Transcript for Encore! EP392 When Patient Journeys Don’t Fit in the EHR with Emily Kagan Trenchard

You can listen to the episode here.

Introduction and Overview

[00:00:00] Stacey Richter: Encore episode, “When Patient Journeys Don't Fit in the EHR.”

Today, I am speaking with Emily Kagan Trenchard.  

[00:00:20] Stacey Richter: American Healthcare Entrepreneurs and Executives  You Want to Know. Talking. Relentlessly Seeking Value.  

The Importance of Digital Evidence in Healthcare

[00:00:29] Stacey Richter: I thought I would encore this show after coming back from the 2023 Node Conference held in the Microsoft building in New York City, which I always enjoy. Node, N. O. D. E., stands for Network of Digital Evidence. Why is evidence so important? 

Here's the NODE answer to this question. It is so smart purchasing decisions can be made by consumers, health systems, and payers, so devices and software that improve patient experience, provide actionable insights, and save time and money become part of care delivery, so trust is built between industry and healthcare. 

No matter what direction you come at this from, evidence for care delivery endeavors is sorely needed.  

What's always interesting to me is kind of the context of this said evidence however, the who said evidence is evaluated by and to what end. It was a really interesting juxtaposition, frankly, to hit up the NODE conference, which is attended mainly by digital health entrepreneurs and health system execs right on the heels of me going to multiple events with self-insured employer types like the PBGH summit in early December, for example. 

What Emily Kagan Trenchard, my guest on this encore, talks about today is very much not a nice to have from the employer slash purchaser point of view. It's a must have from their perspective because all of these care delivery technological and organizational inefficiencies that Emily alludes to. Yeah, it's all defined as expensive waste from the standpoint of the employers or other self insured entities. 

These self insured entities are the ones paying for fragmented and unsupported patient journeys with their escalating commercial rates, after all.  

In sum, I like how Joseph Wu, who is the current president of the AHA, put it at the recent AHA Scientific Sessions in Philadelphia last month, which I was honored to attend. 

Dr. Wu said during his presidential address, work hard, work smart, work together. Emphasis on all of the above, especially the work together. That's what the Relentless Health Value Tribe is all about, after all, so thanks so much for being a part of it. My name is Stacey Richter. This podcast is sponsored by Aventria Health Group. 

So a few things to remind everybody.  

The Role of EHRs in Patient Interactions

[00:02:47] Stacey Richter: First of all, don't forget, EHRs were purpose built originally for billing. This is no secret. People quite openly have called EHR systems glorified cash registers. If I want to be generous. Maybe I would restate this to say that EHRs were designed to document patient interactions. 

This is what their core architecture was built to achieve. But today, there's a lot that goes on that isn't a traditional patient interaction. First of all, me even calling it, frankly, a patient interaction should give longtime listeners a clue where this is headed.  

I mean, say you're sitting at home on your couch. I don't know. You're probably not considering yourself a patient. You're considering yourself a person sitting on your couch. However, say you're sitting on your couch and you haven't taken your COPD maintenance therapy. Hmm. Potentially, that is something of clinical significance that maybe should get figured out and noted somewhere, potentially prior to the acute event going down. 

Or still talking about things that are relevant to patient health, but which don't naturally tuck into an EHR system's native architecture. Maybe we have social workers and nutritionists and all kinds of people who are not doctors or nurses or PAs in this mix. Most of the time, these people don't even have access to the EHR. 

In sum, what is happening between codes getting written in patient health records? Where's all that information going?  

The Limitations of EHRs and the Need for Additional Platforms

[00:04:10] Stacey Richter: My guest today, Emily Kagan Trenchard, makes a super point about all of this that I haven't heard made so succinctly or so eloquently. She talks about identifying the core functionalities, the centers of gravity, that are needed to bring together providers and patients and everybody else in the mix. 

She talks about the four platforms that she feels are very necessary to underpin or be the chassis to best support helping providers and others help patients and people in and out of the clinic.  

The Four Platforms for Improved Patient Care

[00:04:41] Stacey Richter: She calls each platform a tentpole. These four platforms are number one, the EHR, number two, a CRM, a customer relationship manager. 

And by the way, when Emily says CRM, she's talking about more than software. It's more like a philosophy or a whole approach around relationship building with patients slash people slash customers. Then we have Emily's number three, which is a cloud platform for data and analytics and number four, a data exchange. 

One last takeaway for me, at least, Emily has talked about two basic facts that inform her thinking. Number one, providers and patients alike are increasingly not tolerant of friction. And number two, what is easiest, is the most likely to happen. Something that we don't get into in this show, but certainly bears considering, is the larger context here. 

Yeah, we got Amazon, we got Google. Not only what they are doing alone, but also what they are investing in. They have platforms that are purpose built to remove friction and to be really, really easy. One click easy. So let's talk about the WIFM here for health systems to get a move on. When Merrill Goozner was on the show a few weeks ago, this is episode 388. 

He says that when patients and employers and taxpayers start crying uncle on both healthcare prices, as well as just bad friction filled experiences, and also when at the same time technology and new competitors move in on the supply side, he says what's gonna happen then is older incumbents like hospitals, could find themselves getting their lunches eaten, especially as we contemplate the stuff that Mike Thompson was talking about in episode 389 about how there is increasingly data out there which identifies hospitals who are very inefficiently run. Also, I would be remiss not to mention that non purpose built, dare I say bad, technology causes bad clinician burnout. 

Which causes bad turnover, which is really expensive. Dr. Arshad Rahim talks about this in episode 323.


Emily Kagan Trenchard is SVP and Chief of Consumer Digital Solutions over at Northwell Health. Northwell, in case you haven't heard of this health system, is very large. 21 hospitals, 850 outpatient clinics, 300,000 patients a year. 

Yeah, it's big. My name is Stacey Richter. This podcast is sponsored by Aventria Health Group.  

Emily Kagan, Trenchard, welcome to Relentless Health Value.  

[00:07:07] Emily Kagan Trenchard: Thanks so much for having me.  

[00:07:09] Stacey Richter: So just kicking off here with a question that we probably could talk about for three days.  

The Role of CRM in Healthcare

[00:07:17] Stacey Richter: But how does the work that you are doing in consumer digital and really thinking about consumer experience. 

How does it sort of all start? Like, how do we slot your work in digital consumer solutions into the larger health system technology stack or infrastructure or just the traditional way that many conceive of it all?  

[00:07:38] Emily Kagan Trenchard: What it really does is take the consumer experience in a digital world and puts it on par with the clinical experience. 

When we are considering our technology infrastructure, just as we put a degree of diligence and investment into our clinical technology stacks. We need to do the same for what we provide to our patients and that's not exclusively something for marketing or rev cycle or access or just a remote patient monitoring program. 

It is unto itself, its own key constituency who deserves the care and diligence of the design.  

[00:08:14] Stacey Richter: Yeah. So one thing that you have said is that it is very exciting to form a platform around something that is not revenue cycle. But you're obviously starting from a platform that was built around revenue cycle. How do you think about starting anew? 

[00:08:30] Emily Kagan Trenchard: Yeah, great question. And I, and no, no shade to my colleagues in RevCycle, who I love dearly, but As we know, the EMRs and EHRs are usually the center of or have historically been the center of people's universe, and those really were born out of federal mandates that had incentives tied to reimbursement, right? 

So your incentive dictated the architectural structure of these applications. And so you ended up also with wonky things like all of access being driven out of rev cycle when maybe that's not the smartest place to put your access strategy. So when we're trying to think about this from the ground up, it's not to say you don't need revenue cycle systems. 

You do. It's not to say you don't need an EHR. You do. But the question then becomes where else do you have centers of gravity that you should respect in the architecture? And so for us, what that means is not defaulting to the historic center of gravity of an EHR, not defaulting to a historic center of gravity in your registration, your billing systems, but saying, no, there is a constellation of need here and we actually have to give it its proper due in our tech stack. 

And so that involves taking an approach with CRM, right? Customer relationship management applications. And making it another center of gravity so that the tools by which we manage our relationships take their rightful place alongside the tools with which we manage our clinical concerns and our financial concerns. 

[00:09:52] Stacey Richter: Interesting that you are not considering this that the EHR is the center of the universe because obviously like historically we've gone through a couple of phases. Right, like we started out maybe pre meaningful use where it was maybe not as digitized nearly as it is today. So this might not be necessarily a fair comparison, but there was things all over the place. 

Then you have to have the EHRs and everybody starts to think what good looks like is integrating with the EHR. That happened. Effectively, what you're saying is, you know what, the EHR is over there and it was designed for a very specific use case with a very specific infrastructure, which is created at its core for that particular use case. 

Let's not try to use something which was completely built to do something else and try to retool it. To do something that it was not purpose built for.  

[00:10:49] Emily Kagan Trenchard: Yeah. And to be fair, if we're going to torture my constellation metaphor a bit more, it certainly has a gravitational pull that affects all of the other things. 

It is the biggest, baddest thing in our tech stack. Absolutely. And I don't want to misconstrue my point in that way, but exactly as you said, it was purpose filled for our, patients. We interact with way more than just patients. What about our caregivers? What about parents, children, and other members of the community who are part of the care team? 

There's not an inherent way to encode the meaningful relationships and integrate them into care plans in ways that bespeak the sophistication with which we're hoping to operate in our, in the world at large, right? So you need different tools for that. And I think that that's actually a reflection of a move, especially on behalf of health systems away from, again, this, the hospital being the center of the universe. 

And really taking into consideration the role that ambulatory is playing, right? More and more procedures are moving out of the inpatient setting. They're going into this outpatient. There's so much more virtual care. So suddenly again, that has shifted where the attention is. And so you're also now thinking about all of these ambulatory interactions, the beats in between those ambulatory interactions. 

The moments that occur at home, these sort of touch points of customer support or payment or shopping or anything else you might want to call for that truly are going to influence with, if not equal force, the nature of what ends up happening in an encounter that you encode in the, in the clinical record. 

The Importance of Relationship Management in Healthcare

[00:12:22] Stacey Richter: So when you were saying that the EHR was built around the patient, I'm understanding what you mean is that the EHR people aren't patients all the time. So. Effectively, I think what you're, you're saying is that the EHR was built around the moments in time when a person is a patient and they are in a clinical setting and they are talking to a clinician. 

That is the moment in time that the EHR was constructed to wrap around, maybe. And as many have said, it was mainly built to capture codes which then are used for billing. So while that is important, if you start thinking about the entity on the show, we have talked many times about having a defragmented patient journey. 

If you are by the technology's very nature, fragmenting the patient journey, or at least the digital one into, it's only sort of picking up the moments of time when the patient is interacting with a clinician, then there's a lot that is left over.  

[00:13:16] Emily Kagan Trenchard: Absolutely. And I would even say that it's not just the patient anymore. 

Every single one of us has been talking about social determinants of health. Social determinants of health don't happen in isolation. No one of us is an island. Again, pandemic, if it taught us anything, it taught us that. How can we stop thinking about our patients as these teeny tiny discrete entities who don't have connections to other patients, to other people in larger communities? 

If we truly want to do population health, as we all aspire to do, We have to be able to understand the network of relationships in a population that is necessarily going to require us to understand relationships with people who are non-patients. And that is also something that the EHRs are not well suited to be the driver of. 

The Need for Integrations and APIs

[00:14:02] Stacey Richter: That is a really actionable insight you just laid out there that I would love to emphasize. But if EHRs just clip a few moments in time out where one patient happens to be in a clinic with one clinician, they're some little pristine silos of transactional moments. What we inadvertently do is chop up the patient journey into a sprinkling of documented moments inside a gigantic black box. 

Moving on then, if we're thinking about then this other tentpole, I think you called it. So you've got the EHR and what goes on in clinic as one of the tentpoles. And then the CRM, the Customer Relationship Management Tool, as that second tentpole. How do those things interact? Like, is there some sort of API? 

Are they integrated in a big way? You know, how are you thinking about that, both short term, because where we are, where we are right now, but then also from a vision perspective, like, what does this look like five years from now?  

[00:14:59] Emily Kagan Trenchard: Yeah, absolutely. So I think integrations up the wazoo. Absolutely. These two utilities need to play very, very seamlessly with one another. 

And in fact, many of these platforms are suggesting that they have complimentary features that you could actually take your pick.  

The Role of Caregivers in Patient Care

[00:15:13] Emily Kagan Trenchard: You could do a carrier journey navigation in either one of these types of tools. You could do types of sort of social management and trigger off text messages from either one of these utilities. 

So there's going to be some choices, some architectural design choices that we need to make along the way. And as you said, it'll be an evolution, there's probably going to be some things we do today in one that maybe are better suited in another later on down the road. But for us, what, where we're largely starting our sort of implementation strategy in the wild is in the context of the human being who's going to be touching these systems, right? 

And again, always go back to what does it mean for that person in their day to day flow when they've got a patient stepping into the office or stepping up to register. What are the first most important tasks that they need to do? Are they clinical tasks? Or are they more relationship and orientation and transactional in nature? 

If it's more of a relationship management task, you're probably going to start off in your CRM. Now you absolutely are going to need a little bit of clinical context. Where are their elements from the medical record that we can surface up as appropriate in that context or have someone capture and write back? 

[00:16:15] Stacey Richter: So, following the narrative here, patient walks into clinical setting, you said their first interaction might be in a CRM, so they're filling out a form on a tablet and that information might be pre-populated from the CRM information that it already has or it might be information that goes back to the CRM and the EHR is feeding certain things. 

[00:16:33] Emily Kagan Trenchard: Or it could go back directly to the EHR. It might have been the EHR that triggered off forms if they're clinical forms. Absolutely. So again, the hard part in all of this is not can you trigger a form to a patient and collect the data? And the hard part is not can we have one form and have it ingest data that it puts to two different spots. 

The question is, where does a human being work? Where do they do their job? When they open their computer, what button are they clicking first? And that's what we're trying to design around. And so people who primarily need to encode information about, how did you get here? Are you going to be able to get to your next appointment? 

Did you call to reschedule because you don't have a ride? Can I send a car to go pick you up? I see that you're coming in for this procedure, but your kid has an appointment the next day. Should I move that appointment for you? Those are the types of interactions that a CRM is going to best capture.  

If you go on now on the clinical side of things. As a clinician, of course, you're going to start in your EHR, but that doesn't mean you don't want some of the information that might be in that social history in that context that is more rich and dynamic than what you're necessarily going to capture in an HNP. And so that is where you are going to have elements from the CRM world piped in. 

[00:17:36] Stacey Richter: So what is HNPs?  

[00:17:37] Emily Kagan Trenchard: A history and prognosis form. It's like a standard clinical intake form where you capture somebody's general life state, not just a specific reason that brought them into the doctor that day.  

[00:17:46] Stacey Richter: Okay, so I have two questions and one's going to be from the clinical side and then one is going to be from the, you mentioned care navigation side, which is something that is a problem.  

[00:17:56] Emily Kagan Trenchard: To say the least. 

[00:17:58] Stacey Richter: So actually, let's start there. And then I'm going to ask you something that I've heard clinicians say. So from a population health standpoint, we have patients who are falling into one care gap, just situation analysis, falling into one care gap after another. And as I've said on the show, it's really hard to keep mopping care gaps off the floor when the faucet is still running. 

That is creating more and more care gaps because we don't have these defragmented patient journeys. And also it makes PCP's job, clinician's job, really difficult when somehow or another in a seven minute meeting, not only are they dealing with a primary complaint, but somehow or another, they also have all these alerts popping up that says that this patient is missing 15 preventative care. 

So if we're thinking about solving for that specific use, right, like, first of all, you gave some examples where a patient was already interacting with the system. They called to make an appointment and then they canceled. And then I'm assuming that either within that digital interaction or whoever's on the phone with them is saying, why are you canceling? 

Can I help you reschedule? But does the system have ways that aren't patient initiated or patient triggered? Like, for example. The patient gets an email that says something, like, how are we keeping the patient on their nonfragmented patient journey in a really proactive way so that it doesn't turn into a game of whack a mole? 

[00:19:19] Emily Kagan Trenchard: That's a great question and that's exactly why we want to have programs that we can build out not just from an EHR, from a clinical context, but also from a CRM. So this sort of notion of proactive outreach, this sort of outbounding of a message to a patient, which they then can choose to maybe self serve, right? 

Maybe they can book that appointment for themselves or rebook that appointment. Maybe they can use that tool to give an update on how their pain is or something of that sort. That is absolutely the intention in bringing these tools into the mix because we shouldn't have our humans chase, if we don't need to have them chase and every single one of us knows that today in this day and age, we're less likely to pick up the phone and call, right? 

We'd rather just maybe no show for that appointment or put it off another day. We also are not very likely to pick up a phone call from an unrecognized phone number, right? So how can we use tools in channels that not only proactively send an email or send a text message to someone, but then compliment that with a smooth path for the patient to take that next action that doesn't require them to get on the phone. 

So there absolutely has to be this degree of outbounding. And sometimes that outbounding might need to be a little bit more social than directly clinical, right? It might need to be a little bit more. Hey, how you doing? And not, did you know that you haven't taken your med and we saw it, on the tracker, right? 

Or you haven't gotten this prescription filled or whatever it might be. So again, that's, you get back to a relationship management. So inside of these tools, not only can you have the ability to automate these things, right? And automation is a huge component of what a CRM can bring to bear, but it also can do relationship scoring, right? 

So we can actually say, who are our most disengaged patients? Who are the patients who might have digital accessibility concerns, right? Who might normally be an engaged patient, but they actually just had like a trip to the urgent care and it did not go well. That's when maybe I'm not going to send the text message, but I'm going to ask that human to pick up the phone and give a call and see what happened there and see how we can make it right. 

But you won't be able to know those things at scale unless you've got tools that help you understand not only when to outbound, but how to outbound and what's the most appropriate way to reach out to that person.  

[00:21:23] Stacey Richter: What I think about what you're saying, that's really fascinating, actually, is that most of the time I think that people are doing what you are saying in several discrete silos. For example, you have the care navigation people who are doing something or other, right? Then you have the CRM, which is used as a marketing tool primarily. And it is when you say CRM, people think of the technology system that they're using, right? 

Like if I go on a computer and I type in CRM, I'm going to get a whole lot of software vendors. So it's interesting that you're thinking about CRM, customer relationship management, as a whole entity in and of itself that folds together both all the technology that you're using, but also all of the care navigators, right? 

Because they're part of this. And sometimes you want to reach out and sometimes an automated text or email is going to do the trick. But really thinking about the term customer relationship management, like what are those words actually mean?  

[00:22:21] Emily Kagan Trenchard: Yeah, it's really more of a philosophy. And in fact, we're putting together some presentations to start to do a bit more of a roadshow around the organization. 

I've actually started changing it to consumer relationship management because one of the things we can't forget is that relationship management is not just for our patients. We need to manage relationships with our staff. We need to manage our relationships with our providers and relationships between providers really want to make use of the networks we have of the type of cross disciplinary care that we always, again, aspire to, but where do we have friction there? Where do we have clinicians whose practice could be grown, their networks built, their sort of careers strengthened by support from other types of colleagues? That's relationship management as well. Anybody who's a consumer of our digital offerings has a relationship with us, and we need to know how well we're doing at that relationship. If we're doing it right, consumer relationship management should make every single one of us feel like we've got superpowers, right? It should feel like our technology is not just there to drain our headspace and heart space, but to actually make room for more. Right?  

[00:23:25] Stacey Richter: Yeah. And I think there's probably a lot of clinicians that are applauding right now because as we all know, a major cause of burnout and moral injury is getting stuck. You know, I've heard many times doctors don't dislike technology, they just dislike bad technology.  

[00:23:38] Emily Kagan Trenchard: Correct.  

[00:23:39] Stacey Richter: And there's just so many things that are, it's like a bandaid for the workflow bandaid for the bandaid and you just wind up with this quagmire of clicking around. 

So it sounds like having the philosophy that you have and really thinking about the users of the technology as constituents and people who need to have a voice and how this whole thing gets constructed, I'm sure it's gonna work out better.  

[00:24:01] Emily Kagan Trenchard: And I would say that as I think about taking this sort of CRM strategy forward, insofar as on my right side is my partner in marketing. 

On my left side is the CMIO and is the head of clinical informatics because they need to be right there alongside us, making sure that again, this relationship management is benefiting the clinicians as much as it does the patient.  

[00:24:21] Stacey Richter: So I have heard from more than one clinician who says in response to those HNPs, those history and prognosis forms that you mentioned earlier. 

That now you've got these social determinant scores or whatnot that are part of those HNPs that are now appearing in the EHR system. And the clinician's response is, why are you showing me this information? This is not actionable to me in any way. This is just cluttering up my mind space. There's nothing I can do with it anyway. 

It's just data, more data. Why is it even here?  

[00:24:52] Emily Kagan Trenchard: So I think that's such an important concept to unpack because it has a lot of things underneath it. So if we have a clinician who doesn't know what they're supposed to do with social determinants of health information, that tells us a few things. First of all, were they the right person to receive that information if they don't feel empowered to do it? 

If they were empowered to do something about it, would we want them doing it anyway? If what this person needs is a quote unquote prescription to a farmer's market, should that be the clinician's role or should that be somebody else who maybe doesn't have a medical degree and is paid at that hourly rate? 

There's so much just centralization around assuming that the doctor is the one who, that all care pathways must be administered through. We're not making use of our, our NPs, our ACPs, other levels of clinical expertise. How can we make better use of our nurses? How can we make better use of our health navigators? 

If we can decant some of that stuff down to be acted upon by other members of the care team and empower them, so many of those social determinants of health can actually be accounted for in different ways before the patient even arrives. Again, back to the example I gave. If it's a ride to get there, the doc doesn't need to be the one dialing up the Uber. 

That can be somebody else in the office, but perhaps it's really important for the clinician to know that because that this patient has mobility issues, they ask for them to go to two different clinics in order to do the next testing and follow up. That's going to be hard on them. And so maybe we should think about sending them someplace else where it's a multidisciplinary practice or something of that sort. 

So again, clinical context, is this information relevant and do we have enough other people in the mix to act on it? Because again, we can't keep putting the burden only on our docs. There are so many other members of the care team that need to be activated, just as there's so many other people around the patient who could be empowered to support them in their care. 

And again, that's what we're hoping to do with these tools.  

[00:26:39] Stacey Richter: Yeah. And I think you are bringing to bear actually a really important point that there's this idea, there's this notion of team-based care and it can be done very, very well. And when it is done very, very well, it supports and empowers physicians when it is not done well and is a euphemism sounds good. 

Let's just call it team-based care and it's anything but then it diminishes a term that actually does have a very important place in our evolving future to support clinicians and yeah. 

[00:27:09] Emily Kagan Trenchard: Absolutely. And again, it gets back down to relationships, right? How do we make sure that we're allowing everybody the space to have the kinds of relationships they need, which is not just what they bring to the table, but what can they get back out of the relationship? 

Where can we help our physicians feel more supported? Where do we help our patients feel more supported so that they're not pinning all of their hopes for feeling healthy again on those seven minutes they get with that doc, because that's not going to be enough. How can they see other members of the care team? 

As critical to their success as invested in their success to stay healthy. And then how can they also, this is another thing we talk about a lot. I'm pretty passionate in advocating for tools for caregivers. We don't build enough tools for caregivers. How do we make sure that the things we build in the instructions we give don't just get given to that person who might be feverish and coughing and maybe not in the best state to remember every single bit of instruction that you just gave, but can employ others who are in their social network who can be there to support them and help make sure that they're on the right track to, to getting healthy. Again, all of this is about relationships and it's about not just. 

Identifying the relationships and writing it on a piece of paper, but acting on it in ways that are smart, that are well informed, that are meaningful, and that ultimately are going to have a clinical benefit.  

[00:28:21] Stacey Richter: So, Emily, is there anything I neglected to ask you that you think is important to mention here? 

The Importance of Data in Digital Health

[00:28:26] Emily Kagan Trenchard: So the only other thing that I talk about whenever I have the opportunity is to talk about the importance of data in all of this. And it's one of these like boring but deeply important topics, right? Because everybody says, yeah, yeah, yeah, I'm going to click yes to the privacy policy in terms of service. 

Yeah, yeah, yeah, it's frustrating to figure out who, who is buying and selling my data. But at the end of the day, when we move into this world of digital health, the medicine is being practiced not only on our physical bodies, but on our digital bodies. Decisions about our care are made based on how we are encoded in these systems. 

And if you went today and printed out your medical record, if you looked at it, would it have all the accurate information? Someone would need to care for you? Probably not. And those errors, those omissions are what we're training our artificial intelligences on. They're what we're increasingly leaning on as we interconnect these systems to make decisions about what's the next best action. 

How do we empower patients to be active contributors to their medical records in ways that go far beyond what our clinicians would otherwise consider? How do we empower patients to give information that they think is germane to what a clinician needs to know about taking care of them? And have that captured in our records and in our systems so that when we train our artificial intelligence, when we ask our clinicians to take a look at this patient and make a recommendation. They're doing so not only based on what historically has been determined to be what's important to the patient, what the patient says is important to them. 

Really, I think patient empowerment in their own medical record and data management is one of the most critical things we can be talking about.  

[00:29:59] Stacey Richter: Yeah, especially just given, what's that stat that doctors cut off patients after 18 seconds or 30 seconds or something, you know, assuming that after 18 or 30 seconds that the patient feels heard, but probably more accurately is heard is probably a stretch. 

[00:30:14] Emily Kagan Trenchard: Yeah.  

[00:30:14] Stacey Richter: Emily, it has been such a pleasure to have you on the podcast today.  

[00:30:17] Emily Kagan Trenchard: Oh, thank you so much again. I really enjoyed it.  

Conclusion and Final Thoughts

[00:30:19] Stacey Richter: So let's talk about going over to our website and typing your email address in the box to get the weekly email about the show that has come out. Sometimes people don't do that because they have subscribed on iTunes or Spotify and/or we're friends on LinkedIn. 

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