7 Dynamic Solutions for Medical Claims Clerks to Navigate the Complex Pharmaceutical Landscape

Introduction

In the rapidly advancing realm of pharmaceuticals, the complexity of challenges is increasing at an unprecedented pace. The traditional strategies that once sufficed are now proving inadequate in addressing the multifaceted problems that contemporary pharmaceutical companies face. As technological advancements surge forward, issues such as regulatory compliance, personalized medicine, big data management, and the ongoing quest for novel therapeutics demand an innovative approach. Conventional methods often lack the agility and depth required to tackle these dynamic challenges, leaving organizations lagging in a competitive market.

Enter the necessity for groundbreaking, next-generation solutions that redefine problem-solving paradigms. This is where Clerk must step in, embracing agile methodologies and digital transformation technologies, such as advanced data analytics, artificial intelligence, and integrated platforms like KanBo. These tools not only enhance operational efficiency but also ensure seamless alignment with industry regulations and market needs.

For Clerk, adopting such innovative approaches promises to transform the obstacles of today into the achievements of tomorrow. The stage is set for a paradigm shift, ushering in an era of perpetual innovation and sustained growth. As the pharmaceutical landscape continues to evolve, so too must the strategies employed by trailblazers like Clerk, to not only survive but thrive in this complex and challenging environment.

The New Age of Complexity

The role of medical claims support has become more complex due to globalization, technological advancements, and shifting market dynamics, especially within the pharmaceutical industry. These factors contribute to an intricate web of operations that require a nuanced understanding and adaptable skill set for clerks, like those involved in medical claims.

Complexity Factors:

1. Globalization:

- Expansive Networks: Pharmaceutical companies often operate on a global scale, managing a mix of international regulations and compliance requirements. This requires clerks to understand diverse healthcare systems and collaborate with global partners.

- Supply Chain Dynamics: With medications and healthcare products moving across borders, clerks need to manage logistics that include diverse shipping, tariffs, and handling the impact of international incidents on the supply chain.

2. Technological Advancements:

- Digital Transformation: The integration of electronic health records (EHR), AI for data processing, and automated claims systems has transformed data entry and management tasks. Clerks need to be adept at using these technologies to ensure efficiency and accuracy.

- Cybersecurity Concerns: Protecting sensitive patient information against breaches demands a practical knowledge of data privacy laws and security protocols.

3. Shifting Market Dynamics:

- Healthcare Reforms: Changes in healthcare policies, like pricing regulations and insurance modifications, necessitate an ongoing adaptation by clerks to ensure compliance and accurate claims processing.

- Consumer Expectations: Patients now expect more transparency and quicker service from healthcare providers, pushing clerks to streamline processes and reduce turnaround times.

Why Adaptation is Critical for Clerks:

1. Efficiency in Operations: The ability to quickly adapt to new methods and technologies ensures that clerks can maintain effective and efficient operations, minimizing errors and delays in claims processing.

2. Problem Solving: Clerks encountering non-routine issues need to leverage their skills and knowledge to make informed decisions independently and collaboratively with supervisors for more complex problems.

3. Team Dynamics: Working cohesively within a team is essential, as clerks must interface with multiple departments to ensure claims are handled correctly from start to finish.

4. Achieving Deadlines: Ability to prioritize tasks and manage time effectively is crucial to meet strict deadlines, which are often dictated by insurance company policies and patient needs.

5. Continuous Learning: The healthcare landscape is ever-changing, and clerks must engage in ongoing education to stay current with industry trends, technological tools, and regulatory requirements.

In conclusion, the modern-day role of a medical claims support clerk involves navigating a complex environment influenced by globalization, technology, and market shifts. Their ability to adapt and embrace changes is pivotal in managing the intricacies of pharmaceutical and healthcare operations successfully.

Beyond Conventional Solutions

Traditional problem-solving frameworks often fall short when confronted with the intricacies of today’s complex challenges, particularly in fields like pharmaceuticals. These frameworks typically rely on linear processes and predictive models that fail to accommodate the dynamic, interconnected nature of contemporary issues.

In the pharmaceutical industry, the drug development process is a prime example of where conventional methods struggle. Traditional approaches often emphasize a sequential path from discovery through development to approval. This linear trajectory doesn’t account for the non-linear and iterative nature of modern innovation processes. For instance, the rapid advancement of biotechnologies, such as CRISPR and mRNA vaccines, has introduced complexities that require adaptive and iterative problem-solving strategies. Failing to adapt to these realities can slow down innovation, delaying potentially lifesaving therapies.

Moreover, traditional frameworks often lack the flexibility to manage and interpret vast amounts of data generated in pharmaceuticals today. With the rise of big data analytics, personalized medicine, and AI, the volume and complexity of data that needs processing have skyrocketed. Conventional data management approaches may lead to inefficiencies and missed opportunities in drug development and patient care optimization.

For someone in the role of a Senior Data Entry Clerk within a pharmaceutical company, clinging to outdated methods can result in several risks:

1. Data Integrity Issues: Traditional data entry processes may not be robust enough to handle complex datasets, increasing the risk of errors. These errors can have downstream effects, compromising research accuracy and regulatory compliance.

2. Inefficiency and Bottlenecks: Relying on outdated systems without automation capabilities can significantly slow down data processing times. As the demand for rapid data analysis grows, inefficiencies can lead to bottlenecks, stalling critical projects.

3. Inability to Scale: The pharmaceutical industry’s data needs are expanding. Sticking to obsolete methodologies makes it challenging to scale operations efficiently, impacting the organization’s competitiveness and innovation capacity.

4. Non-compliance Risks: Regulations in pharmaceuticals are constantly evolving. Traditional methods may not be capable of adapting quickly enough to new compliance requirements, exposing the organization to legal and financial repercussions.

To address these challenges and mitigate the risks, it’s crucial for pharmaceutical companies to adopt more agile and integrated approaches. Embracing digital transformation strategies, leveraging AI and machine learning, and fostering a culture of continuous improvement are essential to navigate today’s complex landscape effectively. For senior data entry clerks, staying updated with the latest technologies and methodologies can ensure that they contribute effectively to their organizations’ strategic goals, maintain data accuracy, and enhance operational efficiency.

The Power of Context in Workflows

Understanding tasks and processes in the context of a larger objective is a central principle of KanBo's philosophy. This perspective allows individuals and teams to see the purpose and impact of their work within a broader framework, ultimately enhancing task execution and problem-solving. Let's explore how this philosophy aligns with KanBo's distinctive features and its benefits for Clerk:

1. Improving Work Coordination and Efficiency: By organizing tasks and processes around clear goals and objectives, KanBo enhances a team's ability to coordinate work efficiently. The platform enables teams to set goals, assign responsibilities, track progress, and analyze outcomes, ensuring that every task aligns with the overall business strategy.

2. Facilitating Collaboration and Communication: KanBo serves as a centralized hub for all project-related information, documents, and communications. This integrated approach breaks down silos, ensuring that everyone is aligned with the broader organizational goals. The Workspace and Space features allow Clerk to navigate easily, keeping all team members informed and connected, facilitating seamless communication and collaboration.

3. Enhancing Problem-Solving with Contextual Insights: The ability to view tasks in the context of their relationships and dependencies—through features like Card Relations and Space Cards—enables Clerk to tackle complex problems with a clearer understanding of the entire process. KanBo's reporting and analytics tools provide insights into team performance and project trends, empowering Clerk to make informed decisions and address issues proactively.

4. Providing Real-Time Information and Data Analytics: With features like the Activity Stream and Card Issues, KanBo offers a real-time overview of ongoing activities and potential challenges. This continuous flow of information allows Clerk to respond swiftly to changing circumstances and emerging problems, ensuring that tasks are completed in alignment with overarching goals.

5. Supporting Agile Project Management: KanBo's agile project management capabilities help Clerk focus on priorities, adapt to changes, and maintain alignment with strategic goals. By enabling teams to break down tasks into smaller, manageable units and visualize workflows, KanBo ensures that every effort is directed towards fulfilling larger objectives.

6. Balancing Resources Effectively: By understanding the broader context, Clerk can allocate resources more efficiently, avoiding waste or imbalance. KanBo's framework helps teams identify priority areas, ensuring that efforts and resources are directed towards achieving long-term success.

In essence, KanBo empowers Clerk to see the bigger picture and integrate tasks, processes, and collaborations within a meaningful context. This holistic approach not only enhances individual task execution but also fuels strategic problem-solving and efficient resource management, driving the organization towards achieving its larger goals.

KanBo—The Digital Infrastructure for Complexity

KanBo serves as a comprehensive work coordination platform that fundamentally ties individual tasks to the broader organizational objectives, creating a clear alignment that fuels clarity and efficiency. For Clerks in the Pharmaceutical industry, this alignment capability is particularly transformative, revolutionizing traditional operational workflows into streamlined, goal-oriented processes.

Connecting Tasks to Overarching Objectives

Clarity through Hierarchical Structure

KanBo's hierarchical model—from Workspaces down to Cards—ensures that every task is not isolated but exists within a structured framework connected to the organization's strategic goals. For example, a Clerk managing drug inventory in a pharmaceutical company can create a Workspace dedicated to inventory management, organize Spaces for specific drugs or categories, and use Cards to track tasks such as reorder reminders or expiry checks. Each task is linked back to the overarching goal of efficient inventory management, which aligns with larger objectives such as reducing waste or ensuring timely drug availability.

Transparent Goal Alignment

By visualizing the workflow with clear structures, Clerks can see how their day-to-day activities contribute to the company's mission of enhancing public health. This transparency helps prioritize urgent tasks and delegate responsibilities effectively, ensuring that critical goals—like maintaining compliance with regulatory standards—are consistently met.

Revolutionizing Operations with Advanced Features

Agile Project Management

KanBo's agile project management tools are invaluable for the Pharma industry, where adaptability and rapid response times are crucial. Clerks can utilize features such as customizable Card status updates (e.g., To Do, In Progress, Completed) and real-time collaboration tools to manage batch tracking, quality checks, and regulatory documentation processes efficiently. This agile framework supports the swift adaptation to changes such as new drug regulations or production schedule adjustments.

Enhanced Collaboration and Communication

The platform facilitates seamless communication and collaboration, breaking down silos that often impede efficiency in large organizations. Whether conducting cross-departmental reviews needed for compliance checks or collaborating with external partners on research projects, KanBo anchors all conversations and documents in one accessible location. Clerks can make informed decisions faster with real-time data and updates, significantly reducing workflow bottlenecks.

Data-Driven Decisions and Resource Management

KanBo’s real-time analytics and reporting tools provide Clerks with critical insights into task progress and team performance. In a pharmaceutical setting, this capability allows Clerks to manage resources such as raw materials or workforce efficiently, ensuring optimal allocation and minimizing waste. The platform's ability to integrate with existing IT systems like Microsoft SharePoint and Teams enhances data flow across the organization, supporting informed decision-making at every level.

Compliance and Security

Secure and Compliant Environment

In an industry heavily regulated for data protection, KanBo’s hybrid environment offers the necessary flexibility to comply with stringent legal requirements. Clerks can manage sensitive data on-premises while utilizing cloud capabilities for other functions, ensuring that all operations remain secure and compliant with industry standards.

Conclusion

KanBo transforms the pharmaceutical industry's operational backbone by linking every task to broader objectives, providing clarity and enhancing productivity across the board. For Clerks, this means not just managing tasks but strategically contributing to the organization’s success, revolutionizing how pharmaceutical operations are conducted. By leveraging KanBo, the pharmaceutical industry can achieve a proactive, transparent, and goal-driven work culture that consistently meets its critical objectives.

Integrating AI, ML, and Robotics with KanBo

Integrating KanBo with cutting-edge technologies like Artificial Intelligence (AI), Machine Learning (ML), and Robotics presents a transformative opportunity for automating routine tasks, predicting outcomes, and providing insightful data-driven decisions. This synergy could revolutionize how organizations, like Clerk, manage workflows, enhance productivity, and achieve strategic goals.

Automating Routine Tasks

1. AI-Powered Task Automation: Integrating AI with KanBo can automate repetitive administrative tasks such as scheduling meetings, updating statuses, and sending reminders. AI-powered bots can analyze the activity stream within KanBo to automate documentation and reporting tasks, reducing the manual workload and allowing clerks to focus on more value-added activities.

2. Robotic Process Automation (RPA): RPA can work alongside KanBo to perform tasks such as data entry and processing within cards and spaces. This automation ensures accuracy and efficiency by handling rote operations and syncing data between KanBo and other enterprise systems, ensuring that clerical work is streamlined and error-free.

Predicting Outcomes

1. Machine Learning for Predictive Analysis: By integrating ML algorithms, KanBo can predict project outcomes based on historical data. For example, ML models can analyze patterns within card blockers and issues to predict potential project delays or bottlenecks. This advanced insight allows clerks to take proactive measures to mitigate risks and ensure project timelines are met.

2. Predictive Maintenance: In environments where robotics is involved, predictive maintenance algorithms can be integrated with KanBo to flag potential equipment failures before they occur. This integration can automate the scheduling of maintenance tasks within the KanBo platform, aligning maintenance activities seamlessly with operational workflows.

Providing Data-Driven Insights

1. AI-Driven Analytics: The synergy between AI and KanBo can provide deep analytical insights through data visualization and reporting. AI algorithms can dynamically analyze data across workspaces and spaces, providing real-time insights into performance metrics, task efficiencies, and resource utilizations. Clerks can leverage these insights to make informed strategic decisions and optimize workflows.

2. Natural Language Processing (NLP): Integrating NLP can enhance the communication and collaboration features within KanBo. NLP can be used to automatically categorize and prioritize tasks based on their content and urgency. It can also summarize lengthy discussions from comments and activity streams, providing clerks with quick overviews and facilitating faster decision-making.

Futuristic yet Practical Applications

1. Virtual Work Assistance: Imagine a virtual assistant integrated with KanBo that interacts with clerks using natural language, answering questions, finding information, and suggesting actions based on context. Such a tool could significantly enhance user engagement and productivity by simplifying the interface and streamlining interactions.

2. Strategic Goal Alignment: ML models could suggest tasks or allocate resources automatically to align with overarching strategic goals. For instance, when a new strategic initiative is entered into KanBo, the system could recommend team compositions and milestones based on historical data, ensuring that every operational aspect supports the broader organizational objectives.

3. Enhanced Decision Support Systems: Integrating AI can transform decision-making processes by providing scenario analysis and what-if simulations within KanBo. This integration allows clerks to explore different strategic paths and make decisions supported by comprehensive data models, thus reducing uncertainty and optimizing outcomes.

By integrating AI, ML, and robotics into KanBo's robust platform, we unlock a future where routine tasks are automated, outcomes are predictive, and decisions are data-driven. This transformative synergy not only enhances workflow efficiency but also enhances the strategic prowess of organizations, ensuring that clerical tasks are effectively aligned with overarching business goals. This vision provides Clerk with a powerful toolset to navigate tomorrow's challenges with agility and precision.

Non-Obvious Insights and Hidden Opportunities

Adopting KanBo can unlock a host of less immediately obvious benefits that extend beyond improved work coordination and agile project management. These include transformative impacts on company culture, employee empowerment, and enhanced innovation capacity.

Cultural Transformation

1. Transparency and Accountability: KanBo’s transparent task management and workflow visibility promote a culture of openness. By linking individual tasks to broader strategic goals, employees gain a clear understanding of their contributions, fostering accountability and alignment with company objectives.

2. Breaking Down Silos: Through its collaborative spaces, KanBo encourages cross-departmental communication, deterring the formation of organizational silos. This interconnectivity allows for a more cohesive and engaged workplace culture, improving morale and breaking barriers that typically hinder cooperation.

3. Agility and Adaptability: By adopting agile methodologies inherent in KanBo, organizations cultivate a culture of adaptability. Teams become equipped to react swiftly to changes, shifting focus and resources efficiently to meet emerging needs or challenges. This nurtures a mindset of continuous improvement and flexibility.

Employee Empowerment

1. Ownership and Initiative: KanBo’s structure empowers employees to take ownership of their work. With transparent tracking and customizable workflows, individuals understand their roles and responsibilities, encouraging initiative and proactive behaviour.

2. Access to Information: Equipping employees with a unified platform for accessing all relevant documents and tasks promotes informed decision-making. With real-time data at their fingertips, employees are better positioned to make strategic choices without unnecessary delays.

3. Skill Development: The platform’s flexibility allows employees to explore different roles and responsibilities. By engaging in diverse tasks, they expand their skill sets, fostering professional growth and increasing job satisfaction.

Enhanced Innovation Capacity

1. Idea Incubation: With collaborative spaces and seamless integration for sharing information, KanBo acts as a catalyst for brainstorming and innovation. Employees are encouraged to develop and propose ideas, knowing they have a platform to voice their insights and see them materialize into concrete actions.

2. Shared Knowledge Base: Continuous documentation and sharing of knowledge within KanBo's architecture promote a rich, accessible repository of information. This shared knowledge base supports ongoing innovation, as teams can easily leverage past learnings to refine or pivot new projects.

3. Data-Driven Innovation: KanBo’s analytics and reporting features enable teams to base innovations on data insights rather than assumptions. By understanding trends and performance metrics, organizations can focus their creative efforts on areas with the highest potential impact, enhancing the effectiveness of new initiatives.

In conclusion, beyond its apparent functionalities, KanBo serves as a powerful tool in transforming company culture, empowering employees, and enhancing innovation capacity. By integrating KanBo, organizations can foster a dynamic and responsive environment that values transparency, promotes employee growth, and encourages a continuous stream of innovative ideas.

Implementing KanBo and solving complex problems: A step-by-step guide

KanBo Solution Manual: A Cookbook for Efficient Task and Problem Management

Welcome to the KanBo Cookbook, a scrumptious journey into optimizing work processes through KanBo's powerful platform. Just like following a recipe, you will leverage KanBo's features to address business challenges effectively. Let's dive into each task as you would a gourmet meal, step by step, ensuring no ingredient is left out.

Understanding KanBo Features and Principles

Before uncorking the solution to your business challenge, it's crucial to familiarize yourself with the tools and features that KanBo offers. These include Workspaces, Spaces, Cards, Activity Streams, Card Blockers, Card Issues, Card Relations, Space Cards, MySpace, Card Users, and the Document Source feature. Absorbing the essence of these features will empower you to creatively address various business problems.

Cookbook Presentation and Format

For each task:

1. Ingredient List: Start with a list of KanBo features that you will need to address the problem.

2. Preparation Overview: Briefly describe the general principles of working with KanBo relevant to the task.

3. The Business Recipe: Detail the specific business problem that needs solving.

4. Cooking Instructions: Develop a comprehensive step-by-step solution using KanBo features.

Each step will be clearly numbered and divided into sections if needed, akin to a course of meals. Now, let's get cooking!

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Improving Work Coordination and Efficiency

Ingredient List

- Workspaces

- Spaces

- Cards

- Activity Stream

- MySpace

Preparation Overview

Understand how organizing tasks around clear goals can enhance efficiency through KanBo's structured workflow.

The Business Recipe

Your team struggles with aligning individual tasks to the overall business strategy.

Cooking Instructions

1. Set Up Your Workspace

- Create a new Workspace that reflects overall business goals. This serves as your main dish.

2. Organize into Spaces

- Segment the Workspace into Spaces based on departments or specific strategies.

3. Create Cards for Tasks

- Within each Space, create Cards representing specific tasks, linking them to clear objectives.

4. Assign Users and Roles

- Use the Card User feature to designate responsible parties and team members for each task.

5. Monitor Progress via Activity Stream

- Utilize the Activity Stream for a real-time overview of task completion and obstacles.

6. Personal Task Management with MySpace

- Encourage team members to manage their workload using MySpace for tracking personal progress across different Spaces.

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Facilitating Collaboration and Communication

Ingredient List

- Spaces

- Card Users

- Document Source

Preparation Overview

Facilitating communication through centralized information storage and collaboration tools ensures everyone is on the same page.

The Business Recipe

Team members are struggling with fragmented communication and document access.

Cooking Instructions

1. Organize into Collaborative Spaces

- Create shared Spaces that house essential projects and team discussions.

2. Assign Key Roles with Card Users

- Assign users to cards to promote accountability and collaboration on tasks.

3. Centralize Documents through Document Source

- Link project-related documents from sources like SharePoint to corresponding Cards to ensure easy access and version control.

4. Encourage Use of Comments and Mentions

- Use comments and mentions in Cards to foster discussion and feedback among team members.

5. Facilitate Group Meetings and Feedback Sessions

- Schedule regular team meetings to discuss progress and strategies within the Spaces.

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Enhancing Problem-Solving with Contextual Insights

Ingredient List

- Card Relations

- Card Blockers

- Analytics Tools

Preparation Overview

Understanding task dependencies and potential problems upfront allows for more effective problem-solving.

The Business Recipe

Team members often face complex problems stemming from interconnected tasks.

Cooking Instructions

1. Establish Card Relations

- Define parent-child relationships between tasks to visualize dependencies clearly.

2. Identify and Manage Card Blockers

- Use card blockers to highlight tasks impediments, ensuring focus remains on resolving these issues.

3. Capture Insights with Analytics Tools

- Utilize KanBo's analytics functionalities to gather and review data on task performance and trends.

4. Continuous Feedback Loop

- Regularly review task progress and blockers to adapt and refine approaches.

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Providing Real-Time Information and Data Analytics

Ingredient List

- Activity Stream

- Card Issues

- Analytics Dashboard

Preparation Overview

Real-time information ensures that team efforts remain aligned to the changing conditions and objectives.

The Business Recipe

Lack of real-time insights hampers decision-making processes.

Cooking Instructions

1. Utilize the Activity Stream

- Harness the Activity Stream to keep track of all updates and changes as they happen.

2. Monitor Card Issues Consistently

- Identify and color-code issues to make them easily visible and manageable.

3. Leverage Analytics Dashboard for Insights

- Maintain transparency by using analytics to present data-driven insights for informed decision-making.

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By following this Cookbook style guide to utilizing KanBo's features, you can address and solve intricate business problems, driving strategic success within your organization. Bon appétit!

Glossary and terms

Introduction

Welcome to the KanBo Glossary, your guide to understanding the key terms and concepts used within the KanBo platform. KanBo is a comprehensive work coordination tool that integrates with Microsoft technologies, allowing organizations to align their strategic goals with everyday operations. Whether you're a seasoned user or just getting started, this glossary is designed to enhance your knowledge and efficiency in using KanBo by clarifying its fundamental components and features.

Key Terms

- Workspace

- Definition: A Workspace is a collective environment for spaces that correspond to specific projects, teams, or topics. It serves as the main organizational structure in KanBo, allowing for easier navigation and collaboration.

- Control over user access and visibility helps maintain privacy and team involvement.

- Space

- Definition: Spaces are the areas within Workspaces consisting of cards that manage and track tasks. They visually depict workflows and are generally focused on projects or specific tasks.

- Spaces facilitate collaboration and efficient task oversight in a digital format.

- Card

- Definition: Cards are the foundational units in KanBo, symbolizing tasks or items that require tracking and management.

- They contain crucial elements like notes, files, comments, and checklists, adaptable to various needs.

- Activity Stream

- Definition: A real-time chronological feed of activities within KanBo, showing what happened, when, and who was involved.

- Each line links to respective cards and spaces, providing updates specific to individual cards, spaces, and users.

- Card Blocker

- Definition: A card blocker signifies an issue that impedes task progression. There are three blocker types: local, global, and on-demand.

- Enables users to specify and categorize reasons for work delays.

- Card Issue

- Definition: Card issues are specific problems hindering effective card management, with visual indicators like colors to denote issue type.

- Time-related conflicts and card blockings are marked differently for clarity.

- Card Relation

- Definition: Represents dependencies between cards, aiding in task breakdown and workflow organization.

- Includes parent-child and next-previous relationships to delineate task order.

- Space Cards

- Definition: Entire spaces can be depicted as cards, offering a summary for management akin to a regular card.

- Enhances visualization and management of a space as a whole.

- MySpace

- Definition: A personal area for users to gather mirror cards from various spaces, allowing management without affecting original spaces.

- Card User

- Definition: Individuals assigned to a card, including a Person Responsible and possible Co-Workers.

- Card users receive notifications about the card's activities.

- Document Source

- Definition: A feature linking documents from sources like SharePoint to cards, centralizing project files, ensuring collaboration, and maintaining version control.

This glossary serves as a handy resource to help you navigate through KanBo's features and functionalities, enhancing your workflow and project management capabilities.