 I never imagined when I did the first one that there would be 10 more. But that's what we've done and we owe that to your interest and your vigorous participation in the MPA program, and the leadership program, and Brian's. So thank you for all of you for coming and I need to thank Lee Koo. There she is. Sorry I went for one second. You all met Ms. Koo, right? She has replaced our own Mrs. Flora who we thought was irreplaceable. But Ms. Koo has done a fabulous job and she's actually in charge. And I'm here dressed as I am because she told me to wear this. And I have a name tag because she made me put it on. And if you've been around her, you know that she doesn't take no for an answer very easily. We are indebted to her for putting all this together. The logistics of these things aren't easy. And this is the first we plan two more after this. So we're hopeful that the planning goes as smoothly as it did and I think we can count on Ms. Koo to do that. Dr. Norbell of course was a key contributor here with the important comment along the way, the under breath comment that sometimes I didn't want to hear. But nonetheless, she added humor and good sense to much of what we were doing this evening. And I want to thank her. Also this is the event is partly sponsored by the Rhode Island chapter of the American Society for Public Administration. Otherwise known as Rye Espa. And Rye Espa has been connected to this program since at least 2008. And actually the founding of the Rhode Island chapter goes all the way back to the 90s. And then it sort of got lost in the midst of time. So we were lucky enough to restart it. And I think we've been exceptionally successful in doing so. We put on seven, eight will be in the spring, eight public service week conferences. At which we've had the president, the vice president of National Espa since 2008. And they think that our chapter is pretty darn good. And Dr. Norbell has gone to Washington or been involved in a conference call for the midyear meeting of Espa. Where we've gotten a favorite spot on the agenda. And I believe they called it how to take your chapter to the next level. So if we are at that level, we owe it to the membership and to your participation. We thank you for that. And as a matter of fact, Rye Espa also has a board. And some of those board members are here with us tonight. And I would like to give recognition and thanks to them. We have Mrs. Vicki Walters. And we have Ms. Shantel Bhima. We have Mr. Christopher Pierce. And we have Ms. Sasha Zepata. Who elected and had been turned into the office in national headquarters and are on the list of members and board members of National Espa. I will also tell you that our chapter has been stand out, even if we are not at the next level. But it is every year Espa sponsored what is called the Espa Founders Fellow Program. And it usually goes to PhD students. In fact, it almost exclusively goes to PhD students until about two years ago. When a gentleman who was with us tonight walked into my office and said, I'd like to apply for the Espa Fellows Program. And I said, how did you know about it? Because we don't have a PhD. He said he was a member of Espa. He joined. He looked up the Founders Program and he said, I'd like to apply. And would you nominate me? And I said, yes, I'd be happy to do that. So the application went in. I wrote a nomination letter. And lo and behold, that 100 applicants, only 25 of whom got to the Founders Fellow and George Lobani was one of the 25. In part, it was him being able to know the people who were on the selection committee. The President and Vice President at the time were both at our May conference and we all met with the dinner. We sort of winded down them and made them feel at home. And the work got around that they liked our staff. So I think it helped. But George Lobani is an exceptional person. And the Wrentham Police Department is fortunate to have a man of his caliber and I am fortunate as a teacher to have had such a student in my class. George is finishing up and is gathering data. So for those of us here from 501, there's a mentor you want to talk to if you don't talk to me. I'll talk to him. Now also as a result of having the public service week conference last May and having the Executive Director who himself is from Rhode Island and the President and the Vice President of ASPA, the students, several of whom I've introduced here as board members of where I asked formed their own panel. I challenged them to do that in a fall and they did. So impressive were they that the President of ASPA came up to several of them after and said you should apply for the ASPA Founders Felt program. So they have. Well, the deadline is Saturday or Friday. I'm told that most of it's done, but they are finishing up that application. So it is not unknown, Mr. Lobani tells me, for one school to have more than one Founders Felt. So I'm keeping my fingers crossed that we get four. And if you wish, you can wish luck to Christopher Pierce, Sasha DePata, and thank you, Walters and Sean Tilley. I wasn't going to forget you. So we have another very important ceremony this evening and that is for another outstanding student who has finished. Two years ago, we created the Dean's Outstanding Student Award in the MS in Leadership Program. And last year there was a time that this year there was only one student who we felt was deserving of the honor and he is here with us tonight. Dr. Norville, do we have the... We do. The certificate? Not only is it suitable for me, it actually is for me. So you can get it immediately on the wall. I don't recommend push tax. I get those at my house a lot. If you use a sheet-hot rock hanger, it'll work much better. This year's recipient of the Dean's Outstanding Leadership, the student award is Michael Monk. I believe this will be about one second for the photo. I'm going to look up at the least one. What, we're not good enough? I'm on video. For your video. Oh, here we are. The photo is so 2015. It's still there. That wasn't fake. Got the Starbucks camera coming up. Can I just say something? I'd like to say something about Mike. So at the hooding ceremony last May, the provost recognized Mike as being the top transformational student. So the student who started the program with a particular intent in mind and finished the program being transformed as a result of the program but is in the process of transforming his organization as well. So those were the words that our provost, Andrew Workman, had to say about Mike. And we are very proud of him and would encourage all of you, either an MS leadership program or MPA program, to think about the values of Roger William and see how those values, transformation being one of them, can be incorporated into your school work and into your professional work. Members of the board last February, said members of the board last February met with me, Dr. Mobile, I think you came a little later, but you were there. And because I wanted to plan this year's program thing. So we came up with a number of ideas and Sasha Zapata took over the meeting because she's a leader like that. And she said, innovation! And I said, that's a wonderful thing. So we all talked about it and we agreed this year's thing would be innovation. So suddenly it was August. And the fall reception and colloquium were on schedule. And we had a theme but we had no keynote speaker. So the call went out and Sasha Zapata answered. And she said, I am the perfect person. And that perfect person is standing here with us this evening. Her name is Darlene Morris. It turns out that she went to Roger Williams University. I did. And has been to her degree from Roger Williams University. She has an MBA from Townsend & Wells and she's the CIPP, she also is CIPP certified. She is the director of the Center for Improvement Science at Rhode Island Quality Institute. She has also worked with her own Mrs. Walters who vouches for her solid credentials and integrity. Ms. Morris has 30 years of experience in healthcare in performing roles in technology, quality improvement and information privacy. She's also a working mother. She has raised three children and done all of this. I studied her feet. I had three children and you can see what it did to me. She currently leads the practice transformation program at the Rhode Island Quality Institute which delivers health information exchange services and I believe that's one of the projects Ms. Zapata is currently working on. Ms. Morris holds an MBA with a focus in organizational leadership so our leadership students can also relate. SPS and computer information systems as I mentioned is a certified information privacy professional. Ladies and gentlemen, please help me welcome Darlene Morris. Thank you so much for having me here tonight. I realize how things have changed since I've been here. I graduated in 2007 and I understand now students can remote in and go to meeting and if you're home sick you can listen to the class or you can listen to a recording and we had excuses back then. We didn't have them. But anyway, I'm really delighted to be here and I think that the Rhode Island Quality Institute is a perfect organization to talk to you about tonight with regard to innovation. So Sasha, can you switch to the next? Great. So just a brief agenda. I want to talk to you a little bit about the institute. I can set the stage, what our mission is, what our vision is and what we do because that's truly important. Then I'll define innovation and I'll talk to you a little bit about how that happens at the institute. Okay, so you can get a sense of what we do. We truly are innovative. I'm going to prove that to you tonight. I'm going to show you some new products and services and how they came to be. So I have a lot of examples and graphics and things like that that I think will be interesting to all of you. Okay, so the institute is a nonprofit so far. So we're coming up with all these great new products and services which means what? We're starting to think about selling them now because that's what we do. Our mission is to significantly improve health and advance the quality and value of care. And what I want to call out here is health and value because those are very important, especially value when you're talking about innovation when you're creating something new. It needs to bring value to your customers. And health is a theme. We're a health IT company. So you'd think that we focus more on health IT. You know, with a health information exchange for the state of Rhode Island. So we're with the IT folks, right? But not really. We care ultimately about improving health of individuals in the state. And our vision, and of course I highlighted in a red because every time I saw innovation in something of ours, I wanted to point that out. So our vision is of a vibrant, innovative, and connected community that engages the creative energy and commitment of all in the optimization of health. One skin health, innovation, and connected community. Okay, Sasha. And who we are. We're a center of collaborative innovation. So are they of that word again? It just keeps coming up because this is what we do. That advances health and care transformation. And we believe that all of us working together are better than any one of us acting alone. I just really like the statement. The statement goes out with our materials. And just one more word about working together. So we have gathered to, we're fortunate, Rhode Island's a small state. So we can get around the table with all of the key players. And if you were to walk into one of our board meetings and we attend them regularly every month, you'll find that the CEO of every single hospital in this state is sitting at that table and they show up every month, as well as larger organizations too. So we have so many key players. So it's all about bringing together those stakeholders. In other states where we found that this kind of thing that we do does not work well. It's when you don't have those key players around the table. You really need to do it together. So I have four slides. I want to talk to you about what we do there. Because it'll set the context. You really need to know what we do so I can show you how we come up with some of these products in truly innovative ways. So if you imagine that purple drum as a big database and it holds patient data and on the left those are the data sources. So lab results are flowing in, prescriptions are flowing in, X-ray reports, imaging reports, alerts from hospitals that say when you go to a hospital. So say you were admitted in a hospital on the weekend an alert will immediately fly to your doctor from our system to say you are there. So alerts flow in and in the back there's another drop. It's kind of orange and it says business services and I'll talk about that more later. But try to imagine as the data is flowing in right about here there's something called the participation gateway. So we're in opt-in state. So that means individuals you need have to agree to let our data flow into the database called current care. And then we have to agree for that data to be shared with our treating providers. So it's all HIPAA compliant and all that business. But the data hits the participation gateway and the system says are they enrolled in current care? Yes. Okay, put it in that purple drum. No, put it in the orange drum. So we separate data. It's really important because we're in opt-in state. So what's in there right now? 90% of all the lab data sits into that one place. So I know some of you use portals, right? You use your own doctor's portal. You can go in and get your lab results. Maybe it's on your phone or what have you. But what makes current care really unique is that we have data flowing in from everywhere. So we have all the hospitals sending us your data wherever you go. So that's what makes it unique. 85% of all the pharmacy data in the state is in there. So that means your doctor ordered a prescription for you. We know about it. Did you fill it or not? We know about it. So we have all that in there. All the hospitals, like I said, are feeding those admission and discharge notices when you go into a hospital or an emergency room. And we've just processed millions and millions of transactions to date. You don't know how many of them we throw out though because if you're not enrolled in current care, they won't hit the database. So again, we're in opt-in state. There's 1.2 million people in Rhode Island right now and about half of them have agreed to share their data in current care. I mean, if you think about it, that's pretty amazing. How many of you have even heard of current care? Anybody who feels that's good. Excellent. But, you know, we're non-profits, so one of the things we haven't done well, I think, is message it out. Like, you won't see us on billboards or on the sides of buses or anywhere else because we just don't have that kind of money to do that kind of thing. But it's coming. Oh, is that the one? Yep, it's the one right up there. Okay. So, same slide, but I want to call your attention to the right side. So, the data's flowing in, and now what do we do with it? So, on the right side's the outputs, and I want to go over each one of these because later when I tell you about those innovations, you'll understand what I'm saying. The top one is current care and care management alerts. Again, those hospital alerts, when you've been admitted or discharged, are in there and you send them out to your doctor. Current care viewer. It's an online portal. Go right on the internet. You don't need an electronic health record. Your doctor can view all the information about you. It's a portal. The provider directory. All we know about providers in the state. Where do they work? What health insurance companies are they affiliated with? All kinds of demographics on providers. Current care for me is a portal for you, and we just rolled this up. It's brand new. In fact, were you part of the pilot study? I was not part of it. You weren't? Okay. So, I was part of the pilot study, and what was really cool about it was I had had an MRI about a month ago, and I was waiting and waiting, and I was really anxious about the results. And I went into current care for me, and there it was. Like, I got the results the same day that they were finished. And then dashboards are a real-time view of patients who are in the hospital or ED. I'll show you a graphic of that. But just to give you a sense of what the outputs are. So defining innovation. Process of translating an idea into a service that creates value. So keyword's an idea, right? Translated into a service that creates value and has to satisfy a specific need. I really like this business dictionary definition because it resonated with a lot of what we're doing. I looked at several definitions, but this is one I liked. Innovation involves deliberate application in deriving greater or different values from resources. So again, it's about the ideas, satisfying a need, using the resources you have and deriving greater value. And then there are two different categories, right? Evolutionary and revolutionary. Have you heard these terms before? Anybody? Yeah. Great. So most of the innovations we do at the Institute of Evolutionary. We have this technology, this health information exchange. It's a repository of data. And we keep making improvements, incremental changes to it to make it better and more valuable to people like you and I who use it. Revolutionary, those disruptive and new changes that come out. Not so much those. Okay. So here's a story about Hospital Alerts. And I just want to say that our doctors are already beginning to find incredible value and we're starting to gather really good stories about them. I'll give you a quick example. There was a patient who was in a nursing home and so they didn't know much about the patient. It was a new patient. They went in the nursing home for rehab. And so they were going to treat the fracture. And they went into current care to look and found out the patient had cancer. The patient never mentioned it. So it completely changed that treatment for that patient immediately. So it's all about putting the right information in the right place at the right time so patients can get the best care. Okay. So Hospital Alerts, those are those messages. This is a sample of one. It's a test so it's not nice and clear and sharp like a treatment. But this is a patient who was admitted to Westerly Hospital. And so it's an email message. It's basically an email message that says your patient's been admitted to the hospital. And why these are so great is because so the doctor knows you've been admitted to the hospital. If anyone, you don't have to raise your hand, but if anyone's a coastal patient with that bracelet on you, the reason they're doing that is they want to identify you immediately because they don't want you to go in hospital. Because they're trying to keep costs down. They're part of an ACO or an accountable care organization. And so the alerts let the doctor know where you are right away in real time so they can act quickly and get you help. We have another doctor who, as soon as he gets these alerts on his mobile phone, he'll text his patients and say soon in the ED, come to my office. So we're finding doctors use these in really creative ways. It strengthens the patient-provider relationship. We had an employee years ago who went to an ED and she was on her way home and the doctor called her on her cell phone. I understand you were in the ED. Is everything all right? She was just shocked and amazed but the doctor was right there. So and of course reducing costly admissions. So a little story about that is that since 2013 we've been collecting data on hospital admissions we get from the Department of Health. Because this is a big deal now in this new climate where they have to kind of keep the costs down on hospital admissions. And so we've been tracking it in such a the next slide will show that for patients whose providers receive these alerts, that's the blue line, 30-day all-cause readmissions were 12% lower than for patients whose providers don't receive the alerts. So you just see that in a very simple way how effective these alerts really are. And at the bottom it shows that we've already calculated if everybody was involved in current care and everybody was receiving these alerts, there'd be a $22 million reduction in the state in costs in hospital costs. So this is how valuable this is. But we had a big problem with these hospital alerts, right? So they're being adopted across the state. Practices are saying, yes, I need this. I need it right away. Everything was going great and we thought we were on a roll and then what happened? Something changed. The healthcare landscape changed. All of a sudden doctors were moving into these accountable care organizations in these shared savings programs. All of a sudden they were all concerned about utilization, like hospital admissions. And the total cost of a patient's care became really, really important. So of course there was a greater need to reduce the admissions but for all the patients, not just those in current care. So like I told you earlier, only half the population was in current care. So what does that mean? The doctor was only seeing half of the alerts. The other patients who weren't willing to care, he had no clue where they were. So we met with this chief operating officer of the primary care practice and he said, I cannot survive in this new environment. I can't afford the leakage. You've got to do something about it. So there was an idea. So we're moving along just fine thinking everything was great. But somebody said I can't afford this leakage. So someone challenged the status quo right. That's important for innovation. And so we took his idea and the need in our current technology which was current care hospital alerts and we created care management alerts and dashboards. So care management alerts through HIPAA agreements between the hospitals and the institute and between the institute and the doctor's office. We put all those legal agreements in place and now we're able to share alerts on all patients. Not just those enrolled in care care. This is the coolest thing. So this is a dashboard and nurse care managers use these and these bars on the left here, the red bar is showing how many patients, this is real data of all current care enrolled patients. We just did a screenshot. 144 patients on this date were actually in the emergency room and 504 were actually in the hospital on this date. On the right side it shows discharges. Now if you clicked on one of these bars, the next slide will show you exactly I had to take the patient names out, of course. Exactly who's in the hospital and why they're there and it shows you where they are and how many times they've been in the hospital in the last six months and how many times they've been in an ED in the last six months and you should have seen how shocked we were when we read this the first time. And at the top of the list, because you can sort and fill them in all that good stuff, at the top of the list there's a patient who'd been in the ED 30 times in the last six months. And they're like oh my, imagine if providers had this data at their fingertips because maybe they knew the patient was in the hospital but a lot of times they don't. So all of a sudden things begin to open up because it is one innovation. So we have other products, so we had current care viewer, right? And viewer was that online portal for doctors to go in and see your medical data and see your prescriptions, and did you fill the prescription in all that business? But it only had medical data, so that was a problem. So somebody said well it would be really nice if we could integrate behavioral health and substance abuse data in with medical data because we're not treating two people, we're treating one person who has all of these issues. So we again challenged the status quo and we became the first statewide health information exchange in the nation to integrate behavioral and substance abuse data into the HIV and in 2013 we received an excellence award for that work. So something else is that the viewer was only available on the internet. Remember I told you how they had to go out on the internet when you go to your doctor's office and they wheel that card over and they have the laptop and they're not looking at you anymore because they were doing this? Imagine if he's doing this or she and they have to then go bring up the browser window and log into the internet try to remember the password for current care viewer and they said look, our adoption rates were high utilization rates were low they said we don't have time to go into a separate system so we had a need right? And someone said someone had an idea they said what if it could all be in one place? So we created cross document exchange which sent that patient information directly into the doctor's electron health record and now it appears in this place this happens to be epic care everywhere and it appears on the documents tab and it says the document source is current care and they can open it up and then all the information about you that we have in current care pops up and they can simply click on what they want to integrate right into their record so they might do a med record and they might say well this person is on 10 medications and I'm aware of them but current care says they're on 11 and I'm gonna drag that 11th one over and they click it and it becomes part of the record so it's always these new ideas and these needs and we sit down and talk with some of these ideas and one more so patients could not access their data for years and so we decided why can't we open up the portal to patients so we did and this is called current care for me and this is what you see it's a little different from the doctor's screen which is busy and a little complex but the patient's screen is really simple and easy to use and you can get all that data until Duval but you can also try to see where it is this one click here and share your records so you can bring up a copy of your records you can print them you can send them somewhere so imagine if you were seeing a new doctor for the first time or you moved to a different state and you wanted to bring your record with you you could bring it with you but we know it's securely of course in that kind of thing but now you have the data at your hands and I used my own record that way so it's pretty amazing and this is just kind of some snapshots of current care for me lab results, allergies, immunizations it includes a full med line dictionary too so if you have a condition and you don't know what it's all about you click on it and the dictionary opens up and you get all kind of information it's like a one-stop shop ok so same graph as I gave you before just to kind of summarize that we were an HIE that received federal seed money to create this I think it was 10 million dollars just to get it started and we started very simply with connecting to maybe one hospital and then two hospitals growing and growing over the years and then we created all these products and when we discover the need I think what makes us truly innovative is that we are not afraid to fail and so this is really important it's not enough to have those needs and to have current technology and to have ideas that's great you all could have that just sitting in this room but it's really important to have a really fertile environment for that so you have to have an environment where it's ok to make mistakes and we have that environment in fact we used to have failure sessions remember where we would talk about our failures it was kind of silly but we did and it's truly ok to throw things out you have to be open you have to have open minds and be open to new ideas so anybody in the company can come up with ideas and listen to me and you have to challenge the status quo I mean you can't just assume that things are going fine as they are and finally when you're being innovative it's really really important that you be agile so when change happens like the healthcare landscape was just happening before our eyes we had to be quick to make changes we couldn't just sit around and take a year to come up with something new not to say some of these products we couldn't take a year to develop anybody in software development knows that but we had to act quickly we had to be agile and what we're finding now is that competitors are starting to creep into our space and we're not used to that we're a non-profit who just kind of we had the market this is what we do nobody else did what we did and now we're finding these competitors creeping and it's actually keeping us on our toes a little more it's an uncomfortable feeling but it's also a good feeling because we're coming up with more and more of these products and services is that my last slide? okay so what questions could I answer for you about the company is my charter care moved with part of charter care? so it's not and a lot of people ask us that so that's another portal where you can get your information but keep in mind that what you're getting there is just all the information from charter care or all the information from Care New England or Lifespan and Epic does have a great product and their care everywhere gives all the information from everyone using Epic but there's still not all the information and so that's what we're attempting to do is create everything in one place it's not to replace those other products but to give you another option that's a good question so how would we as consumers and end users get the content reviewed to establish an account with current care or is that strictly the hospital to keep it? so that's such a great question too if you pick up one of those prizes on your way out you can take it home and sign up for current care as soon as current care for me that portal becomes available it's live but to certain groups everybody soon we'll send you an email and let you know it's live and then you can get access any other questions? yes, how do you keep it secure? oh, that's right we have a whole slide given on that and we have a whole person who sits there and does nothing but makes sure it's secure so I can't talk the IT talk the way he can but I can just assure you that it is definitely secure up until just a couple of years ago Sasha and I and other staff members dressed very formally in work, like all the men needed to wear suits and ties and everybody dressed really well and the reason I say that is because our CEO always said to us we are the holders of the data in this state it's an important job, it matters ourselves and we need to think about ourselves as having that important job and she kind of relaxed on the dress code just maybe a year ago which benefited the guys a little bit more because if you take those dark ties off even the IT folks had to wear even the IT folks had to wear ties I'm looking at you and they were always getting caught in things while they were on the desk and everything else so that one of my but that's a good question we have a risk management person who takes care of nothing but that and he's constantly auditing the system so you're not supposed to look yourself up if you are say a nurse in a doctor's office you can go through current care for me but you can't look yourself up in a doctor's office if you work there and so he'll audit to make sure the same last names are not looked up by the people so darling Morris didn't look up darling Morris you do you get flagged on that like for sure you can't look up family memories like we keep tabs on that anything any questions yeah thank you so you had mentioned the information goes directly into Epic and so I'm assuming it's only Epic that does that and so I see a shift of everyone changing into Epic so is that kind of system change that is happening from something like this so I think those are two separate things I think people are moving to Epic because it is a good product and because Lifespan recently adopted Epic but we actually have integrated with Epic NextGen and Athena so it's more than one system we're going with the willing we're going with the vendors that want to work with us and don't charge too much do you have any relationship with pre-hospital care pre-hospital care the reason I'm asking is the Department of Health or EMS division is going to web-based records and things like that so there's a lot of patients that receive treatment in the field and the Department of Health and it's on their servers and the care is documented and it's there it's maintained by the state and I didn't know if you had a relationship with them that could be put into the record so I remember a few years back we just come to the ministry and we wanted to give this to them because we thought we needed more importantly than that right there in the ambulance but we ran into some snags around policy that we couldn't overcome at the time we were able to give it to independents who were HIPAA compliant but some of the state EMS run organizations couldn't meet the stringent HIPAA requirements that we insist upon for one reason or another I don't know the details but they couldn't they wouldn't sign our data use agreement so we kind of left that but it's resurfaced now and we're actually about to go into a project I think next year with the state to connect the EMS folks so it's common yeah those legal snags can take forever it took three years to get the Department of Corrections to get access to this that's how long it took because of legal snags like that see because if you're at the Department of Corrections the director of the Department of Corrections has the right to look at any patient information at any time inmates information at any time and we wouldn't allow him to look so we told him we can't do that but he's since said okay he won't look okay anything else I do okay terrific this isn't an off the shelf database isn't no well partly but it is customized intersystems corporation is our base our platform but it is customized and it's a relational database I believe so yes it has to be with those two yes we have some people in here making currently health informatics and I don't know about them but I heard mention of several possible new fields to put in your tables in the database we're using I also heard some very important things that some of our other students I hope heard as well as I did the issue of leadership and if you're going to do stuff that's innovative sometimes it doesn't work so you won't up to it you don't punish people you find out what went wrong so ladies and gentlemen if you think we're not teaching you what to do that's done in the real world there she is it's not just Norvelle and I it's just not all in Norvelle no that's good other questions for Bismarck Carly we thank you for your time we have a wonderful student in fact none of them are wonderful and you know we have a tradition here that we never that a guest can just eat so in recognition we'd like to have you take this and put it on your desk or home and look at it remember that you were here with us and how thankful we were to you thank you so much we have one other thing we thought it appropriate that since one of the board members did yeoman-like work to help put this event together and without her we wouldn't have had this wonderful speaker tonight and so in token of our appreciation we'd like to offer this gift to Sasha Zapato for her wonderful help and it has a double gift giving significance because she has a birthday coming up and she'll be 24 and we have birthday cookies baked by hand by our own Sarah Karn if she wants to share them well again thank you so much for coming I've been enriched by this series of presentations who are you pointing to? dessert oh well just talking about being enriched I think we have again this evening now there are some further refreshments to take part partake of take part whatever so before you go please help yourself and those of us in PA LEID 505 we will be meeting in room 2 30 at 7.30pm I will see you there enjoy