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Patients seem how to buy cialis in usa to like the convenience of telehealth, as well as the ability to remain safe Learn More from erectile dysfunction treatment transmission â especially before the treatment rollout in the United States. But a new study published in the Journal of Medical Internet Research also shows that patient satisfaction with their virtual engagement with clinicians is also comparable to in-person care. "Our study how to buy cialis in usa found that virtual visits facilitate healthcare access and relationship-building, contributing to satisfying relationship-centered care, a crucial aspect of contemporary patient experiences," wrote researchers. WHY IT MATTERS The study, led by researchers from the Cleveland Clinic, surveyed 426 adult patients with a virtual visit between June and July 2017 â notably, before the erectile dysfunction treatment cialis more broadly normalized telemedicine.

The average overall satisfaction score was how to buy cialis in usa 4.4 out of 5, with about 82% of respondents saying their virtual visit was as good as an in-person visit with a clinician. In fact, more than half of the respondents agreed that their virtual visit was better than an in-person one. When it came to engagement how to buy cialis in usa specifically, the vast majority of patients (nearly 93%) said their virtual visit clinician was interested in them as a person. About 95% said they had made a plan of action together with their provider to resolve their health concerns.

"Our study suggests that it is possible to measure the patient-clinician engagement and begin to evaluate empathy and collaborative relationships with patients during a virtual visit," wrote researchers.In terms of technology, 92.7% of patients found the interface easy to use and 94.8% felt comfortable using it.However, how to buy cialis in usa technical difficulties were associated with lower odds of overall satisfaction, and 14% of respondents recommended that patients be given more information before their virtual visits to know what to expect and how to prepare for their appointment.The results of the JMIR study echo another recent survey, conducted by the telehealth vendor Cronofy, that found that 83% of patients rated their remote healthcare experience as positive. And despite reports showing telehealth use is beginning to taper, 87% of respondents in that survey said they expected to use telehealth the same amount or more in the future. THE how to buy cialis in usa LARGER TREND Although patient satisfaction is certainly important, patient access will also be a priority for telehealth's future. Advocates have repeatedly pointed to the prospect of the "telehealth cliff," which patients and providers will face without congressional action to safeguard cialis-era flexibilities.But even with telemedicine-friendly policies in place, some lawmakers and researchers have flagged the danger of virtual care widening the "digital divide," particularly in regions without access to broadband.

ON THE RECORD "Even during a single virtual visit, we found that patients and clinicians could meaningfully engage in relationship-building practices," wrote the Cleveland Clinic researchers in their JMIR study."Strategies to prepare established patients for virtual visits with their clinicians may how to buy cialis in usa ease the transition from in-person care to virtual care, resulting in better experiences for both." Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.A large-scale study recently published in The Journal of Climate Change and Health found that an increase in telehealth use in the Pacific Northwest corresponded to a dramatic decrease in transportation-related greenhouse gas emissions.The study â a collaboration among researchers from Northwest Permanente, Brigham and Women's Hospital and Harvard Medical School â examined six years of outpatient care at Kaiser Permanente Northwest, which serves more than 600,000 people how to buy cialis in usa in Oregon and Washington. "Prior to the cialis, despite rising total visit volume, transportation-associated emissions were already declining due to a greater proportion of telehealth visits," observed the researchers.

WHY IT MATTERS As the study notes, the healthcare sector how to buy cialis in usa is a "significant source" of greenhouse gas emissions. From 2010 to 2018, emissions from the U.S. Healthcare industry increased by 6 percent.Although many of those emissions arise directly from facilities or indirectly from the supply chain, researchers note that patient transportation to how to buy cialis in usa clinics also plays a role in healthcare's carbon footprint. "To date, there are no large-scale studies of emissions reductions due to telehealth across an entire ambulatory system of a regional healthcare system in the United States, nor any studies showing the impact of erectile dysfunction treatment on healthcare-associated [greenhouse gas] emissions as a result of rapid telehealth adoption," they explained.

Team members looked back at the total number of in-person and telehealth visits from 2015 through 2020 how to buy cialis in usa. They calculated the average distance between patients' home addresses and their assigned primary care clinics, and used Oregon Department of Transportation data about how individuals run errands to estimate what percentage of in-person trips were taken by car. They also assumed that telehealth visits replaced in-person visits on a 1:1 ratio (which may not be true, as other studies about downstream how to buy cialis in usa care have shown). Overall, in-person outpatient visits had increased at 1.5% per year through 2019 â but declined by 46.2% in 2020.

Meanwhile, telehealth visits â which had already how to buy cialis in usa been increasing â jumped in 2020 by 108.5%. Researchers calculated that greenhouse gas emissions from patient travel due to transportation for primary care, specialty care and mental health visits fell from 19,659 tons CO2-eq in 2019 to 10,537 tons CO2-eq in 2020. "This reduction is primarily due to increased use of telehealth services as opposed to a decline in total annual visits during the cialis and is evidenced by the total number of visits in 2020 being greater than prior years how to buy cialis in usa that had much larger total emissions," said researchers. "Nor is this reduction attributable to changes in fuel efficiency or transportation mode share over time, which are likely minimal on this time scale and were not modeled in this analysis," they added.

The researchers argue that reductions in transportation-related greenhouse how to buy cialis in usa gas emissions "greatly eclipse" smaller increases associated with the use of computer equipment. The study has limitations. In addition to the 1:1 assumption mentioned above, researchers also pointed out that how to buy cialis in usa some visits would not have been conducted at a primary care clinic. In addition, they acknowledge that the Oregon DOT estimates may not represent medical appointment visits accurately.

Still, "our study likely underestimates emissions reductions how to buy cialis in usa as we did not account for decreased commuting by healthcare providers conducting telehealth visits from home," the researchers wrote. "Furthermore, the environmental benefit of telehealth may not be limited to reductions in transportation-associated emissions if increased virtual care permits healthcare systems to care for more patients without increasing outpatient clinic space," they added. THE LARGER TREND Given the effect of climate change on the environment â and, in turn, on wellness, how to buy cialis in usa particularly for already vulnerable communities â many healthcare experts have called for action, with some noting the role that digital tools can play. In addition to preventative measures such as those outlined in the study, digital health tools may also help in the shorter term with regard to the consequences of climate change.

When a winter storm tore through the southern United States earlier this year, for example, clinicians were able to keep seeing patients from their own homes."If there are natural disasters, which we're seeing more and more of, because of global warming, we're hoping we'll be able to continue to provide care [via telehealth] through more weather events â like the how to buy cialis in usa freeze, like the hurricanes, and things of that nature," said William Kiefer, CEO of Chambers Health, a community-based system in Texas, in March. ON THE RECORD "If the U.S. Healthcare system were to maintain or expand upon current levels of telehealth utilization, additional reductions in [greenhouse gas] emissions would potentially be achieved through impacts on practice design," said how to buy cialis in usa researchers in the new study. "Ambulatory visit carbon intensity would be an effective way to measure these changes." Kat Jercich is senior editor of Healthcare IT News.Twitter.

@kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.Low-code tools have come a long way in recent years, making software development faster, cheaper and more accessible to innovators without traditional programming backgrounds.These tools are now capable of quickly delivering customized, scalable, highly secure, cloud-based solutions, supporting rapid iterative design and development. Some can exchange data with other applications via pre-built application program interfaces or modern data exchange standards like JSON or XML as used by the HL7 FHIR standard.In 2019, a report by IT research firm Gartner predicted by 2024 more than 65 percent of application development activity will be low-code."Low-code platforms are a bit of a misnomer in some cases," explained Scott Love, CEO of Codence, who is scheduled to speak on the topic in August at HIMSS21. "A platform like Claris FileMaker, for example, is capable of deeply complex business logic, functioning across various operating systems and devices, and integrating with web and other technologies," he said.He pointed out that for the healthcare industry, privacy is always a concern.

It's important to make certain you understand the capabilities of security and encryption with whichever platform you choose.Love said the other thing to recognize is that low-code platforms are really just tools â not products."They allow you, sort of like working with a spreadsheet, to create what you need," he said. "While you're not building software from scratch â you're using the building blocks the platform provides â they're capable of an almost infinite array of features and uses. This is custom software at its best."If you use low-code platforms well, they are all about innovation and creative problem solving. That's the whole point," he added.

"There's only so much an individual can do with their own word or spreadsheet documents. Likewise, you won't be able to solve problems in an agile way with a large enterprise-level commercial platform."Love explained that low-code sits in the middle. Apps are built for teams, often by the team itself."Rather than treat technology as driven from a central IT command-and-control, you move the invention of new solutions into the hands of the people actually doing the work," he said. "This process can radically transform a business."Scott Love will share more at HIMSS21 in his session, "Low-Code Powers Innovation.

What You Need to Know." It's scheduled for Wednesday, August 11, from 11:30 a.m.-12:30 p.m. In Caesar's Alliance 315. Nathan Eddy is a healthcare and technology freelancer based in Berlin.Email the writer. Nathaneddy@gmail.comTwitter.

@dropdeaded209Hundreds of medical and social-services organizations have advocated for the passage of the Social Determinants Accelerator Act of 2021, a bipartisan House bill that would establish an interagency council on SDOH, among other provisions. As outlined in a letter sent this week by the Aligning for Health association to members of the House Energy and Commerce Committee, the legislation would empower communities across the country to share data across sectors, foster partnerships, make use of available resources and coordinate care â all with the aim of improving outcomes."Taken together, these elements will address the complexity that often stymies innovative cross-sector efforts or limits the scope and scalability of initiatives at the state and local level," read the letter. WHY IT MATTERS As Aligning for Health pointed out, health and wellness are affected by more than medical care alone. Factors such as housing, transportation, pollution and access to healthy food can all contribute to health outcomes."These challenges have only become more serious in the wake of the erectile dysfunction treatment cialis, which disproportionately impacted vulnerable and underserved communities," noted the Aligning for Health letter.

To begin addressing those needs, HR 2503 would. Provide planning grants and targeted technical assistance to communities to develop and design innovative, evidence-based approaches to coordinate health and social services.Encourage improvements in cross-sector information exchange, allowing for greater coordination and accountability.Create a federal inter-agency technical advisory council to identify key learnings and best practices, and to facilitate a national dialogue around barriers to success. Rep. Cheri Bustos, D-Ill., who introduced the act, took to the House floor last week to encourage her colleagues to join the 35 members of Congress who have cosponsored the bill.

The act, she said, is intended "to empower our local communities to address the day-to-day factors that affect their lives."Aligning for Health â itself composed of multiple healthcare member organizations â enclosed a list of groups supporting the bill, including the American Medical Association, the American Hospital Association, eHealth Initiative, Uber Health, Aunt Bertha and the Blue Cross Blue Shield Association. "We believe that the Social Determinants Accelerator Act of 2021 is a critical step to overcome ... Challenges and move the ball forward," wrote Aligning for Health in its letter. THE LARGER TREND Perhaps energized in part by the erectile dysfunction treatment crisis, many elected officials have pushed forward policies aimed at addressing social determinants of health.

In February, a bipartisan group of senators introduced the LINC to Address Social Needs Act, with the goal of building more robust technology networks for statewide and regional collaboration. That bill is currently in committee. Meanwhile, President Joe Biden has also signaled his support for SDOH-focused digital health initiatives. His health IT wish list in April included millions of dollars allocated toward the Centers for Disease Control and Prevention's Social Determinants of Health Program.ON THE RECORD The bill, wrote Aligning for Health in its letter, "will provide state, local and tribal governments with additional capacity and support to incubate innovative strategies â and the entire nation will benefit from the results of their effort." Kat Jercich is senior editor of Healthcare IT News.Twitter.

@kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.Abu Dhabiâs Department of Health (DoH) has partnered with Israelâs Clalit Health Services, the largest of the countryâs four state-mandated health service organisations, it has been announced. This comes as part of both partiesâ strategies to increase cooperation and the exchange of information between the healthcare sectors of the United Arab Emirates (UAE) and Israel.According to a statement released by the DoH, the Memorandum of Understanding (MoU) âwill form the basis for a definitive medical cooperation between the parties to support and strengthen the implementation of various plans â including, but not limited to â digital health initiatives related to artificial intelligence, visiting doctorsâ programme, professional education, international patient care referrals, research, and clinical trials.âTHE LARGER CONTEXTWith the UAE capitalâs mission to become a leading life science hub and medical tourism destination, it is believed that this partnership will facilitate expertise transfer to UAE medical specialists through both a Visiting Doctor Programme and telemedicine sessions.Additionally, the agreement will allow for the identification of new research products as well as participation and/or contribution to medical trials.âWe are strong believers in the importance of establishing robust partnerships with world-class healthcare institutions in a bid to strengthen Abu Dhabiâs healthcare sector. With the visionary drive of our leadership and the signing of Abraham Accords, this is becoming a reality,â said Sheikh Abdullah bin Mohammed Al Hamed, Chairman of DoH.

ÂPursuing partnerships with Israelâs advanced and high-quality healthcare institutions like Clalit Health Services not only allows us to improve healthcare outputs, research and digital initiatives but establish a strong platform for meaningful bilateral exchange of ideas, innovation and economic growth for both ecosystems.âHe added. ÂWith the largest human genomic sequencing programme globally and one of the most comprehensive health information exchanges world-wide, Abu Dhabi has provided an attractive environment for international investors and entrepreneurs and interested in the future of health. Establishing itself as a global leading hub for startups and leaders in technology, innovation and life science. ÂAs digital health and genomics are becoming key elements in healthcare, we remain committed to implementing cutting-edge initiatives, partnerships and programmes that will undoubtedly accelerate the sectorâs potential and improve its outcomes.âON THE RECORDâIâm proud to lead the cooperation with the UAE, and to sign the first agreement of its kind, for promoting the health of our nations,â said Ehud Davidson, CEO at Clalit Health Services.

ÂOver the past year, ever since the signing of the Abraham Accords for normalisation between Israel and the UAE, we initiated and conducted a dialogue from afar for promoting health and medicine. ÂIâm pleased that the agreement includes the fields of research and digital health, based on Clalitâs huge databases, and Clalitâs experience in translating the data for the purpose of research and innovation.â.

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Promoting Resilience and Mental Health Among Health Professional Workforce - Approximately 10 awards will be made totaling approximately $29 million over three years to health care organizations how do you spell cialis to support members of their workforce. This includes establishing, enhancing, or expanding evidence-informed programs or protocols to adopt, promote and implement an organizational culture of wellness that includes resilience and mental health among their employees. Health and Public Safety Workforce Resiliency how do you spell cialis Training Program - Approximately 30 awards will be made totaling approximately $68 million over three years for educational institutions and other appropriate state, local, Tribal, public or private nonprofit entities training those early in their health careers. This includes providing evidence-informed planning, development and training in health profession activities in order to reduce burnout, suicide and promote resiliency among the workforce.

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Today, the how to buy cialis in usa Lowest price kamagra U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of an estimated $103 million in American Rescue Plan funding over a three-year period to reduce burnout and promote mental health among the health workforce. These investments, which take into particular consideration the needs of rural and medically underserved communities, will help health care organizations establish a culture of wellness among the health and how to buy cialis in usa public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.âThe Biden-Harris Administration is committed to ensuring our frontline health care workers have access to the services they need to limit and prevent burnout, fatigue and stress during the erectile dysfunction treatment cialis and beyond,â said HHS Secretary Xavier Becerra.

ÂIt is essential that we provide behavioral health resources for our health care providers â from paraprofessionals to public safety officers â so that they can continue to deliver quality care to our most vulnerable communities.â Health care providers face many challenges and stresses due to high patient volumes, long work hours and workplace demands. These challenges were how to buy cialis in usa amplified by the erectile dysfunction treatment cialis, and have had a disproportionate impact on communities of color and in rural communities. The programs announced today will support the implementation of evidence-informed strategies to help organizations and providers respond to stressful situations, endure hardships, avoid burnout and foster healthy workplace environments that promote mental health and resiliency.

ÂThis funding will help advance HRSAâs mission of developing a health care workforce capable of meeting the how to buy cialis in usa critical needs of underserved populations,â said Acting HRSA Administrator Diana Espinosa. ÂThese programs will help to combat occupational stress and depression among our health care workers as they continue their heroic work to defeat the cialis.â There are three funding opportunities that are now accepting applications. Promoting Resilience and Mental Health Among Health Professional Workforce - Approximately 10 awards will be made totaling approximately $29 million over three years to health care organizations to support how to buy cialis in usa members of their workforce.

This includes establishing, enhancing, or expanding evidence-informed programs or protocols to adopt, promote and implement an organizational culture of wellness that includes resilience and mental health among their employees. Health and Public Safety Workforce Resiliency Training how to buy cialis in usa Program - Approximately 30 awards will be made totaling approximately $68 million over three years for educational institutions and other appropriate state, local, Tribal, public or private nonprofit entities training those early in their health careers. This includes providing evidence-informed planning, development and training in health profession activities in order to reduce burnout, suicide and promote resiliency among the workforce.

Health and Public Safety Workforce Resiliency Technical Assistance Center - One award how to buy cialis in usa will be made for approximately $6 million over three years to provide tailored training and technical assistance to HRSA's workforce resiliency programs.To apply for the Provider Resiliency Workforce Training Notice of Funding Opportunities, visit Grants.gov. Applications are due August 30, 2021. Learn more about HRSAâs funding opportunities..

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Cialis may also interact with the following medications:

certain drugs for high blood pressure
certain drugs for the treatment of HIV or AIDS
certain drugs used for fungal or yeast s, like fluconazole, itraconazole, ketoconazole, and voriconazole
certain drugs used for seizures like carbamazepine, phenytoin, and phenobarbital
grapefruit juice
macrolide antibiotics like clarithromycin, erythromycin, troleandomycin
medicines for prostate problems
rifabutin, rifampin or rifapentine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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Section 3506(c)(2)(A) of the PRA (44 U.S.C cialis 30mg http://freeonlinepoker.org.uk/review/betfred-poker/. 3506(c)(2)(A)) requires federal agencies to publish a 30-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice that summarizes the following proposed collection(s) of information for public comment.

1. Type of Information Collection Request. Revision of a currently approved collection.

Title of Information Collection. Outcome and Assessment Information Set (OASIS) OASIS-D. Use.

Due to the erectile dysfunction treatment related Public Health Emergency, the next version of the Outcome and Assessment Information Set (OASIS), version E planned for implementation January 1, 2021, was delayed. This request is for the Office of Management and Budget (OMB) approval to extend the current OASIS-D expiration date in order for home health agencies to continue data collection required for participation in the Medicare program. The current version of the OASIS-D, data item set was approved by OMB on December 6, 2018 and implemented on January 1, 2019.

This request includes updated calculations using 2020 data for Start Printed Page 40846wages, number of home health agencies and number of OASIS assessments at each time point. Form Number. CMS-10545 (OMB control number.

Affected Public. Private Sector (Business or other for-profit and Not-for-profit institutions). Number of Respondents.

Total Annual Hours. 9,893,376. (For policy questions regarding this collection contact Joan Proctor at 410-786-0949).

2. Type of Information Collection Request. Extension of currently approved cost of cialis 5mg collection.

Title of Information Collection. Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and CLIA Exemption Under State Laboratory Programs. Use.

The information required is necessary to determine whether a private accreditation organization/State licensure program standards and accreditation/licensure process is at least equal to or more stringent than those of the Clinical Laboratory Improvement Amendments of 1988 (CLIA). If an accreditation organization is approved, the laboratories that it accredits are âdeemedâ to meet the CLIA requirements based on this accreditation. Similarly, if a State licensure program is determined to have requirements that are equal to or more stringent than those of CLIA, its laboratories are considered to be exempt from CLIA certification and requirements.

The information collected will be used by HHS to. Determine comparability/equivalency of the accreditation organization standards and policies or State licensure program standards and policies to those of the CLIA program. To ensure the continued comparability/equivalency of the standards.

And to fulfill certain statutory reporting requirements. Form Number. CMS-R-185 (OMB control number.

Affected Public. Private SectorâBusiness or other for-profits and Not-for-profit institutions. Number of Respondents.

Total Annual Hours. 5,464. (For policy questions regarding this collection contact Arlene Lopez at 410-786-6782.) Start Signature Dated.

July 26, 2021. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs.

End Signature End Supplemental Information [FR Doc. 2021-16205 Filed 7-28-21.

Although we how to buy cialis in usa make a concerted effort to reproduce the original document in full on our Public Inspection pages, in some cases graphics may not be displayed, and non-substantive markup https://highlandgreenapartments.com/rental-application/ language may appear alongside substantive text. If you are using public inspection listings for legal research, you should verify the contents of documents against a final, official edition of the Federal Register. Only official editions of the Federal Register provide legal notice to the public and judicial notice to the courts under 44 U.S.C.

1503 & how to buy cialis in usa. 1507. Learn more here.Start Preamble Centers for Medicare &.

Medicaid Services, how to buy cialis in usa Health and Human Services (HHS). Notice. The Centers for Medicare &.

Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention how to buy cialis in usa to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.

Comments on the collection(s) of information must be received by the OMB desk how to buy cialis in usa officer by August 30, 2021. Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to www.reginfo.gov/âpublic/âdo/âPRAMain.. Find this particular information collection by selecting âCurrently under 30-day ReviewâOpen for Public Commentsâ or by using the search function.

To obtain copies of a supporting statement how to buy cialis in usa and any related forms for the proposed collection(s) summarized in this notice, you may make your request using one of following. 1. Access CMS' website address at website address at.

Https://www.cms.gov/âRegulations-and-Guidance/âLegislation/âPaperworkReductionActof1995/âPRA-Listing.html Start Further Info William Parham how to buy cialis in usa at (410) 786-4669. End Further Info End Preamble Start Supplemental Information Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor.

The term âcollection of informationâ is how to buy cialis in usa defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C.

3506(c)(2)(A)) requires federal agencies to publish a 30-day notice in the how to buy cialis in usa Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice that summarizes the following proposed collection(s) of information for public comment. 1.

Type of how to buy cialis in usa Information Collection Request. Revision of a currently approved collection. Title of Information Collection.

Outcome and Assessment Information Set (OASIS) OASIS-D. Use. Due to the erectile dysfunction treatment related Public Health Emergency, the next version of the Outcome and Assessment Information Set (OASIS), version E planned for implementation January 1, 2021, was delayed.

This request is for the Office of Management and Budget (OMB) approval to extend the current OASIS-D expiration date in order for home health agencies to continue data collection required for participation in the Medicare program. The current version of the OASIS-D, data item set was approved by OMB on December 6, 2018 and implemented on January 1, 2019. This request includes updated calculations using 2020 data for Start Printed Page 40846wages, number of home health agencies and number of OASIS assessments at each time point.

Form Number. CMS-10545 (OMB control number. 0938-1279).

Private Sector (Business or other for-profit and Not-for-profit institutions). Number of Respondents. 11,400.

Total Annual Responses. 17,932,166. Total Annual Hours.

9,893,376. (For policy questions regarding this collection contact Joan Proctor at 410-786-0949). 2.

Type of Information Collection Request. Extension of currently approved collection. Title of Information Collection.

Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and CLIA Exemption Under State Laboratory Programs. Use. The information required is necessary to determine whether a private accreditation organization/State licensure program standards and accreditation/licensure process is at least equal to or more stringent than those of the Clinical Laboratory Improvement Amendments of 1988 (CLIA).

If an accreditation organization is approved, the laboratories that it accredits are âdeemedâ to meet the CLIA requirements based on this accreditation. Similarly, if a State licensure program is determined to have requirements that are equal to or more stringent than those of CLIA, its laboratories are considered to be exempt from CLIA certification and requirements.

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Dear Reader, Thank you for what is better cialis or viagra following the Me&MyDoctor blog. I'm writing to let you know we are moving the public health stories authored by Texas physicians, residents, and medical students, and patients to the Texas Medical Association's social media channels. Be sure to follow us on all our social media accounts (Facebook, Twitter, Instagram) as well as Texas Medicine Today to access what is better cialis or viagra these stories and more. We look forward to seeing you there.Best, Olivia Suarez Me&My Doctor EditorSravya Reddy, MDPediatric Resident at The University of Texas at Austin Dell Medical SchoolMember, Texas Medical AssociationHow does the erectile dysfunction treatment cialis factor into potentially abusive situations?. To stop the spread of erectile dysfunction treatment, we have isolated ourselves into small family units to avoid catching and transmitting the cialis.

While saving so many from succumbing to a severe illness, socially isolating what is better cialis or viagra has unfortunately posed its own problems. Among those is the increased threat of harm from intimate partner violence, which includes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. Potential child abuse is an increased threat as well. The impact of this cialis happened so rapidly that society did not have time to think about all the consequences of social isolation before implementing it what is better cialis or viagra. Now those consequences are becoming clear.Social isolation due to the cialis is forcing victims to stay home indefinitely with their abusers.

Children and adolescents also have been forced to stay at home since many school districts have made education virtual to keep everyone safe from the cialis. Caregivers are also home because they are working remotely or because what is better cialis or viagra they are unemployed. With the increase in the number of erectile dysfunction treatment cases, financial strain due to the economic downturn, and concerns of contracting the cialis and potentially spreading it to family members, these are highly stressful times. Stress leads to an increase in the rate of intimate partner violence. Even those who suffer from what is better cialis or viagra it can begin to become abusive to other household members, thus amplifying the abuse in the household.

Some abuse may go unrecognized by the victims themselves. For example, one important and less well-known type of what is better cialis or viagra abuse is coercive control. Itâs the type of abuse that doesnât leave a physical mark, but itâs emotional, verbal, and controlling. Victims often know that something is wrong â but canât quite identify what it is. Coercive control can still lead to violent physical abuse, and murder what is better cialis or viagra.

The way in which people report abuse has also been altered by the cialis.People lacking usual in-person contacts (with teachers, co-workers, or doctors) and the fact that some types of coercive abuse are less recognized lead to fewer people reporting that type of abuse. Child abuse often is discovered during pediatriciansâ well-child visits, but the cialis has limited those visits. Many teachers, who might also notice signs of what is better cialis or viagra abuse, also are not able to see their students on a daily basis. Some abuse victims visit emergency departments (EDs) in normal times, but ED visits are also down due to erectile dysfunction treatment.Local police in China report that intimate partner violence has tripled in the Hubei province. The United Nations reports it also increased 30% in France as of March 2020 and increased 25% in Argentina.

In the what is better cialis or viagra U.S. The conversation about increased intimate partner violence during these times has just now started, and we are beginning to gather data. Preliminary analysis shows police reports of intimate partner violence have increased by 18% to 27% across several U.S. Cities. Individuals affected by addiction have additional stressors and cannot meet with support groups.

Children and adolescents who might otherwise use school as a form of escape from addicted caregivers are no longer able to do so. Financial distress can also play a factor. According to research, the rate of violence among couples with more financial struggles is nearly three and a half times higher than couples with fewer financial concerns.Abuse also can come from siblings. Any child or adolescent with preexisting behavioral issues is more likely to act out due to seclusion, decreased physical activity, or fewer positive distractions. This could increase risk for others in the household, especially in foster home situations.

These other residents might be subject to increased sexual and physical abuse with fewer easy ways to report it. What can we do about this while abiding by the rules of the cialis?. How can physicians help?. Patients who are victims of intimate partner violence are encouraged to reach out to their doctor. A doctor visit may be either in person or virtual due to the safety precautions many doctorsâ offices are enforcing due to erectile dysfunction treatment.

During telehealth visits, physicians should always ask standard questions to screen for potential abuse. They can offer information to all patients, regardless of whether they suspect abuse.People could receive more support if we were to expand access to virtual addiction counseling, increase abuse counseling, and launch more campaigns against intimate partner violence. The best solution might involve a multidisciplinary team, including psychiatrists, social workers, child abuse teams and Child Protective Services, and local school boards. Physicians can help in other ways, too. Doctors can focus on assessing mental health during well-child and acute clinic visits and telehealth visits.

A temporary screening tool for behavioral health during the cialis might be beneficial. Governments could consider allocating resources to telepsychiatry. Many paths can be taken to reduce the burden of mental health issues, and this is an ongoing discussion. How should physicians approach patients who have or may have experienced intimate partner violence?. Victims of domestic assault can always turn to their physician for guidance on next steps.

In response, doctors can:Learn about local resources and have those resources available to your patients;Review safety practices, such as deleting internet browsing history or text messages. Saving abuse hotline information under other listings, such as a grocery store or pharmacy listing. And creating a new, confidential email account for receiving information about resources or communicating with physicians.If the patient discloses abuse, the clinician and patient can establish signals to identify the presence of an abusive partner during telemedicine appointments.To my fellow physicians, I suggest recognizing and talking about the issue with families.Medical professionals take certain steps if they suspect their patientâs injuries are a result of family violence, or if the patient discloses family violence. Physicians will likely screen a patient, document their conversation with the patient, and offer support and inform the patient of the health risks of staying in an abusive environment, such as severe injuries or even death. A doctorâs priority is his or her patientâs safety, regardless of why the victim might feel forced to remain in an abusive environment.

While physicians only report child and elderly abuse, they should encourage any abused patient to report her or his own case, while also understanding the complexity of the issue. Under no circumstance should any form of abuse be tolerated or suffered. Any intimate partner violence should be avoided, and reported if possible and safe. My hope is that with more awareness of this rising public health concern, potential victims can better deal with the threat of abuse during this stressful cialis â and hopefully avoid it..

Dear Reader, Thank you for cialis 50mg price following the Me&MyDoctor blog how to buy cialis in usa. I'm writing to let you know we are moving the public health stories authored by Texas physicians, residents, and medical students, and patients to the Texas Medical Association's social media channels. Be sure to follow us on how to buy cialis in usa all our social media accounts (Facebook, Twitter, Instagram) as well as Texas Medicine Today to access these stories and more.

We look forward to seeing you there.Best, Olivia Suarez Me&My Doctor EditorSravya Reddy, MDPediatric Resident at The University of Texas at Austin Dell Medical SchoolMember, Texas Medical AssociationHow does the erectile dysfunction treatment cialis factor into potentially abusive situations?. To stop the spread of erectile dysfunction treatment, we have isolated ourselves into small family units to avoid catching and transmitting the cialis. While saving so many from succumbing to a severe illness, socially isolating has unfortunately posed how to buy cialis in usa its own problems.

Among those is the increased threat of harm from intimate partner violence, which includes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. Potential child abuse is an increased threat as well. The impact of this cialis happened so rapidly that society how to buy cialis in usa did not have time to think about all the consequences of social isolation before implementing it.

Now those consequences are becoming clear.Social isolation due to the cialis is forcing victims to stay home indefinitely with their abusers. Children and adolescents also have been forced to stay at home since many school districts have made education virtual to keep everyone safe from the cialis. Caregivers are also home because how to buy cialis in usa they are working remotely or because they are unemployed.

With the increase in the number of erectile dysfunction treatment cases, financial strain due to the economic downturn, and concerns of contracting the cialis and potentially spreading it to family members, these are highly stressful times. Stress leads to an increase in the rate of intimate partner violence. Even those who suffer from it can begin to become abusive to other household members, thus amplifying the abuse in how to buy cialis in usa the household.

Some abuse may go unrecognized by the victims themselves. For example, one important and less well-known how to buy cialis in usa type of abuse is coercive control. Itâs the type of abuse that doesnât leave a physical mark, but itâs emotional, verbal, and controlling.

Victims often know that something is wrong â but canât quite identify what it is. Coercive control can still lead to violent physical how to buy cialis in usa abuse, and murder. The way in which people report abuse has also been altered by the cialis.People lacking usual in-person contacts (with teachers, co-workers, or doctors) and the fact that some types of coercive abuse are less recognized lead to fewer people reporting that type of abuse.

Child abuse often is discovered during pediatriciansâ well-child visits, but the cialis has limited those visits. Many teachers, who might how to buy cialis in usa also notice signs of abuse, also are not able to see their students on a daily basis. Some abuse victims visit emergency departments (EDs) in normal times, but ED visits are also down due to erectile dysfunction treatment.Local police in China report that intimate partner violence has tripled in the Hubei province.

The United Nations reports it also increased 30% in France as of March 2020 and increased 25% in Argentina. In the U.S how to buy cialis in usa. The conversation about increased intimate partner violence during these times has just now started, and we are beginning to gather data.

Preliminary analysis shows police reports of intimate partner violence have increased by 18% to 27% across several U.S. Cities. Individuals affected by addiction have additional stressors cialis prescription online and cannot meet with support groups.

Any child or adolescent with preexisting behavioral issues is more likely to act out due to seclusion, decreased physical activity, or fewer positive distractions. This could increase risk for others in the household, especially in foster home situations. These other residents might be subject to increased sexual and physical abuse with fewer easy ways to report it.

What can we do about this while abiding by the rules of the cialis?. How can physicians help?. Patients who are victims of intimate partner violence are encouraged to reach out to their doctor.

A doctor visit may be either in person or virtual due to the safety precautions many doctorsâ offices are enforcing due to erectile dysfunction treatment. During telehealth visits, physicians should always ask standard questions to screen for potential abuse. They can offer information to all patients, regardless of whether they suspect abuse.People could receive more support if we were to expand access to virtual addiction counseling, increase abuse counseling, and launch more campaigns against intimate partner violence.

The best solution might involve a multidisciplinary team, including psychiatrists, social workers, child abuse teams and Child Protective Services, and local school boards. Physicians can help in other ways, too. Doctors can focus on assessing mental health during well-child and acute clinic visits and telehealth visits.

How should physicians approach patients who have or may have experienced intimate partner violence?. Victims of domestic assault can always turn to their physician for guidance on next steps. In response, doctors can:Learn about local resources and have those resources available to your patients;Review safety practices, such as deleting internet browsing history or text messages.

Saving abuse hotline information under other listings, such as a grocery store or pharmacy listing. And creating a new, confidential email account for receiving information about resources or communicating with physicians.If the patient discloses abuse, the clinician and patient can establish signals to identify the presence of an abusive partner during telemedicine appointments.To my fellow physicians, I suggest recognizing and talking about the issue with families.Medical professionals take certain steps if they suspect their patientâs injuries are a result of family violence, or if the patient discloses family violence. Physicians will likely screen a patient, document their conversation with the patient, and offer support and inform the patient of the health risks of staying in an abusive environment, such as severe injuries or even death.

A doctorâs priority is his or her patientâs safety, regardless of why the victim might feel forced to remain in an abusive environment. While physicians only report child and elderly abuse, they should encourage any abused patient to report her or his own case, while also understanding the complexity of the issue. Under no circumstance should any form of abuse be tolerated or suffered.

Any intimate partner violence should be avoided, and reported if possible and safe. My hope is that with more awareness of this rising public health concern, potential victims can better deal with the threat of abuse during this stressful cialis â and hopefully avoid it..

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SALT LAKE CITY, Nov generic cialis online europe cialis best price. 10, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. (Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today reported financial results for the quarter ended September 30, 2020.âIn the third quarter of 2020, I am pleased to share that we achieved strong performance across our business, including exceeding the mid-point of our quarterly guidance for both revenue and Adjusted EBITDA,â said Dan Burton, CEO of Health Catalyst.

ÂIn addition to this financial and operational execution, we are excited to announce the promotion of Patrick Nelli, our current Chief Financial Officer, to the role President of Health Catalyst, effective January 1, 2021. Patrick's responsibilities as President will include all the major growth functions of the company, including with existing customers, new customers, international expansion, sales operations, marketing and communications. Additionally, I am pleased to announce the promotion of Bryan Hunt, our current Senior Vice President of Financial Planning &. Analysis to the role of Chief Financial Officer, effective January 1, 2021.

Patrick and Bryan, in their newly appointed roles, have my full support and confidence and the unanimous support and confidence of our board of directors. Lastly, I would also like to share two additional promotions related to these changes. Jason Alger, our Senior Vice President of Finance, has been promoted to Chief Accounting Officer, and Adam Brown, our Senior Vice President of Investor Relations, has been promoted to Senior Vice President of Investor Relations and Finance Planning &. Analysis.âFinancial Highlights for the Three Months Ended September 30, 2020 Key Financial Metrics Three Months EndedSeptember 30, Year over Year Change 2020 2019 GAAP Financial Data.

(in thousands, except percentages) Technology revenue $ 27,964 $ 21,160 32% Professional services revenue $ 19,227 $ 18,263 5% Total revenue $ 47,191 $ 39,423 20% Loss from operations $ (23,458 ) $ (20,736 ) (13)% Net loss $ (27,326 ) $ (21,416 ) (28)% Other Non-GAAP Financial Data:(1) Adjusted Technology Gross Profit $ 19,115 $ 14,484 32% Adjusted Technology Gross Margin 68 % 68 % Adjusted Professional Services Gross Profit $ 4,823 $ 6,677 (28)% Adjusted Professional Services Gross Margin 25 % 37 % Total Adjusted Gross Profit $ 23,938 $ 21,161 13% Total Adjusted Gross Margin 51 % 54 % Adjusted EBITDA $ (6,434 ) $ (8,446 ) 24% ________________________(1) These measures are not calculated in accordance with generally accepted accounting principles in the United States (GAAP). See the accompanying "Non-GAAP Financial Measures" section below for more information about these financial measures, including the limitations of such measures, and for a reconciliation of each measure to the most directly comparable measure calculated in accordance with GAAP.Financial OutlookHealth Catalyst provides forward-looking guidance on total revenue, a GAAP measure, and Adjusted EBITDA, a non-GAAP measure.For the fourth quarter of 2020, we expect:Total revenue between $50.5 million and $53.5 million, and Adjusted EBITDA between $(7.3) million and $(5.3) millionFor the full year of 2020, we expect:Total revenue between $186.1 million and $189.1 million, and Adjusted EBITDA between $(23.9) million and $(21.9) millionWe have not reconciled guidance for Adjusted EBITDA to net loss, the most directly comparable GAAP measure, and have not provided forward-looking guidance for net loss, because there are items that may impact net loss, including stock-based compensation, that are not within our control or cannot be reasonably predicted.Quarterly Conference Call DetailsThe company will host a conference call to review the results today, Tuesday, November 10, 2020 at 5:00 p.m. E.T. The conference call can be accessed by dialing 1-877-295-1104 for U.S.

Participants, or 1-470-495-9486 for international participants, and referencing participant code 7195951. A live audio webcast will be available online at https://ir.healthcatalyst.com/. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platformâpowered by data from more than 100 million patient records and encompassing trillions of factsâas well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements.

Health Catalyst envisions a future in which all healthcare decisions are data informed.Available InformationHealth Catalyst intends to use its Investor Relations website as a means of disclosing material non-public information and for complying with its disclosure obligations under Regulation FD.Forward-Looking StatementsThis release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth and our financial outlook for Q4 and fiscal year 2020. Forward-looking statements are subject to risks and uncertainties and are based on potentially inaccurate assumptions that could cause actual results to differ materially from those expected or implied by the forward-looking statements. Actual results may differ materially from the results predicted, and reported results should not be considered as an indication of future performance.Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following.

(i) changes in laws and regulations applicable to our business model. (ii) changes in market or industry conditions, regulatory environment and receptivity to our technology and services. (iii) results of litigation or a security incident. (iv) the loss of one or more key customers or partners.

(v) the impact of erectile dysfunction treatment on our business and results of operation. And (vi) changes to our abilities to recruit and retain qualified team members. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to the Annual Report on Form 10-K for the year ended December 31, 2019 filed with the SEC on February 28, 2020 and the Quarterly Report on Form 10-Q for the fiscal quarter ended September 30, 2020 expected to be filed with the SEC on or about November 10, 2020. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.

Condensed Consolidated Balance Sheets (in thousands, except share and per share data, unaudited) As ofSeptember 30, As ofDecember 31, 2020 2019 Assets Current assets. Cash and cash equivalents $ 111,239 $ 18,032 Short-term investments 163,898 210,245 Accounts receivable, net 36,339 27,570 Prepaid expenses and other assets 11,290 8,392 Total current assets 322,766 264,239 Property and equipment, net 5,319 4,295 Intangible assets, net 105,926 25,535 Operating lease right-of-use assets 25,833 3,787 Goodwill 107,822 3,694 Other assets 2,997 810 Total assets $ 570,663 $ 302,360 Liabilities and stockholdersâ equity Current liabilities. Accounts payable $ 5,189 $ 3,622 Accrued liabilities 14,061 8,944 Acquisition-related consideration payable 3,214 2,192 Deferred revenue 35,090 30,653 Operating lease liabilities 2,425 2,806 Contingent consideration liabilities 5,893 â Total current liabilities 65,872 48,217 Long-term debt, net of current portion 166,200 48,200 Acquisition-related consideration payable, net of current portion â 1,860 Deferred revenue, net of current portion 1,635 1,459 Operating lease liabilities, net of current portion 24,245 1,654 Contingent consideration liabilities, net of current portion 10,279 â Other liabilities 2,817 326 Total liabilities 271,048 101,716 Commitments and contingencies Stockholdersâ equity. Common stock, $0.001 par value.

42,239,922 and 36,678,854 shares issued and outstanding as of September 30, 2020 and December 31, 2019, respectively 42 37 Additional paid-in capital 982,139 811,049 Accumulated deficit (682,632 ) (610,514 ) Accumulated other comprehensive income 66 72 Total stockholders' equity 299,615 200,644 Total liabilities and stockholdersâ equity $ 570,663 $ 302,360 Condensed Consolidated Statements of Operations (in thousands, except per share data, unaudited) Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Revenue. Technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional services 19,227 18,263 57,416 50,047 Total revenue 47,191 39,423 135,566 111,440 Cost of revenue, excluding depreciation and amortization. Technology(1) 9,045 6,740 25,148 20,536 Professional services(1)(3) 15,307 11,892 46,401 33,132 Total cost of revenue, excluding depreciation and amortization 24,352 18,632 71,549 53,668 Operating expenses. Sales and marketing(1)(3) 14,629 14,721 40,618 35,579 Research and development(1)(3) 13,390 13,477 38,539 33,209 General and administrative(1)(2)(4)(5) 13,297 11,013 31,111 23,333 Depreciation and amortization 4,981 2,316 10,952 6,844 Total operating expenses 46,297 41,527 121,220 98,965 Loss from operations (23,458 ) (20,736 ) (57,203 ) (41,193 ) Loss on extinguishment of debt â â (8,514 ) (1,670 ) Interest and other expense, net (3,854 ) (659 ) (7,500 ) (2,924 ) Loss before income taxes (27,312 ) (21,395 ) (73,217 ) (45,787 ) Income tax provision (benefit) 14 21 (1,218 ) 43 Net loss $ (27,326 ) $ (21,416 ) $ (71,999 ) $ (45,830 ) Less.

Accretion of redeemable convertible preferred stock â 18,170 â 180,826 Net loss attributable to common stockholders $ (27,326 ) $ (39,586 ) $ (71,999 ) $ (226,656 ) Net loss per share attributable to common stockholders, basic and diluted $ (0.68 ) $ (1.40 ) $ (1.87 ) $ (17.78 ) Weighted-average shares outstanding used in calculating net loss per share attributable to common stockholders, basic and diluted 40,292 28,223 38,517 12,750 Adjusted net loss(6) $ (8,287 ) $ (9,817 ) $ (20,110 ) $ (26,014 ) Pro forma adjusted net loss per share, basic and diluted(6) $ (0.21 ) $ (0.27 ) $ (0.52 ) $ (0.72 ) Pro forma as adjusted weighted-average number of shares outstanding used in calculating Adjusted Net Loss per share, basic and diluted(6) 40,292 36,373 38,517 36,183 _______________(1) Includes stock-based compensation expense as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Stock-Based Compensation Expense. (in thousands) (in thousands) Cost of revenue, excluding depreciation and amortization. Technology $ 196 $ 64 $ 575 $ 129 Professional services 903 306 2,609 593 Sales and marketing 3,233 1,358 9,724 2,639 Research and development 2,025 3,067 5,987 3,502 General and administrative 3,139 5,179 8,388 6,165 Total $ 9,496 $ 9,974 $ 27,283 $ 13,028 (2) Includes acquisition transaction costs as follows.

Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Acquisition transaction costs. (in thousands) (in thousands) General and administrative $ 1,399 $ â $ 2,670 $ â Total $ 1,399 $ â $ 2,670 $ â (3) Includes post-acquisition restructuring costs as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Post-Acquisition Restructuring Costs. (in thousands) (in thousands) Cost of revenue, excluding depreciation and amortization.

Professional services $ â $ â $ â $ 108 Sales and marketing â â â 306 Research and development â â â 32 Total $ â $ â $ â $ 446 (4) Includes the change in fair value of contingent consideration liabilities, as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Change in fair value of contingent consideration liabilities. (in thousands) (in thousands) General and administrative $ 564 $ â $ (1,004 ) $ â Total $ 564 $ â $ (1,004 ) $ â (5) Includes duplicate headquarters rent expense, as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Duplicate Headquarters Rent Expense.

(in thousands) (in thousands) General and administrative $ 584 $ â $ 709 $ â Total $ 584 $ â $ 709 $ â (6) Includes pro forma adjustments to net loss attributable to common stockholders and the weighted average number of common shares outstanding directly attributable to the closing of our initial public offering on July 29, 2019 as well as certain other non-GAAP adjustments. Refer to the "Non-GAAP Financial MeasuresâPro Forma Adjusted Net Loss Per Share" section below for further details. Condensed Consolidated Statements of Cash Flows (in thousands, unaudited) Nine Months EndedSeptember 30, Cash flows from operating activities 2020 2019 Net loss $ (71,999 ) $ (45,830 ) Adjustments to reconcile net loss to net cash used in operating activities. Depreciation and amortization 10,952 6,844 Loss on extinguishment of debt 8,514 1,670 Amortization of debt discount and issuance costs 5,260 797 Non-cash operating lease expense 2,865 2,696 Investment discount and premium amortization 854 (443 ) Provision for expected credit losses 822 â Stock-based compensation expense 27,283 13,028 Deferred tax (benefit) provision (1,280 ) â Change in fair value of contingent consideration liabilities (1,004 ) â Other 85 (36 ) Change in operating assets and liabilities.

Accounts receivable, net (4,450 ) (3,323 ) Prepaid expenses and other assets (2,937 ) (1,362 ) Accounts payable, accrued liabilities, and other liabilities 6,567 1,661 Deferred revenue (838 ) 7,601 Operating lease liabilities (2,701 ) (2,426 ) Net cash used in operating activities (22,007 ) (19,123 ) Cash flows from investing activities Purchase of short-term investments (163,346 ) (221,444 ) Proceeds from the sale and maturity of short-term investments 208,467 37,277 Acquisition of businesses, net of cash acquired (102,471 ) â Purchase of property and equipment (2,071 ) (1,658 ) Purchase of intangible assets (1,249 ) (1,747 ) Proceeds from sale of property and equipment 10 40 Net cash used in investing activities (60,660 ) (187,532 ) Cash flows from financing activities Proceeds from convertible note securities, net of issuance costs 222,482 â Purchase of capped calls concurrent with issuance of convertible senior notes (21,743 ) â Proceeds from credit facilities, net of debt issuance costs â 47,169 Repayment of credit facilities (57,043 ) (21,821 ) Proceeds from exercise of stock options 29,393 2,177 Proceeds from employee stock purchase plan 3,528 1,216 Payments of acquisition-related consideration (748 ) (773 ) Proceeds from initial public offering, net of underwritersâ discounts and commissions â 194,649 Proceeds from the issuance of redeemable convertible preferred stock, net of issuance costs â 12,073 Payments of deferred offering costs â (4,407 ) Net cash provided by financing activities 175,869 230,283 Effect of exchange rate on cash and cash equivalents 5 â Net increase in cash and cash equivalents 93,207 23,628 Cash and cash equivalents at beginning of period 18,032 28,431 Cash and cash equivalents at end of period $ 111,239 $ 52,059 Non-GAAP Financial MeasuresTo supplement our financial information presented in accordance with GAAP, we believe certain non-GAAP measures, including Adjusted Gross Profit, Adjusted Gross Margin, Adjusted EBITDA, Adjusted Net Loss, and Adjusted Net Loss per share, basic and diluted, are useful in evaluating our operating performance. We use this non-GAAP financial information to evaluate our ongoing operations, as a component in determining employee bonus compensation, and for internal planning and forecasting purposes. We believe that non-GAAP financial information, when taken collectively, may be helpful to investors because it provides consistency and comparability with past financial performance. However, non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP.

In addition, other companies, including companies in our industry, may calculate similarly-titled non-GAAP measures differently or may use other measures to evaluate their performance. A reconciliation is provided below for each non-GAAP financial measure to the most directly comparable financial measure stated in accordance with GAAP. Investors are encouraged to review the related GAAP financial measures and the reconciliation of these non-GAAP financial measures to their most directly comparable GAAP financial measures, and not to rely on any single financial measure to evaluate our business.Adjusted Gross Profit and Adjusted Gross MarginAdjusted Gross Profit is a non-GAAP financial measure that we define as revenue less cost of revenue, excluding depreciation and amortization and excluding (i) stock-based compensation and (ii) post-acquisition restructuring costs (none during periods presented). We define Adjusted Gross Margin as our Adjusted Gross Profit divided by our revenue.

We believe Adjusted Gross Profit and Adjusted Gross Margin are useful to investors as they eliminate the impact of certain non-cash expenses and allow a direct comparison of these measures between periods without the impact of non-cash expenses and certain other non-recurring operating expenses. The following is a reconciliation of revenue, the most directly comparable GAAP financial measure, to Adjusted Gross Profit, for the three months ended September 30, 2020 and 2019. Three Months Ended September 30, 2020 (in thousands, except percentages) Technology Professional Services Total Revenue $ 27,964 $ 19,227 $ 47,191 Cost of revenue, excluding depreciation and amortization (9,045 ) (15,307 ) (24,352 ) Gross profit, excluding depreciation and amortization 18,919 3,920 22,839 Add. Stock-based compensation 196 903 1,099 Adjusted Gross Profit $ 19,115 $ 4,823 $ 23,938 Gross margin, excluding depreciation and amortization 68 % 20 % 48 % Adjusted Gross Margin 68 % 25 % 51 % Three Months Ended September 30, 2019 (in thousands, except percentages) Technology Professional Services Total Revenue $ 21,160 $ 18,263 $ 39,423 Cost of revenue, excluding depreciation and amortization (6,740 ) (11,892 ) (18,632 ) Gross profit, excluding depreciation and amortization 14,420 6,371 20,791 Add.

Stock-based compensation 64 306 370 Adjusted Gross Profit $ 14,484 $ 6,677 $ 21,161 Gross margin, excluding depreciation and amortization 68 % 35 % 53 % Adjusted Gross Margin 68 % 37 % 54 % Adjusted EBITDAAdjusted EBITDA is a non-GAAP financial measure that we define as net loss adjusted for (i) interest and other expense, net, (ii) loss on extinguishment of debt (none in periods presented), (iii) income tax (benefit) provision, (iv) depreciation and amortization, (v) stock-based compensation, (vi) acquisition transaction costs, (vii) change in fair value of contingent consideration liability, (viii) duplicate headquarters rent expense, and (ix) post-acquisition restructuring costs when they are incurred. We believe Adjusted EBITDA provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance. The following is a reconciliation of our net loss, the most directly comparable GAAP financial measure, to Adjusted EBITDA, for the three months ended September 30, 2020 and 2019. Three Months EndedSeptember 30, 2020 2019 (in thousands) Net loss $ (27,326 ) $ (21,416 ) Add.

Interest and other expense, net 3,854 659 Income tax (benefit) provision 14 21 Depreciation and amortization 4,981 2,316 Stock-based compensation 9,496 9,974 Acquisition transaction costs 1,399 â Change in fair value of contingent consideration liability 564 â Duplicate headquarters rent expense 584 â Adjusted EBITDA $ (6,434 ) $ (8,446 ) Pro Forma Adjusted Net Loss Per ShareAdjusted Net Loss is a non-GAAP financial measure that we define as net loss attributable to common stockholders adjusted for (i) accretion of redeemable convertible preferred stock, (ii) stock-based compensation, (iii) amortization of acquired intangibles, (iv) loss on debt extinguishment, (v) acquisition transaction costs, (vi) change in fair value of contingent consideration liability, (vii) non-cash interest expense related to our convertible senior notes, (viii) duplicate headquarters rent expense (see explanation above), and (ix) post-acquisition restructuring costs. Non-cash interest expense related to our convertible senior notes relates to the convertible senior notes that were issued in a private placement in April 2020. Under GAAP, we are required to separately account for liability (debt) and equity (conversion option) components of the convertible senior notes. Accordingly, for GAAP purposes we are required to recognize the effective interest expense on our convertible senior notes and amortize the issuance costs over the term of the notes.

The difference between the effective interest expense and the contractual interest expense, and the amortization expense of issuance costs are excluded from managementâs assessment of our operating performance because management believes that these non-cash expenses are not indicative of ongoing operating performance.We believe Adjusted Net Loss provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance.On July 29, 2019, we closed our initial public offering (our IPO) in which we issued and sold 8,050,000 shares (inclusive of the underwritersâ option to purchase an additional 1,050,000 shares) of common stock at $26.00 per share. We received net proceeds of $194.6 million after deducting underwriting discounts and commissions and before deducting offering costs of $4.6 million. Upon the closing of our IPO, all shares of our outstanding redeemable convertible preferred stock converted into 23,151,481 shares of common stock on a one-for-one basis. We have prepared the below adjusted condensed consolidated statement of operations data to present pro forma adjusted net loss per share amounts that will be comparable between the current and prior periods presented as if the conversion of all outstanding shares of redeemable convertible preferred stock and the issuance of the IPO shares had occurred as of the beginning of the prior year comparative periods.

Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Numerator. (in thousands, except share and per share amounts) Net loss attributable to common stockholders $ (27,326 ) $ (39,586 ) $ (71,999 ) $ (226,656 ) Add Accretion of redeemable convertible preferred stock â 18,170 â 180,826 Stock-based compensation 9,496 9,974 27,283 13,028 Amortization of acquired intangibles 4,276 1,625 8,786 4,672 Loss on extinguishment of debt â â 8,514 1,670 Acquisition transaction costs 1,399 â 2,670 â Change in fair value of contingent consideration liability 564 â (1,004 ) â Non-cash interest expense related to convertible senior notes 2,720 â 4,931 â Duplicate headquarters rent expense 584 â 709 â Post-acquisition restructuring costs â â â 446 Adjusted Net Loss $ (8,287 ) $ (9,817 ) $ (20,110 ) $ (26,014 ) Denominator. Weighted-average number of shares used in calculating net loss per share attributable to common stockholders, basic and diluted 40,292,380 28,222,555 38,517,272 12,749,903 Pro forma adjustments Pro forma adjustment to reflect issuance and conversion of redeemable convertible preferred stock to common stock, assuming the conversion took place as of the beginning of the 2019 period â 6,039,517 â 17,384,812 Pro forma adjustment to reflect issuance of shares of common stock as part of IPO, assuming the issuance took place as of the beginning of the 2019 period â 2,111,413 â 6,048,718 Pro forma as adjusted weighted-average number of shares used in calculating Adjusted Net Loss per share, basic and diluted 40,292,380 36,373,485 38,517,272 36,183,433 Pro forma adjusted net loss per share, basic and diluted $ (0.21 ) $ (0.27 ) $ (0.52 ) $ (0.72 ) Health Catalyst Investor Relations Contact:Adam BrownSenior Vice President, Investor Relations+1 (855)-309-6800ir@healthcatalyst.comHealth Catalyst Media Contact:Amanda Hundtamanda.hundt@healthcatalyst.com+1 (575) 491-0974 Source. Health Catalyst, Inc..

SALT LAKE CITY, how to buy cialis in usa Nov. 10, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. (Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today reported financial results for the quarter ended September 30, 2020.âIn the third quarter of 2020, I am pleased to share that we achieved strong performance across our business, including exceeding the mid-point of our quarterly guidance for both revenue and Adjusted EBITDA,â said Dan Burton, CEO of Health Catalyst. ÂIn addition to this financial and operational execution, we are excited to announce the promotion of Patrick Nelli, our current Chief Financial Officer, to the role President of Health Catalyst, effective January 1, 2021.

Patrick's responsibilities as President will include all the major growth functions of the company, including with existing customers, new customers, international expansion, sales operations, marketing and communications. Additionally, I am pleased to announce the promotion of Bryan Hunt, our current Senior Vice President of Financial Planning &. Analysis to the role of Chief Financial Officer, effective January 1, 2021. Patrick and Bryan, in their newly appointed roles, have my full support and confidence and the unanimous support and confidence of our board of directors. Lastly, I would also like to share two additional promotions related to these changes.

Jason Alger, our Senior Vice President of Finance, has been promoted to Chief Accounting Officer, and Adam Brown, our Senior Vice President of Investor Relations, has been promoted to Senior Vice President of Investor Relations and Finance Planning &. Analysis.âFinancial Highlights for the Three Months Ended September 30, 2020 Key Financial Metrics Three Months EndedSeptember 30, Year over Year Change 2020 2019 GAAP Financial Data. (in thousands, except percentages) Technology revenue $ 27,964 $ 21,160 32% Professional services revenue $ 19,227 $ 18,263 5% Total revenue $ 47,191 $ 39,423 20% Loss from operations $ (23,458 ) $ (20,736 ) (13)% Net loss $ (27,326 ) $ (21,416 ) (28)% Other Non-GAAP Financial Data:(1) Adjusted Technology Gross Profit $ 19,115 $ 14,484 32% Adjusted Technology Gross Margin 68 % 68 % Adjusted Professional Services Gross Profit $ 4,823 $ 6,677 (28)% Adjusted Professional Services Gross Margin 25 % 37 % Total Adjusted Gross Profit $ 23,938 $ 21,161 13% Total Adjusted Gross Margin 51 % 54 % Adjusted EBITDA $ (6,434 ) $ (8,446 ) 24% ________________________(1) These measures are not calculated in accordance with generally accepted accounting principles in the United States (GAAP). See the accompanying "Non-GAAP Financial Measures" section below for more information about these financial measures, including the limitations of such measures, and for a reconciliation of each measure to the most directly comparable measure calculated in accordance with GAAP.Financial OutlookHealth Catalyst provides forward-looking guidance on total revenue, a GAAP measure, and Adjusted EBITDA, a non-GAAP measure.For the fourth quarter of 2020, we expect:Total revenue between $50.5 million and $53.5 million, and Adjusted EBITDA between $(7.3) million and $(5.3) millionFor the full year of 2020, we expect:Total revenue between $186.1 million and $189.1 million, and Adjusted EBITDA between $(23.9) million and $(21.9) millionWe have not reconciled guidance for Adjusted EBITDA to net loss, the most directly comparable GAAP measure, and have not provided forward-looking guidance for net loss, because there are items that may impact net loss, including stock-based compensation, that are not within our control or cannot be reasonably predicted.Quarterly Conference Call DetailsThe company will host a conference call to review the results today, Tuesday, November 10, 2020 at 5:00 p.m. E.T.

The conference call can be accessed by dialing 1-877-295-1104 for U.S. Participants, or 1-470-495-9486 for international participants, and referencing participant code 7195951. A live audio webcast will be available online at https://ir.healthcatalyst.com/. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platformâpowered by data from more than 100 million patient records and encompassing trillions of factsâas well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements.

(ii) changes in market or industry conditions, regulatory environment and receptivity to our technology and services. (iii) results of litigation or a security incident. (iv) the loss of one or more key customers or partners. (v) the impact of erectile dysfunction treatment on our business and results of operation. And (vi) changes to our abilities to recruit and retain qualified team members.

For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to the Annual Report on Form 10-K for the year ended December 31, 2019 filed with the SEC on February 28, 2020 and the Quarterly Report on Form 10-Q for the fiscal quarter ended September 30, 2020 expected to be filed with the SEC on or about November 10, 2020. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law. Condensed Consolidated Balance Sheets (in thousands, except share and per share data, unaudited) As ofSeptember 30, As ofDecember 31, 2020 2019 Assets Current assets. Cash and cash equivalents $ 111,239 $ 18,032 Short-term investments 163,898 210,245 Accounts receivable, net 36,339 27,570 Prepaid expenses and other assets 11,290 8,392 Total current assets 322,766 264,239 Property and equipment, net 5,319 4,295 Intangible assets, net 105,926 25,535 Operating lease right-of-use assets 25,833 3,787 Goodwill 107,822 3,694 Other assets 2,997 810 Total assets $ 570,663 $ 302,360 Liabilities and stockholdersâ equity Current liabilities. Accounts payable $ 5,189 $ 3,622 Accrued liabilities 14,061 8,944 Acquisition-related consideration payable 3,214 2,192 Deferred revenue 35,090 30,653 Operating lease liabilities 2,425 2,806 Contingent consideration liabilities 5,893 â Total current liabilities 65,872 48,217 Long-term debt, net of current portion 166,200 48,200 Acquisition-related consideration payable, net of current portion â 1,860 Deferred revenue, net of current portion 1,635 1,459 Operating lease liabilities, net of current portion 24,245 1,654 Contingent consideration liabilities, net of current portion 10,279 â Other liabilities 2,817 326 Total liabilities 271,048 101,716 Commitments and contingencies Stockholdersâ equity.

Common stock, $0.001 par value. 42,239,922 and 36,678,854 shares issued and outstanding as of September 30, 2020 and December 31, 2019, respectively 42 37 Additional paid-in capital 982,139 811,049 Accumulated deficit (682,632 ) (610,514 ) Accumulated other comprehensive income 66 72 Total stockholders' equity 299,615 200,644 Total liabilities and stockholdersâ equity $ 570,663 $ 302,360 Condensed Consolidated Statements of Operations (in thousands, except per share data, unaudited) Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Revenue. Technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional services 19,227 18,263 57,416 50,047 Total revenue 47,191 39,423 135,566 111,440 Cost of revenue, excluding depreciation and amortization. Technology(1) 9,045 6,740 25,148 20,536 Professional services(1)(3) 15,307 11,892 46,401 33,132 Total cost of revenue, excluding depreciation and amortization 24,352 18,632 71,549 53,668 Operating expenses. Sales and marketing(1)(3) 14,629 14,721 40,618 35,579 Research and development(1)(3) 13,390 13,477 38,539 33,209 General and administrative(1)(2)(4)(5) 13,297 11,013 31,111 23,333 Depreciation and amortization 4,981 2,316 10,952 6,844 Total operating expenses 46,297 41,527 121,220 98,965 Loss from operations (23,458 ) (20,736 ) (57,203 ) (41,193 ) Loss on extinguishment of debt â â (8,514 ) (1,670 ) Interest and other expense, net (3,854 ) (659 ) (7,500 ) (2,924 ) Loss before income taxes (27,312 ) (21,395 ) (73,217 ) (45,787 ) Income tax provision (benefit) 14 21 (1,218 ) 43 Net loss $ (27,326 ) $ (21,416 ) $ (71,999 ) $ (45,830 ) Less.

(in thousands) (in thousands) General and administrative $ 1,399 $ â $ 2,670 $ â Total $ 1,399 $ â $ 2,670 $ â (3) Includes post-acquisition restructuring costs as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Post-Acquisition Restructuring Costs. (in thousands) (in thousands) Cost of revenue, excluding depreciation and amortization. Professional services $ â $ â $ â $ 108 Sales and marketing â â â 306 Research and development â â â 32 Total $ â $ â $ â $ 446 (4) Includes the change in fair value of contingent consideration liabilities, as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Change in fair value of contingent consideration liabilities.

(in thousands) (in thousands) General and administrative $ 564 $ â $ (1,004 ) $ â Total $ 564 $ â $ (1,004 ) $ â (5) Includes duplicate headquarters rent expense, as follows. Three Months EndedSeptember 30, Nine Months EndedSeptember 30, 2020 2019 2020 2019 Duplicate Headquarters Rent Expense. (in thousands) (in thousands) General and administrative $ 584 $ â $ 709 $ â Total $ 584 $ â $ 709 $ â (6) Includes pro forma adjustments to net loss attributable to common stockholders and the weighted average number of common shares outstanding directly attributable to the closing of our initial public offering on July 29, 2019 as well as certain other non-GAAP adjustments. Refer to the "Non-GAAP Financial MeasuresâPro Forma Adjusted Net Loss Per Share" section below for further details. Condensed Consolidated Statements of Cash Flows (in thousands, unaudited) Nine Months EndedSeptember 30, Cash flows from operating activities 2020 2019 Net loss $ (71,999 ) $ (45,830 ) Adjustments to reconcile net loss to net cash used in operating activities.

Depreciation and amortization 10,952 6,844 Loss on extinguishment of debt 8,514 1,670 Amortization of debt discount and issuance costs 5,260 797 Non-cash operating lease expense 2,865 2,696 Investment discount and premium amortization 854 (443 ) Provision for expected credit losses 822 â Stock-based compensation expense 27,283 13,028 Deferred tax (benefit) provision (1,280 ) â Change in fair value of contingent consideration liabilities (1,004 ) â Other 85 (36 ) Change in operating assets and liabilities. Accounts receivable, net (4,450 ) (3,323 ) Prepaid expenses and other assets (2,937 ) (1,362 ) Accounts payable, accrued liabilities, and other liabilities 6,567 1,661 Deferred revenue (838 ) 7,601 Operating lease liabilities (2,701 ) (2,426 ) Net cash used in operating activities (22,007 ) (19,123 ) Cash flows from investing activities Purchase of short-term investments (163,346 ) (221,444 ) Proceeds from the sale and maturity of short-term investments 208,467 37,277 Acquisition of businesses, net of cash acquired (102,471 ) â Purchase of property and equipment (2,071 ) (1,658 ) Purchase of intangible assets (1,249 ) (1,747 ) Proceeds from sale of property and equipment 10 40 Net cash used in investing activities (60,660 ) (187,532 ) Cash flows from financing activities Proceeds from convertible note securities, net of issuance costs 222,482 â Purchase of capped calls concurrent with issuance of convertible senior notes (21,743 ) â Proceeds from credit facilities, net of debt issuance costs â 47,169 Repayment of credit facilities (57,043 ) (21,821 ) Proceeds from exercise of stock options 29,393 2,177 Proceeds from employee stock purchase plan 3,528 1,216 Payments of acquisition-related consideration (748 ) (773 ) Proceeds from initial public offering, net of underwritersâ discounts and commissions â 194,649 Proceeds from the issuance of redeemable convertible preferred stock, net of issuance costs â 12,073 Payments of deferred offering costs â (4,407 ) Net cash provided by financing activities 175,869 230,283 Effect of exchange rate on cash and cash equivalents 5 â Net increase in cash and cash equivalents 93,207 23,628 Cash and cash equivalents at beginning of period 18,032 28,431 Cash and cash equivalents at end of period $ 111,239 $ 52,059 Non-GAAP Financial MeasuresTo supplement our financial information presented in accordance with GAAP, we believe certain non-GAAP measures, including Adjusted Gross Profit, Adjusted Gross Margin, Adjusted EBITDA, Adjusted Net Loss, and Adjusted Net Loss per share, basic and diluted, are useful in evaluating our operating performance. We use this non-GAAP financial information to evaluate our ongoing operations, as a component in determining employee bonus compensation, and for internal planning and forecasting purposes. We believe that non-GAAP financial information, when taken collectively, may be helpful to investors because it provides consistency and comparability with past financial performance. However, non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP.

The following is a reconciliation of revenue, the most directly comparable GAAP financial measure, to Adjusted Gross Profit, for the three months ended September 30, 2020 and 2019. Three Months Ended September 30, 2020 (in thousands, except percentages) Technology Professional Services Total Revenue $ 27,964 $ 19,227 $ 47,191 Cost of revenue, excluding depreciation and amortization (9,045 ) (15,307 ) (24,352 ) Gross profit, excluding depreciation and amortization 18,919 3,920 22,839 Add. Stock-based compensation 196 903 1,099 Adjusted Gross Profit $ 19,115 $ 4,823 $ 23,938 Gross margin, excluding depreciation and amortization 68 % 20 % 48 % Adjusted Gross Margin 68 % 25 % 51 % Three Months Ended September 30, 2019 (in thousands, except percentages) Technology Professional Services Total Revenue $ 21,160 $ 18,263 $ 39,423 Cost of revenue, excluding depreciation and amortization (6,740 ) (11,892 ) (18,632 ) Gross profit, excluding depreciation and amortization 14,420 6,371 20,791 Add. Stock-based compensation 64 306 370 Adjusted Gross Profit $ 14,484 $ 6,677 $ 21,161 Gross margin, excluding depreciation and amortization 68 % 35 % 53 % Adjusted Gross Margin 68 % 37 % 54 % Adjusted EBITDAAdjusted EBITDA is a non-GAAP financial measure that we define as net loss adjusted for (i) interest and other expense, net, (ii) loss on extinguishment of debt (none in periods presented), (iii) income tax (benefit) provision, (iv) depreciation and amortization, (v) stock-based compensation, (vi) acquisition transaction costs, (vii) change in fair value of contingent consideration liability, (viii) duplicate headquarters rent expense, and (ix) post-acquisition restructuring costs when they are incurred. We believe Adjusted EBITDA provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance.

The following is a reconciliation of our net loss, the most directly comparable GAAP financial measure, to Adjusted EBITDA, for the three months ended September 30, 2020 and 2019. Three Months EndedSeptember 30, 2020 2019 (in thousands) Net loss $ (27,326 ) $ (21,416 ) Add. Interest and other expense, net 3,854 659 Income tax (benefit) provision 14 21 Depreciation and amortization 4,981 2,316 Stock-based compensation 9,496 9,974 Acquisition transaction costs 1,399 â Change in fair value of contingent consideration liability 564 â Duplicate headquarters rent expense 584 â Adjusted EBITDA $ (6,434 ) $ (8,446 ) Pro Forma Adjusted Net Loss Per ShareAdjusted Net Loss is a non-GAAP financial measure that we define as net loss attributable to common stockholders adjusted for (i) accretion of redeemable convertible preferred stock, (ii) stock-based compensation, (iii) amortization of acquired intangibles, (iv) loss on debt extinguishment, (v) acquisition transaction costs, (vi) change in fair value of contingent consideration liability, (vii) non-cash interest expense related to our convertible senior notes, (viii) duplicate headquarters rent expense (see explanation above), and (ix) post-acquisition restructuring costs. Non-cash interest expense related to our convertible senior notes relates to the convertible senior notes that were issued in a private placement in April 2020. Under GAAP, we are required to separately account for liability (debt) and equity (conversion option) components of the convertible senior notes.

Accordingly, for GAAP purposes we are required to recognize the effective interest expense on our convertible senior notes and amortize the issuance costs over the term of the notes. The difference between the effective interest expense and the contractual interest expense, and the amortization expense of issuance costs are excluded from managementâs assessment of our operating performance because management believes that these non-cash expenses are not indicative of ongoing operating performance.We believe Adjusted Net Loss provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance.On July 29, 2019, we closed our initial public offering (our IPO) in which we issued and sold 8,050,000 shares (inclusive of the underwritersâ option to purchase an additional 1,050,000 shares) of common stock at $26.00 per share. We received net proceeds of $194.6 million after deducting underwriting discounts and commissions and before deducting offering costs of $4.6 million. Upon the closing of our IPO, all shares of our outstanding redeemable convertible preferred stock converted into 23,151,481 shares of common stock on a one-for-one basis. We have prepared the below adjusted condensed consolidated statement of operations data to present pro forma adjusted net loss per share amounts that will be comparable between the current and prior periods presented as if the conversion of all outstanding shares of redeemable convertible preferred stock and the issuance of the IPO shares had occurred as of the beginning of the prior year comparative periods.