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      "body": "<div class=\"text-justify\">\nRecord keeping is an important tool in any organisation, but the way it is been handled in many health organizations needs to be re-addressed.  There is a need to look into things that need improvement especially if it's getting to the point of affecting the major aim of all health establishments which is; 'saving lives'. I have not written this article to point accusing fingers to health workers on the subject matter but has find it neccessary to open your eyes to the concerns that are becoming the weakness of health organizations.\n\n![computer-1149148_960_720.jpg](https://cdn.steemitimages.com/DQmcbomJB9BDHEAgKgWoo2GB1RC8axQyVyDg6VdskKR3xkt/computer-1149148_960_720.jpg)\n\n<center><sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/medical-record-health-patient-form-781422/\"> Pixabay </a></sub> </center> \nTime will not permit me to give in details, my experiences on the subject matter, but will try to pen down facts which will lead to my suggestions and advice as to my knowledge. As to my references in this letter, i am directing the responsibility to each head of private organizations such as medical directors/manager/director etc as it is called in different establishement, because you should be responsible for the upkeep of all the departments of your organization. Please sir/ma, kindly treat this case with optimum  urgency\n</div>\n\n\n <div class=\"text-justify\">I was priviledge to be part of the health team that did a state evaluation of the health organizations' records inorder to collate some health data of the state. To my surprise, About 78% of the private organizations such as hospitals/clinics, pharmacies, laboratories, physiotherapy centres, dental clinics, eye clinics etc had poor legally sound health records. Infact, some of these health organizations could not present their patient file records nor have a central logbook that has the compiled records.\n \n\n![writing-1149962_960_720.jpg](https://cdn.steemitimages.com/DQmfVn2R6JgeqNRuVJwkxcNdQkH9s4T4K27SVUpCYtcYbGN/writing-1149962_960_720.jpg)\n\n<center>\n<sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/writing-pen-man-ink-paper-pencils-1149962/\"> Pixabay </a></sub> </center> \n</div>\n\n<div class=\"text-justify\">Sir/Ma, the sight of this menace caught me unaware because i could not believe what i saw in your health organizations. I will not be going deep on this issue as i understand how confidential this matter is. But i still deem it fit to raise this alarm so that if it's that you as the head of your own health organization was too busy to attend to examining this department, then i believe you should deem it fit to appoint an expert to monitor your health records. \n\n</div>.\n\nJust as i have pointed out at the beginning, i am writing this letter to make you to be aware of the ongoing situations and also tender my own submission of the subject matter. Sir/Ma, you need to be aware that record is your organization’s Bible – the source from which all other clinical records and documents are generated. It is the set of documents used to provide optimum patient care, document the patient’s progress across the continuum of care and generate a bill for appropriate reimbursement. It must therefore contain documentation and assessments to justify continued stay, support the diagnostic, describe the patient’s progress and response to medications as well as interventions.\n\n<div class=\"text-justify\">\nHealth records assists in protecting the legal interest of the patient and the health care providers. Health record is therefore a legal document because the organization, by law, must have a health record. The health record by definition must meet all statutory, regulatory and professional requirements to be a valid health record for clinical purposes as well for business purpose. If the record does not qualify as health record, it becomes hearsay, not a bonafide record and its integrity for any all uses become suspect\n\n\n\n<p><div class=\"pull-right\">\nhttps://cdn.steemitimages.com/DQmex4h6ve7QhvKv1TbTL6Cy952VXjSBsTLz6HrwXUft6am/ehr-1476525_960_720.png\n\n\n[Pixabay, license under Public Domain](https://pixabay.com/en/medical-record-health-patient-form-781422)\n</div>\n\n\nSir/ma there is a lot to talk about on this issue, but i just want to point out salient point that could be very helpful in corecting some of this menace. Infact, i am no more concentrating this letter on the need to make necassary amends to prevent likely sanctions from the Government, but also passionately looking forward for the records to meet the legal health standard. Therefore, here are the basic principles that must be met for the health records to be deemed admissible as evidence in court. The record must have been:\n\n ●Documented in the normal course of business (following normal routines)\n●Kept in the regular course of business\n●Made at or near the time of the matter recorded\n●Made by a person within the business with knowledge of the acts, events, conditions, opinions, or diagnoses appearing in it.\n\nTherefore, regardless of its format –paper, hybrid, or fully electronic, - the health record must meet the following legal and business record for requirements for the organization:\n●Maintain a medical record for each patient\n●Properly field and retained to ensure retrieval\n●The health record must be accessible\n●The health record system must ensure that medical record entries are not lost, stolen, destroyed, altered, or reproduced in an authorized manner.\n●Locations where health records are stored or maintained must ensure the integrity, security and protection of the records. \n\nIt is also essential to note that that all entries in the medical records must be timed, dated, and authenticated; and a method established to identify the author. Entries should be made as soon as possible after an event or observation is made.  The use of specific anguage should be encouraged whiule vague or generalized language avoided.  Examples of generalization and vague words include patient doing well, appears to be, confused, anxious, status quo, stable, as usual.\n\n![doctor-1228627_960_720 (1)-1.jpg](https://cdn.steemitimages.com/DQmd2eF2fSK2tivyaBBDdjm83MDRwDsUb51icHLmyAvQMfc/doctor-1228627_960_720%20(1)-1.jpg)\n\n<center><sub> [License: Public Domain]: <a href=\"https://pixabay.com/en/doctor-tomograph-i-am-a-student-1228627/\"> Pixabay </a></sub> </center> \n</div>\nHealthcare organizations should set a standard for acceptable abbreviation to be  used in the health record and develop an organization specific abbreviation list. Organizations shold define the level of record documentation expected of their practitioners based on the practitioners’ licensure, certification, and professional experience.\nMaintain a legally sound health record covers a huge territory from the content of the heatlh record and how entries are recorded to the functionality in the system to access, and security.  While the electronic age brings new variables to an old and complex problem, the foundation remain the same: health, records must be maintained in a manner that follows applicable regulations, accreditation standards professional practice standards, and legal standards.\n\n\n![medical-781422_960_720-1-1.jpg](https://cdn.steemitimages.com/DQmZRBH6PSUyrx4sNVTmxqANb7CYj8xemP27BkyoYWpev2g/medical-781422_960_720-1-1.jpg)\n<center><sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/medical-record-health-patient-form-781422/\"> Pixabay </a></sub> </center> \n\n#### </div>Conclusion\n\n Health information Management professionals must play a critical role in the transition from paper to electronic records and must partner with clinical, legal and information techjnologist to adequately address the legal business issues for the heatlh record. Remember to document it because if you have not document it, you did not do it!!!.  </div>\n\nI am grateful for taking your time to read through this article and I hope to see significant improvement during the next round of health records evaluations in the state. Thank you.\n\n\n\n#### REFERENCES\n\n[Importance of vital records and statistics](https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/The-Importance-of-Vital-Records-and-Statistics-for-the-Obstetrician-Gynecologist)\n\n[Health data](https://en.m.wikipedia.org/wiki/Health_data)\n\n[Everything you need to know about electronic health records](http://www.diabetesforecast.org/2015/may-jun/everything-you-need-to-know.html)\n\n\nIf you write STEM (Science, Technology, Engineering, and Mathematics) related posts, consider joining #steemSTEM on discord [here](https://discord.gg/vwzWz3Z). If you are from Nigeria, you may want to include the #stemng tag in your post. You can visit this [blog](https://steemit.com/@stemng) by @stemng for more details. You can also check this blog post by @steemstem [here](https://steemit.com/steemstem/@steemstem/being-a-member-of-the-steemstem-community) and this guidelines here for help on how to be a member of @steemstem. Please also check this blog post from @steemstem on [proper use of images devoid of copyright issues here](https://steemit.com/steemstem/@steemstem/guidelines-on-copyright-standards-in-steemstem)\n\n<center>![U5dsSmbYinRBp5yMiPALPDdL4gudZpv.gif](https://cdn.steemitimages.com/DQmNNVoB2Wn5mRkY8mCR5ZpDU1fFys7yvFtPG72fYkx3d7L/U5dsSmbYinRBp5yMiPALPDdL4gudZpv.gif)</center>",
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      "body": "<div class=\"text-justify\">\nRecord keeping is an important tool in any organisation, but the way it is been handled in many health organizations needs to be re-addressed.  There is a need to look into things that need improvement especially if it's getting to the point of affecting the major aim of all health establishments which is; 'saving lives'. I have not written this article to point accusing fingers to health workers on the subject matter but has find it neccessary to open your eyes to the concerns that are becoming the weakness of health organizations.\n\n![computer-1149148_960_720.jpg](https://cdn.steemitimages.com/DQmcbomJB9BDHEAgKgWoo2GB1RC8axQyVyDg6VdskKR3xkt/computer-1149148_960_720.jpg)\n\n<center><sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/medical-record-health-patient-form-781422/\"> Pixabay </a></sub> </center> \nTime will not permit me to give in details, my experiences on the subject matter, but will try to pen down facts which will lead to my suggestions and advice as to my knowledge. As to my references in this letter, i am directing the responsibility to each head of private organizations such as medical directors/manager/director etc as it is called in different establishement, because you should be responsible for the upkeep of all the departments of your organization. Please sir/ma, kindly treat this case with optimum  urgency\n</div>\n\n\n <div class=\"text-justify\">I was priviledge to be part of the health team that did a state evaluation of the health organizations' records inorder to collate some health data of the state. To my surprise, About 78% of the private organizations such as hospitals/clinics, pharmacies, laboratories, physiotherapy centres, dental clinics, eye clinics etc had poor legally sound health records. Infact, some of these health organizations could not present their patient file records nor have a central logbook that has the compiled records.\n \n\n![writing-1149962_960_720.jpg](https://cdn.steemitimages.com/DQmfVn2R6JgeqNRuVJwkxcNdQkH9s4T4K27SVUpCYtcYbGN/writing-1149962_960_720.jpg)\n\n<center>\n<sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/writing-pen-man-ink-paper-pencils-1149962/\"> Pixabay </a></sub> </center> \n</div>\n\n<div class=\"text-justify\">Sir/Ma, the sight of this menace caught me unaware because i could not believe what i saw in your health organizations. I will not be going deep on this issue as i understand how confidential this matter is. But i still deem it fit to raise this alarm so that if it's that you as the head of your own health organization was too busy to attend to examining this department, then i believe you should deem it fit to appoint an expert to monitor your health records. \n\n</div>.\n\nJust as i have pointed out at the beginning, i am writing this letter to make you to be aware of the ongoing situations and also tender my own submission of the subject matter. Sir/Ma, you need to be aware that record is your organization’s Bible – the source from which all other clinical records and documents are generated. It is the set of documents used to provide optimum patient care, document the patient’s progress across the continuum of care and generate a bill for appropriate reimbursement. It must therefore contain documentation and assessments to justify continued stay, support the diagnostic, describe the patient’s progress and response to medications as well as interventions.\n\n<div class=\"text-justify\">\nHealth records assists in protecting the legal interest of the patient and the health care providers. Health record is therefore a legal document because the organization, by law, must have a health record. The health record by definition must meet all statutory, regulatory and professional requirements to be a valid health record for clinical purposes as well for business purpose. If the record does not qualify as health record, it becomes hearsay, not a bonafide record and its integrity for any all uses become suspect\n\n\n\n<p><div class=\"pull-right\">\nhttps://cdn.steemitimages.com/DQmex4h6ve7QhvKv1TbTL6Cy952VXjSBsTLz6HrwXUft6am/ehr-1476525_960_720.png\n\n\n[Pixabay, license under Public Domain](https://pixabay.com/en/medical-record-health-patient-form-781422)\n</div>\n\n\nSir/ma there is a lot to talk about on this issue, but i just want to point out salient point that could be very helpful in corecting some of this menace. Infact, i am no more concentrating this letter on the need to make necassary amends to prevent likely sanctions from the Government, but also passionately looking forward for the records to meet the legal health standard. Therefore, here are the basic principles that must be met for the health records to be deemed admissible as evidence in court. The record must have been:\n\n ●Documented in the normal course of business (following normal routines)\n●Kept in the regular course of business\n●Made at or near the time of the matter recorded\n●Made by a person within the business with knowledge of the acts, events, conditions, opinions, or diagnoses appearing in it.\n\nTherefore, regardless of its format –paper, hybrid, or fully electronic, - the health record must meet the following legal and business record for requirements for the organization:\n●Maintain a medical record for each patient\n●Properly field and retained to ensure retrieval\n●The health record must be accessible\n●The health record system must ensure that medical record entries are not lost, stolen, destroyed, altered, or reproduced in an authorized manner.\n●Locations where health records are stored or maintained must ensure the integrity, security and protection of the records. \n\nIt is also essential to note that that all entries in the medical records must be timed, dated, and authenticated; and a method established to identify the author. Entries should be made as soon as possible after an event or observation is made.  The use of specific anguage should be encouraged whiule vague or generalized language avoided.  Examples of generalization and vague words include patient doing well, appears to be, confused, anxious, status quo, stable, as usual.\n\n![doctor-1228627_960_720 (1)-1.jpg](https://cdn.steemitimages.com/DQmd2eF2fSK2tivyaBBDdjm83MDRwDsUb51icHLmyAvQMfc/doctor-1228627_960_720%20(1)-1.jpg)\n\n<center><sub> [License: Public Domain]: <a href=\"https://pixabay.com/en/doctor-tomograph-i-am-a-student-1228627/\"> Pixabay </a></sub> </center> \n</div>\nHealthcare organizations should set a standard for acceptable abbreviation to be  used in the health record and develop an organization specific abbreviation list. Organizations shold define the level of record documentation expected of their practitioners based on the practitioners’ licensure, certification, and professional experience.\nMaintain a legally sound health record covers a huge territory from the content of the heatlh record and how entries are recorded to the functionality in the system to access, and security.  While the electronic age brings new variables to an old and complex problem, the foundation remain the same: health, records must be maintained in a manner that follows applicable regulations, accreditation standards professional practice standards, and legal standards.\n\n\n![medical-781422_960_720-1-1.jpg](https://cdn.steemitimages.com/DQmZRBH6PSUyrx4sNVTmxqANb7CYj8xemP27BkyoYWpev2g/medical-781422_960_720-1-1.jpg)\n<center><sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/medical-record-health-patient-form-781422/\"> Pixabay </a></sub> </center> \n\n#### </div>Conclusion\n\n Health information Management professionals must play a critical role in the transition from paper to electronic records and must partner with clinical, legal and information techjnologist to adequately address the legal business issues for the heatlh record. Remember to document it because if you have not document it, you did not do it!!!.  </div>\n\nI am grateful for taking your time to read through this article and I hope to see significant improvement during the next round of health records evaluations in the state. Thank you.\n\n\n\n#### REFERENCES\n\n[Importance of vital records and statistics](https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/The-Importance-of-Vital-Records-and-Statistics-for-the-Obstetrician-Gynecologist)\n\n[Health data](https://en.m.wikipedia.org/wiki/Health_data)\n\n[Everything you need to know about electronic health records](http://www.diabetesforecast.org/2015/may-jun/everything-you-need-to-know.html)\n\n\nIf you write STEM (Science, Technology, Engineering, and Mathematics) related posts, consider joining #steemSTEM on discord [here](https://discord.gg/vwzWz3Z). If you are from Nigeria, you may want to include the #stemng tag in your post. You can visit this [blog](https://steemit.com/@stemng) by @stemng for more details. You can also check this blog post by @steemstem [here](https://steemit.com/steemstem/@steemstem/being-a-member-of-the-steemstem-community) and this guidelines here for help on how to be a member of @steemstem. Please also check this blog post from @steemstem on [proper use of images devoid of copyright issues here](https://steemit.com/steemstem/@steemstem/guidelines-on-copyright-standards-in-steemstem)\n\n<center>![U5dsSmbYinRBp5yMiPALPDdL4gudZpv.gif](https://cdn.steemitimages.com/DQmNNVoB2Wn5mRkY8mCR5ZpDU1fFys7yvFtPG72fYkx3d7L/U5dsSmbYinRBp5yMiPALPDdL4gudZpv.gif)</center>",
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      "title": "An Open Letter to Private Health Organisations: A call for improvement on Health Records",
      "body": "From a concerned Health Expert\n                                  July 1st, 2018\n\nTo:\nHeads of Private Health Organisations,\nNigeria.\n                                            \nDear Sir/Ma,\n\n <div class=\"text-justify\">\nI must appreciate your courage to set up an organisation such as this that adds value to people rather than take away from them. As an adage says: \"A tree does not make a forest\", it is really glaring that your health establishment is a plus that really boosted the effort of the Government in improving the health quality of the masses</div>.\n\n\n <div class=\"text-justify\">\nHowever, there is a need to look into things that need improvement especially if it's getting to the point of affecting the major aim of the establishement; 'saving lives'. I have not written this letter to point accusing fingers on the subject matter but has find it neccessary to open your eyes to the concerns that are becoming the weakness of health organizations.\n\n![medical-781422_960_720-1-1.jpg](https://cdn.steemitimages.com/DQmZRBH6PSUyrx4sNVTmxqANb7CYj8xemP27BkyoYWpev2g/medical-781422_960_720-1-1.jpg)\n<center><sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/medical-record-health-patient-form-781422/\"> Pixabay </a></sub> </center> \n</div>\n\nTime will not permit me to give in details my experiences on the subject matter, but will try to pen down facts which will lead to my suggestions and advice as to my knowledge. As to my references in this letter, i am directing the responsibility to each head of these private organizations such as medical directors/manager/director etc as it is called in different establishement, because you should be responsible for the upkeep of all the departments of your organization. Please sir/ma, kindly treat this case with optimum  urgency\n</div>\n\n\n <div class=\"text-justify\">I was priviledge to be part of the health team that did a state evaluation of the health organizations' records inorder to collate some health data of the state. To my surprise, About 78% of the private organizations such as hospitals/clinics, pharmacies, laboratories, physiotherapy centres, dental clinics, eye clinics etc had poor legally sound health records. Infact, some of these health organizations could not present their patient file records nor have a central logbook that has the compiled records.\n \n\n<p><div class=\"pull-left\">\n\n\n![computer-1149148_960_720.jpg](https://cdn.steemitimages.com/DQmcbomJB9BDHEAgKgWoo2GB1RC8axQyVyDg6VdskKR3xkt/computer-1149148_960_720.jpg)\n\n\n<sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/computer-business-typing-keyboard-1149148/\n\"> Pixabay </a></sub> </center> \n</div>\n\nSir/Ma, the sight of this menace caught me unaware because i could not believe what i saw in your health organizations. I will not be going deep on this issue as i understand how confidential this matter is. But i still deem it fit to raise this alarm so that if it's that you as the head of your own health organization was too busy to attend to examining this department, then i believe you should deem it fit to appoint an expert to monitor your health records. \n\nJust as i have pointed out at the beginning, i am writing this letter to make you to be aware of the ongoing situations and also tender my own submission of the subject matter. Sir/Ma, you need to be aware that record is your organization’s Bible – the source from which all other clinical records and documents are generated. It is the set of documents used to provide optimum patient care, document the patient’s progress across the continuum of care and generate a bill for appropriate reimbursement. It must therefore contain documentation and assessments to justify continued stay, support the diagnostic, describe the patient’s progress and response to medications as well as interventions.\n\n<div class=\"text-justify\">\nHealth records assists in protecting the legal interest of the patient and the health care providers. Health record is therefore a legal document because the organization, by law, must have a health record. The health record by definition must meet all statutory, regulatory and professional requirements to be a valid health record for clinical purposes as well for business purpose. If the record does not qualify as health record, it becomes hearsay, not a bonafide record and its integrity for any all uses become suspect\n\n<p><div class=\"pull-right\">\n\n\n![writing-1149962_960_720.jpg](https://cdn.steemitimages.com/DQmfVn2R6JgeqNRuVJwkxcNdQkH9s4T4K27SVUpCYtcYbGN/writing-1149962_960_720.jpg)\n\n<sub>  [License: Public Domain]: <a href=\"https://pixabay.com/en/writing-pen-man-ink-paper-pencils-1149962/\"> Pixabay </a></sub> </center> \n</div>\n\n<div class=\"text-justify\">\nSir/ma there is a lot to talk about on this issue, but i just want to point out salient point that could be very helpful in corecting some of this menace. Infact, i am no more concentrating this letter on the need to make necassary amends to prevent likely sanctions from the Government, but also passionately looking forward for the records to meet the legal health standard. Therefore, here are the basic principles that must be met for the health records to be deemed admissible as evidence in court. The record must have been:\n\n ●Documented in the normal course of business (following normal routines)\n●Kept in the regular course of business\n●Made at or near the time of the matter recorded\n●Made by a person within the business with knowledge of the acts, events, conditions, opinions, or diagnoses appearing in it.\n\nTherefore, regardless of its format –paper, hybrid, or fully electronic, - the health record must meet the following legal and business record for requirements for the organization:\n●Maintain a medical record for each patient\n●Properly field and retained to ensure retrieval\n●The health record must be accessible\n●The health record system must ensure that medical record entries are not lost, stolen, destroyed, altered, or reproduced in an authorized manner.\n●Locations where health records are stored or maintained must ensure the integrity, security and protection of the records. \n\nIt is also essential to note that that all entries in the medical records must be timed, dated, and authenticated; and a method established to identify the author. Entries should be made as soon as possible after an event or observation is made.  The use of specific anguage should be encouraged whiule vague or generalized language avoided.  Examples of generalization and vague words include patient doing well, appears to be, confused, anxious, status quo, stable, as usual.\n\n![doctor-1228627_960_720 (1)-1.jpg](https://cdn.steemitimages.com/DQmd2eF2fSK2tivyaBBDdjm83MDRwDsUb51icHLmyAvQMfc/doctor-1228627_960_720%20(1)-1.jpg)\n\n<center><sub> [License: Public Domain]: <a href=\"https://pixabay.com/en/doctor-tomograph-i-am-a-student-1228627/\"> Pixabay </a></sub> </center> \n</div>\nHealthcare organizations should set a standard for acceptable abbreviation to be  used in the health record and develop an organization specific abbreviation list. Organizations shold define the level of record documentation expected of their practitioners based on the practitioners’ licensure, certification, and professional experience.\nMaintain a legally sound health record covers a huge territory from the content of the heatlh record and how entries are recorded to the functionality in the system to access, and security.  While the electronic age brings new variables to an old and complex problem, the foundation remain the same: health, records must be maintained in a manner that follows applicable regulations, accreditation standards professional practice standards, and legal standards.\n\nIn conclusion, Health information Management professionals must play a critical role in the transition from paper to electronic records and must partner with clinical, legal and information techjnologist to adequately address the legal business issues for the heatlh record. Remember to document it because if you have not document it, you did not do it!!!.  </div>\n\nI am grateful for taking your time to read through this letter and I hope to see significant improvement during the next round of health records evaluations in the state. Thank you.\n\nTitus T.S\nTB Expert\nNigeria\n\n#### REFERENCES\n\n[Importance of vital records and statistics](https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/The-Importance-of-Vital-Records-and-Statistics-for-the-Obstetrician-Gynecologist)\n\n[Health data](https://en.m.wikipedia.org/wiki/Health_data)\n\n[Everything you need to know about electronic health records](http://www.diabetesforecast.org/2015/may-jun/everything-you-need-to-know.html)\n\n\nJoin #steemSTEM on discord [here](https://discord.gg/vwzWz3Z).\n![unnamed-1.png](https://cdn.steemitimages.com/DQmU7LuBtmeJhNhZQyhisRXHrhSbgqZtfnCBEUf3SHnoYF1/unnamed-1.png)\n![signature.png](https://cdn.steemitimages.com/DQmZnq2xDGwDJrmkozriE1TdKKT36We6aThGxZUVMWCETXz/signature.png)\n\n<center>\nYou can also join Air-clinic on discord[here](https://discordapp.com/invite/rqded5m)![images (13)-1.jpg](https://cdn.steemitimages.com/DQmbtZqwJiZEwV8UgL2BEtBoQMDh7xGphnXwytZcDtg2qMN/images%20(13)-1.jpg)",
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