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Charak- An Introduction

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Charak suite of Healthcare IT Charak suite of Healthcare IT products: An overview products: An overview 1
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Page 1: Charak- An Introduction

Charak suite of Healthcare IT products: Charak suite of Healthcare IT products: An overviewAn overview

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Page 2: Charak- An Introduction

Asclepius Consulting is a Healthcare IT venture global and Indian doctors, software personnel and management consultants

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Dr. A. K. KeshriMS, Civil Surgeon, Bihar

Pratyusha PallaviGE Healthcare/ SP Jain

HL7, DICOM Expert

Dr. Rolika KeshriMS, Obs/ Gyn, PMCH

Dr. Suneel MajagiMS, KLE hospital

Sachin PrasadIITD/ IIMB, Boston Consulting Group

Aravind Hiremath

• BE (CS) -Karnataka• GE Healthcare

• Over fifteen years of experience in design & development of global healthcare software products

• Focused on Diagnostic equipments & CIS with expertise in Healthcare Standards (DICOM, IHE & HL7)

Satyajeet Prasad

• IIT Kharagpur• IIM Lucknow• GE Healthcare

• Over eight years of experience across the globe in implementing high end software solutions

• Expertise in six sigma, HL7, IHE and Healthcare IT solution delivery in Asia, US, Australia and Europe

Vishal Ranjan

• IIT Delhi• IIM Calcutta• A.T. Kearney

• Over five years of management consulting experience with MNCs in setting up businesses and devising growth strategies

• Expertise in BPR, process improvement and business planning

Team

Page 3: Charak- An Introduction

• Hand-holding the client organization during transition

• Training programs and workshops

• Change management• Annual maintenance

support and regular upgrades

• New business set up• Business process re-

engineering• Customer relationship

management• Organization structure • Business planning• Growth strategy• Investment banking

• Synergizes with Charak to support specific IT needs

• India focus & domain expertise to deliver complete solutions

• Six sigma software design and development methodology to ensure world class software

• World class healthcare IT systems built for Indian clinical workflows

• Focus on clinical information systems (CIS)

• Includes HIS, LIS and IIS solutions

• Robust solutions built on six sigma methodology

Asclepius Consulting is a vertically integrated Healthcare IT company with end-to-end IT solutions for Indian hospitals

Offerings

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Page 4: Charak- An Introduction

Hospitals in India are adopting IT in a massive way– driven by changing business conditions

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Why are Indian hospitals adopting IT?

Get more from same set of resourcesGet more from same set of resources

•Most good hospitals are running at close to 100% utilization

•Attempts to improve revenue from same set of resources (Higher revenue/ sq. ft.)

•Specific focus to reduce ALOS, increase efficiency and optimize utilization

Get more from same set of resourcesGet more from same set of resources

•Most good hospitals are running at close to 100% utilization

•Attempts to improve revenue from same set of resources (Higher revenue/ sq. ft.)

•Specific focus to reduce ALOS, increase efficiency and optimize utilization Get more from same set of Get more from same set of

resourcesresourcesGet more from same set of Get more from same set of

resourcesresources

Healthcare insurance needsHealthcare insurance needs

•Cashless insurance lay down very stringent documentation needs across care process

•Major losses in collections due to difference in authorization and approval

•Most corporate customers insist on supporting cashless insurance

Healthcare insurance needsHealthcare insurance needs

•Cashless insurance lay down very stringent documentation needs across care process

•Major losses in collections due to difference in authorization and approval

•Most corporate customers insist on supporting cashless insurance

Healthcare insurance needsHealthcare insurance needsHealthcare insurance needsHealthcare insurance needs

Accreditation needs from GovernmentAccreditation needs from Government

•Stringent process and documentation needs from NABH

•Increasingly patients shall decide hospital quality based on accreditation ratings

•Huge resources required for meeting accreditation needs

Accreditation needs from GovernmentAccreditation needs from Government

•Stringent process and documentation needs from NABH

•Increasingly patients shall decide hospital quality based on accreditation ratings

•Huge resources required for meeting accreditation needs

Accreditation needs from Accreditation needs from GovernmentGovernment

Accreditation needs from Accreditation needs from GovernmentGovernment

Increasing time pressure on doctorsIncreasing time pressure on doctors

•Good doctors are always pressed for time

•Increasing number of patients across multiple facilities

•Spend unnecessary inefficient time in documentation and repetitive activities

Increasing time pressure on doctorsIncreasing time pressure on doctors

•Good doctors are always pressed for time

•Increasing number of patients across multiple facilities

•Spend unnecessary inefficient time in documentation and repetitive activities

Increasing time pressure on Increasing time pressure on doctorsdoctors

Increasing time pressure on Increasing time pressure on doctorsdoctors

Increasingly competitionIncreasingly competition

•Larger hospitals bring state-of-art technology to provide better facilities

•Technology is leveraged to build strong processes and enhance quality of care

•More and higher paying patients are attracted to those at forefront of technology

Increasingly competitionIncreasingly competition

•Larger hospitals bring state-of-art technology to provide better facilities

•Technology is leveraged to build strong processes and enhance quality of care

•More and higher paying patients are attracted to those at forefront of technology

Increasing competitionIncreasing competitionIncreasing competitionIncreasing competition

Increasingly legal pressuresIncreasingly legal pressures

•Liability of clinical negligence is all on hospital

•Documentation is only protection from litigation

•Negligence cases are typical adjudged unfavorably against hospitals

Increasingly legal pressuresIncreasingly legal pressures

•Liability of clinical negligence is all on hospital

•Documentation is only protection from litigation

•Negligence cases are typical adjudged unfavorably against hospitals

Increasing legal pressuresIncreasing legal pressuresIncreasing legal pressuresIncreasing legal pressures

Increasingly aware patientsIncreasingly aware patients

•I can spend money – but don’t have time

•I can’t carry all those reports and files

•I can’t wait for appointments and long queues

•My family need personalized care

Increasingly aware patientsIncreasingly aware patients

•I can spend money – but don’t have time

•I can’t carry all those reports and files

•I can’t wait for appointments and long queues

•My family need personalized care

Increasingly aware patientsIncreasingly aware patientsIncreasingly aware patientsIncreasingly aware patients

Page 5: Charak- An Introduction

Hospitals have been able to achieve multiple benefits from adopting IT

ILLUSTRATIVE

“..leads to better control of the organization through robust

processes”

“..reduces missed/ incorrect charge slips across multiple

service points in the hospital”

..implements scientific management practices like

budgeting, customer relationship management, medical audits,

SOPs”

“.. reduces the missing documentation for insurance

communication leading to better collection”

“..ensures better planning and higher resource utilization for key

revenue sources e.g. OT, surgeons, devices etc.”

“..better material tracking lead to reduction in wastage, pilferage

and inventory in books”

“…reduced medical errors leading to lower litigation costs”

“…increased coordination leading to better planning and lower

unpredictability ”

“…frees up the doctor’s time from paper work and

administrative activities, improves the quality of patient care and significantly improves

hospital bottom-line”

Potential benefits from IT

• 85% faster admission, transfer & discharge

• 40% faster diagnosis time

• 30% reduction in medication dispensing error

• 20% faster inventory re-stocking

• 20% reduction in Average Length of Stay

• 80% reduction in billing errors

• 40% growth in patient volumes

• 33% growth in profit margins

Source: Typical impacts measured by IT implementation in a Pediatric hospital

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Page 6: Charak- An Introduction

Globally, IT in hospitals, undergo a transition from administrative to clinical processes

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Billing

Registration

Admission

Discharge

Pharmacy

Stores

Insurance

Inventory management

EMR – Discharge summary

EMR – Diagnosis

EMR – Medication

EMR – Investigations

EMR – Orders

EMR – Vitals

EMR – Alerts

Clinical decision support

Clinical protocols

Drug data bank

Lab Information system (LIS)

Radiology Information System (RIS)

Remote patient care

EMR – Charting

Time

Cli

nic

al

Ad

min

istr

ati

ve

A scalable and modular solution is needed which can support the hospital all through its growth and future needs

Admin

EMR

ClinicalFeatures for Hospital IT

Emergency handling

EMR -Flowsheets

Patient monitoring

Orders

ILLUSTRATIVE

Clinical rules

Page 7: Charak- An Introduction

Ad

min

istra

tion

Clin

ica

l

An

cilla

ry

sy

ste

ms

Infra

stru

ctu

re

mo

du

les

ILLUSTRATIVE

Core modules

Value added modules

Specialty modules

MTOSS

The product – Charak - is an end-to-end IT solution for the entire hospital with sufficient depth to meet the needs of an involved user

Covers end-to-end treatment cycle• From pre-admission to diagnosis, orders,

treatment, monitoring and discharge Integrates with multiple hardware

• Mobile phones, digital pens, voice recorders, bed side devices

Is accessible remotely• Available on internet, with thin client solution

Built on six sigma quality and international standards• Compliant to HL7, DICOM, IHE guidelines

Provides process control• Through protocols, pathways and clinical

decision support Supports research

• For clinical procedure evaluation, evidence based medication etc.

Is specific to specialties• E.g. different work flows for gynecology vs.

cardiology Meets the documentation needs for

accreditation and cashless insurance process

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Page 8: Charak- An Introduction

Charak has some of the most business relevant & less commonly available features

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ILLUSTRATIVEILLUSTRATIVE

Page 9: Charak- An Introduction

Together with the consulting services, Charak meets a large part of the documentation needs required for NABH accreditation

Accreditation needs from NABH CharakProcess Consulting

Access, Assessment & Continuity of care (AAC) ◑ ●Patient Rights & Education (PRE) ● ●Care of Patient ◕ ◑Management of Medication (MOM) ● ◑Hospital Infection Control (HIC) ◔ ◑Continuous Quality Improvement (CQI) ◑ ◕Responsibility of Management (ROM) ◑ ◔Facility of Management and Safety ◑ ◕Human Resource Management (HRM) ◑ ●Information Management System (IMS) ● ●

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● ○High support Low support

Page 10: Charak- An Introduction

Asclepius adopts robust business process re-engineering (BPR) frameworks to improve upon existing processes while minimizing changes

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To-be process mapping

How do you make pricing decisions – what is your cost to

serve?

How do you make pricing decisions – what is your cost to

serve?

How do you calculate the stock of all paracetamol

medicines put together?

How do you calculate the stock of all paracetamol

medicines put together?

Can you give a single purchase order for the deliveries for the entire

year?

Can you give a single purchase order for the deliveries for the entire

year?

How is the doctor recommending

discounts accounted for?

How is the doctor recommending

discounts accounted for?

Page 11: Charak- An Introduction

The administrative IT solution (HIS) covers the entire administrative needs of the hospitals

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Page 12: Charak- An Introduction

The elements of electronic medical record (EMR) comprise all relevant information from the clinical processes

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• Patients go where the hospitals ‘know them’ – for preventive check up, emergency, surgery as well as standard cure

• EMR generates a single consolidated record for all relevant patient information – valuable during the stay

• The EMR should be readily available – through internet, mobile phones, across hospital facilities

Past and present history

Problems and complaints

Physical examination

Systemic examination

Diagnosis

Investigation reports

Radiology images

Flowsheets & device data

Surgery notes

Progress notes

Medications

Discharge summary

EMR numberRIMS072201223

Aditya Goyal07 NOV 2005B +ve

Page 13: Charak- An Introduction

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All the relevant activities – for the doctor, the patient, the admin staff- can be accessed through a central switchboard

Page 14: Charak- An Introduction

All notes from doctors, nurses, labs etc. can continued to be captured on paper – and seamless integrated with Charak

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The digital pens allow minimal change in clinical practices – at OPD, during wards rounds, discharge, follow ups etc.

Page 15: Charak- An Introduction

The critical data available remotely on mobile phones and hand-held devices

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View list of patients with critical details

Get alerts on patients in wards/ ICU

View key patient data (BP, ECG)

Give medicines and lab orders

Know appointments, schedule-for-day

Advise treatment remotely

The critical data is available remotely on mobile phones and hand-held devices

Page 16: Charak- An Introduction

Charak can extract data from any digital medical device - bed side devices, digital X- rays, CT scans -and integrate it with patient record

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• The Charak team has extensive experience in interoperability of clinical software – across devices, CIS systems, Labs and Radiology systems

• Charak conforms to HL7 standards, hence shall seamlessly integrate with all new hospital software appearing in future

• Charak is built on DICOM standards to ensure easy transfer of digital radiology images

• Charak has specific solutions for image viewing and interfacing with standard PACS solutions

Page 17: Charak- An Introduction

All the patient data is available on simple clicks

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41/F D Sinha

Page 18: Charak- An Introduction

All patient data and investigation reports can be readily reviewed by the doctor through clinically relevant screens

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Page 19: Charak- An Introduction

The software generates relevant MIS for the hospital to check aggregate hospital performance

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Page 20: Charak- An Introduction

The software supports extensive research capability for the doctors to evaluate care protocols and analyze evidence based medication

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Page 21: Charak- An Introduction

The software can been leveraged to a drill-down dashboard framework to “report by exception”

• Effective Surgical Revenue (ESR)• Effective Bed Revenue (EBR)• Effective Diagnostic Revenue (EDR)• Operating costs

Effective Surgical Revenue (ESR) = No. of surgical procedure X Avg. revenue per surgeryEffective Bed Revenue (EBR) = Avg. Length of Stay X Avg. Bed Occupancy X Avg. Bed Rate X Available BedsEffective Diagnostic Revenue (EDR) = No. of diagnostic procedures X Avg. revenue per diagnosis

• Average revenue/ patient• Market share• % of repeat patient • Patient satisfaction index1

• ROCE• Operating Margin• PAT growth• Cost of Capital

• No. of partner patients• No. of referrals from spoke to hub• Operating margin at partner sites• No. of technology transfer initiatives underway

• Attrition rate• No. of employee

training days• No. of full time

doctors• Employee

satisfaction index1

• No. of case sheets generated

• No. of research papers published

• No. of technology initiatives underway

(1) Satisfaction index measured through periodic neutral surveys conducted by external agencies

Level I dashboard(CEO & Board)

Level II(Mid Management)

Operating costs• Consumable costs• Salary costs• Rental costs• Pharmacy costs• Marketing costs• General Admin

costs

Operating costs• Consumable costs• Salary costs• Rental costs• Pharmacy costs• Marketing costs• General Admin

costs

Level III(Process)

Consumable costs• Direct material• Overhead material• A- Category

material purchase• Avg. direct consm

per patient

Consumable costs• Direct material• Overhead material• A- Category

material purchase• Avg. direct consm

per patient

ILLUSTRATIVEILLUSTRATIVE

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Page 22: Charak- An Introduction

Charak can create significant improvements across the hospital

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Long waiting time(At OPD, surgery, wards, discharge)

Delayed emergency response

(Missing data, triage, ambulance)

Multiple investigations(Similar tests conducted due to missing

old records)

Multiple visits(Visits for consultations, labs, reports,

follow ups)

Sub-optimal resource utilization

(OR, wards, doctor’s time, labs)

Limited resources(Doctor’s time, beds, OPD hours)

Poor hospital evaluation(No easy metrics to measure hospital

performance)

Wastages and pilferage(OR material, stores items, pharmacy)

Patients Hospital

Extensive paper work(OT notes, discharge summary,

orders)

Repetitive activities (Patient instructions, pharmacy, billing

estimations)

Multiple coordination(OR planning, duty allocation,

appointments)

Multiple follow ups(Check patient conditions, order

status, room occupancy)

Doctors

Well defined appointments and scheduling

Quick response at the Golden Hour

Standardized care plan

Consolidated clinical data available remotely

Hospital wide resource optimization

High resource utilization

Extensive computer generated MIS

Transaction based material tracking

Computer generated reports

Automated activities with status report only

Centralized planning and scheduling

Alerts and Exception based Reporting

Page 23: Charak- An Introduction

No. 8, 1st Floor, 15th Cross,

100 Ft Ring Road, J.P. Nagar, 6th Phase,

Bangalore – 560078

Tel: +91 80 4165 0200

+91 98800 46849

www.asclepiusconsulting.com

This proposal is exclusively intended for the personnel at Frontier Lifeline, Chennai. Distribution, quotations and duplications — even in the form of extracts — for third parties is only permitted upon prior written consent of Asclepius Consulting.

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Page 24: Charak- An Introduction

• Additional slides

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Page 25: Charak- An Introduction

Charak modules

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The software comprise over 100 modules – majority available as standalone solutions – working seamlessly with existing IT solutions

Existing IT system

ADMINISTRATIVE MODULES

ADMINISTRATIVE MODULES

Admission, Discharge Transfer (ADT)

Admission, Discharge Transfer (ADT)

SchedulingScheduling

Material ManagementMaterial Management

Event-based BillingEvent-based Billing

Orders and Medication Record

Orders and Medication Record

Documentation & Notes

Documentation & Notes

Charting and Flowsheets

Charting and Flowsheets

Alerts/ RemindersAlerts/ Reminders

Clinical Decision Support

Clinical Decision Support

Clinical ProtocolsClinical Protocols

Management Information Systems

Management Information Systems

Device IntegrationDevice Integration

InteroperabilityInteroperability

Hardware OptionsHardware Options

Privacy and SecurityPrivacy and Security

System MonitoringSystem Monitoring

LIS/ RISLIS/ RIS ResearchResearch

CLINICAL MODULESCLINICAL MODULES ANCILLARY MODULESANCILLARY MODULES INFRASTRUCTURE MODULES

INFRASTRUCTURE MODULES

Page 26: Charak- An Introduction

Significantly lower total cost of ownership (TCO)

The software aims to minimizes the total cost of ownership by taking care of all the relevant costs accruing to the hospital

Very competitive license costsLowest customization costProfessional process consulting

Thin client solution implies minimum hardware requirements

Easy integration with multiple devices

Seamless interfaces with existing systemsIntegration with DICOM devicesExpertise in integrating HL7 devices

Free upgrades with AMCsNegligible run time license costsMinimal costs for additional user licenses

High quality lead to low debugging costsLocal service network for AMCRemote performance monitoring

Easy integration with future HL7 solutionsEasily scalable to additional facilities and

expansions

Illustrative

Page 27: Charak- An Introduction

Admin

Clinical

Ancillary

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ADMINISTRATIVE MODULES

AD1 Patient Admit, Discharge, Transfer

AD2 Patient Registration & Identification

AD3 Scheduling and Appointments

AD4 Room management

AD5 Event based Billing

AD6 Pharmacy management

AD7 Hospital services management

AD8 Material management

AD9 Cashless insurance management

CLINICAL MODULES

CL1 Documentation

CL2 Notes

CL3 Charting and Flowsheets

CL4 Medication admission record

CL5 CPOE/Order Entry

CL6 Alerts

CL7 Event manager

CL8 Patient discharge & education

CL9 Workflow and checklists

CL10 Clinical configuration

CL11 Drug databank

CL12 Clinical Protocols

CL13 Clinical Decision Support (CDS)

CL14 Clinical collaboration

ANCILLARY MODULES

AC1 Whiteboard

AC2 Inquiry and MIS

AC3 Printing

AC4 LIS

AC5 RIS/PACS

AC6 Rules Engine

INFRASTRUCTURE MODULES

IF1 Security and Privacy

IF2 User Organization

IF3 Remote service-RM&D

IF4 Interfaces

IF5 Hardware options

IF6 Notification engines

Infra

RECOMMENDED MODULE IMPLEMENTATION PLAN

Enhanced Admin

AD6, AD7, AD8, AD9

Core Admin

AD 1, AD2, AD3, AD4, AD5

Protocols & CDS

CL12, CL13, CL14

Printing and Reporting

AC1, AC2, AC3

LIS, RIS and PACS solution

AC4, AC5, AC6

Core Infra

IF1, IF2, IF3

CPOE & Drug Databank

CL5, CL6, CL9, CL10, CL11

Core EMR

CL1, CL2, CL3, CL4, CL7, CL8

Multiple Hardware

IF4, IF5, IF6

Page 28: Charak- An Introduction

Admin

Clinical

Ancillary

Infra

Enhanced Admin

AD6, AD7, AD8, AD9

Core Admin

AD 1, AD2, AD3, AD4, AD5

Protocols & CDS

CL12, CL13, CL14

Printing and Reporting

AC1, AC2, AC3

LIS, RIS and PACS solution

AC4, AC5, AC6

Core Infra

IF1, IF2, IF3

CPOE & Drug Databank

CL5, CL6, CL9, CL10, CL11

Core EMR

CL1, CL2, CL3, CL4, CL7, CL8

Multiple Hardware

IF4, IF5, IF6

The prices of these solution are contingent to specific needs of the hospital

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R1 R2

R3 R4

• Release #1: Core administrative processes with requisite ancillary and infrastructure modules

• Release #2: Documentation and charting EMR solution with additional administrative processes

• Release #3: CPOE, Alerts and workflow together with hardware options and notification engines

• Release #4: LIS/ RIS solution together with rules engine, clinical protocols and clinical decision support

Cost for 100 bed hospital

Rs. 2-5 lakhs

Rs. 10-15 lakhs

Rs. 22- 25 lakhs

Rs. 32- 40 lakhs

Specific pricing arrangements can be developed to make the overall cost affordable to the hospital

Dashboard reporting

Page 29: Charak- An Introduction

• Six sigma quality leading to negligible bugs

• HL7 and DICOM compliant

• Conforms to IHE and NABH guidelines

• User- centric design

• Extensive domain expertise

• Team of doctors, process consultant, GE Healthcare

• Built by Indian doctors

• Extensive depth in features

• Extracts data from devices

• Extensive configurability

• Integrated ecosystem

• Shows radiology images

• Allows remote data access

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• Very affordable prices

• Cheap hardware required

• Low customization costs

• In depth process analysis

• Zero run time license costs

• Remote performance monitoring

• Collaborative implementation

• Provide hand-holding, drive change management

• Free upgrades with AMCs1

Asclepius offers world class IT solutions – with high quality and international features – at a very affordable total cost of ownership

Free uprades or first 30 customers only1


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