HealthIMPACT Live Presents: Spotlight on Nurse Entrepreneurship - Innovation on the Front Lines - Improving Communication Between Patients and Nurses
Originally Published: Oct 26, 2022
YouTube Video: https://youtu.be/fmqpoYFTS8g
As a registered nurse, Melissa deeply understands the post-acute industry. Her extensive clinical care and operational insight led her to become the visionary entrepreneur she is today. With CitusHealth, she's created our industry's first end-to-end digital health collaboration platform to solve the complexities of managing the post-acute continuum of care and patient and family engagement challenges. We'll discuss innovation on the front lines of healthcare, hear Melissa's founder's story, and discuss how to develop technology that makes healthcare better for patients and healthcare workers.
Melissa Kozak, RN,Co-Founder & President,Citus Health
Megan Antonelli,Chief Executive Officer, HealthIMPACT Live
Janae Sharp, Founder,The Sharp Index
Spotlight on Nurse Entrepreneurship - Innovation on the Front Lines - Improving Communication Between Patients and Nurses
Megan Antonelli: Welcome back everyone. As we continue the Health Impact Series on the future of healthcare workforce. We are talking today with Melissa Kozak. Melissa is a registered nurse and the founder and President of Citus Health. I met Melissa a few years ago at I think it was Health Impact. It might have been DMC where she had just started Citus and we'll discuss innovation on the front lines of healthcare, hear Melissa's founder's story, and talk about how to develop technology that makes healthcare better for patients and healthcare workers.
Hi Melissa. How
are you?
Melissa Kozak: I am doing very well, Megan, thank you for having me.
Megan Antonelli: Thanks so much. And of course we have Janae Sharp here today as well. Hi Janae.
Janae Sharp: Hi. I'm really looking
forward to hearing about this cuz I've spoken to so many like nurses and nurse executives who want to start something and they, oh, they're like, we need to talk more about how to do that.
Melissa Kozak: That's great. I'm so happy to talk to you all today.
Megan Antonelli: So Melissa, tell us about that. Tell us about your experience as a nurse and how, you know you, what led you to start Citus?
Melissa Kozak: Absolutely. So I've, again, my nursing career in New York City working at Lennox Hill Hospital, actually traditionally in a med surge floor, which most nurses started out at and then transferred to the ER.
And I actually had a physician colleague ask me if I would see one of his patients in their home. Sort of after hours, and I did that and absolutely fell in love with this idea of seeing a patient in their environment, actually in their home you know, see what kind of family support they have, what neighborhood they live in, what kind of access they had to food, what was in their fridge, really, how they lived.
Sort of how they tell us that they live. And I realized, I looked into home healthcare and realized, wow, there is a whole field of home based care which is really care that happens outside the four walls of a hospital. So, I ended up getting a job for a home infusion provider. So, you know, home infusion is where patients learn to self minister all sorts of IV infusions.
Instead of going into a hospital or after a hospital stay, they either self-administer or they administer it to their loved ones. And. You know, I just fell in love with the field and worked, you know, for various home infusion providers for about eight years. And while I loved the innovation that was there, that allowed patients to have that level of care in the home which kept costs down. It was their preferred site of care.
They had terrific outcomes, health outcomes. What was very evident to me early on, While there were systems of records in place, so think about EHRs or EMRs, what there wasn't available was a way for those patients between nursing visits to get support when they needed it. So unlike a hospital where there's really care around you as the patient 24 hours a day. When you're in the home, you may have a nurse visit you for one or two hours once a week, and in all that other time, you're essentially on your own. And the only tools available to those patients to get support were the telephone. So they'd have to call an 800 number, be transferred, wait on hold, get hung up on play, phone tag, and by then, you know, there could be all sorts of issues.
Fear, you know, they're running off to the er, et cetera. And then on top of that, You know, because it's outside of a hospital, that care team, which would include nurses like myself and pharmacists and administrative team members, we're not standing in the same room together. So how do we connect and coordinate that care in a way that is timely and doesn't cause delays to the patient?
And that's also really hard when the tools that you have in place are mostly phone and email and disparate systems that don't integrate with each other. So that was really my impetus to start Citus Health was how do we put together a platform that can streamline these things, that can help patients get good support when they're not with their nurse, and help nurses like myself and my colleagues communicate with each other.
Megan Antonelli: Right. That's great. Well, I used to live across the street from Atlantic Hill Hospital, so you could come given me a home visit. , that's, I literally lived right above the subway.
Melissa Kozak: Oh my goodness. That is my old stomping grounds. Megan,
Megan Antonelli: Do you remember? There was a bagel shop on the corner across the way.
Pick a bagel. Yep. Pick a bagel. Yep. And across the street from Pick a Bagel is Loft Opticians, which is my dad's eyeglass store for the last 45 years. Oh my God. No way. Oh, that's
crazy. Oh, funny. I never knew that. Well that's amazing. Well that, and that's interesting. I mean, just how you went from sort of in the hospital to home health, which I think, you know, right now obviously and certainly during the pandemic was, you know, such a big thing in doing that.
It, you know, was there a particular moment, you know, it, you know, in doing that, where you felt like that was, you know there's something I can solve here. Yeah. You know, what was the tipping point?
Melissa Kozak: Yeah, and it was, there definitely was a tipping point, but it was
Janae Sharp: because it kept tipping, tipping, tipping
Melissa Kozak: until there was that point where it fell over.
It was really like a death by a thousand cuts. So, you know, it would be things like I, I would. Get to my patient's home and it would be my sixth patient of the day traveling around the subways and buses of Manhattan. And oh man, that patient didn't have the supply that I needed to be able to care for them.
So I had to call the office, which was in Long Island and wait an hour and a half to get the supply after I've already done like a 12 hour shift or, you know The patient had been waiting to hear back from the office just to find out if they're authorized for more visits or do they need to go back to the hospital.
Or I would be asked at the end of a long day to go back to a patient's home to get a piece of paper signed and then drive it back to the office so that billing could occur. So it would be things like this over and over again. And my patients just telling me, man, Melissa, This is really hard, like getting this care in the home is an awesome thing, but communicating with you guys is really hard.
And so that, that final straw for me was I had a patient who was on an intermittent infusion device. He was being treated for a condition. Endocarditis, which is essentially an infection of his heart. So very serious condition, absolutely needed his infusion device, and I came to see him one morning and he was very distressed.
He had told me that he had been up all night. The pump was alarming. It was keeping his wife up all night and he was essentially trying to get help from the home infusion provider to help troubleshoot the pump. And he was calling a number, which was routed to a call center and that call center could not get a hold of the pharmacist on call.
And essentially he was so frustrated by the experience that he unplugged the. And again, this man was being treated for a heart infection. So that is just an example of a very dangerous, potential adverse event that could have happened to this patient of mine. And that was my aha moment.
I said, man, Why couldn't there be something in place for him to have sent a secure message to the right person on, call it, get routed to them, or maybe have an educational digital library available to him where he could have potentially tried to troubleshoot the equipment himself. But that was what started my journey that day forward.
I knew that I wanted to do something to make this better. That's
Janae Sharp: awesome. So how did it work? Did you go talk to the organization? Were they supportive
Melissa Kozak: and excited for you? Yeah. Yeah, I did for it. Yeah. So I did actually talk to the organization and at that, In my in home infusion nursing career, I was working for, I think the largest home infusion provider in the country.
So I sort of naively thought I could just tell them this great idea and maybe they would fund it and then, you know, I'd get it rolled out to all of their 50 sites or 60 sites. And you know how it is in a big corporation, you have to get to the right people. So, I got a lot of, Hey, that's a great idea, Melissa, but we can't really help you.
So it was more me kind of going out on my own to try to figure out how do we get this built? And you know, there was no objection from them to go, you know, figure it out. But at first there wasn't gonna be any sort of financial support or anything like that. So that kind of began the entrepreneurial journey.
And I, one of the first things that I did, Was figure out, is this really a need or is this just me? Do I just think this is a need or do my colleagues feel this is a need? So I started talking to other nurses. Do you guys feel this pain? Is this, is there this much friction in your day to day life trying to care for your.
Patients and I would go interview my patients, Hey, tell me about your experience. Is this really painful? Would it be better if you had maybe a mobile tool to connect with me and to connect with your care team? And I would, I just did searches on all the major home infusion companies websites to see did they offer something like this?
And there wasn't anything like this, and everyone that I talked to said, yes, indeed, this is an issue. And that large infusion company that I work for, they actually were PBM owned and a very sophisticated pbm, and they didn't have anything like this. So that was enough for me to conclude that.
There's a real need out there. And you know what I went and did after that was found myself a very brilliant technical co-founder named Shahi, and Megan, you know him well and work with him and we, we started from there. Yeah, I mean, it's kind of amazing. I mean, for context what timeframe was that?
Megan Antonelli: When was.
Melissa Kozak: 2015. It was actually September of 2015 was my first call with Shahi and I had come up with the idea just about a month before.
Megan Antonelli: Yeah. Yeah. So that's kind of, I mean, it's just crazy to me that, I mean, cuz it's not like home health was new for nursings, you know, at that point. And so what was the communication like?
Was it just not centralized at all, you know, or was it not patient
Melissa Kozak: facing at. It was not, you're right. It was not patient facing. So there were EMRs and those were not built for patient. They weren't built for patient first communication, and they really weren't built for collaboration of care teams. It was more to house a medical record.
It wasn't real time. Communication where you can, you know, talk and have these conversations to coordinate that care and intervene when things are going awry. So it was more one to one support. It was, Hey, you have an issue. Call this number and we will put you in touch with the right person. And after that right person speaks to you, that person then has to go reiterate the conversation in the emr, and then that nurse in the field who is then going to see that patient who maybe the day before had that conversation.
Doesn't know that conversation took place because they don't have access to the EMR in the field. So they're going into the home sort of blind, not knowing that this issue had occurred with the patient or maybe the patient needed a certain supply ahead of time. So it was that type of disjointed.
Thing that would lead to patient frustration. It would lead to nurse frustration. And we talking about, you know, clinician burnout and I know we're gonna talk some more about that. But there is it's really tough on a nurse when they go into a home. And don't know a critical piece of information about their patient and that they could have prepared for ahead of time, had the right thing pulled in the right order, whatever it is, and they're there.
And now they have to go backtrack, maybe leave the home and then come back. So yeah, it was just not, it was just not one to many communication in real. Everybody could know the whole story. It was very disjointed and still largely is right. I mean,
Megan Antonelli: I just had for the first time, so, you know, in my, you know, my charts and all that for my kids, you know, you can go request an appointment, right?
Right. So that's, the feature's been there, but I, it always results in a phone. It never results in them just making an appointment and that for the first time I just got a notification that I have an appointment set and I was like, wow, something works. But you know, it is and it's like it's syncing up the ay with the real time communication and that's just appointments, which is not, you know, it's like really what you would think would be the easy stuff.
Right. But that's great. I mean, just in terms. You know, finding the problem and then, you know, coming up with the solution. Shahe is also very good at that. Yeah, he's very good at it.
Melissa Kozak: It's
Megan Antonelli: can get you thought of it also. It's
Janae Sharp: interesting, I didn't know that they didn't have access to the emr.
Melissa Kozak: Yeah.
So some organizations need to provide a VPN connection for their nurses to access others don't. And. You know, and sometimes those notes don't sink back to the EMR in real time. Oh yeah. So there's no good time. Or it might be a rural area where they don't have connectivity. So there, there can be lots of reasons or some of those previous conversations with paperwork with patients were on paper and not yet uploaded to the emr.
So lots of reasons why that nurse can go in without all of the information. . Yeah.
Megan Antonelli: Now as a female founder, kind of creating a technology, you know, software in healthcare in the last seven years, you know, which has been an interesting time certainly a lot. We've seen a lot of adoption. What were there any you know, interesting experiences there. I mean it must have been, you know how do you get from having the idea to then, you know, now selling the company and being part of that.
Melissa Kozak: Ooh, we are gonna need more than a half
Megan Antonelli: hour into that. But tiny question. Female founder. Yeah. Just
Melissa Kozak: go . Well, the female founder thing, I have to say, I, I really I had sort of been primed.
You know, females compared to men raise less venture capital funding. They certainly, much smaller percentage are founders. But it didn't get in my way. It didn't get in my way because I just had a will and a determination and I just knew I, there was a problem and I was, I just had the mentality.
I'm gonna do whatever it takes to make this thing happen. So I never felt when I walked, you know, cause we raised several rounds of funding, VC funding angel funding, et cetera. I never felt a disadvantage as a woman. That is not to say it's not real for some women. That there is actually a disadvantage.
I think my mentality was just, I know what I know here. I need to find the right funding partners to go bring this to life. And so I didn't let that hold me back. So that's the female founder part, but how to get it from ideation to successful exit is a huge journey and a huge story. I would say, you know, the first part of it was finding a co-founder who.
Was a very experienced technologist, had started companies before. He had been co a co-founder before many times and had a, he had a passion for solving big challenges in healthcare, and he always, Wanted to partner with a clinician who had a, who really knew the workflow. So we were sort of a match made in heaven from that perspective.
I was a first time founder, first time ceo, zero business experience. I think what really helped me is I didn't know how hard starting a company was. I think if I knew that it was a Mount Everest journey, I probably wouldn't have taken the first step, but I think I thought it was like a hill to climb.
So that was good. I had that in my favor. And getting healthcare companies to part with money is not an easy thing. It is not easy. It's not easy for them to write a check, and it's certainly not easy for them to open up their networks to new software when they're so concerned about security and patients' data privacy.
So it was a lot early on about talking to customers, getting them to identify with the problem that we were solving and relentlessly. Speaking to them until those first few early adopters said, okay, I'll give you a chance. I'll give you a chance in a very small way. And so we would, we built an mvp, right?
That minimal viable product, which came from my. Ideas and you know what I experienced as a field nurse and we put it in the hands of those few early customers and we got that feedback and iterated the pro the product. But I would say the next. Smartest thing that I did as an early CEO is my first hire in the company was a nurse, a named Terry Emre.
She's still with me today and she had 25 years experience in home infusion and other home-based care markets, but, Way more operational experience. Whereas I was a bedside nurse. I knew one part of the workflow. She knew everything from the moment that prescription, that referral came in the door through the insurance verification, the whole revenue cycle, all of the operations.
So she was able to say, oh, that MVP is. But here's two more things we can add to the product that are gonna make the R ROI just skyrocket. And so we added a little bit more there and it was those early customers who, you know, gave those prospects a little fomo wow, if they're using it, maybe we should try to use it.
Right? And just. Not running outta money really helps . I mean you gotta not run outta money when you do this and you just have to. And that's like a great playbook.
Janae Sharp: We need like facts, like here's what you need to do, find awesome people and not run outta money. , that's it.
Melissa Kozak: And be able to get, you know, punched in the face a lot and get back up like that. That's really. And then just believe in what you're doing. And you know what? There were, I think Shahe always believed in what we were doing and believed in me. I. Had a lot of sort of baggage that, you know, I doubted myself and I doubted it, but I, at the end of the day, there was a belief in what we were doing that just kept me going, because let me tell you, you know, we, we have over a hundred customers now that span from home infusion, specialty pharmacy, and home health and hospice, and we're owned by a very big company now.
But in the early days, I would. You know, 50 nos for every Yes and right. And that's hard to deal with, you know, and you gotta just keep going. So yeah, don't rat on money. Hire really smart people, great dedicated people, and just keep getting up and that's what we need. I
Megan Antonelli: love that. It's amazing.
Well, and then you just got recognized for CR by Crane's New York business as the 2022 notable healthcare leaders. So congratulations on that. You got an award. So much success.
Melissa Kozak: Yeah, you send it to
Megan Antonelli: all your old bosses. What I was reading,
Melissa Kozak: but that's a good idea. It's like that pretty woman moment.
Big mistake. .
Megan Antonelli: Every no gets the press release. But you know, in the, I was reading it and you mentioned, you know, obviously the pandemic, right? And what that, how that changed healthcare and how the remote work for all nurses and everyone, you know, has changed it. So tell us a little bit about that experience and what you learned and what that means.
You know for the company and the technology as you.
Melissa Kozak: Totally. Well listen the March 20, 20 days, everybody was in a panic and I lived in New York, so we were hit, we were like, one of the first areas hit really hard. And from a software company perspective we were. Was like, well, how do we help?
What do we do? How do we help? And what we saw, of course, were patients didn't want their nurses to come for visits. They were scared of getting infected with Covid. They didn't want their families, the families didn't wanna go see their loved one and possibly infect them. So you have these patients isolated in the home.
They're not having their family support, they're not necessarily having the visits from the clinicians. So what do they do? And you know, early on, We did is let's just offer our platform out to any, anybody who wants it. Forget about fees, forget about charging. So here we have video chat technology that allows that patient to get on kind of like what we're on here, but HIPAA secure and connect with that nurse remotely.
And then that nurse can loop in the adult daughter across the country and the adult son in another part of the country and see that mom is doing okay. So it, it was, oh, that's amazing. Yeah it was It was rapid adoption of kind of these concepts that we had in place, but it became absolutely necessary at that point.
You know, we were servicing one of the industries that we were servicing specialty pharmacy. This is an industry where patients are diagnosed with very rare diseases. They are on medications where one. Can cost $4,000. And they were terrified. Am I gonna be able to get my life sustaining medications?
What's going on with the supply chain issues? I can't get in touch with my provider. And so we offered tools that allow that patient to track their deliveries and securely message with their pharmacist to find out yes, indeed, they. Gonna be getting that medication and submit early refill requests.
And the feedback from the patients through the pharmacies, which were our customers, were things like, Thank goodness for this platform because I was so scared that I wasn't gonna continue getting my healthcare and getting my medication. So that's really kind of early on. It was just how can we help in any way?
How can we make some of this stuff contactless? Where in, in the home health world, that's pretty ludicrous, but you still have to get pieces of paper signed for providers to get paid. How can we make that digital so that piece of paper can be sent electronically to that patient. And so that was really what we focused on.
Safety of the patient, safety of the clinicians, but that continuity of care. And then on the care team side, where all of a sudden you had many team members who. Worked in an office. Now they're remote. So you have this whole remote workforce and how do they stay in communication with one another when they don't necessarily have all the tools in place to do it?
So we we saw rapid adoption of a feature of ours called patient discussion groups, which is essentially, Like a teams thread, but about a patient without the patient being in it, just the care team and everybody was able to stay connected and know what just happened with the patient, pass the baton on to their care team member and really just keep that care going even though.
People were working from home and not in the office anymore. So that's what we saw. And here we are coming out of the pandemic and those technologies, because they worked so well in this trial by fire are continuing to go. And what we're seeing is that these providers, these patients are just not gonna go back to how it was, you know, pre 2020.
That's
Janae Sharp: fantastic. I do, I think we should also just talk a little bit about things now because nursing is kind of a hot topic lately. Yeah. So maybe we should talk about that. Like what people are talking about tech burnout and tech to solve burnout at the same time. They're talking about, you know, challenges for home in person care.
There's just a so. I'd love to hear your insights about like nurse burnout, whether that be in like the home healthcare, you know, realm or how things are now after the trial by fire. Sure.
Melissa Kozak: And listen, I go to a lot of conferences and the number one topic, whether I'm in a home health, a hospice, a home infusion conference, a hospital acute conference, it's it.
Retention of nurses, it's recruitment of nurses. This absolutely is a hot topic. We know that the pandemic drove so many nurses out of the field, just from the sheer stress of the pandemic, the increase in caseloads, the decrease in staff members to share that workload drove early retirement, all of those types of things.
So that burnout is real. Growing up as a young nurse, it really was the culture of nursing. This is way pre pandemic. It might sound silly, but it was empty stomach, full bladder all the time for a nurse and it was this idea of, it was never put the oxygen mask on myself before I put it on the other person.
It was always put it on the other person and doesn't matter if you choke, you know. And that was before there was this clinical shortage. So fast forward to, you know, this global pandemic and this shortage of nurses and now you've just removed work life balance more than ever before. And so our focus has been, it was before, but it's even more, how do you take away the repetitive.
Non-clinical administrative, busy tasks from nurses that prevents them from having their hands on patients, which is why they got into the profession in the first place. That keeps them doing paperwork well into 10 o'clock at night on their couch, not being able to be with their family or have any downtime or have any shift in their day.
How do we help? It technology's not a magic bullet. We can't make nurses out of thin air. That is a problem and absolutely there has to be. That pool of talent needs to be developed and working with nursing schools and all of that. But in the meantime, how do we give hours back to the nurses that are there on the front lines?
And we've found ways within IUs Health and certainly other technology platforms I'm sure have done this as well, to make it. At the end of the day, that nurse doesn't have to call six or seven patients to set up their visit for the next day. They can just send a simple message to coordinate that, or they don't have to go drive a piece of paper from a patient's home 45 minutes away to an office so it can get scanned into an emr.
So billing has occurred or. Don't have to be woken up in the middle of the night by a text message or a call from a patient saying that they're having a rash because that nurse is so nice that they give out their personal phone number to the patients. Instead there can be message routing in a platform that actually routes that message to the right nurse on call and escalates it.
So these are just a few ways and a few things that we do that just give that time back to the nurse and really lets them end their day and feel like, you know, I did, I had an okay day. So we have to keep focusing on that while that pipeline of new nurses is being.
Janae Sharp: That's interesting so what do you think, like when people come to you for advice, when you're going to those events what do you tell 'em? Do you say try us out, or do you give 'em, like what advice would you give people besides try us out, which we agree with?
Melissa Kozak: What we say is focus on providing tools to your nurses.
That makes their job suck less. And I quoting Megan here, we're having a conversation before we hit record on this. And it's true. So whether they use Citus Health or something else like there hasn't before really been a focus on nurses' wellbeing because there hasn't had to be, frankly. Now when there is such competition out there for nurses where they can go from a home healthcare provider to a hospital and get a $30,000 sign on bonus and they can get five job offers in a week, there has to be a focus on that nurse's wellbeing. My 15 years of being a nurse, I've never seen nurses kind of quote unquote chase the dollar the way that they are now. It had never really been seen as a profession of people going to find the most competitive salaries or anything. But it is that now. So.
Focus on what makes their lives easier. And then if they wanna talk more about what makes their lives easier we give them very simple examples, very low hanging fruit examples. It could feel really hard when you're already short staffed to think about implementing technology. . And if you think about that's like saying we're too busy to implement something that makes us less busy, right?
So we walk them through some of that and how do you do it and what is the benefit for you? And getting leadership's buy in so that those nurses can see, wow, this organization really cares about me. And in fact, we see some organizations using it as a recruitment tool, not just a retention tool, but out there recruiting nurses that way and saying, Hey, You know, you're probably used to being on call five nights a week and having your phone blow up, you know, while you're putting your kids to bed.
Here's what we do so that you can have a life back, you know?
Janae Sharp: Right, I like that.
Megan Antonelli: Yeah. And you know, we've talked to a lot of technology providers now about, you know, how technologies are doing that. And it is, you know, I think when we first started the conversation it was, you know, the EHR and how much technology.
Creating burnout or creating frustration. But now it really is coming in and providing solutions, particularly because I think both the patients and the doctors and the nurses, they're all there. Right? And so it, it's become, you know, because you can connect people in this more continuous way. But as we are running out of time a little bit, why don't you give us a little bit on, you know, just what you see as coming for both Citus and for you.
And you know, in terms of where things will go as this technology adoption continues and we take, you know, sort of more patient centered, but focused on the wellness of the clinician and their wellbeing as well.
Melissa Kozak: Absolutely. I mean we have had our eye on the home since the beginning of the company and now, you know, I think what Covid has shown us is the home is the center of our lives.
One of the silver linings, I guess, of this pandemic has been that the home based care market, which is near and dear to me as a home based care clinician, is finally getting the recognition that it deserves, from physicians referring to it, realizing that they could free up beds in the hospital, payers understanding the value it provides them, that it's the lower cost of care by far.
And patients wanting to stay in the home, not wanting to expose themselves you know, in the hospitals and things like that. So our focus will continue to, expanding into more areas of home-based care. Continuing to integrate further interoperability with all of the major EMRs because we know we can't be successful in a silo.
So we already have great integration with many of the core EMRs and we'll continue that and providing frictionless care really in an omnichannel way. So in our roadmap and what we've done over the last year or two is say let's give our customers who are the home health providers the ability to offer that care in the patient's preferred method of communication. So maybe that's with an app, or maybe that's appless where the patient can just engage through a simple text message or through a simple email. So we're gonna continue focusing on that and really looking at remote patient monitoring. So how do we connect those devices?
So our customers, those care providers can know when something might be going awry with the patient and intervene, keeping them out of the hospitals. You know, one of the big shifts right now that we're all hearing about is. The shift to value based care. So a way for from fee for service and these home health providers have to negotiate these contracts with, you know, these MA plans that are reimbursing at a lower rate than traditional Medicare plans, but they can come to the table with these MA plans and negotiate favorable rates if they can show.
Favorable outcomes and that it's actually valuable for that payer. So how can we continue to help our partners keep patients doing well under their care? So that's our roadmap and that's what our continued focus will be.
Janae Sharp: Wow. I love that.
Megan Antonelli: Yeah, me too. And that's a great focus and a great way to wrap up.
And so thank you. I congratulations. I'm just, I'm excited to be able to say I knew you when , it's just exciting to see you know, it go from idea to a successful product, you know, in the market and serving patients and nurses on, on both sides. So thanks so much for being here and we look forward to.
Talking later hopefully at the round table we'll have questions from the audience then, too.
Melissa Kozak: Wonderful. Thanks Megan. Thanks Janae. Great to be with you today.
Janae Sharp: Thank you.