Saturday, March 05, 2016

Weekly Overseas Health IT Links - 5th March, 2016.

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.

Unsecured doors on truck cause huge records breach

Published February 22 2016, 11:55am EST
Old paper medical records being trucked to an incinerator blew all over a street in Fort Myers, Fla., resulting in more than 480,000 individuals being notified that their protected health information was compromised.
The truck’s driver failed to secure the container door, and staff and physicians at Radiology Regional Center spent three days combing the area and retrieving “virtually” all the records, according to information sent to affected patients.

HIT Think Moving beyond CDs in exchanging diagnostic images

Published February 25 2016, 2:23pm EST
There is a growing need to exchange and share imaging studies with outside entities. Hospitals that have foregone the traditional merger and acquisition route to become affiliates, for example, have a need to share both individual patient and population health data, although their modalities for exchange and viewing may be very different.
Patient transfers—between facilities, specialty and professional consultations, and even telehealth opportunities—have created a new way of thinking about the delivery of images between two related, yet independent points of care. CDs, however, still remain both the most used and one of the largest bottlenecks in healthcare today.

Before its EHR went in, Ontario Shores started over

Published February 26 2016, 5:30am EST
For Ontario Shores Centre in Whitby, Ontario, the journey to its 2015 Davies Award started with preparation. A lot of preparation.
Ontario Shores went shopping for an electronic medical record system in 2007, selected Meditech's EMR system in 2008, and rolled it out in late 2010. Between the vendor selection and the go-live date, the institution had to completely rethink its processes.
“We were a purely paper organization—we didn't have any [electronic] clinical systems for documentation,” says Sanaz Riahi, the center's director of professional practice and clinical information. “But we realized we couldn't fit our paper workflows into this new technology.”

PCORI taps FHIR to give patients easier access to EHR data

Initiative launched at White House Precision Medicine Initiative Summit
February 26, 2016 11:13 AM
The Patient-Centered Outcomes Research Institute announced a plan to make it easy for individuals to access data in their electronic health records and share it for research that could improve care for their conditions.
PCORI Executive Director Joe Selby, MD, revealed at Thursday’s White House Precision Medicine Initiative Summit that 20 of PCORI’s Patient-Powered Research Networks have pledged to help participating patients more readily obtain information from their EHRs.

Joseph Kvedar: Physicians must embrace patient-generated data

February 26, 2016 | By Susan D. Hall
It took 20 years for the stethoscope to be widely accepted in clinical practice, but the industry doesn't have that time to waste before embracing patient-generated data, Joseph Kvedar, M.D., writes at MedCity News.
Home monitoring and similar services have shown to be useful in improving outcomes, reducing mortality and engaging patients in programs to control hypertension and diabetes. Yet physicians resist efforts to make use of patient-generated data, and are more willing to base care on information like blood pressure readings conducted a couple times a year, says Kvedar, vice president of Connected Health at Boston-based Partners HealthCare.

IBM and New York Genome Center’s new cancer tumor repository aims to revolutionize treatment

Ariana Eunjung Cha February 25
At many of the nation's leading cancer centers, doctors have begun to sequence the DNA of their patients' tumors to better personalize their treatments. That information has saved a growing number of lives. It might tell you, for instance, whether a certain type of chemotherapy may be extra toxic for a particular individual or if a different drug that no one ever thought of may be the miracle you were praying for.
The problem is: This approach doesn’t scale. Today, figuring out how genetic mutations may impact a patient's response to a treatment is a time-consuming and manual process. It often involves a team of a half-dozen or more experts combing through hundreds of journal articles and consulting with colleagues around the world for a month. Even then, there's no guarantee that this will lead to useful information for the patient.
Thu Feb 25, 2016 3:03pm EST
Related: U.S., Health

Verily, Vanderbilt to test enrollment in U.S. Precision Medicine pilot

The National Institutes of Health on Thursday named Verily, formerly Google Life Sciences, as adviser to Nashville's Vanderbilt University in a pilot program to launch the Precision Medicine Initiative outlined by President Barack Obama last year.
The pilot program, which aims to enroll 79,000 U.S. participants by the end of this year, is the first phase of an ambitious program to mine medical data, including genetics, environmental factors and lifestyle, to develop better ways to treat or even prevent a wide range of diseases.
Vanderbilt and Verily are slated to test approaches for engaging and enrolling volunteers through a web portal.
February 26, 2016

An Educational Campaign Combined with an Electronic Alert Improved Sepsis Process Measures

Daniel J. Pallin, MD, MPH reviewing Narayanan N et al. Am J Emerg Med 2016 Feb.
A “best practice advisory” pop-up message in the Epic electronic medical record, combined with an educational campaign, improved time to antibiotics and other process measures in sepsis patients.
Electronic alerts from electronic medical records systems have obvious promise but can be a hassle (NEJM JW Emerg Med Dec 2015 and Ann Emerg Med 2015; [e-pub]). Investigators compared sepsis process and outcome measures before (111 patients) and after (103 patients) an emergency department intervention that involved an educational campaign and a new pop-up alert in the hospital's Epic electronic medical record system.

Report: Healthcare providers protect wrong data, putting patient health at risk

Focusing on patient data fails to protect true attack openings, ignores specific hacker strategies, Independent Survey Evaluators report says.
February 24, 2016 08:35 PM
Too many healthcare organizations are focused on securing the wrong assets, leaving them vulnerable to cyberattacks and putting patients at risk, a new report from Independent Survey Evaluators claims.
When healthcare leaders focus primarily on protecting patient data, they often fail to address actual cybersecurity threats that directly affect patient health, the report said. So if an active medical device or electronic work order were infiltrated by cybercriminals, the patient could be directly affected. On the other hand, an electronic health record is secondary – it requires a provider to alter the data before it could potentially harm a patient.

Electronic Health Records and Patient Safety

Recent studies have provided conflicting information about whether or not EHRs improve patient safety. One study, conducted by the Agency for Healthcare Research and Quality (AHRQ) and published in the Journal of Patient Safety found that fully electronic health records (their definition for fully electronic health records is records that include physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically generated) lead to fewer adverse events such as hospital acquired infections. However, an analysis of a large malpractice claims and suits database maintained by CRICO, an evidence-based risk management group of companies owned by the Harvard medical community, found that there were 248 malpractice cases showing serious unintended consequences from the use of EHRs.

EPR implementation led to 'catastrophic loss of confidence'

Rebecca McBeth
25 February 2016
Problems with the introduction of the Epic electronic patient record at Cambridge University Hospitals NHS Foundation Trust led to a catastrophic loss of confidence in the system that took months and a “huge amount of effort to rebuild”, the president of the Royal College of Surgeons has said.
Clare Marx, who is also chair of the strategic clinical advisory group to the National Information Board, was speaking about a visit to Cambridge at a Westminster Forum on electronic patient records this month.
Cambridge went live with Epic in October 2014 as part of a £200 million eHospital programme. It is the first and only trust in the country to have deployed the EPR, which is widely used in the US.

Cambridge: big bang reality

Cambridge University Hospitals NHS Foundation Trust went live with its Epic electronic patient record as part of a £200 million eHospital programme in October 2014. Sixteen months later, Digital Health News editor Rebecca McBeth gets an inside perspective on the system, its deployment, and outstanding issues.
25 February 2016
The words “disaster” “chaos” and “confusion” feature strongly in reactions from staff to Cambridge University Hospitals NHS Foundation Trust’s implementation of a new electronic patient record in 2014.
Unison’s Cambridge Acute Hospitals Branch joint communications officer Carole Proctor found a number of staff willing to answer questions from Digital Health News about the trust’s implementation of Epic 16 months ago.
While most of the clinical and administrative staff that she spoke to say things are much improved and benefits are starting to be realised, Proctor herself describes the period immediately after deployment as “pretty chaotic”.

We're all looking at the same patient safety elephant

February 25, 2016 | By Marla Durben Hirsch
There's been little fanfare about this week's survey results from global physician social network SERMO regarding the apparently different views American and European doctors have about electronic health records and patient safety. More than half of the European doctors polled viewed EHRs as improving patient safety; just 11 percent thought that EHRs negatively impacted patient safety.
American doctors were much more doom and gloom, with only 27 percent believing that EHRs improved patient safety, and 39 percent saying that they worsened it.
This dichotomy of opinion is reflected in the studies about EHRs and patient safety, which according to SERMO is the reason why it ran this survey in the first place.  For example, SERMO pointed to a recent study conducted by the Agency for Healthcare Research and Quality (AHRQ) which found that hospitals using EHRs had fewer adverse events, such as hospital acquired infections. SERMO contrasted that finding with an analysis of malpractice claims and lawsuits maintained by CRICO, owned by the Harvard medical community, which found 248 malpractice cases showing serious unintended consequences from use of EHRs that caused patient harm.    

Andy Slavitt on ICD-10: 'Y2K fears didn't come to pass'

February 25, 2016 | By Dan Bowman
Teamwork, accountability and a focus on stakeholder concerns all have enabled a smooth transition for the healthcare industry to date from ICD-9 to ICD-10, according to Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt.
In a post to The CMS Blog Feb. 24, Slavitt (pictured) touts the effort put forth by CMS and the industry at large to make the shift, although he stops short of calling it a win.
"With good implementation, we never declare victory, and are still at the ready to continually improve," Slavitt says. To that end, he says, "Y2K fears" never materialized, and the transition was one that most outside of the healthcare industry weren't even aware of.

HHS launches Interoperability Proving Ground website to highlight projects

Carten Cordell, Federal Times 1:41 p.m. EST February 24, 2016
HHS’s Office of the National Coordinator for Health Information Technology has launched a new site to spread the gospel of interoperability and its developing projects.
The ONC, which is tasked with helping update the nation’s health IT infrastructure network, debuted its Interoperability Proving Ground on Feb. 24 as a network to share and update stakeholders about ongoing interoperability projects.
“At ONC, we are focused on providing you with the chance to inspire colleagues, share experiences, and describe lessons learned when it comes to interoperability,” said Steven Posnack, ONC’s director of the Office of Standards and Technology, in a post announcing the Interoperability Proving Ground.

HIT Think What healthcare can learn from Facebook and Amazon

Published February 23 2016, 2:44pm EST
Users of Facebook, LinkedIn and other social media applications are often amazed by how omniscient the technology seems to be. How do a bunch of algorithms know, out of billions of users, who you might consider a friend, or which videos you should consider watching just because you liked “The Dark Knight”?
A big part of the answer is a core social media technology that holds great promise for transforming healthcare by making true interoperability at last possible.
It’s called the graph database. Designed specifically to interpret relationships between different sets of data, the graph database is the foundational technology that lets social media applications, as well as companies like Amazon, build sophisticated social networks around each account owner. For instance, it’s what enables us to look at our friends’ friends and navigate through their interests and connections.

Special report: picture archiving and communications systems

Bringing down the walls
The refresh of picture archiving and communications systems triggered by the end of national contracts is almost at an end.
Trusts are now turning their attention to sharing images with different ‘ologies’, with different trusts and – shortly – other services, such as primary care. Kim Thomas reports on some of the different approaches that trusts are taking.
The dust has almost settled on the refresh of picture archiving and communications systems occasioned by the end of the contracts negotiated under the National Programme for IT.

Employee education vital in defense against ransomware

February 24, 2016 | By Susan D. Hall
Employee education and awareness are healthcare organizations' greatest defenses against ransomware, attorney Mary Ellen Callahan advises in an AHA News article.
The malware in such an attack usually infects a network through a phishing scam, though unlike those that hit Magnolia Health Corp. in California and more recently St. Joseph's Healthcare System in New Jersey, the hackers aren't interested in identity theft, but in collecting a ransom.
Hollywood Presbyterian Medical Center in Los Angeles, whose computer systems were offline for a week in a ransomware attack, decided to pay about $17,000 in the cybercurrency Bitcoin to the hackers. However, law enforcement officials advise against paying ransom. There's no guarantee you'll get your data back or that hackers, now knowing you'll pay, won't subject you to ransomware again.

SCCM: Technology Poised to Transform Critical Care Medicine

Technology is transforming the treatment of critically ill patients

by Salynn Boyles
Contributing Writer

ORLANDO -- Google Glass didn't exactly take the world by storm, as tech prognosticators told us it would, but the technology could end up playing an important role in bridging the information gap between first responders and hospital-based medical personnel, a well-known critical care specialist said here Sunday.
The head-worn technology is being used experimentally in several sites in and outside of the U.S. to facilitate live-streaming of videos from paramedics caring for patients en route to hospitals to the clinicians who will treat them once they arrive.
The observation was made at an afternoon presentation on the future of critical care medicine by ICU specialist Jean-Louis Vincent, MD, PhD, of Erasme University Hospital, Brussels, Belgium, at the Society of Critical Care Medicine 45th Critical Care Conference.

Telecritical Care Saving Lives Using Skype

Fran Lowry
February 22, 2016
ORLANDO, Florida — Using telemedicine to provide remote support from critical care specialists to community hospitals reduces mortality, the number of patients needing to be transferred to tertiary care hospitals, and costs, new research shows.
"One year after we started our telecritical care program for community hospitals caring for acutely ill patients, mortality rates in the intensive care units and in the hospital were both decreased by almost 40%," said William Beninati, MD, from Intermountain Healthcare in Salt Lake City.
"There was also a small decrease in ICU costs," he said here at the Society of Critical Care Medicine's 45th Critical Care Congress.
6:57 pm ET
Feb 22, 2016


Health Care Needs To Do a Better Job Encrypting Data: Report

  • By Rachael King
Health-care organizations need to do a better job encrypting sensitive personal information such as medical records and Social Security numbers, according to a report by California Attorney General Kamala Harris.
In 2015, the records of 24 million Californians were breached, up from 4.3 million in 2014. The cyberattack on health-care insurer Anthem Inc. accounted for 10.4 million records and another attack on UCLA Health compromised 4.5 million records.
About 55% of compromised records in the health-care sector are the result of a failure to encrypt data, as opposed to just 16% of breaches in other sectors, according to the California Data Breach Report, released February 16.If companies encrypt information like Social Security numbers and other personally identifiable information, it’s not considered a breach under state law. “The industry appears to be improving in its use of encryption to protect data on laptops and other portable devices, but there is still a long way to go in addressing this preventable type of breach,” according to the report.

Ransomware: What will it take to be prepared?

Much of the ransomware seen in attacks like the one at Hollywood Presbyterian is well known, and detectable with the right tools and strategies in place.
February 23, 2016 04:16 PM
Last week we all read another sobering account of the disruption that cyber incidents can cause. The ransomware attack at Hollywood Presbyterian Medical Center was despicable in its nature and alarming in it what it says about the overall preparedness of healthcare to deflect these threats.
Healthcare is one of our most critical infrastructures and important to every American. The CEO for this institution eventually opted to pay the ransom to return his institution's systems back to service. A decision only he and the leadership of that hospital could make and one I'm sure not easily arrived at.
In most instances the majority of security and law enforcement professionals would advise against paying the hackers, because, 1) there is no guarantee you will get the decryption key, and 2) there is the fear that it will encourage others to follow suit. I would argue that is easy advice to give if you are not the one looking down the barrel of the ransom note. Until you have walked in those shoes you don't really know what you will do.

The best way to share health records? An app in patients’ hands

The technical and regulatory pathway to consumer-mediated sharing is clear. From here, patients must demand that providers enable them to authorize who can and cannot access their health information.
February 23, 2016 09:00 AM
This time of year, millions of Americans file taxes. We are required to move sensitive financial data from employers and banks to the Internal Revenue Service. In the old days, we waited for paper W2’s and bank statements to arrive by mail and then spent hours with pencils and stacks of paper. But now tax preparation software enables automatic retrieval and upload of data in seconds and without error. Why is this possible? Because each of us controls our own financial data. 
Now imagine that we want our sensitive health records transferred to a new doctor. We fill out paper forms, mail or fax them, pay fees, and if we are lucky a stack of printed paper records arrives by fax or mail at our new doctor’s office weeks or months later. Weeks after that they might be scanned into an electronic health record as images but, even then, they can’t be searched easily.

David Blumenthal and Aneesh Chopra: HIT requires alignment of incentives

February 23, 2016 | By Susan D. Hall
While some people working in healthcare say electronic health records have slowed digitization in the industry, two former federal IT officials believe that there are other factors preventing a digital health revolution.
David Blumenthal, M.D., former National Coordinator for Health IT, and Aneesh Chopra, former U.S. chief technology officer, in a Harvard Business Review post, defend the estimated $31 billion the federal government has spent on pushing the adoption of electronic health records.
"Underlying the challenges facing the digital health revolution are economic and social issues that must be addressed if the potential value of electronic records is to be realized," they say.

ONC pushes adoption, evolution of standards through new initiative

February 23, 2016 | By Katie Dvorak
The Office of the National Coordinator for Health IT is embarking on a new initiative to help healthcare organizations "adapt and evolve ONC's standards and technology work processes."
The ONC Tech Lab "will provide internal and external stakeholders with common connection points to ONC's standards and technology efforts," Steven Posnack, director of the agency's Office of Standards and Technology, writes for the agency's Health IT Buzz blog.
This initiative, Posnack says, ties in with all of ONC's latest interoperability efforts, including its Interoperability Roadmap and Federal Health IT Strategic Plan. The agency, in December, unveiled its finalized 2016 Interoperability Standards Advisory.

Philips Announces Launch Plans for Wearable Biosensors

Feb. 23, 2016
Royal Philips plans to introduce medical-grade, wearable biosensors for monitoring at-risk patients in low-acuity hospital settings.
The biosensor measures vital signs and transfers data to a clinical decision support software application that can be set up to automatically notify the caregiver or clinician.
Philips says it expects to unveil a portfolio of solutions that will connect to analysis tools and dashboards — all with an eye toward improving patient care and lowering healthcare costs. — Anisa Jibrell

Epic, Cerner lead EHR mindshare: This and 9 more health IT purchasing trends

Written by Akanksha Jayanthi (Twitter | Google+)  | February 22, 2016
As hospitals and healthcare systems consider purchasing options, Epic and Cerner continue to lead the pack in EHR mindshare in 2016, according to a new report from research firm peer60.
peer60's latest research report analyzes year-over-year trends related to health IT purchasing, including mindshare, marketshare and IT priorities, among other metrics.
Here are 10 trends to know about health IT purchasing in 2016.
1. Epic Systems holds the largest inpatient EHR mindshare segment in 2016, at 32 percent. Second for inpatient EHR mindshare is Cerner, with 23 percent of the market.
2. Following Epic and Cerner in inpatient EHR mindshare are MEDITECH (20 percent), athenahealth (7 percent), Allscripts (7 percent), CPSI (6 percent) and McKesson (2 percent).

Survey: Security, Big Data and Mobility are Top Priorities for CIOs in 2016

February 22, 2016
by Heather Landi
Most CIOs and health IT leaders see security, business intelligence/big data and mobility as the top areas impacting their organizations in 2016 and initiatives related to mobile health and patient engagement are likely driving these IT priorities, according to a survey conducted by TEKsystems.
IT staffing and services firm TEKsystems surveyed healthcare IT leaders, including CIOs, IT vice presidents, IT directors and IT hiring managers, as part of its annual IT forecast and the survey results indicate that 45 percent of IT leaders expert their organization’s IT budget to stay the same this year. Only 41 percent of health IT leaders expect their budgets to increase this year, which represents the lowest percentage expecting budget increases in the past four years. And 14 percent of respondents expect their budgets to decrease.

Healthcare Meets Minority Report, and Patients Like It

Scott Mace, for HealthLeaders Media , February 23, 2016

Using technology associated with a Tom Cruise movie to identify hospital patients is an actuality at one Louisiana hospital, where it saves time at check-in, reduces chances for patients to receive the wrong care, and has already paid for itself.

At Terrabonne General Medical Center, a 325-bed acute care hospital in Houma, Louisiana, patients check in by having their photo taken by a greeter at the door to the waiting room.
Technology behind the scenes scans the unique markings on each patient's irises, matches these patterns up to previous registration data, or flags the patient as being new. The whole iris-matching process takes a couple of seconds. Even identical twins have unique patterns, and the whole thing works with patients as young as nine months old.

After a hack, four steps to manage the crisis

Published February 19 2016, 2:08pm EST
2015 was marked by far too many digital security breaches, a trend that every organization hopes to see reversed in the coming year. Unfortunately, it is unlikely that we’ll be able to stop them all. In this digital era, security breaches are part of the new normal.
So what should you do when facing a security breach? The most important thing that you can do is stay calm. If you keep your wits about you, you will be better able to approach the problem and implement a solution to protect your organization. Here is how to move forward in the face of a digital security breach.
Plan ahead. While you may not be able to plan for the exact details of a security breach – if you could, then you could prevent it from happening – what you can do is prepare a preliminary plan of action for any future breach. Write out a general timeline for what actions need to take place and in what order. This way, when something does happen, you do not lose any time giving direction. All you need to do is to fill in the specifics of the event.

Mobile heart disease risk calculator can interface with EHRs

February 22, 2016 | By Dan Bowman
A mobile tool that helps physicians predict the risk of heart disease for their patients is expanding its abilities and now can interface with electronic health record systems.
The Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator, developed by the American College of Cardiology, uses "multiple algorithms within one analytic" to determine 10-year and lifetime risks for ASCVD, according to an announcement; the tool is available on Android and iOS devices, as well as via the Web. Now, through a partnership with health analytics company Apertiva, the tool can integrate with a provider's EHR.
"The whole industry is moving to free the data and allow physicians and patients to be able to integrate it with other tools," ACC CIO Dino Damalas recently told Health Data Management. Damalas added in the announcement that the partnership will broaden the availability of the decision support-tool, which already has been downloaded more than 250,000 times.

Mobile device security: Health IT execs discuss their strategies

February 22, 2016 | By Katie Dvorak
The following is an excerpt from an article published in the FierceHealthIT's eBook "Best Practices for Securing Your Mobile Network." Download the eBook here to read more.
For executives in charge of mobile device and network security at hospitals and health systems, many factors must be taken into consideration. Employees increasingly are bringing in their own mobile devices, tools that can get lost or stolen, and hackers continue to find new ways to illegally access systems.
The latter, especially, worries Tom Barnett, vice president for health information technology at NorthShore University HealthSystem.

How use of big data can cause harm in healthcare

February 22, 2016 | By Susan D. Hall
Big data must be coupled with rigorous observational methods to prevent grave errors in assumptions, according to an article published at the American Journal of Managed Care.
Austin B. Frakt, Ph.D., health economist with the Department of Veterans Affairs, and Steven D. Pizer, Ph.D., director of healthcare financing and economics at the VA Boston Healthcare System, note that for every 5 million packages of x-ray contrast media distributed to healthcare facilities, about six people die from adverse affects.
With big data, those deaths can be found to be highly correlated with things like electrical engineering doctorates awarded and per-capita mozzarella cheese consumption. 

Vocera showcasing enterprise solutions for communication and collaboration at HIMSS

Written by Staff | February 19, 2016
Vocera Communications, Inc. will showcase the Vocera Communication Platform at the 2016 HIMSS Conference and Exhibition in Las Vegas, Feb. 29 through March 4, 2016.
The enterprise-grade solution enables HIPAA-compliant communication via voice and secure text messaging on a variety of mobile devices. The Vocera Communication Platform also integrates with more than 70 clinical systems, including electronic health records, nurse call, and physiologic monitoring systems.
Vocera arrives at HIMSS16 with strong momentum after recently announcing the selection of its communication solutions at Franciscan Alliance and Massachusetts General Hospital. That energy will continue at HIMSS16 with two Vocera customers sharing their success stories at the health IT event.

A Unique Identifier Could Protect Patient Privacy

Giving every American a unique patient identifier could reduce errors in retrieving their medical records while improving data sharing and security. A national identifier could also help protect patient privacy, or at least not further erode it. Those are key conclusions from Identity Crisis, a RAND study I coauthored several years ago…
The remainder of this commentary is available at

Electronic Health Records: Yesterday's Ebola and Today's Zika

An aedes aegypti mosquito is pictured on a leaf in San Jose, Costa Rica, February 1, 2016
Photo by Juan Carlos Ulate/Reuters
When I showed up at the obstetrical urgent care unit at Brigham and Women's Hospital, the care I received was swift and appropriate. I saw a nurse quickly and a doctor soon after. They asked relevant questions and immediately put a plan for further evaluation in place. Only then did the nurse turn to the computer to enter everything into the electronic record. As she worked her way through the required documentation, she asked several more questions. Any allergies that weren't already in the system? Surgeries she should note? And, of course, importantly, had I been to an Ebola-infected country recently?


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