If you can find one particular solution to save even one life - this product is worth building. Jeff Carroll, the founder of JC Telemedicine and founding member of an online pharmacy, talks about healthtech innovations, mental health and awareness, telemedicine, and overall consumer wellness. In this episode, you’ll learn about the challenges that plague our healthcare system firsthand. Enjoy the listening!
In this episode, we'll talk about:
01:16 The background story of JC Telemedicine
02:03 Technology challenges in the healthcare industry - why all the doctors still use fax machines
03:15 Status quo as the main obstacle to change everything to new technologies
04:00 The primary mission of JC Telemedicine
07:01 How to convince physicians to use telemedicine
08:31 How JC Telemedicine differentiates from other products on the market
10:13 Engaging target audiences of JC Telemedicine: independent physicians or hospitals?
12:42 Connecting new solutions to existing on the practice
15:44 Lack of doctors' education in technology as an obstacle
18:21 Bad Internet connection: is it a problem for physicians working in rural areas?
21:23 The biggest challenge of implementing telemedicine in everyday use
23:01 Today primary focus of JC Telemedicine
26:36 Primary advice to other professionals who would like to develop or implement technology in healthcare
27:50 Rapid Fire Round (3 questions)
Jeff Carrol in LinkedIn: https://www.linkedin.com/in/jeff-carroll-telemedicine/
JC Telemedicine LinkedIn: https://www.linkedin.com/company/jc-telemedicine-consulting-services-llc/
JC Telemedicine Website: http://jctelemedicine.com/
JC Telemedicine Twitter: https://twitter.com/JCTelemedicine
Ivan Dunskiy: Hello everyone. And welcome to another episode of the HealthTech Beat podcast. The mission of the podcast is to show the real-life challenges of implementing technology in healthcare. And the podcast is sponsored by Demigos, a company that develops IT solutions for healthcare, startups, and companies. For more information, you can check the website demigos.com.
My name is Ivan Dunskiy, your today's host as always, and I'm joined by a very special guest Jeff Carroll, founder of JC telemedicine. Also, Jeff was a founding member of an online pharmacy. Jeff is determined to make healthcare affordable by bringing price transparency to the market. He also wants to make prescription treatment widely available to patients. Jeff, thank you for joining. How are you today?
Jeff Carrol: Hey, Ivan. Thanks for having me and doing very well this morning, excited to join your podcast, and yeah, definitely excited to be here.
[01:16] The background story of building a JC Telemedicine
Ivan Dunskiy: Could you please give a brief background of your story in healthcare and the story behind JC Telemedicine?
Jeff Carrol: Definitely. So my name is Jeff Carroll. I'm the founder of JC telemedicine. Before I started JC, I was on the founding team at an online pharmacy. We were the pharmacy that was behind the fulfillment for some really big names in digital health, like Hims and hers, Roman the recently acquired Lemonaid Health and Cerebral. Our pharmacy powered these companies in the backend to send out personalized prescription packages.
So after a few years, I decided to start my own company because I believed I could help these digital health companies in a lot more ways than just doing pharmacy fulfillment.
[02:03] Technology challenges in the healthcare industry - why all the doctors still use fax machines
Ivan Dunskiy: I remember you mentioned that when you worked at an online pharmacy, you saw many challenges in the industry. Were some of these challenges connected with technology?
Jeff Carrol: Absolutely. And it really blew my mind working at this pharmacy. So I think that there's a lot of challenges when it comes to implementing technology in healthcare. When I was working in the high-volume pharmacy environment, it pretty much came as a shock to me that the pharmacies still relied on a fax machine to communicate with doctors, other pharmacies.
Like it's 2017, for crying out loud, or even today, it's 2021, and the pharmacies are still using a fax machine. It just didn't make a lot of sense to me. And so, I set out to see about ways that we can solve this issue of using antiquated technologies. And using better technology to improve the lives of patients and pharmacies.
So it definitely came as a surprise to me to see that doctors were still writing prescriptions on paper pads and that we were still using a fax machine in the pharmacy.
[03:15] Status quo as the main obstacle to change everything to new technologies
Ivan Dunskiy: And why do you think this happens in this way? What is the main obstacle to changing everything to new technologies? It was really the main reason behind that.
Jeff Carrol: I think that's a really good question. I think that there's a little bit of resistance, and there's definitely resistance on the provider side, as well as there's hesitation and reluctance to switch over to new technologies.
I think that one of the biggest challenges and one of the things that I'm looking to improve on is how do we change that status quo? How do we get people to move away from their old way of doing things? And understand that there's a better way of doing things. There's a better way of solving patient needs, improving patient outcomes, improving adherence to medication by using technology.
[04:00] The primary mission of JC Telemedicine
Ivan Dunskiy: And could you please tell me why you decided to start JC telemedicine and, yeah, what is the main mission of the company?
Jeff Carrol: Our mission is fairly straightforward. We are looking to accelerate the digital transformation in healthcare across America. So, what we do is build custom solutions for digital health and other health tech companies.
We worked with, I mean, in the last two years, so we started in 2018. Since that time, we've worked with over 20 clients, from independent doctor's offices to online pharmacies, to clinics and all kinds of different healthcare companies. Our team brings over 35 years of telemedicine, pharmaceuticals, business law, bioethics, and others backward.
So we have a team that is composed of these backgrounds, and we bring over 35 years of experience. We've completed over 90 successful projects for companies ranging from multi-million dollar companies to digital health startups. The companies that we've worked with are responsible for covering a combined two and a half million patient lives. So you know, what we do is we help these companies to understand the nuances of telemedicine and how to deliver that type of virtual care. It's a really exciting topic to help these companies understand that you can reach patients in their homes.
Doctors can work from their homes, and they can reach patients' lives and improve patient outcomes. So it's really an exciting topic. But like I had referenced earlier, we're met with a challenge, and that challenge is the status quo. That challenge is that we're so used to having this centralized type of health care where we go to the hospital to fix our problems, or we have to go to the doctor's office to experience changes and this type of healthcare.
I believe there's a better way of doing things. And that better way of doing things is meeting with a physician from your home or hopping on a video call with a doctor to talk about your symptoms and your problems. Doctors are resilient. They're able to provide health care, and they're able to provide care in so many different forms.
And I think that if we can bring a doctor to the patient's home, it's kind of funny, back in the early 1990s. We were used to doing house calls. And this was the idea that a doctor would come to a patient's home. They would be able to provide care to a patient at that point of care in their home.
And then, we moved away from this type of decentralized healthcare. We moved more towards the hospital systems and independent physicians' offices, but I suspect that because technology is making things easier. For patients and for doctors, we're going to move back into this kind of this decentralized type of healthcare delivery, which is where now, because of technology like in video conferencing and other types of technologies that put the doctor in the patient's home, again, we're going to move back to this house call type delivery.
[07:01] How to convince physicians to use telemedicine
Ivan Dunskiy: Interesting. I'm just curious, how do you convince physicians to use telemedicine, and what kind of challenges do you face when you try to find new customers and Provide services like that.
Jeff Carrol: Yeah, that's a really great question. So I think that the pandemic definitely accelerated technology adoption in the medical field.
We're seeing things like doctors are using products like voice assistance for patient charting and patient note-taking. They're using video platforms and conferencing platforms like Zoom to have video calls with patients, and they're using other products that can really improve patient outcomes.
But there's still such a really large gap between where we are and where we should be. So I think what we're going to see is doctors are going to become more confident with technology. If you talk with doctors today, a lot of them are hesitant to say that, you know, telemedicine and telehealth are really becoming a norm and becoming a way that we're moving.
It's becoming a hybrid model is where I think that a lot of doctors will say that the future is. And so, I suspect that in the coming year, because patients demand telemedicine and because patients want to visit with the physician from their home, I think that doctors are going to catch on and they're going to really start building this type of experience into their patient care.
[08:31] How JC Telemedicine differentiates from other products on the market
Ivan Dunskiy: And I'm curious there are many, many telemedicine products in the market. How do you differentiate yourself? How do you differentiate your products, and your services providing telemedicine from other offerings that are available?
Jeff Carrol: That's another really great question. So, every practice is different, right? Every product should be different. And so there's no cookie-cutter. There's no one solution that fits all the needs of a doctor, right. And so if you go to talk to a physician, he'll tell you: "My practice is different because of this," or "my practice is different because we care more about our patients," whatever the reason may be.
Every doctor is different and every practice is different. So we wanted to bring the solution to the market. We sit down and tailor the need. We sit down and tailor the product that we deliver to our patients and to our doctors in a very succinct manner. And so we sat down and we talked to them, you know, what are you doing today?
What is your practice doing? How are you delivering care to patients today? And sure, we haven't intended to get doctors to use our software platform, but ultimately because we have a consulting layer on top that helps physicians and doctors to design an element of telemedicine that reaches their patients, um, we're able to deliver a highly customizable product.
So short, as I mentioned, we do have software that allows doctors to reach their patients directly to consumers. But ultimately we believe that by providing a really unique experience to our physicians, we can empower them to deliver a really unique experience to their patients.
[10:13] Engaging target audiences of JC Telemedicine: independent physicians or hospitals?
Ivan Dunskiy: And I wonder if you are the most attractive target audience like these independent physicians or more practices, maybe group practices or hospitals?
Jeff Carrol: I think it depends. It depends on what the doctor's trying to achieve. So we do have some examples of clients. For example, we work with a very prominent women's health brand. What they do is operate 38 clinics nationwide.
So these are in-person clinics. And essentially, what they do is provide a point of care for places where patients can come in person. Ultimately during the pandemic, this clinic realized. That's not really a great way to deliver care when people are stuck at home. So they came to JC telemedicine with the hope that we could help them design an ulterior modem that allows patients to reach the doctor and for the doctor to reach the patient from their home.
So we sit down with them, and we say, What type of care are you delivering today? What type of prescriptions do you typically prescribe? What kind of treatment plans do you typically put patients on? And so what we've done is we've sat down, and we've, we've created a whole product offering where this company can now host its offering online and allow patients to go through an intake process, and tell the doctor about the symptoms that they're experiencing or about the conditions that they have. From that point, the physician can review the intake form, the medical history questionnaire, and prescribed medication, if appropriate, or just provide that one-on-one care that a physician can give to a patient.
There's really, you know, the opportunities are endless. When we sit down and work with a company with this really comprehensive medical protocol, all we're doing is digitize that product. We put it onto the website, and then overnight, we're able to reach a tremendously larger patient population.
So today, when you're working with an in-person clinic, you're really limited towards the foot traffic that comes into that clinic. Whereas if you create a digital offering, you can instantly reach patients in any state or in any location or any geography, which is a really cool concept.
When you know, it allows doctors to practice at the top of their license.
[12:42] Connecting new solutions to existing on the practice
Ivan Dunskiy: I assume that when you work with these larger companies, they already have existing solutions in place, EMR systems, EHR systems. So how do you connect your solution to existing solutions in practice?
Jeff Carrol: There is such a massive amount of software that a doctor's office or clinic can choose from in today's climate. And so, you know, that's absolutely a huge challenge is how do we make these systems talk to each other? This concept in healthcare is called interoperability, and it's the idea that all the systems are talking to each other, information is available when a physician needs it.
Information is available to a pharmacist when dispensing medications. They can see the patient history, they can see notes from the doctor. And really that's one of the biggest challenges when using technology in healthcare is how do we create a single continuous type of care for a patient.
So really, when working with the kind of companies and the kind of physicians groups that I work with, we're not looking to necessarily replace what they do today, but we're absolutely looking at ways that we can tie their systems in together. One of those things is, you know, we do have a lightweight EHR or lightweight EMR system that a physician can use.
But obviously, as I mentioned, physicians are set in their ways. They like to do what they know works. So ultimately, by creating a system that allows doctors, technologies to talk to each other, that's a lot more appealing of a proposition to a doctor. When you can say: Hey, I know that you're used to using your homegrown EHR, or you're used to using an EHR that's off the shelf.
We don't need you to change that. Instead, we can augment those systems, and we can allow you to provide more comprehensive services without changing a thing. So this is, it gets really complex, but the idea here, Ivan, basically we can create a technology layer that transmits information from one EHR to a different system, or we can upload patient information from one EHR into a different system. The idea is by getting systems to talk to each other, that's our first key to making a continuous spectrum of care.
Ivan Dunskiy: Of course, and I assume that available data formats such as HL7 are helpful here.
Jeff Carrol: So here's where all deferred to my technology officer. So JC telemedicine does have a number of employees. We have some employees with a background in law and bioethics. We also have various software developers and engineers on our team as well. So, I'm not the most technical person on our team, but we do have folks that are building these solutions in congruence with building these types of larger type offerings for physicians as well.
[15:44] The gap in terms of educating doctors as the other massive obstacle in implementing technology solutions in clinics and hospitals
Ivan Dunskiy: Yeah. And when you implement your solutions, you already mentioned that one of the main challenges is the existing status quo that physicians have. But what are other obstacles to implementing your solutions in clinics and practices?
Jeff Carrol: I think, you know, it really all comes back to how we convince a doctor or a physician that telemedicine really does improve the patient experience.
And so I think, one of those key challenges that we see is how do we make sure that you know, we're not crossing the bridge into misdiagnosis. So this is a very juicy topic in healthcare today when you're visiting with a patient, and you're actually not able to see them face to face.
How do you make sure that that patient is who they say they are? How do you know that they make sure that they're experiencing these conditions that they say they experience? How do you make sure that you can still deliver a great patient experience and a great treatment to that patient when you're not actually seeing them in person?
So, in order to answer that question, I would really just mention there's a lot of different types of telemedicine. So one type of telemedicine is live synchronous video. Like what we're doing now, talking face to face, really helps to improve that communication between a doctor and a patient, but there are other types of telemedicine as well that we're starting to see become widely adopted.
For example, remote patient monitoring, which is the concept of having wearables like an apple watch or a blood pressure cuff that the doctor can actually take this data and use this data to inform his decisions. As well as there is a more nuanced type of telemedicine, which is referred to as asynchronous or store and forward is another term for this telemedicine where basically a patient is answering a group of questions, a set of questions about his or her medical history or their need for treatment. And the physician is then transmitted to the doctor in real-time, where the physician can then review these questions and prescribe treatment if it's applicable.
So, because there's this really large spectrum of what telemedicine encompasses, I think that there's a huge gap in terms of educating doctors and educating them on how to use telemedicine because a lot of them aren't really sure where to start, but that's what JC telemedicine does is we provide that kind of that foundational knowledge for doctors that are looking to reach their patients directly.
[18:21] Bad Internet connection: is it a problem for physicians working in rural areas?
Ivan Dunskiy: Yeah. Thank you. And another question I had an interesting conversation one day with a physician who works in a rural area. And he mentioned the problem that in his area, internet connection is not as good as in big cities. So do you see that as a problem when you work with these physicians and clinics, or do you just focus on companies that are located in larger geographic areas where they have a good internet connection?
Jeff Carrol: Yeah. So, it's easy to deliver a technology program to physicians that are in big Metro areas. It's easy because it's easy to monetize that. So for example, in the San Francisco bay area, which is where I'm located, there are about 60 or so dermatologists that specialize in dermatology. It's easy to get some patients online.
You have a license that allows you to practice in the entire state of California. But the challenge here is how do we bring that same level of care to what we call a desert, a care desert. And so basically yes, one of the challenges is if you don't have a good internet connection, it's really hard to have a live video conversation with the doctor.
It's even more challenging to drive across town and visit a physician in person. So I think you have to kind of pick the lesser of two evils. How can we transmit patient information and get it in front of a physician in a timely way? And so telemedicine lends itself well to certain treatment areas, things as dermatology, like I had mentioned, it's easy to take a picture of your face and send it to a doctor.
That doesn't involve a really strong internet connection. If you're able to just upload an image, then you don't have to have a live conversation with the patient. You know, things like sexual health, erectile dysfunction, or birth control are some topics that physicians can just simply look at some questions that they ask their patients and they're able to provide a treatment plan to a patient based on what they've told them.
Other things like hair loss or we're starting to see a lot more treatment areas being expanded into from the asynchronous telemedicine. In terms of fixing infrastructure challenges, like good basic internet, I think that our country and the world, in general, have a long way to go in terms of closing that gap.
I think there are ways that we can improve infrastructure challenges. But I mean, you look at the number of people in the world that have a smart, right. They're able to take pictures of themselves, or they're able to communicate with the physician using that smartphone. I think that improving access and improving the options that are available to patients are in turn going to allow more accessibility and more affordability for patients alike.
[21:23] The biggest challenge of implementing telemedicine in everyday use
Ivan Dunskiy: Yeah. Digital is coming into our life more and more, it's inevitable. So could you please tell us what problems you are experiencing now that you are trying to tackle and overcome in your company?
Jeff Carrol: Yeah. So, once again, the biggest challenge that I really see is it's not so much as finding doctors that want to do this.
It's more about finding doctors that want to do this and in turn helping them to impact their patients’ lives. I think that there's a lot of doctors that want to use telemedicine, and there's a lot of doctors that want to use digital to improve their patient's experience.
They just don't know how to do it, right?
They don't know where to start. A doctor goes to medical school for eight years, but he doesn't take a single course or a single class on telemedicine, let alone running a business. So these topics are really foreign to physicians and it makes it challenging for them to say, I want to start something from scratch or I want to go.
And here's the vision that I really have for my practice. I just don't know how to get there. So that's really the biggest challenge that I see is that there is a lack of education in the medical field when it comes to using telemedicine and using digital health. I really like to see more information for physicians out there.
And so that's one of the missions as well that I have is to create literature and content that helps any doctor go direct to the consumer. The biggest challenge I had mentioned is getting doctors educated on how to use telemedicine.
[23:01] Today primary focus of JC Telemedicine
Ivan Dunskiy: Yeah. And is this the current primary focus in your work or maybe there are some other projects you're working on currently?
Jeff Carrol: The primary focus of my work is to help doctors, clinics and other healthcare companies accelerate their adoption of technology. So it's to give them whatever tools they need in order to reach those patients. So, as I mentioned before, we do build custom solutions for any clinician or any healthcare company because every practice is unique, but one of the really exciting projects that I'm working on is building a low-cost pharmacy distribution network with the hopes of lowering the price of medication, as well as bringing transparency to the market. So one of the funny things that I always like to mention is, you know, a patient that takes medication, they've never seen a pharmacy catalog before. They don't really know what the true cost of these medications is, but if you saw the prices, it would astound you.
I only know this because I worked at a pharmacy for a couple of years. And so now I understand that most generic cash pain medications literally cost pennies to manufacture. So, I mean, when you're talking about a 365-day supply of generic medication, it shouldn't be more than a couple of bucks.
So I think that one of the cool things that I'm working on is how can we show patients that the true cost of medication for real pure you know, not knock off the medication I'm talking about, a real medication that you take in your home is really inexpensive to manufacture. So how can we show patients that there's a lot of intermediaries, there's a lot of middlemen in our space today that really convolute what that price looks like?
And they make it really challenging to understand that. This should be a lot cheaper than what I'm paying for it today. I think that we've seen some companies like Good RX, for example, that add that layer of transparency, but still when you go to Good RX and you find a $7 coupon for a drug that really only costs 30 cents, still, there's also a lot of work to be done.
One of the other topics that I'm exploring is how do we use big data and how do we use artificial intelligence and other types of technologies like blockchain in healthcare. I think that there's a lot of really exciting applications to these technologies that we have yet to discover. But one of the things that JC Telemedicine is doing is we're experimenting with clinicians and practices to help them understand there are alternative ways to use these technologies. And obviously, we hope to see a really wide adoption once we figure out a solution that fixes these problems for doctors.
Ivan Dunskiy: Yeah. Once you have that skill and that ability, how to convince decision-makers in health care to use technology, that's easier to come up with other solutions as well.
Jeff Carrol: Yeah, it's easier said than done. But once we design a product that is really, truly easy to use and truly something that physicians know and have confidence that will improve their patient's outcomes. I think that then it's just a matter of sharing that with the world and sharing that with doctors and America.
Ivan Dunskiy: Yeah, from our experience, I also observed that it's very important to show people in the industry that you have a solution that really works so that they can trust you. And only after that, they can be committed to trying your solution. So that's really the key.
[26:36] Primary advice to other professionals who would like to develop or implement technology in healthcare
Ivan Dunskiy: So we are coming to the end of an interview. But I have one more question. What kind of advice can you give to other professionals who would like to develop or implement technology in healthcare? For example, they come out with a new solution or a new startup. What can you say to these people?
Jeff Carrol: There is no greater feeling than knowing that your product has impacted a patient's life. And healthcare, in general, is absolutely riddled with problems.
But if you can find that one practical solution to save even one life, that product is worth building in my opinion. So obviously the goal is to build a solution that can save many lives, but ultimately you have to start somewhere. The piece of advice I would give future founders in healthcare is anything worthwhile, does not come easily.
Right? If it's worth building, it's going to take time and it's going to take dedication. So just understand that these things take time and understand that you know, it's challenging to build something that people are going to use. But if you can cross that hurdle and you can get physicians using it and they know that it will change their patients' lives, it's worth building.
[27:50] Rapid Fire Round (3 questions)
Ivan Dunskiy: Yeah. It's great advice, I think. Appreciate that. So I think, the things that we covered, would be useful for our listeners. I would like to end each interview with an exercise called Rapid Fire Round. I will ask you several questions and you can give answers whatever you want.
So the first one is what is your favorite book?
Jeff Carrol: I love to read, and so I have a lot of favorite books. Some of my favorites, like all-time favorites, are things like crossing the chasm, the multiplier effect, or the tipping point. But one of my longest-time favorite books is called Persuading scientists. Marketing to the world's most skeptical audience. It's a book by Hamid Ghanadan. And the book talks about why doctors and scientists are generally very difficult people to sell to. They use logic in their buying process, much more so than most buyers who base their buying decisions on emotion.
So generally when a physician is about to buy something or a doctor or a scientist is about to buy something, they really have done a lot of thinking about a problem that they have, and they already have started thinking about the solutions. Otherwise, scientists and doctors, they've got very particular blinders in terms of they don't like to be sold anything unless they have thought about the idea that they really need it. So that's one of the really exciting books that I find to be most relevant to what I'm doing today is how do we really create a very distinct value proposition and a very clear value for the prospects that we sell to.
Ivan Dunskiy: Yeah. Cool. I have read a book by Jack Trout, Positioning. So he mentioned in the book that there are a couple of types of clients, so logical, and emotional. And kind of people who want to try new things and basically when you build a new product or service, you need to address all the obvious segments of these types of people, yeah. So we had Halloween recently. What costume did you have?
Jeff Carrol: That's a great one. My girlfriend and I always like to do couples costumes. This year we were the tortoise and the hare. So we have our onesies on, I was the tortoise and she was the hare. Had a little funny tale. It was cute. We after last year of not being able to do a new trick or treating we really miss that. So we bought up a lot of candy and we sat on our porch this year, just handing out candy to trick or treaters. It was really nice to get back in the swing of things. But yeah, it was a fun year to be back in a trick-or-treating mood.
Ivan Dunskiy: Cool. And the next one, what is the location that impressed you the most?
Jeff Carrol: Yeah. I love this question. I love to travel. I love to experience new foods, new cultures, and things like that. More recently, my girlfriend and I did a puzzle of the chink Ouattara, which is on the Southern coast of Italy. So we did a puzzle and we actually decided to go and visit the place in real. It was awesome. It's even more inspiring in a real person than it is doing a puzzle in your living room, the colors are absolutely beautiful. It was really an amazing place to go and visit. And the food is to die for.
Ivan Dunskiy: Yeah, of course. That's actually a very interesting way to choose the next place to visit, yeah doing a puzzle. And what is the one piece of advice you would give to your 20-year-old self?
Jeff Carrol: I think, the same advice that I would give to other founders in the space is to persevere, it's really challenging to build something that people will use, but you have to take feedback from your users and from your customers and you have to build with the patients in mind.
So I just looking back on this experience that I've had over the last several, many years is look, it's challenging. It's really hard building products in healthcare. But if you persevere, you'll see your products make a difference in patients’ lives and there is no greater feeling.
Ivan Dunskiy: Yeah, thank you. That's a perfect way to end today's interview. Thank you, Jeff, for your time and for sharing so much from your experience of implementing telemedicine as well as your experience working in an online pharmacy. So I think that things that you share will be valuable for our listeners.
But before we finish, what is the best way to get in touch with you so that people can talk or connect with you?
Jeff Carrol: Yeah. So, you can visit our website, jctelemedicine.com. But I would also recommend that your users follow us on LinkedIn and Twitter. We share articles and information and other content that really helps not just doctors and physicians to use telemedicine, but it helps to inform patients on ways that they can use television. So, yep. Follow us. We have accounts on Twitter and LinkedIn. We also are on different platforms like Facebook, Instagram, medium, and Substack. But those are some just really easy ways that YouTube can get involved in the digital health scene.
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