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I agree with Dan Kraft about the idea that we can deliver a lot of complex Care at home but you know Im a little bit less gadget-centric than than Dan is weve had the potential to Monitor and manage patients at home for the better part of 20 years and yet havent been able to use it and again that absence of a business model I think has really hurt us is that how do you get pain to do it but I think the other part that where I differ from Dan a little bit is when I look at a hospital I dont see technology I see people and if youre going to move the hospital home its the caregiving part thats the really complicated part not the technology the technology to monitor patients remotely to guide their care with digital tools has been there for 20 years and we havent been able to figure out how to use it its the ability to bring the caregivers into the home thats going to be the real problem