Utilizing innovation to create better patient outcomes
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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 speaking with Ivan Delevic. He’s the CEO at OrthoSensor. Ivan brings a wealth of medical device industry experience to OrthoSensor from his prior leadership roles with Johnson and Johnson, G.E. Healthcare, and most recently as a senior leader at MAKO Surgical where he played a pivotal role in the company’s successful growth and acquisition by Stryker. He has experience both domestically and internationally with previous roles at G.E. including General Manager for molecular imaging for the EMEA, Global Marketing and Sales Manager for surgical navigation business development, Six Sigma leader and Black Belt for a global functioning imaging and sales, and also served as a business development advisor to numerous medical device company. He holds an MBA from Technical University of Budapest through a joint program with Heriot-Watt University and an MS in Electrical Engineering from the Technical University of Budapest. He’s a skilled technician but also a wonderful business leader, had the opportunity to meet him in person while at a meeting in San Francisco. And so it’s a privilege to have him here today on a podcast to talk about what OrthoSensor’s are doing to make orthopedics better. And of course patient outcomes better. So with that I want to give you a warm welcome Ivan thanks for joining us.
Ivan Delevic:
Thank you very much Saul, it’s a pleasure to be with you on the podcast. I love what you’re doing.
Saul Marquez:
Thank you my friend. And so tell me what did I leave out of your introduction that you want the listeners to know about you?
Ivan Delevic:
I think that the only thing that I would like the listeners to understand that kind of pervades a lot of my thinking or a lot of my motivation is that when I was with G.E I spent two years as you mentioned in business development. At the time and G.E Healthcare was doing a lot of acquisitions and a lot of equity investments and that is something that I kind of at some level I really found my colleague in doing that I loved doing that. And I have been doing it ever since. So after I left the I got involved basically before I joined full time with MAKO, I got involved with a number of companies and some advisor on BDDL’s and also it’s MAKO. I was one of my functions boss that I had it that business development that we did several acquisitions and investments and that is something that I just wanted to say. It’s one of my passions with the sense also took quite a bit of deals of kinds of business development nature.
Saul Marquez:
So let’s take some time to focus on OrthoSensor and what is it that you guys do and talk to us about how you’re creating results by doing things differently.
Ivan Delevic:
Yes. Well it is important to mention that that OrthoSensor was founded by an old debate a very busy very innovative orthopedic surgeon to Martin Roche from Fort Lauderdale, works out to Holy Cross and is a neat orthopedic surgeon be the very best practice and really OrthoSensor came as came about as a company from the vision of Dr. Roche. And just to mention Dr. Roche was that just for your viewers to know, Dr. Roche was the first surgeon who got involved in the development of the medical robot for the…
Saul Marquez:
Oh was that right?
Ivan Delevic:
He was the first surgeon to do a functional knee with the robot with the first version of the robot. He also was involved in frankly you know he was a part of everything that he had surgeries that was developing during the MAKO days. He was the first surgeon to do a total knee with a robot after we finished that. And he also today is very involved both as an educator and as a developer, we strike continuing to be an educator, a developer with Stryker. And Dr. Roche’s vision so you can see from that his involvement in MAKO surgical and Dr. Roche always had this vision that quantification right is like you know orthopedics is very sophisticated right, carpentry of the bones and ligaments.
Saul Marquez:
Yup.
Ivan Delevic:
His beliefs from even before he was involved with MAKO was that there is a need in order to improve orthopedic surgery and outcomes. One is you need to get the skill set and the bell curve of the skill set and the average in the surgical seal skill set higher and the bell curve tighter. And in order to do that you need to be able to quantify decisions because if you cannot measure right you can not improve it. And he had this vision of that surgical navigation, smart instrumentation, and then ultimately robotics did a phenomenal job in quantifying and improving the ability of the surgeon to plan that placement of data implant with the bony anatomy and then robotic especially but also navigation and smart instrumentation helped plan or help execute the surgery. The missing link in his view and it goes back to 2005. Was that the knee especially… but both knee hip shoulder right. It’s not only that the alignment of the bony anatomy in placing the inflammatory but it causes and it’s held together. And it’s a kind of managed by a number of ligaments and at the end of that procedure no matter how precise your bony anatomic placement is, the surgeons at the end of that knee surgery puts that trial implant in and then take the patient’s leg through a range of motion and try to kind of put treat and pull it and feel in their heads how these ligaments are balanced and how are tantra and say this knee feels good, this knee feels tight, this knee feels you know loose in extension or thigh inflection is a completely subjective feel and this is as a relatively young surgeon who said you know when I was been… my adviser was teaching me and he said okay take this knee and this feels right. And he said that probably didn’t feel right to me but I didn’t know what is right or what is wrong because it was all feeling in the head. And that gave birth to this idea that the only way to quantify that is to measure it and that the centers are the possible solution. And essentially you have to measure that strain or that pressure of these ligaments. And that gave birth to OrthoSensor and…
Saul Marquez:
Nice.
Ivan Delevic:
As part of that, That one’s kind of you pass that thought then kind of if you accept that fact that okay we will try to measure things that things in orthopedics that are not measure today and the way we are going to approach that. And then that kind of the core competency that ultimately ended up building is we are going to use sensors to measure parameters the relevant parameters in orthopedics that are not quantified today and create the data and decision making processes and intelligence based on that. And that is what we believe was the kind of looking back was the kind of differentiating thought that Dr. Roche was very early in that recognition that that needs to be measured. And that is what we have been doing ever since the very beginning.
Saul Marquez:
So it’s all about soft tissue management. Right. Making sure that that’s measured and not just subjective.
Ivan Delevic:
That is correct.
Saul Marquez:
And you know as you were telling me that now I’m just imagining myself checking the tire pressure on my car. I mean if we do it for our car tires, why in the world do we not do it for a knee?
Ivan Delevic:
That is correct also other things
Saul Marquez:
You know, or a lot of other things this.
Ivan Delevic:
Because it’s not the value of the tire pressure. It’s one of our actually the Academy videos. You know we have this looping video and on one of those looping videos I think a year or two ago is one of the themes was that we were comparing Vera says which is our product which is the balancing interrogative device that we make and the video was actually that was a car mechanic selfies saying that’s when you take your car to the mechanic, we were talking about aligning get balance balancing the tires.
Saul Marquez:
Oh.
Ivan Delevic:
So they have sophisticated instrumentation and they show basically you know if you’re yes if your tires are under pressure then on balance they are going to wear out faster.
Saul Marquez:
Yeah.
Ivan Delevic:
Depending on how they are and even a car mechanic uses very sophisticated instrumentation to balance the tires.
Saul Marquez:
That’s an even better analogy. That’s an even better one. Yeah.
Ivan Delevic:
You have to care more about our knees that we care about tires.
Saul Marquez:
We have to care more about our knees than our tires. You know I agree with you. And this is a look let’s call a spade a spade. You know when we’re dealing with incentive systems within our healthcare system you know it really impedes innovations like auto center to make a difference in patient care. And so we’re not going to hold back here in this podcast. You know this is about improving outcomes. And so we got to you know the call to action is fix this people. There’s an opportunity for payers to take a look at this technology which currently isn’t reimbursed and say if somebody is going to come back with a revision which is going to be terrible for the patient but not to mention the economic costs of it it’s terrible. So call the action if you’re a provider. This is an incredible technology that does improve outcomes and should be viewed as integral as part of the surgery. I had a chance to take a look at the device. I had it in his pocket and he sat down for lunch and it’s incredible, it’s low profile, it’s easy to use and frankly low cost in the grand scheme of things. But Ivan so I mean to get on a soapbox there but I definitely do believe that the work you and your team are doing is excellent and necessary.
Ivan Delevic:
Well thank you. We are moving one of the investments and you mentioned the reimbursement and the adoption right and the clinical use that yes in the in the orthopedics kind of there is for technology like ours, right there is this blessing in the curse of the bug of payment and kind of the globe the way the reimbursement in a knee procedure or hip procedure works. It is very difficult to have these add on technologies included with the reimbursements and kind of the whole structure is not really especially if you have a device that is augmenting a procedure. It becomes very difficult to bring it on right. Surgical navigation kind of went better out and it has not been successful in the last twenty five years or so. There is no question that all these implants placed with the navigation can be better placed with the navigation is that it has the navigation industry has struggled in gaining a defect that effectively never gained beyond a very small CBT code for the use of the technology. And this is something that we are learning now. Nevertheless we know that in order to have a chance to get there we need to end the onus is on us. It’s a company right to prove clinical and economic,the benefit. Now that is another thing, that orthopedics takes a long time. As the recovery’s long is like I worked in imaging a lot of my career and imaging is very easy because you create an image and then you have a comparative image that if it is better you can glean more out of it. You know it. You don’t have to wait a year or two or five years. In orthopedics,these processes are long, the data acquisition I mean that the data acquisition with these studies is lengthy and the follow ups are lengthy. We have invested and this is something that I lived. I ran clinical research as one of my functions with MACO and through the life of MAKO and we have done over I want to say over 60 studies and peer reviewed publications that I may even more and I…
Saul Marquez:
It’s a big deal man.
Ivan Delevic:
It was. It was but it was necessary and I can tell you that I kind of almost can recall is that there is kind of having gone through that you almost kind of start to see where there is a critical mass of evidence coming together.
Saul Marquez:
Yeah.
Ivan Delevic:
And a lot of the studies righ first you do kind of the simple studies of how to use it. What does it do? How does it work? And then you start to produce the studies of when you know how you know especially when you developing an innovative technology. Then you start after you explore the initial basically you study still heard the function and the potential benefits of the product. Then you start to do more in-depth clinical and economic, and outcomes data and I don’t want to belabor it but the biggest study that we did that actually took us almost six years from start to finish and it wasn’t a big study. It was a relatively small randomized clinical trial. We did it in Glasgow Scotland with our partner Royal Infirmary hospital. The reason we did it there it was an NHS sponsored study. There was a number of reason that came together and at that time we really didn’t couldn’t really pull that off in that way in the US for kind of I don’t know reasons that we thought at that time existed. We did a study so we set up this study. We set up the protocol and then you know did this. It was about five ago it was about a hundred patients and it was comparing it to another until basically a standard of care implant at that time very much on an outcomes basis. And as I said is that you know it took a year, year and a half to just get these hundred patients done because the study you know has this exclusion inclusion criteria and it’s kind of fairly evolved and then publications really don’t want to look at anything that is less than a year out. So that was the first time when we started to see results being accepted at podiums. But it was very interesting is that that by the time the randomized clinical trial came out which had very nice very positive results for the partial knee for make eye surgery and we have until then let’s say had already 50 billion publications. And we were constantly getting feedback. You guys don’t have enough evidence. There is not enough proof, it’s not strong enough that there is a benefit in a unity right away. And the surgeons that were doing it we’re seeing you know fantastic results and that that the patients who are doing great that even if we had 50 studies because they were kind of level two level three studies they were not in the critical mass. Became when that study started to show and publish it was very interesting to see that all these level two level three studies when these relatively simple smallish randomized clinical trial came out, then suddenly it pulled behind it all those prior for these studies and everything that was kind of not question but was kind of not paid attention to until then became yes it is you know all these studies were showing that it’s much better to do a unity with a robot than do it manually and that is what I meant by this critical mass is that we are now about 45 peer reviewed publications into the sense. So we have done that over the last five years because orthopedics is you know rightfully is a conservative industry because everything that you put in that patient’s body has to function for a long time. So the decisions you are making you are making them for the long time and the orthopaedic surgeons rightfully say we don’t want to take too many risk. As you know with all the things right metal on metal and then some of the laminating and ceramic on ceramic and stuff is there has been a lot of things that looked early on very promising in orthopedics just returned to be massive disasters so that the influence largely also I think the orthopedic community to want to have that evidence and we accept that. It’s a tough for a small company right to get the investment to be able to sustain that in building a company. But we hope that the value we are building through that is going to ultimately be proven.
Saul Marquez:
Well it’s some… I got to give you kudos Ivan because forty five studies is no easy task. How long is it taking you to get there?
Ivan Delevic:
Well we’ve been at it for about six years of studies like from what I said from the initial studies you know with the cadaver studies and measuring what are the lows. What are they going to do now where we do have now…
Saul Marquez:
Clinical and economic and outcomes,right?
Ivan Delevic:
It has economic health. Yes exactly. Exactly. Based on a pretty large population of data. So I believe that you are getting to the critical mass that we can see that there is no question with Dr. Roche came up and BNSF or started you know just like with MAKO it’s like people were laughing get it to say you know why do I need to balance… my hands are perfect. I do a couple of hundred needs and you know I’ve done a thousand these and I have to give my head. And it was the same with the people with the unique needs that they were saying is that what we are accurate is the unit needs are very very it’s a great procedure but it’s a very sensitive procedure through the placement and it’s if it is done well, it will do well. But it’s very unforgiving on mistakes and we believe that this is going to prove out and we see that a subject of knee balancing in the last four years has went to a very peripheral thinking to where now when we go to conferences it is almost kind of one of the of the main discussions and conferences is the next phase of improving outcomes between the knee as good as they are in orthopedic surgery that it’s a really successful surgery and the revision rate kind of has gone down but that patient that 20%, 15-20% of patients that end up not being happy after having gone through the ordeal of their knee surgery has not budged in the last 15 years and that is where Dr. Roche believes and we have now more and more studies coming out to show that that that patient satisfaction can be improved with a properly balanced knee when the patient leads that delivery.
Saul Marquez:
Well Ivan I again I certainly admire your dedication and my mind went as you were talking about these studies yeah it went back to my time at evasive and…
Ivan Delevic:
Yes.
Saul Marquez:
All of the studies that they did to validate and promote the exlift just kind of took me back to my time there and it just…
Ivan Delevic:
Oh it was very similar. You are so right.
Saul Marquez:
Yeah I mean and it took forever but then you hit this point of inflection where it was just like this is it guys. The anatomy studies the basics like you said and then fast forward to the clinical economic and outcome studies and then it was accepted all of a sudden and then everybody wanted to do an exlift versus the various medical tourism. That’s such a difficult thing. So just a fascinating analysis of sort of the industry Ivan and you guys are pretty far along the bell curve and I’m excited to see the inflection point happen and for you guys to really continue to create the increased traction because you already have it. But just to get to that next phase what would you say is one of the most exciting focus areas for you guys at OrthoSensor today?
Ivan Delevic:
Well now that we have matured this technology and we have done a lot in the knee and we believe that we are kind of getting close to that inflection point in the knee. We applied the same technology because the same technology has a role in a very similar way although we also did such a different way in the shoulder and in the hip. Shoulder surgery is also a soft assault procedure and in shoulder surgery has a higher patient dissatisfaction higher failure rate still evolve very rapidly over the last 10 years and the new techniques and we became much better but it has kind of if you have that 15 20 percent other tissue that we believe that the soft tissue ballots get solve that is probably in the 20 to 30% in the shoulder and it’s probably in the maybe in the 10% in the hip so the shoulder although it’s a smaller market is. So we just we are just about to get to C mark. Been working on it. I’ll be the be the partner of developing any job growth mode sensor for the remote shoulder. Right. Yeah very exact… excited about that finished product. It was a great project. We had a great partner collaborating with and it would be launched pretty soon they will start with the seeing market. Finally caught flight that came in the next couple of months but ultimately I wanted to ask a question I wanted to say is that you know we see ourselves as a company that is in the business of quantifying orthopedics by the use of sensors in order to quantify that you need to kind of do that data analytics and help the surgeons decide what information is important then how do they use it. So the data analytics aspect that the data aggregation and automation of data, data collection and data aggregation is very significant. So for me the most exciting project is we are working on now that we have the you know we have partnerships with Stryker which with the nephew Zimmer biomed. We have this partnership with executive on the shoulder and now that we have these sensors we have developed a product called the logic which is our data collection and data analytics platform. It has been developed to automate the data backwards. The data aggregation in the operating room. We are adding features we have expanded it to collect the information from the patient before and after the surgery and then we are going to be adding variables to that. What we are basically creating is that is an ecosystem is like a well integrated ecosystem based on the proprietary inputs primarily from the proprietary imports from sensors at various stages of the episode of care and then building these data analytics system and I’m very excited about what that future will be because if our ortho logic system and our sensors become prevalent is that the same the way we build the system is effectively if you are at a hospital doing hundreds or thousands of knees or shoulders or in the future hips, you will have an automated system for essentially a continuous data acquisition as if every one of your cases easing in the very decent clinical study and this is where I think that it will take the knowledge from doing these studies I mentioned to you is likely to cause the US to do a randomized clinical trial with know how the patients of the family that we have told you about that that if we have they said those as in this ecosystem that I describe implement it the way we are building it essentially they will be randomized clinical trial will go on all the time without people having to do much about it other than kind of using it for their clinical decision making process.
Saul Marquez:
I think it’s fascinating and it just opens it up beyond just you know soft tissue management. It’s wearables it’s… whatever sensor you can and that quantifying orthopedics through the use of sensors I mean that, that is a mission.
Ivan Delevic:
And yes that is our mission.
Saul Marquez:
That is a mission that I think anybody listening to this can get behind. And so because to to measure you know allows you to improve if you can’t measure it you can improve it and we’re all about outcomes here as as everybody listening knows and Ivan story really resonated with me when I when I met him at the conference and I said “Man we got to get you on the podcast you’re doing some amazing things” and I’m glad you’re here now. So Ivan we are at the portion of the podcast where we do a lightning round so I got questions for you there followed by a book that you would recommend to the listeners you ready?
Ivan Delevic:
Okay.
Saul Marquez:
All right. What’s the best way to improve healthcare outcomes?
Ivan Delevic:
Making decisions based on relevant data.
Saul Marquez:
What’s the biggest mistake or pitfall to avoid?
Ivan Delevic:
To ever believe that a subjective decision is better than their data driven decision.
Saul Marquez:
Love it. How do you stay relevant as an organization despite constant change?
Ivan Delevic:
People have to be willing to change with the organization.
Saul Marquez:
That’s a good one man. What’s one area of focus that drives everything at OrthoSensor?
Ivan Delevic:
I would again say people or my focus is people but throughout my career in these various companies in these various roles, I’ve learned that that’s what people always say in management folks but it always comes back to people people.
Saul Marquez:
Not just cliché it’s the reality right but some people.
Ivan Delevic:
No no.
Saul Marquez:
Ivan these next two questions or more on a personal note for the listeners to get to know you better. What is your number one health habit?
Ivan Delevic:
Currently my number one health habit is that about a year ago, I started meditating.
Saul Marquez:
Oh nice.
Ivan Delevic:
And I have to say as you said in the beginning, I’ve come from Europe I’m very frank back engineer volume very technical very data driven.
Saul Marquez:
So that was a leap for you.
Ivan Delevic:
It was a huge leap but I can tell you and I can encourage everybody. But please continue. Is that in this stressful life especially you know that health by kind of current executive life that in this past year what I experienced in meditation has made the biggest change that I feel the most unexpected and the biggest change in how I handle completely mundane problems and stresses of life. How I approach it is it has been fascinating. I can just warmly recommend it.
Saul Marquez:
I love it. I can hear it in your voice you passionate about it and that’s something that I actually when I began doing as well. And actually I’ve slowed down so I’m glad you mentioned that so enthusiastically Ivan because I’ve gotten away from it. So I appreciate you bringing it up again. I’m going to have to revisit it.
Ivan Delevic:
I have my ups and downs so I can’t say that I’m super disciplined about it. And it’s so now that you mention that you are off to date have these days. It’s like I always ask it’s like why do I drop it well I know if I just do it for 10 minutes every day it almost has a cumulative effect.
Saul Marquez:
I know right. Yeah. The cumulative effect yes. Yeah.
Ivan Delevic:
It’s a still kind of your profits that you kind of find it difficult to get back to it. I have committed, I go over and get back to it very time I drop it.
Saul Marquez:
I love it. I just made a note. I just made a note here Ivan. Meditation – Get with it. I’m gonna get it. And one of my favorite quotes is a Jim Rohn quote. And for folks that know me, I’m a big Jim Rohn fan. What he says is “what’s easy to do, it’s also easy not to do” and so…
Ivan Delevic:
That is so-called social.
Saul Marquez:
So if it’s easy to do just do it make it part of your ritual. I’m one of my other favorite quotes Ivan is you’re the average of your five closest peers. So now that I’ve been hanging out with you Ivan you’re bringing my average up, you gotta meditate more.
Ivan Delevic:
Meditation. Meditation probably will bring your average up.
Saul Marquez:
I love it my man. I love it. And the next one here is what is your number one success habit?
Ivan Delevic:
Well giving up. I don’t know if it’s success habit.
Saul Marquez:
It is a good habit.
Ivan Delevic:
But I saw that ultimately that you know you can control very little of the outside world and you can control what you would do. And you can do your best. And if you are open minded and again if you are surrounded by the right people you can always solve things. And it’s kind of the staying power and being persistent in your beliefs is what I found to be kind of working for me is in kind of difficult times and easy times is that you just have to accept that there will be ups and downs and you just go with it and go for it. If you believe you if you believe it. That’s the tricky part is to be open minded enough to know where you are believing you know that you are not tracing it both.
Saul Marquez:
Love it. It’s a great one. What book would you recommend to the listeners Ivan?
Ivan Delevic:
I would really recommend this. And this is maybe again it’s like the opposite end is that my favorite book is Execution by Larry Bossidy.
Saul Marquez:
What is it called?
Ivan Delevic:
Execution. By Larry Bossidy.
Saul Marquez:
Oh okay.
Ivan Delevic:
It was the vice chair of General Electric. He was basically kind of the Jack Welch Spock there for that whole era when he grew. And then he became the CEO and chairman of Allied Signal the absolutely phenomenal job in growing that company. And then Allied signal nurse VITALE Well and he liked Honeywell for a while before he retired and he’s in in my view then maybe because I grew up in G.E. So for me kind of Jack Welch and Larry Bostick Kendall the dance then all the other guys in that era were kind of the gods. And they dressed up their brains with that. But Larry’s special I think even in that pantheon of the biggest leaders is that he is just a very very special person. I had the privilege of having the opportunity to have interactions with Larry both at MAKO and at OrthoSensor. And he is not one of you know rightfully one of the top 10 CEO’s probably of all time. But that book I think so honestly and so brutally captures a lot of the driving principles. Also it is a small or large organization. A lot of it is around people. It talks about the execution and it talks about decision making but a lot of that a lot of Larry’s philosophy is about people and then execution with the right team and the right people. I would recommend it.
Saul Marquez:
I love it Ivan and that’s a great recommendation and folks for the show notes as well as links to all the resources that we’ve discussed, just go to outcomesrocket.health in the search bar type an orthosensor and you’re going to see Ivan’s conversation there with me, the full transcript, the short notes, and all the links that you need from our conversation. So Ivan, this has been a really fun conversation. You know soft tissue management, playing the long game, making sure that you get your validation done. I mean some some incredible messages and some messages around leadership. I’d love if you could just leave the listeners with a closing thought and then the best place where they could continue the conversation with you or the company after this is over.
Ivan Delevic:
To me what I saw. You’ve been making what I saw with all the sense of what I am seeing with with some of the companies I’m involved. Well maybe for the next forecast that you can do is that there is so much innovation to be done and there is so much innovation that can still radically change the future of healthcare. And I think it needs like it’s a fascinating time to be in healthcare now with all the technologies developing. I’m a big believer in this whole you know future of data of what machine learning can bring to the healthcare and clinical decisions. And it’s just a phenomenal time to be in this industry and I’m very optimistic on what the future of healthcare. In the healthcare technology again I spent all my life with healthcare involved. So that is the kind of the field that I that I close still and I just see that there is just so much to be done and so much that is worth to be done. And just the more people can execute value these ideas. And there are a lot of people like Martin Roche with that that’s kind of deeply see the future. They had the privilege to match with the number of these people there I recognize you know sometimes in hindsight is that boy these people kind of have the ability to see that yourself the way that none of us care. And so if you are surrounded by your view, recognize people like death around you, listen to them sometimes they sound crazy and you hear it like three times to realize hey Peter is saying it really. And I had the privilege to work with a visionary like that who is strongly a visionary Rony Abovitz who was the founder basically of a co-founder of MAKO and now he’s is the founder of Magic Leap right. Which is the kind of the one fly the unicorn. And Rony he was that guy that you will have an idea and your organization will look at it and they thought “I thought” it’s just crazy. If your listening for the third or fourth time you realize this is just an ad. Yeah. So my last thought is that those people are diamond and oftentimes they are misunderstood and not listened to. And keep an ear on those people because they are the ones that can bring these revolutionary ideas.
Saul Marquez:
A great message to leave us with Ivan and again just want to thank you for your your passion and and your ideas and for spending time on this today. Really appreciate it.
Ivan Delevic:
Thank you Saul, it was a pleasure being on your podcast.
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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