COVID-19—News of the Day
Now more than ever patients and physicians need our support. Together, we can provide them the education and information they need to continue to have meaningful conversations. We know you have questions about how COVID-19 is affecting the point-of-care landscape. We’re working hard to give you answers. PatientPoint is continually talking to our network of physicians, analysts and industry insiders to provide you with up-to-date insights into the pulse of the marketplace.
Wednesday, August 26
What does the “new normal” look like for patients and doctors—and how has healthcare changed since earlier in the pandemic? Over the past several months we’ve been hard at work analyzing medical claims data and talking to doctors and patients to gain insights into how COVID-19 has impacted patient care. Read more in our latest blog.
Monday, July 27
Recent COVID-19 surges—especially in Sun Belt states like Arizona, Texas and Florida—do not appear to be impacting patient traffic, according to our ongoing analysis of patient-level claims data and independent patient survey data. Read more in our latest blog.
Tuesday, July 21
Patients are going to the doctor and are spending time in the waiting room, according to our ongoing research.
In our latest patient survey, nearly 90 percent of patients say they are spending some time in the waiting room, with an average wait time of 10.8 minutes1,2.
In practices with PatientPoint digital waiting room screens, patients are seeing reassuring custom messages like the one pictured here detailing the steps that practices are taking to keep patients safe. Read more about how practices are reassuring patients to seek the care they need without delay in our latest blog.
1 2020 Wave 1 Nationwide Web PatientPoint COVID-19 Practice Tracking Survey Week of 5/21; among all respondents Primary Care (n=337), Pediatrics (n=75), All Other Specialties (n=112)
2 L Catterton/PatientPoint Consumer Survey, average values of Wave 1 Week of 5/20, Wave 2 Week of 6/3, Wave 3 Week of 6/17
Tuesday, July 14
PatientPoint and COVIDSitters are teaming up to promote free childcare, eldercare and other household services for COVID-19 frontline workers to nearly 30,000 healthcare providers nationwide.
Through the new collaboration, PatientPoint will promote COVIDSitters via the PatientPoint® Access™ back-office care team communication program in physician offices nationwide. Read more in the press release.
Tuesday, July 7
With COVID-19 information and recommendations changing by the minute, patients need trusted, meaningful and timely education to help them live their healthiest lives.
We see it as our duty to help healthcare providers encourage patients to continue to manage their health and feel safe about going to their doctor during the COVID-19 pandemic—and we recently highlighted select content that does just that on our blog. Read the blog post.
Thursday, June 18
The COVID-19 “infodemic” has had a direct impact on the point-of-care industry. Within just a couple of weeks of COVID-19's arrival, we began to see countless forecasts, studies and webinars (many of which were conflicting) about how the virus might impact physician office traffic.
Seeking clarity amid the ceaseless projections and data points, we decided to go directly to the source—doctors and patients—to gather insights about their attitudes and behaviors about COVID-19 and how the virus is affecting their delivery of and dependence on healthcare, respectively—and we're pleased to present the first round of insights from our patient research. Read the blog.
Friday, June 12
We continue to hear uplifting stories from health systems about COVID-19. North Carolina-based Novant Health recently posted this video on their Facebook page celebrating their 1,000th COVID-19 patient discharge. Watch the patient tribute video.
Thursday, June 11
We continue to successfully enroll HCPs and facilities in our leading patient and provider engagement network, and enrollments continue to climb as states reopen. Between June 1-5, our Provider and Hospital Solutions teams enrolled more than 350 HCPs across seven specialties including oncology, neurology, primary care, cardiology, gastroenterology, rheumatology and dermatology.
Beyond these enrollments our team is seeing continued interest—especially from health systems—in in-person visits from prospective healthcare provider customers. This is yet another indication that health systems, hospitals and physician practices are seeing patients in increasing numbers and are prioritizing patient education and engagement as patients return.
Wednesday, June 10
More data continues to emerge about patient readiness to return to the doctor’s office.
According to Healthgrades’ latest COVID-19 Patient Confidence Study, released May 21, nearly three-quarters (72%) of patients reported that they were not delaying a visit to the doctor to discuss a medical condition.
In addition, more than half of patient respondents to the latest Healthgrades survey (52%) said that they expect to see their HCP within the next two months. This reflects a 40 percent increase from late April, when just over one-third of Americans (37%) expected to visit their HCP within the next two months.
The latest Healthgrades data also demonstrate that patients are more comfortable returning to the doctor’s office than they are returning to other establishments or public events. Nearly 90% of patients said they were comfortable visiting their HCP, more than double their rate of confidence reported among patients of dining in at a restaurant (40%) or attending a concert or sporting event (36%). See the latest COVID-19 Patient Confidence Study Results from Healthgrades.
Tuesday, June 9
Over the past three weeks we have seen significant increases in daily scans of the QR codes we have placed on PatientPoint digital exam room screens and brochures to deliver touch-free education.
Daily QR code scans for June 4 represent a 63% increase* from daily scans recorded May 14—a strong indicator that in-office patient visits continue to increase.
*979 scans on 6/4 vs. 602 scans on 5/14
Monday, June 8
As states continue to reopen, health systems across the country are urging Americans not to delay care while assuring them that facilities are safe and ready for patients.
Cincinnati, Ohio-based TriHealth is running TV spots, digital banner ads and is sending patients postcards, among other tactics, to reassure patients their facilities are safe and ready for patient care. Check out the “Safe and Ready. For You.” campaign.
Tenet Healthcare’s Palm Beach Hospital in Florida recently launched a “Candid on Care,” a video in which the hospital CEO speaks with various healthcare providers and business leaders on the hospital’s safety and readiness practices. Watch “Candid on Care.”
St. Louis-based Ascension Healthcare has purchased billboards reminding drivers not to delay ER care. Learn more about Ascension’s safety pledge.
Friday, June 5
Our oncology partner Florida Cancer Specialists & Research Institute, the largest independently-owned oncology practice in Florida and across the country, has launched an “Appreciation Gallery” on their website featuring inspirational artwork, staff photos and other tokens of appreciation for the FCS staff. See the Florida Cancer Specialists & Research Institute Appreciation Gallery.
Thursday, June 4
Our Provider and Hospital Solutions teams continue to successfully enroll HCPs and facilities in our leading patient and provider engagement network.
Over the last two weeks our teams enrolled approximately 300 HCPs across six specialties including primary care, oncology, neurology, cardiology, gastroenterology and dermatology.
Wednesday, June 3
“Coronavirus infections may be leveling off. But cancer is still going strong.”
-Dr. Mikkael Sekeres, Director, Leukemia Program, Cleveland Clinic
In this first-person perspective in The New York Times, Dr. Mikkael Sekeres, an oncologist and director of the leukemia program at the Cleveland Clinic, discusses his concern with the decline in cancer screenings observed during the COVID-19 pandemic—and his concern that the next health crisis will be a spike in new cancer diagnoses. Read The New York Times piece.
Tuesday, June 2
We continue to see great interest from HCPs and patients in the scannable QR codes that we have placed on our exam room products for touch-free exam room education.
Since March 30, we have recorded nearly 20,000 QR code scans of PatientPoint educational content across both PatientPoint® Interact™ Patient Engagement Hub and PatientPoint® Educate™ Exam Room Information Program.
Top 5 Scanned Topics on PatientPoint® Interact™ for May 27:
• Healthy Eating — 8% of all scans
• Heart Attack — 7% of all scans
• Weight Management — 6% of all scans
• High Cholesterol — 5% of all scans
• Type 2 Diabetes — 5% of all scans
Monday, June 1
Patient office visits continue to increase as states reopen, according to the latest patient traffic data from our partners at Symphony Health.
In addition, office visits in most specialties have increased to at least 75% of 2019 levels according to Symphony data as of the week ending May 15.
Friday, May 29
An important part of our team’s service to our 77,000 unique healthcare provider partners is our work to create custom messages for their PatientPoint screens in their waiting rooms, exam rooms and back-office areas.
Based upon the number of custom messages requested since mid-March, practices are more engaged now than ever: Since mid-March, PatientPoint has created more than 825 custom messages!
Importantly, custom messages created over the past 2 ½ months aren’t all about COVID-19. In addition to keeping patients and staff updated on COVID-19, our healthcare practice partners are requesting custom messages for their PatientPoint screens to promote screenings, team birthdays, surveys, ancillary service lines and more.
Thursday, May 28
Healthcare facilities are safe and ready for patients—and we’re committed to delivering impactful content to help our network of 77,000 healthcare providers drive that message home and ensure patients get the care they need. It's all part a new campaign we’re calling #DocsDontStop. Watch #DocsDontStop.
Wednesday, May 27
Reports around the country continue to emerge that more patients are seeing their providers in person.
"...This week I shifted from about 90 percent virtual visits to about 75 percent office visits," says Dr. Doug Degler, a primary care physician based in Monroe County, PA. Watch Dr. Degler discuss his uptick in in-person visits.
“I would recommend an office visit right now. I think your health is vital, and you should see the doctor when you need to," says Amy Pitz, 28, of Buffalo, NY, who recently visited her primary care physician for her asthma. Learn more about Pitz’s in-office patient experience.
Tuesday, May 26
We’re seeing steady increases in QR code scans on our PatientPoint education in the exam room, signaling increased patient traffic in physician offices. To date, patients and providers have accessed education more than 16,000 times across our PatientPoint® Interact™ Engagement Hub and PatientPoint® Educate™ Exam Room Information Program.
Recent popular topics across both PatientPoint® Interact™ and PatientPoint® Educate™ include:
• Healthy Eating
• Daily Skin Care
• Heart Attack
• Weight Management
• Deep-Vein Thrombosis
• Digestive Health
• Trouble Sleeping
Friday, May 22
Our Customer Success team is receiving regular reports from our healthcare provider partners on adjustments they are making to their practices to adhere to social distancing guidelines, such as turning every other chair backwards in the waiting room.
A new segment now airing across our national waiting room network is designed to help practices communicate the many measures they are taking to ensure the health and safety of patients and staff. Watch the segment.
Thursday, May 21
We continue to successfully enroll HCPs and facilities in our leading patient and provider engagement network. Between May 11-15, our Provider and Hospital Solutions teams enrolled 225 HCPs across five specialties including primary care, neurology, cardiology, gastroenterology and dermatology.
In addition to our enrollments we are seeing a marked uptick in interest and movement from health systems: Last week we received strong interest from or were working through pending agreements from nearly 2,000 additional HCPs and three health systems. This is yet another indication that patients are getting back into offices to seek the care they need as states reopen.
Wednesday, May 20
While COVID-19 may have been a catalyst for greater use of telemedicine, its long-term impact and utilization is not fully known at this point.
While nearly 90% of healthcare provider respondents to a recent MedData/IQVIA survey report that they are currently using telemedicine, the same group was evenly divided on the future role of telemedicine in their practice. Of the healthcare providers surveyed, 52% said they planned to maintain or expand current levels of telemedicine services and 49% said they planned to scale back or stop offering telemedicine completely in the future. Read the report.
Tuesday, May 19
Patients and providers are engaging more now with our Interactive Exam Room Devices than in any other time during the COVID-19 outbreak. According to the latest data on scans of QR codes featured on our Interactive Exam Room Devices—allowing access to “no-touch” education and branded information—scans for May 12 represented a more than 110% increase than scans the day the codes launched on March 23. QR codes have been scanned more than 11,000 times since late March.
Top 5 QR Code Scans by Topic for May 12:
1. Healthy Eating — 12% of all scans
2. High Cholesterol — 10% of all scans
3. Managing Your Weight — 6% of all scans
4. COVID-19 — 5% of all scans
5. Heart Failure — 3% of all scans
Monday, May 18
We continue to receive both qualitative and quantitative data indicating increased patient traffic to physician practices across the country. Our PatientPoint Ambassador team is speaking with our healthcare provider partners regularly and the team continues to learn more about how practices are adapting their procedures to follow social distancing guidelines.
Medical claims data also indicates that patients are resuming non-essential healthcare visits, including chronic care management, across the country. Symphony Health’s latest report shows a 29% increase in U.S. office visits across a range of therapeutic areas over the past four weeks. This increase is as high as 63% for digestive diseases and 40% for diabetes patients. Read more in our latest blog.
Friday, May 15
The PatientPoint Strategy & Insights team is closely monitoring how COVID-19 is impacting patient traffic. Our latest blog post, from SVP of Strategy & Insights Eric Talbot, takes a deep dive into patient claims data to uncover specialties most affected by COVID-19, the current and future impact of telemedicine and what to watch for as America reopens. Read the blog.
Thursday, May 14
Our Provider Solutions and Hospital Solutions teams are continuing to successfully enroll HCPs and facilities in our leading patient and provider engagement network. Just last week (May 4 - May 8), our teams enrolled more than 150 HCPs across five specialties including primary care, neurology, oncology, gastroenterology and dermatology.
In addition to the sheer enrollment numbers we’re seeing, we’re also receiving an increasing number of requests from practices to reschedule the screens installation or maintenance they may have delayed during the COVID-19 outbreak, a signal that practices are open and welcoming patients to get the care they need.
Wednesday, May 13
Primary care physicians are increasingly worried about the negative consequences of patients delaying care during the COVID-19 pandemic. According to a May 1-4 survey of more than 750 primary care physicians, nearly 40 percent of primary care physician respondents said they believe delayed care due to COVID-19 will mean serious—potentially fatal—long-term consequences for their patients. Read more.
Tuesday, May 12
Despite the nearly 1.4 million COVID-19 cases reported in the U.S. the virus represented only a fraction of activity in U.S. primary care physician offices from January through April 2020, according to a recent PatientPoint analysis of ICD-10 codes appearing in patient claims data.
The data indicate that hypertension, high cholesterol and Type 2 diabetes constituted the top three reasons for a primary care physician visit during the first four months of 2020. Data also show fewer physician visits for the common cold and other respiratory ailments over the same time period, suggesting that social distancing is helping us to curb more than just COVID-19!
Top three reasons for PCP visits (January-April 2020 average)*:
1. Hypertension — 35%
2. High cholesterol — 22%
3. Type 2 diabetes — 19%
*Source: MedFuse Data by DarkMatter2bd
Monday, May 11
The doctor is in: Both our primary and secondary research indicate that the vast majority of physician offices have remained open during the COVID-19 pandemic.
In a recent survey of a representative sample of more than 2,000 of our PatientPoint physician practices, just 12 percent reported a closure as a result of the COVID-19 pandemic.
A PatientPoint analysis of recent patient claims data also shows that the number of physicians submitting claims has remained stable throughout the pandemic, indicating that offices have remained open.
Friday, May 8
Our Practice Solutions and Hospital Solutions teams have been virtually enrolling new HCPs and facilities every day over the last eight weeks. Over the last eight weeks of our provider recruitment outreach during the COVID-19 pandemic, primary care has been our largest enrollment specialty. In terms of geography, surprisingly, the highest concentration of practice and hospital enrollments have been in COVID-19 “hotspot” areas including New York state, Ohio and Southern California.
Thursday, May 7
As more than 40 states continue to reopen or make plans to do so, health systems are urging patients not to delay important ongoing care in their hospitals and clinics, where patient safety remains their top priority:
• New York City-based NYU Langone Health recently emailed patients a fact sheet and posted resources on their website stressing how patients should not put their healthcare on hold.
• Cincinnati, Ohio-based TriHealth has posted their safety, cleanliness and readiness protocols on its website as part of a new “Safe & Ready. For You.” campaign.
• AdventHealth recently launched a “Let’s Start Healing” campaign, featuring doctors, nurses and associates in this impactful TV spot focused on the system’s commitment to safety in its facilities spanning 10 states.
Wednesday, May 6
Two-thirds of Americans say they think of their healthcare provider as a trustworthy source of information about the coronavirus outbreak, according to a new Associated Press-NORC Center for Public Affairs Research poll. HCPs ranked just below the CDC as a source of trustworthy COVID-19 information in the poll, with 68% of Americans reporting trust in CDC content.
The results underscore how HCP-delivered education and support at the point of care is needed—and trusted—now more than ever. Read more.
Tuesday, May 5
We’ve collaborated with our healthcare provider partners to create more custom messages during the COVID-19 pandemic than ever before.
In March, our team recorded a 61% increase in custom message requests for our PatientPoint® Communicate™ Digital Waiting Room Screens Program and a 126% increase in custom message requests for our PatientPoint® Access™ Care Team Communication Platform in the physician back office.
Monday, May 4
PatientPoint is releasing new COVID-19 content each week and making it available to all healthcare providers via our online COVID-19 Physician Tool Kit. We’ve had more than 2,200 providers download education so far. Our latest COVID content focuses on safety, coping for kids and teens, chronic conditions, HCP wellness and a special thank you to America’s biopharmaceutical companies. See the latest PatientPoint COVID-19 content on our COVID-19 Physician Tool Kit.
Friday, May 1
Yesterday we announced an exciting collaboration with the National Foundation for Infectious Diseases (NFID) to bring their timely, credible and trustworthy COVID-19 education to nearly 10,000 physician practices with PatientPoint solutions nationwide. Read the press release.
Thursday, April 30
Each day we have the honor of interacting with the heroic doctors, nurses and staff in physician offices, hospitals and health systems across our network who are working tirelessly to keep us healthy and safe.
One such provider is Dr. Gary LeRoy, the 2020 President of the American Academy of Family Physicians Board of Directors. We recently sat down with Dr. LeRoy—whose expert perspective has been featured in national media throughout the COVID-19 pandemic—about what he’s seeing on the ground in his practice. Read the Q&A with Dr. LeRoy.
Wednesday, April 29
“…Some of our patients have delayed seeking care out of an abundance of caution. Putting off care indefinitely is simply not good for our patients – and in some cases, deadly.”
– Carl Amato, President and CEO, Novant Health, North Carolina
“I wouldn’t be surprised that when this picks up, we’ll see a blip of increased incidents of new cancer diagnosis.”
– Vince Cataldo, MD, oncologist, Louisiana
As more than 30 U.S. states resume doctor’s appointments and elective procedures, healthcare professionals are urging patients to get the healthcare they need, noting that delaying care can cause serious complications depending on an individual’s medical issues. Practices are preparing for a backlog of missed medical care as patients reschedule, with many sources predict an uptick in office traffic in late Q2 into Q3. Read more.
Tuesday, April 28
Now more than ever, healthcare providers and patients need calming, confidence-inspiring and medically accurate content. Our new collaboration with Everyday Health leverages industry-leading technology to deliver content to foster more interactive, engaging and immersive point-of-care content experiences during a time when it’s needed most. Read the press release.
Monday, April 27
PatientPoint practices remain engaged and committed to education and engagement and are increasingly customizing their waiting room, exam room and back-office screens.
For the week of April 20-24, PatientPoint collaborated with practices to create 110 custom messages for their screens on topics such as office visit policies, patient portal information, general wellness and adherence messaging and screenings.
Friday, April 24
“For some patients, I can schedule a virtual visit. But I can’t draw a patient’s labs to look for leukemia over Skype. Zoom doesn’t have the functionality to transfuse blood.”
– Mikkael Sekeres, MD, Director Leukemia Program, Cleveland Clinic
Oncologists are evaluating each individual patient’s need for in-person visits and are advising them to come in if appropriate and safe for the patient. In this New York Times Op-Ed, Dr. Sekeres explains the importance of in-person visits and how much his patients mean to him personally. Read the New York Times piece.
Thursday, April 23
In late March, we added QR codes to our Interactive Exam Room Devices, allowing providers, patients and staff to safely access “no-touch” education and branded information on their smartphones. As of April 21, QR codes have been scanned more than 6,000 times. Here are the top-scanned topics in our provider partners’ offices for April 21, 2020:
Top 5 QR Code Scans by Topic for April 21:
1. Managing Your Weight — 9% of total scans
2. Healthy Eating — 8% of total scans
3. COVID-19 — 6% of total scans
4. Managing Your Medicines — 5% of total scans
5. Daily Skincare — 5% of total scans
Wednesday, April 22
We are experiencing continued demand for our patient education and engagement content.
In recent outreach to more than 1,000 primary care practices that regularly receive our PatientPoint® Educate™ Exam Room Information Program brochures, 75 percent expressed interest in our special edition COVID-19 shipment containing QR-code enabled brochure racks. These brochure racks allow patients and providers to safely access our award-winning content on their mobile phones.
Monday, April 20
While telehealth during the COVID-19 pandemic has increased rapidly compared with its previously slow uptake there are some obstacles, according to a recent article in MedPage Today. A growing issue: reimbursement. Providers say they're not being paid to the extent they are being promised and nowhere near what they would normally receive for an in-person visit. Read more in MedPage Today.
Friday, April 17
We’re continuing to add content to our COVID-19 library and make it available for all healthcare providers to download and share with patients during this challenging time.
Earlier this week, we made it even easier for providers to find and download the information they need to keep patients safe and informed by launching our new
COVID-19 Tool Kit. View the Tool Kit.
Thursday, April 16
We’ve been hard at work taking special care to ensure that our education and engagement solutions continue to meet healthcare providers and patients’ needs during this challenging time. Read more in our latest blog post.
Wednesday, April 15
“As we come to the other side of this virus and as social distancing eases, we see a world where people are rushing back to their doctors more than ever because people are going to realize that health is everything.” — Mark Boidman, Head of Media & Tech Services at PJ Solomon, as told to the Point of Care Communication Council
This insight continues to come up in our daily conversations with providers, healthcare executives and industry analysts: Providers are preparing for post-COVID-19 surge, a time during which targeted, contextually relevant point-of-care messaging will become more even more essential than it is today. Read more.
Tuesday, April 14
COVID-19 has temporarily upended a critical part of the care journey for patients with chronic and serious health conditions—their regular, in-person visit with a specialist(s). Autoimmune disease patient Jen Horonjeff, PhD, recently shared in a Medium.com article that, while she is happy that telehealth options are being made available during this extraordinary time, nothing can replace the in-person interaction she has with her rheumatologist and other specialists. Read the article.
Monday, April 13
We’re hearing from practices every day about how they’re adapting operations to keep their patients, providers and staff safe. One common precaution includes having patients wait in their cars until they are called in for their visit. As a result, we’ve extended the radius of some of our geofencing messaging through our PatientPoint® Proximity™ mobile engagement platform, sharing custom mobile content to educate and prepare patients for their visit regardless of whether they’re in their car or in the waiting room.
Chief Client Officer Linda Ruschau spoke about this and other innovations alongside industry leaders in a Digital Health Coalition Digital POC Trends Roundtable. Read more and watch the DHC roundtable.
Friday, April 10
During this unprecedented time, we’re producing content focused not only on physical health but mental health as well. This week we launched three new mental health-focused segments on stress reduction, focusing on what you can control and staying connected during social distancing. Watch our new COVID-19 education.
Thursday, April 9
“We loved the content in this video and would love to use it on our practice’s website and Facebook page.” – Iesha Baugh, Administrative Assistant, Frank Laurri, MD, & Associates, Niagara Falls, NY
We’re hearing from many practices like this one that want to leverage our content beyond their PatientPoint engagement solutions during this challenging time. We’re in constant communication with practices to ensure we’re supporting their entire patient communication strategy from websites to social media channels. See our COVID-19 library.
Wednesday, April 8
Since making our COVID-19 educational library available for download to all healthcare providers on March 17, more than 2,500 people have downloaded it for use in their patient communications strategy. And we’re finding that our content is of service right now beyond the U.S.: We had one practice in Australia reach out and thank us for our content. See our COVID-19 library.
Tuesday, April 7
After one week of adding onscreen QR codes to our Interactive Exam Room Devices—allowing patients and providers to safely access “no-touch” education and branded information on their smartphones—QR codes have been scanned nearly 3,500 times!
Top 5 QR Code Scans by Topic (as of April 6):
2. Healthy Eating
3. Atrial Fibrillation
4. Cold & Cough
5. Daily Skincare
Monday, April 6
Patients with chronic, serious conditions need support now more than ever and are still seeing their specialists. In oncology, all major practice groups have continued to see patients and administer treatment plans as normal.
Our partners at major oncology groups across the country have confirmed that while they are restricting the number of care partners allowed to accompany a patient, patient traffic is normal.
Friday, April 3
“I’m thankful for your follow-up and consideration for our practice during this sensitive time.” –Dermatology Office, Washington, DC
Our Customer Success Team is taking special care with frequent check-ins to our practices nationwide to ensure their providers, patients and staff have the education and messaging they need during this challenging time.
Wednesday, April 1
“Patient Point is leading the way in up-to-date COVID-19 information.”
—Gabrielle Rascon, Marketing Coordinator, Heritage Sierra Medical Group, Valencia, CA
PatientPoint is continually producing important COVID-19 education to run in our physician offices’ waiting rooms, exam rooms and back offices. We’re offering this education to ALL providers to download and use in their own communication efforts. Download our COVID-19 education.
Tuesday, March 31
As of March 23, a PatientPoint survey found that provider hours continue to hold steadyin the COVID-19 environment. We will continue to monitor the marketplace and provide updates on any changes we are seeing.