for patients on waiting list so we looked at those services with a waiting list at san francisco againeral. the second is continuity of care. diagnoseests is nob nab surgeries or out patient procedures require longer term patient interaction and follow up to maintain high quality care and this can cause confusion for patients who may not know where to go and requires a lot of data exchange between providers in different networks that our systems are not set up to exchange at this time. finally it had to be within cpmc ability to provide. as supervisors may know, position employed in hospitals are largely independent oceans and not employed by the hospital so we need today have the ability to provide the services that we needed directly so diagnoseistics were the perfect choice. cpcm is providing this sirfbss with now reimbursement. this we thought was a great win for both the development agreement to make sure the obligation is met and the health met network to make sure the patients had access to care. the 1500 med kale ben fishiaries. we are pleased cpmc and north east medical services a