How to transform imaging with behavioral science

Good afternoon everyone and thank you for joining

us today. My name is Melinda Teska,

MLA. And I'm the editorial director of

diagnostic and interventional cardiology

on behalf of D. A. IC. And our sponsor

Change health care. I'd like you to

welcome you to today's presentation

today. We'll be discussing how to transform

imaging with behavioral science,

behavioral science is being applied

in unique ways for enterprise imaging product

design.

In this webinar. Our presenters will discuss

how observation interviews

and experimentation can help the

industry form a better understanding of

current needs and pain points

within the card within cardiovascular

imaging.

Having clinicians involved in the product

design process has led to complete

rearchitect of a new generation

hemodynamic solution.

Using a real world scenario will share

a clinician's experience. Working with behavioral

science and product development teams

provide an understanding of how they're using

de hemodynamics today and

get their thoughts on the future of imaging

and hemodynamics.

by listening to key stakeholders.

New features can be brought to market

that will have notable impact

on the way health systems operate.

By building better products. We can help

improve patient outcomes and ultimately

transform the health care industry.

One behavior at a time.

Our objectives today are to learn

how a next generation hemodynamic

system has implemented 19

user centric concepts and undergone

iterative testing with health

care providers

how health care professionals are providing

their expertise to bring new features

to market that will impact the way health systems

operate

and what a next generation

hemodynamic system can do

to keep pace with new technology innovations

in cardiovascular care and increasing

clinical demands.

At the conclusion of the presentation.

We should have time for a few questions.

Feel free to type your questions in the

chat box and our presenters will answer

as many as time follows.

Our presenters today are Doctor

Barry Berle

and James Danette.

Doctor Berle

is an inter interact interventional cardiologist

and the director of cat

lab at North Mississippi Medical

Center. He's a founding member

of the Mississippi Health care Alliance

which has developed the nation's first

statewide system of health care,

both heart attack and stroke.

He's also board certified by the american

board of Internal Medicine.

In cardiovascular disease, internal

medicine and interventional cardiology

James Stinnett is a behavioral scientist

at Change Healthcare. He's an experienced

researcher with a background in Product

U. X. And behavioral science.

He joins Change Healthcare three

years ago and is currently a researcher

on the behavioral science team.

So thank you all for being here. And

I'd now like to turn it over to James to begin

today's presentation.

Awesome. So again,

my name is James and I'm a behavioral scientist

and researcher here at Change Health care.

Um I appreciate all you guys joining us

this afternoon and before we jump in.

I just wanna talk us through how we'll be spending

uh the next half hour or so together. So

I wanna begin by grounding us

and a shared understanding of what behavioral

science is and our approach to research

uh and design here at change healthcare. And

then I'll move into talking a bit about the work that we've

done and and the re redesigning

our nextgen hemo solution

and then I'll stop talking and I'll get off

uh and then I'll hand it over to Doctor Berle

to talk us through his experience

uh working with us. Uh and with hemo more

hands on

So again, just right out of the gate.

Uh I I wanna kind of get us all on the same

page about what behavioral science

is and really simply stated.

Um behavioral science is a study of human

behavior.

So it it combines psychology,

sociology, social and cultural

anthropology and economics. So

I think academic theory really coupled

with real life application. So

uh empirical data gathering, experimentation,

getting a shared cultural understanding.

And and the real call out here is we

don't want to just camp out in the land of theory, right?

We really want to have meaningful real

life application.

And so long story short, we're here to conduct

research to understand how

people have acted in the past to to

predict and hopefully help nudge a bit

um how people are going to to act in the future.

rational human decision making, really assumes

that we all make decisions by following traditional

economic models. Uh We all think

that we make the best choices that are in our own

best interest.

Um So so for example, let's say that I'm

on the market for a New Tv

right? I I I know the size of the room

that it's gonna hang in behind me. Um I might

do a little online research to know what my options

are at target or best buy.

I'll kind of weigh all the pros and cons,

I'll know how much money is in my bank account

uh and then you know hypothetically I'll go

out into the world hop in my car um

and and make the choice

and purchase that Tv, right? Um I got this,

I I'm a I'm a responsible adult and

I I can make a really pretty uh simple decision

Unfortunately that's not necessarily how it

always goes. Um So as soon

as I walk into target, uh I might

see a first bigger

Tv that is nicer and way larger

um and more expensive than the one that I had decided

to get.

Um But now my gears start turning

and now I'm thinking about um

me memories about growing up in texas,

watching the Dallas cowboys beat the eagles

on Sundays with my family and how

fun those, those experiences were.

And I now I'm kind of thinking oh man,

I'm convinced that I might need this New Tv.

It might let me recreate those happy feelings

uh with with friends now here in my adult life in

Nashville.

And so the experience uh and the emotion

of visualizing all

of that outweighs the the logical decisions

and kind of pre homework that I had done. Um

Next thing I know I'm lugging a giant Tv

out of target and hauling it up the stairs and my bank

account is is substantially lower

than I had any intention of it being.

And so that's why behavioral research

and design is so important. But because humans

don't follow traditional economic models we

can be irrational. We can be illogical.

We can make poor decisions and we all

have a contextual baggage that we

bring into every situation.

And that's a real bummer for all of us as we're trying to move

through the world and make decisions in our own

best interests. But it also means that I

have a job and I'm employed. So love that

for me. But as

it applies to product research and design,

it's imperative uh really that we understand

beyond the basics of just what a tool

needs to do. We also need to understand

why a tool needs to do those things, Right?

So what emotional state is the user in?

What are the time constraints? Uh What's

the social and physical environment?

all of these things uh impact the

end user. And and since I'm not a clinician

or or or a tech or a nurse, we had to ask

um folks like Doctor Berle

And so when we're dealing with people

um there are a few things that we want to try and understand

and take into consideration.

Um The first is context, right? The

situation that people are making decisions in.

Uh we also want to try to account for bias

um which are really just systematic errors

in thinking that flaw our decision making.

Uh We all have a mental map of the world

that allows us to make decisions in

a really complex and data rich environment

and we we have to make so many choices all day every day.

Um So how do we account for those bias

uh that we each have

um in the Tv example, I was biased by nostalgia,

right? And I was able to rationalize that purchase in my head

And also we want to account for choice architecture.

So how are the decisions that we

make? Uh influenced by the layout,

the order, the range of choices that were given?

Um For example if I walk

into target and the and the first Tv ic might be

the one um that I get really attached to.

So all of these things are just a few

of the of of the the the ones that we

want to keep in mind as we're trying to to

best understand people and the decisions that they make.

So we're trying to account for all of these inputs in

behavioral science. And and so behavioral

design takes the research driven

human understanding and nudging of behavioral

science uh and applies it to an interface.

We want to take the user insights of why

people do what they do uh and design

interventions within the tool that can increase

usage uh and adoption of that tool.

So here at change health care we have a mixed

methods insights and research

team that does both behavioral science

uh and U. X. Based research uh comprised

of both U. X. And and behavioral science researchers.

So on the U. X. Side of the house

uh we really want to understand how humans interact

with each component of a system or application.

And and on the behavioral science side

um we really want to understand

human capacity

So how human minds falter where

they might need help. Um Where where minds

Excel and where it's best to take more

of a hands off approach and leave them alone.

So advocating for the user is really our key

responsibility uh and this role as

as health care technology researchers.

Uh and so that that combination of U. X.

And behavioral science is really impactful

uh and can lead to meaningful innovation, especially

when uh clinicians like Doctor

Bela are involved uh in the design process

which is is something that's really important as we're trying to build

um meaningful innovative products.

So now that we have that shared understanding

of more of my role uh in research

and design here at change healthcare, I want

to talk through specifically just some of the work

that we've done um for the next gen

hemo tool

This slide will give you some more background on our research

goals uh that we were digging into for

the hemo product but specifically

uh the research that I want to talk about today

aimed to prioritize user feedback

uh to support the product pipeline and really understand

any barriers to human behaviors that we

could account for.

Um we were trying to really preserve what users

thought was working well um and prioritize

areas of improvement that were suggested

by surgeons, nurses, techs,

um and and and different user types.

So yes, while this research supported

a total U. I. Redesign of

hemo

digging into the behavioral aspect was critical

too as we're trying to again build things that people

actually want to use and

and try to increase adoption of the tool.

So some of the things I'm gonna talk through

today um and the insights

were the products of internal and

user interviews across the span of about

four months. We talked to nurses,

monitors, physicians, uh I. T. Folks

um and and C. A. Admins as well.

And in total we spoke to to users across

uh six customer sites.

several product recommendations came

out of this round of research um but in an attempt

to avoid sounding like a sales pitch,

I wanted to just talk through a few areas

really through that lens of behavioral science.

Um

that I talked that I had on earlier and and

they're just about three areas that that we found

to improve the hemo offering for users again across

all of all of those role types. So

I wanna talk about choice, overload default

bias and this idea of um optimizing

mental friction.

And again, uh we'll we'll start here

by talking about choice overload which really

gets its name from the paralyzing effect

that it can have on our decision making processes.

So essentially it means that the more options

are available to us there are, the harder

it becomes for us to choose.

So in your day to day maybe think of

the last time you went to a restaurant and they brought

you a menu and it was pages and pages long.

That is is a really simplified example

um of of choice overload.

So not only does this make the experience,

um, uh feel more draining to us,

but it also really makes us more likely to choose

nothing right to put off making decision

entirely because we feel so overwhelmed.

Um and this is really especially important

to acknowledge and account for in the

context of human dynamics.

We know that environment exacerbates

sensitivity to choice. Um,

and hemo users are in a really time

constrained higher risk decision

making environments, uh which makes them really highly

sensitive to too many options

and this can pose really considerable consequences

right? Uh from users not maximizing

the hemo product features uh to

leading to total decision fatigue uh where

uh, people might default to their own habits

and workarounds in the tool, it can lead to

a really less than ideal experience for everybody,

um and we want to get ahead and head

off this overwhelm. Um As much as we can,

and so the translation of product really was

um uh less is more

right uh Regardless of any redesign

of the interface of hemo it was really

important for users that we maintain the 1 to

2 click functionality um

especially as we're operating in, in

in in a larger health care context where burnout is

so prevalent and I think doctor belay might hit on

that. Um here in a minute,

It sounds really simple, uh but when

you're working with this complex of a tool as hemo

with as many inputs as it has,

uh prioritizing the features that

are really easily on hand, one or two clicks away

uh is a win.

And again, it it stresses the importance of

of talking to people who are in the cardiology

suite that are really focused um

uh on on time savings as

well, which which I'll hold on more uh here in a bit

The second call, I I I I wanna talk through

is this um idea of default

bias and really the, the double edged sword that

it presented in the context of hemodynamics.

So, default bias

uh refers to people's tendency to choose

an action over action uh as well

as their preference to stick with previously made decisions

or really well worn decision paths uh in

their mind.

Uh we know that default options can reduce

uh mental burdens, right? When, when we're

asking a user to complete a really long

complex task, like working a cardiac case.

Uh default options can help them conserve

their mental energy.

Um

and and we know that making any decision involves

effort. So any place that we could help

clinicians have default options like

fields templates, uh et

cetera really was a win

and at the exact same time, uh we

know right that some choices are unavoidable.

uh simultaneously we we know that he

is a really complex tool in a complex field

uh and for users to get the most out of it there

really needed to be an ability to customize

and configure it to site specific needs

and that needed to be a priority.

So the call out here really was this need to

strike the right balance uh to find the sweet spot

between default options again,

to continue to minimize clicks and mental effort

to try to head off some overwhelm as much as we can

while still allowing the room uh to

do the customization that was needed.

And this is all kind of compounded by the fact

that that cognitive depletion is present. Like

we we know when we're stressed, our decision

making functions are biased toward habit

and make us really unable to handle complex

tasks.

and that's the real behavioral challenge of

of product design. Right playing into this

default bias. Where can we provide defaults

to continue uh to save

time and energy and deliver on time savings.

Um But also where in the tool uh

our our end users may not best served

by just going with the flow um

and needing to customize and configure what specific

uh needs that they have. So that dance of customization

with pre configuration um

was really uh a meaningful call out of this research

as well.

and finally, I want to talk about really the thoughtful

use of mental friction. Um

and and both of these prior points really hit on

this

uh cognitive friction occurs

when a user interface or feature really forces

folks to stop and think which increases

the cognitive load that that that's required of them

to complete that task. And

uh just want to call out that friction isn't always

a bad thing is the point here. Right intentionally

incorporating cognitive friction to improve

user experience.

might sound like it goes against some of what

I've already talked about today, but it really

can have positive effects in the right circumstances.

Um, friction can be vital

for protecting clinicians and techs and nurses,

um and ensuring that they don't complete tasks

accidentally. Um and really

this idea of using mental friction as its own

intervention

and identifying areas where there might need to be more

of a pause to serve as a backstop

um while still being thoughtful and intentional, not

just throwing that in kind of haphazardly,

um, but making sure that any anywhere in mental friction

is added um because it adds

time or effort, um it was a meaningful

uh place to do so

So friction in hemo might look like

error messages for example. Right. We we

heard in our research that there was a big behavioral

barrier to accommodate for um

that was impeding calculation accuracy in the tool.

So if patient height and weight weren't entered

maybe correctly in the pre pre pro

procedure and nursing assessment um

all the calculations afterward afterward

could be skewed.

So having any error messages that

might show specific missing values

was a meaningful use of friction.

another might be uh preventing text

from signing out until the missing fields

that the system highlighted uh were correctly

filled in

And another might be uh sending the referring

physician a notification of the procedure

so that everybody is kept in the loop uh about what's

happening. and

all of these sort of behavioral integrations

can add up to some meaningful impacts on clinicians

and staff.

uh, the first area that I feel

like it really provides value is around time saving,

right? So much of the end user

um, and clinicians, um, uh,

needs and preferences

are really based on maintaining an efficient use of time.

Uh, and this really served as a foundational piece

of the hemo product redesign. So I I know

I'm preaching to the choir with a lot of the audience

today and I know I'll have to tell all of you

that across user types. Time comes

at a real premium. Right? Everyone is fatigued

by having to navigate through too many screens,

too many clicks.

and behaviorally. This story is really powerful.

Um hemos single platform ability

with structured notes are responsible

for for customers saving minutes per case.

Um And one quote that we heard from our interviews

that I thought really drove this point home

uh said you know, if this can save you 15

minutes on every case you do at

the end of the day, that could be a couple of hours

right that physicians

and staff are able to go home to watch their kid play

soccer instead of watching. Um waiting

to do that at the end of the night,

And so time savings uh was one

big big impact here.

The second uh call out uh that

all of this kind of fed into was around a

legal safety net. So we we talked

earlier about behavioral science um

and and part of my job as a behavioral scientist

is to gain an understanding of what it means to be human.

Um One major aspect of that

is that we all want to be in control and seek

certainty especially um

in the context of hemo where where someone's life

um is on the line in the cardiac setting.

So providing a backstop where we can in

this system build on this idea

hemos functionality of showing who

contributed to what, who, who signed

off on what aspects of the data

and also making sure, you know, that all the uh, fields

are filled in correctly on the front end.

So to minimize um, kind of

downstream negative impacts as well as important.

Um It helps validate uh nurses

and techs um and increase their competence

and a tool hopefully leading to

them using it more right. Uh This motivator

of safety was really especially important

um for the nurse users uh that we talked to

who referenced, you know, the single platform

giving them legal coverage um if someone

makes a mistake. So we

know that the mental strain of keeping up while

juggling so many tasks in the cardiac suite.

Um so many different workflows is a really constant

mental burden.

and we want to try to minimize that burden where

we can on the product side to to really

minimize burnout, um,

where we can,

And then finally you know we know that partnerships

require trust. Right? Research has shown

that mature and positive vendor partnerships require

that trust. And we want to involve clinicians

in the research process where we can to really build

on this idea of partnership um

that we're asking about your needs and motivations

um and and issues that you're facing on the floor.

Um So if we add functionality that there's a good

reason for it.

And so again

a lot of that was through the lens of behavioral science.

But here at change we do have a mixed methods

research team. And so in that spirit

I also wanted to call out just a couple of of

meaningful research findings that weren't

necessarily um beci

centric. So

uh first heard about building on a

strong foundation of diagram functionality

uh for the structural heart and vascular system.

So Uh, these additional diagrams

in the uh, current coronary tree. Uh,

physicians and techs really want to be able to customize

those diagrams for anomalies and

really annotate them in more complex lesions

Really ultimately nodding to to

the deeper fact that that this functionality

can provide the ability to quickly annotate.

Um, while still honoring the really the complexity

and the accuracy needed to perform quality medicine

in the cardiac suite.

Another thing that we heard was you know as clinical

advancements continue to outpace um

registries and as reporting mandates change

the hemo product really needs to be able to keep

up with the most advanced surgical techniques

and calculations

and they all really need to be accurately represented

uh in the hemo report.

And then finally there there were numerous U. I. Updates

and call ups that we heard heard that there was a lot

of change healthcare blue like a lot of shades

of blue. Um And so just

uh consideration is that even

um in the redesign of the U.

I. Again we we want to

Um really value

the user feedback that we heard um and

and maintain that kind of 1-2 click functionality

to not and not sacrifice that in the redesign

and really any U. I. Um

findings or any changes really built

on top of all these behavioral considerations

that have already talked um through us today.

So hopefully that gave you a AAA bit

of a glimpse behind the curtain of some of the work that we're doing

uh as researchers uh here at Change Healthcare

um and uh you've heard enough for

me. So at this point I will hand

it over to Doctor Bede

to talk more about his experience working

um with change health care and also his experience

with hemo um more hands on

Thank you James, I appreciate

that introduction.

Uh next slide

And one of the big things that I think is

really important for physicians

is this concept of physician

burnout.

There was actually a Stanford study that was

done that showed that 71%

of doctors compared

this uh onset of the electronic

medical record to the

burnout that a lot of physicians were

experiencing

In 2020. The American College of Cardiology

Clinician well-being work group

published a survey that showed that 35%

of cardiologists reported burnout

and 44% said that they were

actually stressed

Surprisingly mid career cardiologist,

45% of them

said that they experienced burnout. These

weren't their early career or the late

career where you may expect there to be

some concern but these were the the the

workers that are out there.

And unfortunately when we think about

this physician burnout

and um

is that this can cause some problems down

the road in uh maintaining

a long term career?

Now when electronic medical records

first came out, the initial thought

was that this would be something for data,

uh transmission collection

of medical data. But now it's given

way to quality metrics,

coding

billing as well as other

required insurance information.

And so it's led many providers

to have developed carpal click

syndrome

Next slide

One of the other issues that is

concerning is the graying

of cardiologists.

We now see that 40%

of active physicians will be

above the age of 65

within the next decade.

And of those older physicians,

the majority of them are specialist.

and so we certainly can see where this

could impact cardiologist as

we have less of the

mid career cardiologists coming

up to replace these older cardiologists

in some of what they do. And this

will just simply add to that stress.

And the uh burn the the sensation

of burnout that many of these physicians may

feel. next one.

So the behavioral science

unit with change, understands

these stressors. Uh they

actually uh were

uh interviewed our group

and members of our group to try to

understand what are some of the stressors

that we have in our interactions particularly

in the lab

Um so there were not only interviews

of the physicians but also of the staff

and feedback that we gave them

was the necessity for less

clicks.

The inclusion of quality metrics

is part of the guidelines,

Less time to provide that final

report.

providing that referring physician

notification of the procedure

as well as the ability to customize

these for individual physicians or

even individual hospitals.

Next slide.

So how do I use our hemo

system

So within our system,

our patient demographics

are added to the admission when

the patient arrives in our short stay

unit. Also

there in that short stay unit,

preoperative lab work is

entered. and then within

the system itself or may be manually

added by the technicians later.

Previous stents or

bypasses are already on

the diagram and these can

be automatically updated

as I perform the heart Cath procedure,

I'm able to call out lesions

that I recognize on the

angiograms and then the technician

as I perform the heart cath

is able to load these

into the uh this

the reporting system

to make it easier for me when I come

out of the room?

Following that after the completion

of the case we do have pre conformed

procedural reports as

well as pre conformed recommendations

which speed the production

of the final conclusion uh

in the final report. So

it is not uncommon

that I can perform in a complete

evaluation and final report

in less than five minutes at the completion

of my procedure.

and importantly with this

several metrics also get recorded.

the metrics that we uh record

within our system on the uh on

the next line,

and these include the indication

for procedure,

The status of the procedure whether it be

elective, urgent or

emergent,

the moderate sedation time which is

important for billing

the contrast type and the amount

used the fluoroscopy time,

the fluoroscopy dose

the dose area product,

blood loss.

If we performed a Pc. I what

were those indications?

The pre and the post presents

stenosis as well as the

timi flow pre

ipod on any intervened lesions.

And then if this was a culprit lesion

So not only is this important for our

own local documentation but

also for insurance providers as

well as to upload the quality

metric databases such

as like the N. Cd R.

next slide.

The other nice thing is that we

can have these reports immediately

posted to all applicable

E. M. R. S.

In our system right now we have

two E. M. R. Systems and

the final report is immediately posted

to those systems with notification

sent to the referring providers.

presently in our location. The

cases that we will perform and

use the hemos systems include coronary

cases,

structural heart cases such as

tar transmitral valve replacement,

A. S. D. And P. F. O. Closure.

Are peripheral intervention cases

which include renal intervention,

lower extremity intervention, upper

extremity

and as well as cerebrovascular

interventions

and then other cases like MitraClip.

as well as my E. P. Colleagues are now

using this same hemos systems

for a variety of the E. P. Procedures

that they perform, including watchmen.

next one

the future of cardiology is quite

bright and what we are seeing

is that more and more procedures

are moving to the cat lab are

moving to a minimally invasive

approach

and because of this, the

there will need to be some expansion

of this hemo reporting system.

Any hemo reporting system as

we move forward into the future

is going to need to be adaptable.

to evolve to to be able

to evolve to the new technologies

that are coming out as well as the

new documentation and reporting

requirements that are being issued

uh by insurance providers as well

as payers.

And finally this hemo reporting

system has to be sensitive

to the demands on the provider.

Again, physician burnout

is a real phenomenon

We know that these E. M. R. S. Are

a big source of this p

physician burnout

And it is nice that change health

care through their behavioral science

system. Is taking a huge step

forward to incorporating

these issues into the development of future

technologies.

next line and with that we

thank you for your attendance and we'd be happy

to answer any questions that you might have.

Great well thank you so much for that informative

and educational presentation. We

do have a few questions

that have come in from the audience.

Um

First question what practical

applications of behavioral science have

you seen in your work or research

that have had the greatest impact?

Yeah, I I can happen on this one and

we we've had good success

and in lots of areas but a couple come

to mind um

uh first was on research

on how to best tailor outreach for

for rec certifications and and

I think I turned Syria on. Give Me 1/2.

ok I think we're good um

but we we did research

on on how to best tailor outreach um

for rec certifications.

And uh with that tailored specific

outreach um for

for members

um and really accounting for

their specific you know, context and background.

We saw an increase of of 48%.

Um uh which was roughly like

about $16 million dollars a year

in incremental revenue

um that we were able to realize

Uh Another thing that comes to mind was around

dual enrollment applications, um

we were able to add add in highlighted

strips to the areas where members really needed

to read and sign. Um

and that sounds like a small call out but we really

saw a significant bump in in completed

applications.

Um and so I think the main call out here really

is that it it's not always a huge flashy.

um when or redesign but it

it's finding the areas where we can take

you know smaller in incremental

changes and kind of stack them on top of each other.

Um

And I think that was something that we saw in this hemo

uh redesign as well.

Great thank you um for that

explanation. Uh as a practicing

physician with extensive experience

in the use of imaging systems

including hemodynamics. I'm

interested in exploring opportunities

for involvement in product design.

How can I become involved

I would say from my perspective as a researcher,

uh we'll welcome you with open arms.

We're we're always uh trying to get more

uh folks on our on our roster

to to involve in product design. So I

would just say um you can reach

out to our product teams or sales folks uh or

account management folks um and they

can connect you with the right people um and

kind of pass you along to us as as we have research

arounds um and trying to iterate on products.

Great. And this next question is for doctor

Berle, can you share your

personal tips to avoid physician

burnout.

Well that's a big question. So

um with physician burnout

there is many many facets and

as we discussed today is

that the interaction with the E. M.

R. Is just one of those

um so it's really hard to to say

how you can address with physician

burnout. I know that particularly

with the subject matter for today.

One of the big things that was a huge

hassle for a lot of physicians

was to do a number of procedures

within the day

and then have to come back at the end

of the day to generate those

final reports,

And we found that was a big

part of physician burnout where

we would have a lot of doctors

at the end of the day or even at the end

of the week having 20

or 30 final reports

to finalize

and then that ended up hurting the hospital

as well because the hospital was

not able to generate any billing

for those procedures until that final

report was generated.

And so I think that

with the uh advent

of you know, introduction

of the behavioral science in the hemo systems

in this prompt reporting,

is that because these reports can

be done while

the procedure is fresh in the in the

physician's mind, they can generate

those uh final reports

quickly um that

We we do see that there is a big

drop off in the stress

that a lot of my physicians experience

when they're generating these final uh documents.

Great. And here's another question.

Uh what are some of the emerging

trends and innovations you see coming

in imaging and what impact

do you anticipate? They'll have on the field

and on patient outcomes in

the near and long term future.

uh I'm assuming that is coming to me.

So, um I think that you're

gonna see more and more

heart valve interventions

go to the cat lab or the

hybrid lab. So right

now many uh hospitals

across the United States do have

tar available, which is

the the aortic valve replacement.

Uh but in the very near future

you're gonna see more mitr interven

interventions MitraClip

is already there. Um but

we will likely see a MIT

valve replacement uh product in

the very near future as

well as there will be a device

for a tricuspid valve

repair that will also be

percutaneous

um Along with

this. Type of procedures

that are done in the cath lab.

We are seeing multimodality

imaging that is being performed.

Uh It is important when

we think about these reporting systems

that we not just capture the procedure

that we do, but all of these

multimodality imaging uh procedures.

So, if I do a T. E.

While I'm also So doing the fluoroscopy

imaging of the of the

uh procedure. This needs to be

incorporated into the report.

So I think that you're gonna see a blending

of a lot of different imaging

modalities uh when we perform

procedures,

Great, thank you for that explanation.

And I believe this last one is

for you James, what

was the most common behavioral bias

you found that impacted physicians

the most.

I I think there's so much going

on in a cardiac suite that there was a

lot that we heard about, like a a limited

limited addition attention

bias, there's so many inputs that they're having

to take

um take in and take account

for and not just clinicians but also nurses

and techs as well.

Um

And and just like our brands can really

easily think of the events that we're used to.

Um That also incorporates our focus

as well. So the level of attention that we

tend to pay towards certain things

um can prevent us from

considering all the other inputs that are happening.

And so uh a accounting for that

and accounting for

uh

how often split attention is

in a in a cardiac suite. Was was something that we heard

a lot about

Great well, thank you. That looks like

it's about all the time we have for today.

And on behalf of D. A. Ic

and our sponsor change health care.

We'd like to thank everyone for joining us today.

Um and just a reminder that this webinar

will soon be archived for on-demand

viewing at the same URL that

you use today, so please feel

free to share it with others. Have a great

afternoon everyone.