The management of highly trained and skilled staff.
Earlier most savings has dinner and structure around process arm we really need to get to the whole notion a clinical improvement is my blood pressure drop am I staying at the emergency room and I think in order for health care organizations to really staying their successes on knows getting involved in up accountable care the earliest I key I am areas that need to be taken into consideration what about business model transformation mom because I'm a technology um analyst I'll safer colon everyone thinks all I’m talking as technology in certainly enjoy that but on with accountable care that transitions Keith was saying earlier between bullion nurses value is really significant and I actually think on getting involved in arm accountable cares really more change management um story denials anything else on in organizations have to kind of figure out the degree to which with the pace is that they want to go to church transform their organization talk a bit about learn that are terms right partners no organization can go it alone um requires domain expertise both payers and providers on hand also creation a care networks up positions as well the last year really what's no involved in up population health management so that’s really about clinical truth it's really going after that really hard much it's about paged it's me well yes industry have spent a lot of time talking about in attempting patient gauge min it's really pretty much a blunt instrument today there is research being.