Well, we'll continue our conversation. We just had a great session on the other stage about APs and driver of innovation. We have a couple additional panelists here. We have Julie Shea to my left, Nancy right across, Deepthi and Lisa are technically on the panel, but please have everyone join in because I think everyone has a lot of insights here. I do want to, the first question I wanted to start with, and I think this is a great question for this table right here, is how can the Heart Rhythm Society help us be more innovative? Yes, we have HRX and things like that, but what else could we do as a society to drive innovation from an allied professional standpoint? And anyone can just jump in and start chatting. I think one of the things that we see and we've done over the years at HRS is have innovative sessions at the HRS conferences. I think it's important as allies that we put in for the sessions what we think our needs are so the program committee recognizes that. And I just wanted to add, I mean, I think the addition of the LEAP program, the Leadership and Education for Allied Professionals has done a tremendous service to promote innovation for allied professionals. I think it has empowered allied professionals. I think it has challenged allied professionals. I think those I've witnessed, allies that have participated in this program, grow exponentially throughout their year there. And as I always say, you come out a different person than you went in, right? Because you learn so much, you learn the skill sets that you need in order to push innovation, to identify needs. And as Bryn brought up, a lot of the innovation that allied professionals do is born out of necessity, that we see things that need to be. Can I have one of you test the mic? Your headset's flashing pink and purple. Oh, I can hear. Oh, you can? Yeah. That, you know, it's allied professionals, that's something we do every day. We innovate, we find new ways to do things. And so I'm so encouraged by the LEAP program and by all of you that have participated in it. The future is bright for the Heart Rhythm Society. I think that's, I agree 100% with what you said, because it is a program that will not only like hone your skill sets, but also will shift your thinking. You know, it shifts that mentality from just being part of the team members to also, you know, have the skills to become a leader in the space. The other thing, since you're asking a direct question of HRS Bryn, which I think it's great being that you are part of the BOT, right, the board of trustees. I think that bringing back the fact that there should be a track for AHPs in innovation, like there should be a dedicated session, a dedicated time, a day, whatever it is, because that is how you grow that seed that we're planting, because that's what we're doing here. We're planting seeds for AHPs to come up with those innovative workflows, I don't know, technology, whatever it is that we need, but you can grow that into a robust tree, one that's healthy for AHPs, who I consider us boots on the ground. We are hashtag boots on the grounds. You will develop the helmet that will prevent that bullet from just going right into your brain because you're walking Normandy beach. That's how I see us. So that innovation out of necessity, honing skills from a program like LEAP and HRS providing that fertile ground where we can bring that and grow it, have others listen, have capitals ventures listen and fund things like that with those ideas, that's how HRS will grow the next generation of AHPs. I'm leading that charge, I have a flag. And I think also the other thing that we're working on, you know, through the Allied Professional Council is the leadership development track, because I think it's important to provide transparency. You know, we do need to grow the next generation of leaders and I think that we need to have a success in track. So we're actually working on that, trying to develop it so that it will be transparent. We can make sure that people are getting into positions and roles that they should be to continue to develop the skill sets and move the needle forward. I think this is, go ahead, Deepi, go ahead, go ahead. I would add advocacy. So expanding the roles and scope of practices of allied professionals. When I first started training for invasive electrophysiology, there was no one in the state of Georgia that I knew of that assisted in the lab. So one of my first sessions at, or one of my first times attending HRS, I found a couple of APs that did this. So instead of having to reinvent the wheel, I guess really highlighting the roles of allied professionals across the country and even the world. And there may be centers that are already doing things that you would like to do. Another example would be the AFib Center for Excellence. Just to highlight these innovative models, which are not just highlight the model, but kind of create like a flow or a protocol for that would make it easier for other organizations, other allied professionals to adopt easily. That's really great. I think we talked about this earlier on. The other stage is how we collaborate and share. And that can be with publication or it can just be simply sharing with each other by having conversations. I was having a conversation with Jamie yesterday and she was like, I'll share all this stuff with you. And I think we do a great job of that. We're not competitive people. We want to share. In pediatrics, we have our own PACES community and we have a website that we'll put documents on. If you came up with something that works, you throw it on the website. Communities, we can, HRS communities, we have conversations that go, funny I get up in the morning and that's the first thing I see is the community conversations that went all night basically when I was sleeping. So I do encourage all of us to share as much as possible. And I think, again, it's not that anyone is stealing anyone else's work. Of course, we're not that way, but it can trigger other ideas to help in your own center or your own patients. And none of us are out there to say, oh, I came up with that idea. We're all one big team. And so I really encourage us to continue to share. Go ahead, Martha. I think you're absolutely right about that. Not that we're not, there's nothing wrong with being competitive. Being competitive, it's okay. But we are not cutthroat. There's a very big difference in my humble opinion. I will take workflow that worked for your practice to mine and sort of adjust it to what works for my practice. But that idea came from you. And I'm so willing to say, you know what? I got that idea at the meeting from this nurse practitioner, yada, yada. So let's try this here. The other thing I wanted to do, which I think I underutilized and I apologize, HRS, but I think HRS 365, it's a great platform for us to just educate ourselves. They just have to make it a little more affordable for AHPs because we are not making the big bucks. I'm not driving a Mercedes Benz. I'm driving a Kia, you know what I'm saying? I was also gonna mention the Cardi Q website. So this is another resource that the Heart Rhythm Society has provided as a way to share resources. We don't need to reinvent the wheel. People are doing great things. Elliot Antman just published the AF playbook on the Cardi Q website about how to set up an AFib clinic. So all of the, everything from soup to nuts is there for you. So, and there's other great, we posted all of our virtual AFib symposium. I sent all of those to the Cardi Q website as well. So for educational resources. So check that out if you've not taken a look at it. It's a great resource that HRS offers for free. I think one of the things that makes AHPs special, particularly in HRS, is that we are so supportive and that we do share, right? So there are always conversations happening when we see each other, we say hi, we share hugs, we talk about work and we talk about how things are better or how we can make things better. So continuing to support one another and that's the other thing, we show up, right? Thank you all. You know, we show up for one another. We come to your talks. We wanna hear our colleagues share their new information and we wanna be there for you. And I think that that's what makes us unique. Yeah, I really agree. And I think it was Martha in our session earlier was talking about how much the practice has changed and you don't recognize it in your day-to-day activities. But if you look back and think about what we did before, what the devices are, where we're going, it's always evolving and somehow we continue to show up and we continue to be flexible, adaptable. So let's talk a little bit about how do we continue to do that? I think it's a challenging thing to do but that's what makes, personally, my job exciting. I don't know what I'm gonna walk into on any day. So when you walk in and you don't know what's happening, you don't know what to do, how do you just kind of start and make it all work? Because that's what we do. We just make it all work all the time. I think as nurses, we and allied professionals, not just nurses, PAs, everybody, is that in our growth, we've also learned to flex. Everything is not black and white, it's pink and purple. We can't go A, B, C every day. Sometimes we gotta put Z first. And I think that's what makes us special people. And Brynn, you told me after you go to this meeting, this is my first one, you are gonna be so pumped up and I am, I'm pumped up to go back and share and look for things. And I think we all do this and I think that's what makes us good at what we do. I agree. I think it refreshes us because the day-to-day work, it's brutal, it's grueling. I mean, I think that I share that with most of you. I co-founded the practice with Daniel Wong at White Plains Hospital and I have not taken a week off, like in a row, but more stupendously and wonderfully, I took actually two weeks off in a row because my son got married last weekend. And so everyone's going, what, what, what do you mean? I've worked with Martha for seven years, she's never taken time off. You know, that was so, for me, it was just so soothing and so supportive because they're like, you gotta do that more. Because I have like 300 hours of PTO. What I'm trying to say at the end of the, I know, I mean, I don't know what that means, but that sounds like a lot. So, you know, it's sort of like when I grew up, when I grew up as a nurse, it was nurses eat, they're young. And you know what? I just cannot thrive in that environment. I just can't do it. I heard that too, but I don't think that actually happens. I think we are all very supportive. We want to set the future for the younger generation. And that's exactly what I don't want to do, right? Because I grew up that way. You know, nurses were not kind to each other. And I mean, it was tough and it's just not an environment where you thrive. Nevermind grow, but thrive. And I want no part of that. I want to be the change that I want to see. And so I think that that's what this is. This community is wonderful, supportive, and I keep staying and I keep coming back and I look at people like, I look at people like Dee, I'm like, oh my gosh, she wants to talk to me. I'm like, oh, she wants to talk to me. It's wonderful, Dee. You go back to that old saying, you know, be in the room with who you want to be, right? Going back to adaptability, Bryn, that's like the nail on the head, right? I mean, that is one of the things that I learned early on in my career was going to make me successful, was that if I could adapt to the different situations that were thrown at me every day, then I could then carry the patients farther, I could carry the practice farther, I could carry the physicians farther, I could help them and support them more by my own adaptability. And I think it's such a key skill. So it's important to, while things may not be going exactly as you thought, to not get flustered and to step back and say, I can solve this problem. I can go with the flow of the river. I just wanted to add that electrophysiology is such a niche field that if I were to talk to my cardiology colleagues about like a wearable workflow or really anything AFib related, antiarrhythmic therapy, they're like, go to EP. Like it's so, when you come here, you meet people that know what you're talking about. They've been in, they've encountered similar scenarios and maybe they've already come up with a workflow for it. So, I don't know, it just feels like home coming to these conferences. Yeah, I agree. I think that we, together, we're so much greater than the sum of the parts. So I really do think that this is always inspiring to come to these types of sessions and talk about kind of future. And then what I also do is reflect on where we've come from. So I think that it's both ways of how far we've come. And we all had to navigate the COVID pandemic and how that affected our patients, how it affected our workload. So one of the things I want to bring up as a group is, we were talking earlier about kind of changing the paradigm and I forget who was saying it earlier, I think it was Heather. We want to change and actually bring the care of the patients to the patients and not make the patients come to us. So I think that's a great innovation strategy for our allied professional group. How do you think, what's the best way to do that? How is it, how can we get out into the community and bring the care to the patients more than we're already doing? You know, we have wearables, telehealth, but what else can we do to get out to the community, you know, especially with healthcare equity and things like that? So I'd love to hear your opinions. I would say starting with empowering the patient. So we, I specifically come across a lot of patients in clinic who say they don't know much about their diagnosis. Well, this is your chronic condition, so you should. And second would be giving them the proper resources. So they go on Google or these random websites that gives them incorrect information. So giving them proper channels and resources to understand their disease condition, proper resources, or even like having triage centers, nursing triage centers that would answer whatever questions they may have. I think going back to where, you know, like everything old is new again, I think one of the things that we can do as an outreach for patients, especially patients with not just devices, but arrhythmia patients, is bringing back those support groups. When I had that, that was a while ago in my other healthcare organization, you know, it was called the live wires. And we used to do that, and you can do that virtual. I know that, right, Julie, you guys held that virtual patient. I mean, that is phenomenal. That is phenomenal. And I think you cannot let go of the human touch. Thank you. Tiffany or Lauren, why don't you talk a little bit about kind of your very innovative program that you developed, because I think, you know, it's such a great program and the way that you implemented it for contemporary times, for our patients, for our younger patients, for outreach is tremendous. so if you could share that. Yeah so Tiffany and myself we lead an ICD support group at Brigham and Women's Hospital and our first session was in November 2022 and this sort of came up as an idea once we found that patients were asking do you have any resources for patients who are facing psychological stress or PTSD or even just understanding what it's like to live with an implantable device for the rest of your life and so what we did was we created a survey and sent it out to our ICD patients via our EMR to see if patients would be interested in joining an ICD support group and if so then how often, what day, what time, how long should it be, who should be involved, what should the topics be, etc. And we received a great response from many patients who had said yes we would be interested, you know quarterly meetings on particularly Thursday evenings and we decided to also offer that in person and virtual which was great because it allowed patients that you know maybe don't want to travel into Boston at 5 p.m on a Thursday or even those patients who we see or who we manage but live two hours away and so don't want to come into the city and we've found an overwhelmingly positive response. These patients come and engage with each other and we've established breakout sessions where the patients really lead the topics and the discussions and we have moderators there and it's a great opportunity to help provide community for them and also a safe space and providing some education to the extent where they feel empowered by the knowledge that we're sharing with them. If I could just add the other piece that we've learned is there's a huge psychological component of chronic cardiac conditions right and that's one thing that we are not well equipped to serve. I'm not a psychiatrist, I'm not a psychologist, not a mental health counselor. I can try to be but I'm not and I think it's a really important component that we often miss with patients who have cardiac arrhythmias and are living with devices so we established a referral process to a cardiac psychiatrist that we have on site that allows us that if a patient does identify that they have extreme anxiety or they suffer from PTSD that we can give them a pipeline to get the care that they need to continue to progress and not you know fall into a trap and the other thing we've done is with the speakers that we've invited we've actually opened up community. We had two patients who currently live in Florida but our sisters their organization is called Heart Charged. They came and spoke with patients about specifically being young women with devices which is not a profile that's well advertised but does exist right and so we were able to capture community with that which I think has been a huge benefit to people hearing about the program and then we find speakers who want to share their story and and allow empathy with different patient profiles that perhaps aren't necessarily the ones that are mainstream. You know along these same lines I think that one of the things that allied professionals do the best is patient education and I think there's a lot of innovation with patient education so I'd love to hear everyone. I'm going to also pick on Nate over here who helped develop the pediatric content to Upbeat about you know what do you see as the the next steps for patient education. I was talking to Pat earlier there's talk about including you know chatbots and things like that that make it more interactive. CardiQ has made it quite interactive and so how how as allied professionals can we push forward patient education to to make it where it's understandable and interactive with our patients. Can I make a request of these two wonderful women here this is the future of AHP communities right here right here so proud to be in the same space you ladies are in. Just did you would you want to publish how you did that you know patient group support group and whatever because that used to be a thing when I was a long time ago you know coming up in EP but COVID and all that and it just sort of like fell out of vogue or whatever but we just have so many more resources and so many more ways to communicate now. You publish that anywhere you preferably with Aileen Farrick you just a plug for Aileen you publish that and you will be bringing I'm not kidding you will be bringing the next set of AHPs into that wonderful wonderful thing that you've done for patients. Just a request. Thank you yeah we've been working with Dr. Sam Sears as well and so we're we're hoping to get something out in the literature at some point so thank you for the motivation. I'm going to tee up Nate here one of the things that we did at our in our pediatric institution is we created pamphlets basically we all the physicians and Nate and I participated in creating and writing little pamphlets that we have so we we have a book with pictures and with writing that's in I think it's a fifth grade reading level so that most patients can understand it and and I use mostly the pictures when I'm talking to the patients and I say you can go back and read the words on your own time but like here's here's what's going on with your heart and if we're implanting a device so we have one for pacemakers we have one for ICDs we have one for ICMs we have one for SVTs that's a huge part of our patient population and so creating those has been super helpful and then Nate you can take it away with everything you do. Wasn't expecting to talk here but you're on you're on Nate come on. No so like Lisa said I think when we identified kind of the need for having more education for our patients and their families for their procedures specifically one of the things that I thought a lot about was how important it is we don't it's not just like we have the adults to to teach we have kids as well so we have this kind of multifaceted approach of we got to give education to these kids but also their parents so how do we how do we provide education to to support both populations right but like Lisa said we put together a folder with a bunch of different resources we also provide the Upbeat website like Brandon talked about we when I first the first committee I got on it as HRS was on the patient caregiver committee with Bryn she was the chair at the time and our project was to work on Upbeat and providing content educational content and being a part of PACES we already had a lot of that pediatric content provided that we were able to just kind of provide for Upbeat specifically so I think providing education for these kids is super important but also providing education for the parents so that when these kids do go home these parents are well equipped to be able to take care of their kids that just had a either a pacemaker implanted or SVT ablation or anything like that so I think continuing to move forward and pushing new education having proper resources for kids and their parents is super important and something that it's great to see all these new providers and our AHBs taking that advancement. I do also want to say that he created a video on YouTube for our patients to see what will happen on the day of your procedure so Nate pretends to be a patient coming into the hospital walks them from the parking garage to the EP lab and then and I don't I can't remember how it ends but I mean you starred in it. It was pretty sweet I mean I when we're trying to like I make all the patient phone calls for when these kids come for their ablation or for whatever procedure they have and try to describe to the families and I'm normally talking to the parents so I don't even get to talk to these kids unless you know I get to see them in clinic or it depends if they're getting referred from an outside provider maybe they've never been to our hospital before so it was I saw this gap of I'm trying to explain like where to go to these parents on the phone and how many times that the morning of the procedure I'm getting a call from registration or I'm getting a call from the parent like we're here in the hospital but we have nowhere to go and then trying to tie into how am I going to do this for like a teenage population or a kid population and you know with YouTube and these kids having their own YouTube channels and being influencers and you see all these POV or point of view videos I got the idea from basically that to basically hold a GoPro as I walked through the hospital and took a video of like showing them here's the registration desk here's the elevator that you're going to take here's the here's the room that you're going to be in before and after here's what the cath lab looks like and it's been pretty well perceived uh unfortunately we've had some like updates within our hospital so I feel like I was just thinking the other day I'd need to make probably a new video one I don't have hair anymore so these people are probably not going to recognize me but um like they changed some of the registration there was some construction within within that and so but I think it's super important for these kids to be able to see where am I going to be beforehand I can tell the parents all the things but and then you know and then it's it literally is playing telephone the parents then try to describe it to their kids and it's it's hard for them to get a grasp on what's actually happening so I think having these kids being able to view these videos and then come to the hospital it's like they've already been there before it kind of has a sense of um calm provides a sense of calmness for them when they do show up for the first time that's fabulous I think this is exactly how we come uh come to where the patients are right so this is as in pediatrics we obviously we move around them move around with them in the room as they're toddling around or talking to them with the the new slang um but we are coming to the patients where they are and I think that that's a huge role and space for AHPs that's fantastic can I ask Julie Shea and Brenna a question can that be posted in the AHP communities as a this is a workflow that we have found is good to do I mean I'd be happy it's on you it's published on YouTube so I mean anybody could watch it so yeah I'd be happy to share the YouTube link with whoever wants it yeah I mean you could post the link on the community I think you bring up a great point which is the power of social media right now in helping us educate patients is huge I know Dee's really into this um and you know really trying to capture all the platforms that play a role in how patients are getting information they spend most of their time on social media and that's the reality and that's where we can be pushing content that's advertised but certainly content that's just accessible and uh you know affordable and in ways that there's certainly reach people yeah I totally agree I it's also we got to be super careful too when you start moving in that direct direction especially when you're talking about like when you guys are doing your support groups and things like that I'm sure there's things that come up with your patients that are in there if they're providing misinformation or things like that it's so easy to get fake news if you will um on that so I think that's something we also have to really pay attention to as well did this have to did marketing have to vet this before um you put it out on youtube oh for sure yeah and they had a like I basically had a production crew with me through the marketing and pr department um that actually put together the video um I mean yes I I did film with the gopro but they also had another camera and then there was like a production assistant through the marketing department so yeah there was a lot of hoops that we had to jump through to to make sure it was good to be posted I wanted no I was just going to say on our as another initiative at the Brigham that I put together every year a living with atrial fibrillation patient symposium which is a uh it's coming up actually on Saturday October 5th from 8 to 12 and it's an it kind of we had to pivot during the pandemic because we couldn't run our in-person symposium patient uh uh program so we pivoted to virtual and now we've kind of just stayed virtual because it's been so successful and how we format it is that we have four different blocks and our physicians will all pre-record different topics about 10 minutes each because most people's attention spans for things are about two seconds so we try to keep them short and then once people go through the block then there's a 30 minute question and answer period where the physicians are actually live on zoom and the patients can actually post their questions I moderate so I will feed the questions to the physicians all their questions are answered live and then we move on to the next block it's everything you need to know about AFib from what is AFib what are the genetics of AFib we talk about our AF center of excellence at the Brigham we talk about risk factor modification and one of the things that Nate you reminded me of that Lauren did was kind of the the virtual tour through the EP lab kind of what to expect you know before and after your procedure so kind of stepping it through the patient what to expect what things are going to look like because most people learn things visually so we found that to be helpful so you know this is the online program has been a great way to reach people we have had anywhere from three to five hundred people log on I've had people from around the world we've already had somebody register from the UK I've had people from Chile log on so all across the world and that's the power of the internet right that we've opened up this program internationally so so how do we get started with that can you publish that sure I just and now you're going to come back at me with this I wanted to also share with for whatever this is worth to any of you here MRIs and patients that come into the ER let me scratch MRIs patients that come to the ER with devices it is always always a call to the EP service oh could you interrogate this device well why did the patient come in oh the patient broke his leg well what does that have to do with the pacemaker oh I just want an interrogation it it was just really so so tough right I'm like well you know five years of this suffering finally what I did was you know what I stopped kvetching I found a solution and I did a little bit of what Nate did I engaged all the reps from each company to put a two-minute video literally one and a half minutes or two minutes on how to interrogate a device in the ER with the technology that the companies provide getlim express you know latitude consult on demand merlin right oh and now biotronic has their own it's neo express so what I did was I had them do a video two minutes on how to interrogate a device I contacted the IT department obviously with the video we had to do the media people and god forbid you know sign sign your life away with this contract just for this two-minute video so it was it was great it was great engagement that reps felt exactly what I tell them they are they're part of my team we deployed the IT department so that they could build the interface on and now it's easy because when you interrogate a device right you have that wi-fi it sends it to the company what I had them build was who gets this information and gets back to the ER doctor that it's a normal transmission or a normal check so we built that workflow and if the patient requires an EP consult they do that. I educated the ER physicians. When you need an interrogation, please don't call me. Look at this QR because I did the videos with these patients, with the reps, with the media department, and I, this is the innovation, which I should have said at the, you know, our meeting prior. I put it on a QR code and the QR code is attached to each programmer. So you don't need to call me at all. You call me when you need me, because there's an issue with this device. So for whatever that's worth using, I will publish it. That's great. I mean, just listening to all these ideas, they seem so simple, but they make such big differences, you know, support groups and educational videos for the ER and things like that. And this is, you know, again, this is our strength, you know, I personally, I'm not an engineer. I'm not going to come up with some new gidget gadget thing out there, but what I can do is streamline, make things more efficient, you know, and I think all these, all of this is innovation. One of the things I often think about is quality improvement. The way quality improvement comes about is you take a problem and you want to make something better, you know, simple thing. Like we always put a holster on every single one of our patients after ablations. And then why do we do that? And then get the data and, you know, we can make a difference. So I don't think that innovation has to be a physical something. It is fixing something, making it better, making it more efficient. And most of, many of these problems come about because just like Nate said, and Martha said, you're answering the same question a thousand times. The ER is calling you a thousand times. What we're doing is actually taking the work away from us and making it more streamlined. And I think that is the important part of what allied professionals do every single day. And I love to hear these little projects and how they, you know, make such a big difference for our world. I'll tell you that I, oh, I'm sorry, Nate. I just wanted to say that I said to the ER physician, so because you have to have the buy-in from these people, right? Like, how do you get the buy-in from these people? It was easy. I am empowering you, Dr. So-and-so. I'm empowering you. Use the lingo. Yes. I was just going to say, Brynn, that was very well put. You know, it's always a little intimidating coming here to HRX with all these, like you said, engineers and innovators building these products and things like that. But when you can think about it from our standpoint of just developing an education program for a kid, it can be super innovative as well. So I think this is super important and I'd love to see how many allied professionals are here. And hopefully it just keeps growing and we'll keep on pushing HRS to keep that going. I mean, I will say that the producer, all the producers of HRX, which is three of them, over the past, there's been three HRXs and so there's been six, really recognize the importance of making sure that we're here. So Julie and I were on the production team as an allied professional representative, and they were pushing us to make sure that we had quality programming. And really what I have learned time and time again, coming to these meetings, is this is where we do our best. I mean, we really play off of each other. And just like I told Nancy as a first timer, you'll go home and your mind is just going to be spinning with these ideas. And that is the point of being here. So I think it's really important that we just continue to show up, as Martha has said, be at the table and put our ideas out there. And I think it's important to share ideas with each other. I think that for AHPs, Nancy, and I know, we're jaded people, right? We're jaded people. That's okay. I got calluses from all those remote monitoring things. But I just wanted to say that the importance that HRS is placing on AHPs, people like us, we are HRS. That first HRX, it was an AHP who opened that inaugural HRX. I lost six pounds over putting that together. But I tell you, it's been worth every second being here because we do matter. We do matter. We are the wheels on the bus. Well, continuing our conversation, and I'm looking at the happy hour line over there. I am always humbled by being here with such amazing people from across the country. And before I really became into HRS from a kind of leadership track, I was not trapped, but I was in my own pediatric bubble. And I think, and many of you are probably, you're just kind of within this tiny infrastructure. And now you recognize this great group of professionals out there. I think the LEAP program is really, really going to take off. And Julie is one of the co-chairs, co-chairs, is that what you would call it, for LEAP this year? Nope. Actually, it's Aileen. Oh, you were. You was prior. I was last year. Last year. Sorry. So Aileen and Carrie. Yes. So one of the things that I think that we can take back to the LEAP program itself is start putting little innovation sessions in there. How can we drive innovation? And that will get people kind of starting from the beginning to really think about innovation. And like I said, and like Martha has reiterated, it doesn't have to be some major project. It just has to be something that makes our lives easier, plus patient lives easier. So I really like how Lisa brought that back to where by doing all of these things, videos and things like that, we are taking the education, we are taking the care to the patient. And I think that's really helpful. I'll just kind of go on one more tangent here because I would love to hear everyone's perspective on it. I also think that we are very well suited for telehealth and digital health. We are all used to phone triaging. That's something that comes with being an allied professional with remote monitoring, phone calls, making phone calls to patients. So I'd love to hear about everyone's experience in providing telehealth and how did you feel it was easy just to jump into telehealth? Is this something that you continue in your practice? Obviously, it was something we had to do during COVID, but how can we continue to make sure that stays around? Because there are laws coming up that these telehealth codes and things like CPT codes may go away. So we have to get on legislation here to keep this. This is important. Telehealth is important. Go ahead. So in our practice, we live in a pretty central area. People don't have to drive far. They would much rather come in and get their device checked before COVID than go on remote monitoring. So we had to change our standard and the telehealth and stuff. So for us, it was just getting the patients to recognize that during COVID, this is where we was going. We didn't know how long it was going to last. We had to change our protocols for ablations, pacemakers. ICDs no longer stayed all night. We started calling them the next morning, looking at their wounds and doing all that stuff. So it's really hard because our population where we're at isn't really into telehealth, which makes it tough. So as I alluded to earlier, I had worked in telehealth prior to starting my position with Pediatric EP. The model there was that we were creating kind of a a vitals monitoring to keep chronically ill patients out of the hospital. And so we managed a lot of advanced CHF, diabetes, you know, chronic adult illnesses by recording their vital signs and stuff. And that was all telemedicine based. And that was that had been going on for years and they were doing a lot of other telemonitoring. So with those tools coming and then the pandemic happening, it was like there was no other choice for us, right? We had to do it. And why does it still matter? And I think what we need to impress upon the powers that be, the insurance companies and CMS, is that it's so beneficial for patients who do not live next to your office. So we in Missouri cover such a large geographic area that includes Illinois, Arkansas, Missouri. I think we have Kansas and Oklahoma patients too that float in and out that we need to continue to provide care for them and not make them drive five hours every single time they want to see somebody, right? So that's the beauty of remote monitoring. It's the beauty of telehealth. So I think that that's something that gets lost in the shuffle for the people that make those reimbursement decisions is that they're decreasing access to care by getting rid of it. I agree with that a hundred percent. I think that, you know, telehealth is part of the practice for us now. COVID was just global education for us all. So at the end of the day, when patients have to get their results for their Zio patches or whatever it is we have, we have that 15-minute telehealth. I'll tell you where it's become really crucial and more important is where patients go home after their device and they're like, I'm all swollen, there's a bleed, there's something. I'm like, okay, I'm getting on the phone. No, I'm getting on the FaceTime. It's exactly what I do. And I tell patients, this is not a monitor phone, but I'm willing to look at it. I have avoided patients coming in, not that we don't want to see them. Those are the patients that we do want to see because we want to avoid issues. But I'm then, I'm able to reassure the patient. I'm able to tell them that it's okay and they feel better and there's no issue. But most importantly, guys, and I don't want to be dooms person here, doomsday person here, but the next pandemic it's coming up. So we better be prepared and telehealth being in place. It's exactly what we need to do. So we need to let these people in government, CMS, be greater thinkers than they are. Be a visionary because if you don't think that there will be another pandemic, then you're living in a bubble. It's true. It's true. Julie reminded me that I got chatting too much. I forgot about some of the questions and actually much of them have to do with sharing, sharing these wonderful ideas, the virtual health Nate's video. You know, the only option I can think of right that's available right now is by using the platform that we have, which is the communities pages. And if you haven't been on there and you're not part of it, jump on it because there are tons of conversations going. You don't have to read them all, but if one pops up like, Hey, what about patient education? You know, and then, and then people can start feeding this. So make sure that you're part of the allied health community, part of heart rhythm society. And I think that's going to be the important way to get these resources out there. One of the comments Nate is to your video, you know, they thought this whoever shared this thought it was just a really great way to engage our patients. And same thing, there was a question about advertising. So I think that we have to use the platforms that we have. And we also have to think about better platforms. I don't think communities is perfect, but it's what we have right now. And I think it's a way for us to be able to view what everyone else is sharing. And just as Martha's alluded to or said, you know, point blank, publish this. It's very helpful to have it, to have it published. The question I'll, I'll just kind of close out with this probably is what are the biggest pain points in your day to clinical in, in your day-to-day clinical practice that you would love to solve with the help of digital health or health tech? And so I'll let everyone answer at the table. I would say, I think this was one of the round table discussions maybe a couple of hours ago was a workflow for a mobile health or wearables. It's 2024. We have so many patients using it, especially like maybe the pediatric younger populations. And we still don't have a proper workflow. So it's just coming to their individual EP provider, a physician and APPs. And it's not quite streamlined yet. So I think one of the other things that where AI could be helpful is in terms of patient safety. So like making sure that, you know, I would love a remote monitoring system that, you know, tracks heart rate in terms of, you know, high heart rates and sends an alert about it. I mean, I know we do have those things in there, but I feel like a lot of times they're missed. That maybe trends, we see changes in trending more than absolute numbers. And, you know, cause we had a patient the other day who had an AFib alert and our tech missed it and patient wasn't anticoagulated. Fortunately, nothing bad happened to them, but I would love to be able to have AI be able to identify that and send us a better alert about it. We do have that in Epic where, you know, if you have atrial fibrillation and they're not anticoagulated, there is a pop-up for that. But again, it's as good as you putting the diagnosis in. If you don't put the diagnosis in, Epic's not going to see it and not going to alert you for it. And also in terms of guideline directed therapy, making sure that that's being optimized for patients. So that's kind of on my wishlist. I just want to take it back to the clinic, the device clinic. I love HeartConnect and, you know, it's just a, it's not a plug or anything like that, but I don't know if you're aware, Boston Scientific has a HeartConnect in their programmer. Like when, when I don't understand some of the things I'm looking at now, right, you know, I just, I hit the HeartConnect button and it lets me talk to a rep like right away, rather than calling the 1-800 number, yada, yada, yada. And they get to see it. See, that's the key. We are now having bi-directional look at the same thing. So I think that all companies should have that because with the advent of the new technology, you know, the leadless micro, the leadless aver, now the dual chamber aver. I mean, some of the reps still, they don't know some of the, the, the, the technology in it when things come up with it. So I think that industry has a responsibility to educate us rather than asking us always, oh, we're going to so-and-so Academy and just look at that. You know what Academy this, this is like now, can you help me now? So I think that if they have that feature for every company, it would be a really game changer for especially some of the techs and some of the nurses that I want to have check devices without having to always use an APP for it. So Biotronic also has that on their new Renamic, I believe is the name of their programmer. It's supposed to be, that's what the guy said. Anyhow, I think my main thing is the whole keeping up networking, getting ideas from other people of what we do to make our workflow better. Something may work for you, doesn't work for me, but what works for me may not work for her. I just think as the allied professionals have developed over the years, we just have come up with better ideas to take better care of our patients. I agree with Martha on the bi-directional flow of information. I think that's one of the things that I've been learning more about different products here at HRX that the bi-directional flow decreases my number of clicks. And the more efficient that I can be by the less clicking to find the information, the better we are going to be and the easier our days are going to be. So I think that that's something huge in industry that needs to continue is that putting more information in one place. Well, excellent. I will close out by thanking my wonderful panelists for being here and all of you for listening in and sending in questions. But, you know, let's continue the conversation for the rest of the weekend. And then also again, connect on communities pages and things like that. And I think, or just again, getting each other's emails. I think that's important too. But I think if you have a one-way conversation with someone, I think probably everyone would like to hear it, you know, just because that's how we get ideas. So make sure we all stay connected and I appreciate all of you. Thank you for having us, Brenda. You're welcome. Thanks to everyone for coming. It's been a great afternoon.

Heart Rhythm Society

allied professionals

LEAP program

telehealth

digital health

patient-centered care

innovation

collaboration

education