Thank you, I in full disclosure I have a mobile CT unit and that we're using in Western and Central New York where we don't have as remote but we have a very good mixture of high-risk small cities and very very rural areas and so I think some of the take-home messages despite what Melissa said she is one of the more brilliant people in this room because she really has carved out a very high standard for mobile CT screening in a very difficult area of the country of our country. She's looking at people in the whole lens and I think this is extremely important with mobile units when you're getting hard to access people that you don't just look at the lung but that you bring them in. These are people who often have many challenges to accessing the health care system and not only do you have to know the population and know what their challenges are but you have to really address them you get them in a unit and you have to start looking at the whole picture of that person and I think this has been critically important to the success of her program but it is a model and I think incorporated into most of the programs you heard about. Lung cancer screening whether it's brick-and-mortar or a mobile unit cannot operate in a vacuum. You find incidental findings, you find people who may not have lung cancer but they identify other challenges and we really have to address those. Not unique to mobile but it is a great point. Dr. Bellotta has a you know pretty soon he's going to take over the entire Tesco's parking lot that's obvious. I think one of the take-home messages from his talk is that he understands the population that he's he you know he addressed with that first unit and engaged the community so they don't just go to a place cold but they really do soften up the community to be prepared for the unit. Their rates of picking up lung cancer are in the same similar to what Mike Gitsky finds in Kentucky that you know you don't have to do a lot of CT's and in a population that has a lot of smoking that has a lot of symptomology and comorbidities to find a lot of cancers and it's it's impressive. And I think that one factor in the Manchester program which you know clearly is one of the reasons why we see a huge expansion across the UK is that they have figured out how to engage that high-risk population people who don't want to go to the NHS facilities but are willing to get on his bus. Dr. Santos and in my view is an example of an individual who is committed to changing lung cancer outcome for his country. He has implemented extremely good technology and it has led to a mobile unit but he has really created an environment in Brazil that will increase lung cancer screening across the country and engaged multidisciplinary teams which is critically important when you're not in one fixed site. And last Dr. Jones clearly is addressing that really rural population and again viewing them as a whole person so that you don't just address the low-dose CT but that you fly in medical teams into the area so that when they get on the bus or the unit they are having other health issues addressed and that's a theme that all of us in the mobile CT community strongly embrace and and she showed me that in fact you can have a solar-powered CT so I think that's going to help with a lot of other mobile units. I think this is exceptionally good technology it has to be paired with brick-and-mortar medical follow-up but I think it's something we'll see more of in all of our countries. Thank you.

mobile CT units

underserved populations

holistic care

innovative approaches

healthcare access