TelePreventive Medicine: Comprehensive 6‑Month Advanced Curriculum Index with Future Technologies
This document presents a comprehensive 6-month certification program in TelePreventive Medicine, combining cutting-edge healthcare delivery with emerging technologies. The curriculum spans from foundation concepts to advanced applications in AI, quantum computing, blockchain, and nanotechnology, ensuring graduates are prepared for the future of healthcare delivery. With a total investment of \$1,969 versus industry standards of \$25,000+, the program guarantees job placement and practice setup, enabling healthcare professionals to achieve significant income potential while transforming patient care.
Program Overview
The 6‑month TelePreventive Medicine certification prepares clinicians to deliver next‑generation preventive care using telehealth and emerging technologies across the full continuum of prevention. It integrates foundational concepts with practical implementation across systems and specialties, advancing into AI, quantum computing, blockchain, metaverse/VR, nanotechnology, and brain‑computer interfaces—while maintaining rigorous regulatory compliance, business operations proficiency, and professional practice readiness.
Investment
Total Investment \$1,969 vs. \$25,000+ industry standards
Assurance
Guaranteed job placement and practice setup with assured patients
Income Potential
Estimated monthly income \$19,000–\$140,000 (average \$55,600)
Module 1: Foundation of TelePreventive Medicine & Emerging Technologies
The foundational module establishes core knowledge in telepreventive medicine while introducing emerging technologies that will transform healthcare delivery in the 2025‑2030 period. Students will develop a comprehensive understanding of digital health transformation and the evolution from episodic to continuous care models.
1. Introduction to Next‑Generation TelePreventive Medicine
This section explores the fundamental definitions and evolution of preventive telehealth, examining the digital health transformation timeline through 2030. Students will analyze continuous versus episodic care models, with special attention to hybrid care integration strategies that have shown 82% patient preference rates.
2. Historical Context and Technology Evolution
Tracing the development timeline of telehealth, this section examines critical milestones and the permanent adoption patterns accelerated by COVID‑19. Students will study evolving regulatory landscapes projected for 2025 and compare international models of telehealth implementation.
Current and Emerging Technology Landscape in TelePreventive Medicine
The current telehealth technology landscape is rapidly evolving beyond simple video consultations into an integrated ecosystem powered by multiple technological innovations. 5G‑enhanced telehealth infrastructure is enabling ultra‑reliable, low‑latency connections that support real‑time monitoring and interventions, especially in rural and underserved areas.
AI‑powered clinical decision support systems represent a booming market segment with 38.5% CAGR, projected to reach \$19.27B. These systems augment provider capabilities by analyzing patterns across vast datasets, suggesting evidence‑based interventions, and identifying at‑risk patients before symptoms manifest.
Modern telehealth platforms increasingly leverage multimodal AI that can simultaneously process various data types—medical images, clinical notes, vital signs, and patient‑reported outcomes—to create comprehensive preventive care profiles. This integration enables more accurate risk stratification and personalized intervention strategies.
API‑first interoperable platforms are replacing siloed telehealth systems, allowing seamless data exchange between electronic health records, remote monitoring devices, pharmacy systems, and billing platforms. This architecture supports the continuity of care essential for effective preventive medicine practices.
Real‑time transcription and clinical documentation technologies are eliminating administrative burdens, allowing providers to focus entirely on patient care while AI systems accurately capture, organize, and structure clinical conversations into actionable medical records.
Module 2: Advanced Clinical Applications & Comprehensive Disease Management
Module 2 deepens students' understanding of telepreventive care delivery models and their practical applications across numerous disease states and conditions. The curriculum extends from theoretical frameworks to hands‑on implementation of advanced telehealth interventions.
1. Primary Prevention
Advanced telehealth
2. Secondary Prevention
AI‑powered early detection
3. Tertiary Prevention
Chronic disease management
4. Population Health
Big data analytics and predictive modeling
This module teaches students to implement comprehensive prevention strategies across the continuum of care. Primary prevention leverages advanced telehealth tools to prevent disease occurrence. Secondary prevention employs AI‑powered systems for early detection before symptoms manifest. Tertiary prevention utilizes remote monitoring for chronic disease management to prevent complications and deterioration. Population health approaches apply big data analytics to identify trends and intervene at community levels.
Cardiovascular System Applications
Hypertension management with RPM and AI titration
Heart failure monitoring with digital biomarkers
Arrhythmia detection using wearable ECG technology
Coronary artery disease risk stratification
Cardiac rehabilitation through virtual programs
Lipid management and atherosclerosis prevention
Hypertensive crisis prevention and management
Post‑cardiac procedure follow‑up protocols
Endocrine and Respiratory System Management in TelePreventive Medicine
Endocrine System Applications
TelePreventive medicine offers revolutionary approaches to endocrine disorder management through continuous monitoring and early intervention. Type 1 and Type 2 diabetes management is transformed through continuous glucose monitoring (CGM) integration, allowing real‑time data analysis and intervention before dangerous glucose excursions occur.
CGM integration with AI‑powered dosing algorithms and predictive hypoglycemia alerts
Remote medication titration with symptom tracking and lab integration
Comprehensive programs for obesity, PCOS, and metabolic syndrome
Advanced telehealth platforms enable sophisticated monitoring of endocrine parameters, allowing for personalized treatment plans and medication adjustments without frequent in‑person visits.
Respiratory System Applications
Smart inhaler integration tracking medication adherence and technique, with early exacerbation detection through respiratory pattern analysis and predictive algorithms
Personalized environmental trigger identification, peak flow monitoring with digital spirometry, and AI‑guided action plan adjustments
Remote sleep apnea diagnosis with home sleep testing, CPAP adherence monitoring with automatic pressure adjustment, and comprehensive sleep hygiene programs
The curriculum provides detailed protocols for gestational diabetes monitoring, adrenal insufficiency management, osteoporosis prevention, and pediatric endocrine disorders. Students also learn advanced respiratory care including post‑COVID rehabilitation techniques, pulmonary fibrosis monitoring, lung cancer screening programs, and home‑based pulmonary rehabilitation.
Neurological System Management in TelePreventive Medicine
Neurological conditions present unique challenges and opportunities for telepreventive medicine. This section equips practitioners with advanced protocols for remote neurological assessment, monitoring, and intervention using cutting‑edge technologies.
1. Stroke Prevention and Telestroke Networks
Students learn to implement comprehensive stroke prevention programs including remote monitoring of atrial fibrillation with wearable ECG, virtual anticoagulation clinics, and integration with regional telestroke networks for rapid intervention. The curriculum covers deployment of AI algorithms that detect subtle speech and facial changes indicating stroke risk.
2. Headache and Migraine Management
Advanced telehealth approaches to migraine include digital headache diaries with AI pattern recognition for trigger identification, remote biofeedback therapy, personalized environmental monitoring, and precision medication management with electronic medication tracking.
3. Epilepsy Monitoring with Wearable Devices
Students master remote epilepsy management using wearable EEG devices that provide continuous monitoring, seizure detection algorithms with automated alerts, medication adherence tracking, and virtual cognitive assessment for medication side effects.
Neurodegenerative Disease Management
Parkinson's Remote... Alzheimer's Early... MS Progression Monitoring Cognitive Rehabilitation Brain-Computer Interface 0 40 80 120
The curriculum covers advanced applications including remote assessment of Parkinson's disease using smartphone accelerometers, early detection of Alzheimer's through AI analysis of speech patterns and cognitive assessments, and multiple sclerosis progression monitoring with virtual neurological examinations. Students also learn cutting‑edge brain‑computer interface applications for communication and movement restoration.
Additional Systems & Specialties in TelePreventive Medicine
Teletherapy, mood tracking, CBT apps.
Photo triage, virtual consults, AI lesion scans.
Symptom logs, teleconsults, remote stool tests.
Video physio, wearable motion sensors, home exercise guides.
TelePreventive medicine extends well beyond the core body systems to encompass virtually all medical specialties, enabling comprehensive whole‑person care. The curriculum provides detailed protocols for remote assessment, monitoring, and intervention across multiple specialties.
Mental Health and Behavioral Disorders. Students learn to implement telemental health programs including remote psychiatric assessment, digital cognitive behavioral therapy, AI‑powered mood tracking and crisis prediction, virtual reality exposure therapy for anxiety disorders, and medication management with adherence monitoring.
Dermatological Conditions. The curriculum covers store‑and‑forward teledermatology with AI‑assisted diagnosis, longitudinal tracking of skin lesions using standardized photography, virtual UV exposure monitoring, and automated skin cancer risk assessment using computer vision algorithms.
Additional specialties covered include gastrointestinal disorders with remote symptom tracking and microbiome analysis; musculoskeletal conditions using motion capture technology and remote physical therapy; women's health with virtual reproductive medicine and menopause management; pediatric care with developmental tracking; geriatric medicine with fall prevention; infectious disease prevention; oncology survivorship care; ophthalmological conditions; and kidney disease prevention.
Holistic Medicine Integration and Alternative Approaches
TelePreventive medicine embraces a whole‑person approach by integrating conventional medical practices with evidence‑based complementary and alternative modalities. This section equips practitioners with the knowledge to incorporate holistic approaches into their telehealth practice.
Virtual naturopathic consultations including personalized botanical medicine protocols, remote assessment of environmental toxin exposure, and digital detoxification programs. Integration of plant‑based therapies with conventional treatments and telehealth monitoring of response.
Comprehensive virtual intake assessments, remote functional lab testing coordination, digital timeline mapping of symptoms and exposures, and AI‑assisted identification of root causes for complex conditions.
Virtual mind‑body‑spirit healing approaches including teleguided meditation sessions, remote stress reduction programs, spiritual health assessment, and digital mind‑body connection evaluations that measure physiological responses to mental interventions.
Personalized Nutrition and Lifestyle Medicine
Virtual genetic testing and personalized nutrition planning based on genetic variants
AI‑powered meal planning and continuous glucose monitoring integration
Personalized movement programs with wearable tracking and remote coaching
The curriculum also covers mindfulness and meditation with digital therapeutics for chronic pain and anxiety; remote consultations for acupuncture point stimulation and Traditional Chinese Medicine constitutional assessment; Ayurvedic medicine teleevaluation of doshas and imbalances; homeopathy and energy medicine; and aromatherapy integration with environmental modification for therapeutic benefits.
Module 3: Advanced AI, Quantum Computing & Blockchain Technologies
Next‑Generation Artificial Intelligence
Leveraging quantum computing to accelerate machine learning for drug discovery and molecular modeling with exponentially greater computational power than classical systems
Using sophisticated natural language processing for ambient clinical documentation that captures and structures physician‑patient conversations without manual input
Implementing computer vision for advanced medical imaging analysis that can detect subtle patterns invisible to the human eye, enabling earlier diagnosis
Quantum Computing in Healthcare
Quantum computing represents a paradigm shift in healthcare computing capabilities. Students learn how quantum algorithms enable molecular simulations for drug development at unprecedented scales, performing calculations in minutes that would take classical computers centuries. The curriculum covers quantum machine learning for genomic analysis, allowing pattern recognition across vast genetic datasets to identify disease risks and personalized treatment approaches.
Quantum computing in healthcare is projected to grow from early experimental applications today to a \$2.5 billion market by 2030, with primary applications in drug discovery, genomics, and diagnostic imaging.
Additional applications include quantum‑enhanced medical imaging techniques that dramatically reduce radiation exposure while improving resolution; quantum optimization for complex treatment planning in cancer and neurological conditions; and quantum cryptography for ultra‑secure healthcare data protection that is mathematically guaranteed against future computational advances.
Blockchain Technology Implementation in Healthcare
Blockchain‑based health information exchanges enable secure, permissioned sharing of patient data across institutions without central authorities. Includes distributed ledger architecture, zero‑knowledge proofs for privacy, and consensus mechanisms ensuring data integrity while allowing appropriate access for telehealth providers.
Implementation of smart contracts that automate claims processing based on verified clinical events, reducing administrative overhead and payment delays. Rule‑based contracts execute automatically when predefined clinical conditions are met and verified through telehealth platforms.
Applications for pharmaceutical supply chain management ensuring medication authenticity and preventing counterfeit drugs. Track‑and‑trace systems record every transfer of custody from manufacturer to patient, especially critical for high‑value specialty medications.
Metaverse and Virtual Reality Healthcare
The emerging healthcare metaverse creates entirely new possibilities for telepreventive medicine by establishing immersive virtual environments for clinical care. Virtual clinical consultations in the metaverse transcend traditional video visits by enabling providers and patients to interact with three‑dimensional models, visualizations, and simulations.
The curriculum also covers medical education and training simulations that allow providers to practice procedures in realistic virtual environments; virtual reality therapy for phobias, PTSD, and chronic pain; digital twins that create virtual replicas of patients for treatment simulation; and collaborative healthcare platforms enabling multiple specialists to simultaneously interact with patient data in shared virtual spaces.
Module 4: Comprehensive Regulatory Compliance Framework
HIPAA Privacy and Security Comprehensive Framework
Advanced application of the Privacy Rule to telehealth settings, including:
- Virtual waiting room confidentiality protocols
- Minimum necessary standards for remote care
- Patient rights management through digital portals
- Incidental disclosure prevention in telehealth
Comprehensive technical safeguards for telehealth platforms:
- End‑to‑end encryption implementation
- Multi‑factor authentication protocols
- Remote access security architecture
- Secure API integration standards
HITECH Act and Modern Healthcare IT
The HITECH Act significantly expanded HIPAA requirements while promoting meaningful use of electronic health records. Students learn to implement health information exchange standards that enable secure data sharing while maintaining privacy protections. The curriculum covers enhanced breach notification requirements including determination of breach risk levels, mandatory reporting timelines, and documentation procedures for telehealth incidents.
The module also covers HHS and OIG advanced compliance including development of comprehensive compliance programs, False Claims Act prevention strategies, Anti‑Kickback Statute safe harbors for telehealth arrangements, Stark Law compliance for physician‑owned telehealth ventures, and OIG exclusion screening procedures.
OSHA Healthcare Regulations and HealthIT Standards
While telehealth reduces exposure risks, providers coordinating home‑based care must understand bloodborne pathogen standards application to remote settings:
- Remote instruction protocols for home caregivers
- Virtual supervision of exposure control plans
- Digital training modules for caregivers and patients
- Telehealth documentation of exposure incidents
Students learn to implement hazard communication programs for telehealth settings:
- Digital safety data sheet management systems
- Remote hazard assessment procedures
- Virtual training on chemical safety
- Telehealth coordination of exposure monitoring
OSHA recordkeeping obligations extend to telehealth operations:
- Electronic OSHA log maintenance
- Remote incident investigation procedures
- Digital reporting of serious injuries
- Virtual access to workplace injury records
HealthIT Standards and Interoperability
The 21st Century Cures Act prohibits information blocking and mandates interoperability. Students learn to implement FHIR R4 standards and APIs that enable secure, standardized data exchange between systems. The curriculum covers Patient Access Rule compliance, ensuring patients can access their complete health information through smartphone applications and third‑party services.
Additional areas include TEFCA (Trusted Exchange Framework and Common Agreement) implementation for nationwide health information exchange, and comprehensive cybersecurity framework deployment following NIST guidelines with specific adaptations for telehealth environments.
Module 5: Advanced Clinical Practice & Nanotechnology Integration
Nanotechnology‑Enhanced Telehealth
Remotely monitor and adjust nanoparticle‑based drug delivery systems targeting specific tissues with unprecedented precision: telemonitoring protocols, remote adjustment of drug release parameters, virtual assessment of therapeutic efficacy, digital tracking of biodistribution patterns.
Integration of implantable and wearable nanosensors for real‑time health monitoring: remote configuration of detection thresholds, continuous data transmission protocols, pattern recognition for early disease detection, and integration with telehealth alert systems.
Implementation of microfluidic diagnostic devices for home use: remote quality control procedures, digital result interpretation algorithms, virtual guidance for sample collection, and telehealth integration of diagnostic findings.
Brain‑Computer Interface Clinical Applications
Brain‑computer interfaces (BCIs) establish direct communication pathways between the brain and external devices, creating revolutionary possibilities for telehealth interventions. Students learn to implement BCI systems for neurological rehabilitation, enabling remote monitoring and adjustment of neural training programs that help restore function after stroke or injury.
The curriculum covers motor function restoration in paralyzed patients using BCIs that translate neural signals into movement commands for prosthetics or exoskeletons; communication aids for ALS and stroke patients that convert brain activity into text or speech; cognitive enhancement and brain training programs; mental health monitoring through EEG pattern analysis; and seizure prediction systems that detect pre‑seizure neural activity patterns hours before clinical symptoms appear.
Advanced Virtual Examination and Remote Patient Monitoring
Doctor integrates tools for remote diagnostics
- Computer Vision — Analyzes appearance for visible symptoms
- AR‑Guided Exam — Patient follows augmented guidance
- Digital Stethoscope — Captures sound waves and heart rhythm
- Haptic Feedback — Enables virtual palpation remotely
AI‑Enhanced Assessment. Remote physical assessments augmented by AI that can detect subtle clinical signs invisible to the human eye (facial micro‑expressions, voice patterns, movement quality, and skin color changes) during video consultations.
Digital Auscultation. Digital stethoscopes transmit enhanced heart and lung sounds; includes AI‑powered murmur detection, automated heart sound classification, and longitudinal comparison.
AR‑Guided Examination. Augmented reality systems that overlay anatomical landmarks, guide proper hand placement for palpation, and provide real‑time feedback during remote assessments.
Continuous Multi‑Parameter Monitoring extends beyond episodic vital signs to continuous physiological monitoring. Implement systems that simultaneously track cardiac activity, respiratory patterns, movement, sleep quality, stress indicators, and metabolic markers through advanced wearables and ambient sensing. Predictive alert systems use machine learning to identify deterioration patterns hours or days before clinical symptoms appear, enabling proactive intervention through telehealth channels.
Additional areas include wearable technology integration that fuses data from multiple devices to create comprehensive health profiles; smart home health monitoring with ambient sensors embedded in living environments; and IoT‑enabled health monitoring that connects medical devices to telehealth platforms through secure communication protocols.
Module 6: Business Operations & Financial Management
Enrollment Process Flow
Online Application
\$369 Registration Fee
Personalized Consultation
Program selection and planning
Eligibility Verification
Background check and credentials
Financial Planning
Aid options and payment scheduling
Platform Access
\$599 Platform Fee
Comprehensive Fee Structure Analysis
\$469
\$199
\$99
\$234
\$599
\$369
Total Investment \$1,969
ROI Analysis: With potential monthly income ranging from \$19,000 to \$140,000 (average \$55,600), students can expect to recover their total investment within the first week of practice.
Revenue Cycle and Practice Economics
Students learn advanced CPT coding for telehealth services including remote monitoring, virtual check‑ins, and interprofessional consultations. The curriculum covers value‑based care contract negotiation strategies for telepreventive services that demonstrate cost savings and improved outcomes. Students also master direct‑pay and subscription model development, creating recurring revenue streams outside traditional insurance frameworks.
Additional topics include insurance authorization automation using AI‑powered systems; financial analytics dashboard implementation for real‑time practice performance tracking; and multi‑state licensing strategies to maximize geographic reach and revenue potential.
Module 7: Case Studies & Professional Practice Simulation
Comprehensive Case Study Portfolio
This case study explores implementation of a comprehensive diabetes prevention program leveraging quantum computing for complex metabolic modeling and AI‑powered behavioral coaching.
- Continuous glucose monitoring integration with predictive algorithms
- Personalized nutrition planning based on quantum‑analyzed metabolic responses
- Virtual health coaching enhanced by behavioral AI
- Outcome metrics showing 78% reduction in diabetes progression
Virtual cardiac rehabilitation conducted entirely within an immersive metaverse environment.
- Digital twin modeling of patient cardiovascular systems
- VR exercise sessions with real‑time physiological monitoring
- Social support through avatar‑based group rehabilitation
- Outcomes showing 92% completion vs. 64% traditional
Novel brain‑computer interface applications for mental health crisis management.
- Early detection of suicidal ideation through EEG pattern recognition
- Real‑time intervention using neurofeedback techniques
- Integration with crisis response telehealth systems
- Outcome data showing 83% reduction in hospitalization rates
Additional case studies examine cancer screening with nanotechnology diagnostics; holistic women's health with blockchain‑secured records; pediatric development assessment using AR/VR technologies; chronic pain management through digital therapeutics; geriatric care coordination with AI analytics; population health management for rural communities; and international telehealth implementation with 5G technology.
These case studies represent realistic scenarios practitioners will encounter, providing templates for implementing advanced telepreventive medicine approaches across diverse clinical contexts.
A Day in the Life: Advanced TelePreventive Medicine Practice (2030 Vision)
The day begins with an AI‑synthesized summary of overnight patient data. Quantum computing algorithms have analyzed risk patterns across your panel of 200+ patients, identifying three requiring immediate attention. Blockchain‑secured monitoring alerts show a potential medication interaction in one patient and concerning vital sign trends in two others. Your digital twin clinic is automatically updated with this information before you arrive.
You review results from home‑based lab‑on‑chip tests completed overnight. For patients with implanted nanosensors, you analyze real‑time data streams showing molecular‑level changes indicating early disease progression before conventional tests would detect abnormalities. You make minor adjustments to nanoparticle drug delivery systems for three patients, fine‑tuning release parameters remotely.
You enter your virtual clinic in the healthcare metaverse where you conduct immersive examinations of homebound patients. Using haptic gloves, you perform virtual palpation that transmits realistic tactile feedback. For complex cases, you initiate holographic consultation with specialists who join your virtual space to collectively examine 3D renderings of patient anatomy and physiological functions.
Your afternoon includes virtual naturopathic consultations where you use VR environments to demonstrate proper techniques for botanical preparations. You conduct functional medicine root cause analysis using AI systems that identify patterns across thousands of biomarkers and environmental exposures. Mind‑body‑spirit wellness programs are coordinated through integrated platforms that synchronize conventional and complementary approaches.
The day continues with blockchain data management activities, including smart contract processing for automated insurance claims and secure multi‑institutional data sharing for complex cases. Advanced population health analytics identify community‑level intervention opportunities, while research activities contribute to quantum‑enhanced clinical trials. The day concludes with global collaboration sessions connecting specialists across continents in shared virtual environments.
Assessment and Advanced Certification
Rigorous examination assessing understanding of quantum computing principles and applications in healthcare. Includes theoretical foundations, quantum algorithms for drug discovery, quantum machine learning for healthcare data analysis, practical applications in clinical decision support, and future trends and development roadmaps.
Comprehensive portfolio demonstrating practical implementation of blockchain technology in healthcare settings: smart contract development, secure health information exchange architecture, patient‑controlled health record implementation, clinical trial data integrity solutions, and supply chain verification systems.
Demonstrate proficiency in delivering care through metaverse environments: virtual clinical examination techniques, patient engagement in immersive environments, digital twin utilization for treatment planning, collaborative care coordination in virtual spaces, and technical implementation of metaverse clinical platforms.
Additional assessments include nanotechnology integration case studies requiring detailed implementation plans for clinical applications; BCI clinical application demonstrations showing mastery of brain‑computer interface technologies; AI ethics projects addressing bias mitigation and ethical implementation; regulatory compliance assessments covering all major frameworks; holistic care plan evaluations; population health analytics projects; and international telehealth standards certification.
The program culminates with a comprehensive board certification examination and future‑ready healthcare leadership capstone project demonstrating integration of all program components in a realistic implementation scenario.
Continuing Professional Development & Future Technologies
Technology specializations, clinical applications, leadership pathways, research & innovation
Quantum, blockchain, metaverse medicine
Precision medicine and space medicine
Policy advisory and global telehealth
The rapidly evolving landscape of telepreventive medicine requires ongoing professional development. Graduates pursue specialized continuing education pathways to maintain cutting‑edge expertise and explore emerging technologies.
Technology Specialization Pathways. Annual recertification in quantum computing healthcare applications; blockchain health applications advanced training; metaverse medicine specialist certification; nanotechnology clinical integration workshops; BCI healthcare applications advanced practice training.
Leadership & Policy Development. AI ethics and governance leadership programs; global telehealth policy advisory participation; regulatory liaison and policy development roles; health equity and social justice leadership training; cross‑cultural competency in global telehealth.
Frontier Applications. Disaster response telehealth deployment training; space medicine and extreme environment healthcare; precision medicine and genomics integration; digital biomarker development and validation; sustainable healthcare technology implementation.
The continuing education program emphasizes research publication and peer review training, preparing specialists to contribute to the scientific literature advancing telepreventive medicine. Practitioners develop expertise in international conference presentations, sharing innovations and best practices with the global healthcare community.
Additional pathways include technology vendor partnership development, gaining early access to emerging technologies; startup incubation and innovation lab access, supporting entrepreneurial ventures; academic teaching and mentorship certification; and future healthcare scenario planning. The program culminates in legacy planning and knowledge transfer protocols that ensure organizational continuity and advancement of the telepreventive medicine specialty.