WEBVTT NOTE language:en-US NOTE Confidence: 0.960454523563385 00:00:16.480 --> 00:00:19.000 Hello and welcome to today's Health Webinar. NOTE Confidence: 0.8665207028388977 00:00:19.520 --> 00:00:22.154 Today's episode is brought to you by your friends at NOTE Confidence: 0.8665207028388977 00:00:22.205 --> 00:00:22.560 DaVita. NOTE Confidence: 0.9401876926422119 00:00:23.680 --> 00:00:26.073 We would like to remind you that the Q&A feature NOTE Confidence: 0.9401876926422119 00:00:26.123 --> 00:00:28.715 is available, so feel free to send in your questions NOTE Confidence: 0.9401876926422119 00:00:28.765 --> 00:00:30.760 and comments throughout today's webinar. NOTE Confidence: 0.9767897129058838 00:00:31.080 --> 00:00:32.240 We would love to hear from you. NOTE Confidence: 0.9151206612586975 00:00:33.440 --> 00:00:35.709 And with that, I will turn it over to our NOTE Confidence: 0.9151206612586975 00:00:35.764 --> 00:00:37.480 moderator, Doctor Jeff Gillian. NOTE Confidence: 0.6587293744087219 00:00:39.560 --> 00:00:41.240 Well, and thank you so much. NOTE Confidence: 0.9437995553016663 00:00:41.240 --> 00:00:44.360 I appreciate the opportunity to join today. NOTE Confidence: 0.9006964564323425 00:00:44.360 --> 00:00:45.480 My name is Jeff Gillian. NOTE Confidence: 0.9084164500236511 00:00:45.479 --> 00:00:48.665 I'm a nephrologist from Denver, Co and I'm the Chief NOTE Confidence: 0.9084164500236511 00:00:48.727 --> 00:00:50.320 Medical Officer of DaVita. NOTE Confidence: 0.7793779969215393 00:00:50.760 --> 00:00:52.920 DaVita is a large kidney care organization. NOTE Confidence: 0.9596443772315979 00:00:52.920 --> 00:00:56.348 We take care of patients throughout their kidney care journey NOTE Confidence: 0.9596443772315979 00:00:56.404 --> 00:00:59.832 from chronic kidney disease to dialysis to transplant here in NOTE Confidence: 0.9596443772315979 00:00:59.888 --> 00:01:03.204 the United States and also across the globe, South America, NOTE Confidence: 0.9596443772315979 00:01:03.260 --> 00:01:04.159 Europe and Asia. NOTE Confidence: 0.9373489618301392 00:01:04.160 --> 00:01:07.120 And I am joined today by three phenomenal guests. NOTE Confidence: 0.8566024899482727 00:01:07.120 --> 00:01:09.954 I cannot wait to get into our discussion today as NOTE Confidence: 0.8566024899482727 00:01:10.012 --> 00:01:13.772 we discussed the care of patients with multiple chronic diseases, NOTE Confidence: 0.8566024899482727 00:01:13.830 --> 00:01:17.128 Poly chronic disease as it's sometimes noted, and we talk NOTE Confidence: 0.8566024899482727 00:01:17.186 --> 00:01:20.483 about how we can come together to help entire communities NOTE Confidence: 0.8566024899482727 00:01:20.541 --> 00:01:21.119 with this. NOTE Confidence: 0.8939847350120544 00:01:21.120 --> 00:01:23.613 So in just a minute, I'll invite each of my NOTE Confidence: 0.8939847350120544 00:01:23.671 --> 00:01:26.859 guests to to introduce themselves, but let me just give NOTE Confidence: 0.8939847350120544 00:01:26.917 --> 00:01:29.874 a, a quick introduction of each of them because I'm NOTE Confidence: 0.8939847350120544 00:01:29.932 --> 00:01:32.599 so excited to have each of them with me today. NOTE Confidence: 0.847806990146637 00:01:32.720 --> 00:01:34.800 First, let me start with Juliana Crawford. NOTE Confidence: 0.8969496488571167 00:01:34.800 --> 00:01:38.663 Juliana is a part of the American Heart Association, something NOTE Confidence: 0.8969496488571167 00:01:38.725 --> 00:01:40.720 that's near and dear to my life. NOTE Confidence: 0.841563880443573 00:01:40.720 --> 00:01:44.354 My wife is a cardiology nurse practitioner and has been NOTE Confidence: 0.841563880443573 00:01:44.420 --> 00:01:46.800 an AHA member for her entire career. NOTE Confidence: 0.9699963927268982 00:01:46.800 --> 00:01:49.040 So really grateful for the work that you do. NOTE Confidence: 0.9255697727203369 00:01:49.040 --> 00:01:51.904 And of course, patients with kidney disease and patients with NOTE Confidence: 0.9255697727203369 00:01:51.951 --> 00:01:53.360 heart disease overlap so much. NOTE Confidence: 0.9458963871002197 00:01:53.880 --> 00:01:55.200 It's not one or the other. NOTE Confidence: 0.9344131946563721 00:01:55.200 --> 00:01:58.160 These two organs really do rely on one another. NOTE Confidence: 0.9342441558837891 00:01:58.800 --> 00:02:01.360 Next, I'm joined by Doctor Gloria Winters. NOTE Confidence: 0.8892011046409607 00:02:01.480 --> 00:02:04.936 Gloria is the chief health officer for the YMCA, and NOTE Confidence: 0.8892011046409607 00:02:05.002 --> 00:02:09.057 I'm equally feel blessed that we've got a partnership between NOTE Confidence: 0.8892011046409607 00:02:09.124 --> 00:02:10.519 DaVita and the YMCAI. NOTE Confidence: 0.9352566599845886 00:02:10.520 --> 00:02:13.424 Got to spend some time at our Baton Rouge YMCA NOTE Confidence: 0.9352566599845886 00:02:13.487 --> 00:02:17.529 recently where we did an entire community event screening people NOTE Confidence: 0.9352566599845886 00:02:17.592 --> 00:02:21.128 in the community for things like diabetes and high blood NOTE Confidence: 0.9352566599845886 00:02:21.191 --> 00:02:22.959 pressure and kidney disease. NOTE Confidence: 0.8651670813560486 00:02:23.480 --> 00:02:24.400 What an absolute. NOTE Confidence: 0.9176061153411865 00:02:24.800 --> 00:02:27.380 Absolutely fulfilling day it was for me to be able NOTE Confidence: 0.9176061153411865 00:02:27.432 --> 00:02:28.000 to do that. NOTE Confidence: 0.9160007834434509 00:02:28.400 --> 00:02:31.220 And then also joined by Doctor Tiffany Crank from the NOTE Confidence: 0.9160007834434509 00:02:31.273 --> 00:02:34.679 American Diabetes Association, another partnership that we have. NOTE Confidence: 0.9256443977355957 00:02:35.160 --> 00:02:37.938 Again, it's not just heart disease and kidney disease, but NOTE Confidence: 0.9256443977355957 00:02:37.986 --> 00:02:41.244 it's heart disease, kidney disease, high blood pressure and diabetes NOTE Confidence: 0.9256443977355957 00:02:41.292 --> 00:02:43.399 that go together on this metabolic spectrum. NOTE Confidence: 0.94850754737854 00:02:43.400 --> 00:02:46.394 So very fortunate to have all three of you with NOTE Confidence: 0.94850754737854 00:02:46.457 --> 00:02:49.706 me today so that we can talk about really improving NOTE Confidence: 0.94850754737854 00:02:49.770 --> 00:02:53.720 the health, not just of individual people, but truly improving NOTE Confidence: 0.94850754737854 00:02:53.783 --> 00:02:55.440 the health of communities. NOTE Confidence: 0.8361549973487854 00:02:55.919 --> 00:02:58.423 So Juliana, maybe we'll start with you to do a NOTE Confidence: 0.8361549973487854 00:02:58.478 --> 00:03:01.852 quick introduction and we'll we'll go around to Doctor Winters NOTE Confidence: 0.8361549973487854 00:03:01.906 --> 00:03:02.560 and then Dr. NOTE Confidence: 0.8511006236076355 00:03:02.560 --> 00:03:03.400 Crank as well. NOTE Confidence: 0.975174069404602 00:03:03.400 --> 00:03:04.760 And then we will get started. NOTE Confidence: 0.9364013671875 00:03:04.760 --> 00:03:06.400 I'll ask you guys lots of questions. NOTE Confidence: 0.8992239236831665 00:03:07.080 --> 00:03:09.354 Sounds good and so good to hear about your wife's NOTE Confidence: 0.8992239236831665 00:03:09.400 --> 00:03:10.839 dedication to the organization. NOTE Confidence: 0.897054135799408 00:03:10.840 --> 00:03:14.467 We really appreciate appreciate leaders like your wife volunteering for NOTE Confidence: 0.897054135799408 00:03:14.518 --> 00:03:16.000 the organization for so long. NOTE Confidence: 0.8909373879432678 00:03:16.200 --> 00:03:18.799 So my role at the American Heart Association, I sit NOTE Confidence: 0.8909373879432678 00:03:18.850 --> 00:03:21.399 at the National Center based here in Dallas and my NOTE Confidence: 0.8909373879432678 00:03:21.450 --> 00:03:24.661 department is really in charge of solving problems that require NOTE Confidence: 0.8909373879432678 00:03:24.712 --> 00:03:27.414 the kind of the full power of the organization behind NOTE Confidence: 0.8909373879432678 00:03:27.465 --> 00:03:27.719 them. NOTE Confidence: 0.821029007434845 00:03:27.720 --> 00:03:30.800 Not anyone vertical can solve the problem. NOTE Confidence: 0.8235935568809509 00:03:30.800 --> 00:03:33.243 So things like food is medicine, where there's a science NOTE Confidence: 0.8235935568809509 00:03:33.287 --> 00:03:35.599 and a policy and a community and a consumer marketing NOTE Confidence: 0.8235935568809509 00:03:35.643 --> 00:03:36.079 component. NOTE Confidence: 0.8007705807685852 00:03:36.360 --> 00:03:38.976 Things like our audio can be metabolic health work, which NOTE Confidence: 0.8007705807685852 00:03:39.021 --> 00:03:42.418 again requires all of these different departments and different strategies NOTE Confidence: 0.8007705807685852 00:03:42.464 --> 00:03:45.080 kind of strung together and integrated and connected way. NOTE Confidence: 0.8825255036354065 00:03:45.080 --> 00:03:47.026 So we're kind of a hub of a wheel on NOTE Confidence: 0.8825255036354065 00:03:47.080 --> 00:03:49.999 solving these big problems, like those examples there. NOTE Confidence: 0.7666031718254089 00:03:52.280 --> 00:03:53.080 Yeah, that's great. NOTE Confidence: 0.8673170804977417 00:03:53.080 --> 00:03:55.702 So lucky to have you with us, Doctor Winters, why NOTE Confidence: 0.8673170804977417 00:03:55.756 --> 00:03:56.720 don't you go next? NOTE Confidence: 0.9282625317573547 00:03:56.960 --> 00:03:59.040 Yeah, thanks so much for having me everyone. NOTE Confidence: 0.9344012141227722 00:03:59.640 --> 00:04:03.355 So Doctor Gloria Winters, Chief Health Officer for YMCA of NOTE Confidence: 0.9344012141227722 00:04:03.419 --> 00:04:06.879 the USA, I've been a practitioner here in Colorado for NOTE Confidence: 0.9344012141227722 00:04:06.943 --> 00:04:07.840 over 25 years. NOTE Confidence: 0.8259789943695068 00:04:08.120 --> 00:04:10.807 And as a brief interest to why I came over NOTE Confidence: 0.8259789943695068 00:04:10.871 --> 00:04:14.071 to the YMCA, as I was treating patients full time, NOTE Confidence: 0.8259789943695068 00:04:14.135 --> 00:04:17.079 managing practices all across the Front Range. NOTE Confidence: 0.8825125694274902 00:04:17.360 --> 00:04:19.979 And what I began to see was it was becoming NOTE Confidence: 0.8825125694274902 00:04:20.040 --> 00:04:22.720 harder and harder to give good patient care. NOTE Confidence: 0.9444494247436523 00:04:22.960 --> 00:04:25.540 And so I began to imagine what would that look NOTE Confidence: 0.9444494247436523 00:04:25.596 --> 00:04:28.120 like in order to achieve whole person health. NOTE Confidence: 0.8919270634651184 00:04:28.480 --> 00:04:31.570 And as we know, the CDC says that health is NOTE Confidence: 0.8919270634651184 00:04:31.642 --> 00:04:36.026 defined as 20% clinical care and 80% behavioral, physical and NOTE Confidence: 0.8919270634651184 00:04:36.098 --> 00:04:37.679 socioeconomic factors. NOTE Confidence: 0.930526852607727 00:04:37.960 --> 00:04:41.347 In addition, we see that the World Health Organization defines NOTE Confidence: 0.930526852607727 00:04:41.402 --> 00:04:44.517 health as a state of complete physical, mental and social NOTE Confidence: 0.930526852607727 00:04:44.572 --> 00:04:47.959 well-being, not merely in the absence of disease or infirmity. NOTE Confidence: 0.922971785068512 00:04:48.160 --> 00:04:50.488 And so in those definitions, I began to think, huh, NOTE Confidence: 0.922971785068512 00:04:50.534 --> 00:04:52.863 what would that really look like to bring those two NOTE Confidence: 0.922971785068512 00:04:52.909 --> 00:04:53.319 together? NOTE Confidence: 0.854708731174469 00:04:53.640 --> 00:04:55.516 So my role now at at the YMCA of the NOTE Confidence: 0.854708731174469 00:04:55.569 --> 00:04:58.905 USA is to really bring business models and partnerships together NOTE Confidence: 0.854708731174469 00:04:58.958 --> 00:05:01.200 to bring that whole person health together. NOTE Confidence: 0.17636968195438385 00:05:03.560 --> 00:05:04.000 Excellent. NOTE Confidence: 0.8614435791969299 00:05:04.080 --> 00:05:04.600 Thank you. NOTE Confidence: 0.9451967477798462 00:05:04.600 --> 00:05:07.445 Thank you for joining us and thanks for the partnership NOTE Confidence: 0.9451967477798462 00:05:07.497 --> 00:05:09.360 that we have with your organization. NOTE Confidence: 0.8391527533531189 00:05:09.800 --> 00:05:12.339 And Doctor Crank, why don't why don't you introduce yourself NOTE Confidence: 0.8391527533531189 00:05:12.381 --> 00:05:12.719 as well? NOTE Confidence: 0.5842774510383606 00:05:13.240 --> 00:05:14.640 Yep, absolutely. NOTE Confidence: 0.9071593880653381 00:05:14.640 --> 00:05:18.880 Thanks Doctor G and good afternoon, Good morning to some. NOTE Confidence: 0.9336626529693604 00:05:18.880 --> 00:05:21.631 I'm very happy to be here today at the American NOTE Confidence: 0.9336626529693604 00:05:21.690 --> 00:05:22.919 Diabetes Association. NOTE Confidence: 0.9668018221855164 00:05:22.920 --> 00:05:25.594 I have the privilege of serving as the Senior Director NOTE Confidence: 0.9668018221855164 00:05:25.643 --> 00:05:27.079 of Health Access and Quality. NOTE Confidence: 0.9388333559036255 00:05:27.839 --> 00:05:31.304 And essentially in my role, what I have the opportunity NOTE Confidence: 0.9388333559036255 00:05:31.367 --> 00:05:34.579 to do is to lead national and local strategies that NOTE Confidence: 0.9388333559036255 00:05:34.642 --> 00:05:38.799 really advance health access through community driven initiatives. NOTE Confidence: 0.8005974292755127 00:05:39.080 --> 00:05:42.663 You know, those initiatives focus on diabetes, they focus on NOTE Confidence: 0.8005974292755127 00:05:42.723 --> 00:05:47.143 obesity prevention, clinical trial education, and proven access to quality NOTE Confidence: 0.8005974292755127 00:05:47.203 --> 00:05:47.919 health care. NOTE Confidence: 0.9014785885810852 00:05:48.600 --> 00:05:52.608 So essentially my work really involves bridging health systems and NOTE Confidence: 0.9014785885810852 00:05:52.669 --> 00:05:57.285 community organizations and using evidence based frameworks to really ensure NOTE Confidence: 0.9014785885810852 00:05:57.345 --> 00:06:01.293 that our our resources and our interventions are being responsive NOTE Confidence: 0.9014785885810852 00:06:01.354 --> 00:06:04.694 to the communities and the people that they're meant to NOTE Confidence: 0.9014785885810852 00:06:04.755 --> 00:06:05.120 serve. NOTE Confidence: 0.7503117322921753 00:06:05.760 --> 00:06:07.280 Yeah, so happy to be here. NOTE Confidence: 0.9364418387413025 00:06:08.120 --> 00:06:09.280 I appreciate you being here. NOTE Confidence: 0.821083664894104 00:06:09.680 --> 00:06:11.868 So maybe I'll start with you, Doctor Crank and, and NOTE Confidence: 0.821083664894104 00:06:11.911 --> 00:06:13.799 then we can kind of play off of one another. NOTE Confidence: 0.9102274179458618 00:06:13.800 --> 00:06:16.805 But, but obviously you just brought up the work that NOTE Confidence: 0.9102274179458618 00:06:16.863 --> 00:06:20.446 you all do working with other organizations to raise awareness NOTE Confidence: 0.9102274179458618 00:06:20.504 --> 00:06:23.799 and more than that to, to, to prevent disease, especially NOTE Confidence: 0.9102274179458618 00:06:23.857 --> 00:06:25.359 when it comes to diabetes. NOTE Confidence: 0.9078789353370667 00:06:25.360 --> 00:06:27.628 And I, I would love to hear just how you NOTE Confidence: 0.9078789353370667 00:06:27.684 --> 00:06:30.519 think about chronic disease prevention in general. NOTE Confidence: 0.7086541056632996 00:06:31.840 --> 00:06:33.560 Yeah, as a community approach. NOTE Confidence: 0.8688200116157532 00:06:33.560 --> 00:06:37.250 Obviously it's patient centered or person centered because not everybody NOTE Confidence: 0.8688200116157532 00:06:37.301 --> 00:06:40.172 even knows they're a patient when we first interact with NOTE Confidence: 0.8688200116157532 00:06:40.223 --> 00:06:40.480 them. NOTE Confidence: 0.8831261396408081 00:06:40.839 --> 00:06:42.796 But but how do you think about this and and NOTE Confidence: 0.8831261396408081 00:06:42.842 --> 00:06:44.480 leading from a community standpoint? NOTE Confidence: 0.9614134430885315 00:06:45.320 --> 00:06:46.880 Yeah, great question. NOTE Confidence: 0.9098587036132812 00:06:47.360 --> 00:06:51.373 And when I think about community led and continuing person NOTE Confidence: 0.9098587036132812 00:06:51.443 --> 00:06:55.733 centered chronic disease prevention, it's really a shift of us NOTE Confidence: 0.9098587036132812 00:06:55.802 --> 00:07:00.232 doing things for communities to doing things with communities to NOTE Confidence: 0.9098587036132812 00:07:00.301 --> 00:07:05.422 making sure that when initiatives are developed, when they're implemented, NOTE Confidence: 0.9098587036132812 00:07:05.491 --> 00:07:09.505 that they're rooted really in the lived experiences of the NOTE Confidence: 0.9098587036132812 00:07:09.574 --> 00:07:11.720 communities that we're serving. NOTE Confidence: 0.8686416149139404 00:07:11.960 --> 00:07:15.832 And that they implore elements of the cultural relevance to NOTE Confidence: 0.8686416149139404 00:07:15.898 --> 00:07:20.887 make those initiatives almost curated right for those particular communities NOTE Confidence: 0.8686416149139404 00:07:20.952 --> 00:07:22.199 that they'll be in. NOTE Confidence: 0.9597201347351074 00:07:22.440 --> 00:07:25.552 When we do that, that really gives us leverage to NOTE Confidence: 0.9597201347351074 00:07:25.616 --> 00:07:26.759 do several things. NOTE Confidence: 0.8377036452293396 00:07:26.760 --> 00:07:28.120 One, build trust. NOTE Confidence: 0.8630557656288147 00:07:28.120 --> 00:07:31.148 We have the power to catalyze our trust building in NOTE Confidence: 0.8630557656288147 00:07:31.207 --> 00:07:31.919 communities. NOTE Confidence: 0.9172333478927612 00:07:31.920 --> 00:07:35.839 When we're inclusive of community voice, it gives us the NOTE Confidence: 0.9172333478927612 00:07:35.909 --> 00:07:38.919 ability to drive sustained behavior change. NOTE Confidence: 0.9444777965545654 00:07:38.920 --> 00:07:42.250 So when communities, again, are a part of the solution NOTE Confidence: 0.9444777965545654 00:07:42.312 --> 00:07:46.506 development that creates more sustainable solutions that can live on NOTE Confidence: 0.9444777965545654 00:07:46.567 --> 00:07:50.144 in that community far beyond our organization or you know, NOTE Confidence: 0.9444777965545654 00:07:50.206 --> 00:07:51.440 any of those things. NOTE Confidence: 0.8797518610954285 00:07:51.800 --> 00:07:54.748 And it gives us the opportunity to address those systemic NOTE Confidence: 0.8797518610954285 00:07:54.800 --> 00:07:55.680 barriers head on. NOTE Confidence: 0.8766037225723267 00:07:55.680 --> 00:08:00.363 I mean, communities faced very unique and specific challenges that NOTE Confidence: 0.8766037225723267 00:08:00.434 --> 00:08:03.628 that may not fit A1 size fits all solution to NOTE Confidence: 0.8766037225723267 00:08:03.699 --> 00:08:04.479 healthcare. NOTE Confidence: 0.8809646964073181 00:08:04.480 --> 00:08:09.211 So essentially, you know, community LED, community driven is really NOTE Confidence: 0.8809646964073181 00:08:09.281 --> 00:08:11.400 tailoring those interventions. NOTE Confidence: 0.8923404812812805 00:08:11.400 --> 00:08:14.693 So we're sure that they resonate to the people that NOTE Confidence: 0.8923404812812805 00:08:14.757 --> 00:08:17.727 we want to serve and that they can create some NOTE Confidence: 0.8923404812812805 00:08:17.792 --> 00:08:20.439 impact in real world settings at the ADA. NOTE Confidence: 0.46641862392425537 00:08:20.600 --> 00:08:21.840 We really go ahead. NOTE Confidence: 0.8773155808448792 00:08:22.600 --> 00:08:24.723 No, I was going to say, we really just try NOTE Confidence: 0.8773155808448792 00:08:24.773 --> 00:08:27.402 to make it a point to be intentional about including NOTE Confidence: 0.8773155808448792 00:08:27.452 --> 00:08:30.485 that, that element and all of the community initiatives that NOTE Confidence: 0.8773155808448792 00:08:30.536 --> 00:08:31.800 we develop and implement. NOTE Confidence: 0.8176839351654053 00:08:32.679 --> 00:08:35.038 Yeah, I, I just, I mean, it resonates so much NOTE Confidence: 0.8176839351654053 00:08:35.091 --> 00:08:37.973 with me, this idea of, of working with communities, not NOTE Confidence: 0.8176839351654053 00:08:38.026 --> 00:08:38.760 just for them. NOTE Confidence: 0.9067968130111694 00:08:39.720 --> 00:08:41.560 And you know, this is an area of healthcare. NOTE Confidence: 0.9530318975448608 00:08:41.720 --> 00:08:44.850 I think that that generally in medicine, we as physicians, NOTE Confidence: 0.9530318975448608 00:08:44.904 --> 00:08:48.034 we as clinicians have been moving towards which is meeting NOTE Confidence: 0.9530318975448608 00:08:48.088 --> 00:08:49.599 our patients where they are. NOTE Confidence: 0.9328664541244507 00:08:49.920 --> 00:08:52.588 And for you to, to say that about our communities NOTE Confidence: 0.9328664541244507 00:08:52.642 --> 00:08:55.909 as well, just absolutely resonates because what works in one NOTE Confidence: 0.9328664541244507 00:08:55.964 --> 00:08:58.359 community may not work in another community. NOTE Confidence: 0.9091416001319885 00:08:58.360 --> 00:09:01.790 And so, so involving the community in their own care, NOTE Confidence: 0.9091416001319885 00:09:01.855 --> 00:09:06.062 meeting them where they are, meeting their needs, having cultural NOTE Confidence: 0.9091416001319885 00:09:06.127 --> 00:09:09.040 awareness is just absolutely highly profound. NOTE Confidence: 0.8443666696548462 00:09:09.720 --> 00:09:12.502 And, and I know it's something that you, Doctor Winters NOTE Confidence: 0.8443666696548462 00:09:12.553 --> 00:09:14.931 and the YMCA are, are heavily focused on is, is NOTE Confidence: 0.8443666696548462 00:09:14.981 --> 00:09:17.360 serving each individual community individually. NOTE Confidence: 0.9074132442474365 00:09:17.360 --> 00:09:19.366 Would love to hear a little bit about your thoughts NOTE Confidence: 0.9074132442474365 00:09:19.405 --> 00:09:19.720 on that. NOTE Confidence: 0.8318346738815308 00:09:20.640 --> 00:09:23.480 Yeah, Doctor Cranks said it really, really well, right. NOTE Confidence: 0.9036934971809387 00:09:23.480 --> 00:09:27.550 Culturally relevant, meeting people where they live, work and play, NOTE Confidence: 0.9036934971809387 00:09:27.611 --> 00:09:29.920 breaking down those systemic barriers. NOTE Confidence: 0.9605638980865479 00:09:30.120 --> 00:09:32.200 But what does that actually look like, right. NOTE Confidence: 0.8560941219329834 00:09:32.400 --> 00:09:34.160 And so I'll give just a quick example. NOTE Confidence: 0.8280432820320129 00:09:34.679 --> 00:09:36.839 One of the ways that we do that with our NOTE Confidence: 0.8280432820320129 00:09:36.893 --> 00:09:40.672 diabetes prevention program is partnering with a group called Cervicio NOTE Confidence: 0.8280432820320129 00:09:40.726 --> 00:09:41.319 de La Raza. NOTE Confidence: 0.7730646133422852 00:09:41.320 --> 00:09:45.060 So services for the people and they use their primadoras, NOTE Confidence: 0.7730646133422852 00:09:45.126 --> 00:09:45.519 right? NOTE Confidence: 0.9418211579322815 00:09:45.720 --> 00:09:48.600 Use our space because it's a trusted area. NOTE Confidence: 0.8894004225730896 00:09:48.600 --> 00:09:52.237 At YMCA, we help to provide access to our location, NOTE Confidence: 0.8894004225730896 00:09:52.309 --> 00:09:57.159 sometimes through various transportation services to get them there. NOTE Confidence: 0.9191069602966309 00:09:57.400 --> 00:10:00.120 But as Doctor Crank says, if I came in and NOTE Confidence: 0.9191069602966309 00:10:00.185 --> 00:10:03.359 taught that, it would not be culturally relevant. NOTE Confidence: 0.8797245025634766 00:10:03.480 --> 00:10:06.216 When we have their local primadoras do it, the kids NOTE Confidence: 0.8797245025634766 00:10:06.269 --> 00:10:08.898 show up, the family show up, the husbands and the NOTE Confidence: 0.8797245025634766 00:10:08.952 --> 00:10:10.240 wives are both involved. NOTE Confidence: 0.892685055732727 00:10:10.520 --> 00:10:14.133 And that's actually what leads to behavior change because as NOTE Confidence: 0.892685055732727 00:10:14.194 --> 00:10:17.627 we know in this chronic disease space, it's chronic, it's NOTE Confidence: 0.892685055732727 00:10:17.687 --> 00:10:20.638 not acute, it's the long game, it's not the short NOTE Confidence: 0.892685055732727 00:10:20.698 --> 00:10:20.999 game. NOTE Confidence: 0.850323498249054 00:10:21.320 --> 00:10:23.982 And so we really need to do something that gets NOTE Confidence: 0.850323498249054 00:10:24.038 --> 00:10:28.230 them habitually changing lifestyle changes and providing membership at the NOTE Confidence: 0.850323498249054 00:10:28.287 --> 00:10:31.515 YMCA as part of that, along with that diabetes prevention NOTE Confidence: 0.850323498249054 00:10:31.572 --> 00:10:34.404 program in a manner with Cervezos de La Raza where NOTE Confidence: 0.850323498249054 00:10:34.461 --> 00:10:38.200 the pro medoras are actually doing the teaching, the facilitating. NOTE Confidence: 0.8074499368667603 00:10:38.440 --> 00:10:42.990 So we've seen in that component, it's actually become something NOTE Confidence: 0.8074499368667603 00:10:43.062 --> 00:10:45.879 that is then lived in in the community. NOTE Confidence: 0.9551156163215637 00:10:45.880 --> 00:10:50.552 So it's really, really a key piece to changing that NOTE Confidence: 0.9551156163215637 00:10:50.643 --> 00:10:51.560 long term. NOTE Confidence: 0.5326477885246277 00:10:53.720 --> 00:10:54.640 Makes sense. NOTE Confidence: 0.8760273456573486 00:10:54.640 --> 00:10:56.941 And I was just realizing as we're sitting here, you NOTE Confidence: 0.8760273456573486 00:10:56.986 --> 00:10:58.791 guys are all so well lit and I look like NOTE Confidence: 0.8760273456573486 00:10:58.836 --> 00:11:01.680 I'm in the witness protection program with this funny lighting. NOTE Confidence: 0.9568731784820557 00:11:01.680 --> 00:11:03.480 So I'll just apologize to anybody out there. NOTE Confidence: 0.9083155989646912 00:11:03.480 --> 00:11:05.452 I'm not trying to hide like half my face, but NOTE Confidence: 0.9083155989646912 00:11:05.496 --> 00:11:06.680 it certainly looks like it. NOTE Confidence: 0.8287553191184998 00:11:07.559 --> 00:11:10.039 Moving on though, to to more important things than my NOTE Confidence: 0.8287553191184998 00:11:10.086 --> 00:11:10.319 face. NOTE Confidence: 0.7522062659263611 00:11:11.080 --> 00:11:15.173 Juliana kind of picking up on this as we talk NOTE Confidence: 0.7522062659263611 00:11:15.264 --> 00:11:17.719 about specific communities. NOTE Confidence: 0.9256163239479065 00:11:18.040 --> 00:11:20.535 Obviously what comes to mind is the social determinants of NOTE Confidence: 0.9256163239479065 00:11:20.578 --> 00:11:20.879 health. NOTE Confidence: 0.8534964323043823 00:11:20.880 --> 00:11:24.719 There are vulnerable populations that we all seek to to NOTE Confidence: 0.8534964323043823 00:11:24.789 --> 00:11:28.490 serve better and, and, and reaching out and and doing NOTE Confidence: 0.8534964323043823 00:11:28.559 --> 00:11:32.749 this in as terms we've just used culturally sensitive manner NOTE Confidence: 0.8534964323043823 00:11:32.818 --> 00:11:36.239 and and understanding social determinant to help. NOTE Confidence: 0.8742150068283081 00:11:36.400 --> 00:11:39.398 Would love to hear from your perspective and the American NOTE Confidence: 0.8742150068283081 00:11:39.450 --> 00:11:43.080 Heart Association's perspective what some of the the biggest barriers NOTE Confidence: 0.8742150068283081 00:11:43.133 --> 00:11:45.815 are to reaching people that are at risk for cardiac NOTE Confidence: 0.8742150068283081 00:11:45.868 --> 00:11:47.919 disease and and other chronic diseases. NOTE Confidence: 0.8868188261985779 00:11:48.520 --> 00:11:49.120 Absolutely. NOTE Confidence: 0.7731634378433228 00:11:49.120 --> 00:11:50.280 That's a great question. NOTE Confidence: 0.8267443776130676 00:11:50.280 --> 00:11:53.240 And I think just hearing Tiffany and Gloria talk about NOTE Confidence: 0.8267443776130676 00:11:53.295 --> 00:11:57.132 their approaches, we're very, very much like minded organizations into NOTE Confidence: 0.8267443776130676 00:11:57.187 --> 00:11:59.600 how we're doing work on the ground together. NOTE Confidence: 0.5983866453170776 00:11:59.600 --> 00:12:00.920 I think we're very similar. NOTE Confidence: 0.8229659199714661 00:12:01.400 --> 00:12:03.320 We have the same strategic approaches. NOTE Confidence: 0.6111801862716675 00:12:03.320 --> 00:12:06.152 That's just why we're off thin linked arms with local NOTE Confidence: 0.6111801862716675 00:12:06.206 --> 00:12:09.519 YMCA staff and and staff in the American Diabetes Association. NOTE Confidence: 0.8762805461883545 00:12:09.840 --> 00:12:12.167 But what I would say in terms of the commitment NOTE Confidence: 0.8762805461883545 00:12:12.216 --> 00:12:15.286 to understanding the social determinants of health, I think it NOTE Confidence: 0.8762805461883545 00:12:15.335 --> 00:12:18.257 starts with understanding at the point of clinical care and NOTE Confidence: 0.8762805461883545 00:12:18.306 --> 00:12:18.999 that is a gap. NOTE Confidence: 0.8375452160835266 00:12:19.000 --> 00:12:21.252 And so while we're doing all of this work at NOTE Confidence: 0.8375452160835266 00:12:21.303 --> 00:12:25.295 the grassroots level and building strong relationships with community partners NOTE Confidence: 0.8375452160835266 00:12:25.346 --> 00:12:28.673 and linking systems, the Heart Association is also thinking about NOTE Confidence: 0.8375452160835266 00:12:28.724 --> 00:12:32.051 training up physicians from the start when we're writing clinical NOTE Confidence: 0.8375452160835266 00:12:32.102 --> 00:12:35.532 guidelines to ensure screening for social determinants of health is NOTE Confidence: 0.8375452160835266 00:12:35.583 --> 00:12:38.039 the first step in assessing patient populations. NOTE Confidence: 0.9012210965156555 00:12:38.040 --> 00:12:40.748 And so, you know, from the top down, we're ensuring NOTE Confidence: 0.9012210965156555 00:12:40.802 --> 00:12:43.829 that every guideline that we write to drive clinical care NOTE Confidence: 0.9012210965156555 00:12:43.882 --> 00:12:47.388 across the spectrum of cardiovascular disease and stroke and brain NOTE Confidence: 0.9012210965156555 00:12:47.441 --> 00:12:50.310 health in areas in which we have expertise that that's NOTE Confidence: 0.9012210965156555 00:12:50.363 --> 00:12:51.160 the first step. NOTE Confidence: 0.8314682841300964 00:12:51.160 --> 00:12:53.662 And I think the other and important thing that the NOTE Confidence: 0.8314682841300964 00:12:53.712 --> 00:12:56.465 organization has been, has done over the last decade or NOTE Confidence: 0.8314682841300964 00:12:56.515 --> 00:12:58.918 so I'm really proud of is when we are developing NOTE Confidence: 0.8314682841300964 00:12:58.968 --> 00:13:02.321 those clinical guidelines, we are including lay people, people with NOTE Confidence: 0.8314682841300964 00:13:02.371 --> 00:13:05.324 lived experience on, on the writing groups next to clinical NOTE Confidence: 0.8314682841300964 00:13:05.375 --> 00:13:08.328 experts to ensure that that lived experience, that voice is NOTE Confidence: 0.8314682841300964 00:13:08.378 --> 00:13:10.080 coming in from the very beginning. NOTE Confidence: 0.8818029761314392 00:13:10.280 --> 00:13:12.711 So as we're pushing out how do we implement these NOTE Confidence: 0.8818029761314392 00:13:12.761 --> 00:13:15.341 kind of guidelines in the real world, that the first NOTE Confidence: 0.8818029761314392 00:13:15.391 --> 00:13:18.368 step is understanding where people are have barriers so they NOTE Confidence: 0.8818029761314392 00:13:18.418 --> 00:13:21.197 can be referred to community support and all the systems NOTE Confidence: 0.8818029761314392 00:13:21.247 --> 00:13:23.877 we're working to put in place at the community level, NOTE Confidence: 0.8818029761314392 00:13:23.926 --> 00:13:26.159 it's really starting from the very beginning. NOTE Confidence: 0.9338467121124268 00:13:26.160 --> 00:13:27.977 So we can push that out and make it kind NOTE Confidence: 0.9338467121124268 00:13:28.023 --> 00:13:29.886 of a part of the cultural norm of the way NOTE Confidence: 0.9338467121124268 00:13:29.931 --> 00:13:31.839 things are happening at the point of care. NOTE Confidence: 0.8992193937301636 00:13:33.160 --> 00:13:35.577 Starting to, to feel a bit of a theme here, NOTE Confidence: 0.8992193937301636 00:13:35.633 --> 00:13:40.299 you know, patient centered, person centered, community centered, lived experiences, NOTE Confidence: 0.8992193937301636 00:13:40.356 --> 00:13:43.392 all of these terms that quite frankly, as a physician, NOTE Confidence: 0.8992193937301636 00:13:43.448 --> 00:13:45.978 I I probably need to be better at at thinking NOTE Confidence: 0.8992193937301636 00:13:46.034 --> 00:13:47.439 about on a regular basis. NOTE Confidence: 0.916495680809021 00:13:47.440 --> 00:13:50.153 So love the fact that you guys are embedding people NOTE Confidence: 0.916495680809021 00:13:50.206 --> 00:13:53.504 who actually live with these illnesses with the scientists who NOTE Confidence: 0.916495680809021 00:13:53.557 --> 00:13:56.749 are writing the guidelines so that as physicians, when we're NOTE Confidence: 0.916495680809021 00:13:56.802 --> 00:14:00.260 reading the guidelines and we're trying to follow the guidelines, NOTE Confidence: 0.916495680809021 00:14:00.313 --> 00:14:02.814 we're doing so in a, in a truly person centered NOTE Confidence: 0.916495680809021 00:14:02.867 --> 00:14:03.079 way. NOTE Confidence: 0.9432572722434998 00:14:03.080 --> 00:14:05.417 So really appreciate you guys being on the leading edge NOTE Confidence: 0.9432572722434998 00:14:05.460 --> 00:14:05.800 of that. NOTE Confidence: 0.8626375198364258 00:14:06.200 --> 00:14:08.490 And Doctor Crank, maybe I'll just kind of pose the NOTE Confidence: 0.8626375198364258 00:14:08.536 --> 00:14:11.239 same question to you and the American Diabetes Association. NOTE Confidence: 0.9085957407951355 00:14:11.840 --> 00:14:14.904 We know that social determinants of health or sometimes called NOTE Confidence: 0.9085957407951355 00:14:14.954 --> 00:14:17.080 social drivers of health do get in the way. NOTE Confidence: 0.8993817567825317 00:14:17.080 --> 00:14:21.270 They are barriers occasionally for patients being engaged in their NOTE Confidence: 0.8993817567825317 00:14:21.333 --> 00:14:25.587 own care, either being, you know, understanding what illnesses they NOTE Confidence: 0.8993817567825317 00:14:25.650 --> 00:14:28.888 have or seeking access to that or seeking access to NOTE Confidence: 0.8993817567825317 00:14:28.951 --> 00:14:33.142 that care or ultimately then helping themselves partner with their NOTE Confidence: 0.8993817567825317 00:14:33.205 --> 00:14:36.824 healthcare provider to move them along the spectrum of of NOTE Confidence: 0.8993817567825317 00:14:36.887 --> 00:14:37.840 greater health. NOTE Confidence: 0.9407766461372375 00:14:37.840 --> 00:14:39.923 And would love to hear how you guys go about NOTE Confidence: 0.9407766461372375 00:14:39.970 --> 00:14:42.479 trying to overcome some of those social determinants. NOTE Confidence: 0.924658477306366 00:14:42.840 --> 00:14:44.520 Yeah, absolutely. NOTE Confidence: 0.8820352554321289 00:14:44.560 --> 00:14:47.076 I mean, in addition to, you know, ADA has the NOTE Confidence: 0.8820352554321289 00:14:47.132 --> 00:14:50.208 standards of care and Giuliana did did such a wonderful NOTE Confidence: 0.8820352554321289 00:14:50.264 --> 00:14:53.173 job Speaking of how we can incorporate some of these NOTE Confidence: 0.8820352554321289 00:14:53.229 --> 00:14:56.640 things into the clinical aspects of the guidelines that we're NOTE Confidence: 0.8820352554321289 00:14:56.696 --> 00:14:57.199 creating. NOTE Confidence: 0.9647641181945801 00:14:57.440 --> 00:15:00.106 So I'll talk a little bit more about the community NOTE Confidence: 0.9647641181945801 00:15:00.159 --> 00:15:01.919 facing the implementation pieces. NOTE Confidence: 0.9656792879104614 00:15:02.760 --> 00:15:05.893 And when I think about this, you think about hierarchy NOTE Confidence: 0.9656792879104614 00:15:05.951 --> 00:15:06.879 of needs, right? NOTE Confidence: 0.9337435960769653 00:15:06.880 --> 00:15:10.622 When we think about those social determinants of health, often NOTE Confidence: 0.9337435960769653 00:15:10.683 --> 00:15:14.426 prevention and health prevention is trumped if there are other NOTE Confidence: 0.9337435960769653 00:15:14.486 --> 00:15:16.720 competing priorities for that person. NOTE Confidence: 0.9725053310394287 00:15:16.720 --> 00:15:19.256 So they won't be able to focus on health prevention NOTE Confidence: 0.9725053310394287 00:15:19.306 --> 00:15:21.992 if they need other more immediate things like food and NOTE Confidence: 0.9725053310394287 00:15:22.042 --> 00:15:22.439 housing. NOTE Confidence: 0.9649921655654907 00:15:22.440 --> 00:15:25.310 And So what I'll add to this part is with NOTE Confidence: 0.9649921655654907 00:15:25.380 --> 00:15:28.810 a lot of our community initiatives, what we do is NOTE Confidence: 0.9649921655654907 00:15:28.880 --> 00:15:32.800 incorporate A component to make it comprehensive, right? NOTE Confidence: 0.9173653721809387 00:15:32.800 --> 00:15:35.852 They may show up for diabetes or obesity or resource NOTE Confidence: 0.9173653721809387 00:15:35.910 --> 00:15:39.315 and have these community clinical linkages, But how can we NOTE Confidence: 0.9173653721809387 00:15:39.373 --> 00:15:42.249 also layer in being able to service some of their NOTE Confidence: 0.9173653721809387 00:15:42.308 --> 00:15:45.712 more immediate needs because we know they won't care about NOTE Confidence: 0.9173653721809387 00:15:45.771 --> 00:15:49.410 our, our clinical linkage or our obesity prevention if they're NOTE Confidence: 0.9173653721809387 00:15:49.469 --> 00:15:49.879 hungry. NOTE Confidence: 0.8634701371192932 00:15:49.880 --> 00:15:53.030 So, you know, in a, in a specific example, we NOTE Confidence: 0.8634701371192932 00:15:53.100 --> 00:15:57.230 are developing these community hubs that will be, you know, NOTE Confidence: 0.8634701371192932 00:15:57.300 --> 00:16:01.710 this nucleus of, of resources for people in certain communities NOTE Confidence: 0.8634701371192932 00:16:01.780 --> 00:16:03.880 that were that we've selected. NOTE Confidence: 0.939216673374176 00:16:04.600 --> 00:16:07.711 But we know we can't just provide the obesity, the NOTE Confidence: 0.939216673374176 00:16:07.773 --> 00:16:09.079 diabetes information. NOTE Confidence: 0.9299266338348389 00:16:09.080 --> 00:16:13.028 We're being very intentional about layering in connections to those NOTE Confidence: 0.9299266338348389 00:16:13.087 --> 00:16:15.916 points of social care to make sure that a person NOTE Confidence: 0.9299266338348389 00:16:15.975 --> 00:16:19.511 can be served comprehensively, even right there in their own NOTE Confidence: 0.9299266338348389 00:16:19.570 --> 00:16:20.159 community. NOTE Confidence: 0.9161930680274963 00:16:21.800 --> 00:16:23.759 I think if I'm sort of reading between the lines, NOTE Confidence: 0.9161930680274963 00:16:23.799 --> 00:16:26.319 what I'm hearing here is you're building trust, you're building NOTE Confidence: 0.9161930680274963 00:16:26.359 --> 00:16:27.839 trust with the people that you serve. NOTE Confidence: 0.8991973996162415 00:16:27.840 --> 00:16:29.142 And so I want to, I want to get into NOTE Confidence: 0.8991973996162415 00:16:29.179 --> 00:16:29.359 that. NOTE Confidence: 0.9580202102661133 00:16:29.360 --> 00:16:31.040 But before I do, just a couple of thoughts. NOTE Confidence: 0.93719482421875 00:16:31.040 --> 00:16:34.119 Number one, to anybody in the audience, if you have NOTE Confidence: 0.93719482421875 00:16:34.180 --> 00:16:37.501 questions or comments or, or, or anything that you want NOTE Confidence: 0.93719482421875 00:16:37.561 --> 00:16:40.400 to get in, please, please feel free to do that. NOTE Confidence: 0.8100898861885071 00:16:40.400 --> 00:16:43.664 Jump in with the, the Q&A line and the chat NOTE Confidence: 0.8100898861885071 00:16:43.740 --> 00:16:44.119 line. NOTE Confidence: 0.951254665851593 00:16:44.400 --> 00:16:47.081 Let us know what you're thinking and, and what questions NOTE Confidence: 0.951254665851593 00:16:47.129 --> 00:16:47.559 you have. NOTE Confidence: 0.8806592226028442 00:16:47.960 --> 00:16:50.673 I want to take this idea of trust and, and, NOTE Confidence: 0.8806592226028442 00:16:50.736 --> 00:16:53.323 and open it up a little bit more and, and NOTE Confidence: 0.8806592226028442 00:16:53.386 --> 00:16:55.280 get your old thoughts on this. NOTE Confidence: 0.9126691222190857 00:16:55.280 --> 00:16:58.527 And I should say that back in my institution, people NOTE Confidence: 0.9126691222190857 00:16:58.589 --> 00:17:01.274 call me Doctor G And as I've learned in the NOTE Confidence: 0.9126691222190857 00:17:01.337 --> 00:17:03.959 YMCA, people call Doctor Winters Doctor G. NOTE Confidence: 0.856937825679779 00:17:03.960 --> 00:17:07.208 So from one Doctor G to another Doctor G, how NOTE Confidence: 0.856937825679779 00:17:07.280 --> 00:17:10.239 does the YMCA build trust in a community? NOTE Confidence: 0.9740946888923645 00:17:10.240 --> 00:17:12.640 Obviously you are directly there. NOTE Confidence: 0.9584254026412964 00:17:12.640 --> 00:17:15.711 You are in the communities that you serve, brick and NOTE Confidence: 0.9584254026412964 00:17:15.771 --> 00:17:18.783 mortar, but how do you go beyond just being present NOTE Confidence: 0.9584254026412964 00:17:18.843 --> 00:17:20.319 and truly building trust? NOTE Confidence: 0.9064444899559021 00:17:21.119 --> 00:17:23.970 Yeah, that that is core to who we are as NOTE Confidence: 0.9064444899559021 00:17:24.041 --> 00:17:27.533 people, whether we're at the YMCA or any of these NOTE Confidence: 0.9064444899559021 00:17:27.605 --> 00:17:32.736 other organizations represented both attending and of course speaking on NOTE Confidence: 0.9064444899559021 00:17:32.807 --> 00:17:33.520 this call. NOTE Confidence: 0.9351140856742859 00:17:34.200 --> 00:17:39.320 We need as humans, we are relationship centric people. NOTE Confidence: 0.9722875356674194 00:17:39.600 --> 00:17:41.600 We want to belong to something. NOTE Confidence: 0.9603631496429443 00:17:41.600 --> 00:17:44.110 We want to be part of a system that has NOTE Confidence: 0.9603631496429443 00:17:44.174 --> 00:17:45.719 trust and connectedness. NOTE Confidence: 0.946627140045166 00:17:46.119 --> 00:17:49.544 And so it is really key that as we develop NOTE Confidence: 0.946627140045166 00:17:49.626 --> 00:17:55.742 these relationships, we are intentional about creating business models that NOTE Confidence: 0.946627140045166 00:17:55.824 --> 00:18:00.880 actually gear into something that has trust and connectedness. NOTE Confidence: 0.9564609527587891 00:18:01.160 --> 00:18:03.668 So it's not just for the sake of creating a NOTE Confidence: 0.9564609527587891 00:18:03.726 --> 00:18:07.693 business to address diabetes or cardiovascular issues or any chronic NOTE Confidence: 0.9564609527587891 00:18:07.751 --> 00:18:09.560 disease issues for that matter. NOTE Confidence: 0.950837254524231 00:18:09.840 --> 00:18:13.170 It's really about digging into what does that look like NOTE Confidence: 0.950837254524231 00:18:13.231 --> 00:18:14.199 to create trust. NOTE Confidence: 0.9101079702377319 00:18:14.440 --> 00:18:17.343 Part of that is bringing in people that have lived NOTE Confidence: 0.9101079702377319 00:18:17.401 --> 00:18:18.039 experience. NOTE Confidence: 0.7947543263435364 00:18:18.040 --> 00:18:20.220 So at all of our YMCA, as you said it NOTE Confidence: 0.7947543263435364 00:18:20.279 --> 00:18:23.756 so community centric, our boards are made-up of those local NOTE Confidence: 0.7947543263435364 00:18:23.815 --> 00:18:24.640 people, right. NOTE Confidence: 0.8510539531707764 00:18:24.920 --> 00:18:28.067 And so as we're establishing our strategic plans, our business NOTE Confidence: 0.8510539531707764 00:18:28.118 --> 00:18:31.063 models, it is made-up of people that have lived experience NOTE Confidence: 0.8510539531707764 00:18:31.113 --> 00:18:31.519 in that. NOTE Confidence: 0.9135751128196716 00:18:32.119 --> 00:18:34.156 One of the things that I think all of us NOTE Confidence: 0.9135751128196716 00:18:34.207 --> 00:18:36.854 on this group are doing are looking at the community NOTE Confidence: 0.9135751128196716 00:18:36.905 --> 00:18:40.774 health worker, the community health workers, that intermediary position that NOTE Confidence: 0.9135751128196716 00:18:40.825 --> 00:18:43.167 can connect, if you will, the sick care to the NOTE Confidence: 0.9135751128196716 00:18:43.218 --> 00:18:44.999 health and Wellness and prevention. NOTE Confidence: 0.9015125036239624 00:18:45.000 --> 00:18:47.715 And they're the ones that have the lived experience so NOTE Confidence: 0.9015125036239624 00:18:47.766 --> 00:18:50.230 that I can connect with you, doctor, and say, oh, NOTE Confidence: 0.9015125036239624 00:18:50.280 --> 00:18:51.840 this is actually what you need. NOTE Confidence: 0.9729485511779785 00:18:51.840 --> 00:18:54.360 And I know that because I come from that experience. NOTE Confidence: 0.9392348527908325 00:18:54.640 --> 00:18:59.461 Those are really key ways for us to tangibly connect NOTE Confidence: 0.9392348527908325 00:18:59.554 --> 00:19:04.190 those to the things that they need and create that NOTE Confidence: 0.9392348527908325 00:19:04.283 --> 00:19:04.839 trust. NOTE Confidence: 0.8187310099601746 00:19:06.119 --> 00:19:08.251 So for one Doctor G to another Doctor G, you NOTE Confidence: 0.8187310099601746 00:19:08.300 --> 00:19:10.867 know, This is why I love these partnerships that that NOTE Confidence: 0.8187310099601746 00:19:10.916 --> 00:19:13.144 we have with all of you because we continue to NOTE Confidence: 0.8187310099601746 00:19:13.193 --> 00:19:13.919 learn and grow. NOTE Confidence: 0.9023454189300537 00:19:13.920 --> 00:19:17.445 And, you know, we're thinking about community health and you're NOTE Confidence: 0.9023454189300537 00:19:17.501 --> 00:19:21.082 thinking about, you know, business related programs to make sure NOTE Confidence: 0.9023454189300537 00:19:21.138 --> 00:19:24.159 that your community health outreach is, is successful. NOTE Confidence: 0.9126572608947754 00:19:24.160 --> 00:19:25.280 So I, I love that. NOTE Confidence: 0.937816858291626 00:19:25.640 --> 00:19:28.477 And, and community health workers is, is 1 where we, NOTE Confidence: 0.937816858291626 00:19:28.532 --> 00:19:31.042 based on the work that we've done with you all NOTE Confidence: 0.937816858291626 00:19:31.096 --> 00:19:33.988 and, and with others, it's an area we're leaning into NOTE Confidence: 0.937816858291626 00:19:34.043 --> 00:19:34.480 as well. NOTE Confidence: 0.9404510855674744 00:19:34.480 --> 00:19:36.878 And it comes back to this theme of trust and NOTE Confidence: 0.9404510855674744 00:19:36.932 --> 00:19:39.985 meeting our patients where they are and giving them the, NOTE Confidence: 0.9404510855674744 00:19:40.039 --> 00:19:42.982 the resources that they need to be actively engaged in NOTE Confidence: 0.9404510855674744 00:19:43.037 --> 00:19:44.400 their, in their own care. NOTE Confidence: 0.8570084571838379 00:19:44.760 --> 00:19:47.118 And, and so maybe Doctor Frank, I'll just go back NOTE Confidence: 0.8570084571838379 00:19:47.167 --> 00:19:49.333 to you and then Juliana, I'd love for you to, NOTE Confidence: 0.8570084571838379 00:19:49.381 --> 00:19:50.199 to share as well. NOTE Confidence: 0.8797416687011719 00:19:50.600 --> 00:19:54.363 Each of your organization's is known for the trust that NOTE Confidence: 0.8797416687011719 00:19:54.431 --> 00:19:55.799 you have in society. NOTE Confidence: 0.8869913816452026 00:19:55.880 --> 00:19:58.595 People look to the ADA, they look to the AHA, NOTE Confidence: 0.8869913816452026 00:19:58.656 --> 00:20:01.553 not just for scientific guidance like I do as a, NOTE Confidence: 0.8869913816452026 00:20:01.613 --> 00:20:04.872 as a physician, but for guidance in general about our, NOTE Confidence: 0.8869913816452026 00:20:04.933 --> 00:20:06.079 our general health. NOTE Confidence: 0.9488401412963867 00:20:06.440 --> 00:20:09.144 But again, when you're building that trust at a national NOTE Confidence: 0.9488401412963867 00:20:09.192 --> 00:20:12.138 level, that's important, building that trust at a local level NOTE Confidence: 0.9488401412963867 00:20:12.187 --> 00:20:12.959 so that you can. NOTE Confidence: 0.7369813919067383 00:20:13.040 --> 00:20:15.560 Actually impact care to local level is a different thing. NOTE Confidence: 0.8785886168479919 00:20:15.560 --> 00:20:17.789 I would love to hear Doctor Crank how you guys NOTE Confidence: 0.8785886168479919 00:20:17.838 --> 00:20:19.679 have done it and then Juliana as well. NOTE Confidence: 0.9546908140182495 00:20:20.680 --> 00:20:22.040 Yeah, absolutely. NOTE Confidence: 0.8951643109321594 00:20:22.760 --> 00:20:24.641 And Doctor G hit the nail on the head when NOTE Confidence: 0.8951643109321594 00:20:24.686 --> 00:20:26.119 she said the trusted messengers. NOTE Confidence: 0.9469819664955139 00:20:26.119 --> 00:20:28.830 That is certainly some of the secret sauce when it NOTE Confidence: 0.9469819664955139 00:20:28.884 --> 00:20:32.515 comes to engaging communities, finding the people, because it's not NOTE Confidence: 0.9469819664955139 00:20:32.570 --> 00:20:33.600 always the message. NOTE Confidence: 0.9328771829605103 00:20:33.600 --> 00:20:35.080 Sometimes it's the messenger. NOTE Confidence: 0.9295060634613037 00:20:35.359 --> 00:20:38.943 So starting with people and organizations that have established trust NOTE Confidence: 0.9295060634613037 00:20:38.995 --> 00:20:41.799 and leveraging the trust that they have already built. NOTE Confidence: 0.9659385681152344 00:20:42.080 --> 00:20:44.255 I mean, a perfect example is how we can empower NOTE Confidence: 0.9659385681152344 00:20:44.301 --> 00:20:45.319 our faith communities. NOTE Confidence: 0.9211771488189697 00:20:45.320 --> 00:20:47.843 We can go in as ADA or a hospital or NOTE Confidence: 0.9211771488189697 00:20:47.913 --> 00:20:51.417 whoever and, and say this and you know, people may NOTE Confidence: 0.9211771488189697 00:20:51.487 --> 00:20:53.519 or may not connect with that. NOTE Confidence: 0.9536105990409851 00:20:53.520 --> 00:20:56.051 But if we go in and connect with the local NOTE Confidence: 0.9536105990409851 00:20:56.111 --> 00:21:00.029 pastor that then shares the same message with their congregation, NOTE Confidence: 0.9536105990409851 00:21:00.089 --> 00:21:02.320 again, sometimes it is the messenger. NOTE Confidence: 0.9331848621368408 00:21:02.320 --> 00:21:05.370 And so our approach really is to to find those NOTE Confidence: 0.9331848621368408 00:21:05.436 --> 00:21:09.149 champions, find folks in the community that can serve as NOTE Confidence: 0.9331848621368408 00:21:09.216 --> 00:21:13.526 the trusted messengers and empower them, use capacity building to NOTE Confidence: 0.9331848621368408 00:21:13.592 --> 00:21:17.504 build those organizations, build those people to be able to NOTE Confidence: 0.9331848621368408 00:21:17.571 --> 00:21:21.019 be the voice of the education and the initiatives we NOTE Confidence: 0.9331848621368408 00:21:21.085 --> 00:21:22.079 want to, to do. NOTE Confidence: 0.8850771188735962 00:21:22.680 --> 00:21:25.202 But I'll go back to just very first thing when NOTE Confidence: 0.8850771188735962 00:21:25.257 --> 00:21:28.602 we're talking about building trust in communities is first we NOTE Confidence: 0.8850771188735962 00:21:28.656 --> 00:21:30.960 have to make ourselves trustworthy, right? NOTE Confidence: 0.9381335973739624 00:21:30.960 --> 00:21:33.852 I think we talked about building trust with communities and NOTE Confidence: 0.9381335973739624 00:21:33.901 --> 00:21:35.519 how we want communities to trust. NOTE Confidence: 0.943690836429596 00:21:35.840 --> 00:21:39.347 But as an organization and as healthcare professionals, we have NOTE Confidence: 0.943690836429596 00:21:39.403 --> 00:21:41.964 to make sure that when people do show up, when NOTE Confidence: 0.943690836429596 00:21:42.019 --> 00:21:44.803 they do come, when we do breakdown that wall, that NOTE Confidence: 0.943690836429596 00:21:44.859 --> 00:21:48.143 we are ready to serve with compassion and cultural humility NOTE Confidence: 0.943690836429596 00:21:48.199 --> 00:21:52.542 and understanding that there's different contexts and perspectives that people NOTE Confidence: 0.943690836429596 00:21:52.597 --> 00:21:53.599 will show up with. NOTE Confidence: 0.9414241909980774 00:21:54.040 --> 00:21:57.445 And once people do come, once we're able to bridge NOTE Confidence: 0.9414241909980774 00:21:57.513 --> 00:22:01.396 those trust barriers, making sure we're ready to to build NOTE Confidence: 0.9414241909980774 00:22:01.464 --> 00:22:05.551 and leverage that relationship and not, you know, create any NOTE Confidence: 0.9414241909980774 00:22:05.619 --> 00:22:09.978 additional barriers by by not providing the right perspective of NOTE Confidence: 0.9414241909980774 00:22:10.046 --> 00:22:10.999 care for them. NOTE Confidence: 0.8268315196037292 00:22:11.280 --> 00:22:13.879 So those two things and engage, I mean, we've talked NOTE Confidence: 0.8268315196037292 00:22:13.929 --> 00:22:15.079 a lot about engagement. NOTE Confidence: 0.9504154324531555 00:22:15.080 --> 00:22:17.239 I'm sure we're going to have so much more conversation NOTE Confidence: 0.9504154324531555 00:22:17.279 --> 00:22:17.959 about engagement. NOTE Confidence: 0.877192497253418 00:22:18.240 --> 00:22:21.711 But that, that is the additional secret sauce is crafting NOTE Confidence: 0.877192497253418 00:22:21.772 --> 00:22:25.914 with communities and not for communities and being intentional about NOTE Confidence: 0.877192497253418 00:22:25.975 --> 00:22:26.279 that. NOTE Confidence: 0.8971336483955383 00:22:27.119 --> 00:22:30.545 Yeah, I love this idea of of finding champions in NOTE Confidence: 0.8971336483955383 00:22:30.615 --> 00:22:34.599 the community to amplify your message, amplify the voice. NOTE Confidence: 0.8783891797065735 00:22:35.200 --> 00:22:36.720 So, so, so important. NOTE Confidence: 0.85041344165802 00:22:37.160 --> 00:22:40.360 Juliana, what about you all at the American Heart Association? NOTE Confidence: 0.8107624053955078 00:22:40.920 --> 00:22:43.193 He that yes, you know, it's funny, as I was NOTE Confidence: 0.8107624053955078 00:22:43.246 --> 00:22:46.312 thinking about this question, I was reflecting on in 2024, NOTE Confidence: 0.8107624053955078 00:22:46.365 --> 00:22:49.959 the American Heart Association celebrated a century, our 1st century NOTE Confidence: 0.8107624053955078 00:22:50.012 --> 00:22:51.439 of work, 100 years of work. NOTE Confidence: 0.9038779735565186 00:22:51.440 --> 00:22:53.558 And so as you can imagine, in that year or NOTE Confidence: 0.9038779735565186 00:22:53.609 --> 00:22:55.878 so, we spent a lot of time thinking about the NOTE Confidence: 0.9038779735565186 00:22:55.929 --> 00:22:58.501 future of the organization, but also spent a lot of NOTE Confidence: 0.9038779735565186 00:22:58.552 --> 00:23:01.629 time thinking about what are the elements of the organization NOTE Confidence: 0.9038779735565186 00:23:01.679 --> 00:23:02.839 that will never change. NOTE Confidence: 0.9108348488807678 00:23:03.119 --> 00:23:05.313 And what we talked about there a lot was our NOTE Confidence: 0.9108348488807678 00:23:05.363 --> 00:23:09.102 commitment to accelerating the science and the grassroots infrastructure of NOTE Confidence: 0.9108348488807678 00:23:09.152 --> 00:23:09.999 the organization. NOTE Confidence: 0.8189829587936401 00:23:10.000 --> 00:23:13.231 And what that really means is our commitment to investing NOTE Confidence: 0.8189829587936401 00:23:13.287 --> 00:23:15.725 and staff that sit at the local level to do NOTE Confidence: 0.8189829587936401 00:23:15.781 --> 00:23:18.786 just the kinds of things that Doctor Craig and Doctor NOTE Confidence: 0.8189829587936401 00:23:18.842 --> 00:23:20.599 Winters has discussed about it. NOTE Confidence: 0.8554461002349854 00:23:20.640 --> 00:23:23.980 He folks that are focused on community impact strategies and NOTE Confidence: 0.8554461002349854 00:23:24.036 --> 00:23:27.544 building relationships that come from the community that sit in NOTE Confidence: 0.8554461002349854 00:23:27.600 --> 00:23:30.439 markets and across rural areas to connect the dots. NOTE Confidence: 0.7496046423912048 00:23:30.440 --> 00:23:32.703 And so I think that's just again, it's, it's we're NOTE Confidence: 0.7496046423912048 00:23:32.748 --> 00:23:35.646 doing, I think get the similar strategies we're working together NOTE Confidence: 0.7496046423912048 00:23:35.691 --> 00:23:36.280 linking arms. NOTE Confidence: 0.8872188329696655 00:23:36.280 --> 00:23:38.834 But at the Heart Association, we know we can do NOTE Confidence: 0.8872188329696655 00:23:38.888 --> 00:23:41.823 a lot of things nationally as the organization, but we NOTE Confidence: 0.8872188329696655 00:23:41.878 --> 00:23:45.519 also know that the commitment to having a grassroots infrastructure NOTE Confidence: 0.8872188329696655 00:23:45.574 --> 00:23:48.345 in communities will never change and is part of the NOTE Confidence: 0.8872188329696655 00:23:48.400 --> 00:23:50.520 secret sauce that helps us do our work. NOTE Confidence: 0.7353083491325378 00:23:51.920 --> 00:23:53.240 Grassroots I, I agree. NOTE Confidence: 0.9346318244934082 00:23:53.440 --> 00:23:55.305 Well, I got a million more questions to ask you, NOTE Confidence: 0.9346318244934082 00:23:55.344 --> 00:23:57.171 but I'm getting a couple of questions in on the NOTE Confidence: 0.9346318244934082 00:23:57.210 --> 00:23:57.560 Q&A line. NOTE Confidence: 0.8582320809364319 00:23:57.560 --> 00:23:59.920 So I'm going to I'm not going to be selfish. NOTE Confidence: 0.8908886909484863 00:23:59.920 --> 00:24:01.240 I'm not going to ask you my questions. NOTE Confidence: 0.9189804196357727 00:24:01.240 --> 00:24:02.727 I'm going to try to get to some of these NOTE Confidence: 0.9189804196357727 00:24:02.764 --> 00:24:03.360 other questions. NOTE Confidence: 0.901149570941925 00:24:04.520 --> 00:24:07.676 And, and it, there's one that plays off of everything NOTE Confidence: 0.901149570941925 00:24:07.735 --> 00:24:11.367 we've just talked about, but it's specific for building trust NOTE Confidence: 0.901149570941925 00:24:11.427 --> 00:24:15.595 with people who have multiple illnesses or multiple diseases, multiple NOTE Confidence: 0.901149570941925 00:24:15.655 --> 00:24:17.680 comorbidities and are over age 65. NOTE Confidence: 0.8022733926773071 00:24:18.040 --> 00:24:22.334 And, and just wondering, this questioner is asking how, how NOTE Confidence: 0.8022733926773071 00:24:22.406 --> 00:24:27.283 do we prioritize that group's specific pressing questions that they NOTE Confidence: 0.8022733926773071 00:24:27.356 --> 00:24:27.719 have? NOTE Confidence: 0.839693009853363 00:24:27.720 --> 00:24:30.054 So maybe I'll just open it up to any one NOTE Confidence: 0.839693009853363 00:24:30.112 --> 00:24:32.855 of you if you have specific thoughts on on Poly NOTE Confidence: 0.839693009853363 00:24:32.913 --> 00:24:36.414 chronic comorbidities in the older population and how we how NOTE Confidence: 0.839693009853363 00:24:36.472 --> 00:24:37.640 we meet their needs. NOTE Confidence: 0.9465104937553406 00:24:41.200 --> 00:24:42.840 I'll take a stab at that one. NOTE Confidence: 0.8958296775817871 00:24:44.160 --> 00:24:48.320 So direct example that is yesterday our team met with NOTE Confidence: 0.8958296775817871 00:24:48.399 --> 00:24:53.109 Doctor Oz, the administrator for the Center for Medicare and NOTE Confidence: 0.8958296775817871 00:24:53.187 --> 00:24:56.720 Medicaid Services in person in Nashville, TN. NOTE Confidence: 0.9631423950195312 00:24:57.440 --> 00:25:00.160 And that was actually the topic of our discussion. NOTE Confidence: 0.8962589502334595 00:25:00.360 --> 00:25:03.120 So it's a very poignant question for today. NOTE Confidence: 0.801763653755188 00:25:03.640 --> 00:25:06.724 How do we actually meet those needs, Poly chronic disease, NOTE Confidence: 0.801763653755188 00:25:06.778 --> 00:25:08.480 social isolation and loneliness. NOTE Confidence: 0.9167928099632263 00:25:08.720 --> 00:25:11.575 And so we're, and it was at a local YMCA NOTE Confidence: 0.9167928099632263 00:25:11.647 --> 00:25:14.716 and so we actually had quite a few of those NOTE Confidence: 0.9167928099632263 00:25:14.788 --> 00:25:18.643 folks that participate in Medicare in that part of the NOTE Confidence: 0.9167928099632263 00:25:18.714 --> 00:25:20.000 discussion, right. NOTE Confidence: 0.8702467679977417 00:25:20.000 --> 00:25:22.778 So not just us as the quote UN quote experts NOTE Confidence: 0.8702467679977417 00:25:22.841 --> 00:25:26.567 leading that discussion, but we actually, he brought we, we NOTE Confidence: 0.8702467679977417 00:25:26.630 --> 00:25:29.977 had a bunch of folks that we brought into participate NOTE Confidence: 0.8702467679977417 00:25:30.040 --> 00:25:31.240 in that discussion. NOTE Confidence: 0.8756541609764099 00:25:31.560 --> 00:25:35.061 So it, it really is again, this top down, bottom NOTE Confidence: 0.8756541609764099 00:25:35.134 --> 00:25:36.519 up approach, right? NOTE Confidence: 0.9788623452186584 00:25:36.520 --> 00:25:37.760 You have to actually have both. NOTE Confidence: 0.8737930655479431 00:25:37.920 --> 00:25:39.330 You have to have the roof of the house, you NOTE Confidence: 0.8737930655479431 00:25:39.363 --> 00:25:40.970 have to have the foundation of the house and then NOTE Confidence: 0.8737930655479431 00:25:41.003 --> 00:25:42.446 you have to have the guts of the people that NOTE Confidence: 0.8737930655479431 00:25:42.479 --> 00:25:42.839 live there. NOTE Confidence: 0.9565485119819641 00:25:43.080 --> 00:25:44.640 And so that's what we're really trying to do. NOTE Confidence: 0.9459339380264282 00:25:44.640 --> 00:25:47.828 And I mean, that's a very simple explanation of what NOTE Confidence: 0.9459339380264282 00:25:47.889 --> 00:25:51.199 was going on, but it's a very complex question, right? NOTE Confidence: 0.9410371780395508 00:25:51.200 --> 00:25:51.960 How do we do that? NOTE Confidence: 0.8908787965774536 00:25:51.960 --> 00:25:54.929 And so, yes, there are programs that we have in NOTE Confidence: 0.8908787965774536 00:25:54.992 --> 00:25:58.529 place to address those things, but there it's, it's much NOTE Confidence: 0.8908787965774536 00:25:58.592 --> 00:26:01.625 more than that of just create a program and, and NOTE Confidence: 0.8908787965774536 00:26:01.688 --> 00:26:02.319 let it go. NOTE Confidence: 0.7824819684028625 00:26:02.320 --> 00:26:04.968 And, and both of all, all of these purchase, all NOTE Confidence: 0.7824819684028625 00:26:05.023 --> 00:26:07.120 of these speakers know that very well. NOTE Confidence: 0.9631289839744568 00:26:07.320 --> 00:26:11.169 You really, really have to get that community engagement to NOTE Confidence: 0.9631289839744568 00:26:11.234 --> 00:26:14.497 hear from those that have those issues in order to NOTE Confidence: 0.9631289839744568 00:26:14.562 --> 00:26:15.280 address it. NOTE Confidence: 0.8972049951553345 00:26:15.480 --> 00:26:17.440 And what are those specific barriers? NOTE Confidence: 0.9596184492111206 00:26:17.440 --> 00:26:21.200 And those barriers are different one community to another. NOTE Confidence: 0.8147499561309814 00:26:21.200 --> 00:26:23.307 So it goes back to our other questions that we NOTE Confidence: 0.8147499561309814 00:26:23.352 --> 00:26:24.039 just addressed. NOTE Confidence: 0.9346144199371338 00:26:24.240 --> 00:26:26.966 We really need to identify those pieces, But we, we NOTE Confidence: 0.9346144199371338 00:26:27.020 --> 00:26:29.479 really must have the roof of the house, right? NOTE Confidence: 0.9023072719573975 00:26:29.480 --> 00:26:32.989 We must have government, federal participate in that because of NOTE Confidence: 0.9023072719573975 00:26:33.045 --> 00:26:36.220 the regulations that they're creating in order to have us NOTE Confidence: 0.9023072719573975 00:26:36.276 --> 00:26:38.560 allow us to access it from the bottom up. NOTE Confidence: 0.898029625415802 00:26:38.800 --> 00:26:41.720 So I'll stop there and see what the other speakers NOTE Confidence: 0.898029625415802 00:26:41.779 --> 00:26:42.479 have to say. NOTE Confidence: 0.9115862846374512 00:26:43.640 --> 00:26:44.640 I think that's really good. NOTE Confidence: 0.8294076919555664 00:26:44.640 --> 00:26:47.026 That kind of sparked something for me that we're really NOTE Confidence: 0.8294076919555664 00:26:47.069 --> 00:26:49.672 leaning into and this solving this problem with folks living NOTE Confidence: 0.8294076919555664 00:26:49.716 --> 00:26:52.796 with these multiple chronic conditions and trying to navigate something NOTE Confidence: 0.8294076919555664 00:26:52.839 --> 00:26:55.182 we're really excited about in terms of the momentum in NOTE Confidence: 0.8294076919555664 00:26:55.225 --> 00:26:55.920 the marketplace. NOTE Confidence: 0.7722402811050415 00:26:55.920 --> 00:26:58.434 And to your point, Doctor Winters is one of these NOTE Confidence: 0.7722402811050415 00:26:58.486 --> 00:27:01.616 business models that they're going to sustain is the momentum NOTE Confidence: 0.7722402811050415 00:27:01.668 --> 00:27:05.312 around care coordination and some of these reimbursement pathways, care NOTE Confidence: 0.7722402811050415 00:27:05.363 --> 00:27:09.007 coordination and navigation now for people living with multiple chronic NOTE Confidence: 0.7722402811050415 00:27:09.058 --> 00:27:09.880 hair conditions. NOTE Confidence: 0.9361238479614258 00:27:09.880 --> 00:27:11.320 So we're really monitoring that. NOTE Confidence: 0.8483239412307739 00:27:11.320 --> 00:27:13.942 We're talking there's it's sparking a lot of innovation with NOTE Confidence: 0.8483239412307739 00:27:13.986 --> 00:27:16.565 private companies doing more in this space now that there's NOTE Confidence: 0.8483239412307739 00:27:16.609 --> 00:27:17.439 a model to sustain. NOTE Confidence: 0.7585873007774353 00:27:17.440 --> 00:27:20.160 So we're thinking about is the American Heart Association. NOTE Confidence: 0.8561863303184509 00:27:20.160 --> 00:27:22.561 Can we play a role here in guiding, you know, NOTE Confidence: 0.8561863303184509 00:27:22.615 --> 00:27:25.924 what coaching and curriculum looks like for gold standard care NOTE Confidence: 0.8561863303184509 00:27:25.977 --> 00:27:29.499 coordination, for example, and really fuel this, this, this issue, NOTE Confidence: 0.8561863303184509 00:27:29.553 --> 00:27:32.755 because we know it's, it's so difficult when you're managing NOTE Confidence: 0.8561863303184509 00:27:32.809 --> 00:27:36.438 a couple of different conditions and bouncing in between specialties NOTE Confidence: 0.8561863303184509 00:27:36.491 --> 00:27:38.839 and trying to find your hub in primary care. NOTE Confidence: 0.8642414212226868 00:27:38.840 --> 00:27:42.399 There's no silver bullet, but we are really again, encouraged NOTE Confidence: 0.8642414212226868 00:27:42.457 --> 00:27:45.841 by kind of the tipping point of new reimbursement pathways NOTE Confidence: 0.8642414212226868 00:27:45.899 --> 00:27:46.600 in this way. NOTE Confidence: 0.8152554631233215 00:27:46.600 --> 00:27:49.110 And lady it into how can we further advocate that NOTE Confidence: 0.8152554631233215 00:27:49.161 --> 00:27:52.236 advocate for those things to to proliferate more through our NOTE Confidence: 0.8152554631233215 00:27:52.287 --> 00:27:54.490 our policy work that we do and and what are NOTE Confidence: 0.8152554631233215 00:27:54.542 --> 00:27:57.514 other ways in which we can feel that through certification NOTE Confidence: 0.8152554631233215 00:27:57.565 --> 00:27:58.999 models and things like that. NOTE Confidence: 0.8175237774848938 00:28:01.800 --> 00:28:05.460 Yeah, I I mean that I don't have anything better NOTE Confidence: 0.8175237774848938 00:28:05.536 --> 00:28:06.680 to add to that. NOTE Confidence: 0.8916897773742676 00:28:06.680 --> 00:28:09.413 I was going to lean into the pieces about the NOTE Confidence: 0.8916897773742676 00:28:09.474 --> 00:28:12.876 care coordination piece and that I mean that just speaks NOTE Confidence: 0.8916897773742676 00:28:12.937 --> 00:28:16.521 to the importance of having the navigation and clinical and NOTE Confidence: 0.8916897773742676 00:28:16.582 --> 00:28:18.039 social navigators piece. NOTE Confidence: 0.8701699376106262 00:28:18.320 --> 00:28:20.934 I wanted to elevate some of the advocacy elements that NOTE Confidence: 0.8701699376106262 00:28:20.983 --> 00:28:21.999 can come out of that. NOTE Confidence: 0.8212195038795471 00:28:22.000 --> 00:28:25.993 So no, the 2 ladies have summed that up very NOTE Confidence: 0.8212195038795471 00:28:26.084 --> 00:28:26.719 nicely. NOTE Confidence: 0.8748461604118347 00:28:28.080 --> 00:28:31.139 Doctor Frank, now I'm going to put you on the NOTE Confidence: 0.8748461604118347 00:28:31.206 --> 00:28:35.421 spot because Michael Joseph, who's one of our audience members NOTE Confidence: 0.8748461604118347 00:28:35.489 --> 00:28:38.616 wants to get tactical, which is how is the ADA NOTE Confidence: 0.8748461604118347 00:28:38.684 --> 00:28:41.743 and the AHA using AI in the clinical space to NOTE Confidence: 0.8748461604118347 00:28:41.811 --> 00:28:45.958 help detect patients that have chronic disease and, and maybe NOTE Confidence: 0.8748461604118347 00:28:46.026 --> 00:28:50.240 even prevent progression of chronic disease or prevent it from NOTE Confidence: 0.8748461604118347 00:28:50.308 --> 00:28:52.960 happening to begin with or to treat it. NOTE Confidence: 0.8932915925979614 00:28:53.360 --> 00:28:55.911 So AII mean I can tell you, I can barely NOTE Confidence: 0.8932915925979614 00:28:55.975 --> 00:28:58.079 spell AI, but I'm learning a ton. NOTE Confidence: 0.8977903127670288 00:28:58.080 --> 00:29:00.544 It's like drinking from a fire hydrant because everything is NOTE Confidence: 0.8977903127670288 00:29:00.585 --> 00:29:01.160 AI these days. NOTE Confidence: 0.9448906183242798 00:29:01.160 --> 00:29:02.880 There's lots of promise out there. NOTE Confidence: 0.762764573097229 00:29:03.240 --> 00:29:06.706 Wondering how you and the ADA and then Giuliana, you NOTE Confidence: 0.762764573097229 00:29:06.773 --> 00:29:10.239 and the AHA are using this for chronic disease care? NOTE Confidence: 0.9365143775939941 00:29:11.280 --> 00:29:14.081 Yeah, that's a great question That definitely does put me NOTE Confidence: 0.9365143775939941 00:29:14.130 --> 00:29:14.720 on the spot. NOTE Confidence: 0.9297651052474976 00:29:14.960 --> 00:29:17.504 I don't know if I'm even the best person to NOTE Confidence: 0.9297651052474976 00:29:17.563 --> 00:29:21.055 answer that because we have had lots of conversations about NOTE Confidence: 0.9297651052474976 00:29:21.114 --> 00:29:23.778 being on the, you know, this is the, the new, NOTE Confidence: 0.9297651052474976 00:29:23.837 --> 00:29:25.080 the new thing, right? NOTE Confidence: 0.8928987383842468 00:29:25.080 --> 00:29:28.090 And we need to make sure that we are incorporating NOTE Confidence: 0.8928987383842468 00:29:28.150 --> 00:29:30.920 this in a, in a positive and a meaningful way. NOTE Confidence: 0.9569981694221497 00:29:32.120 --> 00:29:34.920 Not very sure what that's going to look like right NOTE Confidence: 0.9569981694221497 00:29:34.976 --> 00:29:35.200 now. NOTE Confidence: 0.9064375758171082 00:29:35.200 --> 00:29:38.335 I'm happy to follow up, you know, as far as NOTE Confidence: 0.9064375758171082 00:29:38.408 --> 00:29:42.783 the community aspects of it in the implementation pieces, we NOTE Confidence: 0.9064375758171082 00:29:42.856 --> 00:29:46.429 certainly are exploring how can we use AI, as you NOTE Confidence: 0.9064375758171082 00:29:46.502 --> 00:29:51.096 know, within our, our marketing and within our health education NOTE Confidence: 0.9064375758171082 00:29:51.169 --> 00:29:51.679 pieces. NOTE Confidence: 0.9227695465087891 00:29:51.680 --> 00:29:56.211 And is there a way to curate and create these NOTE Confidence: 0.9227695465087891 00:29:56.312 --> 00:30:01.850 AI interactions that maybe can be even implemented at a NOTE Confidence: 0.9227695465087891 00:30:01.951 --> 00:30:03.159 local level? NOTE Confidence: 0.9379732012748718 00:30:03.160 --> 00:30:05.658 I mean, is there something we can put in a NOTE Confidence: 0.9379732012748718 00:30:05.718 --> 00:30:10.240 church where people can interact and receive curated healthcare information? NOTE Confidence: 0.8569198846817017 00:30:10.760 --> 00:30:15.013 So I, again, nothing really tangible that I can answer NOTE Confidence: 0.8569198846817017 00:30:15.092 --> 00:30:15.880 right now. NOTE Confidence: 0.895427405834198 00:30:15.880 --> 00:30:18.994 And I'm, I'm sorry, but I will certainly be able NOTE Confidence: 0.895427405834198 00:30:19.059 --> 00:30:21.525 to be happy to follow up and see if we NOTE Confidence: 0.895427405834198 00:30:21.590 --> 00:30:24.639 can get some information back to you, Doctor G. NOTE Confidence: 0.8763934969902039 00:30:25.320 --> 00:30:27.135 Yeah, well, we, I certainly put you on the spot NOTE Confidence: 0.8763934969902039 00:30:27.173 --> 00:30:27.559 with that. NOTE Confidence: 0.8951717615127563 00:30:27.560 --> 00:30:30.209 I know it wasn't something we had planned on discussing NOTE Confidence: 0.8951717615127563 00:30:30.257 --> 00:30:32.039 and it is all cutting edge right now. NOTE Confidence: 0.9572973251342773 00:30:32.040 --> 00:30:34.446 And so there's a lot of promise out there and NOTE Confidence: 0.9572973251342773 00:30:34.499 --> 00:30:37.066 we're all just starting to learn how best to use NOTE Confidence: 0.9572973251342773 00:30:37.119 --> 00:30:37.279 it. NOTE Confidence: 0.8098120093345642 00:30:37.560 --> 00:30:40.600 Juliana, anything to add from a Heart Association standpoint? NOTE Confidence: 0.18664877116680145 00:30:40.600 --> 00:30:40.640 I. NOTE Confidence: 0.8706982135772705 00:30:41.040 --> 00:30:44.083 Wanted to doctor Crank it's it's early days for us, NOTE Confidence: 0.8706982135772705 00:30:44.143 --> 00:30:47.126 but we are kind of attacking it in similar manners NOTE Confidence: 0.8706982135772705 00:30:47.186 --> 00:30:49.991 in terms of we have convened a group of experts NOTE Confidence: 0.8706982135772705 00:30:50.050 --> 00:30:52.915 to help us think about kind of standards for use NOTE Confidence: 0.8706982135772705 00:30:52.974 --> 00:30:56.435 at the clinical level and setting those while also looking NOTE Confidence: 0.8706982135772705 00:30:56.495 --> 00:30:59.359 for opportunities for real world implementation. NOTE Confidence: 0.8622521758079529 00:30:59.640 --> 00:31:02.925 I think particularly in the work that we're launching with, NOTE Confidence: 0.8622521758079529 00:31:02.981 --> 00:31:06.266 particularly with ADA and, and Evita and others with cardio NOTE Confidence: 0.8622521758079529 00:31:06.322 --> 00:31:10.109 kidney metabolic health, you know, we're leveraging this new prevent NOTE Confidence: 0.8622521758079529 00:31:10.164 --> 00:31:13.283 risk calculator and we're going to the health systems to NOTE Confidence: 0.8622521758079529 00:31:13.338 --> 00:31:15.900 see how we can, how we can use that assessment NOTE Confidence: 0.8622521758079529 00:31:15.956 --> 00:31:18.461 to start to move people down this new kind of NOTE Confidence: 0.8622521758079529 00:31:18.517 --> 00:31:19.519 framework of care. NOTE Confidence: 0.9067564010620117 00:31:19.800 --> 00:31:22.411 And so we're think talking to a lot of partners NOTE Confidence: 0.9067564010620117 00:31:22.466 --> 00:31:25.077 that are on the edge here that could maybe help NOTE Confidence: 0.9067564010620117 00:31:25.133 --> 00:31:28.022 us do some real world implementation to test out how NOTE Confidence: 0.9067564010620117 00:31:28.077 --> 00:31:30.466 can it be effectively used in a way that is NOTE Confidence: 0.9067564010620117 00:31:30.522 --> 00:31:33.966 efficient operationally, but stays true to the science and the NOTE Confidence: 0.9067564010620117 00:31:34.022 --> 00:31:36.800 treatment paradigms and all those sorts of things. NOTE Confidence: 0.9269963502883911 00:31:36.800 --> 00:31:40.834 So we're certainly out there testing and learning as quick NOTE Confidence: 0.9269963502883911 00:31:40.904 --> 00:31:43.199 as we can as things move forward. NOTE Confidence: 0.798214852809906 00:31:44.040 --> 00:31:46.853 Yeah, makes sense, Doctor G And then I'll share how NOTE Confidence: 0.798214852809906 00:31:46.908 --> 00:31:49.611 we're using it at DaVita, and then we'll get back NOTE Confidence: 0.798214852809906 00:31:49.666 --> 00:31:52.480 to a little bit more specifics on community health. NOTE Confidence: 0.7234135866165161 00:31:53.120 --> 00:31:53.360 Yeah. NOTE Confidence: 0.8487905859947205 00:31:53.360 --> 00:31:56.048 So I have AI have a thought on that, where NOTE Confidence: 0.8487905859947205 00:31:56.112 --> 00:31:59.504 the consumers now are the ones that are receiving all NOTE Confidence: 0.8487905859947205 00:31:59.568 --> 00:32:01.040 of these at home tests. NOTE Confidence: 0.9678773880004883 00:32:01.360 --> 00:32:04.689 The consumers are now the ones that are using AI NOTE Confidence: 0.9678773880004883 00:32:04.758 --> 00:32:07.880 for their own diagnostic capabilities, right? NOTE Confidence: 0.8768112659454346 00:32:07.880 --> 00:32:11.785 So there's this interesting intersection of of the trained practitioner NOTE Confidence: 0.8768112659454346 00:32:11.840 --> 00:32:13.160 and how we might use it. NOTE Confidence: 0.9449225068092346 00:32:13.400 --> 00:32:16.552 And then there's this other component of the consumer facing NOTE Confidence: 0.9449225068092346 00:32:16.604 --> 00:32:16.919 piece. NOTE Confidence: 0.8502100110054016 00:32:17.160 --> 00:32:20.300 And so as that consumer with their wearables, with their NOTE Confidence: 0.8502100110054016 00:32:20.356 --> 00:32:23.496 at home diagnostic test that, you know, Amazon drops off NOTE Confidence: 0.8502100110054016 00:32:23.552 --> 00:32:25.852 and then you send it back in the mail and NOTE Confidence: 0.8502100110054016 00:32:25.908 --> 00:32:28.599 then they get their their test diagnostic backs. NOTE Confidence: 0.8633977174758911 00:32:28.600 --> 00:32:32.332 Whether it's a breast cancer screening, except prostate cancer screening, NOTE Confidence: 0.8633977174758911 00:32:32.383 --> 00:32:34.991 whether it's the mirrors that now tell us our blood NOTE Confidence: 0.8633977174758911 00:32:35.042 --> 00:32:38.519 pressure and our temperatures, our toothbrushes, our toilets, right. NOTE Confidence: 0.9270111322402954 00:32:38.680 --> 00:32:41.660 So if you think about this expansion of technology as NOTE Confidence: 0.9270111322402954 00:32:41.716 --> 00:32:44.191 a whole, not just AI, but as technology as a NOTE Confidence: 0.9270111322402954 00:32:44.247 --> 00:32:47.508 whole, I really think that that's actually going to change NOTE Confidence: 0.9270111322402954 00:32:47.565 --> 00:32:51.164 how the consumer makes their decisions, which will then actually NOTE Confidence: 0.9270111322402954 00:32:51.220 --> 00:32:54.482 change how we as practitioners are making our decisions in NOTE Confidence: 0.9270111322402954 00:32:54.538 --> 00:32:57.799 helping them to achieve the care that they're looking for. NOTE Confidence: 0.9640085697174072 00:32:57.800 --> 00:32:59.400 So there's a lot more to be said about that. NOTE Confidence: 0.8739422559738159 00:32:59.400 --> 00:33:01.786 And I've kind of dug into it because of the NOTE Confidence: 0.8739422559738159 00:33:01.842 --> 00:33:04.672 the place that I sit in where I'm really navigating NOTE Confidence: 0.8739422559738159 00:33:04.727 --> 00:33:07.780 this consumer world more so even then as a practitioner NOTE Confidence: 0.8739422559738159 00:33:07.835 --> 00:33:08.279 anymore. NOTE Confidence: 0.9561612606048584 00:33:08.440 --> 00:33:10.120 And so that's really an interesting piece. NOTE Confidence: 0.885765552520752 00:33:10.120 --> 00:33:12.221 And I kind of said it a little bit before, NOTE Confidence: 0.885765552520752 00:33:12.271 --> 00:33:15.173 the foundation of the house, if that's data technology and NOTE Confidence: 0.885765552520752 00:33:15.223 --> 00:33:17.725 platforms and we know that it grows at this really NOTE Confidence: 0.885765552520752 00:33:17.775 --> 00:33:20.627 exponential rate, how does that affect the House of where NOTE Confidence: 0.885765552520752 00:33:20.678 --> 00:33:22.979 we're living and then the roof of the house as NOTE Confidence: 0.885765552520752 00:33:23.029 --> 00:33:23.279 well. NOTE Confidence: 0.8770846724510193 00:33:23.280 --> 00:33:27.694 So there's that whole component to consider, not only just NOTE Confidence: 0.8770846724510193 00:33:27.770 --> 00:33:31.880 AI in this practitioner space, but in the actual whole NOTE Confidence: 0.8770846724510193 00:33:31.957 --> 00:33:35.838 of how that consumer, how it's leveling up from the NOTE Confidence: 0.8770846724510193 00:33:35.914 --> 00:33:36.600 consumer. NOTE Confidence: 0.8875023722648621 00:33:36.880 --> 00:33:40.252 And will that actually change the special this the big NOTE Confidence: 0.8875023722648621 00:33:40.315 --> 00:33:44.062 block healthcare systems into more specialty care is where I NOTE Confidence: 0.8875023722648621 00:33:44.125 --> 00:33:47.935 actually have some thoughts about how that actually moves and NOTE Confidence: 0.8875023722648621 00:33:47.997 --> 00:33:51.183 then it informs how we make our business models and NOTE Confidence: 0.8875023722648621 00:33:51.245 --> 00:33:52.120 our decisions. NOTE Confidence: 0.8077876567840576 00:33:53.480 --> 00:33:54.320 Makes a lot of sense. NOTE Confidence: 0.8582382798194885 00:33:54.680 --> 00:33:57.232 You know, there's so much promise for, for AI out NOTE Confidence: 0.8582382798194885 00:33:57.284 --> 00:34:00.566 there, obviously for individual patient care, but also for, for NOTE Confidence: 0.8582382798194885 00:34:00.618 --> 00:34:01.399 community care. NOTE Confidence: 0.9395890235900879 00:34:01.400 --> 00:34:04.242 And, and certainly the way we think about it is NOTE Confidence: 0.9395890235900879 00:34:04.302 --> 00:34:07.023 how do we take care in the community that can NOTE Confidence: 0.9395890235900879 00:34:07.084 --> 00:34:10.893 be somewhat fragmented, disjointed and actually use AI to bring NOTE Confidence: 0.9395890235900879 00:34:10.954 --> 00:34:11.680 it together. NOTE Confidence: 0.8983092308044434 00:34:11.680 --> 00:34:14.186 So there's so much data out there about a given NOTE Confidence: 0.8983092308044434 00:34:14.239 --> 00:34:17.973 patient from their hospitalization stay to their cardiologist visit to NOTE Confidence: 0.8983092308044434 00:34:18.026 --> 00:34:19.359 their nephrologist visit. NOTE Confidence: 0.8767774701118469 00:34:19.360 --> 00:34:21.746 And how do we use AI to package that and NOTE Confidence: 0.8767774701118469 00:34:21.805 --> 00:34:25.385 make it succinct so that the hospital doc, the nephrologist, NOTE Confidence: 0.8767774701118469 00:34:25.444 --> 00:34:29.740 the cardiologist, the endocrinologist, etcetera, are all seeing the same NOTE Confidence: 0.8767774701118469 00:34:29.799 --> 00:34:32.305 data at the same time so that we can break NOTE Confidence: 0.8767774701118469 00:34:32.364 --> 00:34:35.466 down those silos and, and, and help improve care for NOTE Confidence: 0.8767774701118469 00:34:35.526 --> 00:34:40.120 patients, ultimately providing clinical recommendations to providers as well. NOTE Confidence: 0.900612473487854 00:34:40.120 --> 00:34:43.338 Hey, we know this about the patient taking into into NOTE Confidence: 0.900612473487854 00:34:43.400 --> 00:34:46.928 context, not just their clinical care, but their care out NOTE Confidence: 0.900612473487854 00:34:46.989 --> 00:34:50.270 in their community, what they do for a living, things NOTE Confidence: 0.900612473487854 00:34:50.332 --> 00:34:53.550 along those lines and putting it together so that we NOTE Confidence: 0.900612473487854 00:34:53.612 --> 00:34:57.758 can help provide recommendations to physicians about ways that they NOTE Confidence: 0.900612473487854 00:34:57.820 --> 00:35:01.101 can continue to augment the care that they provide to NOTE Confidence: 0.900612473487854 00:35:01.162 --> 00:35:01.719 patients. NOTE Confidence: 0.9152519702911377 00:35:01.719 --> 00:35:05.239 And then certainly with patient engagement, trying to do things NOTE Confidence: 0.9152519702911377 00:35:05.295 --> 00:35:09.429 like Doctor Crank mentioned, putting information at a patient's fingertips NOTE Confidence: 0.9152519702911377 00:35:09.485 --> 00:35:12.111 when they need it, where they need it, how they NOTE Confidence: 0.9152519702911377 00:35:12.167 --> 00:35:15.631 need it, so that they can consume information about themselves NOTE Confidence: 0.9152519702911377 00:35:15.686 --> 00:35:18.703 or about the illness that they're trying to prevent or NOTE Confidence: 0.9152519702911377 00:35:18.759 --> 00:35:21.329 trying to treat so that they can be engaged in NOTE Confidence: 0.9152519702911377 00:35:21.385 --> 00:35:21.999 their care. NOTE Confidence: 0.9147863388061523 00:35:22.000 --> 00:35:25.157 So really, really exciting with all that is to come, NOTE Confidence: 0.9147863388061523 00:35:25.217 --> 00:35:28.375 both at a community level and certainly at a patient NOTE Confidence: 0.9147863388061523 00:35:28.435 --> 00:35:28.800 level. NOTE Confidence: 0.8306936621665955 00:35:29.280 --> 00:35:32.239 We've been talking obviously about the work that the AHA NOTE Confidence: 0.8306936621665955 00:35:32.291 --> 00:35:35.092 does, the ADA and YMCA and DaVita, But ultimately, in NOTE Confidence: 0.8306936621665955 00:35:35.145 --> 00:35:38.104 many ways, we're all working together, or at least we're NOTE Confidence: 0.8306936621665955 00:35:38.157 --> 00:35:41.063 trying to, to get to the same outcome, better community NOTE Confidence: 0.8306936621665955 00:35:41.116 --> 00:35:42.120 health initiatives. NOTE Confidence: 0.9253984689712524 00:35:42.120 --> 00:35:44.943 So would love to hear from you all about what NOTE Confidence: 0.9253984689712524 00:35:45.006 --> 00:35:48.520 good collaboration looks like and why it's so important. NOTE Confidence: 0.8271535038948059 00:35:48.520 --> 00:35:51.415 And, and maybe Giuliana, I'll start to start with you, NOTE Confidence: 0.8271535038948059 00:35:51.469 --> 00:35:54.794 how collaborating with others is helping you move your message NOTE Confidence: 0.8271535038948059 00:35:54.847 --> 00:35:57.529 for further in terms of good heart health and good NOTE Confidence: 0.8271535038948059 00:35:57.582 --> 00:35:58.279 brain health. NOTE Confidence: 0.40149974822998047 00:35:58.880 --> 00:35:59.960 Yeah, absolutely. NOTE Confidence: 0.8127232193946838 00:35:59.960 --> 00:36:02.017 I mean, I think, you know, we of course have NOTE Confidence: 0.8127232193946838 00:36:02.064 --> 00:36:04.168 this list of guiding values at the top of the NOTE Confidence: 0.8127232193946838 00:36:04.215 --> 00:36:06.600 list is powerful partnerships for the organization. NOTE Confidence: 0.9388484954833984 00:36:06.600 --> 00:36:09.416 And so we recognize that our mission and vision is NOTE Confidence: 0.9388484954833984 00:36:09.473 --> 00:36:12.909 large to create this world free of cardiovascular disease and NOTE Confidence: 0.9388484954833984 00:36:12.965 --> 00:36:13.360 stroke. NOTE Confidence: 0.9501998424530029 00:36:13.360 --> 00:36:15.040 And we certainly cannot do that alone. NOTE Confidence: 0.8825023770332336 00:36:15.040 --> 00:36:17.824 So it's kind of I think built into our ethos NOTE Confidence: 0.8825023770332336 00:36:17.887 --> 00:36:21.241 to work across the lines of of clinical and community NOTE Confidence: 0.8825023770332336 00:36:21.304 --> 00:36:24.847 based organizations, you know, to do this work and it's, NOTE Confidence: 0.8825023770332336 00:36:24.911 --> 00:36:26.240 it's not easy, right? NOTE Confidence: 0.841728687286377 00:36:26.239 --> 00:36:29.140 It takes, you know, it takes time, it takes deliberate NOTE Confidence: 0.841728687286377 00:36:29.194 --> 00:36:32.041 care, it takes an investment, you know, and staff and NOTE Confidence: 0.841728687286377 00:36:32.095 --> 00:36:35.157 infrastructure, but it's truly the only way we get things NOTE Confidence: 0.841728687286377 00:36:35.211 --> 00:36:35.479 done. NOTE Confidence: 0.8828067779541016 00:36:35.480 --> 00:36:38.465 And so we do that at at all levels through NOTE Confidence: 0.8828067779541016 00:36:38.536 --> 00:36:42.516 collaborations nationally and how we do this work and in NOTE Confidence: 0.8828067779541016 00:36:42.587 --> 00:36:43.440 communities. NOTE Confidence: 0.8584517240524292 00:36:43.440 --> 00:36:46.085 And we we find that when we take the time NOTE Confidence: 0.8584517240524292 00:36:46.149 --> 00:36:49.827 to do coalition building and coalition LED work, just the NOTE Confidence: 0.8584517240524292 00:36:49.891 --> 00:36:51.439 the outcomes are better. NOTE Confidence: 0.8460653424263 00:36:51.440 --> 00:36:54.590 I was actually reflecting with Doctor Crank that just by NOTE Confidence: 0.8460653424263 00:36:54.646 --> 00:36:57.740 happenstance, I got a recent report just on Friday from NOTE Confidence: 0.8460653424263 00:36:57.796 --> 00:37:00.834 a collaboration that we've been doing in 11 in markets NOTE Confidence: 0.8460653424263 00:37:00.890 --> 00:37:04.659 across the country on cancer with American Cancer Society, American NOTE Confidence: 0.8460653424263 00:37:04.716 --> 00:37:07.359 Diabetes Association and the Heart Association. NOTE Confidence: 0.912097156047821 00:37:07.680 --> 00:37:10.578 And just looking at some of the outcomes from that NOTE Confidence: 0.912097156047821 00:37:10.636 --> 00:37:13.940 work is just by us partnering together as 3 organizations NOTE Confidence: 0.912097156047821 00:37:13.998 --> 00:37:17.244 focused on prevention and screening, we were able to see NOTE Confidence: 0.912097156047821 00:37:17.302 --> 00:37:21.011 referrals and community to community care triple, you know, from NOTE Confidence: 0.912097156047821 00:37:21.069 --> 00:37:24.199 where they were before and screening things like that. NOTE Confidence: 0.8585038185119629 00:37:24.200 --> 00:37:27.919 So really strong, impressive results that I believe are really NOTE Confidence: 0.8585038185119629 00:37:27.979 --> 00:37:30.919 attributed the fact that we took the the time and NOTE Confidence: 0.8585038185119629 00:37:30.979 --> 00:37:33.799 care to partner to hear voices at the table, to NOTE Confidence: 0.8585038185119629 00:37:33.859 --> 00:37:37.279 build coalitions and to lift up community voices that are NOTE Confidence: 0.8585038185119629 00:37:37.339 --> 00:37:40.579 really local that don't always have the capacity to do NOTE Confidence: 0.8585038185119629 00:37:40.639 --> 00:37:43.879 what we have and and really focus on capacity building NOTE Confidence: 0.8585038185119629 00:37:43.939 --> 00:37:46.519 there, you know, and bringing that forward. NOTE Confidence: 0.8620254397392273 00:37:46.520 --> 00:37:49.092 And one other, you know, note from this report that NOTE Confidence: 0.8620254397392273 00:37:49.142 --> 00:37:51.664 again, just came right in time to think about this NOTE Confidence: 0.8620254397392273 00:37:51.714 --> 00:37:54.639 conversation today is policy was really important locally. NOTE Confidence: 0.871412456035614 00:37:54.640 --> 00:37:56.785 We wanted to bring the the power that we have NOTE Confidence: 0.871412456035614 00:37:56.832 --> 00:37:59.406 as an organization that can work at federal, state and NOTE Confidence: 0.871412456035614 00:37:59.454 --> 00:38:02.743 community levels and policy and equips organizations in the community NOTE Confidence: 0.871412456035614 00:38:02.791 --> 00:38:05.174 that may not have had that experience before to do NOTE Confidence: 0.871412456035614 00:38:05.222 --> 00:38:06.080 that kind of work. NOTE Confidence: 0.9362502694129944 00:38:06.080 --> 00:38:08.520 So we are hearing their voices now that we have NOTE Confidence: 0.9362502694129944 00:38:08.572 --> 00:38:11.739 done this work together, they feel equipped to sustain policy NOTE Confidence: 0.9362502694129944 00:38:11.791 --> 00:38:14.439 building, you know, maybe without us in the future. NOTE Confidence: 0.8370084762573242 00:38:14.440 --> 00:38:17.024 And so we were able to build capacity into communities NOTE Confidence: 0.8370084762573242 00:38:17.072 --> 00:38:19.513 and sustain because we took the time and the effort NOTE Confidence: 0.8370084762573242 00:38:19.561 --> 00:38:21.811 to start from the beginning and plan it all and NOTE Confidence: 0.8370084762573242 00:38:21.859 --> 00:38:22.960 and see it all through. NOTE Confidence: 0.823567271232605 00:38:22.960 --> 00:38:25.397 So it's, I think it's just built into the ethos NOTE Confidence: 0.823567271232605 00:38:25.448 --> 00:38:27.937 of how we will do work because just outcomes are NOTE Confidence: 0.823567271232605 00:38:27.989 --> 00:38:29.960 always better when we when we partner. NOTE Confidence: 0.9012147188186646 00:38:31.800 --> 00:38:34.444 Definite wisdom in the adage that if you want to NOTE Confidence: 0.9012147188186646 00:38:34.499 --> 00:38:36.648 go fast, go alone and if you want to go NOTE Confidence: 0.9012147188186646 00:38:36.703 --> 00:38:37.639 far, go together. NOTE Confidence: 0.8657057285308838 00:38:37.920 --> 00:38:41.915 So appreciate, appreciate that Doctor Crank same, same question to NOTE Confidence: 0.8657057285308838 00:38:41.976 --> 00:38:45.063 you in terms of of collaboration and how that helps NOTE Confidence: 0.8657057285308838 00:38:45.124 --> 00:38:46.879 the ADA augment your message. NOTE Confidence: 0.960457444190979 00:38:47.400 --> 00:38:49.080 Yeah, absolutely. NOTE Confidence: 0.8802127242088318 00:38:49.480 --> 00:38:52.899 And the example Juliana just uses is just a beautiful NOTE Confidence: 0.8802127242088318 00:38:52.964 --> 00:38:57.287 example of collaboration at multiple levels, right, Because we have NOTE Confidence: 0.8802127242088318 00:38:57.352 --> 00:39:01.933 collaboration between our organizations and our partnerships that we do NOTE Confidence: 0.8802127242088318 00:39:01.997 --> 00:39:06.063 professionally where we can bring together all of our expertise NOTE Confidence: 0.8802127242088318 00:39:06.127 --> 00:39:07.159 and the science. NOTE Confidence: 0.929237961769104 00:39:07.160 --> 00:39:10.568 And then we have partnership at the community level where NOTE Confidence: 0.929237961769104 00:39:10.627 --> 00:39:14.574 we can then that project that Juliana mentioned, the collaboration NOTE Confidence: 0.929237961769104 00:39:14.633 --> 00:39:18.460 for Equitable Health, we partnered as organizations, but then we NOTE Confidence: 0.929237961769104 00:39:18.520 --> 00:39:21.928 partnered at the local level where we had impact partners NOTE Confidence: 0.929237961769104 00:39:21.988 --> 00:39:25.336 in each of these communities locally that then can bring NOTE Confidence: 0.929237961769104 00:39:25.396 --> 00:39:28.684 the trust and bring the reach and bring the connections NOTE Confidence: 0.929237961769104 00:39:28.744 --> 00:39:30.000 to community members. NOTE Confidence: 0.8624399304389954 00:39:30.280 --> 00:39:33.424 And so when you get all of that together, you NOTE Confidence: 0.8624399304389954 00:39:33.494 --> 00:39:36.360 see the the success that Giuliana shared. NOTE Confidence: 0.88636714220047 00:39:36.360 --> 00:39:39.854 So again, it the collaboration is definitely important, but at NOTE Confidence: 0.88636714220047 00:39:39.910 --> 00:39:42.616 multiple levels is the only thing I will kind of NOTE Confidence: 0.88636714220047 00:39:42.672 --> 00:39:43.799 tease out from that. NOTE Confidence: 0.9125090837478638 00:39:43.800 --> 00:39:46.559 We want to make sure that, you know, as far NOTE Confidence: 0.9125090837478638 00:39:46.623 --> 00:39:50.153 as ADA, we partner and all levels and it's tremendously NOTE Confidence: 0.9125090837478638 00:39:50.217 --> 00:39:54.389 important to make sure we're amplifying those partnerships at the NOTE Confidence: 0.9125090837478638 00:39:54.453 --> 00:39:55.480 community level. NOTE Confidence: 0.8057305812835693 00:39:56.960 --> 00:39:57.600 Absolutely. NOTE Confidence: 0.8980382084846497 00:39:58.239 --> 00:40:00.883 Doctor Winters, I mean, we do a lot of collaborating NOTE Confidence: 0.8980382084846497 00:40:00.933 --> 00:40:03.424 together and, and, and I love it because we bring NOTE Confidence: 0.8980382084846497 00:40:03.475 --> 00:40:06.423 our expertise and you bring your expertise and they're not NOTE Confidence: 0.8980382084846497 00:40:06.474 --> 00:40:07.440 the same expertise. NOTE Confidence: 0.8604719042778015 00:40:07.600 --> 00:40:10.461 And, and it's, it's highly complimentary, but would love to NOTE Confidence: 0.8604719042778015 00:40:10.509 --> 00:40:12.691 hear how you think about it with, with all of NOTE Confidence: 0.8604719042778015 00:40:12.740 --> 00:40:14.679 the organizations that you partner with. NOTE Confidence: 0.8320239186286926 00:40:14.680 --> 00:40:17.582 Sometimes you're the impact partner to use Doctor Crank's term NOTE Confidence: 0.8320239186286926 00:40:17.629 --> 00:40:20.298 and, and sometimes others in the community are the impact NOTE Confidence: 0.8320239186286926 00:40:20.345 --> 00:40:20.719 partner. NOTE Confidence: 0.978050708770752 00:40:20.920 --> 00:40:21.880 How do you think about that? NOTE Confidence: 0.8446850180625916 00:40:22.480 --> 00:40:25.000 Yeah, I think Doctor Crank said it really well. NOTE Confidence: 0.7646447420120239 00:40:25.000 --> 00:40:26.880 It's layered and it's teamwork. NOTE Confidence: 0.9180740714073181 00:40:26.880 --> 00:40:29.827 It's it's partnership, but partnership ought to be defined so NOTE Confidence: 0.9180740714073181 00:40:29.875 --> 00:40:32.146 that it is sustainable so that it's not, if you NOTE Confidence: 0.9180740714073181 00:40:32.195 --> 00:40:35.142 will, throwing spaghetti against the wall and then not having NOTE Confidence: 0.9180740714073181 00:40:35.190 --> 00:40:37.606 it there the next year for those folks that needed NOTE Confidence: 0.9180740714073181 00:40:37.655 --> 00:40:37.799 it. NOTE Confidence: 0.8976991176605225 00:40:38.600 --> 00:40:40.634 So, So one of the first things to do, as NOTE Confidence: 0.8976991176605225 00:40:40.685 --> 00:40:43.635 I mentioned a little earlier, was really create a business NOTE Confidence: 0.8976991176605225 00:40:43.686 --> 00:40:46.280 model behind it to make sure that it's sustainable. NOTE Confidence: 0.7443416118621826 00:40:46.280 --> 00:40:48.600 And I love that Giuliana was talking about that. NOTE Confidence: 0.865261435508728 00:40:48.600 --> 00:40:51.480 It's at the federal, the state and the community level. NOTE Confidence: 0.914516270160675 00:40:51.480 --> 00:40:54.373 So that actually needs to be intrinsic part of this NOTE Confidence: 0.914516270160675 00:40:54.430 --> 00:40:56.360 business matrix as you go forward. NOTE Confidence: 0.8940212726593018 00:40:56.680 --> 00:40:59.764 And that's oftentimes what we see with a community based NOTE Confidence: 0.8940212726593018 00:40:59.819 --> 00:41:03.344 organization is sometimes we're a little smaller and maybe don't NOTE Confidence: 0.8940212726593018 00:41:03.399 --> 00:41:06.484 have that kind of sophistication or savvy from the front NOTE Confidence: 0.8940212726593018 00:41:06.539 --> 00:41:06.759 end. NOTE Confidence: 0.9193795919418335 00:41:06.760 --> 00:41:10.066 And so helping that community based organization to build that NOTE Confidence: 0.9193795919418335 00:41:10.119 --> 00:41:10.279 up. NOTE Confidence: 0.9257858395576477 00:41:10.280 --> 00:41:13.185 In order to do that, I think it's really important NOTE Confidence: 0.9257858395576477 00:41:13.243 --> 00:41:15.799 for the other partners to win in it as well. NOTE Confidence: 0.893017053604126 00:41:16.040 --> 00:41:19.212 One of the examples of that is with with you NOTE Confidence: 0.893017053604126 00:41:19.284 --> 00:41:21.520 Doctor G and DaVita, of course. NOTE Confidence: 0.8972891569137573 00:41:21.520 --> 00:41:25.351 And so in the commute, the collaborative community kidney health NOTE Confidence: 0.8972891569137573 00:41:25.411 --> 00:41:29.661 program, say that five times fast collaborative community kidney health NOTE Confidence: 0.8972891569137573 00:41:29.721 --> 00:41:30.560 program there. NOTE Confidence: 0.8441335558891296 00:41:30.560 --> 00:41:30.920 I got it. NOTE Confidence: 0.8151652216911316 00:41:31.520 --> 00:41:35.577 We've built that partnership with DaVita and launching across seven NOTE Confidence: 0.8151652216911316 00:41:35.638 --> 00:41:38.000 of our large YMCA's across the country. NOTE Confidence: 0.9371868968009949 00:41:38.280 --> 00:41:42.079 And that's all about closing the gap between the kidney NOTE Confidence: 0.9371868968009949 00:41:42.149 --> 00:41:47.607 health education, empowering early risk detection, really letting the community NOTE Confidence: 0.9371868968009949 00:41:47.676 --> 00:41:50.992 know that this is a key piece for decreasing CKD NOTE Confidence: 0.9371868968009949 00:41:51.061 --> 00:41:51.959 risk factors. NOTE Confidence: 0.9527904391288757 00:41:52.200 --> 00:41:53.840 And so this is a really powerful thing. NOTE Confidence: 0.8554790019989014 00:41:53.840 --> 00:41:56.713 And what we did was we actually had conversations at NOTE Confidence: 0.8554790019989014 00:41:56.768 --> 00:41:59.752 the national level and then we found local YMCA's that NOTE Confidence: 0.8554790019989014 00:41:59.807 --> 00:42:02.569 were really needing it, such as in Baton Rouge, as NOTE Confidence: 0.8554790019989014 00:42:02.625 --> 00:42:05.829 you just mentioned earlier in the call, call where there's NOTE Confidence: 0.8554790019989014 00:42:05.885 --> 00:42:08.039 a really high prevalence of this issue. NOTE Confidence: 0.8884461522102356 00:42:08.320 --> 00:42:11.099 And so we were able to layer that over market, NOTE Confidence: 0.8884461522102356 00:42:11.160 --> 00:42:13.758 market map it to see where the need was and NOTE Confidence: 0.8884461522102356 00:42:13.819 --> 00:42:16.720 then drop that down into our local associations. NOTE Confidence: 0.8922271132469177 00:42:16.920 --> 00:42:19.947 But that was really part of the strategic business plan NOTE Confidence: 0.8922271132469177 00:42:20.002 --> 00:42:22.369 in order to do that so that we can actually NOTE Confidence: 0.8922271132469177 00:42:22.424 --> 00:42:25.287 see that it achieves more health outcomes and it and NOTE Confidence: 0.8922271132469177 00:42:25.342 --> 00:42:28.040 reaches more lives than we have thought possible. NOTE Confidence: 0.8682188391685486 00:42:29.320 --> 00:42:31.475 I want to dig into that a little bit because NOTE Confidence: 0.8682188391685486 00:42:31.524 --> 00:42:33.680 this, this more health outcomes, more lives. NOTE Confidence: 0.9744402170181274 00:42:34.000 --> 00:42:35.520 That really is the theme here. NOTE Confidence: 0.9431408643722534 00:42:35.520 --> 00:42:37.619 So on the one hand, we started out by saying, NOTE Confidence: 0.9431408643722534 00:42:37.666 --> 00:42:38.599 look, care is local. NOTE Confidence: 0.9634531736373901 00:42:38.600 --> 00:42:40.943 You got to know the individual community and what works NOTE Confidence: 0.9634531736373901 00:42:40.986 --> 00:42:43.159 in one community may not work in another community. NOTE Confidence: 0.9773939847946167 00:42:43.360 --> 00:42:44.680 I think we would all agree with that. NOTE Confidence: 0.8963826894760132 00:42:45.200 --> 00:42:47.316 And then I had a question and, and one of NOTE Confidence: 0.8963826894760132 00:42:47.368 --> 00:42:50.568 our audience members, Rahul Rosden, had a question that's kind NOTE Confidence: 0.8963826894760132 00:42:50.620 --> 00:42:51.239 of the same. NOTE Confidence: 0.9114953875541687 00:42:51.239 --> 00:42:53.369 So I'll, I'll pose it to you using both of NOTE Confidence: 0.9114953875541687 00:42:53.420 --> 00:42:55.600 our words, which is if care is so local and NOTE Confidence: 0.9114953875541687 00:42:55.651 --> 00:42:58.440 we've got to be focused on an individual community, but NOTE Confidence: 0.9114953875541687 00:42:58.491 --> 00:43:01.280 we want to have impact across the entire United States. NOTE Confidence: 0.8172369003295898 00:43:01.280 --> 00:43:03.872 And in our case, not just at 7 YMCA's, but NOTE Confidence: 0.8172369003295898 00:43:03.934 --> 00:43:06.280 ultimately at lots and lots of YMCA's. NOTE Confidence: 0.9229456186294556 00:43:06.720 --> 00:43:08.200 How do we actually scale this? NOTE Confidence: 0.8839049339294434 00:43:08.200 --> 00:43:10.216 So how do we take what we learn in an NOTE Confidence: 0.8839049339294434 00:43:10.271 --> 00:43:13.760 individual community and then move it beyond just that community NOTE Confidence: 0.8839049339294434 00:43:13.814 --> 00:43:16.213 and scale it in a manner that truly makes an NOTE Confidence: 0.8839049339294434 00:43:16.267 --> 00:43:19.647 impact for healthcare across the country and maybe even across NOTE Confidence: 0.8839049339294434 00:43:19.702 --> 00:43:20.520 plus the globe? NOTE Confidence: 0.7657323479652405 00:43:20.520 --> 00:43:22.865 So maybe I'll just go back to you, Doctor Winters NOTE Confidence: 0.7657323479652405 00:43:22.912 --> 00:43:24.874 and and ask you that and we'll go over to NOTE Confidence: 0.7657323479652405 00:43:24.922 --> 00:43:25.879 Juliana and then Dr. NOTE Confidence: 0.6711139678955078 00:43:25.880 --> 00:43:26.160 Crank. NOTE Confidence: 0.8914288878440857 00:43:26.760 --> 00:43:28.120 Yeah, love it, love it, love it, right? NOTE Confidence: 0.84255450963974 00:43:28.120 --> 00:43:31.652 Because what we haven't done, and I say we the NOTE Confidence: 0.84255450963974 00:43:31.728 --> 00:43:35.875 YMCA historically, we're now going to be 175 years old NOTE Confidence: 0.84255450963974 00:43:35.952 --> 00:43:36.719 next year. NOTE Confidence: 0.788811445236206 00:43:36.920 --> 00:43:41.040 What we haven't done historically and 2700 locations within 70. NOTE Confidence: 0.699237048625946 00:43:41.160 --> 00:43:43.007 J is only 100 years old, so you guys, you NOTE Confidence: 0.699237048625946 00:43:43.052 --> 00:43:44.720 know, you got some catching up to do. NOTE Confidence: 0.9212677478790283 00:43:46.280 --> 00:43:48.753 And I mean, if we're within 73% of any given NOTE Confidence: 0.9212677478790283 00:43:48.809 --> 00:43:51.956 community across the country, like we need to figure out NOTE Confidence: 0.9212677478790283 00:43:52.012 --> 00:43:55.216 how we can create an engine that actually measures health NOTE Confidence: 0.9212677478790283 00:43:55.272 --> 00:43:57.239 and Wellness and prevention, right? NOTE Confidence: 0.869340181350708 00:43:57.239 --> 00:43:59.697 We have a hard enough time measuring sick care and NOTE Confidence: 0.869340181350708 00:43:59.746 --> 00:44:00.679 the outcomes there. NOTE Confidence: 0.9177216291427612 00:44:00.760 --> 00:44:02.240 How do we measure health and Wellness? NOTE Confidence: 0.9215832352638245 00:44:02.239 --> 00:44:05.542 And we all know that it works to eat healthy, NOTE Confidence: 0.9215832352638245 00:44:05.616 --> 00:44:10.239 have healthy lifestyles, have good, all of these things, right? NOTE Confidence: 0.7819244861602783 00:44:10.320 --> 00:44:12.000 Behavior of physical, socioeconomic factors. NOTE Confidence: 0.972912609577179 00:44:12.000 --> 00:44:13.320 How do we actually measure for that? NOTE Confidence: 0.8657869100570679 00:44:13.760 --> 00:44:15.925 And so one of the things that we've done is NOTE Confidence: 0.8657869100570679 00:44:15.976 --> 00:44:18.847 create an engine that actually centralizes for all of our NOTE Confidence: 0.8657869100570679 00:44:18.897 --> 00:44:19.199 YMCAS. NOTE Confidence: 0.9086872339248657 00:44:19.200 --> 00:44:21.908 It's a shared service engine and that is part of NOTE Confidence: 0.9086872339248657 00:44:21.964 --> 00:44:25.180 that business model that I keep alluding to that actually NOTE Confidence: 0.9086872339248657 00:44:25.237 --> 00:44:27.720 allows us to centralized within that engine. NOTE Confidence: 0.9380248785018921 00:44:27.840 --> 00:44:30.800 We actually have an electronic Wellness record system. NOTE Confidence: 0.6483296155929565 00:44:30.920 --> 00:44:34.400 So everybody knows an EHR, you know an EMR, right? NOTE Confidence: 0.9271678924560547 00:44:34.560 --> 00:44:37.629 This was actually created for us as a community based NOTE Confidence: 0.9271678924560547 00:44:37.687 --> 00:44:38.439 organization. NOTE Confidence: 0.92513108253479 00:44:38.440 --> 00:44:41.356 It's really the same thing, but it's an electronic Wellness NOTE Confidence: 0.92513108253479 00:44:41.406 --> 00:44:43.680 record system that can actually grab outcomes. NOTE Confidence: 0.9347857236862183 00:44:44.000 --> 00:44:46.647 So this is the piece that as we work together NOTE Confidence: 0.9347857236862183 00:44:46.705 --> 00:44:49.823 with all of you, we can actually centralized that not NOTE Confidence: 0.9347857236862183 00:44:49.882 --> 00:44:52.764 just for one association, not just for all 7, but NOTE Confidence: 0.9347857236862183 00:44:52.823 --> 00:44:54.999 all of the YS that are participating. NOTE Confidence: 0.9052214622497559 00:44:55.200 --> 00:44:57.836 And this is obviously not just for the YMCA, it NOTE Confidence: 0.9052214622497559 00:44:57.892 --> 00:45:01.089 can be for other community based organizations so that we NOTE Confidence: 0.9052214622497559 00:45:01.145 --> 00:45:05.463 can actually extrapolate this information, health and Wellness and prevention NOTE Confidence: 0.9052214622497559 00:45:05.519 --> 00:45:08.604 data connected over to sick care data and actually show NOTE Confidence: 0.9052214622497559 00:45:08.660 --> 00:45:11.969 we're decreasing the cost of sick care, we're improving the NOTE Confidence: 0.9052214622497559 00:45:12.025 --> 00:45:14.998 health of these folks that are costing $25,000 a year NOTE Confidence: 0.9052214622497559 00:45:15.054 --> 00:45:16.120 and surplus, right. NOTE Confidence: 0.9406800866127014 00:45:16.320 --> 00:45:18.682 That's really going to be where the power of the NOTE Confidence: 0.9406800866127014 00:45:18.731 --> 00:45:20.798 future of health is if and when and we are NOTE Confidence: 0.9406800866127014 00:45:20.847 --> 00:45:23.799 starting to do that, being able to connect that information. NOTE Confidence: 0.8858875632286072 00:45:24.000 --> 00:45:27.063 And hopefully, I don't know that it will change our NOTE Confidence: 0.8858875632286072 00:45:27.124 --> 00:45:30.007 $4.9 trillion spend, but what I think it will do NOTE Confidence: 0.8858875632286072 00:45:30.067 --> 00:45:33.251 was actually help to increase what we are spending in NOTE Confidence: 0.8858875632286072 00:45:33.311 --> 00:45:36.556 the health and Wellness and prevention to make it more NOTE Confidence: 0.8858875632286072 00:45:36.616 --> 00:45:39.560 powerful for that downstream sick care component. NOTE Confidence: 0.7986692190170288 00:45:41.960 --> 00:45:44.577 Well, same question to you Juliana, in terms of of NOTE Confidence: 0.7986692190170288 00:45:44.630 --> 00:45:45.520 getting to scale. NOTE Confidence: 0.774259626865387 00:45:46.040 --> 00:45:48.118 Yeah, it's, it's a question and that was amazing to NOTE Confidence: 0.774259626865387 00:45:48.158 --> 00:45:50.236 hear Doctor Winters, I'm so excited to hear kind of NOTE Confidence: 0.774259626865387 00:45:50.277 --> 00:45:52.070 what we were being able to build from a data NOTE Confidence: 0.774259626865387 00:45:52.111 --> 00:45:52.600 perspective. NOTE Confidence: 0.8645567893981934 00:45:52.600 --> 00:45:54.440 I'm hoping we can chat more offline about that. NOTE Confidence: 0.8956927061080933 00:45:54.440 --> 00:45:57.027 But the way I we think about this a lot NOTE Confidence: 0.8956927061080933 00:45:57.094 --> 00:46:01.407 like what's that balance of systematic delivery and the framework NOTE Confidence: 0.8956927061080933 00:46:01.473 --> 00:46:04.526 that we need for collab for a local, you know, NOTE Confidence: 0.8956927061080933 00:46:04.592 --> 00:46:05.920 local customization. NOTE Confidence: 0.7841452956199646 00:46:05.920 --> 00:46:08.033 And so some of the ways in which we really NOTE Confidence: 0.7841452956199646 00:46:08.083 --> 00:46:10.750 think about that, and we're, we're doing this in our, NOTE Confidence: 0.7841452956199646 00:46:10.800 --> 00:46:13.517 our cardio kidney metabolic health now is kind of mega NOTE Confidence: 0.7841452956199646 00:46:13.567 --> 00:46:13.920 pilots. NOTE Confidence: 0.8352781534194946 00:46:13.920 --> 00:46:16.534 You know, we have a long history in clinical quality NOTE Confidence: 0.8352781534194946 00:46:16.584 --> 00:46:20.203 improvement and working across healthcare systems to improve measures on NOTE Confidence: 0.8352781534194946 00:46:20.254 --> 00:46:23.169 quality of care for coronary artery disease and stroke and NOTE Confidence: 0.8352781534194946 00:46:23.219 --> 00:46:25.079 heart failure and these other things. NOTE Confidence: 0.899409830570221 00:46:25.080 --> 00:46:27.705 And now we're embarking on this journey with cardio kidney NOTE Confidence: 0.899409830570221 00:46:27.750 --> 00:46:28.519 metabolic health. NOTE Confidence: 0.9423162341117859 00:46:28.920 --> 00:46:31.501 And so we do this work through a clinical quality NOTE Confidence: 0.9423162341117859 00:46:31.554 --> 00:46:34.399 improvement program that rolls out across the country. NOTE Confidence: 0.8824946284294128 00:46:34.400 --> 00:46:37.800 Well, for now, we're working in 15 geographic regions. NOTE Confidence: 0.8103169202804565 00:46:37.800 --> 00:46:41.436 I can't say cities because in rural we're taking kind NOTE Confidence: 0.8103169202804565 00:46:41.504 --> 00:46:45.003 of swaths of the country, but largely 15 markets or NOTE Confidence: 0.8103169202804565 00:46:45.072 --> 00:46:49.188 areas of rural communities with enough variation to test the NOTE Confidence: 0.8103169202804565 00:46:49.256 --> 00:46:49.599 work. NOTE Confidence: 0.8382424712181091 00:46:49.600 --> 00:46:52.325 And so test to test the delivery of quality improvement NOTE Confidence: 0.8382424712181091 00:46:52.375 --> 00:46:56.042 programming and gathering the healthcare systems that are participating in NOTE Confidence: 0.8382424712181091 00:46:56.091 --> 00:46:58.519 learning collaboratives to learn from each other. NOTE Confidence: 0.8879205584526062 00:46:58.520 --> 00:47:00.470 So we're able to figure out what is the right NOTE Confidence: 0.8879205584526062 00:47:00.514 --> 00:47:03.158 level of customization that needs to happen in the healthcare NOTE Confidence: 0.8879205584526062 00:47:03.201 --> 00:47:05.889 system and what are the commonalities that we're learning that NOTE Confidence: 0.8879205584526062 00:47:05.932 --> 00:47:08.360 can be more systematically delivered to figure that out. NOTE Confidence: 0.8389120101928711 00:47:08.360 --> 00:47:10.438 And so if we can do this in this mega NOTE Confidence: 0.8389120101928711 00:47:10.494 --> 00:47:13.639 pilot type fashion where we have, you know, 100 hundreds NOTE Confidence: 0.8389120101928711 00:47:13.695 --> 00:47:16.785 of 150 or so healthcare systems that are operating like NOTE Confidence: 0.8389120101928711 00:47:16.841 --> 00:47:19.930 this and sharing best practices, we're able to suss out NOTE Confidence: 0.8389120101928711 00:47:19.986 --> 00:47:21.840 the systematic parts of delivery. NOTE Confidence: 0.8798704743385315 00:47:22.080 --> 00:47:25.361 And then where there is need for local customization for NOTE Confidence: 0.8798704743385315 00:47:25.419 --> 00:47:26.239 the community. NOTE Confidence: 0.7214371562004089 00:47:26.480 --> 00:47:28.342 And we do that in a data back way too NOTE Confidence: 0.7214371562004089 00:47:28.393 --> 00:47:31.212 because of every quality improvement per we roll out has NOTE Confidence: 0.7214371562004089 00:47:31.262 --> 00:47:32.320 a registry behind us. NOTE Confidence: 0.8508335947990417 00:47:32.320 --> 00:47:33.280 There's data there. NOTE Confidence: 0.9182183742523193 00:47:33.520 --> 00:47:36.216 And then we're looking for that sweet spot of the NOTE Confidence: 0.9182183742523193 00:47:36.271 --> 00:47:39.794 consistent delivery and where the community based models need to NOTE Confidence: 0.9182183742523193 00:47:39.849 --> 00:47:41.279 come in for customization. NOTE Confidence: 0.6810000538825989 00:47:42.280 --> 00:47:45.000 Tell you, I I just learned a new word. NOTE Confidence: 0.8704410195350647 00:47:45.000 --> 00:47:48.080 Mega Pilot was not in my vernacular. NOTE Confidence: 0.9030848145484924 00:47:48.080 --> 00:47:49.440 So trust me, I'm stealing. NOTE Confidence: 0.7398190498352051 00:47:49.440 --> 00:47:52.075 That Mega pilot is going to now be a DaVita NOTE Confidence: 0.7398190498352051 00:47:52.136 --> 00:47:53.239 Ease a little bit. NOTE Confidence: 0.8847862482070923 00:47:54.280 --> 00:47:55.802 But I, I think what I hear you saying is, NOTE Confidence: 0.8847862482070923 00:47:55.840 --> 00:47:57.882 look, there's this constant balance and a little bit of NOTE Confidence: 0.8847862482070923 00:47:57.920 --> 00:47:58.440 push and pull. NOTE Confidence: 0.865763783454895 00:47:58.440 --> 00:48:01.000 There's some stuffs that should be standardized and rolled out NOTE Confidence: 0.865763783454895 00:48:01.042 --> 00:48:02.240 to everyone because it works. NOTE Confidence: 0.9317511916160583 00:48:02.239 --> 00:48:04.768 It's a best demonstrated practice and there's no reason to NOTE Confidence: 0.9317511916160583 00:48:04.811 --> 00:48:05.639 reinvent the wheel. NOTE Confidence: 0.9407991170883179 00:48:05.920 --> 00:48:08.851 And then there's stuff that we need to customize, whether NOTE Confidence: 0.9407991170883179 00:48:08.902 --> 00:48:11.937 or not we're in, you know, southern Mississippi or northern NOTE Confidence: 0.9407991170883179 00:48:11.988 --> 00:48:15.228 Massachusetts or somewhere on the West Coast, that depending on NOTE Confidence: 0.9407991170883179 00:48:15.279 --> 00:48:17.954 the community, there's some areas that we we need to NOTE Confidence: 0.9407991170883179 00:48:18.005 --> 00:48:18.519 customize. NOTE Confidence: 0.7805652618408203 00:48:18.880 --> 00:48:21.160 What about for the American Diabetes Association? NOTE Confidence: 0.800775945186615 00:48:21.160 --> 00:48:22.960 Doctor Crank, How do you think about scaling? NOTE Confidence: 0.8107949495315552 00:48:22.960 --> 00:48:26.088 I I just spent time in Chicago at the big NOTE Confidence: 0.8107949495315552 00:48:26.164 --> 00:48:27.919 ADA scientific meeting. NOTE Confidence: 0.8422377705574036 00:48:27.920 --> 00:48:29.880 The scientific sessions were amazing. NOTE Confidence: 0.914243221282959 00:48:29.880 --> 00:48:32.944 So I know how you're scaling to physicians and dietitians, NOTE Confidence: 0.914243221282959 00:48:32.996 --> 00:48:35.480 but how are you scaling more broadly than that? NOTE Confidence: 0.6618555188179016 00:48:35.960 --> 00:48:36.880 Yeah, Yeah. NOTE Confidence: 0.961759090423584 00:48:36.880 --> 00:48:37.960 That's a great question. NOTE Confidence: 0.9204056262969971 00:48:37.960 --> 00:48:42.021 And when we think about scalability, scalability starts really with NOTE Confidence: 0.9204056262969971 00:48:42.081 --> 00:48:45.839 designing programs with equity in mind, right, not just reach. NOTE Confidence: 0.9105229377746582 00:48:46.560 --> 00:48:51.041 And so if an initiative isn't necessarily inclusive or sustainable NOTE Confidence: 0.9105229377746582 00:48:51.109 --> 00:48:55.251 at a local level, replicating that nationally, it's it really NOTE Confidence: 0.9105229377746582 00:48:55.319 --> 00:48:57.560 can amplify the inequities in it. NOTE Confidence: 0.8959155082702637 00:48:57.920 --> 00:49:01.178 So one of the strategies other than what these ladies NOTE Confidence: 0.8959155082702637 00:49:01.240 --> 00:49:04.560 have mentioned is focusing on local capacity building. NOTE Confidence: 0.9292948842048645 00:49:04.560 --> 00:49:08.460 So making sure that when we do the program design NOTE Confidence: 0.9292948842048645 00:49:08.540 --> 00:49:12.600 is anchored in a framework where the process works. NOTE Confidence: 0.9590721130371094 00:49:12.600 --> 00:49:14.399 So you know, kind of zooming out a little bit NOTE Confidence: 0.9590721130371094 00:49:14.439 --> 00:49:15.519 and looking at the process. NOTE Confidence: 0.8909410238265991 00:49:15.520 --> 00:49:18.040 So the details in it may change. NOTE Confidence: 0.9505059123039246 00:49:18.040 --> 00:49:20.777 So if we start with community engagement, you know, what NOTE Confidence: 0.9505059123039246 00:49:20.826 --> 00:49:23.075 we fill in the blank later may change a little NOTE Confidence: 0.9505059123039246 00:49:23.124 --> 00:49:23.320 bit. NOTE Confidence: 0.9195417761802673 00:49:23.320 --> 00:49:27.022 But the process is for us to start with community NOTE Confidence: 0.9195417761802673 00:49:27.097 --> 00:49:32.008 engagement and to start with these qualitative forums where we're NOTE Confidence: 0.9195417761802673 00:49:32.084 --> 00:49:37.600 intentionally engaging communities to build that into the program design. NOTE Confidence: 0.9221618175506592 00:49:38.360 --> 00:49:41.438 Also into the program design, making sure that we're including NOTE Confidence: 0.9221618175506592 00:49:41.488 --> 00:49:42.679 local capacity building. NOTE Confidence: 0.9500011205673218 00:49:42.680 --> 00:49:47.300 So training community health workers, creating a local feedback loop NOTE Confidence: 0.9500011205673218 00:49:47.368 --> 00:49:48.319 that may work. NOTE Confidence: 0.9730935096740723 00:49:48.320 --> 00:49:51.276 You know, you can insert, you know, anything right there, NOTE Confidence: 0.9730935096740723 00:49:51.328 --> 00:49:51.640 right? NOTE Confidence: 0.8819010853767395 00:49:51.640 --> 00:49:55.003 Because it's the, it's the design and it's a model, NOTE Confidence: 0.8819010853767395 00:49:55.069 --> 00:49:59.291 a feedback loop with clinical partners there locally, again both NOTE Confidence: 0.8819010853767395 00:49:59.357 --> 00:50:04.304 qualitative and quantitative, you know, impact measurements that can really NOTE Confidence: 0.8819010853767395 00:50:04.370 --> 00:50:07.799 guide the future of how that program is implemented. NOTE Confidence: 0.9046043157577515 00:50:08.280 --> 00:50:11.556 An example of that is really some community hubs again NOTE Confidence: 0.9046043157577515 00:50:11.616 --> 00:50:15.014 that we're doing with in obesity and the diabetes space, NOTE Confidence: 0.9046043157577515 00:50:15.075 --> 00:50:17.319 but ensuring that the design of that. NOTE Confidence: 0.9508613348007202 00:50:17.320 --> 00:50:19.371 So no matter where we pick it up and do NOTE Confidence: 0.9508613348007202 00:50:19.423 --> 00:50:22.474 it geographically, it may look different at the end result NOTE Confidence: 0.9508613348007202 00:50:22.527 --> 00:50:23.999 of what that hub looks like. NOTE Confidence: 0.9368419647216797 00:50:24.239 --> 00:50:27.704 But the process of how we implement that allows us NOTE Confidence: 0.9368419647216797 00:50:27.773 --> 00:50:30.822 to be able to scale these hubs, you know, in NOTE Confidence: 0.9368419647216797 00:50:30.891 --> 00:50:34.217 a way that our process may work and be effective NOTE Confidence: 0.9368419647216797 00:50:34.286 --> 00:50:36.920 and scalable in different geographies. NOTE Confidence: 0.669008195400238 00:50:38.240 --> 00:50:38.480 Awesome. NOTE Confidence: 0.8980197310447693 00:50:39.040 --> 00:50:41.558 So Doctor Winters, I want to go back to something NOTE Confidence: 0.8980197310447693 00:50:41.609 --> 00:50:44.899 you said earlier, which caught my attention, which is basically, NOTE Confidence: 0.8980197310447693 00:50:44.950 --> 00:50:48.034 I'll probably paraphrase it wrong, but it's moving from sick NOTE Confidence: 0.8980197310447693 00:50:48.086 --> 00:50:48.960 care to WellCare. NOTE Confidence: 0.8725149631500244 00:50:49.239 --> 00:50:52.414 And yeah, Gary Concrete, one of our audience members, brought NOTE Confidence: 0.8725149631500244 00:50:52.466 --> 00:50:53.559 up something similar. NOTE Confidence: 0.910830557346344 00:50:54.520 --> 00:50:58.081 So how are we each thinking about doing that, moving NOTE Confidence: 0.910830557346344 00:50:58.150 --> 00:50:59.999 from sick care to WellCare? NOTE Confidence: 0.9360764622688293 00:51:00.160 --> 00:51:04.365 And then specifically, Gary's question was around how are we NOTE Confidence: 0.9360764622688293 00:51:04.435 --> 00:51:09.061 engaging the federal government in policy change or advocating for NOTE Confidence: 0.9360764622688293 00:51:09.131 --> 00:51:12.495 things that allow us all to move upstream to get NOTE Confidence: 0.9360764622688293 00:51:12.565 --> 00:51:16.279 ahead of comorbidities before they become big issues? NOTE Confidence: 0.9293490052223206 00:51:17.040 --> 00:51:18.320 And so are there anything you're doing? NOTE Confidence: 0.9250715374946594 00:51:18.320 --> 00:51:20.293 I, I've heard from all of you a little bit NOTE Confidence: 0.9250715374946594 00:51:20.340 --> 00:51:22.360 of some of the work that you've done at the NOTE Confidence: 0.9250715374946594 00:51:22.407 --> 00:51:24.943 national level, but would love to hear more about what NOTE Confidence: 0.9250715374946594 00:51:24.990 --> 00:51:27.809 you're doing from a federal policy or advocacy standpoint to NOTE Confidence: 0.9250715374946594 00:51:27.856 --> 00:51:29.359 move from sick care to WellCare. NOTE Confidence: 0.8690003156661987 00:51:30.080 --> 00:51:32.023 And maybe we'll start with you, Doctor Winters, and we'll NOTE Confidence: 0.8690003156661987 00:51:32.057 --> 00:51:33.080 go to Doctor Crank after that. NOTE Confidence: 0.9373663663864136 00:51:33.960 --> 00:51:36.792 Yeah, that's a really good question and it's very, it's NOTE Confidence: 0.9373663663864136 00:51:36.844 --> 00:51:38.080 a thick question, right? NOTE Confidence: 0.9036704301834106 00:51:38.320 --> 00:51:41.131 There's a lot of work to be done to move NOTE Confidence: 0.9036704301834106 00:51:41.201 --> 00:51:43.239 from sick care to healthcare. NOTE Confidence: 0.9628863334655762 00:51:43.360 --> 00:51:46.617 1 of it is first, really understanding the fragmentation of NOTE Confidence: 0.9628863334655762 00:51:46.672 --> 00:51:47.279 our system. NOTE Confidence: 0.8690937757492065 00:51:48.040 --> 00:51:51.300 You know, when you know what the problems are, then NOTE Confidence: 0.8690937757492065 00:51:51.363 --> 00:51:54.560 it's been designing the solutions from that place. NOTE Confidence: 0.744431734085083 00:51:54.800 --> 00:51:55.280 It's easier. NOTE Confidence: 0.871669590473175 00:51:55.280 --> 00:51:57.000 So I've spent a lot of time on that. NOTE Confidence: 0.8754339814186096 00:51:57.239 --> 00:51:59.459 We have at the YMCA of the USA and at NOTE Confidence: 0.8754339814186096 00:51:59.519 --> 00:52:03.299 our local levels, government and advocacy folks who are working NOTE Confidence: 0.8754339814186096 00:52:03.359 --> 00:52:06.299 on this every day, all day, that we actually have NOTE Confidence: 0.8754339814186096 00:52:06.359 --> 00:52:08.759 an office in DC and as you just heard me NOTE Confidence: 0.8754339814186096 00:52:08.819 --> 00:52:11.879 say, had the opportunity to meet with Doctor Oz and NOTE Confidence: 0.8754339814186096 00:52:11.939 --> 00:52:13.679 his team yesterday in person. NOTE Confidence: 0.9147814512252808 00:52:13.680 --> 00:52:16.270 So those are some of the things that we're actively NOTE Confidence: 0.9147814512252808 00:52:16.321 --> 00:52:19.064 working on every single moment, if you will, to really NOTE Confidence: 0.9147814512252808 00:52:19.115 --> 00:52:21.960 advance this work in health and Wellness and prevention. NOTE Confidence: 0.8806686997413635 00:52:22.560 --> 00:52:25.043 I heard a speaker say just the other week, you NOTE Confidence: 0.8806686997413635 00:52:25.097 --> 00:52:28.120 know, we're trying to tell these folks in the government NOTE Confidence: 0.8806686997413635 00:52:28.174 --> 00:52:31.252 that water is wet, meaning, you know, health and Wellness NOTE Confidence: 0.8806686997413635 00:52:31.306 --> 00:52:32.440 and prevention works. NOTE Confidence: 0.9694457650184631 00:52:32.640 --> 00:52:35.640 And while I didn't really like that, it's true, right? NOTE Confidence: 0.9451957941055298 00:52:35.640 --> 00:52:38.720 There's there's pieces of that because we haven't proven it. NOTE Confidence: 0.7634726762771606 00:52:39.480 --> 00:52:42.853 It's a little bit non tangible because we don't haven't NOTE Confidence: 0.7634726762771606 00:52:42.914 --> 00:52:45.858 had the data to say this is actually what health NOTE Confidence: 0.7634726762771606 00:52:45.920 --> 00:52:48.680 muscle prevention does to decrease sick care. NOTE Confidence: 0.9149887561798096 00:52:48.960 --> 00:52:51.466 And so I think that's again one of the key NOTE Confidence: 0.9149887561798096 00:52:51.526 --> 00:52:55.047 components is the ability to provide outcomes in this space NOTE Confidence: 0.9149887561798096 00:52:55.107 --> 00:52:58.091 as we all collaborate together to say this is what NOTE Confidence: 0.9149887561798096 00:52:58.150 --> 00:53:02.626 this work with these different organizations did to prevent cardiovascular, NOTE Confidence: 0.9149887561798096 00:53:02.686 --> 00:53:06.625 diabetes, all these downstream chronic diseases that's going to be NOTE Confidence: 0.9149887561798096 00:53:06.685 --> 00:53:07.640 really powerful. NOTE Confidence: 0.9371086955070496 00:53:07.640 --> 00:53:11.301 We have some great evidence that's already coming out, but NOTE Confidence: 0.9371086955070496 00:53:11.365 --> 00:53:14.080 we need to even have more of that at scale. NOTE Confidence: 0.8331924676895142 00:53:14.240 --> 00:53:17.160 So it's again, it's that both and right. NOTE Confidence: 0.9604844450950623 00:53:17.160 --> 00:53:19.634 It's the top of the framework of the house, it's NOTE Confidence: 0.9604844450950623 00:53:19.685 --> 00:53:22.160 the bottom up and really collaborating together. NOTE Confidence: 0.8466058969497681 00:53:22.520 --> 00:53:24.777 Again, a lot more to be said about that, but NOTE Confidence: 0.8466058969497681 00:53:24.829 --> 00:53:27.600 I'll I'll let my other colleagues impart their wisdom. NOTE Confidence: 0.38971713185310364 00:53:29.040 --> 00:53:30.040 Yeah, Doctor Crank. NOTE Confidence: 0.7844341993331909 00:53:30.040 --> 00:53:32.963 And then, and then, if we have time, Doctor Juliana NOTE Confidence: 0.7844341993331909 00:53:33.021 --> 00:53:33.479 as well. NOTE Confidence: 0.8237790465354919 00:53:34.080 --> 00:53:36.200 Yeah, I'm happy to jump in and I'll be brief. NOTE Confidence: 0.8673563599586487 00:53:37.480 --> 00:53:40.320 ADA has huge investments in the advocacy space. NOTE Confidence: 0.8949541449546814 00:53:40.320 --> 00:53:44.082 That's something that's certainly a pillar of our organization and NOTE Confidence: 0.8949541449546814 00:53:44.139 --> 00:53:45.280 the work that we do. NOTE Confidence: 0.9397158026695251 00:53:45.600 --> 00:53:48.762 There's active engagement going on at the federal, the state NOTE Confidence: 0.9397158026695251 00:53:48.815 --> 00:53:50.080 and the community level. NOTE Confidence: 0.8834879398345947 00:53:50.080 --> 00:53:54.205 Really some of the priorities that that you'll see coming NOTE Confidence: 0.8834879398345947 00:53:54.278 --> 00:53:58.620 out from ADA advocacy really is in insulin affordability and NOTE Confidence: 0.8834879398345947 00:53:58.693 --> 00:53:59.200 access. NOTE Confidence: 0.8723753690719604 00:53:59.200 --> 00:54:01.978 The insulin cap was a huge win for us here NOTE Confidence: 0.8723753690719604 00:54:02.044 --> 00:54:02.640 recently. NOTE Confidence: 0.7729116678237915 00:54:03.080 --> 00:54:08.254 Healthcare access, so the, you know, coverages under Medicare and NOTE Confidence: 0.7729116678237915 00:54:08.333 --> 00:54:11.040 Medicaid and even into the AO, Ms. NOTE Confidence: 0.8089278936386108 00:54:11.040 --> 00:54:12.320 and obesity coverages. NOTE Confidence: 0.8635383248329163 00:54:12.320 --> 00:54:16.582 Lots of activity and act advocacy going into that space, NOTE Confidence: 0.8635383248329163 00:54:16.658 --> 00:54:20.159 in the space of research and research funding. NOTE Confidence: 0.9069812893867493 00:54:20.160 --> 00:54:25.516 There's lots and lots again, of increased funding going in NOTE Confidence: 0.9069812893867493 00:54:25.608 --> 00:54:27.640 for diabetes research. NOTE Confidence: 0.8679226636886597 00:54:28.040 --> 00:54:32.958 And then those individual rights and protections, right, fighting discrimination NOTE Confidence: 0.8679226636886597 00:54:33.020 --> 00:54:36.955 in schools and workplaces, employment and, you know, things that NOTE Confidence: 0.8679226636886597 00:54:37.016 --> 00:54:40.644 are affecting people living with diabetes and obesity at A, NOTE Confidence: 0.8679226636886597 00:54:40.705 --> 00:54:42.120 at an individual level. NOTE Confidence: 0.8768941164016724 00:54:42.720 --> 00:54:44.720 And then of course, the grassroots advocacy. NOTE Confidence: 0.9330053329467773 00:54:44.719 --> 00:54:49.080 So ADA has, gosh, probably hundreds of thousands of grassroots NOTE Confidence: 0.9330053329467773 00:54:49.150 --> 00:54:53.229 advocates all over the country that are implored to really NOTE Confidence: 0.9330053329467773 00:54:53.299 --> 00:54:57.027 work on the community level, to build up the capacity NOTE Confidence: 0.9330053329467773 00:54:57.097 --> 00:55:00.754 of communities to know how and where to advocate and NOTE Confidence: 0.9330053329467773 00:55:00.824 --> 00:55:04.762 share their stories and be able to take this information NOTE Confidence: 0.9330053329467773 00:55:04.833 --> 00:55:08.912 and help make policy advancements at the local, state, and NOTE Confidence: 0.9330053329467773 00:55:08.982 --> 00:55:10.599 even the federal level. NOTE Confidence: 0.8659043908119202 00:55:11.800 --> 00:55:12.400 Excellent. NOTE Confidence: 0.8019757270812988 00:55:12.880 --> 00:55:15.600 All right, Juliana, in one minute or less. NOTE Confidence: 0.7141714692115784 00:55:15.880 --> 00:55:19.239 Yes, I the only maybe similar our federal policy agenda NOTE Confidence: 0.7141714692115784 00:55:19.300 --> 00:55:22.660 is rapidly evolving, you know, to to within the current NOTE Confidence: 0.7141714692115784 00:55:22.721 --> 00:55:24.920 marketplace and lots going on there. NOTE Confidence: 0.8764888048171997 00:55:24.920 --> 00:55:27.143 But maybe the tangible example I'll have where I feel NOTE Confidence: 0.8764888048171997 00:55:27.185 --> 00:55:29.744 like we actually have some really strong connections with the NOTE Confidence: 0.8764888048171997 00:55:29.786 --> 00:55:32.639 priorities of the current administration is around food as medicine. NOTE Confidence: 0.7508196234703064 00:55:32.640 --> 00:55:35.080 And it's, it's really exciting to see there. NOTE Confidence: 0.8000699877738953 00:55:35.080 --> 00:55:38.850 You know, we have a large scale initiative and investment NOTE Confidence: 0.8000699877738953 00:55:38.916 --> 00:55:42.289 for many partners to help us waters wet, good food, NOTE Confidence: 0.8000699877738953 00:55:42.355 --> 00:55:43.480 food is medicine. NOTE Confidence: 0.8530522584915161 00:55:43.480 --> 00:55:46.212 We know it improves health outcomes, but the economic return NOTE Confidence: 0.8530522584915161 00:55:46.258 --> 00:55:48.079 that that is what we're really studying. NOTE Confidence: 0.8725524544715881 00:55:48.080 --> 00:55:51.157 And so to really push for wide scale reimbursement and NOTE Confidence: 0.8725524544715881 00:55:51.214 --> 00:55:53.950 we're seeing a lot of in momentum at the federal NOTE Confidence: 0.8725524544715881 00:55:54.007 --> 00:55:54.919 and state level. NOTE Confidence: 0.8368333578109741 00:55:55.080 --> 00:55:56.924 So I know that's just one piece of a lot NOTE Confidence: 0.8368333578109741 00:55:56.971 --> 00:55:59.323 of things we need to do perfect for prevention, but NOTE Confidence: 0.8368333578109741 00:55:59.369 --> 00:56:01.813 it's a really big bright spot and seeing momentum and NOTE Confidence: 0.8368333578109741 00:56:01.859 --> 00:56:04.488 support for those types of programs and, and just pushing NOTE Confidence: 0.8368333578109741 00:56:04.535 --> 00:56:07.117 that economic case forward is what's going to, you know, NOTE Confidence: 0.8368333578109741 00:56:07.164 --> 00:56:08.639 what's going to move us forward. NOTE Confidence: 0.7485935688018799 00:56:08.640 --> 00:56:10.679 And we, we have our, we're committed to, to pushing NOTE Confidence: 0.7485935688018799 00:56:10.719 --> 00:56:12.839 that out and doing that through the work that's going NOTE Confidence: 0.7485935688018799 00:56:12.879 --> 00:56:12.999 on. NOTE Confidence: 0.8465522527694702 00:56:14.200 --> 00:56:17.346 I'm grateful to each of your organizations for the advocacy NOTE Confidence: 0.8465522527694702 00:56:17.399 --> 00:56:18.039 that you do. NOTE Confidence: 0.8845872282981873 00:56:18.560 --> 00:56:21.737 We are similarly involved in advocacy at a high level, NOTE Confidence: 0.8845872282981873 00:56:21.796 --> 00:56:23.680 advocating for value based care. NOTE Confidence: 0.9706588983535767 00:56:23.680 --> 00:56:25.720 How can we think about holistic care? NOTE Confidence: 0.9312118291854858 00:56:25.719 --> 00:56:28.781 Taking care of the whole patient, not just their kidney NOTE Confidence: 0.9312118291854858 00:56:28.836 --> 00:56:32.398 issues, not just their heart issues, not just their psychosocial NOTE Confidence: 0.9312118291854858 00:56:32.454 --> 00:56:36.016 issues, but bringing that all together because whole person care NOTE Confidence: 0.9312118291854858 00:56:36.072 --> 00:56:38.465 is the way that we move from taking care of NOTE Confidence: 0.9312118291854858 00:56:38.521 --> 00:56:41.582 patients episodically to truly taking care of them as a NOTE Confidence: 0.9312118291854858 00:56:41.638 --> 00:56:43.920 human being and having those connections. NOTE Confidence: 0.8867284655570984 00:56:43.920 --> 00:56:45.783 So I'm, I'm grateful for all of the work that NOTE Confidence: 0.8867284655570984 00:56:45.824 --> 00:56:46.280 you all do. NOTE Confidence: 0.9261510372161865 00:56:46.760 --> 00:56:49.143 All right, we've got 2 minutes left, so I'm going NOTE Confidence: 0.9261510372161865 00:56:49.191 --> 00:56:51.040 to do a quick, very quick round Robin. NOTE Confidence: 0.9606233835220337 00:56:51.840 --> 00:56:54.962 You each have a magic wand and you get to NOTE Confidence: 0.9606233835220337 00:56:55.038 --> 00:56:58.464 do one thing with it to improve the, the care NOTE Confidence: 0.9606233835220337 00:56:58.541 --> 00:57:02.120 or the relationships you have with communities. NOTE Confidence: 0.8370542526245117 00:57:02.800 --> 00:57:04.520 So maybe we'll we'll start with you, Juliana. NOTE Confidence: 0.9210934638977051 00:57:04.520 --> 00:57:06.200 What do you use your magic wand on? NOTE Confidence: 0.8838874101638794 00:57:07.000 --> 00:57:09.226 If I could have a magic wand to help us NOTE Confidence: 0.8838874101638794 00:57:09.284 --> 00:57:11.853 do even better, it would be some sort of tool NOTE Confidence: 0.8838874101638794 00:57:11.910 --> 00:57:15.279 that would allow for the consistent data collection to kind NOTE Confidence: 0.8838874101638794 00:57:15.336 --> 00:57:17.906 of pull up in a consistent way and marry that NOTE Confidence: 0.8838874101638794 00:57:17.963 --> 00:57:20.704 that data at the community level with all of the NOTE Confidence: 0.8838874101638794 00:57:20.761 --> 00:57:23.159 great stuff we have at the clinical level. NOTE Confidence: 0.6430145502090454 00:57:23.160 --> 00:57:24.240 So that's a magic wand. NOTE Confidence: 0.8452228903770447 00:57:24.240 --> 00:57:26.459 So many good things, but it's hard to often get NOTE Confidence: 0.8452228903770447 00:57:26.506 --> 00:57:28.160 the consistent data piece in there. NOTE Confidence: 0.7832211852073669 00:57:28.160 --> 00:57:29.360 So that's my magic wand. NOTE Confidence: 0.7860662341117859 00:57:30.080 --> 00:57:31.120 Actionable data. NOTE Confidence: 0.7785300016403198 00:57:31.120 --> 00:57:32.800 All right, Doctor Crank really quickly. NOTE Confidence: 0.9354355335235596 00:57:33.400 --> 00:57:37.802 Yeah, my quick magic wand moment will be taking some NOTE Confidence: 0.9354355335235596 00:57:37.886 --> 00:57:42.120 of these programs that we've done so successfully. NOTE Confidence: 0.8970746397972107 00:57:42.120 --> 00:57:44.471 And I'm just going to wave it and have a NOTE Confidence: 0.8970746397972107 00:57:44.530 --> 00:57:49.644 scalability and have everybody everywhere understand how important community engagement NOTE Confidence: 0.8970746397972107 00:57:49.703 --> 00:57:53.936 and intentionally involving communities in the planning of programs that NOTE Confidence: 0.8970746397972107 00:57:53.995 --> 00:57:57.110 involve them, the successes that can come out of that NOTE Confidence: 0.8970746397972107 00:57:57.169 --> 00:58:00.109 and just have that blow up widespread till we work NOTE Confidence: 0.8970746397972107 00:58:00.167 --> 00:58:01.519 ourselves out of a job. NOTE Confidence: 0.7007865309715271 00:58:03.400 --> 00:58:03.600 Awesome. NOTE Confidence: 0.6265231370925903 00:58:03.960 --> 00:58:05.480 All right, Doctor G. NOTE Confidence: 0.7663771510124207 00:58:05.920 --> 00:58:08.067 Well, the beauty is, as I just say, Ditto to NOTE Confidence: 0.7663771510124207 00:58:08.116 --> 00:58:08.360 that. NOTE Confidence: 0.8616908192634583 00:58:08.480 --> 00:58:10.268 What I was going to say is a magic wand NOTE Confidence: 0.8616908192634583 00:58:10.314 --> 00:58:13.111 that actually just creates this funnel that just brings these NOTE Confidence: 0.8616908192634583 00:58:13.157 --> 00:58:14.119 lives in right there. NOTE Confidence: 0.8306230306625366 00:58:14.160 --> 00:58:15.960 We just need to grab them and pull them in. NOTE Confidence: 0.8382971286773682 00:58:15.960 --> 00:58:18.786 Once we pull them in relationship trust, all of those NOTE Confidence: 0.8382971286773682 00:58:18.839 --> 00:58:22.413 components actually just allow us to more effectively improve their NOTE Confidence: 0.8382971286773682 00:58:22.466 --> 00:58:22.839 health. NOTE Confidence: 0.8619938492774963 00:58:22.840 --> 00:58:25.303 But it's this grabbing those folks and putting them in NOTE Confidence: 0.8619938492774963 00:58:25.349 --> 00:58:25.760 a funnel. NOTE Confidence: 0.8436136841773987 00:58:26.640 --> 00:58:29.120 All right, well, it is the top of the hour. NOTE Confidence: 0.8774508237838745 00:58:29.120 --> 00:58:31.348 So we're all going to turn into pumpkins or whatever NOTE Confidence: 0.8774508237838745 00:58:31.391 --> 00:58:32.719 the analogy to magic wands are. NOTE Confidence: 0.8933015465736389 00:58:32.720 --> 00:58:35.871 But my magic wand is just to have more collaborators NOTE Confidence: 0.8933015465736389 00:58:35.932 --> 00:58:36.719 like you all. NOTE Confidence: 0.8465730547904968 00:58:36.720 --> 00:58:39.016 I, I just am so grateful, Juliana, for the work NOTE Confidence: 0.8465730547904968 00:58:39.065 --> 00:58:42.144 that we do with the American Heart Association, Doctor Winters, NOTE Confidence: 0.8465730547904968 00:58:42.193 --> 00:58:44.245 the work that we do with the YMCA and, and NOTE Confidence: 0.8465730547904968 00:58:44.294 --> 00:58:47.520 Doctor Crank, the partnership, the strong partnership we have with NOTE Confidence: 0.8465730547904968 00:58:47.569 --> 00:58:47.960 the ADA. NOTE Confidence: 0.8677671551704407 00:58:48.240 --> 00:58:50.719 So that's what I'm using my magic wand is more NOTE Confidence: 0.8677671551704407 00:58:50.773 --> 00:58:51.959 time from each of you. NOTE Confidence: 0.8112179040908813 00:58:51.960 --> 00:58:53.040 So appreciate it. NOTE Confidence: 0.9133855104446411 00:58:53.040 --> 00:58:55.560 And to the audience, thank you for sending in questions. NOTE Confidence: 0.9355653524398804 00:58:55.560 --> 00:58:57.585 I apologize we didn't get to all of them, but NOTE Confidence: 0.9355653524398804 00:58:57.630 --> 00:58:59.880 just really excited to be here and and share these NOTE Confidence: 0.9355653524398804 00:58:59.925 --> 00:59:00.600 ideas with you. NOTE Confidence: 0.9146698713302612 00:59:00.720 --> 00:59:01.680 So be well. NOTE Confidence: 0.9598573446273804 00:59:01.680 --> 00:59:02.080 Thank you. NOTE Confidence: 0.6585012674331665 00:59:02.640 --> 00:59:03.200 Thanks everyone. NOTE Confidence: 0.8312399387359619 00:59:03.600 --> 00:59:06.126 Thank you to DaVita and to everyone that joined us NOTE Confidence: 0.8312399387359619 00:59:06.176 --> 00:59:06.479 today. NOTE Confidence: 0.8776845932006836 00:59:06.920 --> 00:59:11.862 Please visit ourwebsite@community.hlth.com to catch up on all health webinars NOTE Confidence: 0.8776845932006836 00:59:11.927 --> 00:59:14.880 and to watch the recording of today's session. NOTE Confidence: 0.9155386090278625 00:59:15.840 --> 00:59:19.047 And don't forget to join us in Las Vegas October NOTE Confidence: 0.9155386090278625 00:59:19.114 --> 00:59:21.320 19th through 22nd for Health USA.