Saving Lives with Science: The Future of Maternal and Infant Health

The United States spends more on health care than other wealthy nations, with worse results. Most concerning is that we have seen declines in infant and maternal health. But what is driving this and how do we change course. Today we are going to be digging into the important role of data in healthcare.

Hey everybody, this is Chris Brandt here with another FUTR podcast.

Today I have with me Dr. Meg Richards, Executive Director at Panalgo, an AI healthcare analytics company that is helping to improve healthcare for pregnant women and fetuses. So let's talk with Meg about what the data is telling her and how Panalgo is improving lives.

Welcome Meg

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Transcript

Chris Brandt: 0:00

The United States spends more on health care than other wealthy nations with worse results. Most concerning is that we have seen declines in infant and maternal health. But what is driving this and how do we change course? Today we're going to be digging into the important role of data in health care. Today, I have with me Dr. Meg Richards, executive director at Penalgo, an AI healthcare analytics company that is helping to improve healthcare for pregnant women and fetuses. So let's talk with Meg about what the data is telling her and how Penalgo is improving lives. Welcome Meg.

Meg Richards: 0:43

Thanks for having me on, Chris. I'm delighted to be here.

Chris Brandt: 0:46

I'm excited to talk to you about this topic because I think this is a really, really important topic that, um, doesn't really get enough attention and, and is so counterintuitive for how much, you know, healthcare we have in this country and how much money we spend on it. Um, it just seems like our numbers don't head in the right direction. Um, so So can you, can you speak a little bit to, um, you know, why, why is that? Why, why do we see high infant and maternal mortality rates here in this country? And why are these numbers moving in the wrong direction?

Meg Richards: 1:26

Yeah, it's a great question, Chris. And it's really concerning because as you said, the U. S. spends more on healthcare per capita than pretty much any other developing country, developed country in the world. And, um, but, but we have worse outcomes. Um, maternal mortality, for example, in Norway is virtually zero and in Switzerland and other Nordic countries, it's, um, it's similarly very low, almost unheard of, um, I think the reason it's so high in the U S is because. We, um, don't have a number of policies at the federal level that mandate prenatal care, um, maternity leave for moms to spend time at home with their babies or, or dads. After the babies are born, um, with, you know, appropriately supportive, uh, postpartum care. We also have in the U S what are known as maternity desert. Um, where I think one third of the counties in the U S have either limited or no access to any kind of OBGYN care, whether that's through, uh, uh, an OB or a midwife. Um, and that's, you know, when you're not getting prenatal care and you're not seen early and often throughout a pregnancy, if complications arise that complicate the pregnancy, it can have, pretty disastrous consequences for both the mom and the baby. We've

Chris Brandt: 3:04

had, um, recently, uh, I would call it a smorgasbord of laws on, you know, sort of maternal health, uh, across the country. And, you know, you mentioned maternal deserts and, you know, we're seeing some places where, you know, OBGYNs don't feel like they can even, you know, Practice effectively in these locations and are, I mean, entire states are sort of being abandoned in some cases, right?

Meg Richards: 3:32

Yeah. And that's and Chris, that's an excellent point. That's partly the result of the Dobbs decision. That overturned Rosie Wade in a lot of rural areas, um, physicians and, and other healthcare providers, um, fear their ability to practice medicine freely, um, for, for, for concern about maybe their activities being criminalized, for example, if they need to do a medically necessary abortion to perform a medically necessary abortion. Um, There are hospitals that are closing down their OBGYN units because they just don't have the providers to staff them. It's, it's, it's very concerning. And if you look at the The forecasted statistics for babies born and providers there to help provide the prenatal care. There's a big, big gap.

Chris Brandt: 4:30

Yeah. There's a big gap. Well, and not only that, I mean, but it's, um, I, I just think across the board in health care, um, we're seeing a lot of doctors just kind of walking away from things and we're, we're struggling to get certain practices staffed too. Yeah. I mean, there's a lot of pressures from so many different.

Meg Richards: 4:50

Yes, and it's not just the maternity wards that, um, you know, are struggling with staffing and resourcing, but, you know, cancer centers and, and, and, um, cardiology practices within hospitals. Yeah. And, and it's multifactorial, Chris, because it, it, it involves reimbursement and, um, and, you know, um, the quality of life and the culture at the facility and. You know, just all these kind of factors that come into play that, that make it really difficult for a health care provider to. Stay in that practice.

Chris Brandt: 5:27

To be certain. It's not always just the OBGYNs that are providing maternal health care because you know You could have a heart defect or you could have diabetes or you could have, you know, mental health issues or whatever I mean, there's a lot of different aspects of medicine that are under strain right now that all play into Keeping a mother healthy through her pregnancy, right?

Meg Richards: 5:47

Exactly and with the Aging of moms. Moms are having babies somewhat later. In fact, I just, um, heard from my daughter in law the other day that, um, she is termed a geriatric mom because she's 35. Um, but yeah, that and, and with aging comes a whole slew of, um, comorbidities like type 2 diabetes or hypertension or, um, You know, autoimmune diseases that can further complicate the pregnancy. So you're right that the moms need other, potentially need other specialist care besides an OBGYN.

Chris Brandt: 6:28

And not only that, but I mean, I think, you know, we talked about sort of maternity deserts, but um, there's also, you know, sort of socioeconomic determinants of health too, right? I mean, could you speak to how that plays out as well? Sure.

Meg Richards: 6:42

Yeah, there, there, one condition that, that occurs in pregnancy, one complication. is preeclampsia. It's a, it's a malignantly high hypertension, very, very high hypertension. It can, it can vary between a sort of a mild preeclampsia and a very severe preeclampsia. Non Hispanic Black women are disproportionately affected by that and other pregnant, other complications of pregnancy because, Chris, they don't have the same access to health care As, um, say, their Caucasian counterparts, I think that. The frequency of something like preeclampsia is twice as high among non Hispanic black women as it is among white women. That's a huge

Chris Brandt: 7:34

difference. Oh, it's a big difference.

Meg Richards: 7:37

big difference. It's, it's, yeah. And there have been some rather well known, um, persons who have suffered with preeclampsia in their pregnancy. Serena Williams is one. Um, Beyonce with her twins. Thanks. Thanks. Thanks. And so on, um, and it's not only access to care, but there's also this thought, um, Chris, that there's an implicit bias that comes into play sometimes, um, and, and what is called allostatic load, the sorts of, um, pressures that people of color, the stresses that they have to deal with every day in every facet of their lives that just contributes to. These comorbidities that play into further the pregnancy complications.

Chris Brandt: 8:27

Yeah, and I know that, I mean, there's, there's a lot of, um, discussion that's been going on recently, too, about how the medical books are written for white, you know, Caucasian people. And, and some, some diseases, some, you know, uh, morbidities, you know, um, present themselves very differently on darker skin than they do on lighter skin. Lighter skin, you know, like skin cancers and things like that, for example, is a great example of that. Um, you know, so, so there's a lot of, um, unfortunately, this sort of systemic problem that we've had for a long time seems to, you know, like we're still dealing with issues that, you know, have risen out of the past, which is deeply unfortunate, I think.

Meg Richards: 9:12

That continue to haunt us. Yeah, I read it. I read a wonderful interview that Serena Williams did. I think it was for Vogue or Elle Magazine, where she was talking about And just

Chris Brandt: 9:23

to put a point on it, I mean, nobody could be more fit than Serena Williams.

Meg Richards: 9:28

Oh, oh, exactly. So, I mean, it's not a

Chris Brandt: 9:30

matter of, like, your fitness level, you know, for preeclampsia, right?

Meg Richards: 9:33

Yeah, exactly. You know, and, and, There's a certain amount of preeclampsia that's related to obesity and, and clearly not an obese person, a very fit person, as you said, but she talked Chris about, and I found this fascinating. She said, I'm an athlete. I know my body and I knew that something was wrong. I couldn't breathe. I had a terrible headache. Um, but the staff seemed to be more concerned about her baby. And, and not, I don't think she quite said downplaying her concerns, but not hearing her. Yeah. Um, yeah, and I just found that, I was like, wow, Serena Williams couldn't, you know, I mean, and she, she almost had a very bad outcome from that pregnancy, so.

Chris Brandt: 10:22

Wow. Yeah. Yeah. No, I mean, it just, it just goes to show you. Um, so, so, uh, you know, I want to touch a little bit on Penelgo, um, you know, which is the company you, you work for and, and it's steeped in data and analytics. Um, you know, obviously you guys are probably seeing just incredible things coming out of all the data you're, you're collecting. One. You know, like, how are you collecting all this data? Where's it all coming from? And two, like, what kind of insights are you seeing about all this?

Meg Richards: 10:56

So we have a closed claims data source, um, Chris, along with other data sources. We have a collection of Administrative claims, electronic health records, some lab data, some registry data, um, that we are able to offer, um, what we call on demand or via a partnership with the data vendor. We don't, we only own some portion of the data, the rest of it is us helping to get the data in the hands of the clients who need those data. Thank you. Um, to do analytics. Mainly what we offer at Penalgo is an analytics platform called Instant Health Data. But we have recently come into possession of a gorgeous closed claims dataset, um, called the Mother Infant Link Data. And what's special about those data, Chris, is that We've found a way to link the mother and the infant and multiple infants if it's a, a multiple birth, um, and create a mom baby pair for each of the mothers and the babies, which is a very intuitive way to analyze what's going on in that pregnancy event. And what are the outcomes for the mother, as well as the fetus, and then the newborn, and then the infant, if you want to follow them forward for a year or two, um, for whatever outcomes you might want to look towards.

Chris Brandt: 12:31

Yeah. I love that idea of like, you can do longitudinal studies, but I love the fact that you're, you love the data so much that you just said it's absolutely beautiful.

Meg Richards: 12:39

Oh, we, we, I, I'm an epidemiologist by training and we use the word elegant a lot when, when you, when you talk about a really elegant analysis and yes, these are really elegant data and um, we, we've only, um, come into them, We want to come into their possession. Um, a couple of months ago, but we're starting to dig really deep. Um, because there's some very interesting things that we can do that potentially haven't been closely looked at before. Um, I'll go back to preeclampsia just for a minute. Um, there's a, there's a preeclampsia registry. Um, that exists. It's, um, an open access registry where women who are looking for more information about preeclampsia, if they suffer from that, um, can, can agree to participate in the registry and just to input all their information about what happened to them and what they experienced. And it's all self reported, but, you know, Women tend to be pretty good witnesses of their health care and their health care events, especially when it comes to something as important and as memorable as having a baby. Right, right. Um, but we, so what we, we, what's true about our data set, um, the close claims that we have access to compared to this registry, Is that with a registry you have to wait for the data to accumulate Before you can interrogate The registry with whatever questions you want to answer most registries are what we call perspective Um, in other words, you're you're following people forward in time With closed claims that kind of analysis or or electronic health records. Those analyses are retrospective Analyses And you can get an answer almost immediately. You can, you can look to the data and say, here's my question and get an answer without having to wait for the data to accumulate to answer your question. So what we've done with our mom baby data is we've put it in a special module of, um, the instant health data platform, um, so that you can interrogate the mom baby pair. And one of the things that we've been looking at a lot lately is preeclampsia. And the reason for that, Chris, is it's not, it's a poorly understood complication. We think it has something to do with abnormal development of the placenta, which then sets up a sort of an inflammatory cascade. Throughout the rest of the body. Um, and it, and it can have, it can have a bad outcome for, for the mom and the baby. But another thing that we've learned, um, fairly recently is that it's having preeclampsia doesn't put you at risk just during the, the pregnancy event or the immediate postpartum period. It can set you up for cardiovascular issues for the rest of your life.

Chris Brandt: 15:57

Well, because it's because the impression had always been that once the baby was born All the numbers return to normal and that's the extent of the preeclampsia impact, right?

Meg Richards: 16:06

Exactly And now they're saying that preeclampsia Whenever you develop it in the course of your pregnancy, whether it's you know, mid pregnancy late pregnancy or even postpartum Sometimes you don't see it until after the baby is delivered Um, whenever it happens, it can set you up to have, um, you know, chronic hypertension. stroke, heart failure, heart attack. So, so now we realize that the, the preeclampsia event is kind of a canary in the mine that tells you, Oh, I need to follow this woman forward for other cardiovascular complications and give her a full cardio metabolic workup that will continue even through, you know, post pregnancy and beyond.

Chris Brandt: 17:00

Well, and I would imagine, you know, when you look at, you know, sort of vascular diseases like we've seen recently, you know, uh, on a large scale like that, um, that could have some really different outcomes for a lot of people, I, I would imagine. I know there was, you know, there's some of these viruses, you know, like, impact pregnancy more significantly than, you know, non pregnant folks. And, and, you know, if you, if you see how that, you know, the vascular system is, is challenged during pregnancy in that, that regard, you know, that could be really problematic.

Meg Richards: 17:35

And multiple, if you're, if you're carrying multiples, you're even more at risk because it's multiple placentas that can develop abnormally. You tend to gain more weight. with multiple babies. So yeah, there's a, there's a higher risk. But what we'd like to be able to do if we interrogate the data and what we do is we look at a group of women who experienced preeclampsia and compare them with women who did not have a preeclampsic event associated with their pregnancy. And we look to see what, what were the differences and you can imagine what they are. They involve age, obesity is a big factor, um, race, region of the U. S. that you live in. Um, there are some other things, um, you know, pre existing, hypertension, carrying multiples. Um, having type two diabetes or other kinds of cardiovascular disease. COVID caused a big spike in maternal mortality in 2021. It almost doubled in the U. S. Wow. Um, preeclampsia was only part of that. But the thought is, you know, COVID 19 again, you're talking about inflammatory processes.

Chris Brandt: 18:58

Yeah, I can imagine for a pregnant person that would be very challenging. Super

Meg Richards: 19:03

challenging. But at the start of the, the. The podcast, Chris, you mentioned that we're an AI company. Penalco is an AI company. That's part of what we do. That's definitely part of what we do. Um, but we, in addition to the, the core platform, we have what's what we call a data science module where you can use machine learning and artificial intelligence. to interrogate a huge bucket of data. And our mom baby data is actually 3 million pairs. Wow. And you can look predictors of a preeclampsia event or the development of severe preeclampsia using the data science module. And that's what we really want to get to because the sooner we can identify women who may be at risk, the quicker we can devise interventions that will be put into place so that either the mom doesn't have the event at all, or if she does become preeclamptic, they can do things to mitigate the severity of the preeclampsia. Um, yeah, yeah, I mean, preventive medicine is where it's at and being able to predict. Yeah. That's what we'd love to be able to do with those data.

Chris Brandt: 20:29

So like, so let's dig in and, and my understanding is you guys were recently acquired as well.

Meg Richards: 20:35

Oh yes. By a company called Norstella. Chris? Yeah.

Chris Brandt: 20:38

Right.

Meg Richards: 20:39

Um, and we have four sifter companies.

Chris Brandt: 20:41

And I think I interviewed one of your sister companies that was also data analytics and sort of the, the drug side of, of things, sightline, right? Right, right. And, and, um, I thought, I thought that what they were doing was really interesting. And it, it seems like you guys are, you guys are, um, kind of targeting a similar approach. Uh, in the maternal health, uh, category as well, right? I mean, cause you're looking at the data that you're, you're, you're bringing in to help, um, design drugs and, and to, to not, you know, create interventions and things like that. Could you talk a little bit about like the, the ways that, that, What you do is is used

Meg Richards: 21:22

and and that's a great a great way to answer you chris is to talk about Norstella our parent company's vision. Yeah, um, they talk about our tagline is smoothing Um, access to therapies from pipeline to patient. Norstella is truly one of those companies that aspires to, and, and, um, is truly able to provide support to manufacturers or sponsors or whatever we, we, you want to call them, um, from the time that they in license a data asset. I'm sorry, not a data asset of a therapeutic asset, um, to the time it goes on to market and to patent expiry, um, where sightline, um, plays really well. They play really well almost everywhere. Um, and, and we do too, but where sightline has traditionally been really strong. Um, is identifying, um, trial sites and patients for recruitment, you know, uh, study, trial density, patient density, what's, what's going on in terms of development. They have a wonderful platform where you can get all kinds of information about who's developing what treatment for what indication and what's the likelihood that it will be approved and so forth. You know, what's the competition look like? Um, they have, they have fabulous data. Um, Penalco plays a little bit more in the peri post approval space that is, as a manufacturer sponsor is getting ready to go to market, um, and maybe their, um, Wanting to do something like stand up an external control arm for a single arm oncology trial where for For various reasons, you can't have a placebo control alarm because it's not ethical, um, so instead, what we can do is go into the data. We can go into our claims or EHR data and set up a, a, a comparison arm or an external control arm that can be used as a stand in for the placebo or standard of care treatment, whatever, whatever that is.

Chris Brandt: 23:48

It sounds like you guys are a great compliment to each other. I mean, you know, you're, you're, you're bringing very much

Meg Richards: 23:53

so

Chris Brandt: 23:53

bringing the whole A game, uh, to the, to the thing. So, so in that, in that regard, you could you speak, I mean, I, I I imagine you've helped, you know, some of your clients do amazing things. I, I mean, could you speak to some of the, the cool success stories that you've, uh, had over the years?

Meg Richards: 24:11

We've done a ton of cardiovascular research over the years, um, Lately, and, and, and a lot of that is what I'd call, um, sort of health economics and outcomes directed research, Chris, it's looking at the value of treatments. To not just the payers and the manufacturers and the providers, but even to the patients as well. Um, we don't have it in the United States really in a formal sense, but over in the EU, they have these health technology assessment bodies that, um, look at the true value of a treatment, um, when you factor everything in that the efficacy or effectiveness. the safety profile, the cost, how the patients feel about it. We do a lot of that sort of work. We also, um, in Penalco with our data sources, do some, uh, safety signal detection and evaluation and contextualization. You know, sometimes you, because clinical trials are generally relatively small. in size. If there's a rare adverse event, you may not see it in the clinical trial setting, but you will see it in a post approval setting when the product is, you know, mass marketed and, and being used by millions of people. And we've been approached by sponsors who have said, um, we, we think we see the signal. We need to evaluate this event. You know, can you help us within a matter of days. Um, because they usually have to respond to the health authorities very quickly, understandably, because the product is in use and there may be, you know, it may be causing seizures or whatever the issue is. So we, we, we do a lot of that kind of work. Um, I mentioned external control alarms. Um, that's something we do. Another success story, Chris, um, involves, um, we've been, lately we've been doing quite a bit of, uh, uh, generalized anxiety and major depressive disorder research.

Chris Brandt: 26:30

Oh, interesting.

Meg Richards: 26:31

Um, which is an interesting tie in to the whole mom baby data area of inquiry. Because a lot of moms, you know, generalized anxiety and depression are, are quite prevalent these days. And a lot of moms bring those conditions to their pregnancy or possibly develop them in pregnancy. And, um, it's, it's not simply a matter of, you know, not treating the mother for her anxiety or depression or, or reducing her dose because that could cause. Harm to the mom, which could indirectly harm this fetus, plus pregnant moms, metabolized drugs. In a completely different way than their non pregnant cells would metabolize those drugs. So, one of the things we're able to do with our mom baby data is to look at the safety of, um, drugs in pregnancy. That's been for, for anxiety and depression. In fact, that's been going on for some time. So we can use the data that we have to look at the safety of anti anxiety meds and antidepressants. in a pregnant woman. Um, actually a lot has been done to that end. And there's a whole list of, um, mental health treatments that are approved for use in pregnancy, um, with, with perhaps different dosings in different trimesters. But that's the kind of thing where we've, we've had a lot of success and, um, are very proud of the work that we've done in that area.

Chris Brandt: 28:09

When you talk about how drugs impact. A pregnant woman, the fetus and you know, like the metabolism of a pregnant woman, the hormones, uh, the endocrine system of a pregnant woman is going to be extremely different than like sort of the baseline. So it's really interesting that you're, you're going to have that kind of longitudinal data too, to take a look at. How that impacts people. And I think it's interesting because, you know, when you talk about sort of the, the long term implications of preeclampsia, you know, what are some of the long term implications of some of these other, you know, like just usage of a drug and what, what that may, you know, maybe that has some long term implications down the road, you know, that, that, you know, you'll, you'll tease out of the data. So that, that sounds really interesting

Meg Richards: 28:56

and in much the same way that we would like to be able to build a predictive model, So for predicting either eclampsia or severe eclampsia. Um, there's been some effort to do the same with predicting who among the moms are likely to develop postpartum depression. Oh, yeah. Um, if, if depression isn't something that they bring to the pregnancy, It's it's possible that it could develop for the first time, you know, post pregnancy event Um, and and that's a weird that that's a that's a heartbreaking diagnosis for both the mom and her baby and um There's a company out there chris. I think they're called dionysia Who has a a blood biomarker test in development? For predicting You know to try to detect who You know, among this group of pregnant women, who's likely to develop postpartum depression based on some sort of biomarker. That's the kind of thing where we could interrogate our data. Build some models within our data science module to help support that the development of that blood test and also how it's targeted towards the patients who might who might most need to be well and you

Chris Brandt: 30:20

have like what a three and a half million, uh, large cohort to, to, to look into. That's amazing. That's amazing data for that. Yeah. Yep. Where does Penalgo go next? Where do you, you know, you, you've been acquired, you've, you've got this great data set. Are you getting more data sets? Is it like, what, what's, where's, where's everything headed now?

Meg Richards: 30:39

We're growing. And as you said that the data sources themselves are growing, um, we're accumulating more and more data over time. So, for example, the mom baby data set, when we look to see, um, how much sort of follow up did we have on some of the babies, there are some babies who are present who were born in 2018, and we can still see them in 2024. We still have information about their journey through the healthcare system, if you will. Um, we can see multiple pregnancies in some instances for one woman over, over time, over the course of time. Um, one big point of emphasis, Chris, is, um, linking data sources. So by that I mean, we have a way to use what are called tokens. Right. Um, which are, you know, about tokens. And, um, you can. Identify, uh, you know, Meg Richards in a closed claims data source. Find Meg Richards, the same Meg Richards with the same birth date, um, in an EHR data source or even a lab data source. Bring them all together to create this elegantly layered, gorgeously layered look at all of my interactions with the healthcare system. Right. Um. We can even, we've, we've started to do a lot of work with natural language processing of unstructured data. Right, I ask. So when you're looking for clinical notes about an event that might not be, Or, or, uh, something that isn't captured in the structured data. Right. You know, uh, for example, there are rare diseases out there that still don't have, um, an ICD 9 or ICD 10 code. Or maybe they have a code, but it's very nonspecific. Right. There are ways to look into the unstructured data and the structured data. And combine them into an algorithm, PanAlgoRhythm, that's the name of our company, PanAlgo, um, to get better at identifying, okay, here's somebody who we're pretty sure Is suffering from Friedrich's ataxia or or whatever the condition is that you're interested in so that that linkage and that ability to layer data sources and to tap into the unstructured data to paint a very complete picture. Um, of what's happening to the group that you're following, um, the individual patients and then the, the cohort that you, that you've stood up is, is brilliant.

Chris Brandt: 33:35

Put an end cap on, on what you're talking about there. The token helps to keep the data anonymous. But link the data across multiple data sources, so you're still still maintaining that anonymity within the data, but getting a much richer, deeper view into it.

Meg Richards: 33:51

Exactly. Exactly. It's yeah, people talk about an anonymized pseudonymized. It's anyway, it's to me. Yeah, it's worse. We're, we're making sure that the. Data are secure and kept private, and we even, um, I think all companies do this. We, we have, um, access to an expert determination person who will look at the link to data source that we've put together and make sure that we've, um, applied great fidelity in making sure that there's nothing in those data. That would help you, um, you know, identify a single person. Right. So we do things like we mask birth dates. They, they might, like a birth date might get pushed to the first of the month rather than the actual day of the month.

Chris Brandt: 34:44

Right. So you get an approximation.

Meg Richards: 34:45

Exactly. And zip codes are, you know, the first three digits, but not all five digits. And, um, there are other things we do that the expert determination people actually, people. Take a set of calipers and, and, and look at the data and say, okay, what's the probability that an individual person could be identified and then tell us how to correct it if they think that we need to apply any corrections.

Chris Brandt: 35:11

Safe data practices are hugely important these days, right? Yes,

Meg Richards: 35:15

they are. Yes, they are.

Chris Brandt: 35:17

Well, I gotta say, you know, it's, it's really interesting. And I think it's great that you know, you're, you're, you're serving a community that hasn't been necessarily well served over the years. Um, you know, not adequately studied for sure. Um, especially across all types of interventions and things like that. So I think what you're, you're doing important work, which is really great. And I think, you know, I, I mentioned the fact that that the, the, the maternal, you know, mortality rates and the infant mortality rates are, have been heading in the wrong direction in this country for, for some time. I feel like, you know, you're going to bring us some insights that's going to help reverse that trend and, and, and really put us hopefully where we need to be. So, um, keep up the good work and excited to hear about more from, uh, Penalco.

Meg Richards: 36:06

Thanks, Chris. That's, that's our aim. And it was a pleasure to talk about all of this with you. I, I appreciate you having me on.

Chris Brandt: 36:14

Thanks for watching. I'd love to hear your thoughts in the comments below. And if you could give us a like, think about subscribing and share it with a friend. And I will see you in the next one.