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Category Archives: Digital

Get rid of avoidable re-admissions!

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Hospital Readmissions Monitoring

Did you see this headline last month in Healthcare IT News? RPM brings 30-day mortality rate to almost zero for heart bypass procedure. Remote patient monitoring (RPM) offers to extend the reach of care and allow clinical teams to respond faster to changing patient conditions and reduce re-admissions for chronic conditions and post-operative care. While the article references a single site for the results of this RPM program, there have been numerous other studies and reports citing the promising results of these types of programs. Perhaps not a total elimination, but significant reductions are achievable.

There are a variety of companies out there trying to capitalize on utilizing various forms of RPM to capture early changes in the physiologic status of patients. Apple Watch and afib detection/monitoring is probably the most widely known out there of late. But remote monitoring or in-home monitoring devices have been around for decades, with a variety of connections, from dial-up to wifi to cellular. In addition to companies offering remote monitoring devices, there are a variety of companies offering to do the remote monitoring, hiring clinical teams to monitor patient connections. Often these companies can offer the benefit of scale to manage a smaller group of patients that would otherwise be an overwhelming administrative burden.

So what’s the catch? We know there’s always a catch! Remote monitoring sounds like a simple thing to do, and by and large the technology and FDA approvals already exist to make it happen. But as with anything data-related in healthcare, the data flows are a big pain point.

More connected devices from one ecosystem to another. There’s a lot of those in healthcare. Adding another tech burden for clinical teams to trouble shoot and figure out what happened can quickly render an RPM program ineffective. Even the most savvy clinical team and 100% compliant patients can be undone by connections that aren’t talking.

Whether the decision is to outsource and RPM program or handle it in-house, connections need to be reliable to get the right data to the right person at the right time. Anything less can result in a patient heading to an ER or Urgent Care for something that could’ve, and should’ve, been handled in the comfort of their own home. Not only is this detrimental to the patient, but it can also have a negative impact on reimbursement.

Reliable feeds and early notification of problems can keep clinical teams operating smoothly, ensuring patients receive timely care and interventions. Not only does this keep your teams working for the health of your patients, but it also gives patients confidence that your systems are working just as effectively as your clinical teams keeping them healthy.

Automated applications and integration monitoring can help quickly identify and resolve issues to minimize any downtime impact. For over 10 years Tido Inc. has been partnering with health systems to help maximize their IT systems and quickly resolve issues as they arise, often before the end user even notices. Contact us today so we can talk about how we can help you keep your systems working for you clinical teams and patients.

Rise of the [Diagnostic] AI Machines!

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Radiologist reviewing diagnostic imaging

Are we ready to welcome our AI overlords into healthcare yet? Will we welcome a fully autonomous Dr. Crusher? We’re not likely ready to completely abandon our human healers, but there have been a variety of algorithms and machine learning applications that have been creeping their way into our clinical specialties for many years now. The first AI algorithm was approved by the FDA in 1995, in the beginning of 2023 there are 520. The specialty with the largest number? Radiology! Check out this article from HealthExec, it provides some more detail on the approval and advantages of AI in imaging.

Radiology, and similar specialties that utilize imaging, have long embraced computer systems to improve quality, productivity, and sharing. The complexity behind the scenes of these systems can be quite surprising. Once an image is captured it may still go through multiple systems just to be viewed, PAC Systems, VNA, Dicom viewers, the route is anything but direct. If we want to add another step in the process to have the image analyzed, we are faced with yet another connection.

In a previous blog post we pointed out the challenges that staff face when one of these systems aren’t communicating, these certainly impact our physicians as well. As we add more diagnostic solutions to aid our physicians in treating patients, we want to ensure that their time is actually spent doing what they are trained for. The average radiologist makes roughly $300,000 per year, if we assume that radiologist works 40 hours per week, that’s about $144 per hour.

What happens when the machines stop talking? Likely the radiologist calls the help desk… 5 minutes on hold ($12), they will take 3 minutes to explain the problem to the help desk person ($7.20), who will then transfer them to a specialist where they take another 5 minutes talking over the problem ($12). Helpdesk will then forward the issue to multiple analysts and integration team. At-least 2 different analysts getting pulled into diagnosing the issue. Typically, integration and system analysts make 90k-130k per year or on average $50 per hour. These 2 analysts will work on this issue for about 30min ($100) to diagnose the issue. $131.20 may not seem like a significant amount, but now that radiologist may not be reviewing images, may not be discussing treatments with patients, they may not be doing what they’ve been trained to do. If the radiologist is only 50% as productive without this solution, every hour of outage costs $132…  That’s just for one Radiologist. And typically system issues affect all users. So once you multiply the outage costs for all radiologists and other team members it really adds up fast. There can also be significant downstream impacts to other services waiting on imaging as well that become harder to calculate.

Moving beyond the frustration of the healthcare teams, there can be a detrimental impact to patient satisfaction as well. As results are delayed and the team gets backed up, every hour of delay adds to the patient’s anxiety and fear. Anxiety and fear are not feelings we want our patients to experience, we want them to have confidence in our teams and systems.

Automated applications and integration monitoring can help quickly resolve these problems. With early notifications to the right team in a timely manner, problems can be quickly resolved to minimize downtime impacts. For over 10 years Tido Inc. has been partnering with health systems to help maximize their IT systems and quickly resolve issues as they arise, often before the end user even notices. Contact us today and so we can talk about how we can help you keep your systems working for your clinical teams.

Value Based Care Technology!

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Value Based Care

Effective chronic disease management is the backbone of value based care and will be increasingly important in the coming decades. Value Based Care (VBC) has been getting a lot of press lately, currently it still represents a small fraction of revenue. This will likely be changing in the coming years as insurers look to reduce total spend and Medicare contracts with private enterprise increasingly rely on better chronic disease management to reduce complications.

Effective chronic disease management requires higher patient engagement and more frequent monitoring. These things typically require more time from clinical staff. There are increasing options to utilize different technologies to implement these programs, alleviating the burden on clinical teams while allowing them better insights to patient’s condition and better information to more effectively and quickly respond to changes.

There are a myriad of companies and apps promising to revolutionize chronic disease management, but how do they integrate? Does the intervention need to be all that complicated? What works for your patient population? If what works for your patient population is not available on the market today, can you effectively integrate remote monitoring technologies into your current environment?

Why do nurses always ask so many questions?!

Who knows your population better than your team of clinicians that works with them every day? They know what works and what doesn’t, the challenges patients face, the challenges they face in their daily practice. Building a whole platform can be complicated, and sometimes unnecessary. Monitoring weight for your heart failure patients can be accomplished with a scale, does the scale need to be connected? With that there will be a thousand more questions about the ability of the patient to have a connected device, want to know all the troubles? Ask the clinical staff, they already know, they’re already helping patients address these challenges.

Clinical teams can help get a remote monitoring program off the ground fairly quickly. The challenge? Getting the integration right. Rather than setting up a blue tooth connected scale, maybe it’s more effective to just text the patient every day and ask their weight. Simple, easy reminder, intuitive to use, doesn’t require a lot of support to get and stay connected.

Sometimes there is a ready made app for that. There’s an app for everything! Integrating and managing these different applications can be cumbersome. It can be beyond the expertise of IT teams who are focused on support and physical infrastructure. Poorly executed integration and support can reflect poorly on the organization, from the patient perspective and the clinician’s.

Getting the workflows right is key to digital adoption and getting the most out of IT investments. Partnering with clinical teams to get this right is key to a successful program, making sure information is going to the right place, getting to the right people, and being addressed in a timely manner.

Tido Inc. can help with a variety of digital packages, services like digital app management, custom mobile and web applications and EHR integration. For over ten years we’ve been partnering with health systems and practices on digital strategy, and systems monitoring. As more pressure is put on revenues, leveraging the most out of the current IT infrastructure will pay bigger dividends down the road, contact us and we’re happy to see how we can work with you.

Harnessing that free energy in healthcare.

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healthcare free employee time

This isn’t about powering your data center with solar cells on the helipad. It’s actually about capturing the creativity and time that you’re already paying for. Clinical staff inside hospitals are powerhouses of innovation and creativity. Have you seen what a nurse can do with a roll of 3M transpore tape?!

I only half kid about the tape, but anyone who has tried to introduce new solutions and technology into a clinical workspace has undoubtedly been met with skepticism. Anyone who has gone back to see how those systems and tools are actually used, has undoubtedly been surprised to see how and if they were used.

Are those tablets waterproof? They make great trays for carrying medications and water.

Giving clinical staff back time to focus on their patients and get creative with solutions for systems, processes, and technology innovation can be invaluable. In a time when doctors, nurses and technologists are leaving the bedside and joining tech companies, it can be more important than ever to retain that staff and capture those ideas. Many of these ideas are not large scale changes to the macro environment, they are small and relatively simple ideas that make interactions and workflows easier that can lead to better engagement.

How do you give back time? When we think of the time wasted on inefficient processes, especially when it comes to inefficient IT systems, there is a large opportunity to free up time. In previous posts I’ve written about the inefficiency of reporting application and integration outages and how early notification can save clinical time.

How do you harness that “free” energy? Since you’re already paying for it, it’s not really free, maybe it’s more akin to installing a co-generation plant. When you alleviate the burden of reporting IT issues by clinical staff, they are free to focus on their patients, to address their patient’s needs, concerns, and monitor for their safety. Time and attention lead to fewer safety incidents and better outcomes. Beyond that when clinical staff have time to consider their workflows and systems interactions they will come up with better ideas.

Consider all the money spent on “solutions” and upgrades that do not yield expected results. When a new solution is proposed how much engagement are clinical staff able to give before a purchase? How much time and energy are they able to spend making the new solution work? How much thought are they able to give to iterating and improving EHR user interfaces and workflows? All of these things take time, and if they don’t have time, all these solutions will seldom achieve their full potential.

Leveraging IT assets to their fullest potential will improve the ROI, in addition to improving margins. For over 10 years Tido Inc. has been partnering with hospitals and healthcare organizations to leverage the most from their IT infrastructure. Automated applications and interfaces monitoring and alerts, application integration, and assisting with digital strategy. Contact us today to see how we can help capture some of that energy!

I wonder if solar panels on a helipad would work? I think I’ve found today’s rabbit hole!

Is there an orchard full of apples just outside the windows of the hospital?

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Have you ever switched from an Apple iPhone to a Samsung or other Google based phone, or vice versa? It looks familiar, but it’s just different enough to be confusing. I know… I’ve done it. Work issued iPhone, personal Samsung phone. I was able to turn my iPhone notification to vibrate when I first got it… For the next 5 years I could not turn any notification sound on. I’m not new to smart phones, but I’ve always had a Samsung, the IOS screen looks familiar, but it just doesn’t work the same.  I only used the work phone for texting and phone calls, everything else was my personal phone, good thing my scrubs had two pockets.

Websites and apps can experience similar issues with back-end functionality. With the patients, visitors and employees all having different smart-phones, ensuring a seamless end-user experience can be more important than ever. Developing a website or app for a Windows based system may not be able to viewed in the Apple ecosystem.

Everything from way-finding apps, employee intranet sites, public websites, to patient access apps all need to be customized to ensure an end-user experience that is accessible and usable. Imagine telling a patient “there’s an app for that!” only to have them frustrated when they can’t access the information they were directed to. It doesn’t provide a good experience for the patient that can negatively impact things as serious as missing important appointments, to just experiencing un-warranted stress when trying to get to an appointment. Is a patient going to rate you 5 stars if they can’t find the doctor?

Similarly for employees, frustrations can abound when apps are not optimized for different mobile devices. Apps for time and attendance, intranet sites for policies and procedures, are all often made accessible for employees to use on their mobile devices. Apps and sites that are not optimized for their device can frustrate staff trying to request a vacation, or trying to look up policies for titrating insulin drips.

Accessibility in the physical world is important for healthcare, it is just as important in the digital age to have accessibility online as well. Ramifications can be a minor inconvenience or a major frustration. More and more information resources are moved online to save paper and ensure the most up-to-date information is being used, having access is vital to smooth patient experience and care.

How do you test apps and mobile sites for compatibility against thousands of different versions of mobile devices? Ten thousand engineers typing on ten thousand phones for ten thousand years? That might work, or you might get a mobile friendly version of Shakespeare. Hope you have a good IT recruiter!

Automated testing at every stage of development can help ensure accessibility is maintained across desktops and mobile devices. For over 10 years Tido Inc has partnered with hospitals and health systems to provide automated mobile and web testing at every stage of development. Ensuring minimal issues on launch, and faster development times. Contact us today to see how we can help, from development of custom apps and intranet sites, we can extend your IT teams when you need.

Freeing up staff to focus on patients… What can we learn from the ticker tape?

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Applications and Integration Monitoring - Ticker

Ticker tape was a revolutionary tool for moving information fast. Widely used by the financial industry for the quick transmittal of stock prices, sports reporters used it relay scores, and in many other industries for relaying information fast to people who didn’t necessarily know Morse code. Ever wonder where the 3-4 letter symbols for stocks and sports teams came from? How about the traditional 15 minute delay for financial information? Ticker tapes. Crazy right? Traditional ticker tapes went out with the 60’s (1960’s that is), but today we see “ticker tape” scrolls at the bottom of screens and on LED billboards.

Back to the question at hand… What can we learn from ticker tape? Getting information from the people that have it to the people that need in a timely manner can have a real improvement in operations, saving time and freeing up valuable manpower to handle other tasks.

Having a simple scroll at the bottom of the clinician’s screen showing important information can save time, and reduce frustration. Health systems have numerous moving parts and inter-connected technology. When something breaks, who reports it? The front line clinical staff. When an application / system (EHR, Pharmacy, Laboratory, PACS, Mobile, Web Applications) or interface fails , every clinician is impacted at the same time. Problem with the pharmacy network, blood bank, PACS? The front line staff calls the department first, once they are aware there is a problem, then a person from each department will call help desk. This is where the cascade begins.

In large units there will likely be 2 or 3 people calling the help desk before the word gets around to the rest of the unit. Multiply this time X number of units. The calls quickly overwhelm the most well-staffed help desks. What happens when an upgrade impacts more than one system? Gridlock, like a ticker tape parade in New York City.

Automated end-to-end applications and integration monitoring coupled with real information can be a powerful tool to alert front-line staff of application issues, alleviating the need of multiple calls to the help desk. Freeing front-line staff from calling the help desk, and associated wait time, allows them to keep their focus where it belongs, on the patients. Early awareness allows early response and early action, any clinician will tell you this is key to preventing larger health problems down the road. This is just as true for our IT systems.

Automated end-to-end applications and integration monitoring monitoring can alert IT staff to problems early, allowing faster response and resolution, before the calls to the help desk and online tickets quickly overwhelm departments. IT staff can focus on resolving the problem, not resolving the tickets.

Providing high quality patient care is the mission of any hospital or health system, the networks and systems in place are there to support this mission. At a time when health systems need to get the most out of their current FTEs, effectively utilizing technology to quickly relay important information saves time and money, but more importantly, it can help take one more burden off of our front-line clinical staff. For more than 10 years Tido Inc has been partnering with hospitals and health systems get the most out of their IT infrastructure, from advisory services, to systems integration, to Automated end-to-end applications and integration monitoring, we’re here to help extend the reach of your IT department. Want to know how?! Of course you do! Contact us today, we’re happy to connect see how we can help.

It’s winter, are your data pipes frozen?

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Frozen data pipes

Winter can be brutal on pipes, one little spot of missed insulation can cause an air leak that freezes your water pipes. Fortunately there are various systems that can alert you to problems, infrared cameras to detect leaks before there’s a problem, and water sensors to alert when there is a leak.  Imagine testing or monitoring our IT systems like we test and monitor our homes.  Check the systems before there is a problem, or alert us early to take action when there is a problem.  Healthcare is ever more reliant on data flows and pipes to connect the various systems and ensure smooth operation. But how are these problems recognized? Who reports them? Is there an early detection system to alert when there is a problem?

When we build a house it is important to ensure all the pipes are connected and all those insulation trouble spots are tightly sealed to prevent problems down the road when the new owners move in. Fortunately there are infrared cameras and blower door tests for homes to discover potential problem areas. When we’re building new solutions into healthcare networks there are countless points of failure that can occur when systems go live, and with the proliferation of new applications from patient monitoring to clinician web-based and mobile apps, the number of potential points of failure increase. Do we have an infrared camera or blower door test for the maze of networks in a healthcare facility? Testing every connection for a new system, upgrading systems, or implementing a new mobile app will quickly overwhelm even the most well-staffed IT department. Test automation can quickly, efficiently, and repeatedly test systems to ensure that all functionality will perform as expected and provide the end-user experience that is desired.

As much as we can prepare our home ahead of time, sometimes there are events outside of the home that will cause things to go awry. Problems with the electrical grid, gas network or even water distribution can lead to unexpected problems in the home and cause catastrophic leaks. Fortunately we also have tools to monitor the state of our home in the event a change on the outside causes a problem on the inside. Leak detectors can alert homeowners to potential problems, allowing quick action to prevent flooded basements and avoid the physical and emotional stress that comes with clean-up. Similarly in healthcare continuously monitoring networks and automatic notification of an issue can prevent stress on the end-user that relies on these systems for patient. Too often when networks go down, often due to an upgrade or issue beyond the walls of the facility, the end-user is the first to notice. It’s not just one end-user that’s impacted, it can be thousands, and they will start calling the help desk. Applications and Integration monitoring can sound an early alarm and allow IT teams to respond quickly to an event, end-users can be notified early, and IT teams can work quickly to minimize disruption and stress. IT teams should be aware of an IT issue before the end-user, network monitoring can facilitate this.

Back in 2021 research found that one-third of healthcare workers felt that technology contributed to emotional exhaustion, and were frustrated at least 3-5 days per week. In the past 2 years since the study was done, the number of applications and solutions has only increased, as has the technology burden on clinical staff. Clinical staff works to take care of the patient, they seek to prevent problems for patients before they occur, shouldn’t IT systems do the same?

Nobody wants to deal with frozen pipes or disconnected networks. For over 10 years Tido Inc has helped healthcare organizations save over $30 million with our integration and testing packages. Connect with us today and see how Tido Inc can partner with your teams to help build a tighter, better connected, healthcare house.

Healthcare technology in 2023 and beyond!

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Healthcare 2023

We’re not making definitive predictions here, but the rapid changes seen in healthcare have been remarkable these past years, and going into 2023 we can be certain there will be new challenges and opportunities. We do expect some themes to continue into 2023 and beyond.

Challenging margins for health systems and independent practices. As reimbursements to health care organizations has languished, the importance of ensuring the maximum returns on existing investments will be key. Over the past decade there have been massive investments in new systems and networks, every part of healthcare operations has been connected to a tech-enabled system. To realize the gains promised these networks need to be functional and reliable. Are your systems working like they’re supposed to? Or does the staff have the impression that ‘nothing works like it supposed to!’ Disconnected applications or unforeseen application issues can cause significant delays, frustrate staff, and waste valuable time. Applications and Integration monitoring can ensure those technology investments are pulling their weight and maximizing return, supporting clinical staff and powering seamless operations.

Healthcare worker burnout and moral injury are likely to be concerns into 2023 and beyond. Network reliability can be a source of frustration for clinicians, reliable systems are one component of providing a high quality experience, interfaces and tools that provide a better working environment will certainly be another. The proliferation of apps and tools to enhance user experience for both patient and clinician will likely continue, albeit at a slower rate than prior years. Having the best possible tools and apps can be a key strategy to keeping employees engaged and patient focused, whether it is a third party app or custom mobile and web applications, new solutions will continue to be front and center.

Over the past few years we have seen a massive shift in how healthcare is delivered, from a largely in-person environment toward more telehealth and virtual solutions than ever before. While there has been slowing in the market for many of these independent services, telehealth will continue to be a necessity for any health service moving forward. In a distributed clinical environment current systems may not be enough to have a fully functional clinic. EHRs optimized for in-person care may not work with distributed clinical staff, will other solutions be utilized? What portions of intake can be automated, how will those answers be populated into the EHR and get to right clinician at the right time? Is the right patient information populating over, medication history, allergies, radiology reports, the list can be daunting. If a new system is being implement over existing infrastructure ensuring adequate testing and integration will be key to enabling high quality patient care. Moving to a new EHR can pose even more challenges, migrating data is complex and requires a high degree of certainty. Managing these data sharing challenges will continue to be a priority as care becomes more distributed beyond a single physical site.

Maybe we’ll offer one prediction for 2023… Tido Inc. will be here and continue partnering with health systems and practices to face a challenging and changing technology landscape! Reach out today, we’re happy to work with you to face the healthcare challenges in this year, and beyond.

Have the holidays driven us crazy? Crazy about AI maybe!

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AI in Healthcare

Have you heard all the rage in AI? ChatGPT was making the rounds last few weeks as it was open to the public to play around with. The website is pretty cool, but it did take me a few days to get on it to play around due to traffic. For last week’s blog post I decided to hop on the bandwagon and see if Artificial Intelligence could replace a content writer’s Human Intelligence (insert sarcastic comment). Don’t tell the boss I did this though, AI doesn’t have bills to pay. Seriously though, the other blog post last week was written by ChatGPT.

Whether AI, ML, or other letter combination when it comes to advanced computing, there is no doubt that language processing will find it’s way more and more into healthcare. How do I know this? Because AI told me so, go read the other post!

Integrating AI effectively into the clinical space can help nursing in a variety of ways. It can be used to aggregate information on a single patient about their current visit and past visits to help guide interventions. It can also be used to effectively aggregate patient data from large populations to help study the effectiveness of new interventions vs past interventions.

Maybe we use the AI to write custom discharge instructions that are patient specific and relevant to their care? Starting off with a basic template this can be really powerful to drive better engagement and adherence to instructions. Current discharge instructions are often pages long with information dispersed throughout a large packet, providing a succinct summary can make it much easier for patients.

ChatGPT was initially devised as a chat bot, often rudimentary forms of chatbots can be found for patient intake for medical practices, urgent care, or to guide patients toward specialists. If we can better aggregate these sessions into a basic medical history or offer guidance toward potential diagnosis, then there can be significant time savings just on the nursing triage.

Pretty cool stuff that has the potential to really improve healthcare by helping the clinician and the patient alike.

With integrating any computer process automation there are several concerns that arise.

What is the reference source material? In the case of ChatGPT it uses large databases of published material, this can include unverified sources or opinion pieces. With any AI/ML, knowing the referenced source will be important.

Is the output relevant? AI can be confused, just like me, but we often use slang terms that AI may not recognize, this can lead to some weird output. The output definitely needs to be reviewed by professionals.  In the other post there are number of inaccuracies when it comes to the semantics, but they do matter.

How will it be integrated? Is it clear to patients when they are interacting with AI vs. a real human? If not it can be upsetting and cause patients to lose faith in the care system.

How much do we rely on AI? FDA regulations are starting to address this in terms of decision support, but how far AI goes into making patient care and treatment decisions that may fall into a gray area that can be difficult to navigate and ultimately requires a trained professional to adjudicate.

Tido Inc can help your organization answer these questions and help to integrate or develop applications so your organization can effectively leverage AI and ML to help improve clinical workflows and experience.  Now let’s see how much Holiday shopping has messed with my Amazon algorithms!

AI will revolutionize nursing! – Written by AI

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AI in Healthcare

As we continue to advance in the field of artificial intelligence (AI), it’s becoming increasingly clear that this technology has the potential to revolutionize the way we approach healthcare, including the field of nursing. In the next few years, we can expect to see AI being used in a wide range of applications, from improving the accuracy of medical diagnoses to helping nurses manage their workloads more effectively.

One of the most exciting ways that AI is set to transform nursing is through its ability to improve the accuracy of medical diagnoses. AI algorithms are capable of analyzing vast amounts of data, including medical images and test results, to identify patterns and make predictions about a patient’s condition. This can help nurses to make more accurate diagnoses, and it can also help to identify potential health problems before they become more serious.

In addition to improving diagnostic accuracy, AI can also be used to help nurses manage their workloads more effectively. By analyzing data on patient visits and treatment outcomes, AI algorithms can help to identify trends and patterns that can be used to improve the efficiency of healthcare delivery. This can help to reduce wait times and improve patient outcomes, while also allowing nurses to focus on the patients who need their help the most.

Another way that AI is set to transform nursing is through its ability to improve the effectiveness of certain treatments. AI algorithms can be used to analyze the data from clinical trials and other studies to identify the most effective treatments for specific conditions. This can help nurses to make more informed decisions about which treatments to prescribe to their patients, which can lead to better health outcomes.

Overall, the potential of AI to transform nursing is enormous. As we continue to develop and refine these technologies, we can expect to see a wide range of benefits for both patients and nurses. Whether it’s improving diagnostic accuracy, helping nurses manage their workloads, or identifying the most effective treatments for specific conditions, AI has the potential to make a huge impact on the field of nursing.

**This blog post written by AI, I was busy and had holiday shopping to do.  Here was the request:  “Write a 500 word blog post on how AI will transform nursing in the style of Johnathan Klaus”

Tido Inc. can help with digital strategy and custom applications!