Improving Patient Outcomes with Telehealth
Episode 470

Mike Baird, President at American Well Improving Patient Outcomes with Telehealth

Delivering comprehensive care through telemedicine

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Improving Patient Outcomes with Telehealth

Episode 470

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Improving Patient Outcomes with Telehealth with Mike Baird, President at American Well was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2020.

Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the Outcomes Rocket. Such a pleasure to have you. Tune in again today. I have the privilege of hosting Michael Baird. He is the President of Customer Solutions at American Well. Prior to this, Mike was Co-Founder and CEO of Avizia. He launched Avizia in 2013 with the goal of improving access to telehealth by eliminating barriers to adoption for health systems and delivering on the triple aim of reducing costs, expanding the reach ,and improving the quality of health care. American Well acquired a visión 2018. Expanding the capabilities of the American Well platform in the acute space prior to American. While Mike held Senior Positions Leading Strategy, Marketing and Product Development teams in Tandberg, Cisco, McKinsey and Company and Dell. In these roles, Mike use his passion for technology to solve complex problems and delight customers. Mike holds a Bachelor of Science in Accounting, Cum Laude from Brigham Young University and an MBA, a degree with distinction from Northwestern University here in my hometown of Chicago. So, Mike, without any further ado, I want to just welcome you to the podcast. Thanks so much for joining us.

Mike Baird:
Thanks Saul, happy to be here.

Saul Marquez:
So what is it that got you into health care?

Mike Baird:
So most of my career has been in technology and not in healthcare. And I had a moment in oh, it was probably 2010- 2011 where I was working at Cisco and got involved in some of these early telemedicine pilots using carts in the emergency department to treat patients quicker. And I had this sort of revelation that, you know, as a guy that’s been in technology for a long time, everyone wants to be a Google before it was Google, right, because by the time it’s Google, all the gains have happened and it’s a common technology and it’s spread everywhere that you want to be there before it’s happened. And I felt like, wow, this is a technology that is going to absolutely transform lives and the way that we get care. And from that point, I felt like I had no choice but to jump in. And that really it was almost that that technology draw of a way to dramatically change people’s lives that pulled me into health care. And then once you’re in, you stay because you get the benefit not only of working on fantastic technology, but improving people’s lives. And that that one two punch, that combination is unlike any industry I’ve ever worked in.

Saul Marquez:
Yeah, I agree, Mike. It’s invigorating to be able to have that that impact. And so you saw it. You you looked ahead and it was a no brainer for you. You jumped headfirst. You in. Is that when you started Avizia?

Mike Baird:
Yeah. Eventually it led to a visit. So there are a couple of years I ran the health care collaboration teams within Cisco started building some of these products to serve hospitals. And as it started to grow, I felt like it was something that can grow a lot faster with a dedicated focus. And so kind of came to a mutual understanding with Cisco, and they actually helped and encouraged me to spin out my team and start a business. And that was the beginning of my journey in 2013. And sort of over the next 5 or 6 years, we we went from kind of starting at 0 to being in 13 hundred hospitals and doing hundreds of thousands of telemedicine consoles and saving lives. And it was just an exhilarating journey.

Saul Marquez:
Yeah. And I think that’s the right word. Mike and, you know, I just gosh, I mean, just pause here for a second and say incredible work. You know, for the people listening to the podcast there, they’re knee deep, neck deep in either trying to implement solutions as a provider or a solution provider, wanting to help a health system or even just from the payer aspect. But the scale that you guys achieved in such a little time is worth of recognition. What was the secret sauce, if there was one that help you scale like that?

Mike Baird:
Thank you for that, by the way. It was probably naivete. I think one of the great things about transforming health care and not necessarily being a citizen of the health care industry is I didn’t have any idea what the regulatory environment was like, what the challenges were like, how the payment cycles go in health care. And in many ways, that lack of background was actually our greatest strength because we didn’t know the things that couldn’t be done. So we sort of drove in and tried to figure it out. And in many respects, I think we’ve seen that in other innovative companies in health care that when technologists kind of coincide with health care and sort of how those collisions and come in, they don’t come in with necessarily the burdens or the background of the health care regulatory burden, which is which is very difficult. And you have to learn it. And I think the best companies come out of partnerships between technologists and clinicians that can do both. Right. because obviously you have to be in line with the regulatory environments and the payment environment and reimbursement and things of that nature. But you need that innovative chip to get it going. And then a little bit of the grounding of reality which comes from the clinical side, but combined we see great innovation. And I think, you know, coming from either side, it probably wouldn’t happen on its own. It really is in partnership.

Saul Marquez:
I love that. Now, that’s great and appreciate you sharing that with us. And, you know, just obviously today, folks were talking about telemedicine, virtual care. Yeah? What do you want to call it? Mike and I had a good discussion before recording. The point is what you deliver. So on the topic of telehealth. Mike, what is it that you guys are doing to that’s different? And how are you improving outcomes and business models?

Mike Baird:
There’s so many answers to the hard question that I can go into. But in short, the way American Well has come at this market is we’re trying to provide a broad swath of the health care ecosystem, access to technology to improve and improve patient lives. And I say broad because we play in the health plan space. You know, we work with dozens and dozens of plans covering 150 million lives in America. We work in the health system space. We’re in over 20, 400 hospitals at this point. We work with thousands and thousands of employers. And so we’re playing in a very broad spectrum of the health care economy, including, you know, digital innovators like Apple and others that we that we partner with. But we bring that technology that lets them transform their day to day processes into something that can be more efficient, more on demand, and give patients access to care quicker. And so ultimately we bring a brokerage engine Right.. Our job is to match a patient with the right provider. At that point in time, and the right provider obviously has to be credentialed and licensed, then they have to have the right skill set for for that patient. But if we can do that, well, we can transform healthcare.

Saul Marquez:
Love that. And so I am so you guys are working on your end on the acute set. What’s the other side of American Well, what’s that focus?

Mike Baird:
Yeah. We do more consumer video visits than any telehealth company in the country today. It’s very much about making that beautiful smartphone in your pocket into a virtual waiting room. And that ability to see a doctor instantly. And so America Well, we kind of have two product portfolios. One is very focused on the clinical side within the four walls of a hospital or a clinic or a nursing home or a school using devices and then aggregating data to to do more acute meaning consultations. Right. doesn’t have to be neurology Right.. It can be pediatrics as well. And then the other side would be more consumer centric where, you know, I have five kids. So I interact with the health care system pretty regularly. Congrats though, when it’s 3:00 in the morning and my daughter has a sore throat, the fact that I can be talking to a doctor immediately is fantastic. But those are very different worlds in many respects. The the way you find the right doctor, the way you deal with licensing, the specialty that you need and play are a little bit different. And so we focus our efforts along those two, thrust the clinical onto the consumer.

Saul Marquez:
I love it. Thank you for for that clarification. It’s so clear. And for those of you listening that didn’t know that, now you know the split. They’re doing incredible work American Well and the telehealth space setting the example for the way things should be done. What would you say is a setback that you had, Mike, whether it be out of Avizia or American Well, that you you would say you attribute to a lot of your success today.

Mike Baird:
Yeah. I think that’s a great one because as is an entrepreneur, you can’t help but fail. Right. And we feel a lot. And because I’m kind of a product guy, I tend to go to product things where, you know, we picked the wrong software module and some of our code. Because, you know, we’ll use best of breed code for different things like device drivers and things of that nature. Or we pick the wrong monitor or we pick, you know, some process that we did in a way that made sense to us. But then it didn’t make sense to the provider. You know, the way the user interface works, for example, there are so many of those that I couldn’t name them. But I think the reason that it was helpful and this is a theme I talk about a lot in terms of innovation is it brought us down the experience curve in an effect. You know, for example, we launched one of our carts a couple of years ago. And the initial you know, when you do video today, there are hundreds of different video modules you can use on a device. And the first version that we did use, the video module, that just didn’t work very well in hospital systems. You know, it was great for your smartphone, but it wasn’t really good for devices and being able to send stethoscope data, for example, or an examination cameras. And so we tried a second one and we spent six months on the second one. And then it didn’t really meet all the needs that we had. And one, do some fancy things with the camera. And the way we track had a position that was remote, move that camera around the room and we had to move to a third one. And on the one hand, we can look at that and say, wow, we wasted 12 months trying three different video technologies. But on the other hand, I think, wow, we moved down that experience curve. Yeah. And until my competitors or others tried that, they’re actually behind me because that’s the lesson that we learned. And we now know when we evaluate new technologies, things to look for Right.. Does this give me the flexibility to do what I need to do? And can I customize this to work in a health care environment? Because health care is very, very different right there. There are certain requirements that have to have. And so if anything, we try really hard to sort of embrace that concept of failure, but instead make it. How do we fail faster? Yeah. Because the lesson for me was, well, how could I have made that first iteration three months instead of six months? And so we try to focus on that. But we’ve gotten better at that. You know, when I look at where we are today and we’ve gotten over 600 people in America Well, back in the days when a visit was 10, it took a long time to invest in the technology and get one of those failure points. And now we can do neat things to make that happen quicker. We’ve got, you know, five 3-D printers in the lab that are cranking out sample parts that we can try out and do rapid innovation quickly and do the word right. We’ve already school week. It’s really fun. And you can do things like that in software testing as well. And so some of those themes, I think not being afraid of failure is super helpful because it helps you become more resilient over time.

Saul Marquez:
I love that. It’s a it’s a great call out and. And would you say the same thing goes for the adoption of this technology, not just the creation of it, but the adoption, this experience curve. So people want to wait till it’s easy.

Mike Baird:
People want to wait. It’s interesting. We do a lot of data analytics on this of the industry and of consumers. And it’s something like 66 percent of consumers are willing to use telehealth, but only eight have actually tried it any other way more than when we asked that question four years ago, it was like 2 percent. And then two two years ago is like five percent. So, you know, it’s slowly moving up. They’re willing, but they haven’t done it. So that’s the consumer side. And any consumers will tell us a quarter of consumers are willing to switch their PSP if their PCI. He has video visits. We hear things like seniors’, something like 70 plus percent of seniors are willing to try telehealth. And you wouldn’t think that Right. where we think that video and technology, the millennial. So if the demand is there, well, we have to create the supply. And so the challenge that I see with health systems is they get stuck in this rut of a problem isn’t solved. So we shouldn’t even try, right? We don’t. We your reimbursements not perfect yet. You know, we’re not truly shifted to a value based care system yet. You know, we all those things are great. Then we’ll try it. Well, just like my example of video technologies, they’re not moving down the experience curve. And so we’ve seen customers that have jumped in and sort of the classic innovator’s dilemma where you almost have to cannibalize yourself. Right.. If we all accept the notion that in five years or 10 years or pick a number at some point in the future, I think we all believe that the majority or some large number of physician visits will be virtual in some form or another. So if we know what’s going to get there, do I want to be the last person there? Shall I be the first person there? And while that may disrupt the way we do things today, I’ve got to start going down that path now. And, you know, we’ve seen some of our customers jump in and do that and have phenomenal results that they couldn’t have anticipated that give them return on investment of some sort. Long. Before reimbursement exists or before there’s that full shift to value and. And so my encouragement for health systems would be to start jumping down that curve. Now there are concrete things you gotta do to make that happen.

Saul Marquez:
Mike and I read like your your idea here. You know, this this idea that sure. Maybe the reimbursement pathway is not fully established, but if we if we take a look at anything in the market, if you’re able to add value, there’s a way for you to monetize it. By way of either returning patients or you fill in the blank. Right..

Mike Baird:
Well, let me give you an example of that. Sure. We a to hear that that’s jumped in all in on telehealth. You know, they have over 20 different service lines that are telehealth enabled and they found that they have high throughput issues in their E-D and so they basically create a room off to the side of the E-D. So when you show up in the EDI and it’s a 45 minute wait, they say, well, hey, if you want you can come in this room and see a doctor virtually right now. Now, of course, that doesn’t work for every use case. If my arm is sort of dangling from the socket, I’m not where I want to go imitation. But there are a lot of use cases that works for and they’ve seen a 50 percent decrease in door to evaluation time and a 70 percent increase in door to discharge time because of that. So now you’re correct that today, depending on that state and the patchwork of regulations they have, I don’t know if they get a $50 reimbursement or not. But as a system, if I can reduce the wait times in my E-D by 50 percent on some level, that’s going to have an impact on my business partners and patients are going to be much happier. They’re going to get access to care quicker, that we’re going to get the right patients to the right doctor in a much more efficient manner. And so those are fantastic savings. And so this particular health system that’s doubled down on that is getting a return on investment long before anyone else. And not only that, they’re getting better and better at how to deploy video. And so someday when it’s perfectly reimbursed and there’s literally no difference between the two and we’re getting closer to that all the time. They will be so much further ahead because they were willing to sort of take their lumps now and start learning. And I think that’s one of the challenges we see, is it helps us to get a little bit overwhelmed by the regulatory environment. They’re afraid to do more than dip their toe in. And I would argue they actually have to jump all in to start figuring that out now.

Saul Marquez:
Love it. It’s a great example, Mike. So I asked you about a setback and you gave a wonderful description of how you guys innovate products. I love that you took us to inside of your lab, but you have 3-D printers. Didn’t know that a lot of the innovation happened within the walls of your business. So that’s pretty cool. Take us to the other side of that coin, Mike. What’s one of the proudest leadership experiences you’ve had in telemedicine, telehealth?

Mike Baird:
I appreciate you asking that. It’s actually almost I’m an emotional guy. It’s hard not to get emotional when I think about some of these events. I’ve seen many of them, but one that I’ll never forget. We partnered with Dallas Children’s Hospital and Dallas Children’s has this really great program where they partner with the Dallas Independent School District to help augment school nurses with pediatric coverage. A fantastic example. And in many cases, what you’ll find in some of these schools is that a kid will come to the school nurse who has no PCV. They’re not getting regular care. And in one particular example, and they showed us pictures of this kid, a kid showed up at the school nurse with this massive lump on his head and they were talking to a pediatrician. And in the course of that video console, the pediatrician correctly identified this kid had a malignant tumor and cancer and within 24 hours got him into the E.D., got them working through cancer care, ultimately saved this child’s life. And to me, those examples are they’re almost impossible to replicate in other technology industries. And that’s why I love being in healthcare, is the fact that our team created a technology that literally is saving someone’s life. You know, we do thousands upon thousands of stroke consoles every year where you change the outcome of someone’s life in a moment, because this technology is available. And that will always be what makes me proud about being affiliated with American Well is the impact we have on patients lives. I mean, you almost see we can’t do this for free, but you almost wish you could do it for free. You know, we need money to drive innovation, new great things. But for the public good. I honestly wish you could just give this stuff away because it absolutely changes patients lives.

Saul Marquez:
Well, it’s a great story, Mike. And I agree with you there, too. You know, without margin, there’s no mission. And you guys are adding a lot of value and just thinking through that scenario with that child than the tumor and all of the other stories in this country that, you know, are impacted with the social determinants of of health and the power of that telemedicine could have on that is is, I think, just tremendous.

Mike Baird:
Yeah.

Saul Marquez:
So you do an Oscar there. So love that story. Mike, tell us about one of the most exciting projects you’re working on today.

Mike Baird:
So I’m going to phrase this by it’s not going to sound exciting, but it’s exciting. OK. So we we were recently honored to be one of the first telehealth vendors to get some of our apps published in the Epic App Store. And so each bar is rarely something that someone brings up, something exciting. Right. But the reason I’m excited, I’ve been in telehealth for almost a decade now and for a long time it’s been kind of an us vs. them. Each our providers want to promise the moon they’re going to do everything under the sun for you to justify the astronomical price tag and all those things. And in the last two or three years, we’ve seen a massive change in the majority of the each. Our providers are giving ways to collaborate and integrate and work together with technology partners. And so we’re investing a lot in that each hour experience. And I’ll tell you why. Telehealth usually starts with a clinical leader. This is a champion who in that pediatrics example earlier, they see the impact they can make and they just by force of personality can get a grant and they get some people around them. They start a program and that’s great. But generally speaking, those programs are very limited in scale. They help, you know, one hundred patients a year. And it’s really driven by one provider to truly change health care and get to the point where my dream is a field where, you know, virtual visits, double in-person visits. You have to get to all providers. And what we found is that where there will always be some group of providers that use telehealth multiple times a day and they’re willing to figure out new technologies and log into new systems and and really pursued innovation cur-. But the reality is most providers, nurses, clinicians, physicians, whatever it may be, they got really busy jobs. They have to document. They have to do. They’re very busy. And so in many ways, the easier that we can make it for them and incorporate it deep within their workflow. So it’s literally just a button that they can click in the middle of their summer session or their EMR session or their epic session that makes it so much easier for them to adopt it. And so I’m excited because that to me is the ticket to having 100 percent of physicians using this. And even if you know, 90 of them only do one visit a week versus the 10 to do a hundred is the week, that’s ultimately what will make the industry explode. And so that’s something that, again, people don’t typically say, I’m super excited about the work I’m doing on each other today. That’s something I’m really excited about. And I’m grateful for the partnership of the leaders in this country that we’re working very closely with to make that a reality, because it’s helping tell a healthy, more pervasive.

Saul Marquez:
Love it. Yeah. I mean, it’s it’s an access point, right? I mean, that’s the bottom line. If you could get through that access point, it becomes a little less cumbersome and extra work for the providers.

Mike Baird:
That’s exactly right.

Saul Marquez:
Great then. And congratulations on that. It’s not easy, but you guys once again are proving that there is a way to get it done. And and I love that early on you said it’s that naivete. It’s good to keep that alive and keep it going. I know here and it’s been years now, but you still got a dose of it.

Mike Baird:
I never let something that I don’t know stopped me from jumping in sometimes to a personal arm or injury. But we can’t be afraid to try things out.

Saul Marquez:
I love that. Now, it’s a great quality. I love that about you. And so getting to the lightning round here, I got a couple of questions, followed by a book that you recommend to listeners. You ready, Mike?

Mike Baird:
I am. All right.

Saul Marquez:
What’s the best way to improve health care outcomes?

Mike Baird:
I think it’s always about aligning incentives. So in that example I gave earlier. These doctors get bonuses to do telehealth visits. So even if reimbursement isn’t set up today, I take that worry away from them and they have a way, a reason to do it. And so if we’re really going to be serious about making progress on these things, we’ve got to open up those channels to make it happen.

Saul Marquez:
What’s the biggest mistake or pitfall to avoid?

Mike Baird:
I see this often in health systems where they struggle with best of breed versus enterprise. So best of breed means for whatever technology I have. I’m gonna go find the absolute best vendor for every single use case. And that’s a great theory and it works really well on the early end of markets. But what you find on the other end is that you end up with 100 different vendors and a health system, zero collaboration between them and zero gains across different departments and things of that nature. A great example would be there’s thousands of bankrupt imams. It really wouldn’t do that good in a hospital to have 50 imams. We have enough challenges with one Right.. But there is benefits by bringing that data together. And I think as technologies grow when they’re when they’re early, Lessenberry makes a lot of sense as they grow. You need enterprise vendors. They scale better. They understand the inter connectivity of the health system better. And I think that’s a mistake that often gets made because you’ve got a passionate individual that wants what’s best for them as opposed to a strategy that makes the most sense for the enterprise at large.

Saul Marquez:
That’s a really great point. How do you stay relevant as an organization despite constant change?

Mike Baird:
So I love Andy Grove quote from Intel. He said, Only the paranoid survive. And the reality is, this is the classic innovator’s dilemma. You always have to be innovating nonstop. You always have to be learning from your customers, seeing the challenges that they have. Because when you finally go with a solution, that’s good enough for the problem of yesterday, something is going to come today. And so for me, I don’t think that I’m the guy that’s going to come up with all those solutions by myself. I find them from talking to customers, providers, clinicians, physicians, whoever, nurses. They have fantastic ideas on how to transform health care. They’re doing this every single day. They repeat the motions over and over and over again. And they’ll they’ll come up with some of the most amazing insights. And so I always want to be worried about technology that can disrupt me. And the way that I find them is by talking with folks that are in the business every single day, helping people.

Saul Marquez:
Great advice. Something to think about is as you build your own technologies, you can’t rest. It’s that only the parent might survive. I love that. What’s an area of focus, Mike, that drives everything at American Well?

Mike Baird:
Ultimately, I’ll call it quality, but it’s more than just quality. We as I said, there’s a naivete and we want to jump in and we want to try things and innovate. But we always have to remember that at the end of the day, this is about a patient’s life. This is about real healthcare. And for us, it’s not always just a quick visit on my smartphone. Right.. We do neurological console’s while a patient is in the middle or immediately after a stroke. And so we have to remember that whatever we do has to advance the health and safety of that patient. And we take that very, very seriously, not only from protecting that patient’s life, but as a steward of the industry. Telehealth won’t grow or expand if we’re negligent. If we don’t do the right things. And so this is something that we we take to heart and and think about our patients every day as we’re innovating products.

Saul Marquez:
That great, true north and definitely something that drives a lot of listeners here. So out of all the books, which one would you say listeners this?

Mike Baird:
There’s so many great books. It’s hard to pick one, but one I like to share because it’s just a little bit different. It’s called Endurance Shackleton’s Incredible Voyage by Alfred Lansing. And it’s about Ernest Shackleton, who was one of the great Explorer era of the early nineteen. Hundreds of people were all trying to get to new first. Shackleton was trying to cross when the first people to cross Antarctica. And but unfortunately, they took their boat. And as they got there, they kind of got off the coast of Antarctica. The ice crushed the boat and it sunk. So imagine if you were there with 15 men standing on an iceberg in 1910 or whenever this was, and you don’t have the technology of today, how are you going to survive? And he did not only didn’t survive and save the lives of all of his men, but the innovation and the creativity and the leadership that comes from those hard situations is something that motivates me personally, because as an innovator, it’s hard. Right. solutions don’t always work. Customers don’t always buy decisions don’t always pan out the way that you wanted them to. And I’ve found a lot of great insight from watching this group of men and how they interacted as a team to overcome one of the most phenomenal human challenges ever seen at that point in time. The best part about the book is there’s a lot of pictures. And no, I really think of what it would be like to literally watch your ship sink. Well, you stand on a piece of ice. Hundreds of thousands of miles away from people.

Saul Marquez:
Mike, are these actual pictures or just illustrations?

Mike Baird:
They’re either actual pictures. They had a photographer that, despite trying to survive, took the effort to save these photographs. And it’s just human achievement is one of those great things that inspired us all.

Saul Marquez:
Yeah. Now, for sure. And I got goose bumps with your trailer. One that I’m going to pick up, Mike. So I appreciate the recommendation, folks. You pick it up, too. It sounds like a really awesome book to help inspire team keep innovation. Go on where you’re at. At the end of the day, the call to action here, folks, is get into the experience curve. You have to start now because if you don’t, you’re going to get left behind. And and Mike’s provided such a great just reference on stories and customers that have had success with that. But I want to hear from you, Mike. Give us a closing thought. And the best place for the listeners could engage with you if they want to continue the conversation.

Mike Baird:
Yeah. I mean, the closing thought is the recurring theme here. And at the end of the day, we’re all stakeholders in health care and we can’t be afraid to try. Right. It’s really easy. And I think too often in healthcare we think of all the reasons not to Right.. I’ve got liability concerns, regulatory concerns, cost concerns. There’s no political hurdles or whatever it may be. And what inspires me are the brave clinicians and nurses and physicians that try. They want to make the industry better and they jump in and they figure it out as they go. And I think that’s my my goal and my challenge to everyone in the industry is to think of one thing that you can change in health care and start to do it, because, you know, when you fast forward and if you’re so lucky to have your innovation be accepted and to work out as I have been in my career, there is nothing more rewarding than looking back and see the impact of what you’ve done, seeing that you’ve touched hundreds of thousands of lives, and that only happens when someone’s willing to try. And so that’s my push for everyone to give it a go and try something new.

Saul Marquez:
Love it. What a great message. And Mike, if the listeners want to continue the conversation with you or American Well, where do they do that?

Mike Baird:
So you can always go to wwww.AmericaWell.com and plenty of folks will swarm to you could do as to your question. But you can also reach me at Mike@American Well.com. I’m always available. I love to hear from customers and I love to learn ways that we can improve.

Saul Marquez:
Love it, Mike. Really appreciate your time here, sir. And thanks for sharing your insights and been fun.

Mike Baird:
Thanks for. Great to be with you today.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

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