Recent Articles:

News 7/29/19

July 29, 2019 News Comments Off on News 7/29/19

Top News

image

Women’s health and fertility care company Kindbody brings it pop-up mobile clinics to San Francisco and opens a clinic within Carbon Health’s primary and urgent care practice while its stand-alone clinic is being prepared for opening later this year.

Kindbody also has a presence in New York City, and will eventually expand its brick-and-mortar operation to Los Angeles. It has raised nearly $22 million since launching last August. Its proprietary KindEMR was likely built off the IVFqc cloud- based EHR and billing software it acquired from Althea Science around the same time.


HIStalk Practice Musings

image

“The Overstory” by Richard Powers was recommended to me this morning. Wikipedia describes it as the story of “nine Americans whose unique life experiences with trees bring them together to address the destruction of forests.” If you like your descriptions a little more high brow, the Library Journal adds that it’s a “a deep meditation on the irreparable psychic damage that manifests in our unmitigated separation from nature.” Make of that what you will.

Powers supposedly wrote the book after seeing giant redwoods for the first time, which makes me wonder: Do you have a favorite book inspired by nature? “Cold Sassy Tree” by Olive Ann Burns is the only book in my library that comes close. Email me with your favorites and I’ll be sure to share.


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

image

Denver-based virtual scribe vendor Skywriter MD will open a second office in College Station, TX by the end of next year. CEO Tracy Rue expects to hire 200 employees to staff the new location, largely drawing from the area’s medical students at Blinn College and Texas A&M.

Beacon Orthopaedics and Sports Medicine in Ohio partners with private equity firm Revelstoke Capital Partners to launch a national managed services organization.

image

CNBC reports that membership-based primary care company One Medical’s valuation has increased to $2 billion. The company, which also offers an employer service line, has raised $400 million since opening in 2007. Headquartered in San Francisco, it now has 72 clinics in seven states, and has partnered with health systems in several markets. The company has developed its own EHR and patient app, and offers online appointment scheduling and video consults.


Announcements and Implementations

BetterPT adds interoperability functionality from Kno2 to its inbound patient management software, giving physical therapists and physician referrers a more seamless way to share patient data.

image

Simple Interact announces GA of digital informed consent forms that automatically upload to the EHR.

MyOutcomes develops an open source version of its behavioral health measures software.


Government and Politics

image

HHS awards $42 million to 49 Health Center Controlled Networks, which in turn will funnel that funding to 1,182 FQHCs to assist them in adding or upgrading health IT. OCHIN, the largest HCCN in the US, will use its $8 million to help facilities within its network improve care coordination; reduce provider burden; and increase connectivity to state immunizations registries, prescription drug monitoring programs, and HIEs.


Telemedicine

image

Henry Schein Medical introduces an updated version of its MedPod MobileDoc telemedicine equipment. New features include integration with Uber Health, giving physicians the ability to book their patients rides to and from appointments, or more acute care settings.

Physicians in Florida cry foul over licensing and registration fees associated with the state’s new telemedicine laws. Out-of-state physicians who want to virtually care for Florida patients don’t have to pay any registration fees, while in-state MDs must pay a $350 application fee and initial $355 licensing fee. Governor Ron DeSantis vetoed legislation that would have required out-of-state physicians to at least pay a $150 registration fee, saying they would have undercut efforts to curb healthcare spending. 

image

Rite Aid will use software from InTouch Health to launch kiosk-based telemedicine services at a handful of RediClinics within its retail pharmacies.

Ohio Governor Mike DeWine passes legislation requiring payers to reimburse providers for telemedicine visits.


Other

image

Park DuValle Community Health Center (KY) pays hackers $70,000 to unlock medical records that have been held ransom since June 7. Its appointment scheduling system has also been affected, and so patients are being seen on only a walk-in basis. The health center has been the victim of ransomware attacks twice since April. It did not pay the requested ransom after the first attack, instead electing to rebuild its records from backups. CEO Elizabeth Ann Hagan-Grigsby says the center has spent about $1 million on recovery efforts over the last three months.


Sponsor Updates

  • EClinicalWorks will exhibit at the CHCAMS 32nd Annual Conference July 30-August 2 in Biloxi, MS.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 7/24/19

July 24, 2019 News Comments Off on News 7/24/19

Top News

image

Mental health telemedicine and analytics company Telemynd announces plans for an $8 million IPO. Based in Mission Viejo, California, the vendor was spun off earlier this summer from parent company Mynd Analytics before it was sold to Emmaus Life Sciences.


HIStalk Practice Musings

image

Check out the Advisory Board team’s suggested summer reading list. It’s full of suggestions for a wide range of interests. As a huge Star Wars fan, I will definitely check out(!) “The Princess Diarist” by Carrie Fisher.

image

The folks at Hyland have also started a blog series about their favorite business, technology, leadership, and professional development titles.

Does your practice or company share reading recommendations? Email me with your lists and I’ll share them in an upcoming post. Happy reading!


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Announcements and Implementations

NextGen adds OptimizeRx’s point-of-care digital prescription savings software to its Enterprise EHR.

image

HealtheConnections combines its New York-based HIE data with information from state and national healthcare databases to develop the MyData platform, which includes community health dashboards, quality measures, and data discovery capabilities.

image

Modernizing Medicine announces GA of bundled EHR, practice management, and business services software.

image

ESimplify develops Practice Analytics for family medicine providers and internal medicine groups.

CVS Health will work with social services software vendor Unite Us to develop a portal that Aetna Medicaid patients in Florida, Kentucky, and Louisiana can use to find and connect with local resources. The project is part of the $100 million Building Healthier Communities initiative, through which CVS and Aetna are working to improve community-based health and wellness over the next five years. CVS acquired Aetna late last year for $70 billion.


Other

image

Kaiser Health News covers the work University of Chicago Medicine PCP Wei Lee, MD is doing to help providers develop better “computer-side” manner. Lee and her colleagues have developed a curriculum to help physicians use EHRs in a way that makes patients feel included, including an ABC mnemonic for patients: Ask To See The Screen. Become Involved. Call For Attention.

image

So sweet: Medical student Odolphe Augustin proposes to his girlfriend on stage after receiving his white coat at Touro College’s special ceremony. She said yes!


Sponsor Updates

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 7/22/19

July 22, 2019 News Comments Off on News 7/22/19

Top News

image

Starr Investment Holdings invests $700 million in Radiology Partners, which bills itself as the largest radiology practice in the US. The practice, which employs 1,400 radiologists across 21 states, will use the funding to continue its growth into new markets and to purchase and develop new technologies.

Radiology Partners also offers consulting, IT, and revenue cycle management services.


HIStalk Practice Musings

image

I couldn’t help but laugh out loud when I saw this, at the local surf shop of all places. I would have bought one for Mr. H had the packaging mentioned the Oxford comma.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

Previous webinars are on our YouTube channel. Contact Lorre for information.


People

image image image

Consulting firm Comagine Health names Marie Dunn (Health Catalyst) SVP for research and innovation, and Juliana Preston (HealthInsight) SVP for systemwide quality improvement, and promotes Dan Lessler, MD to SVP for clinical leadership.


Announcements and Implementations

image

DrChrono adds DeepScribe’s AI-powered note-taking app to its EHR.


Telemedicine

image

NHS psychiatrist and columnist Max Pemberton writes about his experiences with the GP at Hand app, both of which left him with misdiagnoses and incorrect prescriptions. Aside from his personal use of the glitchy Babylon-powered app, Pemberton points out the lack of evidence surrounding virtual care’s safety and clinical efficacy. He also worries that the app’s young, wealthy, tech-savvy users aren’t really the demographic England’s healthcare digitalization efforts need to focus on; and that brick-and-mortar practices will suffer as telemedicine apps siphon off their patients and overworked GPs looking for more flexible schedules. “I think there’s a place for apps,” he writes, “but this will not save the NHS. It provides a nice, convenient alternative to seeing a doctor, but it can no way replace physical GP surgeries. And the way it has been rolled out risks undermining NHS GP practices and hastening their decline.”


Research and Innovation

PatientPop releases its latest online reputation management report. The survey of 233 providers reveals that competing priorities are likely forcing physicians to give short shrift to patient feedback and online reputation management:

  • Just over a third don’t ask for feedback.
  • Half of survey-takers don’t have a process in place to monitor feedback or online reviews.
  • Nearly 18 percent of those who do monitor online reviews do not respond to negative feedback; half of those do so because they don’t think it will make a difference.

image

New research from Vanderbilt University Medical Center (TN) finds that independent physicians have not kept up with federally-mandated EHR maintenance as much as their employed counterparts. The study of nearly 300,000 physicians found that:

  • Forty-nine percent of independent physicians attested to Meaningful Use at least once, versus 70 percent of physicians in group or hospital practices.
  • Nearly half of independent MDs who had attested between 2011 and 2013 dropped out of the program by 2015, while fewer than 20% of their employed counterparts did the same.
  • Independent physicians who participated in the program on their own were more likely to join integrated systems than physicians who did not participate.

Researchers suggest that the drop-out rate for independent physicians was likely due to the fact that the benefits didn’t outweigh the costs of maintenance. They also surmise that a lack of up-to-date technology may have induced some physicians to opt for employment or retirement.


Other

image

Mountain Family Health Centers Director of Data Quality Chris Tonozzi, MD shares his thoughts on EHRs in the wake of a NextGen upgrade across the FQHC’s six locations in Colorado. Staff spent two half-days in training and slowed their schedules for two weeks to allow for time to adapt to the software’s changes. Tonozzi, who is also known as the “Data Doctor,” shares several ways in which the EHR has helped improve efficiency:

  • We make active efforts to make good use of the data that is generated from the EHR. For example, most of our quality improvement goals are based on data from the EHR, including our hypertension control rates, our diabetes control rates and our tobacco cessation counseling rates. 
  • We regularly coach clinical staff on the connection between their EHR data input and the desired quality outcomes. We continue with a series of “Lunch and Learns” in which we review the outcomes, and how to best document the care related to these outcomes in the EHR.
  • During the EHR upgrade this summer we’ve had a team of very dedicated providers, nurses, medical assistants, office staff and IT staff configuring, training and testing. The upgrade happened with a minimum of disruption. 
  • We make time for clinicians and other users to write their notes and orders in the EHR. Our staffing patterns and clinic schedules account for much of the time needed to document in the EHR.

Sponsor Updates

  • USPTO awards Medicomp Systems a patent for the intelligent filtering of health-related information in its Quippe solution.
  • EClinicalWorks will exhibit at the 2019 FACHC Annual Conference July 21-24 in Fort Lauderdale, FL.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 7/17/19

July 17, 2019 News Comments Off on News 7/17/19

Top News

image

Long Beach, CA-based Agilon Health is reportedly considering an IPO. The company offers primary care practices value-based care transformation services that include proprietary technology and analytics.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

image

Specialty retina practice NJRetina launches Prism Vision Group, an ophthalmology-focused practice management company. NJRetina founding partner Steven Madreperla, MD will head up the new business.

image

Bertie Bregman, MD and Rachel Bregman, MD – the husband and wife team at Westside Family Medicine in New York City – launch Qwell, an online appointment booking and social networking site.

Medical screening device distributor PreCheck Health Services acquires practice management and billing company JAS Consulting and its sister business, CPD Integrated Health Care, which operates seven behavioral health and primary care clinics in Texas and Oklahoma.


Announcements and Implementations

image

The Network of Behavioral Health Providers (TX) selects ClientTrack Community Care Coordination software from Eccovia Solutions. The technology will be used as part of a two-year pilot project that will deliver medical, behavioral, and social services to 300 mental health patients.

Stanly County Imaging (NC) selects RCM and MIPS compliance services from Healthcare Administrative Partners.

NextGen integrates Appriss Health’s prescription monitoring and tracking analytics into its Office EHR and practice management software.

image

Diagnostic Imaging Centers implements patient engagement software including online scheduling, appointment reminders, and digital registration capabilities from OpenDoctor across its eight locations in Kansas and Missouri.


Telemedicine

image

A report from Doximity finds physician interest in telemedicine opportunities has grown 20% each year over the last several years, and that the number of MDs who list telemedicine as a job skill has doubled since 2015. Women were more interested in such jobs than men, though men were more interested in locum tenens opportunities.


Other

image

Tech Crunch profiles Brave Care, a pediatric urgent care clinic in Portland started earlier this year by pediatrician Corey Fish, MD and tech entrepreneur Darius Monsef, the father of several of of Fish’s patients. The clinic, which has raised $1.5 million and is participating in Y Combinator, is working to develop a triage app for parents and may eventually look at adopting telemedicine.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 7/15/19

July 15, 2019 News Comments Off on News 7/15/19

Top News

image

SPH Analytics will merge MIPS software and consulting company SA Ignite with its population health business.

image image

SA Ignite VP Matt Fusan will become GM of population health at SPH Analytics. SA Ignite founder and CEO Tom Lee will move into an advisory role.


HIStalk Practice Musings

image

I’ve been meaning to mention the weekly #HTreads tweet chat for some time now. The chats are a sort of online book club, focusing on books that are typically related to business or professional and personal development. They are held every Tuesday at 9pm ET. Check out the hashtag and @HealthTechReads account for more info.

image

Fun: Just in time for Christmas, Metallica will publish a children’s book titled, “”The ABCs of Metallica,” with proceeds going to their All Within My Hands charity.

image

Not-so-fun: A serial book vandal seems to be on the loose in England. Officials in Kent say the “Herne Bay Book Ripper” has been ripping pages and putting books back on the shelves at the local library and charity shop. They believe 120 books have been damaged by the vandal over a six-month period.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

image

PE Hub reports that primary care management company VillageMD is seeking $150 million in funding. The Chicago-based company has raised nearly $120 million since launching in 2013. It no doubt wants to expand beyond the 10 markets it serves, including adding more clinics to its partnership with Walgreens. It’s set to open five primary care clinics next to the retail pharmacy in Houston by the end of this year.

Health IT reseller Microwize Technology begins offering Aprima EHR and practice management software from EMDs.


Announcements and Implementations

image

West Cancer Center & Research Institute implements interactive digital patient education tools from PatientPoint at its 13 facilities in Arkansas, Mississippi, and Tennessee.


People

image

Federal health IT vendor A-Tek hires Ted Schmitt (Salient CRGT) as VP and account manager.


Telemedicine

image

Bighorn Valley Health Center in Montana will use a $188,000 USDA grant to purchase telemedicine software and supplies that it will use to help patients with opioid addictions. CEO David Mark say the clinic’s new virtual capabilities will be game-changing for patients across the state’s frontier towns.


Other

image

In New York, Adirondacks ACO notifies 25,000 patients of a March data breach that may have exposed PHI found in a spreadsheet related to a population health analysis. The ACO handles analytics for several area hospitals and the Hudson Headwaters Health Network.


Sponsor Updates

  • EClinicalWorks publishes a podcast titled “Interoperability: The Key to Complete Patient Information.”

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

Platinum Sponsors


  

  

  


  

Gold Sponsors


 

Subscribe to Updates




Search All HIStalk Sites



Recent Comments

  1. The article about Pediatric Associates in CA has a nugget with a potentially outsized impact: the implication that VFC vaccines…

  2. Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…

  3. NextGen announcement on Rusty makes me wonder why he was asked to leave abruptly. Knowing him, I can think of…

  4. "New Haven, CT-based medical billing and patient communications startup Inbox Health..." What you're literally saying here is that the firm…

  5. RE: Josephine County Public Health department in Oregon administer COVID-19 vaccines to fellow stranded motorists. "Hey, you guys over there…