard and started reading about Velocity that here is a managed services company, a managed services provider that does a lot of IT work, but they have a media wing and I thought, oh, that's different.  John McCauley: Yes it is, and I think we have a very enthusiastic CEO, Greg Kiley who has really taken to the place-based digital out-of-home media's core component and how it stitches together with our overall managed services business, and I think we're starting to really see the benefits of it with the investments that we've made in both resources and just alliances through COVID. So it's exciting times.  Okay. So let's back up a little bit. Can you tell me a little bit about what Velocity is all about,  where it's based, how large a company it is, those sorts of things?  John McCauley: We're based in Holland, Ohio. It's near Toledo and the company started 15+years ago. Greg Kiley, the CEO, created a rollup of local, regional voice and data services. And from that you create some scale and you create some efficiencies for customers, allowing sort of one-stop shop across like multiple locations across multiple areas of the country, and that proved to be a very fruitful business, saving money of course, and really creating some stickiness between customers. The managed services, the network services, what else can you do on that connection? That was like a birth of where other aspects of the company could grow, and sectors that we'd like to be in including retail and hospitality and entertainment. All those things started to really converge and the company had a lot of success probably for a good 15+ years and two years ago, more or less, we got into sort of the digital out-of-home business and always had connection to our customers and really in response to the customers thinking, what else can we do on the connection?  Starting with merchandising signs, thinking about hotels and maybe retail, those locations would use those to promote offerings and then over time, we start to explore with our customers, can we turn this into a media opportunity, which obviously would provide revenue back to them, creating another revenue opportunity for the company. And I think the timing of that is all very serendipitous for us because digital out-of-home, and technology enabled selling are all converging, and that's a big part of the growth in digital out-of-home is this sort of the technology and the digitization of signs, and we find ourselves in a very interesting and exciting place right now. Did you have end-user customers who were pushing Velocity on some sort of a cost-recovery model, saying, could we put in signs and make money back on these things or was this more something that Velocity came up with?  John McCauley: I think a little more on our side and then the clients obviously are the beneficiaries of it. I think a company like us is thinking about all sorts of growth opportunities and also thinking about ways for more customers to come into the fold. We want to be able to provide as much stickiness as we can. So whether you would come in through our network services side of things and we bring digital signage solutions to you or someone comes in through the digital signage solutions and we're able to extend them network services. The company is very focused on being deep and across the board with as many solutions as we can for our customers.  So right now, if I'm looking at your website, you do call centers services, repair depot, onsite techs, back office support, project management, all the kind of traditional things that you would have out of IT managed services and telecom managed services. I remember having a client in the auto sector that had a digital signage department and they described themselves as the land of misfit toys. They didn't really fit in with the rest of the company. Culturally, how does the media wing fit within a whole bunch of guys or people who are IT services people?  John McCauley: I think we fit very nicely together. There's a lot of similarities within that. First and foremost, we're very customer centric, right? So I think when you start as being customer centric, whether you're providing an immediate solution for a customer or a sort of technology managed services solution, you end up in the right place aligned around that. There's also a lot of cross-pollination, whether you work with CMS systems, or digital signage sort of capabilities, you're working very closely with your IT group, and then also as you're supporting your customers, right? We have a grocery network and a hospitality network and others, and the responsiveness, we all work well together, right? If a sign goes down, you're tapping into your managed services group, the call center is contacting us and it's very symbiotic, and I think the way the company has put these pieces together has worked well. I can definitely see in other places where they may be assembled versus orchestrated, you'd probably see a bit of a difference.  So the media solutions business unit, if you want to call it that, what all is in that?  John McCauley: So we have networks and hospitality, grocery. We have a relationship with cinemas and Cinema lobbies also within Redbox in video toppers on top of Redbox kiosks, and then through another group, as part of a media solution, we have a direct sales group that represents inventory within bars, transit centers, and convenience stores.  So that mixture of that portfolio of media opportunities allows us to leverage a direct sales group that is working on just a representation basis to help bring into the fold of particular deals of other media that we own and operate, and similarly, if we go owned and operate, we can look to extend those opportunities within networks that we represent. I think within the digital out-of-home space, it's important to have that sort of portfolio approach, allows us to nurture some networks, develop other networks, and I think overall a lot is happening in the space and allows us to be nimble too.  Did you start with direct sales or was that a kind of a lesson learned, that we can't really use a rep shop, we need to bring this in-house? John McCauley: We have an affiliate approach. So I would say our channel strategy where we do use Programmatic, of course, everybody needs to connect to Programmatic. We have third-party relationships with people that may have endemic relationships, maybe particularly within grocery. ScreenVision Media represents some of our inventory and they are leveraging the on-screen advertising and people who want to get close to that customer and extend them outside the cinema. So that sort of has its own strategy, and then our direct group is really a traditional digital out-of-home group. So you can't forget that part of the stack of revenue coming in, and I think as we think about revenue and I know a lot of people in the digital out-of-home space think about this is where the layers of the cake are coming from.  It may be in the beginning of the year when the media is not as heavy, like 15% of media might be spent in the first quarter, you might be a little more Programmatic oriented, right? As you get open exchange, not PMP, as you get to later in the year where maybe 40% of the media spend could be in Q4, you're probably going to be more PMP and maybe a little less open exchange. And so that mix of portfolios could also change by the sector, vertical that you're in.  We consciously did that and I think bringing in the digital out-of-home was on the roadmap. It just took us as we started to make our acquisitions and some of the other affiliates came in, but they all have to work together. We're working very closely as a centralized resource, coordinating the efforts, because that's how you maximize the revenue.  The grocery network you acquired, has that been the model for all the media properties you're in?  John McCauley: That was something that we were interested in grocery and retail. That opportunity came our way and we definitely saw our chance to leverage our relationship with our affiliates, as well as combine that with some strategic things that were coming down the road, but many things we just built from scratch. At the hotel and hospitality network, I think there was a recent release that went out with G6. That's something that there is no network that begins, right? So we're deploying the signs and we're starting it from scratch, and I think you'll, over time, see even more from us where we're combining opportunities where there may be existing networks in place, but we can be the catalyst for more digitization and more growth. So the G6 one, that's an operator of a series of Motel 6s, right? John McCauley: Correct. Yes, and hotels are an interesting sort of vertical in the digital out-of-home, not quite landed with media buyers yet, but there's a tremendous amount of purchasing power that resides within hotel guests. Obviously if you stay at a hotel for longer periods of time, you're going to be spending more money in the local economy. But even if you were to go in and have a short-term stay right, more than likely, you're going to be spending some money in the economy.  We also know from just the dwell time, as people are considering things, landing a message that may be more regional in nature, or maybe it's a specific product, that's yet another impression that's made on a customer or potential customer, as they're within the lobbies. There's a little bit of work to do within hospitality, but we're super bullish on that, particularly when you see that the spending ultimately at the end of the day, media agencies and advertisers are looking for what's that incremental media that I can bring to my campaign and media mix that can be the extra, what's going to help me close the loop? And I think when you're sitting in front of people who are away from home, you know they're going to be spending money. That's definitely an opportunity to influence purchase.  I'm guessing and it's purely a guess, but given the history of digital out-of-home, a lot of the networks that kind of bubbled up were often by entrepreneurs who were bootstrapped and were going into places like Motel 6 owner group or whatever, and saying, we can do this for you, we can put these screens in and so on, and maybe in the early days they accepted that. But I think the experience was such that so many of those kinds of bootstrap companies went out of business, that a large well-established IT services firm is probably more readily welcomed in the office to talk about it.  John McCauley: I think the key thing about it is, even if you can bootstrap the signage deployment, ultimately at the end of the day, it's going to be the service, right? With signs, always there's cane activity issues, something goes down the monitoring, the maintenance, right? The ability to help program through CMS systems and that ultimately is how you get across the finish line, and it's super difficult to do, I think if you're bootstrapping and we have the benefit of the resources of Velocity, to create an infrastructure that allows us to support these networks and obviously as we scale, we continue to look at sort of our resources, but we're very much on the radar screen of how we continue to provide that level of resourcing.  So I'm an owner of numerous motor inns in the US Southwest or something like that, and I approach you guys, what all would you be able to do? Do you take it right from start to finish and aftercare or are there things that you still leave for others?  John McCauley: Yeah, this would be end to end. Our way of choice of moving forward is design, I think sometimes that's often missed, what's the best place to deploy? What is the best signage to use? Getting them deployed and then ongoing monitoring of the deployment, and ultimately, depending on whether the customer wants it or not is bringing advertising. But whether you bring the advertising or not, there's a CMS system component and we find if we have everything from the beginning to the end, we can provide the highest level of service for the customer, and look, I don't think it's really lost on our customers who are in the hotel business. Sometimes we use the term digital concierge for the signage that we provide in the lobby because that's allowing the hotel to communicate. These are the services that are available within the hotel. Sometimes it could be a restaurant, right? They are in there and it helps them drive money, sometimes it's a rewards program. ESA has something called the perks program, which allows their guests to download an app and get deals in the community. So that level of communication, we want to be able to provide that CMS component and then advertising is something, and I think generally speaking, when it's handled end to end in a one-stop shop, you're going to get the most from your primary customer, and you can bring the most service, and therefore the most benefit whether it's going to be efficiencies, savings, and obviously, revenue.  I remember with telecoms companies going back 15 years or so, they started looking at digital signage and described it very much as you did a little bit earlier on, where it's a layered service thing where we're already providing the connectivity and the the boots on the ground, so to speak, to come in and repair things. So why not layer this on top of it? Just in the same way that we could maybe layer this building security or whatever. John McCauley: I think layered services is a nice way to describe it, and I think when you're working with companies like Velocity where you're very customer focused and looking to help drive value, for your customer, these things come up and I do think that this digitization of signage and communication, while some people may feel like that's a lot to undertake, once you have it, you're taking the communication and you're changing it up, like on a much more frequent basis.  If you think about movie theaters, and think about menu boards, that used to be that you put them into sort of a plug board, “Popcorn costs $2.50”. Nowadays, a lot of movie theaters have digital menu boards and those digital menu boards allow things to be like by movie, you can change what the offering is. Here's the pack you're going to be focusing on around the time of day and that has really proven to be a driver of an anchor mentality, and that I think is ultimately the proof of the pudding, and I think more people are coming around to that. Posters, things like that, where people would do analog, you can take the same image, send it across digitally, and that now can be customized and tweaked regionally by the market, targeted by time of day, and I think those benefits are becoming much more real to people now, and I think with COVID, in particular, people took the time to think about how digital and technology play a role in my company and I think we'll start to continue to see even more disease of analog opportunities and more exploration of where some signage could be put into venues to drive the revenue and create some efficiencies.  Does it matter at all about focus? So if you're doing Motel 6 lobbies and groceries in New York state and cinema lobbies, those are pretty different kinds of environments. Does it matter in terms of sales and support that you get a little more focused on one particular vertical or a couple of others?  John McCauley: I think from the support side of things, there's a lot more commonality to the back end of how you support those signs because of this connectivity coming in, and I would say that would not have been the case years ago. It would have been more difficult to try to manage multiple like sectors, because maybe the differentiation of signage, maybe the CMS system you're using, a lot of that stuff I think has gone away, making it easier to potentially manage like a variety of verticals, but in particular for the sales side of things, we like to think about our areas of focus proximity to retail and purchase. So lots of times we're nestled within retail, right? You're in a grocery store, we have Redbox, you're there and then the ability to be close to purchase. So whether you're at a bar, you're obviously purchasing in the bar, but oftentimes and with your in hand and the ability to influence purchase, I think is a big deal in digital out-of-home and our network is set up in that way to be around that. We would think about retail and proximity to purchase as a really key component of our business.  You mentioned CMS, is it a case where you're using a partner firm's CMS or have you developed your own? John McCauley: We have our own CMS system and as we've taken on networks, we've had to work with other CMS systems, but ultimately I think in looking at the ad ecosystem, right? If you start at the far left with a DSP slide into the SSP, right? Then you have an ad server, then the CMS and the connectivity to the sign, I think for the most part people who are in the business that we're in, they want to have the CMS connected to the sign, right? Because that's really how you're controlling the sign. You're working with a third party on the signage and having that creates a larger scale and more efficiency. But at the end of the day, a lot of the CMS systems work the same.  We would obviously think ours is better because we were working to work on our signs and making sure they're doing what we want to do, but I think he needed to have flexibility. So at the end of the day if you want to be in the business, you have to have a wide lens and work hard to get people to consider your CMS system.  Do you find with the end user customers who you work with and Target in particular that there's any sort of demand that no, we need to work with this particular CMS partner, we need to use this particular smart display or operating system, or are they pretty open?  John McCauley: I think if you're inheriting something, there's already a bias, that, hey, we've used this and we're looking for a new operator, and I think there are companies that would come in and maybe operate that and certainly we consider everything. I think when things are starting anew then you have the opportunity to bring to bear the capabilities that the company may have around sourcing and designing signage that works as well as the CMS system. I think you need to be competitive, right? So if someone likes a particular CMS system, you understand what those needs are, and you obviously are going to be upgrading your CMS system to have those. So yeah, you need to be definitely paying attention to the marketplace. I think like in anything, whether it's this business or any business, if you have blinders on, and are rigid and say, this is the way we do it, then ultimately you're going to miss out on opportunities, right? Because the marketplace is going to dictate the services and the capabilities that you need to have.  Okay, so if I'm a digital place-based startup and I'm putting screens in, I'll make something up in ski resort lounges or something like that, don't think I'd do that one but anyways.  If I was being smart, I'd determine pretty quickly that I don't know what I'm doing with technology and it would be great if I had a partner who did all that stuff for me, and I just focused on sales or even had sales done by somebody else, and I just run around and get the real estate agreements, is that something you'll do where you just kind of take everything on? John McCauley: Absolutely. That's the type of thing we would put ourselves in position to do, and I think as you were indicating that sometimes we're seeing the customer saying, yes, I'll get the real estate because I have real estate, I want to convert some real estate, I want to better leverage my real estate, but ultimately we find that customers are trying to drive more revenue, right? Like in their existing business, how do they drive more revenue? I know you were using the ski resort, right? Can they get people to the lodge and buy more? Can they get them to do lessons? Ultimately the businesses are very focused on that.  Bringing advertising in, that's obviously very complimentary, and we find that when you're bringing advertisers into venues, particularly on the mix of them, local and regional play well because it's sorta like the company you keep. If there's some advertising in there, people go, oh, look at that. They're advertising at the ski resort. I think that is also things that the venues like, they like to be immersed within either the community or things that their customers are feeling that are current. You've grown a little bit in the media space through acquisition, is this an ongoing thing? Is Velocity looking for other networks that they may potentially acquire as well to build out their footprint?  John McCauley: I think we will always have our eyes on where we can be strategically accretive, particularly around these verticals and sectors and being close to retail and purchase and if there are things that pop up, we're also actively looking. I would say that that's very much in the forefront.  There's a lot of digital out-of-home networks out there. Generally speaking, do you get a sense of how they're doing? There's obviously some large ones that are doing very well, but it's been a rough couple of years for just about everybody. John McCauley: Yeah, I think heading into that quarter before COVID shut everything down, they were really coming off a record year, having a record quarter digital out-of-home, and then basically the world's shut down, and what we're seeing is that traffic is certainly back, people are out and about, depending on where you are in the country, it could be a little bit less but certainly people are feeling more comfortable being vaccinated, and what we're seeing is that a little bit of an over-indexing to transit and billboards. That's the safe play, right? People are out there driving. I think people are over-indexing there.  In that middle sort of ground, like street furniture is almost back to where they need to be from the pre COVID levels, and then the place-based, essential markets, whether it's grocery stores and others, they certainly have had the traffic, and they're shown a little quicker recovery and then things that would be considered more discretionary, whether they be movie theaters or people could argue bars, whether that's discretionary or not, but they serve an essential part of the communities. All of those types of things are definitely starting to show the rebounding and heading towards the trajectory of getting back to pre COVID levels.  But I think that's just the cadence of the way people have responded to it. They have to see that the traffic is steady and consistent, that we can weather the storms of having variance that really impacted the traffic, and then ultimately I think Q4 is a good time for it, right? Because at the end of the day, Q4 is when many companies, whether you're selling stuff, whether it be media or selling products, you need to get your impressions, you need to reach, you need to get impressions. You need to influence people who are in position to purchase. I think this quarter in particular will really start to provide the wind behind the sails heading into 2022. There was a DPAA conference last week which was really encouraging. It was well attended by 600 plus people in person at Chelsea Piers in New York. The energy was high, lots of clients there. Lots of things happening within the digital out-of-home, and I think there's a lot of optimism around place-based.  And I think you told me in our pre-call that Velocity is a member of the DPAA?  John McCauley: Yeah, we're members of the DPaA, and in my prior life, I was at the ScreenVision Media and I was on the board. So I'm very friendly and familiar with the leadership there, and I think they've done a very nice job.  Between the DPAA and the OAAA representing the industry, evangelizing the industry, making sure it's staying top of mind with agencies and brands and CMOs, I think that's an important component and I think there's the retail networks whether it be Walmart doing Walmart Connect or Walgreens or CVS or our efforts at retail, I think they have a very high value, and I think people are really paying attention to the ability to influence customers with wallets out.  I assume, right now, Velocity is its revenue and its focus is heavily in its traditional business of IT services managed services and so on, and that the media side of it is a fairly small percentage of the revenue.  Is there a longer-term vision where Velocity starts to become more and more a media company? John McCauley: We'd have to ask Greg and the leadership team about that, but I see a real enthusiasm for the media business and how the media business supports and can support other opportunities within the company, and so I think as a result of that, it's strategic importance will continue to grow and so will the revenue but we definitely want to be in the business, whether we're powering networks, whether we're monetizing networks, there's a lot of connectivity that we like being around the space and it plays very well into sort of the overall company of network services and then layering on the media services. All right. That was terrific. I appreciate you taking some time with me. 

Dr. Adaeze Enekwechi is a leading voice in health equity and evidence-based health policy making who is committed to meaningfully improve access to equitable, quality healthcare for all Americans. Dr. Enekwechi is currently an operating partner with Private Equity firm Welsch, Carson, Anderson & Stowe and serves on the Boards of several companies.  She is also currently a Research Associate Professor of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University and is an Executive in Residence at The Health Academy.  Her research areas cover the aging population and Medicare, health equity for vulnerable populations, and evidence-based policymaking all of which are important topics that I look forward to covering today. Show notes: Books:  The Love Songs of w.e.b. du bois by Honoree Fanonne Jeffers; When No One Is Watching by Alyssa Cole;  I Alone Can Fix IT: Donald J. Trump's Final Catastrophic Year by Carol Leonnig and Philip Rucker.

This week I talk about having an emergency plan. [powerpress]

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