>> Welcome to this IBM Watson Health client conversation. And we're probing the dynamics of the relationship between IBM and it's clients. We're going to look back at some of the challenges of 2020 and look forward to, you know, present year's priorities. We'll also touch on the future state of healthcare. My name is Dave Vellante. I'll be your host and I'm from theCUBE. And with me are Doctor Alex Towbin, who's Associate Chief Clinical Operations and Informatics at Cincinnati ChilDoctoren's Hospital and John Chrisman of course from IBM Watson health. Welcome gentlemen, Good to see you. Thanks for coming on. >> Thanks for having us. >> Yeah, thanks for having me. >> Yeah I know from talking to many clients around the world, of course virtually this past year, 11 months or so that relationships with technology partners they've been critical over during the pandemic to really help folks get through that. Not that we're through it yet but, we're still through the year now, there's I'm talking professionally and personally and Doctor Towbin, I wonder if you could please talk about 2020 and what role the IBM partnership played in helping Cincinnati children's, you know press on in the face of incredible challenges? >> Yeah, I think our story of 2020 really starts before the pandemic and we were fortunate to be able to plan a disaster and do disaster drill scenarios. And so, as we were going through those disaster drill scenarios, we were trying to build a solution that would enable us to be able to work if all of our systems were down and we worked with IBM Watson Health to design that solution to implement it, it involves using other solutions from our primary one. And we performed that disaster drill in the late January, early February timeframe of 2020. And while that drill had nothing to do with COVID it got us thinking about how to deal with a disaster, how to prepare for a disaster. And so we've just completed that and COVID was coming on the horizon. I'm starting to hear about it coming into the U.S for the first time. And we took that very seriously on our department. And so, because we had prepared for this this disaster drill had gone through the entire exercise and we built out different scenarios for what could happen with COVID what would be our worst case scenarios and how we would deal with them. And so we were able to then bring that to quickly down to two options on how our department and our hospital would handle COVID and deal with that within the radiology department and like many other sites that becomes options of working from home or working in a isolated way and an and an office scenario like where I'm sitting now and we planned out both scenarios and eventually made the decision. Our decision at that point was to work in our offices. We're fortunate to have private offices where we can retreat to and something like that. And so then our relationship with IBM was helpful and that we needed to secure more pieces of hardware. And so even though IBM is our PACS vendor and our enterprise imaging vendor, they also help us to secure the high resolution monitors that are needed. And we needed a large influx of those during the pandemic and IBM was able to help us to get those. >> Wow! So yeah you were able to sort of test your organization resilience before the pandemic. I mean, John, that's quite an accomplishment for last year. I'm sure there are many others. I wonder if one of you could pick it up from here and bring your perspectives into it and, you know maybe ask any questions that you would like to ask them. >> Yeah, sure, Doctor Towbin, that's great that we were able to help you with the hardware and procure things. So I'm just curious before the pandemic how many of the radiologists ever got to read from home, was that a luxury back then? And then post pandemic, are you guys going to shift to how many are on-site versus remote? >> Yeah, so we have a couple of scenarios. We've had talk about it both from our PACS perspective as well as from our VNA enterprise imaging perspective from PACS perspective we always designed our solution to be able to work from a home machine. Our machines, people would access that through a hospital-based VPN. So they would log in directly to VPN and then access the PACS that way. And that worked well. And many of our radiologists do that particularly when they're on call works best for our neuroradiologist who are on call a little bit more frequently. And so they do read from home in that scenario. With enterprise imaging and are used to the enterprise viewer and iConnect access. We always wanted that solution to work over the internet. And so it's set up securely through the internet but not through the VPN. And we have radiologists use that as a way to view studies from home, even not from home, so it can be over one of their mobile devices, such as an iPad and could be at least reviewing studies then. We, for the most part for our radiologist in the hospital that's why we made the decision to stay in the hospital. At COVID time, we have such a strong teaching mission in our department in such a commitment to the education of our trainees. We think that hospital being in the hospital is our best way to do that, it's so hard. We find to do it over something like zoom or other sharing screen-sharing technology. So we've stayed in and I think we'll continue to stay in. There will be some of those needs from a call perspective for example, reading from home, and that will continue. >> And then what's your success been with this with the technology and the efficiency of reading from home? Do you feel like you're just as efficient when you're at home versus onsite? >> The technology is okay. The, our challenges when we're reading from the PACS which is the preferred way to do it rather than the enterprise archive, the challenge is we have to use the PACS So we have to be connected through VPN which limits our bandwidth and that makes it a little bit slower to read. And also the dictation software is a little bit slower when we're doing it. So moving study to study that rapid turnover doesn't happen but we have other ways to make, to accelerate the workflow. We cashed studies through the worklist. So they're on the machine, they load a little bit more rapidly and that works pretty well. So not quite as fast, but not terrible. >> We appreciate your partnership. I know it's been going on 10 years. I think you guys have a policy that you have to look at the market again every 10 years. So what do you think of how the market's changed and how we've evolved with the VNA and with the zero footprint viewers? A lot of that wasn't available when you initially signed up with Amicas years ago, so. >> Yeah, we signed up so we've been on this platform and then, you know now the IBM family starting in 2010, so it's now now 11 years that we're, we've been on as this version of the PACS and about eight, seven or eight years from the iConnect platform. And through that, we've seen quite an evolution. We were one of the first Amicas clients to be on version six and one of the largest enterprises. And that went from, we had trouble at the launch of that product. We've worked very closely with Amicas then to merge. And now IBM from the development side, as well as the support side to have really what we think is a great product that works very well for us and drives our entire workflow all the operations of our department. And so we've really relished that relationship with now IBM. And it's been a very good one, and it's allowed us to do the things like having disaster drill planning that we talked about earlier as far as where I see the market I think PACS in particular is on the verge of the 3.0 version as a marketplace. So PACSS 1 one was about building the packs, I think, and and having electronic imaging digital imaging, PACS 2.0 is more of web-based technology, getting it out of those private networks within a radiology department. And so giving a little bit more to the masses and 3.0 is going to be more about incorporating machine learning. I really see that as the way the market's going to go and to where I think we're at the infancy of that part of the market now about how do you bring books in for machine learning algorithms to help to drive workflow or to drive some image interpretation or analysis, as far as enterprise imaging, we're on the cusp of a lot there as well. So we've been really driving deep with enterprise imaging leading nationally enterprise imaging and I have a role in the MSAM Enterprise Imaging Community. And through all of that work we've been trying to tackle works well from enterprise imaging point of view the challenges are outside of radiology, outside of cardiology and the places where we're trying to deal with medical photos, the photographs taken with a smart device or a digital camera of another type, and trying to have workflow that makes sense for providers not in those specialty to that don't have tools like a DICOM modality workloads store these giant million-dollar MRI scanners that do all the work for you, but dealing with off the shelf, consumer electronics. So making sure the workflow works for them, trying to tie reports in trying to standardize the language around it, so how do we tag photos correctly so that we can identify relevancy all of those things we're working through and are not yet standard within our, within the industry. And so we're doing a lot there and trying and seeing the products in the marketplace continuing to evolve around that on the viewer side, there's really been a big emergence as you mentioned about the zero footprint viewers or the enterprise viewer, allowing easy access easy viewing of images throughout the enterprise of all types of imaging through obtained in the enterprise and will eventually incorporate video pathology. The market is also trying to figure out if there can be one type of viewer that does them all that and so that type of universal viewer, a viewer that cardiologists can use the same as a radiologist the same as a dermatologist, same as a pathologist we're all I think a long way away from that. But that's the Marcus trying to figure those two things out. >> Yeah, I agree with you. I agree with your assessment. You talked about the non DICOM areas, and I know you've you've partnered with us, with ImageMover and you've got some mobile device capture taking place. And you're looking to expand that more to the enterprise. Are you also starting to use the XDS registry? That's part of the iConnect enterprise archive, or as well as wrapping things in DICOM, or are you going to stick with just wrapping things in DICOM? >> Yeah, so far we've been very bunched pro DICOM and using that throughout the enterprise. And we've always thought, or maybe we've evolved to think that there is going to be a role for XDS are I think our early concerns with XDS are the lack of other institutions using it. And so, even though it's designed for portability if no one else reads it, it's not portable. If no one else is using that. But as we move more and more into other specialties things like dermatology, ophthalmology, some of the labeling that's needed in those images and the uses, the secondary uses of those images for education, for publication, for dermatology workflow or ophthalmology workflow, needs to get back to that native file and the DICOM wrap may not make sense for them. And so we've been actively talking about switching towards XDS for some of the non DICOM, such as dermatology. We've not yet done that though. >> Given the era children's hospital has the impact on your patient load, then similar to what regular adult hospitals are, or have you guys had a pretty steady number of studies over the last year? >> In relay through the pandemic, we've had, it has been decreased, but children fortunately have not been as severely affected as adults. There is definitely disease in children and we see a fair amount of that. There are some unique things that happen in kids but that fortunately rare. So there's this severe inflammatory response that kids can get and can cause them to get very sick but it is quite rare. Our volumes are, I think I'm not I think our volumes are stable and our advanced imaging things like CT, MRI, nuclear medicine, they're really most decreased in radiography. And we see some weird patterns, inpatient volumes are relatively stable. So our single view chest x-rays, for example, have been stable. ER, visits are way down because people are either wearing masks, isolating or not wanting to come to the ER. So they're not getting sick with things like the flu or or even common colds or pneumonias. And so they're not coming into the ER as much. So our two view x-rays have dropped by like 30%. And so we were looking at this just yesterday. If you follow the graphs for the two we saw a dip of both around March, but essentially the one view chest were a straight line and the two view chest were a straight line and in March dropped 30 to 50% and then stayed at that lower level. Other x-rays are on the, stay at that low level side. >> Thanks, I know in 2021 we've got a big upgrade coming with you guys soon and you're going to stay in our standalone mode. I understand what the PACSS and not integrate deeply to the VNA. And so you'll have a couple more layers of storage there but can you talk about your excitement about going to 8.1 and what you're looking forward to based on your testimony. >> Yeah we're actually in, we're upgrading as we're talking which is interesting, but it's a good time for talking. I'm not doing that part of the work. And so our testing has worked well. I think we're, we are excited. We, you know, we've been on the product as I mentioned for over 10 years now. And for many of those years we were among the first, at each version. Now we're way behind. And we want to get back up to the latest and greatest and we want to stay cutting edge. There've been a lot of reasons why we haven't moved up to that level, but we do. We're very careful in our testing and we needed a version that would work for us. And there were things about previous versions that just didn't and as you mentioned, we're staying in that standalone mode. We very much want to be on the integrated mode in our future because enterprise imaging is so important and understanding how the comparisons fit in with the comparison in dermatology or chest wall deformity clinic, or other areas how those fit into the radiology story is important and it helped me as a radiologist be a better radiologist to see all those other pictures. So I want them there but we have to have the workflow, right. And so that's the part that we're still working towards and making sure that that fits so we will get there. It'll probably be in the next year or two to get to that immigrating mode. >> As you, look at the number of vendors you have I think you guys prefer to have less vendor partners than than more I know in the cardiology area you guys do some cardiology work. What has been the history or any, any look to the future of that related to enterprise imaging? Do you look to incorporate more of that into a singular solution? >> Cardiology is entirely part of our enterprise imaging solution. We all the cardiology amendments go to our vendor neutral archive on the iConnect platform. All of them are viewed across the enterprise using our enterprise viewer. They have their unique specialty viewer which is, you know, fine. I'm a believer that specialty, different specialties, deserve to have their specialty viewers to do theirs specialty reads. And at this point I don't think the universal viewer works or makes sense until we have that. And so all the cardiology images are there. They're all of our historical cardiology images are migrated and part of our enterprise solution. So they're part of the entire reference the challenge is they're just not all in PACSS. And so that's where, you know, an example, great example, why we need to get to this to the integrated mode to be able to see those. And the reason we didn't do that is the cardiology archive is so large to add a storage to the PACS archive. Didn't make sense if we knew we were going to be in an integrated mode eventually, and we didn't want to double our PACS storage and then get rid of it a couple of years later. >> So once you're on a new version of merge PACS and you're beyond this, what are your other goals in 2021? Are you looking to bring AI in? Are you using anybody else's AI currently? >> Yeah, we do have AI clinical it's phone age, so it's not not a ton of things but we've been using it clinically, fully integrated, it launches. When I open a study, when I opened a bone age study impacts it launches we have a bone age calculator as well that we've been using for almost two decades now. And so that we have to use that still but launching that automatically includes the patient's sex and birth date, which are keys for determining bone age, and all that information is there automatically. But at the same time, the images are sent to the machine learning algorithm. And in the background the machine determines a bone age that in the background it sends it straight to our dictation system and it's there when we opened the study. And so if I agree with that I signed the report and we're done. If I disagree, I copy it from my calculator and put it in until it takes just a couple of clicks. We are working on expanding. We've done a lot of research in artificial intelligence and the department. And so we've been things are sort of in the middle of translation of moving it from the research pure research realm to the clinical realm, something we're actively working on trying to get them in. Others are a little bit more difficult. >> That's the question on that John, Doctor, when you talk about injecting, you know machine intelligence into the equation. >> Yeah. >> What, how do you sort of value that? Does that give you automation? Does it improve your quality? Does it speed the outcome and maybe it's all of those but how do you sort of evaluate the impact to your organisation? >> I there's a lot of ways you can do it. And you touched on one of my favorite one of my favorite talking points, in a lot of what we've been doing and early machine learning is around image interpretation helping me as a radiologist to see a finding. Unfortunately, most of the things are fairly simple tasks that it's asking us to do. Like, is there a broken bone? Yes or no, I'm not trying to sound self-congratulatory or anything, but I'm really good at finding broken bones. I get, I've been doing it for a long time and, and radio, you know so machines doing that, they're going to perform as well as I can perform, you know, and that's the goal. Maybe they'll perform a little bit better maybe a little bit worse but we're talking tiny increments there they're really to me, not much value of that it's not something I would want. I don't value that at a time where I think machine learning can have real value around more on some of the things that you mentioned. So can it make me more efficient? Can it do the things that are so annoying that and they'd take, they're so tedious that they make me unhappy. A lot of little measurements for example are like that an example. So in a patient with cancer, we measure a little tumors everywhere and that's really important for their care, but it's tedious and so if a machine could do that in an automated way and I checked it that, you know, patient when because he or she can get that good quality care and I have a, you know, a workflow efficiency game. So that one's important. Another one that would be important is if the machine can see things I can't see. So I'm really good at finding fractures. I'm not really good at understanding what all the pixels mean and, you know in that same patient with cancer, oh what do all the pixels mean in that tumor? I know it's a tumor. I can see the tumor, I can say it's a tumor but sometimes those pixels have a lot of information in them and may give us prognosis, you know, say that this patient may, maybe this patient will do well with this specific type of chemotherapy or a specific or has a better prognosis with one with one drug compared to another. Those are things that we can't usually pick out. You know, it's beyond the level of that are I can perceive that one is really the cutting edge of machine learning. We're not there yet and then the other thing are things that, you know just the behind the scenes stuff that I don't necessarily need to be doing, or, you know so it's the non interpretive artificial intelligence. >> Dave: Right. >> And that's what I've been also trying to push. So an example of when the algorithms that we've been developing here we check airways. And this is a little bit historical in our department, but we want to make sure we're not missing a severe airway infection. That can be deadly, it's incredibly rare. Vaccines have made it go away completely but we still check airways. And so what happens is the technologist takes the x-ray. They come in to ask us if it's okay, we are interrupted from what we're doing. We open up the study, say yes or no. Okay, not okay, if it's not okay they go back, take another study. Then come back to us again and say, is it okay or not? And we repeat this a couple of times it takes them time that they don't need to spend and takes us time. And so we have, we've built an algorithm where the machine can check that and their machine is as good or a little bit worse than us, but give can give that feedback. >> Dave: Got it. >> The challenge is getting that feedback to the technologist quickly. And so that's, that's I think part for us to work on stuff. >> Thank you for that. So, John, we've probably got three or four minutes left. I'll let you bring it home and appreciate that Doctor Towbin >> I think one of the biggest impacts probably I knew this last year with the pandemic, Doctor Towbin is this, I know you're a big foodie. So having been to some good restaurants and dinners with the hot nurse in a house how's the pandemic affected you personally. And some of the things you like to do outside of work. >> Everything is shut down. And everything has changed. I have not left the house since March besides come to work and my family hasn't either. And so we're hardcore quarantining and staying you know, staying out and keeping it home. So we've not gone out to dinner or done much else. >> So its DoorDash and Uber Eats or just learned to cook at home. >> It's all cooking at home. We're fortunate, my wife loves to cook. My kids love to cook. I enjoy cooking, but I don't have the time as often. So we've done a lot of different are on our own experimenting. Maybe when the silver lining one of the things I've really relished about all this is all this time I get to spend with my family. And that closeness that we've been able to achieve because of being confined in our house the whole time. And so I've played get to play video games with my kids every night. We'd been on a big Fortnite Keck lately since it's been down making. So we've been playing that every night since we've watched movies a lot. And so as a family, we've, I it's something I'll look back fondly even though it's been a very difficult time but it's been an enjoyable time. >> I agree, I've enjoyed more family time this year as well, but final question is in 2021, beyond the PACS upgrade what are the top other two projects that you want to accomplish with us this year? And how can we help you? >> I think our big one is are the big projects are unexpanded enterprise imaging. And so we want to continue rolling out to other areas that will include eventually incorporating scopes, all the images from the operating room. We need to be able to get into pathology. I think the pathology is really going to be a long game. Unfortunately, I've been saying that already for 10 years and it's still probably another 10 years ago but we need to go. We can start with the gross pathology images all the pictures that we take for tumor boards and get those in before we start talking about whole slide scanning and getting in more of the more of the photographs in the institution. So we have a route ambulatory but we need inpatient and ER. >> All right one last question. What can IBM do to be a better partner for you guys? >> I think it's keep listening keep listening and keep innovating. And don't be afraid to be that innovative partner sort of thinking as the small company that startup, rather than the giant bohemoth that can sometimes happen with large companies, it's harder. It is fear to turn quickly, but being a nimble company and making quick decisions, quick innovations. >> Great, quick question. How would you grade IBM, your a tough grader? >> It depends on what I am a tough grader but it depends on what, you know as the overall corporate partnership? >> Yeah the relationship. >> I'd say it's A minus. >> Its pretty good. >> I think, I mean, I, we get a lot of love from IBM. I'm talking specifically in the imaging space. I not, maybe not, I don't know as much on the hardware side but we, yeah, we have a really good relationship. We feel like we're listened to and we're valued. >> All right, well guys, thanks so much. >> So even if it's not an A plus- >> Go ahead. >> I think there's some more to, you know, from the to keep innovating side there's little things that we just let you know we've been asking for that we don't always get but understand the company has to make business decisions not decisions on what's best for me. >> Of course got to hold that carrot out too. Well thanks guys, really appreciate your time. Great conversation. >> Yeah, thank you. >> All right and thank you for spending some time with us. You're watching client conversations with IBM Watson Health.

>>from >>around the globe. It's the Cube with digital coverage of AWS reinvent 2020 Special coverage sponsored by A. W s Global Partner Network. >>Hello and welcome to the Cube. Virtual in our coverage of AWS reinvent 2020 and our special coverage of a PM partner experience where the Cube virtual and I'm your host, Justin Warren. And today I'm joined by Mike Gill. Fix. Who is the chief product officer for IBM Cloud PACs. Mike, welcome to the Cube. >>Thank you. Thanks for happening. >>Now. Cloud PACs is a new thing from IBM. I'm not particularly familiar with it, but it's it's related to IBM's partnership with with a W s. So maybe you could just start us off quickly by explaining what is cloud packs and what's your role as chief product officer there? >>Well, Klopp acts sort of our next generation platform. What we've been doing is bringing the power of IBM software really across the board and bringing it to a hybrid cloud environments, so make it really easy for our customers to consume it wherever wherever they want, however, they want to choose to do it with a consistent skill set and making it really easy to kind of get those things up and running and deliver value quickly. And this is part of IBM hybrid approach. So what we've seen is organizations that can leverage the same skill set and, you know, basically take those work quotes, make him run where they need thio. Yields about a 2.5 times are y and cloud packs it at the center of that running on the open shift platform so they get consistent security skills and powerful software to run their business running everywhere. And we've been partnering with AWS because we want to make sure that those customers that have made that choice could get access to those capabilities easy and as fast as possible. >>Right? And and the cloud PACs have built on the red hat open. Now let me get this right. It's the open hybrid cloud platform. So is that open shift? >>It is Open shift. Yes. I >>mean, IBM >>is incredibly committed to being thio. Open software and open ship does provide that common layer, and the reason that's important is you want consistent security. You want to avoid lock in, right? That gives you a very powerful platform A fabric, if you will, that can truly run anywhere with any workload. And we've been working very closely with a W s to make sure that is Ah, Premier. First class experience on AWS. >>Yes. So the the open shift on AWS is is relatively new from IBM. So could you explain what is open shift on AWS? And how does that differ from the open shift that people may be already familiar with? >>Well, the Colonel, if you will, is the same. It's the same sort of central open source software, but in working closely with AWS were now making those things available a simple services that you can quickly provisioned and run, and that makes it really easy for people to get started. But again, sort of carrying forward that same sort of skill set. So that's kind of a key way in which we see that you can gain that sort of consistency, you know, no matter where you're running that workflow and we've been investing in that integration, working closely with them Amazon, >>right? And we all know red hats, commitment, thio, open source software and the open ecosystems. Red hat is rightly famous for it, and I I am old enough to remember when it was a brand new thing, particularly in enterprise. Thio allow open source toe to come in and have anything to do with workloads. And now it's It's ALS, the rage, and people are running quite critical workloads on it. So what are you seeing in the adoption within the enterprise off open software? >>The adoption is massive, I think. Well, first, let me describe what's driving it. I mean, people want to tap into innovation and the beauty of open source is your your kind of crowd sourcing, if you will, this massive community of developers that are creating just an incredible amount of innovation and incredible speed, and it's a great way to ensure that you avoid vendor lock in. So enterprises of all types are looking to open solutions as a way both of innovating faster and getting protection. And that commitment is something certainly redheaded tapped into its behind the great success of Red Hat. And it's something that, frankly, is permeating throughout IBM and that we're very committed to driving this sort of open approach. And that means that you know, we need to ensure that people get access to the innovation they need, run it where they want and ensure that they feel that they have choice >>on the choice. I think is a key part of it that isn't really coming through in some of the narrative that there's a lot of discussion about how you should actually, should you go cloud. I remember when it was. Either you should stay on site or should you go, Go to Cloud and we had a long discussion there. Hybrid Cloud really does seem to have come of age where it's it's a a realistic kind of compromise, probably the wrong word, but it's it's a trade off between doing all of one thing or all another. And for most enterprises, that doesn't actually seem to be the choice that that's actually viable for them. So hybrid seems like it's actually just the practical approach. Would that be accurate? >>Well, our studies have shown that if you look statistically at the set of work, oh, that's moved to clouds, you know, something like 20% of workloads have only moved to cloud, meaning the other 80% is experiencing barriers to move >>and some >>of those barriers is figuring out what to do with all this data that's sitting on Prem or, you know, these these applications that have years and years of intelligence baked into them that cannot easily be ported. And so organizations looking to hybrid approaches because they give them more choice. It helps them deal with fragmentation, meaning as I move more workload, I have consistent skill set. It helps me extend my existing investments and bring it into the cloud world. And all those things again are done with consistent security. That's really important, right? Organizations need to make sure they're protecting their assets. Their data throughout, you know, leveraging a consistent platform. So that's really the benefit of the hybrid approach. It essentially is going to enable these organizations unlocked more workload and gain the acceleration and the transformative, effective clouds. And that's why I think they're really That's why it's becoming a necessity, right, because they just can't get that 80% to move. Yah, >>Yeah, I've long said that the cloud is a state of mind rather than a particular location. It's It's more about an operational model of how you do things, so hearing that we've only got 20% of workloads have moved to this new way of doing things does rather suggest that there's a lot more work to be done. What for? Those organizations that are just looking to do this now they've they've done a bit of it and they're looking for those next new workloads. Where do you see customers struggling the most? And where do you think that IBM can help them there? >>Well, um, boy, where they struggling the most? First, I think skills. I mean, they have to figure out a new set of technologies to go and transition from the old World to the new. And at the heart of that is lots of really critical debate. Like, how do they modernize the way that they do software delivery for many enterprises, right. Embrace new ways of doing software delivery. How do they deal with the data issues that arise from where the data sets their obligations for data protection? Um, what happened to the data spans multiple different places, but you have to provide high quality performance and security thes air, all parts of issues that you know, spanned different environments. And so they have to figure out how to manage those kinds of things and make it work in one place. I think the benefit of partnering, you know, with Amazon is clearly there's a huge, you know, customer base. That's interesting. Amazon. I think the benefit of the idea and partnership is you know, we can help to go and unlock some of those new workloads and find ways to get that cloud benefit and help to move them to the cloud faster again with that consistency of experience. And that's why I think it's a good match partnership. We're giving more customers choice. We're helping them to unlock innovation substantially, faster, >>right? And so, for people who might want to just get started without how would they approach this? Do you think people might have some experience with AWS? It's It's almost difficult not to these days, but for those who aren't familiar with the red hat on a W s with open shift on AWS, how would they get started with you? Thio to explore what's possible? >>Well, one of the things that we're offering to our clients is a service that we refer to his I. D. Um garage Z you know, an engagement model, if you will, within IBM, where we work with our clients and we really help them to do co creation. So help to understand their business problem. Or, you know, the target state of where they want their I t to get to. And in working with them in co creation, you know, we help them to affect that transition. Let's say that it's about, you know, delivering business applications faster. Let's say it's about modernizing the applications they have or offering new services new business models again, all in the spirit of co creation. And we found that to be really popular. Um, it's a great way to get started. We we leverage design thinking approach. They can think about the customer experience and their outcome. If they're creating new business, processes, new applications and then really help them toe uplift their skills and, you know, get ready. Thio adopt cloud technology and everything that they dio. >>It sounds like this is, ah, lot of established workloads that people already have in their organizations. It's already there. It's generating real money. It's It's not those experimental workloads that we saw early on which was a well, let's try. This cloud is a fabulous way where we can run some experiments, and if it doesn't work, we just turn it off again. These sound like a lot more workloads, air kind of more important to the business. Is that be true? >>Yeah, I think that's true now. I wouldn't say they're just existing work clothes, because I think there's lots of new business innovation that many of our, you know, clients want to go on launch. And so this gives them an opportunity to do that new innovation but not forget the past, meaning they could bring it forward and bring it forward into an integrated experience. I mean, that's what everyone demands of a true digital business, right? They expect that your experience is integrated, that it's responsive that it's targeted and personalized, and the only way to do that is to allow for experimentation that integrates in with the, you know, standard business processes and things that you did before. And so you need to be able to connect those things together seamlessly, >>right? So it sounds like it's it's a transition more than creating new thing completely from scratch. It's well Look, we've done a lot of innovation over the past decade or so in cloud. We know what works, but we still have workloads that people clearly no one value. How do we put those things together and do it in such a way that we maintain the flexibility to be able to make new changes as we as we learn new things? >>Yeah, leverage what you've got. Play to your strength. I mean, that's that's how you create speed. If you have to reinvent the wheel every time, it's going to be a slow roll. >>Yeah, that does seem like an area where an organization, probably at this point should be looking to partner with other people who have done the hard yards. They've They've already figured this out. What, as you say, Why can't make all of these obvious areas yourself when you're you're starting from scratch? When there's a wealth of experience out there, and particularly this whole ecosystem that exists around around open software? Uh, in fact, maybe you could tell us a little bit about the ecosystem opportunities that are there because red, that's been part of this for a very long time. AWS has a very broad ecosystem is we're all familiar with being here. It reinvent yet again. How does that ecosystem claim toe? What's possible? >>I well, let me explain why I think IBM brings a different dimension to that trio, right? IBM brings the industry expertise. I mean, we've long worked with all of our clients are partners on solving some of the biggest business problems and being embedded in the thing that they do. So we have deep knowledge of their enterprise challenges where they're trying to take them. Deep knowledge of their business processes were ableto bring that that industry know how mixed with, you know, red hats approach to an open, foundational platform coupled with, you know, the great infrastructure you could get from Amazon. And, you know, that's a great sort of powerful combination that we can bring to each of our clients and, you know, maybe just to bring it back a little bit to that idea of Okay, so what's the rolling cloud packs in that? I mean, compact are the kind of software that we've built to enable enterprises to run their essential business processes right in the essential digital operations that they run everything from security to protecting their data or giving them powerful data tools to implement a I and, you know, to implement ai algorithms in the heart of their business or giving them powerful automation capabilities so they can digitize their operations and also make sure those things were going to run effectively. It's those kinds of capabilities that we're bringing in the form of cloud PACs. Think of that is that that substrate that runs a digital business that now could be brought through right running on AWS infrastructure. Good. It's integration that we've done >>right. So basically taking things that as a pre package module that we can just grab that module, drop it in and and start using it rather than having to build it ourselves from scratch. >>That's right. They make them leverage of those powerful capabilities and get focused on innovating the things that matter. Right? So the huge accelerant to getting business value. >>And it does sound a lot easier than trying to learn how to do the complex sort of deep learning and linear algorithms that they're involved in machine learning. I have looked into it a bit and trying to manage that sort of deep maths, and I think I'd much rather just just grab one off the shelf, plug it in and just use it. >>Yeah, It's also better than writing assembler code, which was some of my first programming experiences as well. So I think the software industry has moved on just a little bit since then. >>I think we have to say I do not miss the days of handwriting. Assemble at all, uh, sometimes for nostalgia reasons. But if we want to get things done, I think I'd much rather work in something a little higher level >>specific drinking. >>So thank you so much for my for my guest there. Mike Gill. Fix chief product officer for IBM Cloud PACs from IBM. This has been the cubes coverage off AWS reinvent 2020 and the a p m. Partner experience. I've been your host, Justin Warren. Make sure you come back and join us for more coverage later on