Learning from other countries' healthcare systems

Speaker A: Hi. What the. Health tech listeners, I'm your host this week, Matt Fuster, and this is the podcast where we tackle some of the trending topics, ideas and best practice in health and social care. In this episode we're chatting with this co founder of Radar Healthcare, Paul Johnson. Radar, uh, Healthcare is a UK based health and social care tech organisation making waves internationally. Join us as we dive into Radar Healthcare's global insights from the NHS to the US and Qatar and explore what different systems can learn from each other to improve care, safety and outcomes. Welcome to the podcast, Paul.

Speaker B: Thank you very much.

Speaker A: Quite an intro.

Speaker B: Yeah, yeah.

Speaker A: Um, so if we start at the beginning. So Radar Healthcare has been going since 2012. Um, how was the vision or mission evolved over that time, especially now that we've expanded internationally? Um, or is it still the same concepts and principles as the first few days?

Speaker B: I mean the strategy, the reach, all of that side of things has obviously evolved and we can touch on that through the course of this session. I think we're still rooted on the same principle which was, if you think about when we started this thing, it was that healthcare in general, health and social care certainly in the UK was largely underserved in terms of having systems to help them worry about the right things, inform the way that they operate to deliver safer and better outcomes, which invariably, if you deliver better outcomes to the patient, you tend to become a more efficient organization so you get some of those tangible outputs. So the we're still rooted to the same principle mission that we had from day one. It's just obviously when you go international, there's fundamental, uh, differences between, for example, the Middle east, the US and the uk. But each one is rooted on that same principle of what their aspiration is to deliver, which is better and safer healthcare.

Speaker A: Yeah, I think same on the trips that I've done from Qatar to the us and obviously working in the uk, ultimately the problem you're fixing is the same. The regulations might vary, the kind of different things people need to evidence might vary, but ultimately actually an outcome for a patient, that's the bit that matters and that's the bit that we drive.

Speaker B: Yeah, I think just expanding on that, if you think about it, that's probably why the product has traveled so well, because the fundamentals that Radar healthcare underpins around quality compliance, patient safety assurance, um, and then providing intelligence and insight to the organizations to act upon that is exactly the same, albeit there are nuances against those health systems.

Speaker A: Yeah, so why, what influenced the decision basically to expand into the US and we're kind of picking Qatar here, specifically in the Middle East. So what drove that?

Speaker B: So I think there was, I suppose there's two elements to it. One is we had uh, as our reputation grew, so, so as you start, uh, for example we work with Cleveland Clinic in London. So they're setting up a brand new state of the art ambulatory, um, surgery center, day treatments in a hospital there. And so that brand of the Cleveland Clinic raises awareness in the us, um, and internationally as well because it's an international brand that's also in the Middle East. And when you think about some of the organizations that we work with from an nhs, from a, if it's a boop or a nuffield, you know, these are quite prestigious organizations. So our, ah, our brand if you like. And our people became aware of what we do. So we started to receive inbound inquiries and interest from different territories. So that's, that's a driver that says to you, look, here is people are interested and there is a need. And then uh, as you know we were both involved in qualifying out and understanding these healthcare systems and you quickly realize there is a need M. And then there's a bit of excitement because, because there are differences and the way that they're structured. So working with the Emirates Health service, you know, 90 hospitals and health centers all using radar, uh, and driving in a slightly different way to what the NHS does. We knew that this would happen. It would take us into those territories, which is something we want to do as a business because we want to push radar to as many localities and territories as we can because we know move the needle. But the learning that we get, that informs the product, the product roadmap that you're personally involved with is that's quite exciting and it drives innovation in the product. So that's the key driver.

Speaker A: Yeah, I think some of the, you mentioned Emirates Health Services. Some of the innovations they've done around how they generate an incident or an event in the first place is very different in terms of how they think and their approach to it than you might typically get in the uk. It's around actually what can we use from a tech standpoint to reduce the need for individuals to have to do this in the first place. It's all driven from an epr, basically. There's no human in between. Which I think is super cool.

Speaker B: Yeah, I mean if you think about that, you know, IHI triggers has been around for a while and for the listeners. And what does that mean is essentially there is coding within the patient record that is an indication that patient harm may have occurred or has occurred. So therefore you're right, the time to act is reduced. Why do you need somebody to go in and replicate that in a system? Let's trigger it and we know the response. I think for me, the big, the cultural thing is so different. I remember this being at a, um, we fortunate enough to work with the patient safety team in the Emirates Health Service and it was the, I think they called it the Safe Catch, which is near misses. And people say, I did this thing wrong. The celebration, uh, and people being acknowledged and receiving awards for saying, here's something we were doing wrong. We've picked it up. And the fact that Radar Healthcare was able to play a part in that, that was pretty cool. Yeah. Culturally, that's very different.

Speaker A: Yeah, no, it is. Uh, I think there's a lot of cultural differences that help drive that innovation as well. Almost that ability to be able to say, we think this is a good idea and it's driven forward super quickly because it's almost mandated to happen rather than sometimes in the uk these things maybe drift and because it's not necessarily mandated from a government level, it doesn't happen.

Speaker B: Yeah. And even that, you know, the mandated. And look, I'm not going to get into the whole. The NHS is a challenging ecosystem, so whoever's in, in power at the time politically is. It's always going to be a challenge. But there is a fundamental commitment with people like Qatar, people like the Emirates, which is, they are held to account by the people they serve. And I feel that in the uk we don't necessarily have that where the general population can hold the NHS to account. It's almost, it's done at a government level. Whereas there, there is a genuine commitment that if they're not delivering the best health service to the people they serve, then they're going to be held to account for it. Yeah, involvement with the patient is, is very real.

Speaker A: 20, 30, 40, even 50 year plans, you know, very, very forward thinking. Um, so we can't, we're obviously entering into these markets at the moment. So what do you think were the biggest challenges we faced doing that? And then where do you think the opportunities are and how are we navigating them and going to navigate them?

Speaker B: If you think about our foundations here in the UK and the UK health system, the biggest challenge is you cannot disrupt or impact that. We've gained a great reputation in terms of our customer service m ensuring that we continue to innovate in the UK so that customer Service, that delivery of the product. How do you ensure that you don't impact that? Because if I'm a customer and I've got some frustrated, I want something fixing in Radar Healthcare and I'm waiting for that thing to be fixed and I'm seeing something, oh, these guys are over in America or Qatar, that's going to be frustrating.

Speaker A: Yeah.

Speaker B: So you've got to create capacity. That's the biggest challenge. The product, as we just alluded to right at the beginning, is it travels well because we solve the same things. Then when you think about they are being underserved in those respective markets, that bit's the easier piece.

Speaker A: Yeah.

Speaker B: But you have to create capacity and space in the business to be able to do it. That's the challenge.

Speaker A: And um, that focus as well, I would say of actually, you know, this thing is, is super important to. We need to create the time and space to make it happen.

Speaker B: Yeah. So I'd say that's the biggest challenge.

Speaker A: Yeah. I think from a product perspective, like you said, the value propositions the same. There's obviously nuance in terms of the content and regulations and all that kind of good stuff that we would drive anyway. But I think there is that challenges, like probably personal challenges for me is understanding that and getting up to speed on that so you can actually have an articulate conversation with somebody. Yeah. So even in terms of, you know, the definitions they use for service types and things like that, like ambulatory M, they mean very different things to how we might think of them. So that, that, that I think is something that, a challenge from an individual perspective, but also the rest of us as a business and actually how do we, probably, me and you, to be fair, communicate that out to everybody else so that they understand what the differences are?

Speaker B: It's like, I think you mentioned that, you know, what are the opportunities that have arisen from our, uh, expansion into these international systems. One of the challenges you have now is how do you translate that back? I give you a great example. So we mentioned Qatar a couple of times and the thing and just so again for the benefit of listeners is the Qatar system is national. So we are connecting every single health system into radar healthcare through a national taxonomy and things like that. But fundamentally we are connecting all health systems so that the ministry can understand and visualize how are they performing, right down to the level of the quality of care they're delivering, you know, to the, to the, to the communities they're serving.

Speaker A: Yeah.

Speaker B: And so you've got gp, primary care, secondary care, Tertiary, you've got all these different health systems all feeding in. So that, I mean, if you take that system and, um, now what? Here in the UK, we're trying to drive in ICBs, integrated care boards, we're starting to try and have similar models. Well, we've delivered that system. It's demonstrable, it's proven, it's delivering results, it's helping the Ministry improve and move the needle. Where do they need to invest, where, you know, all those kind of things. How do we get the UK to then adopt that model? That's a real challenge, it's an opportunity. But learning from these systems, we learn and we input that into our product roadmap. How do we. Because we don't want to mandate to our customers. Because our customers are the, you know, they're so great at and understand how they deliver the best healthcare. Certainly from an NHS and those system view. Yeah, that's where we could learn.

Speaker A: Yeah. I think it's interesting, it kind of goes both ways. If we pick up Qatar, so Qatar, size wise thinks about the size of Manchester icb, so obviously it's a country, but yeah, exactly that. Roughly about the scale of it. So, yeah, that that concept can, can transfer over. But then the Qatar taxonomy, our learnings from the UK helped shape the Qatar taxonomy. So we learned what people's frustrations were with the kind of UK version. Yeah, it worked where it didn't work. So, uh, they do flow both ways. It's almost like the system is just feeding itself. So while we are talking this entire things about what are the differences internationally, actually there are some really core, uh, threads that flow ah, through that are the same everywhere.

Speaker B: Yeah, yeah, yeah, you're absolutely right. And learning from patient safety events, lfpse, the frustrations at a customer level and sometimes that was vented at us and we were in control of that. But having to be able to create something in the product to alleviate some of those frustrations. Uh, to your point, you know, to be able to then demonstrate that to these systems. Yeah, that you're right, it travels well.

Speaker A: I mean, I was in Qatar probably three weeks ago, literally doing the usability testing on the national taxonomy for some of the taxonomy changes and just that, uh, even simple things like how long does it take somebody to fill in the form? Do they even understand some of the questions that you're asking them and the things that you might think. Actually, yes, this makes complete sense to me because I'm sitting in an office somewhere and I understand it. The railing on the Ground is completely different. And again, that tying into lfpsa, we learned that from them in terms of. Actually, uh, you've got to think seriously about what your questions need to be because people might not know the answer to these. And then that helps. Share Power Taxonomy. And it's. And it's very simple for a user to complete, but powerful for the Ministry in terms of the data and the information that they're getting. So you kind of get the best of both worlds. But I think we would have, we would have taken longer to get there without knowing the stuff we know from the uk.

Speaker B: Uh, yeah, and it's. And the other pieces as well, is. Don't you. They almost. Oh, so we can capture all this information and data? Well, yes, but don't capture it all unless you're going to do something with it and demonstrate back to the people that are using that system. You've asked me for all the information I gave you, what have you done with it? If you're only using 10% of that, you've just wasted 90% of my time.

Speaker A: Yeah, absolutely. I mean, again, think of like what we're doing at a, uh, super high level with the taxonomy is looking for insight and patterns in the data to say, actually, here's the thing that I need to worry about.

Speaker B: Exactly.

Speaker A: And then ask for more. Don't try and think, well, I'm going to try and capture everything because you're never going to, you know, you're not going to ask the right questions, you're going to get bad data, which is probably the key point. So just kind of, you need to steer yourself with the information to what you need to work on. I think we've sort of answered this next question, but, um. So how do healthcare priorities differ across the uk, US and Qatar? I think we're kind of saying they don't necessarily from what we're doing, from a system point of view. But do you think any differences you've seen in terms of your visits? I mean, there's some big differences in terms of how the ecosystems operate, but

Speaker B: priorities wise, I think you're right, there will always be nuances. So if you take, if we look at the US and the us, people can be critical of the US health system. And really, if you break it down, you've kind of got Medicare, Medicaid, so you're worrying about people that can pay for healthcare, um, and people who can't pay for healthcare. So they would be outside Medicare, Medicaid, and then you've got the elderly. Again, that fitting in that model. So there is a provision of care, but it's very constrained in terms of investment and the level of care they're going to get. People that are working are in health plans, and health plans pay for the, the care. And so if you take, we mentioned ambulatory surgery centers, ASCs, where people go in, have a hip replacement and go home that same day, the efficiencies that they've driven, that would be, for me, is there's a learning there.

Speaker A: Yeah. 100.

Speaker B: You know, I'll tell you this little story. It always stuck on me. I was fortunate enough to go and visit quite a large, um, ASC health system in the US And I had a tour of one of the facilities. And as I was walking around the tour, I saw a gymnasium, I saw a cafe, I saw, you know, operating theaters, everything around this whole thing. And at the end of the tour, he said to me, he said, he said, do you see that room there? And there was a door. And he said, that is the only place on this facility that does not make money. And I said, what do you mean? He said, so the gymnasium that you saw, which is for, you know, therapy and, you know, rehabilitation, etc. He said, it's a members gym.

Speaker A: Yeah.

Speaker B: So we've doubled up. The cafe is open to the public, and, and so every single part of the hospital. And you're thinking, well, and, and, and I said, well, what's that? He said, it's the boardroom that is the only part of the facility. And I thought about it, and I thought it seemed quite mercenary at the time.

Speaker A: Yeah.

Speaker B: And then as I got speaking to, you know, the people that were working in that facility, the reason for that is they have to maximize that investment. And so having a referral to come back is the last thing they want because it impacts the profitability of that. And they've connected the two things, profitability and great care actually do go hand in hand. And so the way they'd constructed that whole to ensure that they give the absolute best level of care, an operative, you know, level so that you don't get those, you know, downstream. You know, we talked about prems and proms that we. Things that we look at as well. It's critical that when that patient goes home, um, it's the outcome that the patient wants and that ASC wants.

Speaker A: I mean, the whole system's built around the patient in the sense of that you've got a choice to, you know, I'm going to go here or I'm going to go here or I'm going to go here. Same, um, thing in terms of some of the trips I've done to the US Just seeing how even specific hospitals might be tailored to a. Like, incredibly tailored to a certain demographic because that's who their customers are. So the whole. The whole thing in terms of that individual's journey through the hospital is focused on them and their culture almost to a certain degree. Consent, obviously, is something we do in terms of products. Now, again, one of the US Trips I did, I'll kind of shortcut the story, but basically it was informed consent on, um, brain surgery. And, um, went into, um, one of the hospitals, met the brain. He was like a rock star. This guy came in, shared. Everyone's like, oh, it's doctor.

Speaker B: They are rock stars.

Speaker A: He's cool. And he said, right, okay, you're in for this operation. We're going to be doing this, but we're removing a tumor and it's in this location. And the purpose of the next half an hour, for argument's sake, is to enable you to give informed consent at the end of it. And so we went into. I didn't know what to expect. Went into this room, and it's like VR headset. So it's like, I'll put the VR headset on. Okay, put the VR headset on. I'm now going to perform the operation that I'm going to do for you tomorrow in VR. You're going to see me operate. You're going to see me take out this. And I. Oh, okay. And then we kind of went through it. He kind of. Again, he didn't do the full operation. He just kind of went, look, this is how it works. And then took the headsets off. And at the end of it, he went after this. Would you kind of give me consent to do that? And you're like, yeah. God, yeah. You know, but it's that. Because I'm the customer, the whole thing's tailored around making sure that I was super comfortable. I had, you know, all the information that I needed. So when I did give consent, it was informed consent. Yeah. And again, we're not. Our systems. It's not the same. Yeah, we're not. But we're kind of like just in and out. Try and get people through the machine almost for a better way of describing it.

Speaker B: Ah, there are so many learnings.

Speaker A: Yeah.

Speaker B: You know, I mentioned the, you know, from an ambulatory surgery center, uh, into how can we be more efficient and effective, you know, and we. We embed some of those processes in Radar. So you've got a blueprint that we can replicate here in the uk. And again, it comes back to my point. The challenge is when we work with individual entities and customers, there's always a blend of what have we learned and what do we have in the product and what is their ways of working. And then we come to a kind of mix of the both to get the best practice for that organization from a system level and the opportunity in the NHS to share that. That's a challenge and an opportunity and that's something we desperately want to pursue.

Speaker A: Yeah, I think again, we kind of touched on this. Are there any innovations or practices abroad you think the NHS could have, uh, adopt or adapt? We kind of touched on it there. Do you think there's anything technically that you've seen?

Speaker B: I mean you see, you see so many.

Speaker A: Yes.

Speaker B: Uh, you do, uh, you know, it really does kind of. It isn't so much the, I mean I could list, you know, many, uh, innovations and things that you see, you know, and, and invariably they will be here in the UK as well and you know, things that we'll be doing here that they don't do in the US and the Middle East.

Speaker A: Yeah.

Speaker B: I think the one thing that always comes across to me is, and I know we have research hospitals and NHS trusts and teaching hospitals and etc. The level of research, I'm just going to use the US not so much. The Middle east is incredible and so the amount of investment that goes on and so research centres have been built now that they have so many health systems and hospitals within. They are the hospitals and health systems for those states, for those cities, etc. So people are coming and going as normal and I'll give a great example. Uh, again, I've just come back a couple of weeks ago and I was in with St. Jude's Children's Hospital in Memphis. It's a research facility. Um, and it's huge. It's a huge complex. It's a multi billion revenue turnover business. It's got less than 50 beds. So now think about that. Hang on a minute. How can you have something that's almost a city itself? It's the research. And so the way they've constructed that is, and don't get me wrong, there's a lot of donation based because it's a non profit.

Speaker A: Yeah.

Speaker B: So what are Those less than 50 beds? They are the sickest of sick children. You know, they give them the most, the highest level of care but you almost have to qualify because it's Falling into a research line to one, um, it might be gene therapy.

Speaker A: Yeah.

Speaker B: And so there's an opportunity to research and learn and then they share that learning with the world.

Speaker A: Right.

Speaker B: Okay, that's. And there's a lot of them. The text in Texas.

Speaker A: Yeah.

Speaker B: In Tennessee, in, in Florida, in Memphis and, and seen it with St. Jude's the research machine is very real and they're super connected.

Speaker A: Yeah.

Speaker B: Across all the different health systems.

Speaker A: I think you touched on it there though. It's the funding really isn't it always boils down to that.

Speaker B: Yeah. And that's how do we overcome that challenge? Uh, that would be very difficult.

Speaker A: Um, do you have any kind of specific examples of how radar has made a measurable uh, impact? I mean we've kind of touched on it as well to be fair. We tend to wander off, don't we and answer half the questions before I, ah, answer them. But any kind of demonstrable examples of how red I've made an impact kind of us. Qatar we can probably talk about. To be fair.

Speaker B: Yeah. I mean um, again, uh, actually going away from Qatar, but um, the Emirates Health Service. I think one of the things is they've always had a culturally around. We mentioned it before holding a light up to people that have highlighted things that weren't perfect to help them underpin best, best practice reviews. We talk about it in the UK and we try and do it a little bit but there it's almost part of the DNA. Ah but through radar, uh, healthcare we've been able to make that a systems based approach. So ie the systems looking at measuring apples for apples against whether we're looking at neonatal specific things or we're looking at community services, primary care, whatever it is, because we can see somebody's performing at a greater level instead of looking at well why are you falling behind that they almost flip it on the head and saying why are you ahead of everybody else?

Speaker A: Yeah, it's about the shared learning.

Speaker B: How do we learn from that? And we put it into radar as a system based approach so that they do a more structured best practice review using the system then to drive the improvement actions and measure. Is everybody coming up to that level now?

Speaker A: Yeah.

Speaker B: So that's been a demonstrable change.

Speaker A: I think that's something product wise as well. That'll come back the other way just to make it, you know, as easy as possible for the organizations within the peer group for better way of describing it to be able to share and understand from each other because it is still relatively siloed in the sense of you got customer A, customer B, customer C. Actually, they're all sort of doing the same thing. So the learnings are valid for all of you. I think that that's, I think that's, that is definitely kind of a behavioral thing in the UK that I think we, we almost need to help to shape, to kind of go look. You know, everyone's super comfortable overseas sharing this. You know, we should be getting into the same, um, same, um, way.

Speaker B: And that's probably the same for the US actually. You know, we can talk about specific little things and processes that we've underpinned. And this had a demonstrable impact and improvement to, uh, whatever health service. But the connectivity is. That seems to be. The systems can be quite disparate and siloed and then they get this more connected view that holistic oversight to, uh, the head office of these entities we work with has been, you know, it's been a demonstrable, measurable improvement for them.

Speaker A: Yeah. Um, might be a question as much for me, this one, to be fair, how do cultural and regulatory differences influence the way you approach innovation and implementation in each region?

Speaker B: Yeah, can we, can I throw that one to you? It is, I mean, I don't think

Speaker A: implementation doesn't change that much, if I'm honest. I think it's kind of, that's fairly the same. You know, there's obviously a little bit of nuance, um, innovation. I think there's a bit more openness to innovation, I would say, especially kind of some of the Middle east, like, you know, being able to generate things directly from a, from an EPR without necessarily a human being involved. I think the UK would love to do it, but there's, there's barriers being placed in the way to stop that from happening, which is, you know, kind of frustrating. But they do seem to be much more open to innovation and also driving in themselves. So not necessarily innovation radar led, but innovation, customer led. And that blue sky innovation rather than that incremental stuff of almost. Actually, why don't you do this? This is revolutionary. Let's go down, go down this route. Yeah.

Speaker B: I think there's a, also culturally there is an, an openness to share the challenge in the problem.

Speaker A: Yeah.

Speaker B: So what's amazed me, certainly in the us, you know, if I reach out to us, you know, for me to sit with the, you know, the chief medical officer of St. Jude's it would be a challenge for me to be able to do that in, you know, great Almond street or something, because it's just there's their openness, an eagerness to, oh, what, you know, what's this? This is a UK system. It's been working with the nhs. They've been doing stuff in the Middle east, now they're in us. I want to see what you're doing.

Speaker A: Yeah, that is. They look for transformational change, they don't look for intervention. Yeah. It's like, how can I literally make m move the needle?

Speaker B: Yeah, exactly that. And I think that is the difference certainly in the US and so they will take the meeting. Obviously you've got to have something that's relevant, but to your point, it is. I'm not looking for small changes. This thing could change and they will make the change and do make the change. You know, Texas center for Health, a long term very large incumbent there that's been established for over 25 years and was quite prominent here in the UK, still is prominent in the UK. For them to switch out at a system level, you know, you don't always see that in the UK and with large health systems there is. We understand the change that this is going to drive. We're making decision, we're making a change. Yeah, that's.

Speaker A: And linking that change to the outcome. I think that, you know, we are transforming for this fundamental reason. It's not the micro stuff of look, we need to move the move what we're doing here. Yeah, yeah. And I think some, some of the kind of lower level stuff as well. So culturally, again, some of the Middle east where filling in the forms and the kind of information people want to put in, some of the individuals kind of culturally want to give you information, even if it's. They almost want to please you for filling in a report. And so you've got to kind of counter against that of that actually they're just going to want to fill this information in because they want to do the right thing by filling in a form in whether they understand the question sometimes or not. So again, culturally we've had to learn how to construct forms where they're super clear about what it is that you're asking and any ambiguity needs to be completely removed so you don't get kind of this false data coming in. So even things that you wouldn't necessarily expect in the uk, if you fill in a form and you don't know the answer to the question, you go, I don't know the answer to that question. Whereas kind of at certain cultural levels people would just fill that information in. Which again, I think that's the Sort of stuff you don't necessarily um.

Speaker B: I don't know how many people are familiar with Neom but Neom is or the line which is a uh, project in Saudi Arabia which is to establish a whole new way of thinking about how we habitate and literally creating and people go online and have a look at it. It's an incredible project. It's very real and it's being realized. This thing is being built in the middle of the desert and they're going to do it sectionally but they're going to create, instead of building cities out, they're going to build it within. You know, I can't remember what it is a kilometer wide by X height, all glass encased now. And it is a different way of thinking and culturally, if you were talking about culturally, if you think about Saudi Arabia, whatever m you are, your opinions about that in terms of their ambition there is to think about the way that we live on this earth in a very different way. And, and they want to all the things that they're going to learn from that will be shared with the world. And I've said, oh, what that sounds, you know, almost Star Trek. And uh, the guy, the, the innovation leads it to me. Well it is because it doesn't exist yet. Yeah, he said so our thinking is we shouldn't be constructing building a city for the future based on what technology and innovation is available to us now. We should be setting the requirement for what is needed to realize that. And then by putting the funding in and engaging globally, they will attract people that are going to be able to develop, meet that need.

Speaker A: Yep.

Speaker B: That's driving innovation. What have we got? Yeah, uh, you know, what should we need, what should we have? And I think that's, that's pretty cool.

Speaker A: Yeah, yeah, it's cool. Um, so what's next for Radar healthcare? Any other kind of regions or partnerships on the horizon?

Speaker B: I mean I suppose we answered the question right. The thing we get excited when and we get kind of interest in demand globally.

Speaker A: Yeah.

Speaker B: But again it comes back to the point we made right at the beginning is what is the challenge? You have to have capacity to be able to sustainably meet those demands. So we will do more in the Middle east. We know that this, there's just the progression of healthcare in that and their need for innovation and what we're aligned to the US we have boots on the ground, we're expanding there. We already have a great customer base. We have uh, a diverse set of customers from hospitals, children's hospitals, behavioral health Primary care, et cetera, et cetera. So health system and then the work that we do from consent, we have a presence, quite strong presence in Australia. So that's probably somewhere that we're going to look to expand out and, you know, work with the Australian health system. Because there are similarities with the uk. I don't think anybody here is saying that we're going to suddenly go fully global. And because it comes back to my point, the worst thing we could do is say that we're going to start to support the full MENA region, so start thinking about Africa and places. If we can't sustain and deliver and meet those full demands and requirements, then it's the wrong thing to do. So I think learning and expanding in those territories that we're in will be the key focus for us.

Speaker A: Uh, and then what's the one thing you would like today's listeners to take from the episode?

Speaker B: I suppose it depends who you are as a listener. If you're a health system listening to this, I would say be open, be brave and reach out. You know, when you get those, whether it's from Radar, Healthcare, Med Tech, whatever it is, if it's something that's potentially of, um, value to you, try and create the time and say, yes, have a look at whatever that system is. It may well, you know, move the needle for you. So that. So that would be my. Just from a people that are delivering this career, it might be something that can bring great benefit. Take the time to have a look what's out there, because the world is moving and healthcare innovation is moving.

Speaker A: Yeah, I think that's it. If you don't make the time to go look, this stuff's not going to come to you.

Speaker B: Yeah, that would be the one thing I would ask people to take away.

Speaker A: Yeah. Um, great. Uh, at the end of each episode, we ask our guests to share their what the Health Tech moment. Um, a standout experience in health or social care that has impacted them in some way. We've had everything from the weird and wonderful to deeply emotional. Are you going to give us deeply emotional and inspiring memories? Can you share a memorable moment from working within the sector, please?

Speaker B: Um, I suppose I could go all geeky and, uh, I've just. I've been out in San Diego. I've just been out in the US and I was in San Diego and then, um, I went on the Midway Aircraft Carrier. Yeah, I'd love to talk about that. It's probably not relevant.

Speaker A: Do you have a podcast on.

Speaker B: But it was linked because I was on a healthcare trade mission. You know, I'm looking at meeting Healthcare Systems and got to see that thing. It's very cool. But I think for me, I, I can't remember if I've told this story before and I, I apologize now because I can't pull all the details. But, um, many, many years ago, when we first started working with Cleveland Clinic, London.

Speaker A: Yeah.

Speaker B: We had to fly to Ohio to meet the, um, the management team there and the legals and things like that. To negotiate the contract.

Speaker A: Yeah.

Speaker B: And get that in place. And on our first visit there, uh, we were met by somebody and again, it frustrates me that I can't remember these names because it was such a long time ago. It was over five years ago. But I remember and I would say, oh, how long have you been here? You know what, you know, what's the backstory? And the Backstory was this. 20 odd years ago, he was given a very short time to live. And because of the research program in Cleveland Clinic, he was given an opportunity to go into one of those research projects, which I think was gamma knife surgery for a brain tumor. The guy had multiple brain tumors and he went into that. So going from 6 to 12 months life expectancy, went into a research program, went through that process. Twenty odd years later, he's works for the, for the health system.

Speaker A: Yeah. That's cool.

Speaker B: So it's two things. One is he went through that innovation and. Which comes back to my point about the research that goes on in these things.

Speaker A: Yeah.

Speaker B: And then the, and then it kind of made me reflect. And again, on this trip, how many? So, uh, uh, we were going around another health system trying to work with so many, uh, maybe it was St. Jude's actually, I think it was St. Jude's and you get, they're so proud of it that before you have your meeting, you get a tour.

Speaker A: Yeah.

Speaker B: And they take you around the facility. The person that gave the tour was a patient.

Speaker A: Yeah.

Speaker B: You know, you know, people stay, you know, with that health system because so those two things stuck in my mind. They were my. What, the health tech moment.

Speaker A: Yeah. Is it? I mean, I've had the same on the US Trips, whether you've got somebody who's been through something in that particular service provider and then they, they end up volunteering there and. Yeah, yeah. Same thing. They always typically start with as a patient or someone who's going to give you the guided tone, give you the, give you the story.

Speaker B: Yeah, yeah. They stand out. They stay with you when you come back.

Speaker A: Yeah. Absolutely. Um, thank you very much for joining us today and, um, sharing your global insights. Um, join us next time for another episode. Don't forget to rate and subscribe. And if you've got any questions for us or our guests, please email. What the. Healthtechadarhealthcare.com.

Speaker B: Sam.