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Reimagining Patient Care: Vytrak's Proactive Health Model, Integrative Technology, and Future Medical Innovations with Zach

• Evan Kirstel

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Join us as we explore an inspiring and transformative journey with Zach from Vytrak. Growing up with severe asthma and later serving as a trauma medic, Zach's personal experiences unveiled the significant gaps in reactive healthcare. His mission to shift to a proactive healthcare model led to the creation of Vytrak, a groundbreaking solution designed to intervene precisely when a patient's health begins to decline. You'll learn how Zach's vision is making proactive healthcare accessible to everyone, irrespective of technological capabilities, by effectively triaging vast amounts of health data and fostering seamless care collaboration.

Patient engagement is at the core of Vytrak's approach. We discuss the importance of integrating technology into healthcare without disrupting provider workflows. Zach shares the "see one, do one, teach one" training method, which ensures patients effectively use life-saving technology. We also tackle the complexities of scaling these solutions across diverse healthcare settings, ensuring they remain adaptable and patient-focused. Hear about Vytrak's tailored solutions and understand how they cater to a wide array of clients—from health systems and private practices to school districts and the houseless community—all while maintaining a commitment to patient-centric care.

Finally, get excited about the future of health technology with Vytrak's innovative advancements. Discover how using everyday devices like iPhone microphones for respiratory diagnoses and cameras for dermatological assessments is revolutionizing patient care. We address the critical need for in-person interactions post-COVID and share an inspiring success story on postnatal hypertension in black mothers, showcasing the profound impact of proactive monitoring. Tune in for an episode filled with insights and pioneering solutions aimed at improving patient outcomes and reducing healthcare costs.

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Speaker 1:

Hey everybody, fascinating chat today, diving into the world of digital health and patient monitoring and so many more interesting topics, with an innovator in the field from Vytrak Zach. How are you Good? Good, how are you guys doing? We're doing great. Thanks so much for joining, really intrigued by you and the team and the mission. Maybe start with some introductions on your personal journey to VITRAC. And what's the mission? What's the big idea?

Speaker 3:

Awesome. I think my journey flows really well into the mission at VITRAC. So my career in healthcare started when I was about eight years old. I was doing a pulmonary lung function test and turns out that I had the lungs of an 84-year. Eight years old I was doing a pulmonary lung function test and turns out that I had the lungs of an 84-year-old female. I tested out of the male category somehow. It was that bad. So growing up with asthma and lungs that bad I was in tons and tons of clinical trials for all these experimental drugs and things that were coming out. So I got a very unique view into healthcare from a pretty young age. From there I got just obsessed with all the different ways that healthcare moves. So eventually I became a trauma medic out in Los Angeles and got a whole other view from there, decided I wanted to be a physician, Eventually in medical school this is where the VITRAG journey really began is the way that they teach in a lot of medical schools is they do what's called case-based learning.

Speaker 3:

So case-based learning what they do is they treat you as a detective and they'll say, here, solve this case, and you get up and you present it to the class. So it became a running joke every day. Either before I would present a case or a classmate would, I would have the same exact question every single day in med school, and it was this. It was how did the patient get this bad? How? This is their third diabetic ulcer. This is their fourth heart attack, right? The only reason these things are happening is because we're doing entirely reactive care. We're just reacting to however sick the patient is when they finally feel horrible enough to show up in our doctor's offices or ERs.

Speaker 3:

And I couldn't stop thinking about this just broken constant reactivity we had in healthcare and I started to wonder if there was a better solution out there, something where, in fact, we could be much more proactive with our care. If we could figure out this amazing technology where we'd be able to pinpoint the moment somebody's healthcare goes in a direction we don't like, intervene there. Imagine the amount of lives we could save, the amount of costs we would reduce for a health system, and even with, now, Medicare and CBT codes and almost any PPO, actually generate entire streams of revenue for providers. So while I was in med school, I dropped out in order to start Vitrac and actually work on what that solution ended up being, which is today, Vitrac, and now bringing that solution to anybody anywhere on the planet, regardless of chronic condition, level of chronic condition, level of technology literacy.

Speaker 3:

Whether you have a smartphone, don't have a smartphone, have Wi-Fi, don't have Wi-Fi, it doesn't matter, Because the core premise for us is we now know six years of doing VITRAC this technology always saves lives, always reduce costs, always is going to even, in some cases, generate revenue. What's our responsibility? To provide this to everybody, no matter who you are, what you look like, where you are. So that's been our core focus really since day one at FITRAC.

Speaker 1:

Wow, Wonderful mission. Irma, do you want to open up with any initial questions thoughts?

Speaker 2:

Yeah, I was going to say it's a fantastic story, and one of the things I love so much about talking to entrepreneurs like yourself basically on a daily basis is how often what they do in the world now helping others has a personal story attached to it, has that component of why they first got passionate about it, whether that was because of their own experience of the healthcare system or that of their loved one. So we would love to dive into all the details about your solutions, and we know remote patient monitoring is one of them. So tell us how your solution is different from others or perhaps goes further than some of the other options out there.

Speaker 3:

Awesome. Yeah, it's interesting. You said that because at Vitrack, we've been having a lot of conversations about no longer describing ourselves as an RPM company, right, I think that pigeonholes you into. We gather a vital sign and we trigger an alert. That is not what we are at Vitrack. That is certainly a piece of what we do, but we like to think of ourselves more as a proactive health company, right, A care collaboration company, because it's not just about pinpointing okay, this trend of alerts have come in and figuring out that moment. It's also about answering the question of what? Now? Right, what do you do with that, the thousands, millions, if not billions, of data points that are coming at you? How do you have a system that's going to help you triage that, get to the most important thing you need to deal with first, right? So understanding not just access to care from a patient's perspective. How can we make care delivery more accessible from the other side of it? So, a few things that differentiate us.

Speaker 3:

I'll start on the patient side. Number one is access to care. That's been our focus since day one. How we do that is by meeting every patient where they are. So I'll paint a picture for you a quick spectrum. Right, let's say, quite an elderly patient. Right, and in that situation I often see maybe this patient has a smartphone but they're never keeping up with it right. Or, to take it a step further, they may have no smartphone or a computer at home or, to take that a step further, they may not even have Wi-Fi right. So, no smartphone, no Wi-Fi. How do I still get data from this patient?

Speaker 3:

All the way to the other end of the spectrum, you might have a patient who's a little bit younger, more tech-savvy, wants the most cutting-edge ways that exist to monitor their vitals and get in touch with their provider. It's not the same solution for everybody across the spectrum. In fact, there are very different solutions for very different kinds of humans who happen to be patients. So on one end of the spectrum, let's talk about the really elderly patient with no Wi-Fi, no computer, no smartphone.

Speaker 3:

We use 4G-enabled devices. What that looks like is you actually take a SIM card, like the one inside of your cell phone, and you embed it in a medical device, a piece of hardware a blood pressure cuff, a weight scale, a thermometer, glucometer, all the ometers right, and with that, this elderly person does not need to scan a QR code, get on the internet, do anything. They literally just use the device by pressing a button. As long as they have one bar of LTE cell service, which is most of the country, that device will go straight to a satellite, down to the provider's dashboard, coded as green, yellow, red, All the way across the spectrum to, of course, the Bluetooth devices, all the wearables, the Fitbits, the Apple Watch, the Oura rings, you name it.

Speaker 3:

We connect something like over 50 types of devices, but all the way to the very other end of the spectrum we have the ability to gather vital signs from a patient just using a smartphone camera. By just holding up your smartphone camera to your face for about 45 seconds, we can get a heart rate, a pulse, ox, a respiratory rate, a blood pressure now which is pretty new and even a stress level. So the stress level one actually has opened up a whole new world for us, because we're no longer just looking at how a chronic condition affects a patient physiologically.

Speaker 3:

Now we can ask how a chronic condition is affecting a patient's mental wellness, Because that stress level is not just how happy or sad you look when you're doing the reading. It's taking your HRV, the time in between your heartbeats, and a calculation with your heart rate, how fast that heart is beating, and a calculation with your respiratory pattern to give us an actual data point for your mental wellness. So now we can see beyond diagnosis. We can also look at prognosis. So I have a little brother who recently diagnosed with diabetes and everything changed for him beyond just the actual diagnosis. What does it mean to go to a buffet for the first time and choose different foods, to go to a party and go in the corner and have yourself with insulin? These changes in your life have true effects and if we can measure them and intervene and respond based on them, maybe we suggest therapy, psychiatry, psychology, different kinds of therapies than we would traditionally. I think that helps us take a true look at a whole patient rather than a symptom or a diagnosis.

Speaker 1:

Wow, wonderful approach. And you mentioned all this data you're collecting from patients. How do you use AI to help those caregivers, doctors with real-time insights or predictive health? I mean, what is your?

Speaker 3:

approach. Great question so AI is? I want to be careful, because it's a very ubiquitous term out there right now. It is more of a fun term, I would say 90% of the time. When you're hearing about AI, mostly what you're actually hearing is large language models and machine learning, right, hyper complex. If, then, engines that are taking into account tons and tons of factors, that's different than what AI is. So what we're doing is we're utilizing large language models and machine learning to do what exactly? Great question, right, when an alert comes in, of the tons and tons of alerts that are coming into your system on a given day.

Speaker 3:

And here's something that I think is really interesting, because I personally see a gap in the industry forming. A huge gap that almost nobody is addressing is, as we see, health systems and physicians and a lot of healthcare move to a tons and tons of more data. That data that we're gathering from these patients are only useful based on our interaction with it, based on our response to the data. So what we're developing at VITRAC are algorithms, large language models and things to actually take those millions and billions of data points and answer three questions. What's the first data point you need to deal with Suggesting what you should do with that data point, based on age, background, demographic, chronic condition, tech literacy, all those different factors, and then, from that, tracking the whole lifecycle of that data point until it's quote, unquote, completed or finished. So, from the provider side, our goal is to actually create healthcare at the click of a button, right, solve it one at a time. So we'll give you the five or six things our system will allow you to do, for example, in response to a red alert, blood pressure or a yellow alert from a questionnaire, but also using those models to suggest what you might want to do in response.

Speaker 3:

Obviously not diagnosing. I know, for some reason, and I can't wrap my head around this 99% of healthcare innovation is going directly toward diagnosis, which the one thing that I've learned is doctors and nurses don't hate anything more than when you tell them how to do their job. They hate it. If you tell a doctor, here's the patient's diagnosis on my software they're just going to hate you immediately out of habit or instinct. We're focusing not on diagnostic efficiency, we're focusing on workflow efficiency, which is a very different thing.

Speaker 2:

Oh yeah, workflow is one of those key words in healthcare because, with such overload and burnout already existing in the healthcare system on the provider side, last thing you want is to give them some amazing technology that's just going to disrupt their workflow and make their work even harder. So clearly you keep that in mind. Now back to the patient side of things. Clearly, to have all that data that you can then analyze and provide those actionable insights, you need patient participation and patient engagement. So you've already started talking about how you meet patients where they are. So that's very important. But how do you actually get them to use this technology? Do you train them on using this? Is it on the providers to get them started with this? Like talk about this aspect of patient engagement?

Speaker 3:

When I first started getting really involved with the software and the technical side and now knowing enough to be dangerous when working with developers. There's a saying that developers have which is the right technology is the technology you use, and that's something we think about at BITRAC all the time. Right, you can have the best, the flashiest we talk about always building a better mousetrap but at the end of the day, the right technology is the technology that somebody uses. So the way I think that we historically have gotten our adherence numbers for patients to a higher level than I would say is standard at all within the industry is two things. Number one, like we mentioned, it's figuring out the right thing for that patient. If I put a technology burden on a patient they can't handle, it'll never work. So something that we've been experiencing at Vytrack is we go to these large health systems and I say, hey, we've got amazing solutions for you. And they say, yeah, we tried, it Doesn't work. And I say, can I guess what happened? Can I assume what the model was? We're trying to make work. And they go sure, it's like let me guess this is what happened.

Speaker 3:

Some big, fancy company in our space with a name that is beyond recognizable, came to you and said, hey, we do. What did they do? They sent a box of devices to an elderly patient's house. That first one device, let alone five, it's never going to happen. And then you ask that patient to understand how to link Bluetooth devices to a central hub that is then going to transmit their readings to the hospital. And it never made it out of the box. Is that what happened? Yeah, that's what happened.

Speaker 3:

Cool, let me explain to you how we're going to do this differently. We're going to create different programs for your different patients, based on their population and based on their technology. Literacy, right, and the fact that we can gather a lot of data just from a smartphone, means we can get a lot more nimble with the kind of devices we we deploy, right. So we have heart failure programs, for example, where we give a patient a 4G enabled device but also an app. Now we're gathering five or six vital signs from a patient just by sending them one weight scale, but on top of that, our algorithms will automatically, based on certain vital readings, put you into a questionnaire to get us more information automatically, push you a piece of education, help us avoid a hospital readmission.

Speaker 3:

So from that perspective, I think number one is meeting the patient where they are. But the other thing you asked about is the training. Right when I was trained to become a medic out in LA, I remember we had this guy. He was a veteran, he was in the military, fought in Kabul, blackwater. This was one of those really hardcore guys and he had this mentality that I think is emblematic of what is the way military teach. It's this, it's a process of see one, do one, teach one, and that was how our entire medic training went.

Speaker 3:

You saw somebody do it. You would do it yourself and then you would teach them how to do it. Any time where Vitrac is involved in the training of patients and getting them to understand the program and the why, we always, always do the method of see one, do one, teach one right, so you see us here's how we do it.

Speaker 3:

Here's how you take your blood pressure. Here's how to use the app. Now you do it and we watch them do it and I go. Okay, I actually have no idea what any of this stuff is. Can you teach me how to do it? Until they can teach it back to me, you don't let that patient go home, right? You don't let them leave, because what's really important is, at the end of the day, this is truly life-saving technology and we have so much data at this point, so many stories I can tell you from doctors and health systems calling and saying this patient would have died. Right, they were going in a horrible direction, and we caught this early enough to change a Lasix, to bring them into the office, to tell them to self-admit to a hospital. Right, those data points are so important that it is worth every moment of sitting with that patient and making it important to them, and I think a lot of other companies miss that as well a lot of other companies miss that as well.

Speaker 1:

Wow, really well said. So let's talk about how you scale up in our very large and fragmented healthcare system. You got small clinics, huge hospitals. How do you think about going to market and meeting the different needs of all of these healthcare providers, and what's the challenge there that you kind of have to overcome?

Speaker 3:

So our advisors over the years at Vytrak have kind of changed their tune a little bit when it comes to the type of business that we take on at Vytrak. At first they were very much pick your niche do diabetes really well? Do hypertension really well? Do heart failure really well? And I just kept thinking the reason that I left medical school was to try and save as many lives as I could. I realized with one good deal at FITRAC I could save more lives than I could in five lifetimes as a practicing physician, right. So it always felt too narrow. I wanted to affect macro systems rather than an individual chronic condition. So over the years I eventually got them to come around to my way of thinking. Which was this? Any health system that is providing any level of reactive care, if I can change that to proactive care. That's a type of client that I want. So our clients look very different, everything from your classic health system to your private practice physician. But we also do a lot of work with school districts. We also do a lot of work with the houseless community or those experiencing houselessness. So we're not afraid of different verticals. And how are we able to meet the needs of all these verticals? To your question is all these verticals have very different needs, right?

Speaker 3:

When I go to a health system, I say, all right, well, what do you already have in place to get in touch with a patient, to teach them something, to do follow-up? Usually there's a nurse navigation team, which is colloquially at every health system. They have one of these. They have social workers that are already going to patients' houses. All we do is we figure out what workflows are already in place and how do we just change them slightly so we're not interrupting the system. And then for physician offices, every single one is its own use case. I've never met two physician's offices that are like, if you're going to be successful at a physician's office, you got to get in the weeds, you got to learn the MAs and how everything operates and who's responsible for what. So that takes a little bit more time. But if you show these physician's offices and health systems that you're willing to create an entirely customized program for their needs, that's a client that's going to stay with you, no matter wow, um, so you've already, uh, told us a bit of a success story.

Speaker 2:

I would love to hear maybe another one where you take us end to end. You mentioned how your um solutions literally save lives. Would you give us one example of, of someone that we can kind of picture in our mind, of how it made a difference in their life?

Speaker 3:

yeah, so I I can god I can tell you stories for tell you war stories about, but I'll give you one that that, for whatever reason, is sticking out to me right now, in this moment. I was invited to go to the Clinton Foundation's Global Health Initiative and there you have the best and brightest, all these incredible people. The Queen of Jordan is there.

Speaker 3:

Like you have some pretty amazing people at these conventions, and every year there's a different theme that they focus on, and last year when I went, the theme that they focused on was maternal health, what they call the fourth trimester, and there's a huge disparity across the country between the death rates of black mothers and white mothers huge something like I think it's, nine times across the country, 13 times in New York, and I'm sitting at this panel, it's with I think it was like JB Pritzker and I think it was the African-American Mayors Association, and Secretary Clinton was up there and they're going on and on about how horrible the disparity in the death rates are and why that might be, and I'm sitting in the audience going. I can tell you exactly why that is. We're watching white mothers much more than black mothers. We're watching them much more closely. The only reason these death rates are happening is because they leave the hospital and we cross our fingers and say hope they'll be okay.

Speaker 3:

That's why we did a study with a hospital I don't think I'm allowed to disclose which one, but they're one of the larger systems and what we did was a study of 60 mothers and we looked at postnatal hypertension, right. So the usual readmission rate for postnatal hypertension, I think, is around 60% In our study. And all we did was give these mothers a blood pressure cuff where they could take their vital readings and, based on those vital readings, a PA and an NP would monitor them and call the patient to make changes. Usually, hey, change a dose of Lasix and record all these things. Throughout our study of the 60 mothers, we had zero readmissions not one. Because it's not rocket science, right.

Speaker 3:

Blood pressure doesn't go out of control like in a day, in an hour, in a moment. The way blood pressure works, right is you've got a normal, healthy valve that's open and slowly that builds up over time. You can catch that moment that buildup first starts. That's a yellow alert, right? If I can catch you there, we're doing really well. Usually patients are coming in and feeling symptoms like here, right? That's the problem. So if I just give you some really solid ways to catch those moments, we're always going to provide better care.

Speaker 3:

So I think for us that was really telling is because that's a direct way to see some good that we've done and we're working with a lot of these systems to try and just this is one of the most frustrating things about having a solution like ours is we just want to shout from the rooftops as much as we can.

Speaker 3:

We can save lives, we can help you. Whatever problems you're dealing with as a health system, the solution is here. And the solution is not rocket science, right, it's if we give our patients more closely, if we give true well care, proactive care we'll always save more lives and we'll always give better care and the fact that it's here and it exists in such an incredible cutting edge way, what's our responsibility as providers of health care, as patients, to demand this, to change the level of care that that we experience as a standard Right? So if you go on our website at VITRAC, the first thing you'll see and this is something we truly believe is the standard of care has changed, and I think that begs a lot of very interesting questions.

Speaker 2:

Wow. So I think I might know the answer to this question, but I want to ask it anyway. So let's talk about the future of healthcare. It looks like you're already kind of bringing that into the present. So what I want to hear in your words what changes in healthcare do you think we'll see over the next few years, and how is VITRA getting ready to perhaps champion them or at least embrace?

Speaker 3:

them. It's interesting because there's a side of me that is super optimistic and another side of me that has been kind of in the trenches for the last few years in healthcare from so many different perspectives. So I'll give you my very optimistic approach and, to Medicare's credit, right, Medicare has a lot of problems but also does some things that are really great for patient care. So the only reason I was able to start VITRAC I had this vision in medical school where I said I can give amazing proactive care to patients. And everybody I called, who I respect in the industry, all had the same question. You can guess what that question is who's going to pay for this? And I said, well, people will pay for it because it's the right thing to do.

Speaker 3:

And I eventually learned that is not a reasonable answer In November 2019, all of a sudden decided to prioritize with some of the most lucrative CPT codes they put out in a very long time remote proactive care. So they put out a whole set of codes called the RPM CPT codes and those reimburse at about $120 per patient per month. We go to some really rural communities where doctors are maybe making $100,000 a year. In those communities we can say to a physician if you have 500 patients to put on our program, that's an added quarter million dollars in revenue per year. Your patients go through the roof. You're going to save lives. You're going to change every what I do. Just as a tangent here, anytime before I go into a physician's office and this is really boots on the ground I'd go on Yelp and I'd see what their score was. I'd read all their comments and the comments are almost always this the waiting times and the doctor took two hours to do this, and that.

Speaker 3:

I look six months after VITRAX starts and it's completely different. It's the doctor cares about what happens to me outside of the office the doctor. When I come in, he has my blood pressure readings ready to go. I'll tell you a story which I love. One doctor says to me going to visit doing a client checkup. Doctor says you want to see something really cool. I said, sure he goes. All right, I'm about to take you into the room with me. This patient is going to immediately complain about the medication I put them on. I'll tell you that right now and just watch this. Okay, I go into the room during the visit.

Speaker 3:

I'm standing in the corner and the patient right out, a chart, all his ViTrack blood pressure readings. And what do you see? Green, green, green, yellow, yellow, yellow, red, the peak. He goes. What's the danger of blood pressure? He said about two weeks ago. He goes. I can tell you the exact date right there and he points to the highest red peak. That's when I changed your medication. And now look, red, red, yellow, yellow, yellow, green, green, green, green. And the patient went oh my God, I can see what the medication is actually doing to my health. Now he's one of his most compliant patients. It's that easy. I think. Patients just want to know why you're doing what you're doing and provide them some evidence.

Speaker 3:

And it's right there, show them. You can prove why your healthcare is actually objectively getting better or worse. So I think it's fun to ponder all of the different applications of what you can do. But I think, to go back to your question, where do I see the industry going? More of this, more and more proactive care, more and more data. That's happening every day that this is the only sustainable path forward, and then for us, knowing that it's okay, well, how are we going to handle all that data? And that's what we're currently focusing most of our innovation on at iTrack.

Speaker 1:

Wow, wonderful anecdote. What a great story. So final question here I'm a bit of a wireless tech geek, yeah, and it seems your approach really allows you to support many different countries and regions with embedded wireless technology. You know, standardized Is that something you're planning is entering all these markets and reaching patients globally?

Speaker 3:

So I'm I'm a huge techie, so it's everything from wearables to all these different things, so I'm also looking at things that are starting to be developed. So right now, as long as you are anywhere on the planet with one bar of LTE cell service, I can get a viral from you. It does not matter where there are parts of the world that don't even have access to that. So I've I spent a lot of time for a few months out in Uganda. We were out in the bush and I worked there with a doctor who was the only doctor for hundreds of miles around, so you would have a line at this guy's door every day from people who'd walked miles to get health care from somebody. And I remember thinking one day I'd love to solve that issue right, if I can really do rural health care across the world.

Speaker 3:

And right now, what they're working on which is really cool it's not ready yet is the ability to if you think about data, right, average data.

Speaker 3:

It's almost like you're sending a full airplane suitcase, not a carry-on right, to get data from one place to another, and the way that data travels is you have to have enough space for that suitcase to pass through, to get onto the airplane to get where it needs to go.

Speaker 3:

So what they're working on now is you don't always need a full suitcase, right. A lot of times we're just putting in the suitcase a small little cube or a small, small little, I don't know, maybe a one t-shirt. You don't need your heels for one t-shirt. So they're actually working now on ways to make it so you can actually send a very small parcel the size of a letter through the waves to get it onto the airplane instead of a giant suitcase. You can get that to anywhere in the world. As that technology moves further and further, we can get vitals from any place on the planet, almost regardless of level of cell signal, as long as there's cell signal within a certain amount of miles from where that individual is we may be able to piggyback off of that and get it up to the satellite, down to a dashboard.

Speaker 3:

Once we have that discrete piece of data, we can do anything with it right. We can code it for alerts, we can triage it, we can suggest workflows based on it, based on the region. So there's a lot of cool, really cool, things happening in terms of health tech, and I see new things every day. I'll just leave you with a few things that I've seen coming down the pipeline that we're currently integrating with. I think what should be available for beta test in a month is the ability to cough into your iPhone microphone and suggest a band of likeliness of what respiratory condition you may be going through, right.

Speaker 3:

So we're just trying to think about all the different kinds of technologies someone may interface with at any point in their day. How can I get more health data, more information, to try and figure out is there something going wrong that I can fix? We're also using even the iPhone camera beyond gathering vitals, taking a picture of something on your skin and giving you a band of likeliness of what dermatological condition. So really trying to use everything we have at our disposal to gather health data from and with all that data, right that data. What's important about good data is the story that it tells. So trying to pull those stories and the narrative from that data, that's how you save lives.

Speaker 1:

Wow, what an incredible mic drop moment. Well, we will wrap up on that very optimistic and exciting note. What are you up to the rest of this year? You must be out and about at meetings and gatherings, events, conferences. What's on your radar for the next couple of months?

Speaker 3:

Forever stops. I joke that I love living in Philadelphia, but I actually joke that I live on an airplane. So back and forth, conventions, meetings people just want to be in person now and I think one of my biggest takeaways post-COVID is what takes me six months to a year in Zoom meetings I can do in two in-person meetings. I think people want that a bit. So a lot more client-facing being there, being present, and for me it's always been, even during COVID.

Speaker 3:

No matter who we onboard as a client, I'm there on the ground with the medical assistants. I'm there during patient onboarding and triage for weeks at a time. You can understand from up here, right, you have to get down here with every client to understand. And now that I think we're starting to normalize that a little bit more, I'm looking forward to this year doing a lot more of those patient-facing experiences, getting back to really understanding on the ground where healthcare is and taking those insights and using them to create some amazing technology that hopefully I'll have some more news about the next time we do an interview.

Speaker 2:

Fantastic, I see that. Look there for sure.

Speaker 1:

Congratulations, and we're all rooting for you and we hope we'll meet you in person, either in Philadelphia or Boston or wherever that we will find ourselves out of the marketplace. Thanks, zach. Thanks for joining.

Speaker 3:

Thanks for having me guys. Thank you so much.

Speaker 1:

All right and thanks everyone for listening and watching. Reach out to Vitrak and follow the amazing work they're doing. Thanks so much.