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Nils Mueller-Kronast, MD

Nils Mueller-Kronast, MD

Interventional Neurology, Neurology
Boynton Beach 33472

Creating Hope

Andy’s Story

Andy's Story

Andy Rogers, Back In School And On The Farm Thanks to Advanced Stroke And Neurology Treatments.

It all started that day when I was in science class finishing a half-hour reading assignment. I started vomiting all over the place, my right side felt weird and I had trouble speaking. School staff called an ambulance and I was taken to a local hospital where, during a CAT scan, they found swelling in the left frontal lobe of my brain. I was initially treated for seizures at the hospital. However, because of the uncertainty of my condition the decision was made to send me south to the Level 1 Trauma Center at St. Mary’s Medical Center in West Palm Beach. My mom demanded that I be airlifted, and I’m glad she did.

The Trauma Hawk helicopter flight crew was on the ground for five minutes when they asked me to smile – the left side of my mouth went upwards like a normal smile but the right side didn’t move. The flight crew immediately diagnosed me with a stroke. They called a stroke alert to St. Mary’s and Dr. Nils Mueller, an interventional neurologist, rushed to the hospital to save my life. My father gave Dr. Mueller, a man he’s never seen, never met, and knew nothing about, permission to attempt to remove a clot from my brain.

I had an ischemic stroke, which is an obstruction in a blood vessel supplying blood to the brain. My mom recalls me getting wheeled into an extremely high-tech operating room – Dr. Mueller literally ran into the room and wasted no time in saving my life. She said that it was the longest hour of her life.

Dr. Mueller went through an artery in my groin and successfully retrieved the blood clot that caused my stroke and threatened my life. My mom told me I had people all over the world, from all religions, praying for my recovery. Sunday, she said I made it to the Pope’s prayer list. When I awoke from the procedure, I felt weird and didn’t know where I was. I spoke a word, but couldn’t put together a full sentence. Later that day, a neurologist gave me a pen and paper and asked me to write down my favorite food. So, I wrote down: steak!

Since leaving the hospital, I have had follow-up appointments at the Palm Beach Neuroscience Institute for cognitive testing with Dr. Christina Zafiris, a pediatric neuropsychologist. I like having Dr. Zafiris as a physician. She is very thorough in the way she explains the tests and I am very comfortable under her care. She treats my family and me with respect. The school district waited for Dr. Zafiris’ initial reports on me before making any decisions on me returning to school and resuming classes. Today, I am back in school for three classes and the 4-H Club, a youth development and mentoring organization. The second half of the day I head back to my family farm where I meet my homebound teacher for studies.

Before my stroke, I enjoyed spending my free time taking care of livestock. I raised a baby pig named Miss Piggy to show at the annual county fair and my family bought a heifer named Milkshake to start off our herd. Then, three weeks before the fair I had my stroke. The first thing I did when I got home from the hospital was visit Milkshake, who had been staying at my friend’s house.

Three weeks after my stroke, at the Indian River County Firefighters’ Fair, I showed my pig without any help from another peer or an adult, participated in the whip cracking contest, helped my friend show his breed stock cattle, and won Intermediate Barn Prince for my age group. This year, I grew a Glen Navel citrus tree, raised a steer and laying chickens that I showed at the fair. I also showed Milkshake in the breed stock show. Once again, I participated in the barn king and queen competition and the whip cracking contest.

From the day I got home until now, my small, tight group of friends pushed me to get better. They didn’t settle for the head shakes, head nods, and the finger pointing I would use to communicate. They told me, ‘you need to find your words… you need to use your words.’ Even physically, I got right back out there working with the cows. I help take care of a cow that weighs 1,700 pounds and today I don’t even hesitate putting a halter on her. Since leaving the hospital just over a year ago, I’ve even been able to compete at the county fair and present the animals I had helped raise, including a pig, chickens, a steer, and of course, Milkshake.

Today, I feel better, but I am still on a long road to the recovery. I want to say thank you to the doctors and nurses who took care of me at St. Mary’s. I am glad that they didn’t waste any time in saving me from my stroke. It’s true – time lost is brain lost.

Creating Hope

Edward’s StoryEdward playing guitar


Edward Mayer – Retired Architect and Interior Designer.

After thrashing around in my bed like I was having bad dreams most of the night, I had a stroke at 4 a.m. in the morning on Good Friday, April 18, 2014. I don’t normally wake up that early, but when I did that night, the first thing I noticed was that I couldn’t feel my right arm. It was like my arm was missing. Half asleep, I felt around and was able to find my left arm, which still had feeling. Then, I tried to speak but couldn’t find my voice. I formed sentences in my head but would just mumble words together when I tried to speak. It was like I knew what I wanted to say but couldn’t get the words out. At that point, I knew what it was with that type of speech coming out of my mouth. My 50-year-old son Greg, one of my identical twin children, could tell something was wrong. I put my clothes on and we went to the closest hospital.

Luckily Dr. Sheryl Strasser, a neurologist with Sunrise Medical Group (SMG) on-staff at the hospital, recognized my symptoms and told my family she knew that I needed to be brought to a center with the latest diagnostic and therapeutic advances that also offered a wide range of interventional options that had the potential to stop a stroke in progress and minimize potential damage it would cause to my brain. Dr. Strasser referred me to the Comprehensive Stroke Center at Florida Medical Center, a Campus of North Shore located in Lauderdale Lakes. The Comprehensive Stroke Center is prepared 24/7 to rapidly and accurately diagnose and treat stroke patients.

At Florida Medical Center (FMC) Dr. Nils Mueller-Kronast, an interventional neurologist with Palm Beach Health Network Physician Groups (PBHNPG) was able to save my life with virtually no surgery involved. Through an artery in my leg, Dr. Mueller used the Solitaire Pipeline Embolization Device to enter my brain and retrieve a blood clot that had caused the stroke in my brain. The procedure saved my life. The amazing thing was that there was virtually no surgery involved. I came out of that procedure without a scratch. In fact, during a checkup by a cardiologist a few days later, the hospital staff discovered I had carotid artery disease and that I needed a new pacemaker in my heart. I had the pacemaker put in the next day, just a few days after I was cleared from the stroke.

I feel lucky that Dr. Mueller is equipped with and uses some of the latest technology to help in the stroke diagnosis process. As a lead stroke doctor at a Comprehensive Stroke Center, Dr. Mueller has the technology and the expertise in interventional neurology and endovascular surgery to remove clots or blockages from blood vessels in the neck or brain, which are some of the most complex stroke cases.

Looking back at my stroke, I didn’t have all the symptoms but I did have a few warning signs. I stopped smoking 30-years ago. About a week before my stroke, I noticed during my weekly walks in an area mall I do to stay fit, I was having a hard time breathing and had angina. Then, I couldn’t get to the mall entrance without stopping to catch my breath. Normally, I had an easy time walking the mall and to my car. Over the course of the next week, I wasn’t eating well. I thought I had the flu. The night before the stroke, I ate a good supper and spoke to my son Greg about car racing and boxing. My favorite fighter is Manny Pacquiáo, he’s a real fighter just like me! We also love car racing and had a great conversation. Then, I went to bed.

I have done a lot in my life of 82 years, and I won’t let a stroke keep me from doing more. Up until seven-years ago, I was a college professor, but after heart surgery I retired at age 75. As an architect and designer, I designed the first mall in America in Concord, California. I was always a fighter, ever since I was put in Japanese Concentration Camps at age four when the Japanese invaded the Indonesian island I’m from in the South Pacific Ocean.

I know after my stroke there was going to be a lifestyle change but I can’t wait to get back to playing my lap steel guitar and my bass guitar. During my career with the Army, in my free time, I played right along with the best of them including Charlie Christian and Benny Goodman. Over time I became no. 1 in the world for steel guitar. I wrote the steel guitar theme played at the beginning of the SpongeBob SquarePants TV Show and also a few Hawaiian Travel Channel programs. Thanks to the care I received from Dr. Mueller my face or arm didn’t get paralyzed. Today, I feel healthy and back to what I enjoy most – playing lap steel guitar tunes.

Creating Hope

Karen’s StoryKaren Kerner


Survival the FAST Way.

Thanks to my husband memorizing the FAST acronym he was able to save my life from a stroke. He also prevented me from becoming paralyzed or otherwise injured. Of course, I am overjoyed and tremendously grateful for his actions, but what exactly did he do?

On an early summer morning, I fell out of bed. When my husband Andy couldn’t make sense of what I was saying, he immediately diagnosed the fact that I was having a major stroke. He immediately dialed 911 to tell the paramedics I was having a stroke, and they quickly rushed to bring me to the hospital. The paramedics agreed with Andy’s diagnosis and sent a stroke alert to Delray Medical Center, which has a dedicated stroke team. Within 88 minutes, Dr. Nils Mueller and the Delray Medical Center stroke team had treated me with the most effective new clot-busting drug, and a large blood clot had been removed from my brain. In consequence, I have had no resulting deficits or damage from the stroke. The medical and nursing staffs said I was a miracle, and I’ve even become an unnamed poster girl for the hospital.

All this happened because my husband remembered the acronym FAST, which defines the procedure for diagnosing a stroke quickly. F (stands for face): does the affected individual show a drooping or contorted face? A stroke victim’s face definitely looks abnormal. A stands for arms: can the affected individual raise both hands above his or her head? Stroke victims may not be able to. S stands for speech: can the affected individual speak clearly? Stroke victims slur their words and cannot speak clearly. T stands for time: the faster you can get a stroke victim to the hospital the more likely it will be that he or she will survive and have few or no consequences of the stroke. If a stroke victim can be treated with tissue plasminogen activator (tPA), the clot busting drug used to breakdown blood clots in the brain within three hours of the onset of the stroke, the better the medical outcome for the stroke victim.

Because of my good fortune in having a knowledgeable husband who knew the FAST test, I am still (or again) a healthy, independent person. I would like my experience to bring the knowledge of how to diagnose strokes to the wider public, so others can survive this frightening experience as well and as quickly as I did. It is absolutely critical to treat someone having a stroke as fast as possible, and, preferably, in a hospital with a dedicated stroke team. Time really is of the essence in dealing with this medical emergency. The faster you deal with a stroke, the more likely there will be a positive outcome. Please remember FAST and use it as quickly as you can if someone is showing signs of having a stroke. The longer a stroke patient waits to be treated, the more likely major damage will occur. Think positively: work FAST!

Creating Hope

Marina’s StoryMarina tending to plants


Marina Bojazi, Piano Virtuoso.

It was a normal Wednesday afternoon – the calm before the storm. I was eating lunch with my friend Robert when I started to drool and slur my words. All of a sudden, I fell out of my chair. The next thing I remember, I was laying on a stretcher.

Looking back, I was not showing any signs or symptoms of having a stroke until the day it happened. My stroke had come as a complete surprise to me. I am a healthy person. I love ballroom dancing and have been playing the piano for years. At 77 years old, I’ve experienced a lot in my life.

I was originally taken to a nearby hospital and within minutes I was transferred to Delray Medical Center’s Comprehensive Stroke Center. While at Delray Medical Center, Dr. Nils Mueller-Kronast, a neurointerventionalist, had used the Covidien Solitaire FR Revascularization Device to remove a blood clot in my brain. Dr. Mueller had gone in and snatched the clot, pulling out the device and allowing immediate blood flow. Because of his expertise and quick turnaround time, he was able to stop the stroke, limit my brain damage and save my life. Dr. Mueller really made me feel important. He talked to me as a person and not as a patient. He was very impressive; he explained to me, in detail, everything he had done.

After staying at the hospital for a week, I was transferred to Pinecrest Rehabilitation and Outpatient Hospital, where my experience was excellent. As an inpatient, I was given physical, speech and occupational therapy. The support of Dr. Mueller and his team, as well as the support of the therapist, made this process a lot easier. Everyone made me feel comfortable and at home.

Since my stroke, I have a continuation of in-home therapy, where a nurse comes to see me every week for physical and speech therapy. I also go to checkups with Dr. Mueller every 3 months at his office in Delray Beach.

It has been two months and I am still recovering. I can see clearly now and I’m really looking forward to my sister coming to see me and staying with me for a few months. I can’t thank Dr. Mueller and the staff at Delray Medical Center’s Comprehensive Stroke Center enough for saving my life.

Creating Hope

Irving’s Story

Irving sitting in a gazebo
My name is Irv. I’m a management consultant. My winter home is in Delray Beach, Florida. Long term I live in Huntington Valley, Pennsylvania, a Philadelphia suburb. I’ve been married 55 years. Got three grown children, four grandchildren. I enjoy international travel in the summertime and I spend my winters, you know, here in Florida. In Florida I like to play golf, I like to go to the beach and we participate in a lot of theatrical entertainment that’s available to us.

Last year, I was playing golf at the public course at Kings Point. I was on the 16th hole, drove the ball, went to roll up on the green and when I got to my ball, I was unconscious. Person that I’m playing with realized that there was something wrong, immediately started to scream at me, what’s the matter, what’s the matter? Had a body experience was that I was witnessing what was happening as if I were sitting in a tree watching and wondering why I didn’t get out of the cart to hit my ball. Took another couple minutes and I was on the ground. I don’t know how I got onto the ground. He was screaming for an ambulance. Ambulance found me on the golf course and told me that they thought I was having a stroke.

The ambulance driver got me off the golf course into, the ambulance and informed me through the fog that I was in that he was going to take me to Delray Medical Center, encouraging that Delray of all the hospitals in the area, was particularly prepared to handle stroke victims.

When I met Dr. Mueller, he introduced himself to me as a neurologist, a vascular specialist and an interventionalist. And there was a blood clot in my brain and he was going to get the blood clot out. I know that I had an MRI. They were using fluoroscopic x-rays for live pictures of my brain. Went through my groin, up through my carotid artery into my brain. Told me don’t breathe, don’t talk, don’t move. He said that three times, the third time he said it, he told me to open my eyes and in the palm of his hand was a two by two inch gauze pad which looked like a dead fly. And he told me that he had just removed that blood clot from my brain and the blood flow in my brain started to regenerate, and there was positive flow again. He assured me that I was going to get better because he told me he was effective within two hours of a stroke.

I was in the intensive care unit for three days. At the end of three days, I was discharged. I had to learn how to walk again since I wasn’t able to walk for three days, but, within a week or so, I was,  back to almost normal.

I consider myself so fortunate to be at Delray. They have a comprehensive stroke center, they have people like Dr. Mueller.

Well, Dr. Mueller was outstanding. Wouldn’t have gotten the results we had if he didn’t have a team behind him, everything from the ambulance drivers who have been prepped to recognize the symptoms the CAT scan people to recognize if it’s a stroke and give him the pictures they want, the technicians to operate the fluoroscopic equipment so that he’s got a moving picture of my brain as he works, the subsection of intensive care that focused on stroke victims. They all played an important role and they all were the reason for the success I had.

I continue to reflect on the fact that my father’s mother, my grandmother and his sister, my aunt, both had strokes identical to mine. Both of them were younger than I am when they, when they had the stroke. Neither of them spoke again, neither of them walked again and both were dead within a year.

The stroke was 13 months ago. At the time I had the stroke I was grossly overweight which probably participated in my having the stroke. Since then, I’ve lost 75 or 80 pounds. I walk two miles every day and I’ve actually never been in better health.

I live day today knowing that I went through this traumatic event and could have had catastrophic consequences. It makes every day sweeter and happy to be alive, feel in good health and I’m looking forward to the future.

Watch the video here

Source: Delray Medical Center

Creating Hope

Pat’s Story

Pat sitting on a bench

Fast Treatment Means She’ll Crochet Another Day

On what seemed to be an ordinary day, Pat Zaugg was at home, eating lunch with her husband. She went to reach for a cracker, when suddenly, everything changed. She couldn’t reach. She couldn’t speak. Her face was drooping, and her whole left side was numb. Pat didn’t know what was going on, but luckily her husband recognized the signs of a stroke (Face, Arm, Speech, Time, or FAST) and immediately called 911. Because of the unique cooperation in Palm Beach County between EMS, giving notification of patients likely requiring catheter treatment, and the hospital, they transported her to Delray Medical Center, a comprehensive stroke center. At Delray Medical Center she received a clot-busting agent within 7 minutes and catheter treatment was started 30 minutes from arrival (50 minutes from first symptoms). The clot was rapidly removed with a catheter, the most effective treatment for her type of severe stroke.

“I don’t remember much about what happened in the ambulance or upon my arrival at the hospital. But I do know that I have no residual impairments because I was treated so quickly,” Pat said.

Pat was in the hospital for three days to treat her cause of the stroke, and was very impressed with the care she received. “I had never been admitted to a hospital before, so I was nervous. But the nurses were attentive and reassuring, the doctors were excellent, and the speed with which they treated me was amazing!” exclaimed Pat. Pat’s stroke occurred in February, and today she has picked up her life where she left off—with one big change.

“My stroke made me appreciate life more. And, it was the incentive I needed to quit smoking—a habit for the past 50 years! I notice now I’m coughing less and my voice isn’t so raspy. And my kids are thrilled!”

Pat is happy to be home and back to enjoying her favorite hobby — crocheting. “When I had the stroke, I was so scared that the paralysis wouldn’t go away, and I wouldn’t be able to crochet anymore. I was devastated! But luckily, I’m fine and back to crocheting hats and blankets that will keep my family members up north warm.”

Source: Delray Medical Center

Creating Hope

Ronald’s Story

Patient with Hospital Staff

With his stroke behind him, once again, Ronald is ready to focus on his swing.

Spending the winters in South Florida allowed Ronald Williams to escape the cold Canadian winters back home. But little did he know that his proximity to Delray Medical Center would provide him something even more important.

“It was a normal day, and I was home alone, sitting at my computer, when I began to feel pins and needles on my forehead. All of a sudden, my pen dropped out of my hand and hit the floor. That’s when I fell to the floor, as well. Though extremely difficult, I made my way to a chair, but I couldn’t imagine what had happened or what was wrong,” said Ronald Williams.

Luckily, Williams’ wife came home shortly after his fall. She saw that his mouth was drooping, and that he was unable to speak and was concerned he was having a stroke. She ran and got a neighbor, and they took him to the hospital immediately.

“I was out of surgery within two hours of the time I entered the door at Delray Medical Center. I was once again able to lift my leg and arm, and my speech returned. Dr. Nils Mueller cut out the clot, and I have no residual problems from the stroke,” continued Williams.

Williams’ stay at Delray Medical Center lasted for four days.

“The care I received was beyond excellent. Dr. Mueller is down-to-earth, yet brilliant, and all the nurses were amazing. Julianna and Charity in the ICU were so kind, and they monitored me constantly. When I moved to the fourth floor, Jessica, my nurse, was heaven-sent. Her cheerful demeanor would make any patient feel better!” he described.

Back home in Canada, Ronald is going to therapy and feeling good.

“I can’t wait to get back to the warm weather in Delray Beach—and get back on the golf course. I live in a small town in Canada, and I am so lucky that if I had to have a stroke, it happened while I was in Florida, close to Delray Medical Center.”

Source: Delray Medical Center 

Creating Hope

Arthel’s Story

As Arthel Sweet learned firsthand, a stroke can happen at any moment. For about a month leading up to his stroke, he experienced a constant headache, dizziness and sometimes had trouble walking. Against his better judgment, Arthel ignored the warning signs and continued his daily routines.

“I don’t remember much from the day of the actual stroke, but I do remember that I was talking on the phone and all of a sudden my head felt heavy, like it was full of water,” he recalls.

Arthel’s stepdaughter noticed something was wrong and immediately called 911. The paramedics transported him to Florida Medical Center. As a Comprehensive Stroke Center, the hospital is equipped with the expertise and technology designed to rapidly diagnose and treat stroke patients.

Arthel underwent various tests, which revealed a blood clot in his brain. Dr. Nils Mueller, an interventional neurologist on the hospital’s medical staff, performed a thrombectomy to remove the clot. Once Arthel regained consciousness four days later, the medical staff was relieved to see that the stroke didn’t cause any long-term damage.

“Dr. Mueller told me he was surprised I was able to speak and react so quickly after my stroke because most people either don’t speak again or have worse outcomes,” says Arthel.

To help maintain his health and prevent another stroke, he follows an exercise regimen, eats a strict diet and takes medication. However, if he does suffer another stroke, Arthel is now aware of the warning signs and how important it is to seek medical attention immediately.

“God helped me overcome this experience, and I thank Him everyday,” he says. “I am also eternally grateful for the stroke team at Florida Medical Center for giving me the opportunity to walk out of the hospital and live a normal life.”

Source: Florida Medical Center

Creating Hope

Richard’s Story

One Saturday morning, as Cyndie Paul carried out her usual weekend routine, she noticed her husband Rich hadn’t gotten out of bed yet, despite the fact that it was past noon. When he finally made it to the kitchen, he attempted to make breakfast and was unaware that she was trying to get his attention.

“I noticed that he was holding the skillet at an odd angle and its contents were falling out,” Cyndie recalls. “When I walked towards him and got a closer look, I was horrified – his eyes were bulging, the left side of his face was lopsided and his speech was slurred.”

After calling 911, the paramedics arrived and informed Cyndie that her husband had suffered a stroke. Even though there were closer hospitals nearby, they told her they would take him to Florida Medical Center because of its status as a Comprehensive Stroke Center.

Once they arrived at the emergency room, Rich underwent various tests, including a CT scan and an MRI. He was admitted to the hospital and scheduled to have an urgent angiogram and possible vertebral stent the next morning with neurologist Dr. Nils Mueller. However, Rich suddenly had a second stroke and required an emergent procedure to remove the clot.

“Dr. Mueller worked tirelessly to save my husband and ensure that my son Bryan and I were comfortable as we waited,” Cyndie says. “He also kept us well-informed of the surgery’s progression with pictures and in-depth explanations.”

After the procedure, Rich stayed in the hospital for a few more days. During this time, the nurses and physicians who cared for him in the ER came by to check on him.

“With so many people worried about our well-being, we felt like part of the Florida Medical Center family,” says Cyndie.

Following discharge, Rich underwent physical and occupational therapy, but thanks to the excellent treatment he received at the hospital, the therapists said he needed very little rehabilitation. The couple is thankful that Rich doesn’t have any critical, lasting effects. At the advice of his physicians, he has stopped smoking, drinking and has cleaned up his diet significantly.

“My husband is now in a much better physical state than before the strokes and is looking forward to getting back to work as an A/C mechanic, living a full life and spending more time with his family,” Cyndie says. “We are eternally grateful to Florida Medical Center for giving us the chance to enjoy many more years together.”

Source: Florida Medical Center

Creating Hope

John’s Story

John and Roberta Lisi love vacationing in South Florida, especially during the spring when it’s still very cold in Pittsburgh. But one Easter morning, their dream-like vacation turned into a real-life nightmare.

“I was taking a shower when I was overcome by a strange feeling,” says John. “All of a sudden, I couldn’t stand any longer. I slid down the shower stall into the tub and was unable to move. My whole left side was paralyzed.”

John called out for help and his daughter immediately called 911. Moments later, he was in the back of an ambulance being rushed to Delray Medical Center.

Quick care matters
Doctors quickly determined John was having a stroke. Within 30 minutes, they administered intravenous tPA, a clot-busting drug, into his system. Dr. Nils Mueller-Kronast, director of neurointerventional service, and his team immediately created John’s personalized treatment plan.

“I was awake during my entire treatment, and Dr. Mueller explained that my carotid artery was blocked and that he was going to remove the blood clot in my brain,” John explains. “To my surprise, I was out of the hospital three days later and back on my vacation.”

Knowing the signs
Looking back, John knows there were warning signs before the stroke occurred.

“I kept uncontrollably dropping things out of my left hand,” he says. “But I was on vacation and figured I would deal with the problems when I got home. Now I urge people having any unusual symptoms to take them seriously and see a doctor immediately.”

John and his wife are deeply grateful to Dr. Mueller and the staff at Delray Medical Center.

“I credit divine intervention for saving me, coupled with the skills of a talented stroke team,” he says. “We will never forget their kindness and professionalism. We can’t thank them enough.”

Source: Delray Medical Center

Patient Survey Results

The Patient Survey score is an average of all responses to physician related questions on our independently administered Patient Satisfaction Survey. Responses are measured on a scale of 1 to 5, with 5 being the highest score. Learn More

rating: 4.9 out of 5 stars.
4.9 out of 5 (0 Comments, 70 Ratings)
rating: 4.9 out of 5 stars.
Provider showed concern
rating: 4.9 out of 5 stars.
Friendliness/courtesy of CP
rating: 4.9 out of 5 stars.
Provider explained things clearly
rating: 4.9 out of 5 stars.
CP spoke using clear language
rating: 4.9 out of 5 stars.
Provider included you in decisions
rating: 4.9 out of 5 stars.
Patients' confidence in CP
rating: 4.8 out of 5 stars.
Likelihood of recommending this provider

Comments also gathered from our Patient Satisfaction Survey and displayed in their entirely. Patients are de-intenified for confidentiality and patient privacy.