SpellBound with Christina York

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The way we execute our product through mobile devices means that it’s really accessible to everybody, even across socioeconomic strata, that we can really democratize access to that technology.
— Christina York

In this episode, I talk with Christina York, founder and CEO of SpellBound, which uses augmented reality to improve the patient experience for children in hospitals. Spellbound makes the hospital experience less scary for patients, and it motivates them to participate in treatment and recovery. Christina shares ways in which a hospital delivers the products in small and large scale ways.

They have been in the market for 2 years, and currently, have about 25 hospitals around the globe using Spellbound. They do not currently sell in international markets, but have donated it or had hospitals try it out in those countries in order to learn more about those markets, with the plan to go international in three years. The current focus of Spellbound is pediatrics and any hospital that serves children. Within 3-4 years, the plan is to expand the technology to serve adults and go beyond the hospital to clinics and home health care.  

Topics In This Episode:

  • Taking a failed idea and reinventing it to create Spellbound

  • How the technology is used in different departments within a hospital

  • Implementation within a hospital

  • Current status of Spellbound

  • Methods and importance of obtaining quantifiable data

  • Finding talent to work on and develop the technology

  • How to prioritize time spent working in the business, versus on the business

Contact Info:


Transcript

Mike Kelly:
Welcome to the podcast. Today we have Christina York, who's the founder and CEO of SpellBound. Christina, welcome.

Christina York:
Thank you very much for having me.

Mike Kelly:
Why don't we start with a quick elevator pitch for SpellBound and what you guys do?

Christina York:
Yeah. SpellBound uses augmented reality technology to improve the patient experience for children in hospitals. We use super-immersive technology delivered through mobile devices to manage pain, improve patient education, and motivate patients to get up and moving around, to help with healing.

Mike Kelly:
Can you give some specific examples of what that looks like, make that a little more tangible?

Christina York:
Yeah, for sure. We deliver our product to hospital staff. Now, this could be a therapist or a nurse or a doctor or radiologist, different roles in the hospital, and they use our product with their patients for different purposes. So for example, with our pain management tool, it's used to provide distraction for children during painful procedures like needle-related medical procedures, blood draws, IV starts, chemo port accesses, or other procedures like burn dressing changes or catheterizations, things that have a level of pain that when the children don't cooperate, it can cause the procedure to go longer. The hospital can resort to using measures they don't want to use, like restraints, holding children down, or sedation in some cases.

Christina York:
We create these 3-D digital experiences that are placed on top of the hospital environment. A child might have, say, one of our SpellBound cards that when they point a mobile device or a tablet at it, it'll add a 3-D interactive experience to it. So that at a very small scale while they're sitting for a procedure, they could be using it. Or in a very large scale, they can point it at a mural in the hospital, point a mobile device at a mural, and see that mural come to 3-D life. There might be gamified elements in it, where they have to, I don't know, fling starfish at a pirate ship or things like that. But they get to interact in 3-D, large scale or small scale, depending on the ability of the patient with that digital environment. And it just makes it less scary and motivates them to participate in their treatment.

Mike Kelly:
All right, that is awesome. This is totally why I wanted to talk with you. Thanks. Okay, that's great. That tangibleness is perfect. When you engage with a hospital, what does an implementation look like? When I imagine a mural or something like that, are you guys going in there and applying something that would be interactive, or are you just taking existing things and just putting small codes next to it that the phone picks up? What does it look like for you to actually instrument a hospital for this kind of partnership?

Christina York:
Right. If a hospital doesn't have, we often call them triggers, we use the mobile device's camera to recognize images and text. With our card systems, we send the cards to the hospital. They can get going as soon as they download the app and enter their code. It's like two minutes and they're up and running. With the larger-scale experiences in our space transformation product, we don't have to use things that we make, and that's the beauty of it. Hospitals often come with beautiful artwork. They have specific themes to their hospital. So whether it's posters or signage or murals, we can just simply take a photo of those and upload it in our backend to be able to recognize that as the trigger. A lot of times the hospitals we've worked with so far, they have their specific art style that they want, and we can just use that.

Mike Kelly:
That's awesome. All right. For somebody's who's listening, if you could paint a picture of kind of where you're at and your team is at on the journey? That can be any sort of ANIA metric like revenue, number of hospitals, number of employees, funds raised, anything you want to share that can help somebody who's listening know where you're at.

Christina York:
Yeah. We are an early stage company. We've been in the market for about two years. There's a total of about eight of us on the team right now, and we have upwards of about 25 hospitals all around the globe using SpellBound. Now, when I say around the globe, what I mean is that we're focused in the market in the US, but we've had interest from countries like Indonesia and the UK and Canada and Australia and China and Japan and Kenya. So while we do not sell into those markets right now, we have either in some cases donated it or are having hospitals try that out in those countries, so that we can learn about those markets as we're getting ready to go international, maybe in about three years.

Mike Kelly:
That's awesome. All right. Sorry, I just have kind of business questions now. I'm fascinated by this. Are you primarily, then, selling to children's hospitals? When you break down the market, when you think of ... obviously, there's thousands of hospitals in North America, when you start to break down that market, where are you focused today, and then I'd love maybe your thoughts on how does that change three to five years from now?

Christina York:
Right. Where we're focused today is on pediatrics. We sell to any hospital that serves children. The natural place to start was pediatric specialty hospitals, and we have many of the top 10 hospitals in the country using SpellBound. That's fantastic, but general hospitals, rural hospitals, private for-profit, non-profit, everybody serves children. We have other types of specialty hospitals that are customers, as well as general hospitals and health systems. That's where we are right now.

Christina York:
When you think about introducing a frontier technology like augmented reality into maybe a more traditionally conservative market like healthcare, you just really have to look for that entry point. Using this type of imaginative play technology with children was a natural place to start. It was a great place to introduce something that was new and different. Kids are natural early adopters, and so we right away got great reaction from the product.

Christina York:
What we see in three to five years is that children are not the only ones that have to deal with pain or anxiety as part of hospital treatment. Adults certainly feel all those emotions as well, and so we really plan on expanding the technology to serve adults and certainly to go beyond the hospital, whether it's to clinics or home healthcare. The way we execute our product through mobile devices means that it's really accessible to everybody, even across socio and economic strata, that we can really democratize access to that technology because of the way we do it. So that's our vision, is really to start here, start focused with children, prove the value, and then move out to serve all populations across multiple channels of healthcare.

Mike Kelly:
And when you're selling to a hospital, is a hospital choosing to bring in this technology? Do they just view it as a kind of a sunk cost, meaning there's no way for them to bill this back to patient experience, and they're just viewing this as a way to create a better-differentiated patient experience and have better health outcomes? Or are some of those hospitals finding ways, whether it's through insurance or some other way, recoup some of the cost for this?

Christina York:
Right now, we're not reimbursable through insurance. It is a way of introducing the technology into the hospitals. It's a sunk cost. They pay an annual access fee, because we add and improve the experiences all the time. Networks right now, I think that hospitals are really struggling to find great scalable patient experience solutions. So whether it's pain management or getting patients to better understand what's going to happen to them, so that they can make better decisions and participate more in their recovery, I think hospitals really, the status quo isn't satisfactory to them, and they're mandated to ... Why do you need to sedate children so much for MRIs? This is out of hand. This is a risk and a cost that's not necessary.

Christina York: So hospitals are looking at the cost of SpellBound as really a counterbalance to the cost of what they're doing now around the patient experience, just trying to get the procedures done or reducing the cost of those procedures. That's how we directly compare.

Mike Kelly:
That's awesome. Do you see a version of the future where you're even able to capture some of that data in a quantifiable way, like where you could potentially be measuring like this is, on some sort of scale, this is how we think our technology is affecting pain management for kids while they're undergoing this type of procedure versus that type of procedure? Do you think you'll be able to quantify any of that at any point in the future?

Christina York:
Yeah, absolutely, and we're working on a bunch of it right now. What we started with is just getting the product, a really simple product, into the market and saying, "Are they going to use it, and what are they going to use it for?" And then can we collect that anecdotal data, that qualitative data? Can we interview those clinicians? Can we hear what the families think and get that back and use that as a starting point to say, "Now, where do we begin to quantify this impact?"

Christina York:
What we've started doing is creating research partnerships with hospitals, top research hospitals in the country. One of them is going to be working on validating our pain management tools. Can we actually quantify this impact, in terms of is it making the procedures more efficient? Are you getting higher throughput of patients, say, in a certain department? Are patients adhering better to their treatment? You know, post-surgery, when they say, "Get up and walk," and you have to walk 15 minutes a day up and down the hallway in the hospital. Are you actually doing that? Are you complying with the instructions, and then are they seeing progress in terms of recovery?

Christina York:
Those things are all measurable. When we think about our products like our MRI simulation, we create a simulation that patients can have in their home of what it's like to be inside an MRI, so that hospitals don't need to sedate children as much just to hold still for the MRI. Sedation is expensive, it's risky, it requires longer recovery period, it can have complications. Nobody wants this solution. We can actually measure the impact we have on sedation rates for children, and that's a really great metric to be able to walk in when you're talking price with a customer.

Mike Kelly:
When you think of competitors for SpellBound, who or what comes to mind?

Christina York:
The biggest competitor we see right now is virtual reality. There are no other augmented reality companies that are focused on healthcare, but there are a handful of virtual reality companies that compete roughly in the same space. Sometimes they're more, I'll say, niche competitors, so maybe just in pain and anxiety management or in physical therapy. But I would say virtual reality is the technology competitor. Of course, we compete with the way they do things now, which, as I mentioned, sedation, restraints, undesirable. But they do things like also provide toys to children or what's called medical play, scale model MRI machine, so a kid can play with it and learn it. So other types of hardware are things that hospitals might use. We do compete, just in terms of changing the way they do things, taking those dollars away from those type of things to put toward technology.

Mike Kelly:
With virtual reality, if I'm the patient, I'm putting on a headset, right?

Christina York:
Yes.

Mike Kelly:
And to your point, that could be much more specific in terms of the type of outcome that you're going for. I guess when you look at future technologies coming down the road, or maybe things that are emerging now in the AR-VR space that have you excited, are there any new things or things that you guys are anticipating in the next 12 to 24 months that maybe isn't quite mature enough yet, that have you kind of excited for things that you guys can do better down the road?

Christina York:
Well, I think the big thing that we were excited about recently was the move on mobile devices, ARCore and ARKit. Really, having those things built into the mobile devices everybody owns is the first step to saying this is an everyday thing. This is going to be an everyday thing, augmented and virtual reality. I think one of the biggest impacts for us with that was, it's going to mobilize a whole army of people who are able to develop experiences for augmented reality. That's been a big thing. When you're starting a tech company, and you're looking for that talent pool, where can you draw from? How many people have these skills? That's a challenge when you're early in the market. So that was a big thing for us.

Christina York:
I mean, we are excited about headsets. I think that ultimately hands-free is going to be a better experience down the road, but right now, it's not there. The market is not there. And when you think about the challenges of change management, especially in a hospital, where everything is based on protocol or procedure, how do you introduce a piece of hardware, where they might get really excited and say, "Oh, this is clinically proven. It's going to work"? But then how do you manage it into their workflow? Where do they store that headset? How do they sterilize it between patients? You're actually changing the way they work and asking them to develop new protocol, and that can be a barrier to adoption.

Christina York:
We think that while the virtual reality companies are out there, great. Let them acclimate the customers there. We'll fit right into their workflow right away. They are all assigned mobile devices that they carry with them around patients, so let's just use that for now and get the usage and get the loyal customers and get the use cases and get the data. And then when the market is ready, when hospitals are really ready to adopt headsets, or that maybe the consumer market has started adopting headsets, it's easy for us to port our technology over to those devices to be delivered. So really for us, being agnostic in that sense and just watching where the market is going is exciting for us, because we'd love to start developing for headsets as well.

Mike Kelly:
Awesome. I'd love some of those early conversations with the hospital. Forget maybe some of your earliest adopters, who were probably, I'm assuming, your friendliest conversations, right? As you guys have started to move to hospitals where maybe they're not going to be the first movers, and they're, I'm assuming, looking to see results from some of the hospitals you've been working with over the last couple of years, what do some of those conversations look like? Are you finding that they're fairly open to those types of changes and want to explore this? Or is this just like any other sales cycle, where you've got to find a champion, and you've got to arm them with all the data and the stories to help you get in there and be able to do a pilot? Or is this an easier sale, where people can at face value just see how this could be a better way to get better outcomes?

Christina York:
I think that we're attempting to make that leap right now. Some were early adopters that we can sell to, but really starting to bridge that gap with that early majority, and those are people that are very practical. They don't really think of themselves as risk takers or these early adopters, these technophiles. We have to really focus on practicality, and in medicine it's evidence-based. Or in business it's return on investment. Can we really prove to them that it's going to move the numbers that they want to move? That could be around cost of care or a very specific metric. Like I mentioned, we do sedation in this specific situation.

Christina York:
And this really depends on how we enter the hospital. We haven't come in from the top down. We've only been in the market two years, so we started with very limited content on our platform, and it was really targeting specific departments like child life or radiology or anesthesiology. That way we're looking at every department in the hospital as a mini-market, if you will, to come into. But once we're in the hospital, looking at how we can leverage those relationships and the success stories we get with them to introduce us to other departments in the hospital that could be making use of it. So in that way, we're kind of like backing our way into an enterprise level deal with the customers.

Mike Kelly:
Got it. And now I'm kind of going to be all over the place, so forgive me here. Do you have a way that you ... do you formally track whether it's competitors or even, I'm guessing, it's just medical technology, so you can kind of stay up to speed on what's happening in the market in general? Even though I'm sure it's not all going to be AR or VR related. Do you track that stuff on a regular basis? And if you do, is there a way that you do it?

Christina York:
Yeah. I'll say there's three things that are kind of packaged up in there. The first is competitors. Do we track them? Yes, we primarily track competitors through the eyes of our customers. There's a lot of, I guess we'll say blue ocean out there, in terms of AR-VR, particularly in healthcare. We're all going after these top tier customers, the real big name brands, and so it's likely that when we come into a hospital, they've already encountered our competitor, or they already have the product in the hospital. That way, getting the feedback in terms of what are the challenges that you're encountering with that? Can we help solve that with our product?

Christina York:
So really keeping tabs. We check in regularly with our customers. We have a strong customer success program, and we do other things like going to conferences, professional conferences and trade shows, and keeping tabs on our competitors, again, through the eyes of the customer. We watch them interact. How are the people interacting with their products and stuff like that? So it's a great kind of competitive intelligence platform.

Christina York:
Beyond that, our real strategy is to not worry about the competition. And I say that lightly, because you always have to worry about your competition, but not to base what we're doing based on what they are doing. Really base it on the need of the market right now, and there's just so much opportunity that if we're really listening to our customers, we've got the best basis we could have.

Christina York:
Now, the other two things you mentioned around our market is we need to be keeping tabs on technology, the evolution of the technology. And we also need to be keeping tabs on the healthcare market, what changes, whether it's in insurance or mandates across healthcare. What changes are happening in the healthcare space that would change the way hospitals would want to use our product? Those are two important things for us to keep an eye on, especially with the newer technology. We're always struggling to mold that technology to the purpose of the market, and for hospitals, performance is key, and reliability is key. We really need to make sure that any new development technology that could help us with those challenges, we are staying on top of.

Christina York:
So simple things like subscribing to key online publications and blogs and setting up Google alerts around those type of things. Usually I try to schedule some time every Friday to do a quick review of what's going on in healthcare and technology, to try to keep myself up to speed.

Mike Kelly:
Nice. That was a beautiful answer to a kludgy question. Well done. I appreciate it. You keep doing that, I'm going to sound awesome as an interviewer, so that's great. All right. You sparked something in there, particularly at the end, while you were talking about kind of where you get some of those sources of information and when you reflect on it. It took me down a slightly different path, which I'm kind of curious about. This is one of the things I suck at in any of the endeavors that I'm involved in. I don't really, as a general practice, step away from the business and reflect on it and think about where are we going and what could I be doing better in that, and what's my role in that? One of the things that I heard in that response is you might actually be good at doing that. Do you do that on a regular basis? Do you ever step away from the business, or do you provide structured time on your calendar for you to kind of eject yourself from the day to day and reflect on what it is you're trying to do?

Christina York:
Yeah. I think it's really important to differentiate, especially in the early stages that could consume you with fires or opportunities popping up at any moment, constant distractions. Really differentiate the difference between working on the business and working in the business. I've been really conscious of that all along now. That being said, do I schedule time in my calendar? Yes. Do I adhere to that all the time? No. Things come up, and it's a constant prioritization juggling act, I'd say. But there are times too when I say, "Okay, I didn't get that done in the office this week. Guess what? It's going to be, guess what I'm doing Friday night from 10 to midnight? Or Saturday morning or Sunday afternoon."

Christina York:
It's saying that trying to have in my head, committing 10 to 20% of my time, whatever that might be that week, of really working on the business, and that's understanding what's the competitive landscape, what's the market doing, are things changing? Let's review some of our customer notes and take a step back for a second. We've really been working on including more discovery more regularly. And of course, we have this great customer success program, but how do we look beyond what we have right now and being really conscious about it?

Christina York:
Does it always pan out, in terms of yes, I scheduled Friday afternoon from 3 to 5? No. It does not always pan out, but I think making it a priority and making it one of our core values is the way that it kind of keeps it sticky for us.

Mike Kelly:
That's awesome. Do you have a hard time staying focused? I'll unwrap that a little bit. Specifically thinking through, you're in kind of a bleeding edge technology space that is super fun and hot to talk about, right? Augmented reality, virtual reality. You're in healthcare, which has tons of opportunity. I'm sure you can find places to take some of your success and start applying them, which potentially could be a distraction, right? How much do you focus on products that you guys have already built out, versus exploring what are other ways that you could apply this technology? I have to imagine that's a constant struggle. I'd love your thoughts on how you and the team manage that today.

Christina York:
Yeah. Focus is a challenge for every startup. For us, it's a really big challenge, because as soon as we show our product to a customer, you know you've got them when it's sparked their imagination. They're suddenly coming up with new use cases. Or, "Well that's great, but what about this?" And as soon as you spark their imagination, you get this flood of ideas, which of course you don't want to necessarily ignore. We capture, we look at. But how do you take what's just a flood of ideas from one customer, one data point, and turn it into a roadmap or a three-year plan for the company?

Christina York:
So stopping and saying, "Well, we have a great relationship with other customers. Let's see. Are other people facing similar challenges?" Certainly, as a specific example, we started with pain management, because it has such general use, and that's great. And now we get exposed across lots of departments in the hospital. We had an idea of where we would go, and we loosely called it patient education. We knew that many hospitals struggled with getting patients to engage with complicated or overwhelming information, certainly when they're in a high stress situation.

Christina York:
So we knew we wanted to go in that direction, but we didn't say it's going to have to come from us. We looked at the problems, and the number one thing with MRIs is sedation rates and how unnecessary it is. We saw that every customer that we talked to had this issue, and so then we looked for a partner to develop that. Our process is always, we're going to develop kind of like a proof of concept or an MVP, whatever people want to call it. We put it out to a handful of customers that are trusted, that really are open to engaging with new ideas, and we see how it is used in the clinical setting, which is completely different than where we might be testing in our office setting. We get that feedback, and then we use that feedback and put that work into actually productizing it and rolling it out to the market.

Christina York:
The focus is really around ferreting out opportunity, in terms of as a small company with limited resources, is this something worth putting our limited resources into? What is it going to get back for us, and what's it going to get back for our customers? What is that value for them? It's really just creating a backlog of opportunity and kind of ferreting out what's going to not only make impact for our customers and what's going to help us to grow in the market around our goal? I guess a mixed agile between product development, as well as our business goals, is what we focus on.

Mike Kelly:
Nice. I'm curious, how did you started in AR?

Christina York:
By accident. No, I think when you ask how we get started with AR, it was really, I'd worked in technology for many years, more than a decade, by the time I started my first AR company, and it was really I had never worked with augmented or virtual reality before. It was one of those things where-

Mike Kelly:
Wait. I gotta pause you real quick. Your first AR company, so this is not your first AR company?

Christina York:
Technically it is, but it's not. In 2015, I started an augmented reality company with a co-founder that was focused on publishing and higher education. The concept was use immersive technology to get children engaged with literacy and literacy activities, so adding augmented reality to books. That was a great idea, had lots of attention, but zero traction, so we wound that company down at the end of 2015. But during the course of that company, we talked to a lot of parents, did a lot of discovery. And one of those parents worked at a hospital, a local hospital, and really saw the potential for the technology in the hospital environment. That is where we killed the other company and sat down and focused on healthcare. And then SpellBound was born after that.

Mike Kelly:
And then even in the publishing company, when you first sat down to start doing that, you were just looking for a project where you thought you could apply augmented reality? You were just intrigued by the technology?

Christina York:
Yeah. I mean, you hear a lot of sometimes negative things about gaming or virtual and augmented reality, about the old cliché of kids playing video games and being called for dinner and not answering, right? When you think about the negative connotations around how immersed we are in technology, can you actually take that power and use it for good? Can you take that immersive power and apply it in situations where that could really help, like pain management or building literacy skills? I think there's lots of opportunity around learning and healthcare for these technologies, and that's what really the idea was. Take something that just had so much power and potential behind it, and find a really great use case for it, and start with the need and apply it.

Christina York:
I think that there's a lot of things, people were shying away from it just in terms of early failures, like with Google Glass and stuff like that. And oh, it's never going to be mainstream, and it's never going to be used in these situations, and really kind of breaking that myth by starting with people who have a high need and that are not biased against any solution. They just really need to solve this problem. We had teach ourselves augmented reality, and we had to learn with our early customers certainly, about building the technology specifically for those use cases. And now a few years in, we've got the most experience anywhere about building augmented reality for healthcare, and that's a wonderful thing to be able to walk into meetings with CIOs and CEOs of hospitals and really say, "We understand what you're facing, and we are doing this to solve this problem for you."

Mike Kelly:
I love it. That's great. This is somewhat related. You had mentioned this earlier, where one of the things you were excited about is ARKit and stuff like that becoming a little bit more mainstream, and thus you think the pipeline for talent for developers and people who can help you grow the company as you grow should start to open up in the future. I'm a little curious, how have you found talent to date? Are you finding people who have been tinkering with this on the side and are excited and happy to do it as a full-time job, or are you having to grow that talent internally and just find people who are willing to learn, and then you have to invest the time to get them up to speed?

Christina York:
Yeah. We are based in Michigan, so Midwest.

Mike Kelly:
Yeah, the hotbed. I mean, it's basically Silicon Valley.

Christina York:
A hotbed of augmented and virtual reality. Yeah, it's just teeming with possibilities. No, we had to say there is ... We looked at local universities and colleges. Are there programs turning out people who have a certain level of skills? And in many cases, it's no. It's traditional computer programmings, ++ and oh, we offer one gaming course over here or one course with C# or Unity gaming engine. And we're like, "Okay, great. Let's start there and make relationships with these places." When we looked at those universities and said, "Oh, well they're not really offering a robust program around augmented, virtual reality, or game development, but there's gotta be interest." So were there student groups? Were there student-formed clubs or hacker clubs or meet-ups?

Christina York:
We started there, and would go bring pizza, show up and say, "Hey, can we talk to you for 10 minutes?" I mean, people have passion projects and band together and create clubs out of these passions. You got a great talent pool there, right? And also a group of people who are willing to be self-taught. That's where we started. We also looked at where else might there be 3-D modeling and animation going on in the world? Being in Michigan, it's the auto industry. How are they visualizing new models of cars and trucks, and can we, us tiny startup, try to poach talent from these big companies?

Christina York:
What we found was that there was such limited opportunity in the area to apply those skills that people really got pigeonholed, and then very frequently worked at that job for a few years and then went off to the West Coast to find more opportunity. And so it was easy at that point, when we figured out where they were, to tap in and say, "Hey, this is what we're doing. It's amazing, and it's making a huge difference in the world. And you can be a part of it." People were just jumping onboard to help out, and for us that's great. We weren't competing for talent. We weren't having to pay outrageous hourly wages for contractors like on the West Coast. And it just helped us get stuff done right out of the gate.

Christina York:
Of course, we have to train. Of course, we have a proprietary platform. We have a patent around our technology. So we're going to have to onboard anybody and get them up to speed about how we do augmented reality, but it's so much easier to train people when you've really just got people with passion and grit and who are just willing to commit to learning this new technology. So that's a great place for us to start.

Mike Kelly:
That's awesome, and I want to wrap up there. If people want to get ahold of you or learn more about SpellBound, where can they do it?

Christina York:
Our website is SpellBoundAR.com, and all our social media is SpellBoundAR, and I can be reached at christina@SpellBoundAR.com.

Mike Kelly:
Christina, thank you so much for taking the time. I really appreciate it.

Christina York:
Thank you for this opportunity to share.