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Solution Showcase: Ambient AI Mythbusting and Successful Pilots with Kali Ihde

Bill Russell: [00:00:00] Today's episode is brought to you by Abridge. There's no secret that care teams spend too much time on documentation before, during, and after patient visits. Abridge transforms clinical conversations into complete, compliant and accurate notes in real time. Integrated directly into the EHR workflows.

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I am Bill Russell, creator of this Week Health, where our mission is to transform healthcare, one connection at a time. Welcome to today's solutions showcase where we [00:01:00] spotlight innovations, making real impact in health systems. Let's take a look at what's working today.

Bill Russell-1: All right. Today we have a solution showcase, and I am excited to be joined by Kali Ihde, director of Ventures and Innovation at Northwestern Medicine Kali. Uh, welcome to the show.

Kali Ihde | Northwestern Medicine-1: The invite

Bill Russell-1: Looking forward to this conversation. There's so much going on in this world. I, I don't know about you, but do you have a, at least five AI conversations today at this point?

Kali Ihde | Northwestern Medicine-1: Every hour, at least five. It never ends. If I have a meeting where we don't mention ai, I'm concerned at this point.

Bill Russell-1: have you found it's going outside? Like last night we had people over to the house and they're like, Hey, you're an AI guy. I'm like, okay. And then they, they wanna know. It's like, what does this mean? What do you tell, like the average person who comes over for dinner, like, what does AI mean? What's like your standard response?

Kali Ihde | Northwestern Medicine-1: Yeah, I mean, I typically say it is fancy new automation. So automation that's more [00:02:00] sophisticated than ever before that can make decisions, help you collect information, and do things better every day. I love that you mentioned at a dinner party. I got a text from my parents, um, on Sunday for Valentine's Day.

That was an AI generated Valentine's Day virtual card that had them as digital cartoons. And I was just like, how did you create that? My dad was so proud. Chat, GPTI mean, it is everywhere in every, you know, it doesn't, it doesn't matter if you are, you know, in the boomer generation, it doesn't matter if you're young.

I mean, everybody's in it.

Bill Russell-1: That is, that's amazing. Um, I kudos to your parents for doing that. That's.

Kali Ihde | Northwestern Medicine-1: How to do it. I wanted to send one too, because now I left out.

Bill Russell-1: , A little confession here that it depends who I have over, whether I give 'em like the positive outlook. Oh my gosh, look at all the things I could do for you. Or if I make them like, go home and like sulk and think, oh, my, my world is going to end because, 'cause you could go in either direction with this and people get a very concerned. Let's give people a little bit about your [00:03:00] background. How did you get to this role and, and. start there. And then I want to hear what innovation and ventures looks like at Northwestern Medicine.

Kali Ihde | Northwestern Medicine-1: Happy to, you know, I, I tell everybody that my, my whole career has been translating between humans and technology. I started straight out of college at Epic, so a big company that most people are familiar. With, especially in the healthcare industry. Um, and it really gave me a grounding in what actually works with technology, but also what doesn't, um, and how it can, how technology can help and or hinder in, in this environment.

And so I've been really fortunate ever since those first years at Epic to be able to then stay connected to technology and healthcare.

Bill Russell-1: in a client facing role at Epic?

Kali Ihde | Northwestern Medicine-1: I was, I was in the implementation division, so always working with hospitals on how do we prepare, how do we activate, how do we stabilize all that great work?

Bill Russell-1: Yeah, that's, that's gotta be. And so that, that prepares you pretty well for, a, a role where you're looking [00:04:00] at innovation. I, I would assume pragmatically, 'cause you've, you've been there.

Kali Ihde | Northwestern Medicine-1: You got it. And honestly, that epic background comes in handy when I'm working with startups, when I'm working with, you know, well established industry. Vendors as well of, all right, here's how epic actually works. You know, you can't, can't get by me by saying, oh yeah, we're a deep epic partner. I can usually, you know, work through that pretty quickly.

Um, and it also grounds me in what's truly novel. What are we trying, you know, we're not replicating any EHR when I look for something novel. So how, how can these new, whether it's ai, whether it's another digital tool, how can it really impact what's going on every day?

Bill Russell-1: how'd you get to Northwestern and, and talk a little bit about innovation and, and ventures at Northwestern.

Kali Ihde | Northwestern Medicine-1: I got connected to Northwestern through a physician innovator who actually I had met through some startup company introductions, and then as I was recognizing sales wasn't the right way for me, um, he connected me into the northwestern medicine world. And, and with that epic background, naturally my first few years were [00:05:00] all around epic implementations and helping us get onto the system and transitioning.

Um, new hospitals, new sites into our, you know, epic environment. And then the pandemic hit and anybody with a project management background or implementation background got tasked with one of the core work streams of helping us respond to the pandemic. And I got telehealth the Friday before the stay at home order went into effect.

And so I don't remember that weekend, but we got through it.

Bill Russell-1: I was gonna say, how and how fast did that scale?

Kali Ihde | Northwestern Medicine-1: I mean, it was, I mean we had to, you know, necessity breeds innovation. We didn't have a choice. We had been piloting telehealth, trying to figure out how to get it embedded. And that weekend we had to figure it out. And within that following week, every specialty, every physician had figured out how to make it work.

And was it optimal? Certainly not. But we did it and it kind of proved, you know, these type of new digital tools can work. Um, and. Folks recognize that it took effort to get it embedded into [00:06:00] the work that they do every day.

Bill Russell-1: Necessity is the mother of invention. I, uh, that was the, the pandemic was, had a couple things to it. One was the necessity, the other was focus. We were so focused during that time on just solving a handful of problems, and we did it very well. I wish. If there's part of me that wishes we could get back to that focus, not to that time, but to that focus that health systems had, uh, along those lines, you know, where is your team focused right now?

When you, you think about, uh, innovation.

Kali Ihde | Northwestern Medicine-1: Like everyone else, we have to be focused on AI right now. It, it's everywhere. Like we started this conversation. So that's, that's a big focus, but I, I think it's, it's a parallel mindset of the realism of it. How can we stay focused on what of those headline grabbing comments about AI taking over the world, AI being more sophisticated than you think, you know, ai, you know, being the doom of society.

Which of those are, are real? Which of them [00:07:00] are hype, which of them are theoretical? Um, but also.

Bill Russell-1: plus AI can't do math. Ai hallucinates AI doesn't reference. I mean, you have, you have both sides like, oh my gosh, it's so advanced. And then you have the other side saying, well, I'm not sure it's advanced enough yet. It needs guardrails, it needs,

Kali Ihde | Northwestern Medicine-1: I say sometimes that part of our team's role is myth busting. You know, much like that show for years, we test, we validate, we ask questions. We provide an environment where folks can safely explore the early stage stuff that they're not quite sure if it's as promising as it says. Um, but it's really about enablement too.

You know, that's our dual focus. It's realism and enablement We want. To be a leading user of these technologies. We want our physicians, our administrators, our back office folks to benefit from these tools, but we also wanna be smart and and safe about it. So that's what my team does, you know, powered by some donor funding and a team of folks who like to get stuff done is, let's set these up.

And you know, we [00:08:00] use the term pilot still, and I know that that can have a negative connotation, but we small scale. Proving environment to try something out and then measure the impact.

Bill Russell-1: So 2026 is ai and it's really about an. Enablement. which is, which is, uh, I mean, when you think about enablement, are you thinking mostly on the uh, uh, clinical side? You thinking on the patient side, you're thinking on the OR, or, uh, administration side, or is there really all of those things?

Kali Ihde | Northwestern Medicine-1: Yes.

Bill Russell-1: Yes.

Kali Ihde | Northwestern Medicine-1: All of the above. And, and part of that isn't a lack of focus or attention, it's finding the areas where it feels safe, where it feels valuable, and where we have champions within our organization who are interested and eager to pursue it. 'cause that's the other thing, is we don't want people to feel like AI is being forced on them.

We want it to be something they feel a part of that is enabling for them that allows them to, again, do the work that they do [00:09:00] better versus, you know, fear around is it replacing, is it not? I mean, the, the best way to build confidence or interest in these tools is to build the trust.

Bill Russell-1: I'm gonna come back to and adoption. In a minute. 'cause I, I, I want to talk about those two things. Those are topics that come up an awful lot when we're talking about, um, about innovation and new tools, and especially ai. But I, I want to, I wanna start with ambient ai. I, I've, I've grown accustomed to in our 2 29, uh, city tour dinners of starting with, alright, tell me what AI projects you're doing that isn't ambient, ambient, crossed that threshold.

Everybody's doing it. And I, I asked one of the groups, I asked them if. Why, why is everyone doing it? And they said they're, they're afraid if they don't have it, that it will be a recruiting issue at a, at a minimum because it has become now the baseline for all health systems. What are you seeing?

I mean, that's obviously the floor, like it's the baseline, but. But there has been the reason it's been adopted and the [00:10:00] reason crossed that threshold is there is real world impact ambient ai. Uh, I'd love, I'd love for you to share stories or, or, or outcomes, uh, around your ambient journey so far.

Kali Ihde | Northwestern Medicine-1: we love Ambient and we've been on the journey for a number of years. We, we like to say we were an earlier adopter of the technology, but also waited until it was. Truly generative and, and independent and could be used as a tool in and of itself without extra reviews or, or, you know, delays after the note was generated.

Um, we like, you know, ambient because, and you kind of mentioned you wanna get back to ROII have to have the conversations together because ambient has been the truly the easiest to measure the value because it checks so many value boxes. So there's the, the. Obvious one of physician satisfaction and reduction of burden, which we've done multiple surveys and.

Everyone has said it's saving me [00:11:00] time, it's giving me peace of mind during the day, the cognitive burden, which wasn't a term I really had in my vocabulary until ambient came along, but just that from the moment my clinic opens until the moment it closes, the amount of information swirling in my head that I need to get out of my head and to the right place.

Um. This tool now helps do that so that again, it's not just sitting up there, it is not taking up all that space and that pressure, um, day in and day out. And so we love it for, for that, which was great because our whole goal was let's address physician burnout. Let's address, um, our provider, you know, administrative burden.

But then it checked so many other ROI boxes in terms of actually quantifiable benefit. And so we were able to show a measurable decrease of the time spent in notes, um, to the tune of 20 to 30% on average for our physicians. We were able to then equate that into hours. Which [00:12:00] is, you know, tens to hundreds of hours every week depending on the num.

Like as we grew the number of users on the ambient tool, we then looked at what folks were doing with that time back. 'cause again, if we're giving you hours back, are you going home and spending it with your family, which is fantastic and important. Um, but what we found is so often the physicians were giving it back to their patients and opening more scheduled spots.

And so again, without a mandate, without asking them to do that, that was. What a large majority of folks were doing because they also want to meet the continuing challenges of getting their patients in to be seen when they need to be seen without a long wait. And so we are actually able to quantify, we were seeing, you know, per physician on average about nine additional visits per month, which is.

Slots on schedule. That's, you know, not having to wait multiple months for an appointment. And so, you know, and, and naturally that then hits the bottom line that's generating more revenue. That's, you know, making our patients happy. That's helping in a lot of other ways. Um, and, and just really, you know, [00:13:00] resonated with our whole organization.

Bill Russell-1: as I go around, I ask people about adoption. Uh, I'll, I'll ask this to you in a, in a different way and I'm gonna ask you what keeps us from a hundred percent adoption. You just rattled off a lot of things to love about ambient ai, but I've yet to talk to a health system that's at a hundred percent adoption.

What, what are the, the barriers that keep us

Kali Ihde | Northwestern Medicine-1: Yeah.

Bill Russell-1: that level?

Kali Ihde | Northwestern Medicine-1: don't know if our target should be a hundred percent adoption because I think everyone uses tools differently. Some, some benefit. I will say we had some physicians who wanted to try ambient and did, but found, look, I do very, you know, bulleted notes that are very short, very brief because the type of specialty I do or the type of work that I do, and it, it meets all the requirements and regulatory needs.

I don't need, you know, more robust than that. And it was actually faster to use templates the way that I did before. And so I, that's still a win. Great. You're, you're faster with the stuff you have today. Fantastic. I'm not [00:14:00] gonna try to make you use a tool that would slow you down in any way, shape or form.

So I think it's a little bit of, again, tools are just that they're a mechanism to let you do your work. And so. You know, if, if this one doesn't move you in the positive direction, that's okay. And so I think that's where we sit on that one is it's not necessarily that everybody needs to use every tool. I think we've learned with EMRs and others that when you mandate, you just don't have the same success.

Bill Russell-1: Uh, that was a, that was a, a, a very, epic response by the way. It's like if you spent the time to customize your EHR with the right tools, it works really well for you. Um, but, it, gosh, having lived that, that is so true that the physicians who spent the time to really. to, to customize the tools to the way they function, the way they operate. they may not see the need for it because they are very efficient. I've, I have seen that. Um, have you, have you seen, uh, the pit,[00:15:00]

Kali Ihde | Northwestern Medicine-1: Oh yeah,

Bill Russell-1: have

Kali Ihde | Northwestern Medicine-1: sure. I, I just actually caught up on the latest episode.

Bill Russell-1: so, so the storyline, um, for those who haven't seen it, it's, uh, the pit. It's on HBO. Um, and it's, uh, the storyline. There's a generative AI storyline where it, it documents, uh, the, you know, the, the meeting and it hallucinates, which by the way, I think is like an episode it's moving so fast. I think it's, it's an episode that should have been written six months ago, today.

Like the AI models today. Aren't the, the chain of thought reasoning and whatnot. They're not hallucinating as much and they're

Kali Ihde | Northwestern Medicine-1: Um,

Bill Russell-1: but in, in the show, it, it makes up a bunch, a bunch of stuff. It's a, I'm, I'm curious your thought, if you watched the latest episodes, what, what are your thoughts on that storyline?

Kali Ihde | Northwestern Medicine-1: I nerd it out a little, the first time it got brought up because I was like, this is what I do when I'm like sending it to my family, sending it to friends. Like, is anybody watching the pit? This, this is what I do. , So I think that's exciting because it, it's just reading awareness. It's, you know, getting, you know, out to the masses.

A [00:16:00] bit of a, an explanation of, of what it is, but it also very realistically calls out why. We still ask providers and physicians and whoever's using it to, to review it after the fact in the real world. I do think it's unfortunate that they. Focused so much on the hallucination. 'cause again, there are, to your point, so many examples of it that rarely happens often, but it, but it is a real consideration.

Uh, but I, I just think it's great that that show, which is doing so many wonderful things for exposure to healthcare and the real challenges every day of the folks. At the front lines, taking care of patients, plus trying to meet business needs, plus trying to incorporate techno, like it's so many things, um, that it's, it's good.

I think it's great.

Bill Russell-1: I do wanna go back to ROI and adoption a little bit. Uh, and I, I guess the question is, you know, how are you measuring return on innovation investments and. Uh, what and what's working to drive adoption across the organization? Uh, it, I mean, [00:17:00] word of mouth obviously is a beautiful thing that we saw with, uh, ambient, uh, listening across the board.

It's, it's been fantastic from that perspective. from a, from a, I guess this is more the, the venture side and the innovation side is, uh, how do you, how do you measure the, the success, uh, of the, the solutions that you're bringing in?

Kali Ihde | Northwestern Medicine-1: Yeah, it's, it's a good question and, you know, a core function of, of my team's role and, and I think the role of the. Any organ, any, you know, individual or team who's helping the organization look at new technologies or new solutions or anything in that regard. We're pretty disciplined about it at this point because, and you've heard me say the word a couple times, like value and I purposely use value and not ROI because I think value has a much broader.

Definition and allows for the, the many different, you know, pillars of value. And so we think of it, of everything from improvement in experience, whether that's our clinicians, [00:18:00] our, you know, business office folks, uh, patients as well. And so like we think of experience as a bucket of value and, you know, being able to measure, you know, is sentiment going the right way.

Our, you know, our, you know, satisfaction surveys, our ratings, things like that. Going in the right way.

Bill Russell-1: you saying there's more ways to measure things than just money? That's what I hear you saying,

Kali Ihde | Northwestern Medicine-1: It turns out, actually, I think the step further than that is it's, it's not just money, but you can actually translate improvement and experience into money. So there is a way to take, I'm happier in my job, I'm not leaving, so you're not taking on turnover costs or you know, a patient is staying and thus they're not going to another health system and thus they're continuing to get care.

Like those can be translated into dollars. And so. A lot of things that might seem soft can actually be translated into harder dollars. That, of course, naturally build business cases more easily.

Bill Russell-1: Talk about the adoption, uh, lifecycle, if you will. So you, you. [00:19:00] Do a pilot. You guys are traditional, do do a small pilot, prove it out. But I assume during that time you are looking at okay, engaging the right stakeholders at that moment of the pilot to make sure that when it's time to scale it up, that there is an adoption curve.

You, I mean, you've been in this adoption space for a long time. What, what tends to work the best?

Kali Ihde | Northwestern Medicine-1: For us, we don't even consider a pilot in an area without finding subject matter experts and champions who want to be a part of it. And so we've had a lot of technology that other health systems say has been really successful. But you know, if we can't find those leaders and those folks. On, you know, the grounds of our hospital, in our practices, in our business office, who genuinely want to be a part of it, we won't even start.

And so you've gotta have them from the beginning. Because a, they're gonna help you evaluate the solution, whether it's even worth looking at. B Then when you pilot, you've got the people who can help make sure you're preparing, you're setting it up, you're, you're, um, defining how you're going to measure success [00:20:00] or not.

What does success look like, which is a core part of that value analysis, ROI analysis and then. They're the ones who are using the tool when it's activated. They're the ones who are, you know, figuring out the workflow, the tech, the people, all of it together. And then ultimately, they're the ones that champion it when it's successful, or are the ones who provide that critical insight if it's not.

And help us, you know, learn for the next time. And so for us, adoption starts always with the individuals who are gonna care the most about it and then, you know, sticks with them as we define, measure, and then showcase value. I.

Bill Russell-1: let's take another area. Let's take access. How is innovation improving patient access, and, and what's the opportunity there?

Kali Ihde | Northwestern Medicine-1: I think it's the real, you know, challenge of healthcare these days. There is more demand than supply, and so we have a population that wants care, but they want it a lot of different ways [00:21:00] depending on who they are and what they need. So you have everything from folks who only want. Telehealth or remote options or on demand digital solutions.

You have individuals who also want to be in person, want to see face-to-face and get that time. You have primary care specialty. Now we have wellness as a component and a, a broader impact and input into everybody's healthcare journey, and so it's. Access is a challenge. You know, we are in a dense area between the Chicago, you know, city and the surrounding suburbs.

You know, it is one of our biggest challenges.

Bill Russell-1: let, let's not forget Naples, Florida, okay?

Kali Ihde | Northwestern Medicine-1: I appreciate you bringing that.

Bill Russell-1: I'm, I'm pulling up my Northwestern medicine right now, and I'm seeing what my telehealth op opportunities are from down here. So anyway, I'm just,

Kali Ihde | Northwestern Medicine-1: No, I like it. I like the real world test of,

Bill Russell-1: well, and I,

Kali Ihde | Northwestern Medicine-1: really offering.

Bill Russell-1: you're, you're trying to integrate all these different ways that people come in to, to [00:22:00] take into account there. There're di different ways that they want to engage in their, in their health journey.

Kali Ihde | Northwestern Medicine-1: You got it. And, and that doesn't, and that requires then the right people, the right tools, the right capabilities to be able to enable all of those. Because when you think about a physician now. Same physician you wanna see, but you wanna see 'em sometimes virtually, sometimes in person. And oh, also, I'm also going to be sending you messages via my patient portal.

I wanna access you every way. You know, it's still just that one physician and so

Bill Russell-1: not,

Kali Ihde | Northwestern Medicine-1: we help.

Bill Russell-1: a tech, that's not a technology problem per se. No.

Kali Ihde | Northwestern Medicine-1: I would say it's. It's a, an outcome of the transition to digital. You know, there are now so many different ways we consume and we want to consume healthcare and, you know, the world Now, we as the health system have to figure out how to deliver that all without overburdening our clinicians and allowing them to be the great clinicians that they are.

Bill Russell-1: Do you find that startup companies are more. [00:23:00] Grounded in how healthcare functions and how it works, or is there still people who come to you with a very tech heavy, like, Hey, this is gonna solve the problem, and you have to sit there and go. Okay, let's, uh, let's start at square one kind of thing and let's, let's step back.

This is what healthcare is really about. Your, the complexity of this is not a technology problem, it's a, really a, a process and a, and a, a people problem. Like we have limited we have limited specialists, we have limited scheduling times, we have limited block blocks and kinds of things.

I mean, where, where do you find that those, uh, those startups are coming to you from?

Kali Ihde | Northwestern Medicine-1: You're gonna love this answer. It's a mix. It depends, but at the same time, we still, what we find, what I hear all the time now, and this is awesome, but also a challenge is you have. Entrepreneurs, CEOs, founders who identified a problem from the patient perspective. So I went through X, [00:24:00] Y, Z treatment. I struggled to get an appointment.

I had this experience with my, you know, elderly parents or my young child. I had all these challenges, so therefore I felt the need to solve them, and I did. So creatively, you know, with this digital solution, with this AI solution. What we find then is so often it sounds perfect and great from the patient perspective, but they didn't actually take into account how healthcare runs, how insurance works, how you know the, the behind the scenes of the functions of those physicians that they want things to change with the scheduling teams that they want changes from or to use this tool.

So what we love to do, and we have an accelerator program that enables this, is we love to work with those early stage companies. To give them that environment to then learn more about this side of healthcare and not just the patient side so that they can build a better product. And so I think, I think that's the neatest opportunity is when you [00:25:00] find these folks who are so passionate about the problem, great, let us help you then design and improve and evolve your solution so that it solves both.

The patient, individual, community member who's having the experience, but also works within what is a complex healthcare environment.

Bill Russell-1: Well, I, I wanna give you an opportunity to talk about, uh, other areas. We talked about access, we talked about ambient. listening, uh, before that, uh, you know, I, uh, I'm, I'm really impressed. I mean, I know you probably don't have much to do with this, and it's, it's probably the team at, uh, the, the IT team there, but who has worked. But my, uh, cardiology referral instructions are here. Uh, schedule your flu vaccine is here. I mean, this is. This is a pretty well, uh, you know, information about vaccine information and whatnot around respiratory viruses and, pretty well designed, uh, implementation of, of MyChart anyway, what, what other area, what other areas, what other areas would you, uh, focus in on?

Or, or, or that, that is a focus area for you [00:26:00] guys right now?

Kali Ihde | Northwestern Medicine-1: I think, I think we've just sort of hit the tip of the iceberg, so to speak, of how automation and AI can continue to reduce the administrative side, the paperwork, quote unquote, the digital paperwork side of what healthcare has going on between, you know, our, you know, patients and communities that we're.

Trying and, and very successfully taken care of in many ways to our, you know, insurance companies that we are partnered with to make sure that everything is funded and taken care of. And then us as the health system providing the care. I think, you know, there's still so much, ambients a great example.

It's, you know, been. Instrumental in proving how AI can truly help transform and make things better. But it's, it's not exclusive, it's not the only thing out there. So let, let's, I love that we're still looking and finding more areas where AI can help. Um, in the back office, you know, for, you know. Revenue cycle, finance, all of that.

It's such an exciting space to help get [00:27:00] more efficiencies because that's the part of healthcare that patients, you know, rarely see all the details and all the people that are behind it. But it's, you know, such an important part of, of a, you know, making sure our organizations and our health systems are strong financially functioning organizations, but also that are, we're not putting that burden on our patients.

We're not putting more financial burden on our patients to do it. So for me, it's. You know, we're sort of at our plot twist moment in healthcare where we, we have this opportunity with all these new tools to continue making life easier. Um, and to show that this technology can do it effectively. Um, I would say at the same time, there's a lot of considerations around that.

I, um, I don't think technology itself and AI itself and all these tools themselves, I don't think are the, the biggest challenge. I think it's, we need to make sure it feels human. And it feels real and it's safe and it's not exacerbating inequities and problems that we know already exist in healthcare, but it's, it's solving to those and improving them while reducing the friction that we have [00:28:00] in what we do.

Bill Russell-1: It seems like a great time to be in ventures and innovation in the healthcare space. Uh, there's, um, quite a lot going on. In fact, when it gets to be a storyline on an HBO show, there is definitely an awful lot, on. This is gonna be, this is gonna be a fun year. I'd love to, uh. back in with you later on and, uh, I don't know, maybe reprise this conversation and, and see, see what's, uh, see what's changed. I wanna, I wanna thank you for your time today and, and thanks for sharing your experience at Northwestern Medicine.

Kali Ihde | Northwestern Medicine-1: Thank you. We're, we're proud of what we do and, and excited about what's to come. So always happy to share more.

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