the lines here. We're just going to let a few people get registered, come on screen, and so as soon as we get these folks on, we'll get the webinar started. Okay, so we have a few more people coming on live. So let's get things started a little bit differently. Today's presentation sponsored by GE is Heart of the Matter Strategies for Building a Successful Cardiac CT Program. Things will be a little bit different today where this is gonna be actually a pre-recorded session. So if you have any issues with volume, be able to be prepared to turn up your volume. But also we have added closed captions. So if there's any difficulty, you should be able to work through things nicely. We have two presenters that should be joining us for a live Q&A at the end of this presentation. That's Dr. Furman and Dr. Fournier. And the two things to be aware of is down at the bottom, there is a chat button. And if you just hover over the bottom, you'll see the chat button. There, you're gonna actually have a link to the presentation that's gonna be given today. So you can download the presentation itself and share this with your colleagues, review it at another time, et cetera. There is also a Q&A button during the presentation. If you have any questions that you'd like to present to the panelists, you can put that into the Q&A feature and enter those. And we'll be monitoring those throughout the presentation and address those at the end of the presentation. So with that, we're gonna turn this over to Max, who is on the prerecord. This was done about a week ago. So with that, let's get started, do an introduction and enjoy it. We'll see you for the Q&A at the end. Thank you. Thank you everyone for joining us today. We're excited to have a great panel joining us to talk about the heart of the matter, strategies for building a successful cardiac CT program. And we have some excellent folks with us to talk about this topic. So joining us today, we have Dr. David Furman, the Medical Director of Computed Tomography at St. Luke's University Health Network and the Site Director of St. Luke's Upper Bucks Campus. We have Dr. Robert Fournier, Vice Chairman, Department of Radiology at St. Luke's University Health Network. And we also have Matt Larson, CT Clinical Specialist, St. Luke's University Hospital and Health Network. Gentlemen, thank you all so much for joining us today. Thanks for having me. Thanks for having me. Now, I wanted to kick off with a question I'd like to pose to you all. And so that everyone has a little bit of context, could you explain to us the current layout at St. Luke's Health Network, how many sites you have and how that's structured? So we are actually located in Northeast Pennsylvania in Western New Jersey. We're a hospital network of about 13 hospitals, we have four or five outpatient imaging centers, 20,000 employees, 4 billion in revs and the significant market share in our region. That's kind of the broad brush of where we're at in the radiology space. We are a thousand technologists and 800 pieces of equipment spread across all this distance, about 50 square miles. So we have a little bit of geography to cover. Great, Dr. Fournier, thank you so much for explaining us a little bit about how St. Luke's is structured. Now, as you were considering an intensive cardiac program with CT across St. Luke's Health Network, what were some of the goals of this when you were initially strategizing and planning? Yes, we started doing the deeper dive and looking at whether we actually needed this program. Actually, our feedback from cardiologists were, this is coming and we're looking at this as a new tool. There's a change in the imaging paradigm that's gonna have to happen for all of us and it's putting the CTA at the forefront. So we knew we needed to start a program in this particular space because we were expecting this to explode very quickly. And so that was the main driver, was really our clinicians, our firm clinicians who wanted it. And some patients were actually calling in and asking, do you offer this or not? Our competitor also started a program in this space. So again, we had to be competitive and compete against them. Some of the main drivers we had. And Dr. Fuhrman, would you say too, as far as the goals go, is there anything else that came up from maybe any other departments? Dr. Fournier, I think those are terrific goals. I was curious if other departments might've had other thoughts. Sure, well, we actually started doing coronary CTA in 2006. I've always been kind of interested in coronary CTA and CTA in general. And over the years, we saw a lot of opportunity for coronary CTA to be used to decrease the number of negative cardiac catheterizations. We saw a real opportunity to help our patients. And then as years have gone by, more and more interest from cardiologists has arisen. And we saw opportunities to partner with these cardiologists to help them improve the efficiency of the cath lab by decreasing the number of patients who went to the cath lab that were not getting revascularized. So we wanted to make sure that if the patient is going to the cath lab, they're gonna need some revascularization. And we saw this opportunity to expand our program and improve upon what cardiologists were getting from their nuclear medicine scans. There are a lot of patients who are much more appropriate for coronary CTA. And I think we can see that, we can all see that in the volumes that are the demand for coronary CTA throughout the country. And specifically, we're trying to meet that demand here on our network. Perfect. How about in terms of getting buy-in and support across the organization? So maybe there were, folks may view this a little bit differently. Was there anything you had to take into consideration? Absolutely. We were really fortunate. I feel very fortunate to work for a network that is very committed to not just a quality, but also to access. So it was really not difficult to convince our network administrators that if we were to expand our fleet of cardiac capable scanners, we were gonna be able to meet our patient's needs better than we were previously. We also had an aging fleet of scanners, which was very timely, but that kind of worked together. We were able to convince them that by improving our scanner capability, we were also gonna be able to improve our patient offerings and our patient access for cardiac imaging. So we got a lot of buy-in pretty early on in our process. And I guess one of the big areas we're looking at is where's the ROI? What administration went here? You know, where is this revenue gonna come from? And actually comes from multiple areas, decreasing the length of stay. We'll talk a little bit about that a little bit later. And also we're just looking at the overall utilization of the cath lab in a proper fashion increases the revenue of that cath lab, for sure. Those are two really hard ROIs. And how about within, maybe to get even really specific, anytime around this topic, the question that probably comes to mind is how about specifically with cardiology and radiology since they're gonna be so involved? Yeah. Bob, do you want me to take that? You bet. Yeah. This has been, you know, this is gonna be a primary focus for I think anyone who is building a coronary CTA program is that it really is so helpful to have a team approach. And we've been really fortunate to have a very great relationship with the cardiologists on our network. You know, some of them coming to me asking for, you know, for us to help them with certain diagnoses or certain procedures that they're hearing about in cardiology literature. And sometimes me going to them and asking them for help with clinical aspects of starting up a coronary CTA program. So we do have a great relationship. I think there's no way to really build out a comprehensive coronary CTA program without developing some teamwork between cardiology and radiology. So I'm really excited to work with them. And, you know, we do, we have a great relationship. And I think that's essential because, you know, they have obviously clinical experience and that we absolutely have to have in order to make sure we're meeting the patient's needs and the network's needs. So. I have to echo that, Dave, because if you don't have a champion to pushing it from the radiology side, knowing the technology, having that, they're gonna find a way to do it. Having that, they're gonna understanding the technology and the software that's coming out. You definitely need a cardiologist that I don't drive it on their side. Yeah, there's a huge educational component associated with launching these programs. How do you use this technology? And what patient population and what patient types? And that's where we have our cardiology colleagues working together with Dave, a great diet and kind of pushing the entire program from a network perspective, not from a surface line silo. Yeah, and just to kind of echo off of that, I think it's also the opposite point is true. I think it's very difficult to build a comprehensive cardiac imaging program without radiology. I know that that's a thing that is, sometimes cardiologists feel that they have to do because they don't originally have buy-in from radiologists who might not have experience with coronary surgery or might not have experience with coronary CT imaging and feel like they have to build a program on their own. I think it's very difficult to do. I think it's a lot easier to do if you were to approach radiology and kind of work as a team. I think that both sides of that are true that we bring certain expertise and a lot of it is functional in terms of implementing a program within a hospital network or even within a larger outpatient imaging center. I think there's stuff that we can do that cardiology needs help with. And there's of course stuff that we need cardiology's help with in order to make it work. Yeah, thanks. And Matt, from your perspective, how have you felt like that collaboration has panned out? I mean, so far it's going great. There's so much that I take from the expertise of my cardiology counterparts. And a lot of them are younger in our network. They're recently trained. They have done imaging fellowships from a cardiology program. And they have tons of expertise in the clinical utility of coronary CTA, but they don't have a lot of expertise in sort of navigating the ins and outs of a radiology department, which is what we need. We need to be able to do that in order to get our patients through. So together, I think we've been very successful so far. Sorry, Matt, your thoughts? Do you have any thoughts on that to add? No, just having both the cardiologist and the radiologist to kind of tap into from a tech perspective is amazing. Like it really, really, and acting as a liaison between the both of them really helps us implement strategies that we want to implement very rapidly. And we can get the message across very quickly to the techs and produce quality standardized exam. That's great. Dr. Fournier, when you were first kind of introducing St. Luke's to us and kind of your goals, you mentioned essentially, I guess, what amounts to additional patient access and a better experience overall for them. So I'd like to take a few minutes to discuss that for a bit and have a few questions for you. Currently, you're working with GE Healthcare and you'll have 20 CT scanners installed over the next five years. Is that correct? The numbers? That's actually a really difficult question to answer. So we have 13 hospitals and 13 presidents. Each one of those presidents calls me and says, I need this system today. I need this system today. They're all clamoring to have it. Well, how we decided to deploy it was really on a network perspective. We started with deploying it, made the main campus where our CT specialist lived. Again, it was in his fingertips. He could play with it every day and kind of enhance it, find out what it could do best and then bring it to, in essence, the rest of the network. We then moved it to our tertiary care center and opened up an imaging center there for specific cardiac. And now we're starting to deploy in some of the community settings. One of our farthest out is probably 30, 40 miles from where I'm sitting today. They don't have a cath lab. They have the ability, they're forced to kind of transfer patients every single day to one of our additional campuses. Again, that's expensive and not the right thing to do for our patients. The network's perspective has always been, we want to keep patients in their environment. We don't want them driving an hour to a big box and having this imaging done. Our goal is actually to deploy it throughout our network, each one of those hospitals will have this capability. And again, as we change that imaging paradigm, you'll see these systems make this so much easier than it used to. I'm used to having our older scanners. We had only two technologists in our network who actually knew how to run these protocols and get it right. And I'll tell you, our success rate wasn't great. I want to say about 80, 85%. As we moved to this new technology, we actually can now use it on every single campus. Every single technologist is able to deliver this level of care. They've embedded a lot of features, which makes it so easy for our techs. And now they call it a gated PE study. And that's their perspective. So now we have the ability to deploy it everywhere. And again, meet the needs of our patients and the patient population without making them drive. And it's made hospital presence very happy with us. And as we go forward, we're gonna get really, really busy. One of our experiences to date is we started one of our smaller campuses. They now want this 24-7. They wanted it to serve ED patients, inpatients. Our goal is really just, we started with the outpatient. We've got to really feet wet with those outpatients. And then we're gonna move to the ED space. We've done a few of them already. And then we'll start looking at the inpatients. Overall goal is, again, we want cardiac disease without having to send them to a cath lab. And how do you think, I guess, from a decision-making standpoint, in terms of going this route, are there any examples maybe you could give us on how it's impacted the network? That's a good question. Well, we can start with our volume of coronary CTAs way up. So that's, we always had pent-up demand. So before we installed our first eight-centimeter detector at Upper Bucks, I think we were something like six weeks out for a coronary CTA. Patients' waiting times were six weeks out. And the utility of the examination six weeks out is obviously diminished. If a patient has to wait six weeks, it's probably not the right test anymore. So that's a great thing. We've got our wait times down to maybe 10 days. So that's one major thing. And we're in the process of implementing CTFFR, which I think is gonna make another huge impact in the amount of volume that we're seeing. I think that's gonna really increase the volume, which is something we're preparing for. And so, yeah, that's a big impact on the network so far. And then another thing that I would mention is that we are increasing our volume for other coronary CTA procedures. So not just coronary CTA, but also pre-transcatheter aortic valve repair. We've been scanning patients for left atrial appendage thrombus and structural imaging that we had not been doing before. And a big part of that is our relationship with the cardiologists. We are letting them know we can do this now. We can do it at multiple campuses. Patients are not gonna have to travel over an hour to get here. We can do it at Bethlehem, we can do it at our Upper Bucks site, and soon we'll be able to do it at more sites. And so that has been a major impact already. I think it's just helping more patients with studies that they really need done. And here's where you turned it on because you have the Upper Bucks campus. You've actually immunized patients, both the ED and inpatients. That actually decreased by a significant amount. We've seen that. We're expecting that also to ramp up as we go forward. But yeah, with guardrails. Remember, put guardrails around the scanner because again, 24-7, every patient walking in the door with a chest pain, you have to be selective in how you do that. Totally. We're definitely in the early stages of inpatient and emergency department coronary CTA scanning, but I very much expect that we're gonna be able to make a major impact on length of stay for these patients, which is gonna be another great thing for the network. So, but we're in the early stages of that. Great. And I know that some of these sites, as you're evaluating them, you just mentioned inpatient, but that you do have some outpatient centers as well. And are those candidates or sites that you're targeting to implement this strategy with as well, and how might that look differently? Yeah, absolutely. Oh, go ahead. Yeah, comment, if you will. So you're looking at your strategy right now, if you're doing it on the inpatient side in a hospital like this, you're somewhat space limited. This has been our biggest problem. How do you kind of push all these cardiac patients through an inpatient scanner when you don't have enough space to kind of pre-treat them and get them evaluated prior to getting the scanner? On the outpatient side, it's a lot easier to do that, but we only have limited outpatient sites in our network to date. So space is pretty, so I'll cut you off. Oh yeah, no, I'm sorry. Yeah, I would just echo what you said. We, you know, doing a cardiac examination when we had the four centimeter detector VCT, we sometimes would take up to an hour with the patient on the table getting IV beta blocker. We are, as we do greater volumes, we are very much streamlining that. Our appointments are down to 30 minutes per appointment. And a lot of times it doesn't, the patients on the table for significantly less than that. It is a lot easier to kind of plan for a cardiac day for outpatients because we're not getting interrupted by ER patients. And so that was our original goal is to have the majority of our patients be done in the outpatient setting. And I think that's a good strategy because we're trying to future-proof our program. I think what we're gonna see as time goes on, in addition to increased volumes, we're also gonna start to see in the future some requests for plaque analysis. And down the road, that's gonna be even more important to the cardiology community. And once that happens, we're gonna wanna have a robust outpatient cardiac CT program that's ready to go, that's ready to scan many patients a day efficiently. And the more you do, the better you are at doing them. And so that was part of our strategy for sure. I think one of the lessons learned is when we first developed the program on your campus, David, up above, we tried to duplicate it over here in this campus in Bethlehem. The setup and the layouts are so different in every building. We were hoping to cut, copy, paste and move it all forward to each institution, but that's not possible. That has to do a lot of customization along the way. Yeah, totally. I think we found sometimes it's harder to do four patients at a hospital in a day than it is to do 12 patients in an outpatient setting in a morning. If you have things set up in a very specific way to do a complex examination, but you have the right scanner, you have the right nurse in place, you have the right staff in place, you can get high quality examinations in a much more efficient way. Yeah, Matt, I was wondering if you could elaborate a little bit on that then. So you're finding as you implement this, I mean, maybe not even different settings entirely, inpatient versus outpatient, but even just different sites with a similar model that you're having to adapt this a little bit? Yeah, yeah, just a little bit. It hasn't, like the scanners have made it easy though, to be honest with you. A lot of the mental math that the techs used to have to do with the new scanners, it's just not there. The scanner takes care of most of it. So that, I mean, yes, it translates into like lower, decreased table time for the patient, but it also means that the tech can spend more time with the patient, which is like, helps like our service immensely. So, you know, less time on the table, more attention given by the technologist makes it just translates to a better general overall. Great, and are you seeing that you're able to see more patients in a day as well because of this? Yes, we actually at the Bethlehem campus, we were able to basically double the amount of cardiacs that were throughput there without decreasing the amount of outpatient flow. That's, you know, that's pretty significant. Matt, I'd like to pose a question to you specifically, and then maybe get the thoughts of Dr. Furman and Fournier after if they have anything to add, but has there been any changes in your coronary gating and medication preps for patients? Yes, we found that we've actually had to reduce the amount of beta blockers given the patients for this. And Dr. Furman, if you want to elaborate. Yeah, I mean, we have decreased, we've decreased the amount of beta blocker we've had to give, and even we're still tweaking our medication protocols to make them more efficient and more effective and kind of more uniform throughout our network. And just this morning before this meeting, I had a meeting with one of our cardiologists who I work with in order to perfect our pre-medication protocol, both from an efficiency perspective and from a perspective of getting quality imaging. But we've had to diminish the amount of medications that we give because, not had to, we've been allowed to diminish the amount of medications that we give by the improved scan quality. So whereas we used to really try and get the heart rate below 60 with our four centimeter detector scanner, that's really not necessary. We can be less aggressive. And so we can, that's one of the main reasons we've been able to keep our table time down because we don't have the patient sitting on the table getting IV beta blocker like we used to. And we're still working on diminishing it even more. So it's collaborative effort, but it's been absolutely improved by the improved scan quality. Dr. Fuhrman, I'll throw this one to you. Have you noticed standard cardiac exams can now be done at all sites across the board? Are you able to expand services in some areas? Absolutely. Everywhere that we have installed an eight centimeter detector scanner or greater, we have a 16 centimeter detector at Bethlehem. When we are finding that it's a fairly simple process to expand our offerings to that site, we have a plan that is similar to the one that we put in place at the first site and we have been able to implement it. The technologists are very quick to learn how to do these studies on this new scanner. I think they actually very much prefer to scan on the, obviously the newer technology has some features that makes it easier for them to be with the patient. And just like Mark said, Matt said, they prefer it. And they spend more time with the patient and they prefer being able to give the patient a better patient experience. And I have found that they're very excited about being able to offer something new and I'm excited, the cardiologists are excited. There's excitement around the whole process that I think makes it a little, it gives them a little extra job satisfaction to be doing something new and interesting like that. So yeah, I think everyone's been quick to learn and quick to adapt. And it kind of goes through all levels of our CT techs. New ones, the most experienced by the better than 30 years, they've picked up this technology and they're able to run with it. What I'd like to be able to discuss next and starting to talk about some of the outcomes achieved here. And we've certainly talked about broader goals and the experience, and you just alluded to a few things there and shared that story, but overall, has this, in terms of your staff, how are they handling these changes? Has that been difficult to get this implemented or is there just immediate buy-in and it made a lot of sense and they're looking for new opportunities like you just told us? Yeah, I mean, in the past, there has definitely been trepidation when we discussed expanding our cardiac program. Technologists remembered being nervous and finding that it was difficult to complete a high quality coronary CTA study on the four centimeter detector system that we were doing as outpatients, which we had been doing in years past. You know, a lot of things had to go right. It was still very possible. We were still getting, I thought, pretty good quality examinations, but I think maybe Matt can tell you even in more detail how the technologists and the nurses have responded to utilizing the new scanner for these sometimes challenging situations. Yeah, from the traditional days when we started doing cardiacs back in like mid 2000s, it was basically the domain of like the super techs. You know, it would be basically one or two techs in the department that were kind of tasked out to do cardiacs and, you know, like Dr. Furman alluded earlier, it would take about 45 minutes to an hour to get a cardiac done. Now we can take a tech, like a one year out of school technologist, they can sit down on this machine and with autogating, with, you know, the other like post-processing software or Snapchat freeze, they can, it's essentially they equate to doing a PE study, the complication of doing a very common PE study. So the amount of workload, again, I spoke about this before, but the amount of workload that's on the techs to do this is so much, so much less. It's actually a really good recruiting tool. In this day and age, CT techs are really hard to find. They love this new technology. You can actually use this to steal techs. Just saying. That's an interesting point, certainly. So have you all found that because of this technology, you're now able to handle more complex cardiac cases that maybe you couldn't in the past? Yeah, absolutely. I think we can, we can not just, we could have done a lot of the cases that we are doing now, but they were so much harder to do that we frequently did not. And one example is the left atrial appendage evaluation. We do it now to evaluate for thrombus in patients with atrial fibrillation, but we also do it both pre and post Watchman procedure. It's a very efficient way to get that imaging done. Often it saves patients from having to go through transesopageal echo. And the other studies that we do, the structural studies that we are doing, because we have these relationships with the cardiologist that we might not have had previously, are gratifying. The cardiothoracic surgeons are probably the most pleased with what we've been doing from a structural perspective. But I think the whole department, the cardiology department is happy that we are able to discuss whenever they come across a study that's being done in the literature, they will approach us. And usually we can get the study done. And that collaboration gives you the feedback you need to make sure we're doing it right. And have you seen that it's enhanced your ability to do things like TAVR, for instance, at other sites or do it better at current sites? Dave, do you want to talk about the story of how often they complained about a TAVR scanner? Yeah, I mean, I don't want to make anyone sound like they were complaining too much, but they were complaining a lot about the situation with TAVR. And I actually kind of remember a meeting in which I said, well, I will be happy to take credit for solving this problem after the new scanner is installed. And the new scanner got installed and we have almost no complaints about our TAVR program now. And I take credit whenever I can, but it's really the scanner, it's nothing to do with me. But yeah, that was a real point of contention with the cardiothoracic surgeons who were not happy with the quality of our TAVR imaging prior to our acquisition of an eight centimeter detector scanner. And now we're doing them at multiple sites with very high quality, with no complaints. I get very few calls from technologists who are wondering, should we re-scan the patient? We're re-scanning almost nobody. That has been probably one of the top successes of the program so far. And then the other thing is it has really led to more collaboration with my cardiology colleagues, the cardiothoracic surgeons come to me looking for solutions for other problems, not just TAVR imaging, but probably the case that I was gonna show, we had a case in the slides there where it was kind of an interesting story. It was a Friday afternoon and the cardiologist contacted me about a patient who had a very confusing echo study. The echo study showed hypokinesis and a lot of thrombus in the left ventricle, thinning of the left ventricle. The patient had recently undergone revascularization after complete occlusion of left anterior descending, which was opened and stented, but the patient was having chest pain. They were concerned that there was rupture of the free wall of the left ventricle and they wondered if CT was something that could help figure out what to do next. And we were able to scan the patient on the 16 centimeter detector scanner with no beta blocker and get an excellent result. And we demonstrated that the free wall was not ruptured, but that there was just a reactive pericarditis with a lot of fluid, which was what made the echo a confusing study. This is the kind of thing where, prior to us starting up our cardiac imaging program, there just wouldn't have been this discussion of using CT. We didn't have these relationships. They wouldn't reach out to me directly. It wouldn't have been something that was thought about. So to me, that's one of the main successes, just the relationships that we've developed in order to do problem-solving with CT. And then also the tools, having the tools available to solve those problems. To me, that's just a massive victory. Well, I think Dr. Furman, that's a great segue. You all have mentioned now that it certainly has, maybe cut down exam times and you've been able to see more patients. Matt, I was wondering if you could share a specific example of some of the ways that it actually is cutting this time down. It's one thing to maybe hear that it does, but just from a practical standpoint. Yeah. The amount of time the tech spends post-processing exams, that's always like a hidden cost of time from anybody external to CT, but that's where we know that's the real workload of the technologist. The amount of work that the techs have to do post-exam is so much reduced, so less than it was before that, again, I spoke about earlier, but they can easily transfer that time into taking care of the patient better, spending that extra one minute with the patient on the table. It's directly affected our patient. Thank you. Maybe going through each one of you, just starting with Dr. Furman, just to wrap up on the topic today, is there, was there anything as you implemented this that maybe stood out to you or was a surprise, pleasant surprise, maybe not, but that you weren't expecting? Yeah, I think, well, this is kind of like sort of an esoteric little tidbit, but I mean, I was pretty shocked by how good Snapshot Freeze is. Matt, would you agree with that? I mean, it is a post-processing miracle. It takes- It's an incredible thing. The way, the improvement in the quality of the study that can be done after the scan's already performed is, I was shocked by that. I was impressed by it, by that, for sure. I mean, I knew that the wider detector and the increased speed of the gantry is gonna improve the study, but the amount that the study can be improved by software or reconstruction algorithm is, that was shocking to me. I was impressed by it. Yeah, that translates into probably 20 minutes of what used to be post-processing, the ECG trying to stitch that together and Snapshot Freeze takes care of it. That's a direct time-saving. Yeah, I guess I was just shocked by the state of computer science in 2020. It's pretty impressive. Yeah. Great. Dr. Fournier, how about you? Is there anything that was a surprise to you? I think one of the lessons was, you can't underestimate the educational process around this. Pushing this out to the required clinicians and how they use it is a challenge, but you have to have the right champions on your side because it won't just end with the cardiologist. It's gonna move over to the primary care. It's gonna move over to urgent care. There's other sites and service lines. You gotta be prepared to educate all of these people on how to use this technology, have the right people kind of sitting by your side to help put that all together and spread the word. And Matt, I know you just, you know, chimed in with what Dr. Fuhrman shared, but in addition to that, anything else that comes to your mind? No, that was really it. I just, like, the techs love the scanner. I wanna bring that out too. Like, everybody is very happy with it. You know, obviously something new, there's a little hesitation, but once they use it, it quickly becomes their favorite scanner. Yeah. Matt, in the past, how few techs did you have just scanning cardiac? Maybe a handful at best? Two, three? A handful at best. I wanna say two to three out of probably a staff of 15 to 20. And consistently doing it. Now, you know, we have every tech doing it. Every tech that works with shifts is capable of doing this, and they're comfortable doing it too. That's the other part. And the top side of that is that the exams are consistently high quality. That's the kind of drop the mic thing, is that everybody can do a great cart on these scanners. Well, Dr. Fuhrman, Dr. Fournier, Dr. Larson, can't thank you enough, or Matt, I'm sorry, can't thank you enough for sharing your experience with the MedAxiom community around this, and really happy to hear that the implementation has been so positive for you all. We do now wanna transition into the question and answer period. So we will hand it over to Chris Romeo, and he will be fielding questions from our audience and posing them to our presenters. So thank you all again for sharing your experience. Thanks for having us, Max. Thank you.

Cardiac CT Program

St. Luke's University Health Network

coronary CTA

CT scanners

patient care

radiologists

cardiologists

imaging quality