Leadership, Tech, & Navigating the ASC Landscape w/ Shawna Alfano MSN BSN RN

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Erik Sunset: All right. Hello and welcome back. I’m Erik Sunset, your host of the DocBuddy Journal. Here at DocBuddy. We deliver healthcare solutions that take the pain and costs out of broken workflows like with our op note solution, which gives ASCs the power of instantly generated operative reports approved from the point of care can learn more about op Note and our whole portfolio of solutions at DocBuddy.com. And today we’ve got a special guest. We’re joined by Shawna Alfano, who’s director of operations for Mavericks health. She’s also the president of Enzio consulting. Shawna has over 20 years combined experience in business and in nursing. Shawna has experienced an unprecedented amount of diversity, growth, and change in evidence based practices and in culture.

Erik Sunset: Shawna has also worked in acute environments as charge nurse, as well as surgical and sub acute environments. Shauna, that’s quite the read in. Thanks for joining us today.

Shawna Alfano: Very welcome.

Erik Sunset: We’re glad to have you here. Oh, it’s our, absolutely our pleasure. And if, um, if that intro didn’t cover it, [00:01:00] what else should our listeners know about you?

Shawna Alfano: Oh, I think that said it pretty well. Um, definitely a varied background for sure, um, to land where I’m sitting today. Um, but a lot of good experiences along the way to bring into the SE industry. So happy to be here.

Erik Sunset: We’re really excited to get your, your insight and your expertise. And you, um, you really can speak to it all. You, you recently changed jobs from the administrator and director of nursing for a very busy California surgery center. And now you are director of operations at Mavericks health. How is that different?

Erik Sunset: What are you doing today?

Shawna Alfano: Yeah, definitely different. Um, so today my world looks, um, a lot different in that, you know, um, my past life involved day in, day out on the clinical floor, meeting with the surgeons, dealing directly with the surgeons every single day, um, managing clinical emergencies that they took [00:02:00] place, uh, managing full teams of employees.

Shawna Alfano: Um, on the day to day basis to, um, now I am overseeing several operations in terms of being the resource for the administrators and the clinical directors on the floor or the, uh, teams of staff where I am not the, uh, first line of defense, if you will. Um, but instead again, guiding the leaders who are leading those teams, as well as.

Shawna Alfano: working in the background on the operational piece, making sure that all things are working together, um, in unison from revenue cycle to, um, you know, clinical compliance to just overall operations, uh, business office, all of those things. So, um, it is definitely a new and exciting challenge.

Erik Sunset: Well, those, uh, groups who, uh, have your oversight are certainly lucky to have you. Um, one of, uh, one of the reasons we’re together today is you were quoted back at the end of last year, maybe? Or the turn of [00:03:00] this year in, in, in Becker’s ASC? And we’ll spread the listeners, uh, kind of our drawn out story to finally get to record together.

Erik Sunset: But it’s a busy year, um, and it’s centered around as 2023 comes to a close on on Becker’s ASC, and we’ll of course have a link to that, uh, to that article in the show notes, but it’s centered around potential changes that payers are making that can impact the bottom line of consumers. And obviously with the ASC, you know, achieving to the greatest extent possible in U.

Erik Sunset: S. healthcare, that triple aim of a line between patient, provider, and payer. Payer is a big part of that equation. Um, what kind of predictions were in that article? Are they coming true? Has anything changed?

Shawna Alfano: um, what I had said last year was, I think one of your biggest challenges going into the new fiscal year across the board, especially in the ASC realm is not knowing what the final rule is going to be, right? Um, when Medicare is [00:04:00] looking at what are we going to take out? What procedures aren’t we going to allow into the ASC?

Shawna Alfano: What are we not going to pay for? What are we going to add to the ASC? Um, you know, it’s, it’s very difficult. When you’re, um, the person responsible for planning the business, the plan itself. Right. Um, and you’re trying to appropriately align for the year to come, you know, your staffing, your resources, your, um, operational plan.

Shawna Alfano: If you know, let’s say your bread and butter, um, if all of a sudden they change, you know, they’re not going to pay for, two out of three types of hernia repairs, which, you know, has happened. Um, but they’re going to pay for an appendectomy that they previously wouldn’t allow in an ASC. Um, what does that look like?

Shawna Alfano: You know, what are the rates? Did they reduce rates? And they do that often. Um, did they completely take something off of, uh, your, your fee schedule for Medicare Part B? Um, people don’t realize maybe in the day to day operation, if they’re not heavily involved in that, but it does affect. All levels of operation, because obviously your revenue is going to be hit.[00:05:00]

Shawna Alfano: Um, that ties to your supply and demand and what you can and cannot bring into a center. You know, it affects whether you can grow and continue to recruit and retain physicians, all of those things. So I would say, yes, some of that did happen. Um, you know, we did see changes in various areas of, um, you know, payments and, and those types of things, um, you know, and, and those things are definitely affecting centers.

Shawna Alfano: As costs continue to rise, um, in general across the board.

Erik Sunset: You hit the nail on the head there. Obviously, a lot of pressure on the surgery center to do more with potentially less than it’s, than it’s ever had. Um, again, payers are a part of this triple aim patient provider and payer. Um, it doesn’t seem like reimbursements are going up and especially in a zero offset budget item like Medicare, somebody is going to have to give if ASC is going to take, so there’s a universe, a whole galaxy of issues out there.

Erik Sunset: What do you, what do you do [00:06:00] about it?

Shawna Alfano: Yeah. I mean, you just work harder, which is hard, right? Um, it creates a lot of obvious other issues as well because there’s burnout involved in an example. Um, Medicare is inclusive for your implant reimbursement. We all know that your, um, ortho cases, you know, your scopes, your, your things that are basic, no problem.

Shawna Alfano: As you get into meniscectomies and total joints and these, um, providers of these systems that you need in these implantables, continue to charge more and more and more, you know, um, you have to be all over your implant costs and reimbursement. You have to be all over as an administrator, your negotiations directly with those vendors.

Shawna Alfano: You can’t allow necessarily the vendors to come in and communicate directly to your OR staff, which is what they will undoubtedly try to do. Um, you have to be on top of and have your thumb on every little thing when it comes to those costs, because those are your. Intermittent costs that will make or break a center, to be [00:07:00] honest, you know, if, if you’re not all over your implant logs, for example, as part of your revenue cycle process, you’re not going to notice that they quoted you at 4, 900 for a total joint, um, system.

Shawna Alfano: And at the end of the day, you get the invoicing appeal was created for 7, 500 and you’re questioning what happened. Oh, somebody dropped this on the floor and we had to open a new X, Y, Z. Um, you know, all of those things, right. That’s an example of. Cost containment and how hard we’re having to work to be all over it.

Shawna Alfano: And that is just one tiny little area. It doesn’t, um, even get into all of the different and other specialties, you know, and what is involved, you know, in everything that comes with that.

Erik Sunset: So work harder at the ASC level. And we know all of our folks in ASCs are, are, are working hard. There’s, there’s layers to it though. Uh, there’s what you can control right there in front of you and you got to do the best you can there. But there’s some things that are maybe slightly less [00:08:00] in control and groups like ASCA are advocating on behalf of ASCs nationally every day of the year, um, to improve the economic conditions of ASCs.

Erik Sunset: Before we started to record, we were talking about the macro pressures, you know, from the payer into all of, all of healthcare, really. So if you, if you had a magic wand and obviously work harder, doesn’t fix legislative issues, but if you had a magic wand, where do you think you’d start to improve that economic?

Shawna Alfano: I would continue to, um, go after accountability. I would continue wholeheartedly and willingly take part in audits. And I’ve, I’ve been part of those, you know, where, um, Medicare is coming in and they’re saying, Hey, we want to see the books. We want to see what you were doing in this specialty. Um, and we want to see what the physicians were doing in this specialty.

Shawna Alfano: We see you have a high volume of X, Y, Z. Um, and I think that’s important because it keeps everyone. Above board, right? Um, we should be doing the right things when it comes to billing and we should make sure that when our audits come back [00:09:00] and there’s a question on something that doesn’t align. Okay, if it doesn’t align and we don’t have the documentation to prove why it should align, then we don’t get paid for it.

Shawna Alfano: Um, that is not how you want to operate your business, but it’s an honest, um, checks and balance system. And I think that it should apply to the physicians. And I think that the insurance company should also have to be accountable. Um, and I think that transparency and accountability is where the future is for the success of ASCs.

Shawna Alfano: And it needs to be that we are all, we being, um, you know, these, uh, supportive groups such as CASA in our state, ASCA, as we all know, the administrators on the ground level, you know, um, we need to have physician champions who are about. The patient and the best care possible for them. We all have to collectively as a group work to make these things happen.

Erik Sunset: Well, I think, I think that’s important to, um, listeners of the show will know I’ve got somewhat of a background in revenue cycle, not to the extent that you do having to actually, you know, administer and operate [00:10:00] a facility. But payers and providers are at odds. It seems like it’s cats and dogs. And it, in my opinion, it ought to be a little more collaborative.

Shawna Alfano: Yep. I agree. Um, you know, they don’t always see eye to eye, right. Um, and a physician will oftentimes come with valid knowledge, expertise, experience about, and surrounding, you know, a code, for example, that in their minds, For the, um, principle of, let’s say, the science behind the procedure that they’re doing, right?

Shawna Alfano: The actual anatomy and the structure. Um, it isn’t that they don’t have a valid point. It’s just that, on the flip side of that, the payer is looking at it from a very black and white viewpoint. Um, not having that in depth knowledge. And it’s just an example of where I see it fall off all the time. It’s, you know, no, we’re going to deny this because X, Y, Z, and the surgeons going back and forth with them, you know, they’ve done peer to peer.

Shawna Alfano: I’ve been on those calls and they just can’t align. And it’s something so minuscule, [00:11:00] just something so, um, avoidable in my opinion, or, um, easily solved that those are the types of frictions we can’t have in the industry. If we’re going to fix this system, you know, um, I could see where if there’s such a, Clear and concrete difference in something where, you know, a physician may be clearly trying to pull Something under the rug that’s different.

Shawna Alfano: Um, but I, I don’t see that a lot of the times they see these, these very minuscule little tiny things where they’ll flat out deny a patient healthcare because they’re not going to approve a procedure because it’s not within their black and white description of what they feel to be the accurate code indicator.

Shawna Alfano: And that is just, there’s got to be some give and take. And again, it’s just one small example, but it is something that I see all the time.

Erik Sunset: Well, and that, uh, that friction leads to physician burnout, you know, universally across the board, obviously. And, you know, to point it back towards, uh, back towards the ASC, their staff burnout too, you know, [00:12:00] we’ve heard over the course, really since COVID, uh, but particularly over the course of the last 18 months.

Erik Sunset: Can’t retain staff. Can’t make a hire. I just need a warm body. And that’s obviously a gross oversimplification, but I can’t even do that. So what are you seeing happening now? Are things getting better? Worse? Staying the same in terms of the staffing shortage impacting the industry?

Shawna Alfano: I don’t want to be negative, Nancy, but I can’t say that the staffing situation has gotten a whole lot better since COVID. There was a definite shift in, it seems like mentality in terms of what, uh, employees are looking for. You know, we get a lot of requests for, and this is not only clinical as a nurse, but this is, you know, hiring business office staff, support staff.

Shawna Alfano: Um, We get a lot of requests for remote positions, which I do understand, you know, there’s a balance to be had, but in some circumstances, especially clinical, for example, a nurse that’s in the clinical component or area of her career can’t be remote because we need [00:13:00] hands on patient care. Right? So, um, that’s a really difficult one.

Shawna Alfano: And, um, the trade off in saying, no, we can’t allow you to be remote. Um, we need you here in person tends to be then, for example, someone will come back with, well, if I’m going to actually be coming in, I want X, Y, Z rate, and these rates that we’re, we’re seeing, uh, being requested are just astronomical, which it’s unbelievable to me.

Shawna Alfano: Um, or, you know, people aren’t staying, um, in places. It seems as though they’re kind of jaw popping a lot more than I’ve ever seen in the industry. Um, it’s just a really weird place, if you will. Um, and, and I’ve never seen anything. It’s unprecedented to be in this, this time we’re in. Um, so, so it’s a little bit concerning.

Erik Sunset: The concerns, real, valid, you know, shared across the board from all the administrators that we speak to, and on the flip side of that, you know, maybe on the positive side, if you’ve got a positive hat to put [00:14:00] on, some of the, some of the tactics around retaining good staff, obviously pay is important. And what we hear from other administrators is if you just want the pay, then I can’t do it for you.

Erik Sunset: The hospital will pay you more than I ever could. But there’s a culture component to this too. Maybe a little bit less of a cog in the machine at the surgery center. So for our, for ASC administrators, uh, listening, uh, to the show, what are some pro tips you would have around generating a really positive culture where maybe, you know, Hey, it’s important, you know, that’s why we’re working obviously from the power ball.

Erik Sunset: Maybe there’s a discussion to be had, but, um, there’s more than that.

Shawna Alfano: Yeah. It’s, it’s funny you bring that up. I’m actually working on a platform right now for, um, some, some insight into successful leadership because I was blessed to have for the better part of the last seven years, at least a lot of the same staff. Um, and the one thing that, um, you know, I made sure they always felt was autonomous.

Shawna Alfano: Um, I felt like it was really important for me [00:15:00] to give them. self empowerment. If that makes sense. If they needed help, it wasn’t a delegation. It was I’m going to jump in and help you if they were struggling to the best of my ability. I would balance my workload with I’m going to struggle with you. If they had ideas, it wasn’t always just a no.

Shawna Alfano: It was let me hear what you are saying. Let me understand the concept behind your thought. Let’s look at it and dissect. Will this work? Let’s give it a try. Um, you know, Being accountable for my actions. If I make a mistake owning it, um, being transparent, if I don’t know something owning that and letting people know, I don’t know, I’m going to find out, or we’re going to find out together.

Shawna Alfano: Um, when a process isn’t working, instead of complaining, it’s going through it and figuring out how do you fix it? And if you can’t fix it, who can we bring in to help us fix it? Um, I feel like all of those mentalities combined. Um, and this isn’t to toot my horn. I was working with fantastic people and [00:16:00] I’ve been blessed in my career to work with a lot of fantastic people in general.

Shawna Alfano: But I just feel like if you are authentic and transparent, honesty is encompassed in those things. In my opinion, uh, you are able to draw and retain people that are aligned with you and that will, that will be willing, even if they’re not a hundred percent aligned to jump in and try, because they see you doing the same thing.

Shawna Alfano: You’re not just delegating, but you’re actually one of the team.

Erik Sunset: It’s interesting that that’s your response. We didn’t go over this before pushing record. But when you look at all the physician and nurse burnout reporting, and there’s there’s a lot of it, that’s one of the top factors across the board. No matter who you’re looking at, it’s around. It’s around autonomy and then alignment with organization leadership.

Erik Sunset: So did you know that it’s a great answer?

Shawna Alfano: No, thank you. No, it’s just how I lead. So, um, that’s something that’s really important to me. And that’s probably the one thing that I miss the most in moving on. Um, as much as I love my new position, I [00:17:00] miss my colleagues. Cause you know, I love leadership. So

Erik Sunset: Well, that’s it actually offers up a really nice segue for me, too, because in addition to lack of autonomy and lack of organizational alignment leading to burnout, one of the other factors is kind of a new frontier for the A. S. C. And in these burnout reports, just to have a complete thought, the technology that physicians and health care teams are forced to use is also a huge driver of their burnout.

Erik Sunset: And that’s not news, Um, but the ASC obviously not a part of the high tech act. There’s no meaningful use for ASCs for better or worse. And I do think there was some good there, especially on the patient side at the healthcare side, you know, I saw it first or secondhand, maybe not so great for practices and those that have to use it.

Erik Sunset: You’re seeing now that ASCs are digitizing their records and everybody’s got a practice management system. Some have EHRs, not very many from the folks that we talked to [00:18:00] you, but what are you seeing, what are some of the best practices and reasons, I guess, to, to digitize your ASC

Shawna Alfano: You know, I can speak directly to the days of having a file room and doing your absolute best in a busy clinical setting that, um, to have your nurse staff, you know, at the end of the day, Hey, we’re going to audit these charts and we’re going to get all of this done. And, you know, that’s a great thought, right?

Shawna Alfano: When you’re doing 450, 500 cases a month, routinely 12 months a year, um, that is not realistic. It’s extremely challenging fighting the physician signature fight every day gets exhausting. Um, and. Equally as such, anytime I’ve been, you know, in a hospital where we went from at a county level on paper charting to Cerner, that was a huge undertaking.

Shawna Alfano: I was part of the super user team there. A lot of us have worked with Epic. Um, ASCs generally aren’t working with those big powerhouse hospital systems. Um, but, They are bringing in, like you say, um, these other [00:19:00] EHR practice management, um, software. And so, uh, actually in our center, you know, in, in California, we, we did transition in 2021 to an EHR system.

Shawna Alfano: Um, and we knew what was going to happen. You know, we built a great team of super users. We pulled people from every aspect of the ASC. So we would have that insight. We walked through months. And, you know, item masters, putting them in place and getting medication databases built. We all played a critical role in it.

Shawna Alfano: Um, and we knew D day was going to be the day we rolled out, which I will never forget September 13th, 2021. Um, because we knew that was the day that the physicians and anesthesiologist physicians, everyone across the board, we were going to hear it from them and we did, and we planned it. Um, for about two months we knew.

Shawna Alfano: Uh, and what I thought was, okay, you know what we need? We need to hire. Some sort of administrative assistant, you know, that can stand in the pre op area and every single day walk each physician through This is how you log on. This is how [00:20:00] you log on. This is how you log on. Oh, this is what you click This is what you do So we went through that routine for literally two months and the shortened end of the story is at the end of the day You know, fast forward three years later, no longer do we have piles of files sitting on the floor, you know, out of compliance, uh, that same admin person that helped transition those physicians into this system, or is the same person that continued on doing the auditing?

Shawna Alfano: Because now it’s all electronic. Um, you know, a lot of these. systems and softwares offer, um, you know, a to do or a, um, what do you call it? Uh, you know, basically they log in and they have their little to do folio when they get in and it’s like, Hey, you didn’t finish these three charts. And it’s very simple for them to go in and go, Oh yeah.

Shawna Alfano: And sign off, click, click, click, you’re done. So now our compliance goes from 22 percent to 85 percent in the matter of 12 months. You know, I think it’s fantastic in that regard. I think if you are. [00:21:00] Um, detail oriented and consistent in the process, it will pay off tenfold for the center. Um, you know, it made so many things, um, connected as with like the hospitals and how they, you know, want things to be synonymous and easier for us to gain access to as medical professionals.

Shawna Alfano: And that’s exactly what I did. I mean, anesthesia no longer had to print out their Logs at the end of the day and take them to some billing office. You know, now we could give, um, HIPAA compliant access to a billing team, which gave them just billing print information that was necessary to do the billing.

Shawna Alfano: So all of those things were a hundred percent improvement. And I am a hundred percent a supporter of

Erik Sunset: and even going back to your September 13th, 2021 D Day. That still is seemingly in the minority, you know, it depends who you ask, but EHR penetration into the ASC is, uh, it’s not a majority right now. The question I have for you is how much longer can facilities operate on paper in a meaningful way? I mean, can you?

Erik Sunset: [00:22:00] Yeah. Should you?

Shawna Alfano: Yeah. I mean, that’s the thing is, to be honest, continuity of care, all of the things, right? There’s so many changing components. Now there’s so many, like I said before, there’s so many patients that are coming over to the ASC environment that are ASA level two and bordering on three, you know, which is not great for ASC traditionally, but as long as those can be safely done and they are reviewed appropriately, um, I think it’s necessary because we need to be more connected now than ever because we need to be able to get into multi platforms and pull information quickly.

Shawna Alfano: We need to not be relying on paper to, you know, to write things out and to have to go back and search a file to find something. I mean, I think that as, um, the acuity level and sicker patients are coming into the outpatient industry, um, we really need to be prepared for that. Um, you know, simple things such as a transfer, God forbid, if someone has an emergency situation in the past.

Shawna Alfano: We had to fill out, you know, [00:23:00] 10 pages of paper while we were, the ambulance is in route to the center. If you have a transfer happening actively. And when you switch over to an EHR management system, you know, immediately now you have this transfer set that you can print. That’s pulling all of your collective data from your charting that you’ve already done.

Shawna Alfano: And it prints out in a matter of 10 seconds and you’re ready to roll. Now you can give report, you can focus on what’s important. You’re not using nursing staff to fill out paperwork while you’re trying to manage an emergency situation. So it’s very, very important. And

Erik Sunset: Yeah, that’s the common gripe on the practice side was that it’s dragging down physician productivity. But when you look at the patient safety side, the. Throughput through to your revenue cycle from a visit to reimbursement. You know, those things are just not possible without software

Shawna Alfano: at the end of the day. The continuity of care, I’m telling you, from starting pre op to the minute they roll out of PACU, everything is there. Um, I think what people dread the most, Erik, honestly, is just the implementation phase and dealing with the surgeons. And it is hard. [00:24:00] Don’t let me fool you. It’s hard.

Shawna Alfano: You just have to stay the fight, and you have to be consistent, and you have to plan for it.

Erik Sunset: wise words. I have nothing to add there. Let’s, let’s pivot over to the hottest topic in healthcare. Bar none. We’ve hit some of the big ones. Reimbursement, uh, staff shortages, physician burnouts. Those are pretty hot topics, but they don’t hold the candle to AI and healthcare. What are you seeing? What are your thoughts?

Erik Sunset: Open ended.

Shawna Alfano: I’m torn on this topic, honestly. Um, you know, uh, I’m not against it per se. I know that it’s still a new, um, concept in, in the relative term new, I guess. Right. Um, You know, but things such as AI and RCM because I’m hearing a lot about that right now I know people in that market and I think while it’s 100 percent a great concept does AI really do what the brain does at the end of the day?

Shawna Alfano: Is it gonna touch on every [00:25:00] single point? Necessary right to make sure that I’m not seeing appeals coming into my inbox at a high level How is it really connecting that up? Right? I’m not Um I’m not against it. I’m just still in that skeptic phase of how do we translate that over into the healthcare industry?

Shawna Alfano: Now, quite honestly, in a lot of areas, I do think that they’re, um, they’re making some significant headway, you know, in, in terms of things like diagnosing, um, you know, via video and AI, I mean, detecting symptoms of emergency situations, stroke victims, all of those things. I think it’s going to be very critical and helpful data.

Shawna Alfano: Um, at some level in the future, but do I think that we can 100 percent just replace the human mind in a lot of aspects, which, you know, in a lot of ways is the goal in some areas, not necessarily, um, because you’ll never create compassion and, um, complex thought process. [00:26:00] And true, um, critical thinking in my opinion, um, with AI platform.

Shawna Alfano: But, but again, that’s just me. Um, I think as more and more information comes out, it will be very useful in a lot of arenas, but maybe not all.

Erik Sunset: Yeah, I think you’re right. And you kind of hit on a dog whistle for me. First of all, with the name of it, artificial intelligence and health care, more like machine learning and predictive analytics and health care would be a more fair way to frame it. And there’s also to your other point, it doesn’t mean the same thing to everybody.

Erik Sunset: Like, what are we talking about? A revenue cycle workflow? Are we talking about diagnosing things or something that we talked about before reporting? Nursing is the engine of healthcare, hands on with patients, ensuring everybody is getting what they need and everybody’s safe. Can AI do that?

Shawna Alfano: No, I mean, I don’t, I don’t think so. I mean, no matter what we do, if someone rolls into the emergency room, we’re not going to turn on a computer and have it, you know, be able [00:27:00] to deal with the family that’s losing a loved one or, you know, um, jump in and, and give critical medications at a time of need, you know, necessarily.

Shawna Alfano: Um, I think it has a long way to go is what I should say. Right. And. Again, I just don’t think it’s ever going to be able to be the human mind. Um, but I will say again, I think it does have a lot of useful, um, implementations if you will. And maybe those will, um, make themselves known over time. And then the things that maybe we shouldn’t be looking to AI for will also make themselves known if you will.

Erik Sunset: Yeah, we’re, I think we’re really aligned on that. We’re still at the very beginning of this process. It’ll shake out. There’ll be some, for sure, great applications. And very rarely am I one to, uh, hope for legislation really of any kind. But this is still the wild west. There are virtually zero [00:28:00] consumer AI privacy and protection laws, let alone patients.

Erik Sunset: So that’s going to guide a lot of this as we get further into this decade and, you know, we’ll see. There will be some very good uses for AI in healthcare, undoubtedly.

Shawna Alfano: I agree.

Erik Sunset: Well Shauna, that’s a, that’s a pretty good run at it there.

Erik Sunset: Where can our listeners connect with you online? Any social medias or things like

Shawna Alfano: Yeah. So I’m working on my social media presence right now, um, as a consultant, because I do help, um, a lot of different companies and other areas of nursing and the surgical industry. So, um, basically the best way to reach one, Would be to email me at Shauna at NCO group. com. Um, and my company is I N Z I O group.

Shawna Alfano: com.

Erik Sunset: We’ll be sure that, uh, makes it to the show notes and anything else you’d want to share with the audience that you’re, they’re working on what you’re up to. What’s exciting in your world.

Shawna Alfano: Yeah, I’m [00:29:00] actually working on a, um, digital media platform right now. I’m going through the process of that, uh, with the team and we’re going to, um, talk a lot about my consulting services there just because, um, I feel like I’m very passionate about building teams in the surgical center, um, environment. So that’s something I really like to help.

Shawna Alfano: As well as, um, accreditation and compliance. I want to make sure that our centers are as safe as possible. So that’s something that I’m often called on to help a lot with. Um, and so that platform is going to be a tool to use, um, to get in touch with me for those types of projects when needed. Um, and I’m also going to be also offering some leadership courses on the platform as well.

Shawna Alfano: So I’ll have to stay in touch with you, Erik, and get that information to you as it comes out.

Erik Sunset: Yeah. It’d be our pleasure to have you back on and talk about it when it’s live. And we, uh,

Shawna Alfano: I would appreciate

Erik Sunset: you promote that.

Shawna Alfano: That would be awesome.

Erik Sunset: Cool. Well, Sean, thanks so much for joining us today.

Shawna Alfano: Yeah. Thank you for having me. I appreciate it.

Erik Sunset: Anytime. And on behalf of the entire DocBuddy [00:30:00] team, thank you for listening. Be sure you’re subscribed on Apple podcasts, So you can always get the newest episodes of the show. And until next time, I’m your host, Erik, we’ll talk to you again soon.