That's a great question. In the case of home hemodialysis, the cost savings are essentially the fact that the patient is taking over the role of the nurse, which is significant. Nursing ratios went from 2:1 to 20:1 as a result. Quite honestly, with the increasing prevalence of diabetes and end-stage renal disease, there's plenty of work for nurses to do. This problem will just get worse, and the fact is, because of some of the technological barriers right now, we can offer only about 25% of the patients with end-stage renal disease a service such as this. I don't think that was a particular problem, and those nurses at Toronto General are still employed—they're just dealing with more patients coming through the door now.
As for the hypertension study, you're absolutely right that when we first approached them about this, family doctors did not like the idea. They felt they were going to be looking at reams of new data that they didn't get paid for, but they are also faced with a situation that they're not totally equipped to deal with—this influx of patients with serious chronic conditions. We designed the system so that they only receive exceptional readings, so very high blood pressure readings need attention, but most of the time they see nothing from the patient. As we've shown, there was no increased number of visits and so on.
I think if you ask most physicians, if a patient is doing well and their workload is not impacted, it’s a win-win for both parties.