Saturday, September 06, 2014

Weekly Overseas Health IT Links - 06th September, 2014.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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ONC power team: Improvements needed to share patient queries, data

August 29, 2014 | By Marla Durben Hirsch
Improvements need to be made to the Consolidated Clinical Document Architecture (C-CDA) implementation guidance and elsewhere to facilitate electronic health record queries for patient records for the 2017 edition of certified EHR technology, according to recommendations by the Health IT Standards Committee's Nationwide Health Information Network (NwHIN) power team.
In its latest meeting, held Aug. 28, the team noted that standardization of transport and data elements for queries of patient records was "not sufficient" and that public-private collaboration is needed to resolve issues regarding trust, patient identity and record locator services.
Certified EHR technology also needs the capacity to generate a query requesting a document containing a current summary of clinical data for a named patient and to return certain specified documents, such as a list of documents containing the requested information or a list stating that such information is not available, according to NwHIN.
The team also recommended that the committee should support efforts to develop Fast Healthcare Interoperability Resources (FHIR) services, and should seek vendor input to clarify high priority improvements in interoperability.
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IBM Watson Takes Computing Capabilities to Next Level

AUG 28, 2014 10:27am ET
Having learned the nuances of human language, improving its ability to search for and use data to support new procedures such as personalized oncology treatments, a new version of the IBM Watson supercomputer is taking its computing capabilities to the next level.
IBM Watson Discovery Advisor, now available, understands the languages of chemistry, biology, legal and intellectual property, according to the company, and early adopters that tested the new capabilities have reaped fast rewards.
At Baylor College of Medicine, researchers using Watson analyzed 23 million abstracts of scientific literature and identified 70,000 articles on “p53,” a tumor suppressing protein. They then analyzed the studies to predict other proteins that turn on or off activity in p53. While scientists have averaged one targeted protein discovery annually, Baylor researchers took just weeks to identify six potential proteins for new research.
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When our wearables talk with our doctors

Summary: Soon, our wearables could change health care – but perhaps not in the way you expect.
By Laura Shin | August 29, 2014 -- 11:46 GMT (21:46 AEST)
John Francis’s family has a history of high blood pressure, so when the 53-year-old Minnesotan saw that Apple’s online store offered a blood pressure monitor by iHealth that could upload data to a smartphone or tablet app, he bought it and began tracking his blood pressure.
Surprisingly, the readings showed not only that his blood pressure was low but also that it was getting lower and lower. A month later, when the monitor, which also checked his pulse, measured it at a frightening 30-35 beats per minute (a normal rate is 60-100), he went to the ER, where he was told waiting a few more days could have meant death. Now fitted with a pacemaker, he continues to monitor his blood pressure.
“My blood pressure monitor is literally a life saver,” he told iHealth last month.
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Patients' 4 top frustrations with online portals

Written by Akanksha Jayanthi (Twitter | Google+)  | August 28, 2014
Although patient portals are gaining in popularity as a means to engage patients in their care, as well as being a requirement for MU2, patients still have a handful of frustrations with their usability.
A recent survey of 1,540 patients by EHR comparison resource Software Advice found nearly one-third of respondents had access to a patient portal.
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NIH issues genomic data sharing rules

Posted on Aug 28, 2014
By Mike Miliard, Managing Editor
The National Institutes of Health has issued a final policy it hopes will promote genomic data sharing as a way to improve health while still protecting the privacy of research participants.
The NIH Genomic Data Sharing policy traces back to the Human Genome Project, which necessitated rapid and broad data release during its mapping and sequencing of the human genome, officials say.
The new GDS policy extends and replaces the Genome-Wide Association Studies data sharing policy, which, since 2007, has governed biomedical researchers’ submission and access to human data through the NIH database for Genotypes and Phenotypes, or dbGaP.
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New DEA rule means changes to eRx

Posted on Aug 28, 2014
By Anthony Vecchione, Contributing Writer
A restrictive new rule change from the Drug Enforcement Administration, making it more difficult for physicians to prescribe opioids, will necessitate some changes to e-prescribing products and practices.
Proponents of the DEA's rescheduling of hydrocodone combination products, or HCPs, from schedule III to schedule II contend that the move will help to curtail the epidemic of drug diversion and drug overdose associated with controlled substances.
But detractors assert that the rule change will negatively impact the ability for patients with genuine medical needs to access pain medications.  
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Immunization info systems key to boosting vaccination rates

August 28, 2014 | By Susan D. Hall
Immunization information systems (IIS) play a key role in helping patients and providers keep up to date on vaccinations and in prevention and effective response to disease outbreaks, according to a blog post at Health IT Buzz.
They will be an important part of the Department of Health and Human Services' Healthy People 2020 plan:
  • To include the shot records of 95 percent of children under age 6
  • To increase the number of states recording at least two age-appropriate vaccines for adolescents 11 to 18
Twenty-five states already meet the first objective, while just nine so far meet the second. Meeting these goals will require physicians to commit to using these systems.
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6 myths about ICD-10 debunked

August 28, 2014 | By Katie Dvorak
The deadline for ICD-10 is a little more than a year out, and the Centers for Medicare & Medicaid Services is working to make sure that myths about the process are squashed.
In a fact sheet published this month, CMS takes a look at some of the biggest myths surrounding ICD-10 and supplements them with the facts. Here are six:
  1. Myth: Extension of the ICD-10 deadline of Oct. 1, 2015
    Fact: The date will not be extended again, according to CMS.
    Oct. 1, 2015, it is.
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Incorporating clinical event notifications in HIEs can improve care coordination, study finds

Written by Helen Gregg (Twitter | Google+)  | August 27, 2014
Regional health information exchanges with clinical event notification services have the potential to improve care coordination and possibly reduce unnecessary inpatient admissions and duplicate testing, according to a study in Generating Evidence & Methods to improve patient outcomes.
CENs alert appropriate stakeholders when a patient experiences one of a preset list of clinical events, such as an emergency department admission. The CEN service in this study, incorporated in Healthix, an HIE for the metro New York City area, includes several features the researchers believe to be unique — the CEN system sends alerts through multiple channels including email, text messages and EHR inboxes, as well as automatically entering the encounter into the patient's EHR.
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Greenway Health completes Walgreens Cloud EHR

August 27, 2014 | By Michael Johnsen
CARROLLTON, Ga. — Greenway Health on Wednesday announced the completion of one of the largest centralized pharmacy cloud-based electronic health-record systems ever deployed, Walgreens Cloud EHR. Walgreens has completed its chain-wide rollout of the Greenway Health-powered EHR solution, giving pharmacy staff at all of its more than 8,200 locations a single, complete view of patients’ prescription, immunization and health testing records.
The EHR platform further enables Walgreens pharmacists to identify opportunities to close gaps in care and to share patient information with other providers, helping to ensure continuity and care coordination.
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BMJ Qual Saf doi:10.1136/bmjqs-2014-003053
  • Original Research

Cost and turn-around time display decreases inpatient ordering of reference laboratory tests: a time series

  1. Daniel Z Fang1,
  2. Gurmeet Sran1,
  3. Daniel Gessner1,
  4. Pooja D Loftus1,
  5. Ann Folkins2,
  6. John Y Christopher III3,
  7. Lisa Shieh1

Abstract

Objective Reference tests, also known as send-out tests, are commonly ordered laboratory tests with variable costs and turn-around times. We aim to examine the effects of displaying reference laboratory costs and turn-around times during computerised physician order entry (CPOE) on inpatient physician ordering behaviour.
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Malpractice dangers lurk in every nook of EHR use

August 27, 2014 | By Susan D. Hall
Electronic health records pose an array of dangers for physicians in terms of potential malpractice claims, according to a Medscape article.
"Anything could be a malpractice issue, from the product itself, to the way it was set up, to how you've been using it," Ronald B. Sterling, an EHR expert in Silver Spring, Maryland, and author of Keys to EMR Success, says in the article.
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DOD releases RFP for $11 billion health record project

  • By Adam Mazmanian
  • Aug 26, 2014
After more than a year of preparation, the Defense Department released its request for proposals for its new electronic health record (EHR) procurement on Aug. 25. The single-award, indefinite-delivery, indefinite-quantity contract is expected to have a total lifetime cost of $11 billion through 2030.
The Defense Healthcare Management System Modernization was created after Defense Secretary Chuck Hagel scrapped a plan to combine DOD's and the Department of Veterans Affairs' EHR systems into a single solution in May 2013. DHMSM seeks a single, commercial product to be adapted to the military's unique set of needs and requirements, which include full interoperability with the VA's VistA health records system and private-sector interoperability standards. It will reach a population of about 9.6 million service members, retirees and dependents.
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KLAS: One Quarter of Ambulatory EHRs Could be Replaced

August 26, 2014
More than 25 percent of both large and small ambulatory practices report that they are considering replacing their electronic health record (EHR), according to the latest KLAS report on ambulatory EHR perception.
The report further finds that another 12 percent would like to replace their system but cannot do so for financial or organizational reasons. As part of this study, KLAS interviewed more than 400 large and small practices across the country about their EHR solutions.
Of respondents who recently switched EHRs, more moved away from GE Healthcare and NextGen than any other vendors. Looking forward, Allscripts, GE Healthcare, McKesson, and NextGen stand to lose more customers than other vendors, as 40-50 percent of their responding customers reported potential plans to leave. Additionally, the report found that customer satisfaction with McKesson, NextGen, Allscripts, and GE Healthcare is relatively low, and customers report less confidence in these vendorsmeaningful use readiness.
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Patient Portals: Strategies For Engaging Users

8/26/2014 09:02 AM
To qualify for Stage 2 Meaningful Use, 5% of your patients must access their own medical records. Here's how to make sure that happens.
To meet Stage 2 Meaningful Use criteria, hospitals and physicians will most likely implement patient portals. There really are no good alternatives to portals to efficiently meet the requirement to provide electronic access to patient records and lab results within the specified time frames (four days for physician office visits, 36 hours for inpatient hospital stays). Also, portals can help streamline patient registration and appointment setting, which benefits both patients and healthcare providers.
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10 Ways To Strengthen Healthcare Security

As recent hacks show, keeping a healthcare organization safe from security threats takes planning, technical expertise, and business knowledge. Has your team taken these 10 steps?
8/26/2014 10:06 AM
Alison Diana
In the wake of the
Community Health Systems breach and FBI warnings about healthcare organizations' vulnerability, security has advanced to the top of many industry executives' to-do lists.
Real safeguards and policy implementations, however, speak louder than any number of crisis meetings. Securing any healthcare organization -- from a solo practice to multi-location hospital systems -- takes measured planning, technical expertise, and business knowledge. It's the only way security professionals can balance their quest for impenetrable devices and software against medical users' demand for easy, accessible data and tools.
"New regulations tied to the Affordable Care Act are now in effect regarding protected health information and electronic health records, which only underscores the need for data security to ensure privacy among patients," said Fred Chang, director of Darwin Deason Institute for Cyber Security, and Bobby B. Lyle, Endowed Centennial Distinguished Chair in Cyber Security at the Lyle School of Engineering at Southern Methodist University, in a statement. "Cyberspace can be a pretty bad neighborhood, with too few barriers standing between hackers and their targets. Healthcare providers recognize that data security is of vital importance to their business." 
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Little To Show For $26 Billion Health IT Investment

The electronic sharing of information (health information exchange) plays a critical role in improving the cost, quality, and patient experience of healthcare. However, there is very little electronic information sharing among clinicians, hospitals, and other providers despite more than $24 billion in incentive payments to hospitals and eligible professionals who "meaningfully use" electronic health records, and another $2 billion spent on interoperability standards and EHR certification over the past five years.
This according to a health policy brief written by Janet Marchibroda, director of the Health Innovation Initiative at the Bipartisan Policy Center published by Health Affairs and supported by the Robert Wood Johnson Foundation.
Marchibroda explains, “While considerable investments in health IT have been made, advancement of interoperability and electronic information sharing across systems has been slow,” and “Additional action is needed to provide the information foundation necessary for higher-quality, more cost-effective, patient-centered care in the United States.”
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Are EHRs Life Savers? Maybe So, According to Preliminary Research

August 25, 2014
Can the adoption and implementation of electronic health records (EHRs) be tied to hospital performance and lowered mortality rates? While we might be a bit of time away from being able to make that precise claim, new research does suggest a measurable beneficial relationship.
The findings were revealed by HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society (HIMSS), and Healthgrades, an online resource for comprehensive information about physicians and hospitals. The value of EHRs has long been discussed, but until now evaluations have lacked comprehensive clinical data, according to HIMSS officials.
Using HIMSS Analytics’ Electronic Medical Record Adoption Model (EMRAM) and mortality rate measures collected by Healthgrades across 19 unique procedure and condition based clinical cohorts, the analysis found that hospitals with advanced EHR capabilities (as reflected in high EMRAM scores) demonstrated significantly improved actual mortality rates, most notably for heart attack, respiratory failure, and small intestine surgery.
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Failure of Aetna’s CarePass platform might be a bad omen for Apple HealthKit and others

August 26, 2014 3:45 PM
Mark Sullivan
Last week, the health insurance giant Aetna said it would discontinue its CarePass consumer health data platform by the end of 2014. And when a player as big as Aetna dumps its health data platform, it’s cause for discussion, if not concern, in digital health circles.
Numerous startups and a few big tech players are building similar aggregation platforms. Lots of developers want to build apps that pull data from them. And investors are trying to understand the profitability and sustainability of the platforms.
CarePass is not an app; it’s a place in the cloud with a bunch of application programming interfaces (APIs) to connect and receive data from a variety of health wearables and apps. So an Aetna member (or a nonmember) might store their running app data, weight numbers from their connected scale, steps from their Fitbit, and data from her diet app all in CarePass. This is exactly what emerging platforms from Apple, Google, and Samsung will do.
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A look inside VA's clinical decision support toolkit wish list

By Government Health IT Staff
As the U.S. Department of Veterans Affairs builds out its HealtheLiving Assessment toolkit, it’s seeking cutting-edge applications it hopes can help deliver personalized patient reports on health status, disease risks, and recommendations for better care.
The VA, despite its recent healthcare failures, has a reputation for forward thinking in its use of technology, particularly relating to mobile devices and applications.
Now the VA wants to use a decision support technology platform to enable clinical subject matter experts to build complex decision support applications without IT support. The department has issued a Request for Information hoping to find solutions for their ambitious program.
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Patient de-identification needs to balance privacy, value of analytics

August 26, 2014 | By Katie Dvorak
Data analytics are making an impact on the healthcare industry, but as concerns remain over patient privacy and security, the industry is turning to de-identification as a way to keep information private.
The two ways to de-identify data include the statistician method and the "safe harbor" method, Anna Spencer, a partner in Sidley Austin's Washington office and global coordinator for health IT privacy, tells HealthITSecurity.com.
Safe harbor, Spencer says, gives details around de-identification standards, but the method is not popular with everyone in the industry. The method removes or codes information such as names, birth dates, phone numbers, Social Security numbers and 14 other pieces of identifying information.
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Spine2 is alive

26 August 2014   Lis Evenstad
The replacement for the NHS data spine, Spine2, went live over the bank holiday weekend.
The NHS Spine is a national repository and supports and connect and is used by services such as the electronic prescription service, personal demographics service, Summary Care Record application and Choose and Book.
The new Spine service, which has been build based on open source software, has replaced the old NHS Spine, which has been in use for around a decade.
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mHealth Tackles Readmissions

Scott Mace, for HealthLeaders Media , August 26, 2014

Healthcare leaders are finding that consumer-ready technologies can help patients right where they are.

This article appears in the July/August 2014 issue of HealthLeaders magazine.
Health technology advances are beginning to reduce hospital readmissions. The smartphone itself is becoming a way of keeping tabs on recently discharged patients. Smartphone apps are engaging patients. Sensors are providing the kind of mobile monitoring that only recently graduated from the ICU to the general hospital bed, and now is able to be used wherever patients resume their normal lives.
Other mobile technology helps patients arrange for rides or reminds them to take their medications, weigh themselves, or perform other necessary daily activities to stay out of the hospital.
"We have one practice that we follow closely" that is applying consumer-ready technologies, such as cell phones, the Internet, and digital cameras, to enhance the patient-physician relationship, says Joseph Kvedar, MD, founder and director of the Center for Connected Health, a division of Partners HealthCare, a Boston-based integrated healthcare system with nearly 60,000 employees and a research budget of $1.4 billion. He is also an associate professor at Harvard Medical School.
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Healthcare Interoperability Consortium Shows Promise

Scott Mace, for HealthLeaders Media , August 26, 2014

CIOs and CMIOs around the country would do well to stop imagining that perfect solutions in a decade are worth waiting for, and instead focus on how pretty-good interoperability could serve us all in the near term.

Everyone is talking about interoperability, and at least one fledgling group, spurred by a large healthcare provider, is willing to serve up real demos to prove they mean business.
The Healthcare Services Platform Consortium (HSPC) is an intriguing mix of modern IT thinking, real-world use cases, and (so far) quite modest hype that also has that elusive quality in the interoperability world known as momentum.
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Ehealth plan designed to save money and patients

Hiqa is working on standards for a new ‘health identifier’ system that aims to simplify medical records

Elaine Edwards
One of the many challenges facing new Minister for Health Leo Varadkar will be to oversee the Government’s ehealth strategy, published by his predecessor, James Reilly, at the end of last year.
It will require investment not just in information technology but in new work practices and governance structures in the health service. It will be a slow process but, if handled properly, should pay big dividends for patient safety and for the healthcare system generally.
Ehealth is described as a fully integrated digital supply chain, involving “high levels of automation and information sharing”. In English, that means making consistent, accurate information about every patient available when and where it is needed, eliminating duplication, increasing patient safety and improving, for example, the management of chronic illnesses.
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The evolution of PACS

August 25, 2014 | By Dan Bowman
By Dan Bowman
As the healthcare industry increasingly adopts new accountable care payment models, providers must determine the most cost-effective ways to deliver quality patient care. In the case of radiologists, that means improving communication with fellow doctors and cutting back on unnecessary imaging as reimbursement dollars will be handed out based, not on the volume of patient tests conducted, but the sustained good health of those patients.
To that end, the evolution of picture archiving and communication systems (PACS) is crucial.
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Research touts 10-year success of telestroke units

August 25, 2014 | By Susan D. Hall
Telestroke units helped increase the number of rural patients treated and deliver treatment faster, according to a 10-year evaluation published in the journal Stroke.
At the studied telestroke units in Germany, regional hospitals had 24-hour access to vascular neurologists, including evaluation of brain imaging and patient examination via videoconferencing when needed.
Twelve regional hospitals with neurology and neurosurgery departments entered the telestroke program in 2003. That number had grown to 15 by 2012, with 31,864 consultations provided, according to an announcement. During that time, the percentage of patients with symptoms of stroke or mini-stroke who were treated through the telestroke units grew from 19 percent to 78 percent.
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Study: Electronic Alerts Can Reduce Hospital-Acquired Urinary Tract Infections

August 22, 2014
Electronic alerts can help reduce urinary tract infections in hospital patients with urinary catheters, a new research study at Penn Medicine has revealed. 
Using data from 222,475 inpatient admissions in the three hospitals of the University of Pennsylvania Health System over the course of three years, the researchers were able to conclude that targeted automated alerts in the electronic health record (EHR) system reduced urinary tract infections in hospital patients with urinary catheters by a significant amount. According to Penn Medicine, 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Many of these infections are preventable, researchers say.
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Premier comments on improving utility of healthcare data

Written by Akanksha Jayanthi (Twitter | Google+)  | August 20, 2014
Charlotte, N.C.-based Premier has drafted a letter to Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) on the Senate Committee on Finance regarding strategies to enhance the availability and utility of healthcare data.
Among other recommendations related to the types of data that should be made more broadly available and reforms to reduce fragmentation of healthcare data, Premier largely emphasized application programming interface technology and applications.
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CHS Breach a Sign of Health Care's Security Illness

By Robert Lemos  |  Posted 2014-08-24

NEWS ANALYSIS: The health care industry spends less on IT security than other industries, and data shows that breaches are on the rise.

Community Health Systems announced  Aug. 18 that hackers had breached its health care network of 206 facilities and stolen sensitive information on approximately 4.5 million patients.
The compromise and subsequent data loss is part of a general trend in the sector. The health care industry has given short shrift to IT security, spending less on protecting its systems and data than most, if not all other, industries, as measured as a percentage of the overall IT budget. And data from firms that track threat intelligence shows that signs of breaches are rampant in the health care industry.
Over the last 10 months, for example, security firm Websense has seen attacks on health care-related firms increase by 600 percent, according to Carl Leonard, senior manager of security research for the company.
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The New Face Of Healthcare Innovation: 7 Ways Telemedicine Changes The Healthcare Landscape, And What It Means For You

It’s no secret that the healthcare space is broken. A 2013 study conducted by the Journal of Patient Safety estimates that between 210,000 and 440,000 patients die in the US each year from accidental practice. To put this into perspective, an estimated 600,000 Americans die from heart disease each year and another 565,000 from cancer (source: www.cdc.gov), which puts healthcare incompetence as the third leading cause of death in the United States.
The pool of entrepreneurs in the race to offer mobile health consulting is growing larger by the day. With telemedicine, users have the power of accessibility in their hands with apps such as TouchCare and iBluebutton (see below). While the concept of telemedicine isn’t anything new, having the accessibility to one’s doctor is. Here are seven ways telemedicine changes the healthcare landscape—for the better:
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Enjoy!
David.

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