Kintinu'd Conversations

S3E20 - Rehabilitation Reimagined

September 20, 2023 Brad Dexter and Claire Thelen Season 3 Episode 20
Kintinu'd Conversations
S3E20 - Rehabilitation Reimagined
Show Notes Transcript Chapter Markers

Backed by decades of experience producing exceptional clinical outcomes, Kintinu Telerehab connects recovery to everyday life. In this podcast, we explore hot topics in rehabilitation, the keys to personal growth and recovery, and how to apply it all to the real-world.


Picture a world where technology and human compassion join forces to revolutionize rehabilitation. In this episode of Kintinu’d Conversations, Brad Dexter sits down with QLI CEO Patricia Kearns and CTO Scott Meyers, as we navigate the cutting-edge world of technology in the rehabilitation setting. From integrating robotics to employing artificial intelligence, we're pushing boundaries to enhance the lives of the people we serve.

We discuss the role of the research and development team at QLI, and how we need an "all hands on deck" mentality to explore new technology within our company. As we look into the future, we delve into the importance of building partnerships and leveraging technologies. We are proactively influencing product makers to better cater to individuals with different communication and physical abilities, and ensuring that QLI continues to emerge as a trailblazer in the field of rehab. So, tune in to this enticing episode and imagine a world where technology and empathy work hand in hand to create a future full of possibilities.

Listen to the episode on Spotify, Amazon Music, Apple Podcasts, and Buzzsprout, or on your favorite podcast platform.

Brad:

Welcome to continued conversations where we explore hot topics and rehabilitation, the keys to personal growth and how to apply it all to the real world. Hey, welcome back to the conversation, looking forward to what we have today. So I have a couple of guests in the studio with me. Patricia Kerns is our CEO at QLI and Scott Myers is our CTO at QLI. I feel like I'm kind of sitting in the C suite in some ways, right? Scott is shaking his head, and so is Pat.

Patricia:

Brad's our chief podcast. Author. Wow CPO.

Brad:

That actually stands for something right. Cpo isn't that like accounting?

Scott:

It does now.

Brad:

Right, hey, we've had an opportunity. Well, for a long time at QLI, we've integrated new technologies, we've tried to stay on the cutting edge of what's going on in the rehab world, and one big reason for that is really tied to our mission statement, which is deliver life-changing rehabilitation and care, protect dignity and still purpose, create hope and commit to excellence. Right, and so as we start maybe diving into this topic of technology and how we integrate that into QLI at large, I want to kind of frame it through our mission statement, because I think the purpose of doing it comes back to that. And so, pat, I might just kick it over to you to maybe talk about why is it so important to integrate new technology into our company and how does that tie into our mission statement.

Patricia:

Absolutely Well. Thanks for having us first Love being in the space with you and having a chance to talk to our team members. So if I think about the first line and the last line of our mission statement delivering life-changing rehabilitation and care and making a commitment to excellence and then I lean into a mindset that Kim Hoguevain, our founding president and CEO, instilled in us early on, called Never Quite Satisfied, it really leads me to the power of embracing technology and progress generally in the company. So the Never Quite Satisfied mindset is the idea that, well, something may currently work for us, it may be fine, we may have results from it, but we're probably always away for a process to be better, for us to be better at something, and we should make sure that we have the curiosity and the drive. Again, even if something's okay, we should have the curiosity and the drive to find a way to not be satisfied with the status quo but to find a way to be better and in order to produce life-changing results and really be on a path of pursuing excellence. That Never Quite Satisfied mindset's important. And technology as fast as it's developing.

Patricia:

I've been at QLI for 23 years and I remember when I started we had very few computers. We certainly didn't have these little handheld computers, these iPhones, in our hands. There was an electric typewriter still out there that was to type our state survey results on. It was completely innovative that it could backspace and white it something out when you made a mistake. So if I think about the past 23 years at QLI just in my time here and how technologies changed, advance so quickly and the conveniences that has brought us improved communication, rehab technology, how much better we can serve every individual on the rehab campus or on the East campus it's really been life changing and had a big impact on a lot of people. And so if we look ahead at where technology is going and how fast it continues to change, there's excitement behind that.

Patricia:

Again while we're doing some great things. Now, technology is going to allow us to change lives in a bigger, better, faster way, and we need to embrace that. We need to stay on top of it, stay ahead of it if we can.

Brad:

Absolutely so. Even as you're saying, some of that like new technology can help us change lives in a bigger, better, faster way. We're also, it seems like, at least with the populations that we serve. We're getting less and less time with them. So do you see, kind of marrying, what we do with technology as a way to help serve that population even better?

Patricia:

Absolutely, and one of the things that our leadership team the executive leadership team had started to do in 2020, right before the pandemic hit, was moved down this path of acknowledging that there's more need for the population we serve than there are dollars, medicaid and other insurance company dollars to really serve them. So there's going to be a crunch in getting people closer to injury, having less funding in time with people than we really want, and we need to find a way instead of to just sulk about that, complain about it even though I do like to complain about that, but we're funding a lot, but we need to move ahead and say, ok, how can we find a solution?

Patricia:

Is there a way to continue to reinvent how we can provide services, given the hand that we're dealt with those funding challenges? And so our leadership team went through a process of I don't know as much strategic planning as it was just dreaming and saying Kuhl, I was 30 years old at the time and if we look ahead 30 years, where's technology going to take us that would really allow us to say, ok, the short and length of stay is fine, because with technology and with everything that we know about neuroplasticity and learning and the impact of tridimensional rehab all three of those dimensions and where they intersect based on all of those things, how can we continue to change lives and to get people back to life embracing these new technologies? So yeah, the funding challenges are definitely top of mind for us and should be a motivator. They are a motivator for us to continue to make change.

Brad:

Yeah, absolutely so. The funding motivator probably isn't the only thing. There are other challenges that face maybe our health care organization and other health care organizations at large too. But what are some of the maybe different areas that we might be facing? Some challenges that technology could help meet some of those needs. I've always working with a lot of the rehabilitation technology. It's not that the exoskeleton is life changing. It's actually the people around the person that we're serving that are life changing and we're using tools to help with some of that recovery process, and so it's always going to be about the people, the team members that we have on campus. But what are maybe some other areas outside of faster or shorter lengths of stays that technology could be integrated into QLi?

Patricia:

I'll start and then I'm going to kick it off. Scott Brad, I couldn't agree more. We have amazing people at QLI, and so it's absolutely a motivator to find ways to make the work that we do easier, faster, better. If we can take a load off our team members by using technology to make communication faster at some point, to make some of the physical work easier, to make our environment more fun as well. If we can take really great care of our team members, which we do. That's a constant focus for us, but if technology can make that even better, that's a big deal for us.

Patricia:

So I was going to say both. Sarah is one of my favorite new implementation that speaks to ease of communication and fun.

Scott:

Yep, and that was one of the things that we implemented recently to try to improve the communication around campus and also integrate with our nurse call and that kind of thing, so that we could use that new technology. That's been around for a while but it's new to us. So that was one of the things and you kind of hit on. The reason behind the R&D department in general is to keep asking those questions, keep looking forward and identifying where can we utilize technology. Because that's the most important piece is, you get into the routine of doing your job and doing things you forget to ask. Should we do it differently? And I think that's one of the focuses of the R&D team is to continue to ask those questions.

Scott:

But you look at areas in robotics and artificial intelligence is another way. How can we integrate that into our work environment to help either take care of a resident or help that resident get back to the best version of their lives again? So that's really what we're trying to do. So those are a couple of examples of things that we're looking at how to make their stay more enjoyable while they're here, using technology for smart home type stuff, which is more directed towards a consumer. But how can we utilize that to extend that to the residents lives. So that's another area that we're looking into strongly, and we've been doing that for a little bit on a smaller scale, but now we're looking at how can we do this across the board, and so that's an area that I think would be real beneficial.

Scott:

And then how can you extend that immersive experience so that you can involve family members when they're not here, and how can you bring them into participating in certain portions of their rehab and make it be like they're actually here, and that's part of the use of the communication and technology that we're hoping to extend. So that's a couple of ideas, but ultimately it's about putting together the right team and having those individuals look at the different areas of ways and explore, and then reaching out to other individuals to say, hey, what if? What are some of the other ideas that you can come up with that we haven't thought of yet, because it'd be arrogant to think that we're going to think of everything. No, we need everybody to be able to help us do that, and that's part of why we exist.

Brad:

Yeah, so, pat, you kind of alluded to the fact that a couple of years ago, leadership teams started looking into what's coming down the line. How do we be forward thinking in some of this? And, scott, one of the things that's come out of that is maybe the research and development team, and we're going to come back to this later too. But this is all hands on deck in a lot of ways, right, we need everyone to kind of pitch in and help with that. But the research and development team has been getting together for several months now maybe about five months, maybe something like that and I know the purpose that we've kind of come up with for the team is to identify, influence and integrate cutting edge technology to drive QLIs mission forward. So we've talked about QLIs mission and we have ideas about how we can identify new technology or current technologies, influence our company at large right and integrate some of those technologies into what we're trying to accomplish.

Brad:

Some of the things that I heard you say that we're looking at, scott, when you were talking, we're really around these ideas of communication and making communication even more fluid and efficient. There's a lot of things happening around campus on any given day. There's one of the things that makes our program go is the effectiveness and the efficiency of that communication right, not just internally but also externally to families, to make sure that there's that maintained connection that you were talking about. And if you don't make mie, and from a technology perspective, you have to have lots of systems and infrastructure in place to make those things happen right, which is really up Scott's alley too. And then, pat, one of the things that you were talking about earlier was just kind of easing the load on our workers too, and I guess one of the things that I think about, as you said, that was ultimately, again, we care about the people that we're serving, and we want our team members to be freed up to do the things that make sense for them, for their families, and inevitably, though, like, there are other things that are craving our attention right, whether it's documentation or it's other aspects of our team members' days that maybe pulled them away from that at times, and so part of our job, too is also, you know, how do we look at large scale things that could help again, make that communication or the workload easier?

Brad:

How do you make transfers go more smoothly, safely, effectively reduce the number of, maybe injuries that can happen to our team members? How do you offload our maintenance team with some of the things that they need to do on a regular basis to keep our campus beautiful and to maybe help turn their attention toward the people that we're serving on campus too? How do you make you know we've talked about energy use on campus? What are the big things that we spend on typically and how do you reduce spending? Like, there's been a lot of great conversations that have come out of those times already and I hear you guys talking about those things as we've been conversing too. As I kind of summarize what you guys have said, is there anything I'm missing or anything that comes to mind on your ends?

Patricia:

No, let me add a couple of examples of what we have been and technology that has made some of the changes that you're talking about. So back to the gate lab. When you think about the zero G in the exoskeleton, I graduated as a physical therapist ages and ages and ages ago almost 25 years ago which puts me, as you know, physical therapist. Longer than half of our team members have been alive. That makes me really old, but. But in those days we didn't have that technology right. So it took three or four of us to drag somebody behind one of those tall Eva or call them evil walkers and it was ugly, it was hard. You wouldn't get the repetition in you need, you really couldn't get somebody up until much later, post injury. And so now with those technologies in the gate lab, you can get people up sooner with fewer hands involved, with fewer risk of injury to your therapist because residents are supported, fewer risk, less risk of injury to the individuals being served as well, and you can get a lot more repetition in with a better gate pattern right. So technology that has really had a profound impact both on the individuals we're serving and our team members. I'll add an example for our facilities team too. We have 65 acres of land and a whole lot of trees around here, which means, in the fall which is coming upon us really, really soon, that's a lot of leaves to rake by hand, and we have an awesome facilities team that would do it every year until a few years ago, when they found this awesome piece of technology, a leaf beggar. And so now, instead of multiple hands doing that physical work that could put you at risk for injuring your back and take hours and hours and hours and take away from other things that those team members can be doing, they have a leaf beggar and a couple of guys can go out and get all the leaves in one swoop in a much shorter amount of time without the same risk of injury and better use of their time. So a couple of technologies that have made a really big difference.

Patricia:

Of course, what we're talking about in the future will be magnified in a way.

Patricia:

What if we had technology that cleaned all of our toilets for us, right, so we could free up the time of our housekeeping team or our residential team members from having to do that? What if physical transfers could be easier because we continue to have more technologies that will help us with some of that non repetitive physical kind of work. What if we have a fall management system in the apartments that will continue to get more and more affordable and accessible? That will help us not just identify when somebody's had a fall, but will predict and prevent that fall because of the AI component in there. And so what a huge change in the workload on our team members and in the success of the individuals we're serving. For some of those technologies, alex is going to get reinvented into a different environmental control unit that's also going to have a better AI focus and be able to add more cognitive support and maybe more fun, more predictive things around routines into somebody's environment. So lots on the horizon that's going to make a big, big difference for everybody involved here.

Brad:

Yeah, that's awesome. So technology, especially newer technologies, always fun to kind of explore, to see it work. You start to imagine like how you can, how you can actually integrate that into your own personal life or you know, as we're talking about this in this conversation at QLI, but there's always some inherent challenges or risks at bay to with new technology. Can you guys maybe both talk about that a little bit, Scott, maybe from your perspective? Let's start there.

Scott:

Well, change is always hard, as the is. Probably the biggest challenge is, in part of what we're trying to do is get a different mindset about change being good. It's actually not bad necessarily if you apply it the right way and you think about it the right way. We're not just trying to change the world because it makes that's what we want to do. It's there's really a purpose behind that and let's embrace that and kind of think about what's possible, as Pat mentioned. So that's the biggest challenge is getting people to think differently and not resist change and to be actually embracing the future of what it can do for us. So that's one of the challenges.

Scott:

The other thing is technology changes so fast. How do you prepare yourself for something that's going to be obsolete next week? I mean that kind of thing. So you really have to start strategically thinking down the road. And how can I prepare myself to be able to be flexible in a moment or as new things become available? And Pat mentioned the prototype apartments, and that's exactly what we're doing with that is, we're taking what's currently available, applying that to the best of our abilities, but also setting us up, understanding that we're going to need some changes to pieces out and we're going to evolve with that. So how do we set ourselves up for that and be able to adapt as new technology comes out?

Scott:

The other thing is you mentioned being on the cutting edge. There's the leading edge and there's the bleeding edge. The leading edge is right where it exists right now. The bleeding edge is trying to drive the next greatest thing, and so we've kind of shifted ourselves a little bit to that, which is the challenge, is trying to figure out what direction do you go, what are the areas that you really want to focus on? There are new exploratory areas. That can be a challenge as well, because you can pick the wrong one and it's going to cost you a lot of time, effort and resources. But if you're strategic about it, you can pick the right one and really help guide some things that could be beneficial. That's another challenge that you face, or a risk that you take.

Patricia:

Yes, scott's really in tune to I'll just add on kind of that resources and maybe the financial risk side of things. Scott's been really good at helping navigate as we're evaluating technologies. As a lean nonprofit organization who prioritizes investing every penny we have into the individuals we serve and into our team members, we don't have a lot of opportunity to waste money on technology that we're not going to need next week or it's going to be outdated and so that careful evaluation. I think the physical and occupational therapy teams have always done a really good job of this with our rehab technologies and there's something we need we better investigate the company that's making it. Are they going to be around so they can continue to repair the equipment? How reliable is the equipment? Is it going to break down regularly and we're spending a bunch of money on maintenance? And then what is coming down the road? How do we make sure that we can get in on updates and software or whatever kind of the next version of something is? So Scott's been that on and his team, our awesome technology team, on every piece of technology that we have here. How do we make the right decisions for technology?

Patricia:

The prototype apartments are a good example too of, I think, as a leadership team, just really intentional decision making around what makes sense. And we have talked about apartments. They've been in the C level of our decision making funnel for well over a decade and we've spent the last five or six years including that 2020, you know strategic planning and dreaming that we did. We really wanted apartments as kind of a next level of care, but as we kept trying to wrap our head around what's in those apartments from a technology standpoint how big are they, how many, what are we going to use them for we just kept coming back to a lot of I don't know. And so we decided, very responsibly, to build just two apartments instead of building 20 or 30 apartments.

Patricia:

We were able to fundraise for those apartments and say let's do a prototype, let's do a trial with these apartments so that we can explore what technology is available to us right now, what we think is best going to serve our population, and then we can evaluate that over the course of two to five years, learn from it, make adjustments. New technologies will come out. We can integrate those and when we hit a point that we're like this is it, this is exactly it, and the price points in a better spot. Then we can go out and fundraise and build 20 or 30 apartments. So responsible decision making to make sure that every penny, especially for fundraising, for those dollars, every penny gets put to good use. And we are really lucky to have Scott lead in that process because he's not only a wizard at technology you're a wizard at technology.

Brad:

You say cheap. I can appreciate that.

Patricia:

I know Chag or CFO appreciates that too. But to have a good steward of QLIs dollars and somebody that really knows technology is a great problem solver and a great project manager. We've been really lucky to have Scott on our team.

Brad:

So, scott, this is this is a nice little segue for you, but we've talked a little bit about I think we spent a good amount of conversation talking about identifying that technology and even in some ways, integrating newer technologies into our company, but one of the things you guys are just hitting on with the prototype apartments was maybe influencing some of that cutting edge technology. Right. So you have to get it, you have to use it, but that, even beyond that and this is something you've hit on over and over, scott you've got to have partnerships and you've got to be able to maybe have ways to give feedback or be able to influence the makers of these products in ways that might serve the population that we're serving. Can you talk about, maybe, some efforts that we have going on toward that right now?

Scott:

Sure, you bet the challenges you face is, you realize, incredible in the industry that they are in, but there's other things out there that we just don't know how it might apply. So what we do is we look at establishing partnerships with other companies other either globally or internationally or local, like Microsoft is an example. We had a resume come through from Microsoft and we ended up connecting and went out to Microsoft and met with the inventor of the Xbox Adaptive Controller and through that exchange it was really fascinating. But one of the challenges that we run into and you talk about driving the prototype apartments have appliances in there right, and appliances, even where they are right now, are still kind of in the infancy of what they can do for a population with need, and they're great at doing minor things, telling you this is ready or that's ready, but it doesn't really help you. And so what we're hoping to do is help guide some of that technology to say what if it could do this? We apply that artificial intelligence, we have a microwave that you can voice control it, tell it to open and you can tell it to set a temperature and that kind of stuff. But what if you could have a conversation with it and say I would like to do this and it helps you, instead of you just telling it what to do and making it a convenience. So that's an idea of how we could guide that down to maybe make it a little bit more practical for the residents we serve. So that's an example.

Scott:

We have some local connections that we've been working with. It, like the biomechanics laboratory is great. We've had some nice conversation with them we're looking at. Virtual reality is another area we're looking into. We've made some connections here locally with some people. That that's their expertise and it's not something that we've focused a ton of time on, but we've got some things going with that.

Scott:

Getting into those resources are really help of accelerate what we can do and even create new things. I mean, part of that is there's nothing that exists that will do this for an individual, so let's create that. So that's another partnership that we've done. We're also looking at various companies like Amazon and Apple and we've made connections. No-transcript. It's really kind of finding different ways to tap into the other industries that can help figure things out for things that may apply in their industry, but they never thought about using it in something like a rehab setting, and so those are other examples of ways that we can utilize those partnerships to help. And then finding people that are passionate about what we do is another one that you find the right people and you can get people behind you and make a lot of things happen.

Brad:

So yeah, I mean those relate. Forming those relationships, developing those partnerships, has been really, really crucial. Anything you want to add to that at all?

Patricia:

Pat, no, he nailed it, didn't he, he told you, we're so lucky to have her.

Brad:

I think one of the things, as as a team, that we've had to be cautious about when we're having some of these conversations Scott and you've been good at keeping us on track is sometimes it's easy to just see a current problem and want to address that problem right now. Right, and finding a solution right now, and you've kept saying no, we've got to look forward. Our job is not to solve current problems. It's to think about what problems might exist down the road, what current or future technologies exist, and how do we develop those relationships and partnerships to influence those technologies so that one day it might be able to be integrated on our campus, right?

Scott:

Yeah, it's fun. That's. The funnest part about this group is there are a bunch of amazing problem solvers, but that's not necessarily why we're there. Now, that's part of what we're there. I mean, that's obviously what the purpose behind a lot of this is to maybe find those challenges that we're facing and come up with solutions. Really, research and development is about more projecting and take what you currently are experiencing, but then also see what we can do with that down the road. Or maybe, if there is a short term solution will get us to a long term objective. But you haven't thought about that long term objective. You won't know. So that's really the getting people out of that mindset of I'm trying to solve every problem. Today, it's more of I'm trying to build that foundation.

Patricia:

I think that speaks to probably the biggest growth area.

Patricia:

That we have as a company, as a leadership team and as an entire team is. We all love what we do when the people we serve and it is easy, because it's busy, to get wrapped up in what we're doing here today. I get that. But if we are serious about our mission statement and assuring that Q Li celebrates 100th anniversary someday, it is time for all of us to be forward looking and and say what does recreating not just rehab, but living life for an individual after a court injury or brain injury or primary progressive multiple sclerosis diagnosis whatever that is what is living life?

Patricia:

Look like 10 years, 1520 years from now, and maybe it looks different than the rehab campus and the long term campus that we have built. Maybe that is more like the smart apartments. It's a smart neighborhood, it's a smart community, it's a smart city. It's time for all of us to look ahead 101520 years and say what are the possibilities based on all the technology that's coming down to us really, really quickly, and how do we start preparing for that? How do we start looking ahead and putting an idea of what that can be together? How do we start influencing bringing in partners or influencing policy or whatever that is and really start thinking seriously about another major reinvention and how we have been care provided for the individuals we serve.

Brad:

That's a perfect segue to probably wrap up the conversation and and come back to something that you said at the very moment, in the sense that this is this takes everyone you said at the beginning you just said it right now to this takes everyone on our team at QL I know some of our listeners aren't from QL I, you don't work here.

Brad:

I would challenge you guys to take this information and use it in your own way, and I think that's one of the things that we have to do to help people with this.

Brad:

And I think that's one of the things that we have to do is to take this information personally, professionally, find ways to integrate new technologies, to partner with companies that are doing that, so you might be able to ultimately help serve the people that you're serving even better. But if you're a team member at QL, I and you're serving and you guys can find that in pay velocity you can you can drop ideas that you have in there and those ideas are being looked at Honestly as an R&D team. We want to hear those ideas. We want to see those ideas and be able to investigate them further, to ask questions. Part of the process that has been fun has just been asking a lot of questions of other people around the company to learn what some of the current people are doing and what might be coming down the line to you. Right? And so am I missing anything on this EBA funnel or am I hitting it right?

Patricia:

on the, you're hitting it. And I shout out to Lisa Bignolo, or engagement specialist, who wanted to make contributing small to big ideas really easy for all of our team members. So absolutely. There's a link on the community pay loss of the page for all of the QL I team members to click on the idea funnel to add your idea. Please add your name to that. Don't do it because we want to pull you in to some of that processing. And then I look at that spreadsheet every month that Lisa provides me with all of those ideas and I filter those ideas out to a variety of other individuals who might be involved and some of our big ideas that may sit in the C level funnel for a while.

Patricia:

As we're kind of processing, we're looking at all of them and processing. Some of the ideas, though I can tell you, that have already come through technology related and otherwise, can very quickly move to the B level or even the A level of the funnel. So so put the ideas in there. We are looking at them regularly. We have a place to store them, to keep coming back to them as well. It's nice and easy to access. I'd be curious if you could name off to the members of the R&D team, scott and Brad. So as team members or maybe searching out, sometimes, as you're walking by somebody in the hallway, you have an idea. And it's even easier, before you get back to your computer and you lose it, to just say, hey, I have something I wanted to share with one of you.

Scott:

Sure, well, obviously, brad and I, steve Kershke, megan Potter, anna Schafert Nice, got the good catch and Olivia Hollis yeah, they say her already.

Brad:

I can't remember. Okay, who might miss in? You said Megan Potter. Yeah, I think we got everyone, okay, yeah six of us.

Scott:

They're not in front of me, so, no, you did great. You worked around the table and you hit it all yeah.

Brad:

So, yeah, so if you guys see us and maybe you've dropped an idea in or maybe you've come up with something, honestly, those ideas could come from anywhere it could. It could come from your, your YouTube binging, and you come across something right. It could come from relationships with people that you know in the community or elsewhere maybe a conversation that you've had with a resident on campus or a family member. They're going to come from all over the place and we want to hear them. So put them in the CBA final, catch us when we're walking around. We want to hear about it. Thank you to both of you just for sitting down to have the conversation Really fun to do that and listeners, thank you for tuning in.

Patricia:

Thanks for having us, brad. Thanks Brad.

Scott:

Thanks for joining the conversation with us today. If you found it helpful, please share with your family and friends. You can learn more about us on our website at continuetelleriehabcom, or check us out on YouTube, instagram and Facebook.

The Importance of Technology in Rehabilitation
Exploring Technology and Innovation for QLI
Preparing for Obsolete Technology and Influencing new Technology
Building Partnerships and Looking Ahead