Patient Engagement in Rural Areas – Facing technology limitations

When it comes to patient engagement in rural areas, there are many challenges, one of the most prevalent being technology limitations. One key challenge is access to broadband services.  With the lack of broadband availability and the limited funding faced by most rural facilities it can seem nearly impossible to provide patients with access to the technology resources they need. How can we expect patients to engage if they are unable to access their information? This can also create another challenge around patient education.  If they don’t have access to technology, this can often mean that they have little to no experience with technology.

So what can be done to solve these challenges? First, identify where the technology is available, such as libraries and community centers.  You can educate patients on how to access and use these resources. Another way to tackle the issue of the lack of access to technology is by rolling out kiosks in designated areas, such as grocery or drug stores, so patients are able to access their information and engage with their physician. Pursuant Health has recently announced that they are partnering with the American Diabetes Association to provide the Association’s Diabetes Risk Test through Pursuant Health’s national in-store health kiosk network.

Another way to solve these patient engagement challenges is by organizing focus groups within your community and/or hospital to gather ideas on different ways to engage your patient population, and then use trial and error to track what works best. Another suggestion is setting up a discussion with another rural hospital that is currently or has recently overcome technology limitations. This would be incredibly beneficial for you team, and CoreTech can help arrange and lead the discussion to ensure that you walk away with ideas on how to improve these issues in your patient population. CoreTech can also conduct general research on your population, and provide additional suggestions based on the outcome of that research.

Your organization should market your new technology to promote adoption by your patients. By taking the time to evaluate and implement a marketing plan that will best target your patient population, you can really empower patients to want to take ownership of their personal health. Access to health information is as simple as logging into and sending an email, either at home, a local library or from a smart phone, and once patients understand the ease and convenience these tools offer, they are much more likely to use the technology. There are several positive outcomes you can use to motivate them, which include direct messaging and interaction with their physician, quicker access to their health information, better understanding of their health condition, faster and more thorough follow up, and the ability to correct errors they see in their patient record. As patients take greater ownership of their health and the technology tools available to them this will ultimately lead to reduced hospital readmission rates and less money out of patient pocket spent on unnecessary tests.

If your facility is facing technology limitations, you have the option to apply for a Hardship Exemption. When trying to meet Meaningful Use requirements, CMS will acknowledge that you have a certain set of challenges and will be more lenient with your numbers or extend your deadlines. For more information about how to apply for a hardship exception visit:

You can also apply for grants to help fund new technology and patient education and ultimately be able to promote patient engagement. There are multiple resources that provide more detailed information on this subject. Here’s one source that provides information on the process of applying for grants and allows you to apply directly:

In rural areas, you have to get more creative with solutions for these kinds of issues, and are required to think outside of the box like the suggestions that we’ve provided above. CoreTech has years of experience helping rural facilities with their technology limitations, and we will use our expertise and experience to assist your organization in engaging your patients and improving your patient care. Contact CoreTech today and see how our team can help your facility overcome patient engagement challenges!  

CoreTech is offering a Patient Portal that ensures your organization meets Meaningful Use requirements!

CoreTech has recently partnered with Dynamic HealthIT and we are excited to offer their outstanding Patient Portal to our customers. Like CoreTech, this product is vendor agnostic, meaning the Patient Portal can be used in conjunction with other another vendor’s products or your existing tools. This alone could save an organization a substantial amount of money if this is the only application they’re looking to purchase! On top of that this Patient Portal is designed to meet the numerous requirements for Meaningful Use which is critical as we are winding up 2016 and heading into 2017.

Given CoreTech’s ample experience assisting organizations in meeting critical Meaningful Use  requirements, we understand the importance of finding the best product for your budget so you can begin tracking and reporting your numbers as soon as possible. From our years of experience working with patient portals we believe that it’s crucial to find a patient portal that enables you to meet Meaningful Use requirements as efficiently as possible.

CoreTech believes that this Patient Portal has several features that stand out and make it of great value for our customers. A prominent feature is that this Patient Portal meets both inpatient and ambulatory certified criteria for Meaningful Use. The Patient Portal also meets the Meaningful Use Stage 2 (2014 Edition) View, Download & Transmit requirement (VDT) – which provides patients the ability to view, download and transmit their health information within four business days of the information being available. VDT is one of the most difficult Stage 2 requirements for both vendors & providers. It’s vital to meet these Meaningful Use requirements in order to avoid penalties and receive monetary incentives from CMS.

The Patient Portal also features a direct address book that allows patients to send and receive secure messages to their provider or clinical staff through the Intranet. This will help providers track patient engagement, which allows patients to take greater ownership of their healthcare, and allows faster and easier access for patients to communicate with those providing them care. The portal also offers built-in connectivity to the MaxMD HISP, with optional connectivity to other HISPs. This HISP functionality allows users to view, download and transmit the CCDA via Direct messaging. In addition to the features mentioned above, below are the Patient Portal’s additional outstanding features:

  • Web-based Dashboard for Administrators feature
  • Audit log for patients to monitor their Portal activity
  • Create Patient Portal accounts with or without Pin/Token
  • Broadcast public messages to personal email
  • Access to the Clinical Summary and ability to print those documents
  • Automatic and manual utilization reporting, if using the ADT feed
  • Customizable user interface and features for account activation and notifications
  • Customizations include: custom provider branding, custom disclaimer text and landing page, and user-friendly explanatory text

 CoreTech can assist your organization in determining if this patient portal will fulfill your needs. We achieve this by taking the time to understand your processes and workflow and aligning them with the functionality that this tool offers. CoreTech is the best company in the industry for you as we have years of experience implementing patient portals in both large and small organizations. We always put our clients needs first and will work diligently until we meet the needs of our customers. Contact CoreTech for more information and see how we can help your organization today!

The Importance of Normalized Data

According to CNN Money, medical errors are costing the industry $17 billion a year in wasted expenses, showing just how important it is to normalize data. Normalization is the process of organizing a relational database to reduce data and remove duplicated data. When proper patient matching isn’t done, patient’s information won’t follow them and the patient suffers. For hospitals, duplicate records aren’t just a minor record-keeping inconvenience. If a patient’s medical information is spread across separate records (or merged with another patient’s information), privacy rules could be broken and care could be negatively affected . Accurate patient data improves data sharing capabilities as hospitals and provider networks consolidate.

Communication among all parties is key when it comes to normalizing patient data. It starts with the registration staff at the hospital or when the patient walks into a provider office for an appointment; it’s vital that they are properly trained on how to capture all required information at check-in. To add to the complexity, application analysts within different departments (LAB, RAD, PATH, etc.) need to openly communicate with each other and the interface engineer to ensure data is being received in the required format. Although a hospital may require the data in one format, a vendor may require them to provide a different outbound format. Therefore, the person in charge of sending that data must understand the different needs of various vendors and confirm and document that they are able to send the data in the required format of their vendors. This goes for the vendor as well. All of this is critical for proper and accurate patient matching!

In our experience, we have dealt with a disconnect between departments and systems where they’re not using the same processes or standards for entering data. When you try to normalize that data, you’re unable to match the patient records. Bridging that gap is a complicated process and it varies based on hospitals and policies. It’s important to understand what tools are available within each hospital and then create a customized plan to move forward. At CoreTech, we believe that the EMPI (Enterprise Master Patient Index) is only as good as the data being fed into it. The hospital system needs to take responsibility to make sure they have good data which produces good results.

So how can CoreTech help? CoreTech can come in and evaluate the current processes, work with clinical staff and engineers and help come up with a solution to the problem. CoreTech is the best company for you because we truly have our customers best interest in mind and we’re vendor neutral. We’ll do the due diligence to ensure that you’re getting the best product to fulfill your specific needs. At CoreTech, our relationship with our customer is our number one priority. We’ll do what it takes to ensure that your organization is compliant and running smoothly by reducing medical errors. We will always keep you and your patients’ care as our top priority.

CoreTech is excited to offer an outstanding Quality Reporting Tool to our customers!

One of the products CoreTech is proud to offer as part of our partnership with DHIT is their CQMsolution Clinical Quality Reporting application. CQMsolution is an easy to use, web-browser-based application for calculating, displaying and producing clinical quality measures. CoreTech was recently notified that CQMsolution is now certified for ONC 2015 Edition (Stage 3/MACRA/MIPS) and Clinical Quality measure (eCQM) criteria for Meaningful Use! This is the latest criteria from ONC and CQMsolution is the first and only application available that meets this criteria. CQMsolution is certified on all 93 CMS eCQMs, which breaks down to the 29 Inpatient measures and 62 Ambulatory measures, including the 64 PQRS crossover measures. We have found this tool to be outstanding and highly recommend it to our customers.

CoreTech is excited to offer the CQMsolution application as we feel it has many benefits that will make a huge impact to any organization that is currently putting in the huge undertaking of tracking and reporting their numbers to meet Meaningful Use requirements. One critical benefit that the application offers is that it is vendor agnostic meaning you can use it as a bolt-on application with your existing tools or you can use it with the other DHIT products. Another benefit of this tool is the granularity it offers your organization to truly drill-down by each specific patient you have and see how they’re information plays a part in your performance with each measure you’re tracking. The ability to have this insight into your numbers and how you’re tracking each month is invaluable!

The CoreTech team will take the time needed to work with your organization to identify your reporting needs based on the measures you are required to track. Our goal is to help your team  assess how you can utilize the full reporting functionality of the CQMsolution application to meet Meaningful Use. Once this is completed and we determine that this application is a great fit for your organization, our experienced team will guide you through the implementation process so you can begin tracking your measures and reap the benefits as soon as possible. With assistance from CoreTech, this tool will help your organization avoid penalty fees and be compliant with the measures you are tracking. The deadline to submit Clinical Quality Measures (CQMs) to the Medicare EHR Incentive Program – and to submit EHR-based PQRS measures – is end of February, 2017.

In addition to the many benefits mentioned, below are CQMsolutions’ key functions and features:

  • User-friendly browser-based UI
  • Extracts data from your EHR database to calculate and display eCQMs.
  • For Stage 2 and 3 EPs (ECs in MACRA/MIPS), supports all PQRS measures aligned with CMS EHR Incentive Program and selected non-aligned measures.
  • Calculates Category III output directly from a database or by aggregating Category I QRDAs
  • Supports the latest CMS measures and latest Cypress version (3.0)
  • Includes QRDA Category I Report calculation and QRDA Category III output
  • Certified to support the latest version of all 93 CQMs
  • Supports all 64 aligned PQRS measures for EPs (additional PQRS Measures can be supported)
  • Imports QRDA I XML files or vendor-supplied data for Report Calculation
  • Performs optimal calculation of measures for QRDA III submission
  • Generates QRDA I, QRDA III and PQRS QRDA output from your data
  • Single Sign On (SSO) support
  • Audit log for monitoring system activity

At CoreTech, our primary focus is on building relationships with our customers; ultimately we want to help our clients find a robust reporting tool that best suits their needs. From experience, we understand how daunting the entire implementation process can be for our customers. That’s where CoreTech will become a huge asset to your organization because we have a total of over 15 years of project management experience with researching and implementing EMR’s, Patient Portals and Reporting applications.

Contact CoreTech today for more information and see how we can help your organization track and meet your Meaningful Use requirements!

The Frontier Community Health Integration Project Demonstration Will Implement New Technology And Improve Patient Engagement!

The Frontier Community Health Integration Project (FCHIP) Demonstration was created to develop and test new integrated and coordinated health care technology and practices in small, rural populations. The overall goal is to improve health outcomes and lower Medicare costs.

Critical Access Hospitals (CAHs) often serve as the base for health care in the most rural populations, where specialty services may not be financially feasible due to lack of patients. The Frontier Community Health Integration Project Demonstration aims to support the CAH in keeping their patients in the community who might otherwise be transferred to providers in other cities for specialized care. According to the CMS website, “the specific objective is to test whether investing in certain services will enhance care for patients, increase integration and coordination of care among providers, and reduce avoidable hospitalizations, admissions and transfers, ultimately improving the quality of care for Medicare beneficiaries and lowering costs.”

The Medicare payment changes for the selected CAHs went into effect August 1, 2016 for a duration of three years and is scheduled to end July 31, 2019. What were the requirements for the eligible organizations to participate in the Demonstration? The CAHs that were selected were located in a state in which at least sixty-five percent of its counties have a population density of six or fewer people per square mile.These states were limited to: Alaska, Montana, Nevada, North Dakota and Wyoming. The CAHs also had to express intent in meeting community health needs in areas of telemedicine, nursing facility care, home health services and ambulance services.

The project includes new processes, education of medical staff, implementing new technology that is targeted for rural communities to increase patient engagement and educating the patient in those areas and on how to take ownership of their health. This demonstration could make a huge impact in rural communities and greatly improve patient care.

CoreTech has experience with rural facilities and we encourage HIT and new implementations that lead the way in technology. We’ve assisted other rural facilities in implementing new technologies such as patient portals, telemedicine, and connecting to an HIEs. We are excited to see the results and actions implemented by the hospitals from this demonstration. The results from this process will prove that although implementing new technology and processes is tedious, it will pay off in the end by increasing patient engagement and patient care.

We’d love to create a discussion with you on this project or other projects CoreTech is working on that relate to this project. Contact us for us for more information or check out CMS’ website for more information on FCHIP:

The Guyer Institute: Customization Project Will Enhance EMR, Patient Portal and Customer Care!

About The Guyer Institute
The Guyer Institute (TGI) offers a multidisciplinary, scientifically-based approach to discovering the “root cause” of illness, putting the patient on the path of achieving and sustaining optimal health and well-being. Their vision is to come alongside their patients and create a new standard of medicine where their clients know that they are valuable to them. To achieve this vision, TGI limits patient consultations to 10-12 clients each day, ensuring that they can create personal relationships with each one. Unlike traditional health care facilities, TGI uses molecular medicine, therefore their needs are not the same. Dr. Guyer incorporates Bio-Identical Hormone Replacement into his treatments and some of his specialties include the treatment of Complex Chronic Fatigue Syndrome and Fibromyalgia cases.

TGI’s Requests
In 2013, TGI was in search of an EMR and Patient Portal that could be easily integrated with a customized online store, where patients could purchase supplements and compound medicines from their in-house licensed dispensing office, to fit the unique needs of their practice. CoreTech was hired by TGI to lead this project to help them determine the best path forward in finding and implementing a product that fulfilled their needs. Based on research and assistance from CoreTech, TGI selected iSalus as the vendor application that would best fit their needs for the EMR and Patient Portal component. CoreTech’s senior developer built the online store website and functionality within it where patients and non-patients could purchase supplements from without a prescription. After the completion of the initial implementation of the EMR, Patient Portal and online store, TGI identified a need for customizations within the patient portal and to integrate the online store with iSalus’ EMR and Patient Portal (MyMedicalLocker). Due to CoreTech’s experience and the relationship that had been established with TGI, CoreTech was chosen to manage the customization projects and also complete a portion of the development work for the integration of the online store with iSalus. The process started by working with TGI to understand exactly what they wanted and from there, we worked with our internal development team and also the iSalus team to map out the entire project, create contracts for all parties involved, develop a schedule and begin development work.

TGI’s first customization request was to customize their patient portal. TGI wanted the functionality for their patients to be able to request a medication refill prescribed to them through their individual Patient Portal account. This request would send a notification to TGI staff and allow them to log into the patient account in the EMR and either approve or decline the refill. They could then communicate their response to the patient through their Direct account within the patient portal. This request required extensive development work from iSalus so CoreTech’s role in this customization is to manage the entire project to keep all parties aligned and on track. This includes weekly status updates and coordinating any testing for final approval of the work completed by iSalus.

TGI’s second customization request was to integrate their EMR, Patient Portal and Online Store so that any medications prescribed by TGI that can be filled in their in-house licensed dispensing office will populate in the patient’s patient portal account and also in their ‘wish list’ in their TGI online store account. This customization will also give patients the ability to purchase Guyer medications prescribed to them via the online store and either have the medication delivered to them or opt to pick it up at their convenience at TGI office. When patients make their purchases in the Online Store the patient’s account in the EMR will be updated to show that the medication has been purchased and on what date. This project involves development work to be completed by one of CoreTech’s senior developers, along with extensive testing with TGI staff, CoreTech team and feedback from the iSalus team. CoreTech’s role is to lead this effort to completion by managing all parties involved, identify and track all issues and risks and coordinate testing. CoreTech will also help train TGI staff on how to use this functionality once the development work is completed.

Currently, we are in the development phase of the patient portal customization which is set to wrap up towards the end of 2016. The integration of the online store with the iSalus EMR and MML is in the final stages of testing and will be completed in the next several weeks.

The End Results
Once this project is completed, TGI’s EMR, Patient Portal and Online Store will all be integrated as well as the patient’s ability to request medication refills from the patient portal account. This results in a better overall experience for the patient and allows Dr. Guyer and other TGI staff to perform more patient centered work and have more information available to them so they can interact and communicate with their patients effectively. It also allows easy access for patients to request medication refills which is so important in today’s busy and technology driven world. TGI prides themselves in personalized patient care and these customizations will allow them to maximize their patient’s experience.

Exciting Partnership Announcement!

CoreTech is proud to announce that we have recently partnered with Dynamic Health IT! Dynamic Health IT was established in 1999 to meet the increasing demands of modern health IT technology. Dynamic Health IT provides multiple Health IT tools that we have found to be outstanding and we feel will add great value to our customer’s organizations. One major benefit of working with Dynamic Health IT’s tools is that you can purchase all of their tools as a package or you can purchase specific tools that will satisfy the needs of your organization. This is extremely important to us because we receive multiple customer requests for very specific functionality. We appreciate the flexibility that Dynamic Health IT offers, which is something that is important in the consulting industry.

We were looking to partner with a company that has a robust product offering that many of our current and future customers in the health industry could benefit from. We wanted a joint effort where we could work together to sell and implement their products where CoreTech lead the implementation efforts and the DHIT team provided the development and support aspects of the implementation. CoreTech has a team of seasoned project managers, two PMP certified, who have extensive project experience implementing from planning to Go-Live of EMRs, Patient Portals, Transition of Care programs to help hospitals meet reporting requirements, migrations of data in the nation’s largest HIE, and many other areas in the HIT arena. We are very excited about our partnership because Dynamic Health IT and CoreTech Revolution combined have very knowledgeable staff and many years of expertise working with major hospitals and software vendors with a focus on Meaningful Use requirements. We also appreciate that Dynamic Health IT is a small business like CoreTech and embodies many of the core values as we do.

Dynamic Health IT offers several products. One of their featured products is CQMsolution, which is an easy to use web-browser-based reporting application for calculating, displaying and producing clinical quality measure output. Another product that they offer is ConnectEHR, which received the 2014 Edition Inpatient & Ambulatory HITECH Modular Certification. ConnectEHR meets interoperability requirements for Health IT Certification Criteria and smoothly connects with any EHR. With base EHR and bolt-on ConnectEHR functionality, you will meet Meaningful Use requirements. ConnectEHR also has a customizable Patient Portal that is ONC certified for Meaningful Use 2014 and meets both inpatient and ambulatory certified criteria for Meaningful Use. The patient portal allows patients to view, download and send CCDA documents and communicate with their provider through secure messaging. It also allows patients to access their clinical documents and send secure messages to their providers. In addition to Dynamic Health IT’s products being exceptional, they are bolt-on applications, meaning that they can be used with most any other products, including ones from other vendors or your existing tools.

At CoreTech, we want to review your workflow and work with you to identify exactly what your organization needs and ultimately find the best solution for you. CoreTech will work with our customers to determine the tools that are the best fit for their organizational needs. CoreTech has the expertise and experience to assist with the implementation to our customer’s environment while DHIT will do the development and training aspects of the implementation. At CoreTech, we’re excited about our new partnership with Dynamic Health IT and we’re looking forward to helping our customers find the products that best suit their organization-specific needs.

Telehealth at the IRHA Conference

What is telehealth? Telehealth is the use of technology to deliver health care, health information or health education at a distance. There has been a growing need for telehealth, especially in assisted living facilities. In Ohio alone, the number of adults age 85 and over will nearly triple over the next 30 years to 650,000 in 2050. More than 70 percent of Americans over the age of 65 will need long-term care services at some point in their lives and the cost of institutional care is currently $75,000 to $100,000 per year and rising.

At the Indiana Rural Health Association’s Annual Conference, a case study on telehealth was presented from a partnership between Maple Knoll Communities and The University of Cincinnati. The presentation was led by Dr. Debi Sampsel, the Chief Officer of Innovation and Entrepreneurship from the University of Cincinnati, College of Nursing and Megan Ulrich, the Director of Corporate Communications Maple Knoll Communities, Inc. The University of Cincinnati partnered with Maple Knoll Communities to observe how a variety of Telehealth devices can be used in aging services settings, from remote control robots to biometric monitoring. From this case study they learned about residents, families, health care providers, and engineering faculty’s response to use of telehealth and the link to access to care. They were also able to use the results of this case study to plan necessary steps for implementation and organizational readiness for telehealth application and/or expansion of services.

One telehealth device they used was the Flo-Bot. According to the presentation that was given, Flo-Bot is an InTouch Remote Presence Robot that performs patient assessments. It’s a specialist that “treats” from remote locations. Flo-Bot’s service results in quicker intervention and fewer trips to the ER. Flo-Bot provides better care at a lower cost. Another telehealth device that they provided to the Maple Knoll Communities is the V-GO. V-GO is in the beginning stages of “rounding” in Independent Living Apartments to help individuals live independently with the assistance of a physicians or nursing staff member. Some of the other benefits of V-GO include: patient education, monitoring, and remote communication. V-GO provides health assistance at a lower cost and assists in ability to age in place.

There were some challenges involving the telehealth devices. Some of those challenges include: the lack of funding for telehealth devices, educating and training on the telehealth devices for staff and physicians, and making sure that they maintained a high speed connection that is compatible with their devices. Their solution to their financial issue came from their partnership with the University of Cincinnati, and their solution to their education challenge was that they made sure that they gave an early notification of program and transparent goals and guidelines so that their staff and physicians were well prepared.

Telehealth affects people in rural areas because people living in those areas could have limited access to internet and the elderly may not be comfortable with computers, but if we could make the services intuitive enough and easy to use the elderly would be more likely to use it, and they could avoid long commutes to a nearby hospital for minor things. According to Wiring in Rural Patients, “Investing in telehealth may make more financial sense for health systems with rural facilities than staffing up those facilities with specialist providers.”

We need to work with hospitals to connect patients with expert care which will save them time, money and travel. We should also provide education on assisting older adults to care givers and providers who can improve their quality of life. Lastly, we should leverage technology for health monitoring and assistance which can help catch issues sooner and monitor critical or chronic patients and provide assistance in a timely manner.  We need to continue to create new technology, products and systems. If we advance telehealth and make it available across the nation, we can lower readmission rates, especially if we expand telehealth into assisted living facilities to help older adults age in place. With the elderly population growing, advancing telehealth should be a top priority since telehealth is a proven way to effectively care for elderly patients while also saving money.

Indiana Rural Health Association Conference

Summer is officially here and so is the 19th Annual Indiana Rural Health Association’s conference! The conference was held on June 21st and 22nd at the gorgeous French Lick Springs Resort. This year’s theme was “Rural Health: Align, Connect, Engage.”

The IRHA’s Annual Conference brings together physicians, nurses, pharmacists, public health professionals and other rural health practitioners from all over the state. National experts and skilled practitioners from the field discuss current topics, as well as share the experiences of others in public health and rural health care delivery. The conference’s schedule was packed with speakers, networking and social events and even a 5K Fitness Walk/Run! This year, telehealth was a hot topic during the learning sessions, with the speakers addressing the steps that need to be taken to build a Telehealth program. A featured speaker was Ed Bell, a farmer from Hagerstown, IN. Bell is a gifted communicator, a powerful motivator, a born leader, and a true overcomer. He has had personal experience dealing with disability and hardships. He is a survivor of a violent criminal attack and sustained a gunshot wound which left him permanently paralyzed. His keynote speech was on “The Patient Experience: Disabled Farmers Farm— Overcoming Adversity.”

IRHA has also developed an app you can download to help you navigate through the conference and connect with other attendees. We highly recommend downloading the app if you plan to attend next year! The beautiful location, the innovation of the topics being discussed and the many fascinating keynote speakers creates a wonderful learning environment, you won’t want to miss the 2017 conference!

Here’s a link to all of the resources that were presented at the IRHA’s Conference, make sure to check it out!

Baby Announcement!

Adalynn CTCoreTech is proud to announce Ashley and Jon had a baby GIRL at 6:01pm on March 30th.  Her name is Adalynn Marie and she was 7 pounds 1 ounce, 22 3/4 inches long.  She is beautiful and everyone is healthy and happy.

Ashley has been with the CoreTech Revolution Team since August of 2011, she is our Human Resources and Office Administrator. She is always willing to take on a new project and helps in any way she can. She has been a key player in helping with web development and managing web projects for some of our clients. We wish Ashley and Jon the absolute best in their new life together and welcome to the CT Team baby Adalynn!! <3