Growing the lab by expanding diagnostic services to boost revenue and patient-centered care

All right, so good afternoon, everyone. I'm so excited to be on stage here in the Idealab. We have Robin Herbner, so she is the chief administrative officer at Wisconsin Diagnostic Labs, as well as the chief financial officer for Adalan. And to her right, Steve Serota. He's the president and chief operating officer of Wisconsin Diagnostic Labs, as well as the CEO, so the chief executive officer, of Adalan. So we're here today, and let's get started to talk about the pathway to growing your lab.

So as we get started, there's a lot of pressure on labs today. So decreasing reimbursement, increasing costs, and then staffing challenges. So with all of those pressures, there's a trend in our industry and in diagnostics to maybe outsource your lab, or even sell your lab. And you've got a different pathway, so we'd love to hear a little bit more about your lessons learned in this case study with Froedtert Health and Wisconsin Diagnostics Labs. - Thanks, Maggie. 

Yeah, and thank you for giving us the opportunity to come and talk on this really important topic. So you may be asking why Robin and I are here, and really we're here because WDL was born out of a dissolved partnership between a large commercial laboratory and an academic health center. And we've got a really vested interest in the idea of creating a robust, independent ecosystem of laboratories. And in order to do that, you really need to be able to control and own your lab. So as we talked about here, the WDL story goes a little something like this. WDL or Froedtert decided to partner and outsource their lab to a third-party commercial partner. And they worked together for a number of years until such time as Froedtert started to recognize that the financial impacts and the impacts to care and patients weren't advantageous. And at that point, they decided to dissolve their partnership.

And the commercial laboratory took all of the outreach, they took the core infrastructure, and Froedtert was left with a shelled core laboratory, core hospital laboratory, and a two-year non-compete. And as you can imagine, and unfortunately this is a story that happens pretty regularly, and what really happened is patient care started to slip. There was a focus on labs as a commodity, and there was a focus on centralization to third-party locations as opposed to investing in in-house laboratory services. So when that dissolution occurred, Froedtert was really in a tough spot, because their clinicians were really unhappy, patients weren't getting the right level of care, and their finances were really suffering. So they brought me in at that point, and that was about seven and a half years ago, and said, hey, look, we believe that laboratory medicine is core to clinical care. We need to invest in the lab, we need to grow the lab in the right way, and we need to become a major player for the good of our patients. So, as you know, we really went to work.

The first piece that we kind of dug into was we needed a cultural refresh. Laboratory medicine is not a commodity. It is a core foundational piece within healthcare, and it was essential that we had those services in-house to be able to take care of our patients in the right way. And that story really resonated incredibly well with our staff. And in a world now where we all know we've got 25 plus percent vacancy rates from laboratorians, creating a really compelling story that empowers your staff to focus on patient-centered care really was a game changer for us. We saw a dramatic drop in our vacancy rate. We now operate at a sub 5% functional vacancy rate, which is phenomenal from a laboratory perspective. And to the latter, if you ask any of our staff members across the board, they will tell you they are here for the patient first, and they put the science of laboratory medicine and its impact on patient care in the highest regard.

So what we did after that actually was we went and we actively worked to rebuild our core laboratory. So as you can imagine, after years of neglect and centralization, we were left with a shell. And it was incredibly challenging for us. But we got the health system to really buy in that laboratory medicine was essential. We rebuilt our core infrastructure and our core laboratory. We found some really great partners, one who invited us here today, to help get us the right technology at the right time that we could utilize in service of our patients. And we went to work rebuilding the lab as a cornerstone of Froedtert Health. As we did that, we evolved to say, how do we take a look outward? 

We know that there's a tremendous population that isn't getting the sort of laboratory services they need, and we began to work on expanding ourselves outward. So one year post our two-year non-compete, we went back out to the market, and took back 98% of the business that we lost during the dissolution, which was an incredible boom, both financially to the organization, but also to the mission of servicing our clients in a better way, and providing better community health. And really post that, we continued to grow at about an 18.5% CAGR year over year, because what folks realized was when you can get access to high-value laboratory medicine, it's a difference maker. And you know, we have been successfully doing that for five plus years, and then, you know, COVID happened, and luckily we were in a phenomenal position, and again had really strong partners that allowed us to go out there, and really provide incredible care to our patients. And that value has helped to kind of springboard us even further. We moved from being what amounts to be the fifth largest lab in the state of Wisconsin to as a regional reference lab, we're in the number one, number two spot now, which has been really great. But we looked at it and we said, hey, look, we know that this value that we're driving is valuable to patients outside of our own geography. We need to grow even further. And with that, about 24 months ago, we worked with some partners and launched a company called Adalan, which is a tech-enabled clinical partnership platform that allows academic and affiliated laboratories to work together, and utilize reservoirs of capacity to service more patients at different geographies through a seamless integration without having to sell or divest their laboratories.

'Cause we know, as Maggie said, almost every lab, if you haven't experienced it yet, you know at some point it's coming, where your board's gonna look at you and go, should we sell? 

Because labs are considered to be a cost center. And historically speaking, have been dramatically undervalued. And part of why we're here today is really to reinforce this idea that A, you're not alone, and B, that there is a pathway forward to demonstrate your value as a profit center, as a core competency for health systems, and as a core good for patients. And really that's something that we're incredibly proud of what we've done at WDL and for Froedtert, and that we're continuing to be really excited about what we're doing with our partnership through Adalan. With that, we've kind of developed here a pathway to allow other folks to move forward, and have broken it down, as my colleague Robin loves to do, into digestible bits. And we can kind of talk here through about the seven steps that we've built to grow your lab. - [Robin] Sure, we'll get started.

Yeah, so I have a very first question. So step one is to know your lab. And that's the question I have for you is what do you mean by that? What do you mean you know your lab?

Absolutely, and I think this is really important. You know, we tongue-in-cheekly always joke about it. Before you can love someone else, you gotta love yourself. Well, that works in the lab space too, right? So knowing your lab is really having a keen understanding about your capacity, your expertise, the levels of technologies you have, where do you have gaps, where do you excel as an individual, how do you find that niche that drives value inside of your health system, and with your external partners? 

And before you can go and ask for dynamic investment, or really dig into other pieces, it's incredibly important for us to dig into who we are as a lab, what we have, and what we can utilize to go and grow. And that's really what we mean here. You gotta get into the data. You gotta understand the source of truth. And you have to be able to really explicitly be able to describe who you are and what you are to all of your key stakeholders. - All right, so now we know ourselves. Robin, tell us about knowing your worth. 

Yeah, knowing your worth comes really down to after you're armed with all of that data, going out and making sure that everybody within the organization understands that as well. And it comes in a couple key areas, people that you interact with every day that may not understand the lab very well. So making sure you understand the lab trends, making sure you find your clinical friends, the medical directors of the different segments within the health system, making sure they understand the role of the lab, getting to work with them, helping them develop different techniques and different processes for working through things, and educating everybody on what outsourcing would mean to their areas. 

Yeah, and I'm just gonna stick there with aligned clinical and financial, you know, leadership. How do you align those two? 'Cause it's a very different focus.

Yeah, this is, again, I'm a finance person, I think it comes down to finding the right finance person. There's two types of people in finance. There are accountants and there are finance individuals. And finance individuals really are gonna wanna understand your business. So find somebody that comes into the lab, they wanna come into the lab, they wanna understand what it means to operate a lab. That's gonna be your best friend. Because then they can be the translator to the individuals that aren't, you know, are just running a spreadsheet. And so that's to me one of the key paths to find in your organization.

Yeah, and I'll tell you, Robin has been a fundamental game changer for our laboratory. And it's because, and I know I'm preaching to the choir here, but laboratory is a different language. And as a guy who, I started my career in surgery, and I walked into the lab, and I'm like, you know, you spend the first 15 minutes just trying to figure out what the heck anybody's talking about. And finance is a completely different language too. And really having someone who speaks both laboratory and finance, and converting that to, you know, the lay person is a difference maker. Because what we saw is first, we had to seek to explain to our clinical colleagues, most who we would already assume understood what the lab really did, the true value that we were bringing, and how we were setting the table, and how we were actually the foundation of creating intelligently-designed clinical care plans, and then we had to get the finance team, who were used to only looking at the dollars and cents, to understand where the downstream impacts from laboratory interventions could yield financial performance. And having those two pieces intersect really is what allowed us at Froedtert to not only have a seat at the table, but in many cases to set the table for all of the other clinical discussions that would go on.

Well, I love that analogy, setting the table versus just the seat at the table. So grow the core, I wanna hear more about this. I would love for you, though, to define core, just so we're grounded on what that is. And then limiting leakage. I wanna hear more about this.

Sure, so when we talk about growing the core, this is really what I would call the bread and butter of laboratory medicine. We have to be great everyday. So there's a push to say that laboratory medicine is a commodity. I fundamentally disagree. Laboratory medicine is a core component of all clinical healthcare, but we've gotta be good at the nuts and bolts. We have to be incredibly operationally efficient. We have to understand our operational processes. And we have to get it right 100% of the time. You know, our executive director of laboratory operations, Mike Baron, always likes to call us the line, if you use it as a football analogy. And the real reason why is nobody cares who your offensive line is until you get sacked, right? 

And when we think about this, growing that core and understanding that core is really about making sure you are great at core operations, that you can do the day to day, and then you can prevent this leakage that's going out. And when I say leakage, what I mean is testing that could be done on site with higher residual value for your patients that's going out to a third party. Whether that be from lack of investment, whether that be for lack of technical expertise, or from IT challenges. Right now, we know there are a lot of labs out there that are going, I'm gonna take the easy path, I'm gonna send out to a third party. And in many cases, that's to the detriment of the patients they serve. So that's why we say you've gotta get incredibly good at running your core and growing your core, making friends, bringing everybody to the table, and you've gotta make sure that you're taking advantage of every opportunity you have to service those patients who rely on you.

Yeah, it's really hard to make friends if every time you go to talk to a financial or a clinical leader within the organization, they wanna talk to you about a problem they're having, versus, you know, how you can bring value. And so that really, that step one, knowing your lab and filling those gaps in has to come first in order to really get that buy-in across the organization.

[Steve] Absolutely.

Step four is to evaluate the market possibilities. And, you know, after you've looked at your core, you understand where your strengths are, you've closed any gaps that you might have in terms of operational performance, you're rallying your friends, while you're doing all of that, you wanna evaluate your market. And there are lots of places where you can do expansion. You know, these five areas here kind of give you five different verticals that you could go after. Each one of them is gonna require a different level of expertise, and a different level of investment in terms of IT, logistics. And you know, when you're working with, and you're talking to your finance team, or working with everybody internally, you'll need to understand what kind of investment you have. And the point of this is, you know, really you can start small like a home health agency that's going to go out and grab, they're gonna go out and draw their own samples. They'll drop 'em off at your front door. They just need said services available to them. And then you can go all the way to helping, you know, other local hospitals where, you know, they're going to require couriers, and supplies, and all of those, and a full integration to their EMR. And so you can start small and then grow over time, but really knowing what your investment level is, your investment appetite, and your expertise is gonna drive really how successful you'll be in each of the verticals you know, as a starting point.

So Robin, did you start with home health? Where did you guys start?

Yeah, when WDL, when the non-compete expired, we were really starting with our discharge partners, the Froedtert discharge partners. So home health agencies, long-term care facilities. That was a business that we had kind of right off the start, and then built over time to like some of the multi provider and specialty clinics. And we have three federally-qualified health centers in Milwaukee area that are partners with Froedtert Health, and that allowed us to, you know, now we do all the lab work for those areas, and then we were able to expand to local hospitals over time, including, you know, servicing the VA and other hospitals with some of our specialty work. So, you know, we serve this entire continuum now, and have built over time. Our sweet spot is really that multi-provider specialty clinic, and you know, we have a large long-term care facility group.

Perfect, thank you.

And Robin, I think one of the really unique parts about this that comes back to having that great finance partner is there are a lot of these things where people go, I don't wanna get into that business, it's low margin, it doesn't make logical sense. If you have the right financial partner, and you can create the right kind of strategic relationships, there is a ton of requisite value that comes in multiple places, especially as a health system laboratory. 'Cause you have to remember that readmissions have value, that the ability to get to a discharge in a timely fashion have value, the overall care and outcome for these patients have value. So it's really important to be able to look at not only strategic, and I'll call it specialized, contractual relationships that can yield positive value from an ROI perspective, but also the comprehensive value that you can bring to these partners when you expand in the areas.

Yeah, I mean, if I have one piece of finance knowledge to send home with you, remember the words incremental costs, because the reality of an outreach business is very little of it is incremental, because you've built your lab to support a health system that likely has capacity into it. Any dollar that you get to fill that capacity is money that would otherwise not be within the health system. So the staffing is already paid for, because it's there, because it has to be there for the hospital. If you run five more PT/INRs on a shift, that's no incremental cost.

All right, I am so excited about step five, right? Aligning stakeholders. So Steve, I don't know, you just shared a little bit about it, but could you give us an example of a mission-aligned reinvestment? 'Cause I love that you called this out. Well, and I think this is a really important point. When you are talking about an academic health center, we have a mission around providing greater or high-value care to our patients. And it's about keeping a community healthy. And laboratory medicine is one of the cheapest interventions that you can perform that has incredible value. And one of the things that we really have looked to do as we've grown into this space, and we encourage everyone to do, is find your partners in subspecialties that can really benefit from early intervention from a laboratory perspective. Think oncology, think partnerships with pharmacy. You know, when we talk about time to treat, that partnership, that strategic intervention at the early stage can dictate intelligent clinical care plan design. So when you can become really good as a laboratory partner at engaging the patient early on, and engaging your clinical colleagues, not only do you reinforce the value that you bring to the table, but at the same time you maximize the outcome benefit to your patient. So when we say this, what we're really encouraging you to do is to understand who your big users are, and if they're not your big users, who should be your big users? And what places are you touching where people don't realize you're having directed impact? 

Emergency management planning, you know, disaster response, IT integration. I mean, 'cause let's be really honest, what is a lab but an IT company that happens to do testing, right? So we gotta know all of our partners, and we gotta know how to bring them into the fold, so that we get, it's not only the lab singing the value of the lab, but it's the entire C-suite and the entire medical team who line up behind us. And I'll tell, you know, and I tell Robin this all the time. One of my proudest moments is the fact that Froedtert literally will tell people they lead the lab. When we started our integration talks with Theda, which is a new partnership with us, ThedaCare Health, Froedtert went in and said, you know, one of the reasons you should partner with us is our lab, because our lab is gonna add value to your patients. And that is an incredible statement about how far we've come. We went from a place where our clinicians, our patients, and our C-suite was really upset to the point that they dissolved the joint venture to a place where they stand up and say our lab is so superior that other health systems should work with us solely to get access to that asset.

Okay, well, Robin, I know how to create your plan. This has got to be an area that you get pretty passionate about. 

Yeah, I mean, absolutely. You have all this information, but you need a place to go with it, and create a plan. And if you don't have a plan, you'll find yourself going in a lot of different directions based on what opportunities are flowing to you. And you can put yourself in a situation where you get spread pretty thinly pretty quickly. And so the important part of creating a plan is finding out where your expertise is, what kind of investment you're going to have, and find the fit that'll go there, and that little steps then create incremental value that you can then ask to get reinvested, and you can create and grow your plan along the way. Like Steven mentioned, you know, Froedtert made an investment in Adalan. That was a result of the value that we had built in the lab over five years to, you know, growing our outreach business, bringing that value in, and then getting that opportunity to get the funding to invest in this company that's gonna help us grow even further. And so developing your plan along that way is kind of how you wanna think about it. You know, find those early first steps, and then think about how you would roll that investment over going forward and creating that. And there's lots of different steps to that, but I would really, knowing that you have a strategy, and being able to execute on that strategy will be key to the leaders that you'll talk to.

All right, seventh step. Yeah, so- Leave no doubt, tell me. I think at the end of the day, right, this is what it all comes down to. It's about leaving no doubt. It's about the fact that the laboratory is a cornerstone to modern healthcare, and that we, as laboratorians, need to be very proud of this. This is not, you know, 20, 30 years ago, where we were locked in the basement with no windows, and they said, hey, this is a black box, just go do what you do, and spit us out a result. We wanna be at the front of this. We wanna demonstrate our patient alignment, our patient-centered focus, and we wanna be part of key decision making. And all of that only works if you can document it, and you can prescribe and demonstrate that core value. It's wonderful to have somebody like me stand up here and go, we're great, we're great, we're great. It's a heck of a lot better when I can put a sheet of paper down in front of somebody, and go, this is the value we created, this is the cost avoidance that we've brought to the system, and this is the top-of-the-funnel growth that is differentiated. Because the real answer is at the end of the day, and people ask me one of the reasons why I get into laboratory medicine, 'cause like I told you, I have a psychology undergrad, and I ran surgical sterile processing and then surgery. But the reason I got into laboratory medicine is because a great surgical suite, or surgical operating room, will do maybe 100 cases a day, and touch 100 patients, right? 

A great health system may touch three, four, 500,000 patients. Even a mid-market laboratory is going to touch millions of people. There's probably no subspecialty that has more direct impact on more people than the lab. And I think that's incredibly important. And it's incredibly important to make sure that health systems understand there's no better way to expand the top of your funnel than having a high-value laboratory that can reach out to community partners and demonstrate the value that your health system can bring through high-value patient care. Okay, your last bullet point, though, says build industry partnerships. Can you give us an example? 

So all of this doesn't work if you don't have the right partners. And I will tell you this very honestly. We are up here and able to stand and have this conversation today because we got incredibly lucky in finding a group of industry partners who are willing to invest in the same vision that we had, which was that patient-centered care makes a difference, and that laboratory medicine, when done right, adds incredible value. And whether it's our partnership through Roche, which gave us access to instrumentation that we normally would've never been able to bring, to bear in our localized market, or some of our IT partnerships, or our systemic partnerships that we've created with other labs across the country to really connect on best practice, and to work together to provide increased value to patients not only in our local geography, but nationwide. That makes an enormous difference. And the solidification and return on that really comes full circle. So, you know, as we grow, Roche's investment in us has grown and our, you know, our payback to Roche is in working to drive their value out to more patients. So it really, it's one of those things that we can work collectively and cyclically together to service and provide higher value to all of the patients we serve. 

Yeah, thank you for that.

All right, so we have three pillars ourselves, and the third pillar is patient-centric partnerships. And so really just so thankful for the work we have gotten to do with you, and throughout all of our diagnostic franchises. And so as we come to a conclusion, though, what words of wisdom would you want to impart on our audience that are interested in, you know, everyone wants to grow their lab, and so I would love to hear your words of wisdom. Yep, so I think I would tell you very openly, one is you can see on that screen right there, this is not a ten-year process that you have to go, hey, I am going to start it, and somebody else is going to finish it down the road. If you follow the steps, this is a meaningful thing that can be done, I am never going to call it rapidly, but I am going to call it strategically, and you can grow your lab, and I think there is a real path in a three-year period where you can go from really what is just core laboratory operations, just getting by, to an incredible contributor to your health system and the communities that you serve. 

And you know, one of the questions I get asked a lot is, well, you know, what happens if I do not have that level of expertise? What happens if I do not have the bandwidth to get started? And I think a really important point with this is there are powerful partnerships out there. We talked about it from an industry perspective, but look around, find mission-aligned partners, and work with them to fill those gaps that exist. Because I think we can all agree that a strong, independent ecosystem, or a strong, independent ecosystem of laboratories is phenomenally important for the overall healthcare of our nation and patients across the country. But you do not have to do it alone. There are people who want to invest in your success. There are people who are happy to share lessons learned. And there are people who have a tremendous reservoir of capacity to be skilled partners, whether that be on the instrumentation side, on the design development of your laboratory side, on the bioinformatics side, on the clinical side, and/or on the financial side. Find the right mission-aligned partners, and it really will ease the journey. 

Yeah, and I piggyback on that a little bit too. It can get overwhelming, but small steps and small partnerships over time compound into something really big. And so it might just be that first step you might take may just be a couple independent physicians that need to send, you know, a few tests every other week, but word of mouth happens fast, and the next thing you know, you have ten of those, and then the next year you have one hundred of those. And so that builds over time, and so I would just encourage you to think, those slow, steady steps will keep you in that race. Well, Robin, Steve, thank you so much, and now we are going to open up for some questions from our audience. If you have a question, please just raise a hand and we will begin with that. We will be over to these first couple questions. Well, thank you so much for laying out these seven steps so comprehensively to grow your lab. So this week at ADLM, we actually heard about this silver tsunami. So for those of us who have not heard, there are so many people turning 65 every day, right? So what is your opinion in helping us get ready from the lab's point of view for this silver tsunami? 

Yeah, I will take that. So I think again, this takes us back, and it is a little bit of what happened during COVID, right? So we saw during COVID a wave of demand, and labs worked their butts off to meet the demand. But we all know we fell down in certain areas. And I think it behooves us as an industry to strengthen our ability to expand, to create innovative partnerships that allow us to help leverage each other, to make sure that we can always meet the demand and the services of the patients who need us. So one of the things that we are really, we are champions of is to find ways to work with your partner laboratories, build those foundational partnerships, so that we can leverage each other to be ready to meet any demand that comes our way. We know that the demand for laboratory services is only increasing, so that should aid in our ability to invest in that infrastructure. But creating the right sort of partnerships is going to help take that investment even further. Hi, thank you so much for the great discussion. My question to you is, of the seven steps, which was the most difficult? And did that surprise you?

I do not know which one was the most difficult. I am trying to think. I mean. So from my perspective, I would tell you that knowing your lab when you do not have great data informatics is incredibly challenging. And as a lab that was born out of a dissolved partnership, we did not have a ton of great informatic support from our health system. So we flew a little blind. And when we talk about partnerships, there are now some phenomenal companies out there who can really help supercharge that approach, and give you some great sources of truth on which you can build your plan. But for us, I think, really getting deep on what we were doing, how we were doing it, and making sure that that source of data was very clean was very challenging. Robin? 

No, I would agree. I am pretty comfortable flying blind, so I was like, oh, good. 

Yeah, and keeping that data going, and then also just it is a continuing education to, you know, you are continuing having to find new friends and bring that along. And so that to me, I think one of the more surprising areas is every time we turn, you know, there is a new leader, a new person to kind of bring along to the party along the way. So Robin, you are good at flying blind, but what if you are not, and you want to grow your lab, and you do not really have those partnerships yet? Where do you recommend that people get started to find those partners, and reach out, and form the lab that you all have created for yourself? 

Yeah, I mean definitely, you know, obviously conferences like this, you know, getting to talk to different people, and finding people who are helpful, who know people. You know, talking to the different vendors you have and maybe trying to connect with labs that look like you, you know, that would be a way to connect. We will always talk to anybody that wants, you know, that wants some help. And you know, Steven mentioned too, there are lots of data companies, and consulting companies, and stuff that will help along the way. But those are all the places that I would suggest starting. If you do not have a large budget for consulting or anything, the first thing I would do is ask some of your vendor partners to recommend a lab that is similar, that they serve, that is similar to you, and use that connection to get started on some conversations. And I would tell you that one of the things that I love most about the laboratory industry is the fact that there is such a willingness to share amongst peer laboratories. So I think that is really a strength of our industry. We have not done it incredibly well, because we have lived very siloed, but you know, as we start to do more and more of this, as we start to really open up those conversations. The other piece of this is we are seeing a lot more non-laboratorians being pushed into laboratory leadership roles. And in those instances, it is really important to find the right mission-aligned partners. And I cannot overestimate the value of that enough. Make sure that the partners that you are finding have your best and your patient's best interest in heart, because, you know, the right partnership, I tongue-in-cheekly like to say, the right lab partnership yields great results, pun intended, but as we go down that route, you know, the real fact of the matter is finding other labs who have a vested similar interest in growing themselves and empowering you is a great place to start looking for those tool sets. I mean we built Adalan solely for that purpose, right? 

It is not about growing a company for the sake of a company. It is about growing a company to empower other labs to be able to work together for everyone's shared benefit. So I understand incremental changes in large, so once the time will be leap, and then you have a whole new building just for laboratory medicine, you know, over last four years, we, you know, develop molecular lab because of COVID, and then we now we have all molecular, and then we develop a, you know, micro lab, and then you know, all now, but we started in each corner of medical centers. We can find the spot. So, but I think there is a way, we say I need to be higher efficiency, and to centralize my laboratory instead of sending my samples everywhere across the campus. 

Yeah, and I will tell you, I think because of the value that labs really generate, it is a great opportunity if you can get to the right point of documenting that residual value, it puts you in a great position to be able to describe why it is important to centralize, because part of the deal with laboratory medicine in general is we are strongest when we are together, and when we can optimize access to specimens, it decreases variable time to diagnosis, which decreases time to treat. 

And as we start to be able to really accurately describe and outline that value, that's what gives us the most power in those discussions. We are in the same boat today. Yeah, and I think in this, when you ask can you get a whole new lab building? I'm like, well, we're seven years in, and we haven't got, we're working on it. But getting ahead of that, and like with whoever within your facility, there's a facility master plan likely in your system, you gotta find out who does that and get there. It took the experience that we had with COVID really got us to a point where we could have a seat at the table for that master facility plan. Prior to that we didn't have that. So I would say, you know, it takes a little bit to get to that seat, but find out who that is, and start inviting them to your space. Well, and the other thing is that I be friend of those people, right? Invite 'em to your party. Invite 'em to your parties, yeah. And I would kick back to Maggie too, 'cause one of the things that I think is incredibly important is some of the stuff Roche has done with innovative space management, it doesn't take the same space that people used to think it took to centralize a laboratory. So finding the right sort of partner, and Maggie, you can talk about some of the new products that you guys have with comprehensive space management planning that can really differentiate. Yeah, and it's so critical, because laboratories generally are not getting bigger. Every lab I go into has a wish to get a new lab, but very few actually get that wish granted. And so that's where we've had to really evolve with our workflow and healthcare consulting is to be able to work within the four walls, or the infrastructure that you have, as well as from a design perspective. Keep giving us that feedback, because as you've heard about design specs, that's what we also continue to look to do is how do we now make sure that we're continuing to design systems that will fit into the laboratory? We have time for one more question for this esteemed panel. This has been a really instructive conversation. Do we have one more question in the audience? Well, there's no waiting at the coffee bar. I did see that from up here. A resounding endorsement for the coffee bar. Thank you to Maggie, Robin, and Steve. Let's give them one more hand. Thank you.