Mapping of HL7 Items to FHA D Mapping HL7 Functional Model to FHA Revised Health Domains (N = 127) Primary Domain

10 12 43 59 Secondary Domain 0 17 27
30 70

FHA Revised Health Domain Manage Access to Care Manage Population Health and Consumer Safety Manage the Health Care Business Deliver Health Care Services Support Health Care Research and Practitioner Education Totals

60

50

40

61
20

3 127

22
10

127
0

Note: Source of information, HL7 HER-S Functional Model, document dated 2004 and FHA Health Line of Business Revised Health Domains, briefing dated 15 Dec 04. N = 127 line items within the HL7 Functional Model.

Manage Access to Care Manage Population Health and Consumer Safety

10

12

17

Manage the Health Care Business Deliver Health Care Services Support Health Care Research and Practitioner Education

43

27

59

61

22

7 Items to FHA Domains

Break out of Primary Domain

2% 8%

9%
Primary Domain Secondary Domain

Manage Access to Care Manage Population Health and Consumer Safety Manage the Health Care Business

47%
Deliver Health Care Services

34%

Support Health Care Research and Practitioner Education

Break out of Secondary Domain

0% 17% 14%
Manage Access to Care Manage Population Health and Consumer Safety

Consumer Safety

21%

Manage the Health Care Business Deliver Health Care Services

48%

Support Health Care Research and Practitioner Education

Health and

Care Business

Services

Research and

ealth and

are Business

ervices

Research and

Primary FHA Domain A D D D D D D D D D D D D D D C C C C C C C A A A A A D D D D D D D D D D D D D

Secondary FHA Domain D C B B B B B C C C C C C E E D D D D D D D D D D D D C B B C E B B B B E E E E

Functional HL7 Name DC1.1 DC1.1.1 DC1.1.2 DC1.1.3. DC1.1.3.1. DC1.1.3.2. DC1.1.3.3. DC1.1.4. DC1.1.5. DC1.1.6. DC1.1.7. DC1.1.7.1. DC1.1.7.2. DC1.2. DC1.2.1. DC1.2.2. DC1.2.3. DC1.3. DC1.3.1. DC1.3.2. DC1.3.3. DC1.4. DC1.4.1. DC1.4.2. DC1.4.3. DC1.4.4. DC1.4.5. DC1.4.6. DC1.5. DC1.5.1. DC1.5.2. DC2.1. DC2.1.1. DC2.1.2. DC2.1.3. DC2.1.4. DC2.2. DC2.2.1. DC2.2.1.1. DC2.2.1.2.
Health information capture, management, and review Enable the provider to identify and locate a patient record Capture Patient Demographics Manage Other Summary Lists Manage Problem List Manage Medication List Manage Allergy List Manage Patient History Summarize Health Record Capture and creation of clinical documents and notes Capture Other Key Data Capture external clinical documents Capture patient-provided data Care Planning, Critical Paths, Protocols Present clinical guidelines Mange patient specific care plans, guidelines, and protocols Manage patient specific instructions Medication ordering and management Enable medication ordering Manage Medication Formularies Manage medication administration Orders, Referrals, and Results Management Place generic orders Order diagnostic tests Manage order sets Manage referrals Manage results Enable the ordering of blood products Consents and Authorizations Manage consents and authorizations Enable capture, maintenance and access to patient advanced directives Health information capture and review Support for standard assessments Support for Patient Context-enabled Assessments Support for identifying anomalies or potential problems Patient and family preferences Care Planning, Critical Paths, Protocols Support for condition based care plans, guidelines, protocols Present standard care plans, guidelines, protocols Present context sensitive care plans, guidelines, and protocols

Functional HL7 Area Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support

Legend: A = Access to Care B = Pop Health & Safety C = Health Care Business D = Deliver HC Services E = HC Research & Education

Primary FHA Domain D D D D D D D D D D D D D D D D D D D D D B B B B D D B D D D D D C C C C D

Secondary FHA Domain E E E E C C C C C E E E E E E E E E B B B C C D D E E D C C C C C D D D D B DC2.2.1.3. DC2.2.1.4. DC2.2.1.5. DC2.2.1.6. DC2.3. DC2.3.1. DC2.3.1.1. DC2.3.1.2. DC2.3.1.3. DC2.3.2. DC2.4. DC2.4.1. DC2.4.2. DC2.4.3.1. DC2.4.3.2. DC2.4.4. DC2.4.4.1. DC2.4.4.2. DC2.5. DC2.5.1. DC2.5.2. DC2.6. DC2.6.1. DC2.6.2. DC2.6.3. DC2.7. DC2.7.1. DC2.7.2. DC3.1. DC3.1.1. DC3.1.2. DC3.1.3. DC3.1.3.1. DC3.2. DC3.2.1. DC3.2.2. DC3.2.3. DC3.2.4.

Functional HL7 Name

Capture variances from standard care plans, gidelines,and protocols Support management of patient groups or populations Support research protocols Support self care Medications, medication management Support for medication ordering Support for standard drug, food, allergy and weight/age-based dosing interaction checking Patient specific dosing and warnings Medication recommendations Support for medication administration. Orders, Referrals, Results and Care Management Support for non-medication ordering Support for result interpretation Support for referrals Support for referral recommendations Support for Care Delivery Support for safe blood administration Support for accurate specimen collection Health Maintenance: Preventive Care and Wellness Alerts preventive services and wellness Notification for preventive services and wellness Support for population health Support for clinical health state monitoring within a population Support for notification and response Support for monitoring and appropriate notifications regarding an individual patient's health Support for knowledge access Access clinical guidance Patient knowledge access Clinical Workflow Tasking Clinical task assignment and routing Clinical task linking Clinical Task tracking Clinical task timeliness tracking Clinical Communication Inter-provider communication Pharmacy Communication Provider/Patient/Family Communication Patient, Family and Care Giver Education

Functional HL7 Area Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and Operations Management and

Legend: A = Access to Care B = Pop Health & Safety C = Health Care Business D = Deliver HC Services E = HC Research & Education

Primary FHA Domain D E E C C C C C C C C C C C C C B B B C D C C C C C C C C C C A A A A C C

Secondary FHA Domain C D D D D D D D D D D D D D D D D D D D C D D D D D B D D D D C C C C D D DC3.2.5. S1.1. S1.2. S1.3. S1.3.1. S1.3.2. S1.3.3. S1.3.4. S1.4. S1.4.1. S1.4.2. S1.4.3. S1.4.4. S1.5. S1.6. S1.7. S2.1. S2.1.1. S2.1.2. S2.2. S2.2.1. S3.1. S3.1.1. S3.1.2. S3.1.3. S3.1.4. S3.2. S3.2.1. S3.2.2. S3.2.3. S3.3. S3.3.1. S3.3.2. S3.3.3. S3.3.4. S3.3.5. S3.3.6.

Functional HL7 Name

Communication with Medical Devices

Notifiable Registries Donor management support Provider Directory Provider Demographics Provider's location within facility Provider's on call location Provider's general location Patient directory Patient Demographics Patient's location within a facility Patient's residence related to the provision and administration of services Optimize patient bed assignments De-identified data request management Scheduling Healthcare recource availability Measurement, monitoring, and analysis Outcome Measures Performance and accountability measures Report generation Health record output Encounter/Episode of care management Specialized views Encounter specific functionality Automatic generation of administrative and financial data from clinical record Support remote healthcare services Information access for supplemental use Rules-driven clinical coding assistance Rules-driven financial and administrative coding assistance Integrate cost/financial information Administrative transaction processing Enrollment of patients Eligibility verification and determination of coverage Service authorizations Support of service requests and claims Claims and encounter reports for reimbursement Health service reports at the conclusion of an episode of care

Functional HL7 Area Care Management Operations Management and Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support

Legend: A = Access to Care B = Pop Health & Safety C = Health Care Business D = Deliver HC Services E = HC Research & Education

Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial

Primary FHA Domain D C C C C C B C E B B B

Secondary FHA Domain B D D D D D D D D D D D S3.4. S3.5. S3.5.1. S3.5.2. S3.5.3. S3.5.4. S3.6. S3.7. S3.7.1. S3.7.2. S3.7.3. S3.7.4.

Functional HL7 Name Manage Practitioner/ Patient relationship Subject to Subject relationship Related by genealogy Related by insurance Related by living situation Related by other means Acuity and Severity Maintenance of supportive functions Clinical decision support systems guidelines updates Patient education material updates Patient reminder information updates Public health related updates

Functional HL7 Area Care Management Financial Adminisrative and Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial

Legend: A = Access to Care B = Pop Health & Safety C = Health Care Business D = Deliver HC Services E = HC Research & Education

th & Safety are Business HC Services arch & Education

th & Safety are Business C Services arch & Education

th & Safety are Business C Services arch & Education

th & Safety are Business HC Services arch & Education

Primary FHA Domain A A A A A A A A A A B B B B B B B B B B B B C C C C C C C C C C C C C C C C C C C C C

Secondary FHA Domain D D D D D D C C C C C C D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D

Functional HL7 Name

Health information capture, management, and review Place generic orders Order diagnostic tests Manage order sets Manage referrals Manage results

Enrollment of patients Eligibility verification and determination of coverage Service authorizations Support of service requests and claims
Support for population health Support for clinical health state monitoring within a population Support for notification and response Support for monitoring and appropriate notifications regarding an individual patient's health Patient knowledge access

Measurement, monitoring, and analysis Outcome Measures Performance and accountability measures Acuity and Severity Patient education material updates Patient reminder information updates Public health related updates
Mange patient specific care plans, guidelines, and protocols Manage patient specific instructions Medication ordering and management Enable medication ordering Manage Medication Formularies Manage medication administration Orders, Referrals, and Results Management Clinical Communication Inter-provider communication Pharmacy Communication Provider/Patient/Family Communication

Provider Directory Provider Demographics Provider's location within facility Provider's on call location Provider's general location Patient directory Patient Demographics Patient's location within a facility Patient's residence related to the provision and administration of services Optimize patient bed assignments

C C C C C C C C C C C C C C C C C C C C C C D D D D D D D D D D D D D D D D D D D D D D D

D D D D D D D D D B D D D D D D D D D D D D C B B B B B C C C C C C E E C B B C E B B B B

De-identified data request management Scheduling Healthcare recource availability Report generation Encounter/Episode of care management Specialized views Encounter specific functionality Automatic generation of administrative and financial data from clinical record Support remote healthcare services Information access for supplemental use Rules-driven clinical coding assistance Rules-driven financial and administrative coding assistance Integrate cost/financial information Administrative transaction processing Claims and encounter reports for reimbursement Health service reports at the conclusion of an episode of care Subject to Subject relationship Related by genealogy Related by insurance Related by living situation Related by other means Maintenance of supportive functions
Enable the provider to identify and locate a patient record Capture Patient Demographics Manage Problem List Manage Medication List Manage Allergy List Manage Other Summary Lists Manage Patient History Summarize Health Record Capture Other Key Data Capture and creation of clinical documents and notes Capture external clinical documents Capture patient-provided data Care Planning, Critical Paths, Protocols Present clinical guidelines Enable the ordering of blood products Consents and Authorizations Manage consents and authorizations Enable capture, maintenance and access to patient advanced directives Health information capture and review Support for standard assessments Support for Patient Context-enabled Assessments Support for identifying anomalies or potential problems Patient and family preferences

D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D E E E

E E E E E E E E C C C C C E E E E E E E E E B B B E E C

Care Planning, Critical Paths, Protocols Support for condition based care plans, guidelines, protocols Present standard care plans, guidelines, protocols Present context sensitive care plans, guidelines, and protocols Capture variances from standard care plans, gidelines,and protocols Support management of patient groups or populations Support research protocols Support self care Medications, medication management Support for medication ordering Support for standard drug, food, allergy and weight/age-based dosing interaction checking Patient specific dosing and warnings Medication recommendations Support for medication administration. Orders, Referrals, Results and Care Management Support for non-medication ordering Support for result interpretation Support for referrals Support for referral recommendations Support for Care Delivery Support for safe blood administration Support for accurate specimen collection Health Maintenance: Preventive Care and Wellness Alerts preventive services and wellness Notification for preventive services and wellness Support for knowledge access Access clinical guidance Clinical Workflow Tasking Clinical task assignment and routing

C
Clinical task linking

C
Clinical Task tracking

C
Clinical task timeliness tracking

C
Patient, Family and Care Giver Education

B
Communication with Medical Devices

C C B D D D

Health record output Manage Practitioner/ Patient relationship Notifiable Registries Donor management support Clinical decision support systems guidelines updates

Functional HL7 Area Care Management Care Management Care Management Care Management Care Management Care Management Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Care Management Care Management Care Management Care Management Care Management Care Management Care Management Operations Management and Operations Management and Operations Management and Operations Management and Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

10

12

Clinical Support Clinical Support Clinical Support Measurement, Analysis, Research, and Reports Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

43

Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Operations Management and Communication Operations Management and Communication Operations Management and Communication Operations Management and Communication Operations Management and Communication Operations Management and Communication Operations Management and Communication Measurement, Analysis, Research, and Reports Adminisrative and Financial Clinical Support Clinical Support Adminisrative and Financial

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

59

Primary FHA Domain C D D D D D D D D D D D D D D D D A A A A B B D D D D D D D D D D D D D D D D

Secondary FHA Domain B B B B B B B B B B B B B B B B B C C C C C C C C C C C C C C C C C C C C C

Functional HL7 Name Information access for supplemental use

Capture Patient Demographics Manage Problem List Manage Medication List Manage Allergy List Manage Other Summary Lists Consents and Authorizations Manage consents and authorizations Support for standard assessments Support for Patient Context-enabled Assessments Support for identifying anomalies or potential problems Patient and family preferences Health Maintenance: Preventive Care and Wellness Alerts preventive services and wellness Notification for preventive services and wellness Patient, Family and Care Giver Education

Manage Practitioner/ Patient relationship Enrollment of patients Eligibility verification and determination of coverage Service authorizations Support of service requests and claims
Support for population health Support for clinical health state monitoring within a population Enable the provider to identify and locate a patient record Manage Patient History Summarize Health Record Capture Other Key Data Capture and creation of clinical documents and notes Capture external clinical documents Capture patient-provided data Enable the ordering of blood products Enable capture, maintenance and access to patient advanced directives Medications, medication management Support for medication ordering Support for standard drug, food, allergy and weight/age-based dosing interaction checking Patient specific dosing and warnings Medication recommendations Clinical Workflow Tasking Clinical task assignment and routing

Clinical task linking

D D D D D A A A A A A B B B B B B B B B B C C C C C C C C C C C C C C C C C C C C C C C C

C
Clinical Task tracking

C
Clinical task timeliness tracking

C
Communication with Medical Devices

C C D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D

Health record output

Health information capture, management, and review Place generic orders Order diagnostic tests Manage order sets Manage referrals Manage results Support for notification and response Support for monitoring and appropriate notifications regarding an individual patient's health Patient knowledge access

Measurement, monitoring, and analysis Outcome Measures Performance and accountability measures Acuity and Severity Patient education material updates Patient reminder information updates Public health related updates
Mange patient specific care plans, guidelines, and protocols Manage patient specific instructions Medication ordering and management Enable medication ordering Manage Medication Formularies Manage medication administration Orders, Referrals, and Results Management Clinical Communication Inter-provider communication Pharmacy Communication Provider/Patient/Family Communication

Provider Directory Provider Demographics Provider's location within facility Provider's on call location Provider's general location Patient directory Patient Demographics Patient's location within a facility Patient's residence related to the provision and administration of services Optimize patient bed assignments De-identified data request management Scheduling Healthcare recource availability

C C C C C C C C C C C C C C C C C C E E E D D D D D D D D D D D D D D D D D D D D D D

D D D D D D D D D D D D D D D D D D D D D E E E E E E E E E E E E E E E E E E E E E E

Report generation Encounter/Episode of care management Specialized views Encounter specific functionality Automatic generation of administrative and financial data from clinical record Support remote healthcare services Rules-driven clinical coding assistance Rules-driven financial and administrative coding assistance Integrate cost/financial information Administrative transaction processing Claims and encounter reports for reimbursement Health service reports at the conclusion of an episode of care Subject to Subject relationship Related by genealogy Related by insurance Related by living situation Related by other means Maintenance of supportive functions Notifiable Registries Donor management support Clinical decision support systems guidelines updates
Care Planning, Critical Paths, Protocols Present clinical guidelines Care Planning, Critical Paths, Protocols Support for condition based care plans, guidelines, protocols Present standard care plans, guidelines, protocols Present context sensitive care plans, guidelines, and protocols Capture variances from standard care plans, gidelines,and protocols Support management of patient groups or populations Support research protocols Support self care Support for medication administration. Orders, Referrals, Results and Care Management Support for non-medication ordering Support for result interpretation Support for referrals Support for referral recommendations Support for Care Delivery Support for safe blood administration Support for accurate specimen collection Support for knowledge access Access clinical guidance Health information capture and review

Functional HL7 Area Adminisrative and Financial Care Management Care Management Care Management Care Management Care Management Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Operations Management and Communication Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Clinical Decision Support Clinical Decision Support Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Operations Management and Communication Operations Management and Communication

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

17

Operations Management and Communication Operations Management and Communication Operations Management and Communication Operations Management and Communication Measurement, Analysis, Research, and Reports Care Management Care Management Care Management Care Management Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Measurement, Analysis, Research, and Reports Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Care Management Care Management Care Management Care Management Care Management Care Management Care Management Operations Management and Operations Management and Operations Management and Operations Management and Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support Clinical Support

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

27

Measurement, Analysis, Research, and Reports Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Adminisrative and Financial Clinical Support Clinical Support Adminisrative and Financial Care Management Care Management Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support Clinical Decision Support

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 61

22