Good afternoon, everybody. This is Chris Romay. I'm the Senior Vice President of the Ventures team here at MedAxium. Welcome, and I appreciate everybody attending. Today's presentation is called Unleash the Power of Enterprise Imaging for Cardiology, Improving Efficiency, Clinical Accuracy, and Resource Optimization. This is sponsored by our partner ACFA Healthcare. And we just want to go through a couple of housekeeping items prior to getting started. So first of all, in the section below, you're going to find an access to the presentation and slides. So if you'd like to click on that, you can download that for future reference. Also, everybody is going to be on mute through the course of the presentation. So if you do have any questions, and we do encourage questions, please submit those via the Q&A section down below. We're going to be monitoring those throughout the course of the webinar. And at the end of the presentation, we'll be presenting those to our speakers and to our partners at ACFA. So with that, I'd like to get things started. Our panelists today are Dr. Bradford J. Chu. He is the Medical Director of Echocardiography for Children's Minnesota. Dr. Chu is a proud native son of the state of New Jersey. He earned his medical degree at Rutgers Robert Wood Johnson Medical School. He completed his residency and fellowship training in pediatric cardiology at New York University with a specialty in fetal and pediatric echocardiography. He's been at Children's Heart Clinic in Children's Minnesota since 2016 and became the Medical Director of Echocardiography in 2020. He's going to be joined today by Stephanie Bazinet. Stephanie is the Senior Cardiology Market Segment Manager for Agva Healthcare. Stephanie is a registered sonographer specializing in general and vascular 2D and 3D ultrasound. She has a BS in IT business management and has been working with Agva for over eight years. So with that, we'd like to get started. I'm going to turn it over to Stephanie. Thank you again for joining us and please submit any questions during the course of the presentation. Thank you. Thank you, Chris. I am super excited to be here with everyone today. And I'd like to give and take the opportunity to let you know a little bit about Agva Healthcare's next generation platform, which is called Enterprise Imaging. So before we kind of dive into that, though, I want to give you a little bit of better history on Agva and what we do and how we got to where we are today. So our company, Agva Healthcare, has been in business for 150 plus years. And that evolved over time from color to printing to digital diagnostic film, ultimately into the PACS world, as we know today, called our PACS imaging systems. In 2005-ish, I think, we acquired the Heart Lab solution, which afforded us the ability to not only have a radiology PACS solution from Agva, but also now we acquired a cardiology vascular solution from a PACS perspective. And fast forward about 10 years from that, we decided, being innovative, that we wanted to create a next generation enterprise imaging platform. And that platform would house and be a single solution for all the diagnostic imaging that patients receive within a healthcare organization. So it provides you with the ability to access images, whether it's radiology and or cardiology or point of care or ophthalmology, any imaging that's associated with that patient, really leveraging the ability for you to have a true holistic patient medical history record, if you will. And with that concept, I know today we're going to focus more on our cardiology solution, which is what you see on the slide in front of you, meaning that it is a complete cardiovascular solution for all modalities within cardiology, offering you image review and post-processing analysis, offering you mobile access to do reporting and or image review, giving you that full enterprise image view for your patient historical studies, letting you have the ability to collaborate as well with whether you're collaborating with sonographers, technologists, residents, physician, primary care, referrals, etc. We also support CT and MR, ECG, CAS and your basic ultrasound. So with that, you have the ability within our solution to image enable your electronic medical records. So the idea is that with this new generational platform, you have image accessibility quick and easy through either your EMR or through our solution in a standalone environment. So Anne, if you'll hit the next slide for us. We've invited Dr. Chu here with us today, and I'll kind of briefly go over the agenda and then turn it over to him. But what he's going to do is share his experience coming from a heart lab solution, which again was an ACFA acquired solution back in 2005, and how they made the decision to move forward with our next generation platform. Any of the workflow efficiency gains that he's achieved through our new platform, any special configuration that they've done within their system, essentially them having the ability to do it and not have to call ACFA healthcare back and the ease of being able to make those changes and own your own system. And then we'll talk about enterprise integrations through the EMR and or other software solutions. And then last but not least, we'll talk about our customer partner relationship and how that's been experienced with Dr. Chu and his organization. So with that said, I'm happy to turn it over to Dr. Chu so that we can get dive right in. Hi everybody. Thanks, Stephanie. Thanks to Chris for inviting me and introducing our experience here. So, we've been working with ACFA for a number of years with the heart lab solution, and I think with our practice, which is quite unique, it was a big decision process and to go with this major uphaul from heart lab into enterprise imaging. To tell you a bit about our practice here at Children's Minnesota, it's a unique practice where we have a number of cardiologists in a medium to large size practice. But it's non-academic, so we're a non-for-profit institution and our practice works exclusively with the Children's Hospital. We have a number of sonographers who help perform our studies and we are both hospital based and a regional center, so we have multiple outpatient locations as well. So our echo utilization is quite high. We do about 15,000 echoes per year in children, and we read even more that get imported through the ACFA system. Because of the growing practice, our model has really moved away from each individual cardiologist reading their own echoes into a more streamlined echo service line. So that's where I came in to help create that service line. So individual providers, essentially, instead of signing their own reports, they would come into the echo lab and we have an echo reading doctor multiple per day. And so, really, we needed more advanced capabilities because, you know, instead of the EP doctor really reading their own echoes, now we have echo doctors doing that work for them. And so the ask was really a more integrated environment and a better capability from the echo PAC system. I think anybody who's used heart lab knows that it's an extremely fast solution and the viewing was incredibly accurate. But we were looking at different other solutions and everybody trained in different places, so had experience with other vendors. And they all have their pluses and minuses. I think one of the major pluses for us looking for a modern imaging platform was TomTech integration with ACFA enterprise imaging. I think that around that time in 2019 or so, when we were moving our enterprise imaging platform, was when TomTech really partnered with Philips with that acquisition. It streamlines what we were doing on our all Philips ultrasound machines with the TomTech integration. So we definitely were familiar with the advanced echo capabilities of TomTech on the Philips carts, which eventually mirrored very well. So the major things were 3D and strain, which instead of launching new applications to do this type of analysis, either during or after the echo was performed. It was all under one program and all looked very much similar to what we were used to coming from different imaging platforms and training. And you just didn't have to use a different machine or a different workstation or launch different applications. So all under one roof was nice. The other thing that was very important was enterprise imaging was quite new in the cardiology world, but also in the pediatric cardiology world, which is quite small. So we did look to consult with Dr. Luke Mertens from Toronto SickKids, who helped with the design of the reporting aspect of enterprise imaging. And so we were able to speak with him multiple times and talk about some of the choices that were made in how the reporting was structured. And definitely he being an expert pediatric echocardiographer made us comfortable that that was all vetted through somebody with expert eyes. And he's a friend of one of our senior cardiologists. So it was an easy partnership there. And then, you know, the final thing was to be able to have all of the imaging modalities under one application. We were using Heart Lab for our cath imaging as well. And I think the thing with enterprise imaging is, as this picture shows, you can have cath imaging filed under the same patient as the echo imaging and advanced imaging. We use a different platform for our ctMRI advanced imaging, but certainly we import back and forth between AGFA and that other platform. And so we can view quite easily those ctMRI images in AGFA and the future may go towards us having everything under one application as well. So I think that kind of talks through the journey towards getting this in place. And it certainly was not an easy decision, but it was, after several years, it definitely turned out to be the right decision. So the other thing that we'll talk about is when we designed our version of AGFA, what were the things we were looking to really fine tune and also what were the strengths of enterprise imaging? Like I said, our service, our echo service line really evolved from being individual cardiologists performing and interpreting their own echocardiograms to a sonographer based practice and an echo reading service. Where an echo doc would be reading these studies and trying to convey those results back to the ordering provider or the cardiologist who was in a different site. With multiple cardiologists working at the same time, this task-based workflow certainly was essential. I think in enterprise imaging, this is a screenshot of my screen at the beginning of a day. And so the cardiologist would be reading these studies and trying to convey those results back to the ordering provider or the cardiologist who was in a different site. And so the cardiologist selection shows the to-do list, which is pre-filtered depending on the site that you're in, Minneapolis, St. Paul, for us, four major sites, and then outside studies and things like that. You can also filter all studies today or your specific list if it was assigned directly to you. And so the way that our workflow allows the sonographers to have their own tasks that then get shuttled into a cardiologist task. And there actually is a pretty easy co-authoring workflow that allows us to shuttle those tasks back and forth. So if the cardiologist is reading a preliminary report from the sonographer and wants to make comments, there's a place to make comments that is not front-facing on the report, wants to adjust a measurement, can do their own measurements, and also send that back to the sonographer so that it pops up in their work list again. I like to call this the virtual reading room. Normally, we all sit in the same room and the sonographer does the study and clears the study with the cardiologist before they're done. Definitely in the time of COVID and really just in the way that our practice is going and regionalization is going, we have a cardiologist that is physically separated from the sonographer doing the study. We have the cardiologist physically separated from the other cardiologists that are seeing the patients at the same time. So having a platform to allow for that type of mobile workflow and for the sonographer and the cardiologist to really work in parallel and not just on top of each other, that was one of the things in heart lab that we struggled with was it was hard to tell who was in a study or editing a report. And now it's quite easy to know who is making measurements. Those measurements don't get lost. You can reconcile multiple versions of the report a little easier so that one person isn't making a report and making measurements and another person just layers onto it and wipes out all of their hard work. So that's been a nice enhancement. And we certainly, in the prior versions of Heart Lab, have had examples of sonographers not being done with their prelim report and itchy cardiologists just citing them and it being quite inaccurate and then having to go back and edit that and addend that later. So trying to eliminate those errors or potentials for error has been a major improvement. Conferencing and keywords has been another enhancement to our archive and our collection in enterprise imaging. In conferencing, we can easily select a study and drop it into a conference folder. That conference folder can be dated so that for our weekly cath conference, those studies are added in. They can encompass any form of imaging. So not only echo, but cath, and if we want to import other advanced imaging, it can all be within the same folder. So when we are presenting, we have a collaboration with Mayo Clinic and we present about a dozen patients every Thursday for the cardiologist to be able to drop all the studies in there, have the sonographers edit those studies, and to be able to review all of those within one folder certainly makes it a lot easier for presentation purposes. Keywords is another nice enhancement that I think stems from the teaching aspect. So being able to tag studies with keywords that is separate from the reports, but embedded within the study can allow you to have a lesion-specific keyword, like these are ventricular septal defects, and you tag those. And so you can pull up those keywords or search by those keywords in an advanced way to really hone down which studies you want to mine for research purposes, for education purposes. And I think the further enhancement of that is the screenshot on the right, which is the new teach and research tool that hopefully we'll be getting soon. It allows for anonymization of studies, again, an even deeper categorization based on pathology and category of study. And I think that'll be a huge enhancement for the evolving workforce. We're not an academic center, but in our work with Mayo Clinic, we will be training some of their advanced imaging fellows, and also the evolving sonographer workforce. We have lots of new sonographers and sonography students that work with us that would love to see examples of rare defects like double outlet right ventricle or hypoplastic leptaric syndrome or what have you. And we can categorize them with this tool even better. And the sonographers can find them themselves. Trainees can find them and be able to flip through those studies in a powerful way. So with being a pediatric cardiologist for a number of years and working with other persnickety pediatric cardiologists, I think the devil certainly is in the details. The image here for those familiar with echocardiography is a nice example of devil horned multiple muscular VSDs. But the details really are, and if you can go to the next, much more daunting. So we were able to work for a good amount of time with onsite support from AGFA on getting these reports right. So getting the measurements mapped over properly from the machines, turning on and off certain measurements, getting even just the significant figures on the decimal points right, having them labeled in the way that we like them labeled. Pediatric cardiologists are notorious for being particular about how they name things. So having that kind of the acronyms right and the naming process, how we like it was essential. And certainly there is a long glossary of pediatric cardiology terminology that we had to build into each of the dropdowns. So it was nice to have that. Mapping directly from the Philips machines auto-populated the measurements. We had to do multiple test runs while we implemented EI and sometimes it mapped well, sometimes there were things lost. And so multiple iterations of that work with AGFA at our side was essential in getting it right, getting it in a way that we knew was powerful, not excessive measurements or excessive blank spaces. One of the other things that was important when we did a major uplift was making sure it looked kind of how everybody was used to. When those reports started to look a little bit different, we worried that the ordering providers, which were not always cardiologists, neonatologists, primary care doctors who sent us patients could easily read the reports and knew what they were looking for. And so we had to go through and standardize this and make it look familiar to everybody with institutional layout and headers and things like that. So it was nice to have the report look exactly like we wanted. And then the kind of final thing with configuring these reports, for limited studies that are based on certain protocols, we have been doing a better job with kind of not only making the study acquisition more narrow, but also making the reporting more standardized for that protocol. So an example would be our pulmonary hypertension protocol. We were able to make a certain macro or a template for those studies. And so the report would look a certain way. It would prompt the sonographers to report those measurements in multiple places. It would auto-populate some of those measurements as well. And so it was a nice, it's been nice to not only do that for certain protocols or certain scanning purposes, but also the sonographers and cardiologists like things worded the way they like it or laid out the way they like it. And so individuals can have their own templates and protocols or templates and macros so that it really just looks the way you like it. You know, if you're gonna perform or read thousands of echoes a year, you want it kind of the way you want it. So there's not only on that institutional level, that configurability, but on the individual level as well. And you can go to the next. Our workflow, I think, is very similar to other cardiology practices. And part of the, you know, implementing any major imaging platform was integration into our EMR. Our EMR here is Cerner or PowerChart. We use this for research and development use this for really everything outside of the imaging. So ordering studies for publishing those reports, for reconciling the billing and all of that had to be worked out so that it all matched. You know, things that were pulled in from the EMR like vital signs, diagnoses, provider, ordering provider and referring provider information, patient demographics, all of that had to be accurate. So the ordering process works well going from Cerner into enterprise imaging. And then not only does that order have to come into, from the EMR into Agfa, but the, has to go into the ultrasound machine. So that work listing and, you know, identification of types of studies. And then really for us, the live uploading is essential with our practice, which is sonographer based. So sonographers will be independently scanning inpatient scenarios without a cardiologist. And, you know, the example here is the middle of the night and a sonographer is asked to go and do a study in a regional site and they're doing their study and we need to be ready to help them with the imaging while it's being acquired. So having our machines integrated with the enterprise imaging and the archiving so that not only does it come over as they're scanning and the cardiologist can be watching from the comfort of their basement, which is in my example, but they can give feedback. They can see it quickly and accurately. I often will just kind of text the sonographer while they're doing the study, you know, give me a better picture of the aortic valve and then it gets done. But also, you know, when in an on-call scenario or in a mobile scenario, that allows for the physician or another sonographer in parallel to be working on a report while one sonographer is acquiring. So everything is just much more efficient that way rather than having to record the study, bring it back and download it. That sonographer has to, you know, do the measurements and then create the report. And that's several hour process in the middle of the night. We can have the report, you know, basically signed by the time the sonographer leaves the bedside. And be confident that the report is accurate and has gone through the expertise of the echocardiographer. Getting those reports into the EMR is, sounds easy, but is often challenging as well if it's not set up right. And so I think we had a little bit of tweaking to get it uploaded well, able to be visualized in the multiple ways that EMRs are viewed. So not only on a computer, but on laptops, on mobile versions of the EMR. And I think we're undergoing further enhancements there. I don't know, Stephanie, if you want to talk about future state with Cerner and imaging. Absolutely, happy to do it. So Anne, if you'll jump into the next slide. So as Dr. Chu mentioned, this is something that they're working towards. And this is essentially embedded view of our enterprise viewer within Cerner for their instance. Now we have these integrations with various types of EMRs, but the goal here is because just like we stated originally, you have the ability within our system to modularize, if you will, the areas or the departments that you need access to images. So anything, whether it's radiology, cardiology, point of care, any image from your patient, we have the ability to ingest into our single core platform. And then within the patient EMR, within their chart, within their record, you could see this holistic, what we call as a longitudinal timeline of all of their imaging. So whether you're the physician, cardiologist, radiologist, referring physician, ED physician, you have a quick, easy glance and looking at all images for your entire patient. And this is what we're working towards implementing with Dr. Chu's organization so that we have done the ability for easy access of images. Now, the good thing about our platform solution is that you don't have to take everything. It is modular. It can expand upon with licensing configuration and developing workflows, the areas that you need. It's not a rip and replace of the technology you may be using today, but as those software licenses become expired or go out of date, you have then the ability within the core infrastructure of EI to build upon and utilize different areas or modules of our solution as you need. Next slide. Yeah, I'm very excited about this. I think one of the pain points for lots of providers is having to go back and forth between different platforms and certain workstations, not having the right software and things like that. So it's nice, especially when our practice is just moving all over the place. So if you're seeing patients in a place that you don't have your computer, your workstation to be able to access the EMR and pull up images, even just in the patient exam room to show families certain images, key images is very helpful in the patient experience. So talking about the relationship between us and Agfa, we have a relationship not only with the providers. So as the director of the ECHO program here, I work closely with the team at Agfa. Not only with the account management, but some of the application specialists, but also our local IT. So they're essential in really implementing all the things that we're asking for and helping find a way to do these updates and upgrades in convenient times that don't mess with our daily workflow. I think that relationship has only strengthened over time. All that upfront work certainly paid off in the implementation of the platform, but also those first couple of years and really making it how we wanted. It was a learning process for everybody because as one of the few pediatric cardiology practices working with this new enterprise imaging, we didn't have a lot of other examples of people how people were implementing it or how people were executing certain measurements. And so I think Agfa has been really great in troubleshooting all of those things. One of the things that I think some of our cardiologists complain about is they find a problem and they report it and then they don't hear any kind of feedback about what's going on with that problem. And so we've been lucky enough to really go up the phone tree. So we haven't had to call a hotline, customer service, wait on hold, press one, press three for somebody else. We've been able to have a good direct relationship with the people that know the application the best, especially in the CV implementation and specifically the pediatric implementation. And so that's been really nice to have that relationship. The last thing is we identified that there were some areas that we just needed to talk about more. And so having monthly touch points to talk about those identified issues, progress in solving those issues has been really important. And being able to work with the same faces, same people has been a really just pleasant relationship for me. Awesome. We certainly at Agfa strive for our customer success. Your success as a customer is Agfa success. So all the things that Dr. Chu has gone over thus far, it's all based on, again, the scope of what is needed at the facility. Learning how to maintain and manage and configure your system is a method that Agfa wants to employ within our users. So giving you the keys to drive the car essentially and not have to call Agfa and have us bill you for some additional configurations and or training. We want to have those monthly touch point meetings so that we are developing a relationship with you to ensure that you're having a success within our solution. Yeah. Next slide. Yeah, next slide. I don't know if we touch on this. Yeah, just the one thing there, we've been fortunate to really solve all the problems. We had a couple of issues with speed bottlenecks and identifying whether that was something with how the software was configured or how our IT services were configuring our workstations or the resources on the network side. So we were able to solve those with the proper amount of attention and feedback from our providers and users. So I think really it's just, it feels like we're making it better and better and we're always impatient on how quickly that happens. But in preparing for this, I realized, oh, it's only been three years or so. And we've really gotten it to a place that's incredibly powerful and flexible, so. Well, thank you very much, Dr. Chu and Stephanie and especially to Agfa for sponsoring this. We've got quite a few questions already, so I'll read them off. And Dr. Chu, if you or Stephanie would like to take these, that'd be great. The first one was involving your EMR, which you mentioned with Cerner. The next question was, I see you're doing echo-structured reports. Do you do other types of studies using Agfa structured reporting? Absolutely, I can take that one. So we absolutely offer a full CBIS solution from a reporting perspective. So if you have any needs for any cardiovascular reporting, whether they're basic echoes, stress echoes, pediatric echoes, non-invasive vascular studies, CAF, CTMR, we do offer a full suite of structured reporting options for you. Great, the next question is, the data included in the report extracted directly from the images, DICOM headers by mapping the DICOM tags, or is there another post-process slash post-acquisition activity to create these reports? Yeah, so I can take that one. And Dr. Chiu, if you want to add anything, please feel free. I think, actually, I just, I moved my, I was reading my question and now it's disappeared. If I remember the question correctly, the DICOM SR from the modality will come in and populate our structured report solution, whether or not you're using our reporting or whether you're using a third-party reporting, such as an EMR reporting or a dictation or something like that. Was there something else in that question? I feel like I'm forgetting. Just whether you're mapping it via tags or post-process, post-acquisition. Oh, either one. Yeah, thank you. So either one. So sonographers generally routinely will take measurements during the procedure on the machine. Those will come over and populate. We then provide you with the post-processing tools to either remeasure, edit the measurement. Maybe you didn't do the measurement at all and you want to do that within our solution. We give you all those advanced post-processing tools, whether it's 2D DICOM or M-mode measurements that you can do. And then you have then the ability to update by either saying you want an average of the measurements done on the cart and offline, or do you want the highest, the minimum, maximum, peak, et cetera, to where you have then the ability to identify which one of those measurements you do want on your final report. Yeah, and the other power of that is not only can you identify which one you like to use, like the highest or the average, but institutionally we've kind of said, okay, well, we just want either the most recent or the average and depending on the measurement. So it's kind of nice. I would say the post-processing is excellent. Some of our sonographers find it more accurate and more efficient to do only post-processing and others, I think it just depends and it's nice and flexible in that way that depending on who is doing the imaging or doing the reporting, it matches really nicely all the measuring tools. Yeah, and one thing I'll add there is it provides you with consistency and vendor neutrality when it comes to things like strain. If you're not performing strain on the same machine, every single time your patient comes back, you're most likely not comparing the same algorithm or formula. So actually performing those strain measurements offline is recommended by the ASE so that you have that consistency and you are comparing apples to apples with sequential studies. The next question, increasingly top of mind, can you talk about AI integration now and for the future? Sure, so I'll take that one. And again, Dr. Chu, if you wanna add on anything, be helpful. From an AI perspective, within our post-processing imaging tools, we have automated measurements and we also have algorithm measurements that are gonna, let's just say you took a 3D or 4D volume acquisition and all you did was capture that volume. You send that to our solution and we then give you the tools or post-processing functionality to be able to perform a 2D or a 3D strain, to be able to perform a valve analysis if you're looking at the mitral valve because you're doing mitral clips, things like that. So there is built-in technology within the image post-processing viewer to automatically detect structural landmarks and then place, let's just say the wall motion for the strain, et cetera, automatically for you to identify either the apex or the mitral valve or whatever it is so that you're having to interact less and do it less manually so that that AI algorithm is there. Okay, next question. What z-scores are supported by enterprise imaging for cardiology? Sure, so Dr. Chu, do you wanna talk about the z-scores you used today and then I can add on to there? Yeah, so we're currently using the Pediatric Heart Network z-scores which is kind of the most recently published set of z-scores with a large patient population across multiple races, genders, and seems to be kind of moving away from other z-score packages just in the pediatric cardiology world. This, when we first started using enterprise imaging, we were using the Toronto-based z-scores and in the past couple of years, we've moved to the PHN z-scores which seem to correlate extremely well with not only the Toronto-Detroit but also Boston z-scores which is, I would say, probably the most commonly used. The nice thing about our reporting is you can turn on and off z-scores for certain measurements. So certain things where you just don't want those PHN z-scores, you can turn it on and off. And then the other thing is, you certainly can, the way we have our reports structured has a summary text field where if you want to put in a different z-score calculator, you can report that as well and compare them. So it's, but currently we've been happy with the PHN z-scores. They seem to reconcile well with other historical ones. Yep, and I think you hit all the high ones that I was gonna mention, so I don't really have anything to add there. Okay, next one. What percent of your time's post-processing analysis is performed within the EI solution? Yeah, like I said, it's kind of dependent on the user. I think that it's always telling when certain sonographers and cardiologists prefer to use the EI solution over for strain and 3D over the things on the cart. I think people just are so used to interacting with the Echo machine. That post-processing is seems daunting and learning all of the where to click and which menu to go into. I think really Tom Tech and Phillips have aligned nicely so that it really feels very familiar and you can rely on not only manual measurements, but also the automated measurements and points being very similar. Same goes with Stress Echo. I think Stress Echo has demonstrated that very high accuracy in not only mapping the protocols, but looking at the different ASC segments on the LV. So we've been happy with post-processing, but it's kind of user. At this point, it's nice that there's multiple ways to do it. Okay. How are you able to make sure that you can access all of your images from the EHR? So, sorry, I'll take that one. So our goal is to image enable the EHR like we spoke about earlier. And Dr. Chu and their organization is working towards that drive. But today, because there may be multiple software solutions at any institution or organization, we have the ability within that timeline view that I showed you to either federate or query and retrieve from another solution. So let's just take the example that you have a radiology solution and it's a different vendor than your cardiology solution. We can still pull those images in, even if you don't have that single core solution of EI in place today to support both departments, you still then have the ability using our zero universal viewer embedded within your EMR to gain access to those images easily and quickly. I would say another aspect that's been nice is because we are a referral center from multiple other institutions, they send us images through PowerShare often. And so we have a nice link between Agfa and PowerShare where you can just click it on PowerShare and it goes right in and it has all the DICOM information and measurements and also the demographics seem to line up nicely. So there's a strength in that that you don't always have to kind of flip back and forth between multiple modalities if you're using Agfa as your primary image viewer. Okay, that's all the questions we have for right now. We've got another minute if anybody wants to pose another question, but let me give Dr. Chu or Stephanie a few closing comments if you'd like. Yeah, I'd just like to thank Dr. Chu for your time. I know it's precious, I know you're busy, but we really appreciate your partnership and we appreciate you sharing your experience with us today. And for all of those that did join, thank you for taking the time out of your day. Yeah, I would say, I think there's definitely more to come in terms of unleashing the power of this type of imaging platform. And again, if you look at what we were doing five years ago compared to now, I think that Agfa's solution has really encompassed a lot of the benefits of other echocardiographers, of the benefits of other echocardiography and cardiac imaging solutions. And now we're just kind of reconciling which ones are more legacy in electrophysiology and advanced imaging that we can really leverage Agfa as one platform. And any provider, it's hard to let go of something that you're used to. And so we're trying to show those enhancements and highlight them so it doesn't seem like such a daunting challenge to change. Well, I wanna thank Agfa and Dr. Chu for joining us and thank you all to the MedAxiom attendees for being here today. We will be recording or we have recorded this presentation. If you have any questions, contact Stephanie at Agfa directly or feel free to contact somebody here at MedAxiom and we'll get you in touch. But thank you guys very much. I appreciate your time and have a great day. Thank you everyone.

Chris Romay

Senior Vice President

Ventures team

MedAxium

Enterprise Imaging

Cardiology

Efficiency

Clinical Accuracy

Resource Optimization