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TrendsMD podcast: A host's perspective

Get to know our podcast host, Tony Passalacqua, and learn how his unique career path led him to TMLT's Risk Management Department.To maintain social distancing, this recording was conducted virtually. Due to some portions of the podcast being hard to hear, a transcript of the conversation can be found below.

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Tony Passalacqua on a medical response team.











The above photo is of Tony while on a humanitarian mission with the USNS Comfort. 


Sara Bergmanson: Hello podcast listeners. My name is Sara Bergmanson, and I work in TMLT’s marketing department as the Digital and Social Media Specialist. I’m taking over as interviewer, because this episode is all about getting to know our podcast host, Anthony Passalacqua, aka Tony. We'll also discuss some of the top risk management recommendations Tony often gives to physicians during practice reviews and consultations. Tony has a very interesting and diverse background, including time in the military as a corpsman for the US Coast Guard, where he worked on a medical emergency response team. He has a certification in cybersecurity architecture, is a certified nursing assistant, and a nationally registered emergency medical technician. His experience also includes working with hospitals on EHR implementation and HIPAA compliance. Tony joined TMLT’s Risk Management team in 2014, and he, along with the entire Risk Management Department, are a valuable resource to our physician policyholders. In addition to getting to know Tony, this podcast offers some practical risk management takeaways in the practice of medicine and explores emerging trends in medical liability. So, Tony, tell us about yourself and your time as a military medic. Do you have any favorite places and or memories that you'd like to share?

Tony Passalacqua, 1:31: Yes, I do. Places that I've ever gone to, I actually have two. One of my first ones was Antarctica. So I actually did about six months in Antarctica, probably one of the most unique areas I've ever lived or been to. I think one of the unique experiences that I had when I was there, I was doing some cold weather survival training. It kind of changed my expectations of how you know, like all the commodities that you have, that you take advantage of such as heat and water. So that was kind of a unique experience. I think one of the other neat things about being in Antarctica was that it kind of forced you to learn how to work with a small team. So on a ship of about 165, I was part of a three-person medical team at the time, and so I only had nursing assistant training. Essentially, I had another corpsman that kind of came in, and he kind of took me underneath his wing as well as a physician assistant. So I had a lot of really good on-the-job training for about a year and a half. I guess one of the other really unique things as well about Antarctica was, is when we go down, especially with those icebreaking operations, we go down in the summer months. And so unlike other parts of the world, the sun actually didn't set for about three months. It was intense. And then the other unique area that I've gone to was a humanitarian mission. And so we went all over the Caribbean. Probably one of my favorite ones was the humanitarian mission that we did to Mako Colombia. At the time, the USNS goes on something called the Continuing Promise mission, and we treat about 100,000 patients in about three to four months. It's an impressive feat. It's joint, so we work with multiple agencies, multiple NGOs. And essentially, as we're going through the whole process, we get to talk to and work with people from like Norway, physicians from Norway, physicians from Canada. And so it's just a very, it was a very unique experience. And getting to see all those Latin American countries really changed my perspective on the health care that we have here in the United States. Probably one of my favorite memories was also on that USNS tour. So it kind of changed my perspective of medicine. So when we were going in, you know, we're trying to treat a lot of people. And every time I usually go into an environment, I would say to myself, I just want to make a difference in one person's life. Like that's it, that's all I want to do. And I figured it was going to be something with the medical side. So one of the unique things we were allowed to do as corpsman is, underneath the direct supervision of a doctor, we're actually able to work with them, and then we're allowed to perform different procedures. And so I was able to perform a couple of different ones. One was a ganglion cyst aspiration, and that was a unique experience. And then the other one was suturing somebody in the middle of the ocean. So we had one of our sailors, they needed some treatment. So our dermatologist came in, and he took out the mass that needed to be removed, and then he threw in the deep sutures. And then after he was done with that, he pretty much said, “Okay, it's up to you to go ahead and finish doing all the superficial sutures.” So I pretty much sat there on the ship, it was rocking back and forth, as I was dropping in about I think it was like 15 to 17 sutures on this guy. It was really, really interesting to be in that environment, having the opportunity to actually practice a little bit of medicine.

Sara Bergmanson, 5:16: Yeah, I mean, that sounds like a lot of pressure, though, to get a crash course and doing stiches and then having to do it on a rocking sailboat. Wow. So what were the types of medical treatments that you gave? Like when you were in Antarctica and on your humanitarian mission? So yeah, I'm curious what kinds of procedures or things did you treat the most?

Tony Passalacqua, 5:43: Yes, yeah, no, it's great question. So it was really unique. So in the military, you get the opportunity to essentially practice medicine. And it's based literally, sometimes on doors, right? So for instance, when you're on a ship, and you're in the middle of nowhere, you're it. So if you don't know how to respond to emergencies, you don't know how to mobilize someone's C spine, you don't know how to do an IV, those can all literally lead to someone dying on you. So there's, there's a tremendous amount of pressure to learn and learn everything very quickly. And then you're also kind of in a situation to try to practice above your skill set. So for instance, if you're unsure if you needed to do like an IND, so an incision and drainage for our non-medical listeners. And then if you had to do like, let's say, lacerations, and you're doing wound repair. So that's where you're doing like those sutures that I was talking about. You had to be able to do all of those. And in some instances, if you were the one who got injured, and you're the only medic, you also had to perform procedures on yourself. So it's this really kind of bizarre, extreme situation. For the most time, though, you're looking mostly at like colds and flus. So you're looking at basic head, ears, eyes, nose, throat exams. So it was a really fun, unique experience.

Sara Bergmanson, 7:06: But did you ever have to treat yourself?

Tony Passalacqua, 7:11: Yes, yeah, yep, yep. So for instance, I was part of the Medical Response Team. And then I was what they called an independent duty corpsman. So you go through special training. And I really can't necessarily call myself that, but that's the role I played. And so they attached me onto a group of guys called the Seabees, which is a civil engineering unit. And as we were in these different countries, they actually deployed us ahead of, sometimes like, an hour out by helicopter into some of these really rural areas. And then I was it. I had to perform anything that I needed. And I remember specifically having some breathing issues at one point. And so of course, I have like this bag of just different medications. And so I had to essentially prescribe myself an albuterol inhaler, just so I can breathe with just the allergens that were there.

Sara Bergmanson, 8:10: Tony, was there anything else you wanted to share or add about your time as a military medic?

Tony Passalacqua, 8:15: No, I think that's about it. I just remember, for me, sometimes it's not just the health care treatment that helps to improve someone's quality of life. We also knew that some of these children in these areas had no choice. And so one of the other things that we do is, they would drop off a bunch of stuffed animals from some of those NGOs. And then we would hand those out to the children just to give them something to hold on to, especially in some of the chaos that was ensuing in their area. And I think one of my favorite photos I have is still in my office, and it's me, given this frog stuffed animal to this child, and the child was just, you could see that it just brightened up her day to be able to receive that toy. So that was probably just, I think one of the most precious memories that I had from that deployment.

Sara Bergmanson, 9:04: Oh, that's really sweet. Maybe we can attach that photo on the Resource Hub where we post this episode. Absolutely. Let's segue to your career at TMLT and career in risk management. What brought you to a career in risk management?

Tony Passalacqua, 9:24: So what brought me here, especially for a career in risk management, was I remember working as a nursing assistant on a late night shift. And one of the things that was really interesting is, you're working inside of this hospital environment, you're receiving a lot of this direction from a lot of individuals who didn't have any sort of medical training. And at the time, I was accepted into nursing school. And so I remember thinking to myself, okay, I can go the nursing route, become a nurse, or I also got accepted into an MBA program. And I thought, you know, this would be a good time or good opportunity for me to maybe take some of that experience that I had working in the health care profession. And instead of continuing down the road as a nurse, maybe kind of jumping over and doing the more administrative side, such as risk management. And so fortunately for me, once I completed my program, I was able to kind of jump over into the Risk Management Department here at TMLT. And so, for me personally, the other reason why I was really excited to jump in, and especially in risk management on the medical malpractice side, is that it really gives me an opportunity to give back to so many of these physicians, because even though we were operating a lot individually, we were still heavily trained by a lot of our military doctors. And so for me, this is just a way that I can give back to the physician population by trying to help them out now, especially in their times of need.

Sara Bergmanson, 10:53: Yeah, that's great. I love that. That makes me want to kind of jump back a little bit, because we talked about your time as a military medic and the US Coast Guard. But we didn't really go much into what you did after that. And I know that you worked with a hospital and helped with their EHR implementation, and you have a lot of experience with HIPAA compliance. Can you talk a little bit more about your time with that?

Tony Passalacqua, 11:19: Yeah, absolutely. So one of the first things that I started to notice, especially as I was gaining more knowledge and experience, was that the compliance side has a lot of just very interesting caveats to it. For me, from the compliance perspective, I found it highly fascinating, especially as I was doing such things as IT. I ended up working in an IT department for several months in an emergency room. And as I continued to work, I kind of noticed that there's all these different ideologies, the ways that we do things. But then compliance is kind of this overarching thing that stays pretty standard across the board. And so I kind of fell in love with that. I was really fortunate. I had a privacy officer when I was doing my internship see me, and asked me to intern inside of her department. And it gave me an opportunity to just learn how complex and interesting HIPAA can be.

Sara Bergmanson, 12:17: You worked in the IT department for an emergency center. Is that how you first kind of got interested in health care technology and that side of health care?

Tony Passalacqua, 12:29: Well, actually, it was kind of interesting. So I started off as like an ER tech, because it was a good fit with the EMT background. And then they ended up not keeping that position open, and so they asked me if I would jump into the IT side. So that's how I kind of ended up working in an IT department for about a year.

Sara Bergmanson, 12:53: Cool. And so then from there, that's when you got offered the internship to explore more in the health care IT world.

Tony Passalacqua, 13:01: Yeah. So yeah, a little bit. Yep. Then that's what kind of built my passion for kind of understanding the IT side of things. And so I remember just all the equipment that you have, trying to keep up with it, the inventory logs. It was a lot of just the basics of just trying to keep up with your equipment to make sure that if there was some sort of allegations that equipment was missing that could facilitate a potential breach reporting. I had a really good understanding of that, because I actually worked on that side of things, trying to keep up with all the inventory that was inside of the hospital.

Sara Bergmanson, 13:37: Yeah, I think that's a part of medicine that often gets overlooked is, you know, your doctor, treating you and other people for whatever health concerns they may have. But a whole other side of running a healthcare organization, whether it's a hospital or a physician practice, there really is a lot of technology, you know, there's so much technology used in patient care, but then there's like, the back end stuff with your medical records and making sure devices talk to each other and are encrypted. So I know that you having that background is so valuable, especially to physicians who maybe aren't as well versed in the technology side. I know that’s an emerging, growing trend, and so yeah, there's a lot of doctors out there that I'm sure are so happy to tap into your brain sometimes when they call with some of their issues. So let's talk a little bit about what you do at TMLT, and your role as a Risk Management Representative. I know there might be some listeners out there who may be policyholders who aren't familiar with the Risk Management Department, or possibly use your policyholders, or who may not know that we have a really robust Risk Management Department, but I think it would be great if you could talk a little about your role and the department function in the company.

Tony Passalacqua, 15:05: Yeah, absolutely. It's, um, it's probably one of my favorite jobs I think I’ve ever held. I can't speak enough good or positive about our Risk Management Department. I think one of the unique things that a lot of our listeners may not know, especially our policyholders, is that we do offer advice from a risk management perspective. And it seems really counterintuitive to call up your medical malpractice carrier to see how you can handle a specific situation, but the neat thing for us is that from the risk management side, our goal is to be proactive in our approach to help physicians identify and then navigate specific issues that they have. So for us, like some of my job responsibilities is to do these things called practice reviews. And so it's a program that our Risk Management Department offers, it's actually a free service, which I think is just phenomenal. And then on top of it being a free service, we will provide a discount to you as well if you request it, and it's just our way of saying, “Hey, you know, if you need some help with this, just give us a call.” We'll send somebody out to your office, or we'll do it virtually, and help you navigate some of these things such as potentially, like your documentation style, or your templates. And we can really help identify those specific risks before you have any sort of issues that could potentially be detrimental to your practice. Not only do we do those, but again, since we are a medical malpractice carrier, we also do these things called Underwriting Reviews. Those are reviews that we go out in person. Our goal is to try to help someone who has had something happen, navigate some potential pitfalls, and then help them learn from those mistakes, and potentially get to a point where those mistakes may not happen again. So it's just a very unique way of doing things. The other things that I do outside of risk is, I work in Product Development and Consulting Services, and we do things called Security Risk Assessments. So those are a huge component of HIPAA. We answer calls between those two departments and HIPAA, how to close a practice, how to terminate a patient-physician relationship. And so we're there to help our physicians navigate through those different needs that they have at that specific time. If anyone needs to contact our Risk Management Department, our phone number is 1-800-580-8658.

Sara Bergmanson, 17:34: Yes. And this is the phone number that they can reach you, but there is a caveat. You do have to be a policyholder, correct? It's not just free advice to anyone. It's special to those who are a policyholder with TMLT.

Tony Passalacqua, 17:47: Absolutely. Yes. And I believe it also includes LSA, so our Lone Star Alliance, and that's our national group.

Sara Bergmanson, 17:56: Yeah, physicians with Lone Star Alliance or Texas Medical Liability Trust. If you're not with us, join now, so you can take advantage of our risk management services. There's a lot of complexity, so I think I know that I've heard from a lot of our physician policyholders that having the Risk Management Department as someone that they can call and talk to and trust is huge, because none of that stuff is you know, written in plain words. And so just I guess, to kind of let people know who may not know, but you guys are available Monday through Friday, business hours, 8am to 5pm, for private consultations. And then the Underwriting Reviews, are those typically done maybe after somebody has been sued? Or is that something you do maybe when there's just a claim that maybe it hasn't gone anywhere? Or what triggers that as opposed to a Practice review, which is kind of a voluntary thing anyone can sign up for?

Tony Passalacqua, 18:58: Yes, yeah. No, it's a great question. It's really just at the discretion of the underwriter. So if the underwriter decides that a specific practice maybe has like claims activity or something else that may trigger them to want us to go out, then they may request an underwriting review.

Sara Bergmanson, 19:13: And the last year since telemedicine began to be used more broadly due to the pandemic, what have you seen physicians struggling with the most?

Tony Passalacqua, 19:25: I have to say, adapting to technology is probably the most difficult part, because it changes all aspects of medicine. So I'll kind of give you a good example. So when I first started, I used to have to do medical shorthand, and the physicians that were training me at the time told me if your notes go above a page for a patient with a cold and flu, then you've over documented and you need to kind of figure out a way to dial it back. And so what that kind of gets to is, when we first started doing notes, we only really documented what they call pertinent positives, so things that really helped you identify that a case was a specific diagnosis. And then I was fortunate that we were running kind of like a hybrid model at the time, so I learned not only how to do handwritten notes with medical shorthand, but also watched the initial push of health-related IT. And so I remember our physicians just struggling with printers at first, because there, you just didn't even use burners. Then as things kind of slowly went on, we had to start learning how to use EHRs. And then once you learn how to use your EHR, you had to learn how to do like mobile devices. Then what really gets interesting in all of this is not only are you adapting to the technology as you're going along the way, but then you also have all of these different regulatory requirements too, such as the security component of it. Okay, let's see, you have all of this equipment now. But how are you going to integrate and then protect the electronic health protected information? The interesting thing is that a lot of our physicians went from kind of ops normal, very financially stable, it was a really stable job. Then, all of a sudden out of nowhere, we have the public health crisis that kicks in full here, and physicians who were doing elective surgeries were told, okay, well, you need to stop. And so elective surgeries were halted. So then that changed the way that they were doing things. And then on the telemedicine side of things, our other physicians were trying to figure out, well, how do we keep the doors open? And how do we can make, you know, continue to pay these bills? And so you watched a lot of people essentially overnight, or a lot of our physicians overnight transition from essentially working in office to completely going virtual. And I think that transition was really difficult, because not only were you trying to transition from working maybe in inside of your normal work location, but you're also having to upgrade and update all of your equipment in your house, in your home, and then trying to figure out how to protect that as well. And so I think that that was the thing that I saw physicians struggle with the most. And then the other thing is, is it really was dependent on how your IT infrastructure was set up. So if your work location had mostly laptops that allowed for portability, and for the movement of your equipment in and out prior to the public health crisis, that may have seemed like maybe not a great idea, because it's really easy to take a laptop and tuck it under your shoulder and just head out the door. And then after this public health crisis hit, it was like, well, no, those laptops were amazing. Because you could literally take that laptop and do the same thing, tuck it on your shoulder and walk out the door and continue your work from home. So that was kind of, I think, the biggest difficulty for physicians. And then the other thing is, you also lost the ability to smell and touch, which doesn't seem like a huge issue to a lot of our listeners who may not have a lot of medical experience, but you can gain a lot of information from just those two senses.

Sara Bergmanson, 23:03: I'm sure there was also maybe some physicians who didn't want to do telemedicine and just kept practicing kind of as usual. Did you see a lot of that?

Tony Passalacqua, 23:16: We did, and that's where it became even more complicated, because at that point, you had physicians who were maybe running really lean, just to try to help cut costs. And then there was this huge need for PPE, and so masks, gloves, all of that. Overnight, it became a really difficult item to try to find. And I think that's something that TMLT did really well on that timeframe. We actually stepped up and said, okay, well, at a minimum, one of the things that we really want to help our policyholders out with is being able to gain access to PPE, such as KN95 masks. And so we actually, I believe, gave out about 100,000 masks to just our policyholders.

Sara Bergmanson, 24:01: Yep, you're right. That is what we did. And I was a part of that process and helped figure out how to distribute and mail the needed PPE. And it was definitely a very gracious thing that Bob did, our CEO. He on a whim, I think just decided, like, what can I do? And it was kind of at the beginning of the crisis.

Tony Passalacqua, 24:27: Well, thanks, Sara. I know that was a really interesting time I think for everybody. Because I think a lot of us were trying to figure out well, what are we allowed and what are we not allowed to do when it comes to social contact? So thanks for everything you did.

Sara Bergmanson, 24:43: Oh, well, thank you. So moving on from telemedicine, what recommendations do you find yourself giving most often to physician practices when giving Practice Reviews?

Tony Passalacqua, 24:54: I would say that probably the most common recommendations we give is updating or obtaining policy and procedure manuals. From a risk management perspective, that's probably one of the best things that you can do. It allows you, as a potential owner of a company, to essentially help guide your employees on exactly how you want them to handle very specific situations, and sometimes even what forms to use underneath those given circumstances. I would say that's probably the number one recommendation that we do give, and then the second is updating notes. So with the implementation of EHRs, it became extremely easy to kind of use these templates. And the issue is, is that as time goes on, you sometimes forget what the body of that note contains. You just remember, okay, I need to have a patient or I have a patient who has a cold, so I'm going to go ahead and use the cold template, you put the cold template in, and you forget to check it for any sort of errors. And that's where we kind of come in and we’ll sometimes identify errors inside of that template and then notify our physicians.

Sara Bergmanson, 26:03: Yeah, I know that that is a common risk management tip that we give when we write our case studies. And I know at the end of the year, we always publish, or I'm sorry, at the beginning of the year, we always publish it in our Top 10 Risk Management Recommendations, and that template issue has been a common one maybe for the past six or seven years, maybe more. I think you might know better.

Tony Passalacqua, 26:33: Those case closed studies, for any of our listeners, are amazing. You can access them on our TMLT Hub.

Sara Bergmanson, 26:40: Yeah. So because you are interacting with policyholders often, whether it's on the phone giving the consultations and through Practice Reviews, what is your most memorable policyholder, interaction or scenario?

Tony Passalacqua, 27:01: So Sara, great question. So one of my most memorable UR experiences, they're not always necessarily positive in nature. Sometimes when we do those Underwriting Reviews where something's gone bad, those are sometimes the ones that I think we tend to remember the most. In our specific situation, we had an individual, they ended up passing away, you know, at the facility. And then one of the things that we had to do as risk managers was to go in there and then help talk to the practice about the loss of a patient. As an EMT, I mean, we used to, sometimes you're getting patients in sometimes the worst condition that they can be in. And it makes it really, really difficult, especially when you're treating somebody and then they pass away, and it's a patient that you've had for a long time. And so inside of the industry, we call it the patient-physician relationship. And it's literally like those patients sometimes become a member of your family. And so going there and just seeing how the practice was and just the energy there was just very somber, like, you could sense that, that the loss was weighing very heavy on the staff, because a lot of them have the opportunity to respond to the emergency. And it just, it felt like a failure, I guess would be the easiest way to explain it, even though it was very much out of their control. And so I think that one sticks with me the most.

Sara Bergmanson, 28:34: Yeah, unfortunately, due to the nature of our business, I know a lot of our employees, whether they're in the Claims Department, sometimes Underwriting and like you in the Risk Management Department, they have to deal with some heavy, really sad scenarios. And I know a lot of times, you know, when these things happen and they result in a claim, it's obviously as a physician something that physicians struggle with. But at the end of the day, we have to be there to support the physicians. So what topics do you get the most questions about and what resources do you recommend the most?

Tony Passalacqua, 29:15: It’s interesting, we get a lot of really good generic questions. I think HIPAA is probably the one that trips up the most of our physicians. And so again, you know, feel free to give us a phone call. And then on the risk management side, we get a lot of questions on such things as terminating the patient-physician relationship and closing practices. Those are probably the two big ones. So if you're selling or closing your practice, there's a lot of regulatory requirements. So feel free to give us a phone call. We'll go ahead and send those resources to you if you're a policyholder. And then the other one that we sometimes see kind of like upticks in every once in a while is social media. So that's the other one, and brand management. So if any of our policyholders are interested about any of those, social media and brand management, we actually sat down with Laura. She's our VP in Marketing, and she is the one who actually sat down with me on one of our first podcasts and talked to me about how our physicians can keep up with that without spending a whole lot of time just doing the manual searching.

Sara Bergmanson, 30:23: Yes, yes, I remember that. That was a really good episode. Y’all talked about online reputation management. We also have several other resources on our Resource Hub,, sending in a quick plug. All those things you've mentioned in terminating the physician patient relationship, reputation management, online reviews, we have a ton of content available. So definitely go browse our website. You can look at it by search through topics. We also have CME courses as well. Tony, what is something you wish every physician knew?

Tony Passalacqua, 31:04: I think the biggest thing that I wish every physician knew on our policyholder side, is that when you do call our 1-800 numbers, so the 1-800-580-8658, that when you do talk to a risk management representative, that information doesn't go to Claims or Underwriting and then your file’s immediately flagged and then your premiums go up just because you asked a question. I think that that's one of the biggest things that I want our physician policyholders to know. So just feel free to give us a phone call. Because that's why we're here again, from eight to five, Monday through Friday with the exception of holidays. And then I think what every physician just needs to know is that things are changing quite rapidly. Just trying to identify and understand who your resources are, are really important. So if you don't, if you're not a policyholder from TMLT, one of the best things to do is just to try to figure out what services you have maybe available to you that you're already paying for. And then utilize those resources when you have questions, because even for me as a Risk Management Representative trying to keep up with all the regulation, it can become very arduous and very difficult. And so just me keeping up with it is difficult. I can only imagine what it’s like for a physician who is trying to treat patients all day long. And then trying to keep up with the compliance side as well, it would be very difficult. So just know your resources. For anyone who's a member of the TMA, they have a lot of resources as well. And then for any of our LSA policyholders, check with your specific colleges and associations to see if they have anything that can help you out with when you're trying to answer some of these very specific questions.

Sara Bergmanson, 32:55: Well, Tony, I'm really glad that you gave that reminder and pointed out that just because you call and get a risk management consultation, that does not mean that we're going to flag you and drive up your premium, because I'm sure that might be a concern for a lot of physicians who aren't familiar with our risk management services and how we operate internally. But if you call, email, have a question, it is totally private. So Tony, what are your predictions for the future of risk management and medical liability? And do you have any predictions about telemedicine?

Tony Passalacqua, 33:40: Great question. So I absolutely love technology and how that technology can be utilized. And so one of the things that I see is technology becoming more entangled as time progresses. And so I think that in terms of training, I can't speak too much to the liability perspective. But I can say that training is a huge component of risk management. Some of the neat things that I'm starting to see trending, while I would say trending on the net, on the web, but some things that I'm starting to see utilized is the whole concept of augmented reality. I think as that technology continues to progress, I think it's going to be amazing. They're starting to use it now to train pilots, and I could see the same technology being used to train physicians on how to perform surgeries. I think that that will be a very neat technology down the road. Some of the other things, I always tell physicians just hang in there. A lot of this technology already exists, it's just trying to put it together so that it makes sense. So like for instance, right now, all the notes have to be written. Notes have been written for just as far back as I can remember. With all this integration into telemedicine with teleconferences, you know, video, you can transfer video feeds into a text message using like augmented or using artificial intelligence. Talk-to-text may actually remove a lot of those templates and notes that physicians are using now. It may actually go to something where you sometimes see in Star Trek, where there's this monologue about what you're seeing on a patient, and then that will transfer into a note. I think that that's just down the road. And I think one of the other things that I'm really going to see in the future is that as healthcare continues to progress, and society itself is progressing more towards the patient experience, or the individual’s experience to be more specific, you're going to see more rules kind of come out. And one of the latest rules that's coming out on April 5 is something called the Information Blocking Rule. What that does is it allows a physician to transfer data from their electronic health care record, and as long as it meets the guidelines that are set by the Information Blocking Rule, you have to transfer that data without delay. So there's just different things like that that are occurring in the future.

Sara Bergmanson, 36:14: Yes, and we did recently release a recorded webinar about the Information Blocking Rule that goes into effect April 5, so that is also on our Resource Hub and the webinar section. It's also available on YouTube. But that deadline is coming up, so definitely something that physicians should be aware of. I know it's something that we've been trying to communicate and make sure that you know, they're preparing for it. Is there anything else that you would like to add about the Information Blocking Rule? I know it's kind of one of those complex laws that I feel like it's going to be like HIPAA and cause a lot of confusion, am I right?

Tony Passalacqua, 36:58: It's, um, it is a complex rule. And it's kind of misleading. So when you hear information blocking, a lot of individuals think, well, that's not going to really impact me too much, because we're really already agreeing or restricting, or we're already, we're very aware of a patient's right to access records, and we take every chance we can to confirm who an individual's identity is before we release the records. And in this specific instance, with information blocking, it's actually quite the opposite. It is in regards to people who are blocking. It's really easy to become a violator of that if you're not aware of the specifics, so I cannot suggest enough going in and checking out those webinars. ONC is another great source, I would definitely go to their website and look up their FAQ section. So that way, you can become more educated on it. So the ONC is the Office of the National Coordinator for Health Information Technology.

Sara Bergmanson, 38:02: Well, thanks so much for chatting with me today, Tony. I've really enjoyed getting the opportunity to interview you. So thank you for letting me come on and ask you questions. I hope that our listeners enjoy learning more about you just as much as I have. And I think that this is going to be a helpful episode.

Tony Passalacqua, 38:22: Yes. And thank you too Sara for everything that you do in social media. We greatly appreciate it, especially on the podcast side. I know our team values everything that you do to help promote the podcast.

Sara Bergmanson, 38:35: Well thank you for listening to our podcast. If you are a policyholder, please feel free to contact us with any questions by calling 1-800-580-8658 or you can check us out online at and visit our Resource Hub at Thanks for listening.