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The Power of Patient Advocacy

Episode 424

Recommended Book:

The Bright Hour by Nina Riggs

Best Way to Contact Leilani:

leilani@clarahealth.com

Mentioned Link:

leilanigraham.com

The Power of Patient Advocacy with Leilani Graham, Director of Patient Advocacy at Clara Health transcript powered by Sonix—the best audio to text transcription service

The Power of Patient Advocacy with Leilani Graham, Director of Patient Advocacy at Clara Health 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 2019.

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

Saul Marquez:
Welcome back to the podcast. Today, I have the privilege of hosting Leilani Graham. She's the Director of Patient Advocacy at Clara Health. She's a four time cardiac arrest and four time open heart surgery survivor, former implanted cardiovascular defibrillator, owner, heart transplant recipient and current pacemaker user. She was diagnosed with hypertrophic cardiomyopathy after an aborted sudden cardiac death at age 13. She was transplanted on February 3rd, 2016. And the next day, her new heart failed. Leilani coded and was put on Akmal for a period of 10 days with three subsequent open hearts before the donor heart eventually recovered. A year later, the donor heart presented with Total Heart Block. And today, she's an influential patient advocate. Lending her 20 year expertise in chronic illness by consulting for TED Med, the American Heart Association, Verily, PCORI and well, Medtronic and others. They Leilani is an ex Googler Stanford Medicine XE patient faculty member and is the Director of Patient Advocacy at Clara Health. As we introduced her so. The story is an incredible story. I got to meet Leilani at the TED Med meeting where I was just awestruck by her story. And I said, "wow, we've got to get you on the podcast so you could share with the listener." So with that, I want to open up the microphone to Leilani and welcome her to the podcast. Welcome.

Leilani Graham:
Hey, thanks so much for having me. It's so great to meet you in person. And I really appreciate your wanting to ask to share my story on your show.

Saul Marquez:
Hey, Leilani, it's a true pleasure. And the one thing that that struck me from just chatting with you is your is not your story in and of itself, but your passion and your resilience. And so you were sort of forced into healthcare through your own experiences, but truly wondering more about like the reason you decided to work within healthcare because you didn't have to. So know just curious about that.

Leilani Graham:
Sure. I mean, I think you hit the nail on the head there that I often tell people I am the patient, not out of choice, but because I have to be. And, you know, for a long time I had hypertrophic cardiomyopathy or HCM, and I really didn't consider myself a chronic patient. It was just sort of the nuance to my life. And maybe that came from a place of sort of childhood naivete. But, you know, I really didn't consider myself a patient until I had the transplant and sort of wrapped into living day to day in order to basically do treatments and go to appointments. And so for a long time, I thought, well, I want to go into a field that's completely different from this. I have to deal with it every day. But I noticed once I started not only sharing my story, but doing so in a setting that was really impactful. So I started out more for residents in hospitals and hearing from them after that, they had they'd never met a patient post ICU or, you know, they'd never seen someone after the transplant was just kind of mind boggling to me that they were being involved in such a specific nuance of healthcare and then not able to be the end product with regularity. And I realized that I could move my influence in healthcare beyond kind of the tokenism as sharing my story to consulting and then having that kind of impact. And I started to realize on a personal note that sort of the maters of my experience could actually help inform changes and ameliorate somebody else's care. And that felt really gratifying to me. And so that's really why I moved into doing the kind of work that I've been doing with greater regularity and why actually transition working full time and patient advocacy.

Saul Marquez:
It's a great story. And you know, I, Leilani… I have a quote on my whiteboard. And the quote says, "Impossible is just an opinion." And when I think of you and make your story, it's like, "wow, you know, this is Leilani right." Impossible is just an opinion. You know, you got through this stuff that that you went through and have the courage and fortitude and tenacity to continue doing it for others to help them and their experience. I think it's awesome. So, you know, as you work to do your work, what would you say is something that needs to be on health leaders agenda and how are you approaching it?

Leilani Graham:
Great question. You know, I think there's a lot of talk in the industry right now about patient engagement and what that means. And, you know, I sometimes go to the conferences that where I'm the only patient who's there, you know, the physicians and nurses and different clinicians and everybody's talking about how do we engage patients? And there's not a single person who the patient really in the audience just kind of shocking. Because it's sort of like, you know, if I could take an analogy, it's sort of like talking about how to write music about anybody that actually plays music in the audience. And I think it's kind of a misnomer because patients, you know, we're sitting here, we're waiting, we're ready to be engaged. And I think with the adoption of tech in healthcare and how much we're using telemedicine and all these different apps and stuff, self-appointed data, I think we need to be thinking about meeting patients where they are and finding ways to dig into the resources and the technology the patients are already using. We're trying to use to connect with their healthcare rather than building new platforms or Brady apps that are a barrier to entry because a patient has to download that. One more thing. And specifically with regard to the work that I'm doing now and working with Clara Health, what we're trying to do is make clinical trials more accessible to patients. And, you know, I think there's a there's a lot of questions that we ask the industry that why doesn't every clinical trial have a patient ready web page? Why do patients have to seek out these trials? What shouldn't they be easily accessible to them? And so we're trying to make that process more streamlined and like valuable across the board.

Saul Marquez:
It's a great initiative, a great mission to tell yourself to Leilani. So it be great to hear an example of how this is being done. You know, accessibility is increasing for patients and maybe a story if you have one.

Leilani Graham:
Sure. So, you know, on the personal side, just remember, you know, back in the day, quote unquote, that, you know, if I wanted to reach a clinician, I would have to either book an appointment or maybe give a phone call to a central phone bank and that would be granted to a nurse. And then I saw back in two or three days. And nowadays, I'm able to text my nurses and say, "hey, I've got this funky symptom that's happening and I'm kind of concerned about it." And I can get a response within 24 hours. And it's so valuable to me because on the one hand, it saves them time because they're not having to take time out of their day to do a whole phone bank callback. But then it also saves me sort of the mental energy of having to wait for an answer or having to hop out of a meeting to plan to make these phone calls. And it improves your core so that I'm able to understand where the boundaries are in terms of I don't I won't use their phone numbers if it's not between 8:00 a.m. and 5:00 p.m., but at the same time helps them understand how I like to be cared for. And on the you know, on the Clara Health side, you know, what we're trying to do is, you know, the mission that the founders signed at the company, one of our co-founders, Phil Chen was at her university. And I was noticing how on different dashboards around campus or different information portals, there would be all these papers with, you know, the traditional like "do you have LTV, join this study' and it would have all these little tear off leaflets. And she was just kind of dumbstruck by that and was like, there has to be a better way. So at Clara what we're trying to do is connect, which is course potential treatments through cutting edge technology and really wanting to make sure that every trial that we bring in has that patient. A web page has a process that doesn't rely on faxing and phone calls, but is bringing in a charge just as easily as we're bringing in patients and is making sure that the process is just not extra work for these patients who may be chronically or even terminally ill for whom clinical trials might be their only option. I think a lot of these companies don't necessarily cater to the fact that that people are already going above and beyond to seek out these opportunities. So we need to be more sensitive to their needs and what's going on in their environment.

Saul Marquez:
Yeah. You know, super interesting. And add a visual of the co-founder of walking around campus and there it is next to the rental. You tear it off to call. And oh, by the way, hey, if you have this sad, you know, symptom or disease, call us. It's like so antiquated…

Leilani Graham:
That's an open mike sign.

Saul Marquez:
Yeah right open mike and free donuts. And now, by the way. Right. Yeah. And so you talk about accessibility and it's definitely a big thing to keep in mind. And so many people are looking for solutions. And you mentioned earlier in the podcast meeting people where they are. How do you do it? You know, because it is challenging. How are you guys finding the people to get them the treatments?

Leilani Graham:
Great question. And that's definitely a challenge. I guess the way that we think about it at Clara, is, you know, we try to, again, meet the patients where they are. So we're not just ingrading ourselves in the doctor's office. We're doing that. You know, we're having those leaflets and we're having those traditional marketing with the paper, but we're also using Google AdWords. We're using Facebook ads. We are partnering with advocacy groups and reaching out to patient influencers who are kind of this up and coming group of social media gurus. And we're trying to do that all in a way that's caring, that's respectful, but not pushy, like traditional big pharma and something eat. And, you know, one thing we're really trying to to lean on is that if we don't have the right clinical trial for you right now or worse, the one that we are maybe cosponsoring isn't right for you. We want to make sure that we have another trial in our database. That is the right fit. But we want to make sure that you know, that you have other options. So whether that's recommending a second opinion service or recommending a support group or an advocacy organization that might be able to help. We want to make sure that if we aren't the right place for you, we're helping to find a place that is.

Saul Marquez:
Got it. Got it. So is the approach direct to consumer or are you working with providers as well or how does that work?

Leilani Graham:
Yes. So the majority of the work we do is direct to consumer because we really believe that patients are the end user and in technology and really in healthcare. I think on the personal side, for a long time, I was really struck by the fact that, you know, a lot of device companies or pharmaceutical companies are selling to providers. And that was kind of surprising to me because at the end of the day, it's patients who walk away with these things implanted in their body, patients with the responsibility of taking those medications every single day. So, at Clara, we really try to focus on the patient as the end user. That being said, we definitely partner with providers and with clinicians because we want to make sure that there's a certain level of trust that comes from these healthcare professionals and these licensed individuals to really understanding industry. And we want to make sure that we have their buying them so that patients feel comfortable and feel that they can trust by way of approval from providers.

Saul Marquez:
Yeah, that's great stuff. And folks, for everybody listening. Clara Health right. I mean, think of them as as a as an opportunity to connect to somebody that you know to a therapy or a pharmaceutical that can help them in what they're going through.

Leilani Graham:
Exactly.

Saul Marquez:
So this is a great opportunity for you to put this company in. And also think of Leilaini, when you think of, "hey, you know, how can we help people that we know?" Because it doesn't end up becoming a grassroots thing and that's how it spreads.

Leilani Graham:
And that's exactly why I joined Clara to begin with. And, you know, it was kind of perfect because I'd been doing some consulting for them as a patient advocate. But, you know, the woman who had held this role before me is, was and is a patient. And I was so struck by how important it is to Clara to make sure that that voice is represented at the highest level. So, you know, for a long time, in my professional experience, my heart condition and my heart disease has sort of been "how much do I share about that?" And I think traditionally in the business world, we're told, you know, don't talk about your illness and that will be a reason for discrimination. But at Clara, I was hired in large part because of my story. And not only because of the nature of my story, but because how I used it to be able to talk about what has happened to me or what I can see as something that needs to be improved on in healthcare and the kind of advocacy partnership that I had built sort of in my personal journey. And so, you know, at Clara we said, "hey, we want all of that. We want your experience. We want to know how to talk to patients. We want to make sure that we are including the patient's voice at every level of partnering with these different scenarios, with different clinical trial organizations." I was just so blown away by how important the patient's voice was to them. And, you know, I think a lot of reasons that the different companies want to partner with us to help recruit and retain patients for their clinical trials because they know that we're so tapped into this network. And that's something that a lot of other companies are really honing in on. And it's one of the reasons that sets us apart as being able to recruit and retain patients in clinical trials at a rate far greater than a lot of companies in the industry.

Saul Marquez:
Yeah, definitely a strong value add having a direct connection to the patient voice and the stream of thought. And so as you reflect on your career in healthcare, Leilani, what would you say is a time when you had a major setback and what did you learn from that?

Leilani Graham:
That's a great question. I think, you know, at Clara, one of the things that that we experienced was one of the first patients that we enrolled into the clinical trial, into seeping into a clinical trial, passed away very shortly after the study began. And the team was totally heartbroken. You know, we really wanted to help the patient. And we received a handwritten letter from the late. And sharing how thankful he was that we had helped their family just turn over every stone and evaluate every potential treatment. And even though he had lost the love of his life, he could sleep at night without wondering if there's something else he could have been doing. And that was really a defining moment for us, because in some ways we sort of felt like, oh, wait, we found the patient because she passed away. But it really taught us no. I mean, in the eyes of the family of this patient, we had been able to make a positive impact because we had really, really left no stone unturned for them. And that's what our internal bar really high, because we knew that we never wanted to leave a family member wondering if something else could have been done. And that really hit home for me, because, you know, in my personal journey as a patient, there were times where I felt like, you know, either perhaps my providers or perhaps even myself that I had ignored some symptom or I haven't recorded something that was going on. Or maybe they had kind of brushed it off as being within the standard deviation. And then and that particularly happened for me with a heart block at it. You know, it took us a year and four months to diagnose history. And, you know, that was something that I still look back on and think, "gosh, could I have, you know, the days I was feeling dizzy? Was that something I should have talked about?" And I think, you know, in my own personal healing and understanding of what happened to me, I think I've had to really kind of cut myself some slack because, you know, my internal voice wants to say, "well, you failed because you didn't recognize this was happening and you missed something." But when I really look at it on paper and my team, we left no stone unturned. I did every cardiac arrest in the book from an EKG study to an MRI to every external monitor that is on the market. And finally, we were able to diagnose it. And I think that's something that's really tough for patients who go undiagnosed for so long or who are seeking a clinical trial for so long because they feel like when their head hits the pillow at night, "gosh, there's something else I could be doing." So I'm really motivated by that feeling.

Saul Marquez:
Yeah, that's powerful. And, you know, just knowing that you're you're not leaving any stone unturned is a good feeling. And I guess that the word that comes to mind is hope. Right, you're giving these guys all hope and a system that let's just be honest, this is hard to navigate. Where do you go? You know what? Well, what's available? And then scraped it to be somewhere that you're sort of a hope merchant of some sort. And that's pretty cool.

Leilani Graham:
Yeah, that's so true. And that's something that is so impossible to quantify. But once you hit on it, you just know.

Saul Marquez:
Yeah. For sure. And so what would you say the proudest thing that you've experienced to date in your work?

Leilani Graham:
Yeah so, you know, as a part of my sharing my story, I think I think one of the proudest moments I had was I'm speaking at a symposium for pursuing this and for anyone listening that doesn't know that there would be technicians that help from Hartland bypasses and an AMA, which is that extra click or no oxygen there, which in itself is a mouthful, but.

Saul Marquez:
Yeah.

Leilani Graham:
Yeah, right. And they're highly trained professionals and they basically are able to monitor that machine that takes the blood out of your body, mechanically oxygenated returns that your body, which is just mind blowing. So I was thinking for them on my experience being on GMA, because it's actually rather rare that someone is conscious while on it and post transplant while we are figuring out what was happening. I was conscious for about 10 days. And so I know for better or worse, remember a lot of experience. And I was sharing that story and I come from from a theater background. And so I was putting some jokes in and I was trying to make a light hearted cause that's sort of how I feel, a trauma. And I noticed none of those jokes were landing and I wasn't getting any laughs tonight. I kept thinking to myself, gosh, tonight I don't write this much to the on my performance. And I got to the end of the speech and I was finally able to make eye contact with the people in the audience. And I realized that everyone was just sobbing, just sobbing. And, you know, precision just came up to me afterwards and she hugged me so tightly. And my mother was there with me, too. And she said, you have no idea what it means to me that you came and spoke with that, because I've been doing this work for 20 years and I see patients every day in the ICU who are completely unconscious and were frankly on death's door. And she was you know, it's so easy to burn out from that because you see so much, so much suffering and said you just really made money. My whole career worthwhile. And I was like, "oh, my gosh." You know, I practically started crying because it's really that human to human connection that that makes all of this so important and so worth it. And I think, you know, in the work that I'm doing now, that that's exactly what we're trying to hit on and work with with patient advocate specifically who has really suffered with this. And we continue to suffer either because of the bureaucracy and that's it. Like you said, the difficulty navigating it or because, you know, their condition has been really, really trying, you know, and they may not have been receiving the gold standard of care that they could be. So it's listening to those stories and trying for to advocate on behalf of them to make the experience better. If even if we can't help make their condition better, make, you know, try to make sure that they're they're getting the best care they could get.

Saul Marquez:
Love that. Yeah, you know it's a great call out. And, you know, it's an incredible experience, I'm sure, to have delivered that message and impacted the clinicians life. I mean, you said you impacted her career. You know, it's a big deal. And it's funny because you're thinking, "man, none of my jokes are landing." In the grand scheme of things, you're really touching them in a deeper way. And I think it is really, really great that that you had that moment and I'm sure it open your eyes to even the greater good that you could do when you speak to people. So what's an exciting project that you're working on today Leilani?

Leilani Graham:
Yes. So part of my role is that I'm working with Medicare patient advocate who, you know, a guest in the industry and trying to learn from them. So I clearly have something called the breakthrough through. And that is essentially our cohort of these really stellar, really incredible individuals who have a wide variety, a diverse variety of illnesses or diseases that can be just like me to to the nuances of their experience. What we're trying to do is build out that breakthrough and make sure that we have diverse representation not only from from different diseases, but also from different ethnic backgrounds and so few economic classes and age. You know, I think that's something that is an area that's kind of untapped, at least from what I see. And advocacy across social media is, you know, tend to a lot of younger millennials who know how to how to navigate these apps really well. But, you know, there are a lot of people who are experts in their disease, isn't an expert in navigating the system who have had to do so for 50 or 60 years. We're really excited about getting more feedback from them, from those kinds of individuals and making sure that we're representing a wide variety of experiences and some of the other work that I'm doing in making sure that we demystify clinical trials. I think something where we're really trying to avoid it, Clara, is this kind of magic wand syndrome of health tech. I mean, you know, right now it's AI every company tells you they're doing. And, you know, coming off of being a Google, I feel like I understand a little bit more that the A.I. is not quite the magic term. You could just apply to your company. It needs to be built. And two years ago, it was chat box and telemedicine. And so right now, I clearly believe that the biggest pitfall in technology is believing that the solution is something in and of itself, because just like we were talking about earlier, it's only when tech is adapted to fit the needs of the user that it becomes really viable. So, again, it hearkens back to that concept of meeting the patients where they are sort of building these sort of extraneous tools that are going to require the user to adapt to them.

Saul Marquez:
A great message. Yeah. Focusing on the solution is the way. Listening to the problem, as Leilani is telling us about this is the right way, the best way to find a way to support patients through what they're going through. And so if you are a patient or know of one that are experts in navigating the system at the end of the podcast here, we'll share how to get in touch with Leilani and her team so that you could collaborate on the awesome work that's that's being done over there at Clara Health. Now Leilani the next thing is the lightning round. So I got to ask you a couple questions and then favorite book you recommend to the listeners. Ready?

Leilani Graham:
Great.

Saul Marquez:
All right. What's the best way to improve healthcare outcomes?

Leilani Graham:
Well, at Clara Health you can't make the best decision without all the option. So we really believe that every patient should have access to FDA approved treatment alongside those dietary and holistic medicines that exist tangentially to clinical trials. So the best way to improve health care outcomes is making sure you have all the cards on the table in front of you.

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

Leilani Graham:
Yeah, I mean, I think going back to the technology piece that they get, pitfall is building something for the sake of building it. You know, the example we like to use is, you know, I think a lot of people in healthcare kind of looked down. And some of the apps that are just sort of for the silliness of it. But Snapchat, for example, is a remarkable and complex machine learning visual tools. But the effect it gives off is the value of it is joy. And so we're trying to build tools that help at least reduce stress, if not induce joy.

Saul Marquez:
Love it. I love that. How do you stay relevant as an organization despite constant change?

Leilani Graham:
I think a lot of that is the open to constant learning and constant feedback. I mean, we are talking every single day to the patients who are in the trenches trying to navigate their disease. We're talking to caregivers and researchers who want to partner with these patients and who want to find the best outcome for the people that they care for. So listening to these big ideas is listening to the up and coming technology. You know, we really want to have a pulse on the biggest pain points that these end users are experiencing in healthcare. And we want to hear the new ideas to solve them. We understand we won't solve every problem people have. And we operate in a very small, comparatively mission that just sort of monster the U.S. healthcare. And beyond that, we do some work internationally, too. But but it's really that end user experience that drives the health of the company. It's being constantly amendable to the ideas that come from that and use it.

Saul Marquez:
Love it. And what's one area of focus that drives everything in your organization?

Leilani Graham:
That would be the patient. You know, we really believe that patients have power. We believe that the patients that are always at the center of care. And, you know, it's that voice, if that story is that experience that drives everything we do.

Saul Marquez:
So these next two are a little more on a personal note. What's your number one health habit?

Leilani Graham:
My number one health habit. That's a great question. My number one health habit actually kind of aligns a lot at Clara and not being constantly understanding what's out there. I mean, I think for me, I've learned that in my own personal care, you know, going from being sort of a passive patient to kind of accepted what like, you know, doctors and nurses and clinicians believed works really well for a long time. And it builds up a lot of trust for me and in my providers. But now I'm kind of I have a pulse on what's going on and new technologies that are available. And it has drastically improve my care to be able to to bring in examples of really, really up and coming technologies or alternative treatments or stories from other patients and doing so in a respectful way that that's not pushing back necessarily on someone, you know, many, many years of training in the field, but partnering with them as a peer and really as a colleague in my care. And so seeing my care as something that deserves partnership and is not just sort of a passive discipline.

Saul Marquez:
And what would you say your your number one success habit is?

Leilani Graham:
This habit would be believing that my story is not which I have to remind myself of that all the time, because especially as as I grow my understanding of what's out there for patients, it's really easy for me to say, "oh, someone's had it so much worse" and in many ways that's true. But I can't let that stop me from sharing what has happened to me, because it's really like anything else in life that if you start comparing yourself and if you start believing that your voice isn't worthy of sharing, you're going to cut yourself off from a lot of different opportunities. And I try to share that, too, you know, all the time I have different patients approach me saying, "oh, you know, what I've been through is nothing compared to what you've been through." I kind of want to stop them right there. I mean, there's someone I really look up to as normal in a weekly podcast called "Terrible. Thanks for asking." And she has an episode, I'll be a bummer Olympics. And you know, a lot of what she talked about it. A lot of us tend to compare ourselves and say, "oh, what happened to me isn't nearly as bad as what happened to you." And you have to remember that what happened to you might be the worst thing that's ever happened in your lifetime or the most difficult thing that you've had to go through. And that's enough. And so I think that's my biggest driver of success for me, is reminding myself that that my voice, that my experience is enough.

Saul Marquez:
What a great message and one that I think should resonate to all of us as we work to make an impact and in our space, our healthcare space for patients and our businesses. Your voice is enough, take that home with you. And what book would you recommend to the listeners Leilani?

Leilani Graham:
So I guess my shameless plug as I'm eventually working on my own book. I really love you know writing about my experience, and I have patients who have told me that the work that I have shared has really shaped how they feel about their own experience in their care. And again, that makes it worth it 100% of the time. But the book that I love that I reread all the time would be The Bright Hour by Nina Riggs. And that is a novel that was that was written by a woman who unfortunately passed away from breast cancer a couple years ago. But she wrote it while she was experiencing the different stages of breast cancer. And she was a poet by training and she had an MFA and her writing is just so human and so beautiful and so, so affronting and in kind of the best way that it really looks that way to to reframe elements within your own life rather than letting illness be your only narrative. And I constantly go back to that book when I'm personally struggling with my story just so that I feel like I have a friend. When I'm reading it and I recommend it to anyone, but especially to healthcare professionals, anyone who works with patients, I think should really read it.

Saul Marquez:
And it's called The Bright Hour.

Leilani Graham:
Yes.

Saul Marquez:
Outstanding. Sounds like a great book. So folks, take a note of that one. And if you're driving, don't take a note. And just kind of the five guess website. You guys know where to go. It's outcomesrocket.health in the search bar type and Leilani or type and Clara Health. And you'll see this part guess episode pop up with all the show notes, a full transcript and links to everything that we've discussed. Leilani, leave us with a closing thought and where the listeners could get in touch with you if they want to continue the conversation.

Leilani Graham:
Wow. So listeners can get in touch with me at leilani@clarahealth.com. They can also check out some of my writing and more interesting things of my story at leilanigraham.com. I'm also Leilani Graham on all social media. My closing thought is really if you are someone who's working in healthcare in any part of the stratosphere, whether it is technology to direct patient care. I think my closing that would be take a step back and remind yourself why you're in this industry, whether it's your own experience or the experience of a loved one, and really think about what it was in that experience, not just the technical elements of it or the medical terminology, but what was at the heart of that? What was the driving force behind it? And I think you'll find that very often. Really, the patient is the end user. And I think that's something that we all can remind ourselves of as we continue to do this really important work.

Saul Marquez:
Love it Leilani. Great closing thought. And the invitation is there for everybody listening today to connect with Leilani. If you feel like there's an opportunity to help with the projects that she's got going on. And with that, just want to give you a big thanks, Leilani. Really appreciate hearing your story, your passion and just the work that you're doing. I really want to when I give you a big thanks for joining us.

Leilani Graham:
Absolutely. Thanks so much for having me. Doing great.

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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