 If you can take an effective practice that somebody else has and bring it into your own practice it can have a dramatic effect. One example of this is our total joint registry. In Sweden, a total joint registry had been established that demonstrated its dramatic improvement in outcomes of total joints. So we said, well, why not do this in Kaiser Permanente? Twelve years ago we started on this venture and since that time we've become the largest total joint registry in the country. We have the lowest revision rates recorded by all of the registry internationally. Because of that our patients get better care because they have lower re-operations, lower revision rates, lower re-admission rates and it's something that we can be very, very proud of.