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I've always thought of it as a prompter for the other person to tell me how they are, unless it's in an email. In an email or letter, then it's an ender, and a prompter, sort of like saying...."well I've said my piece, and I hope you're well" intending that they write or call me back to tell me what's going on with them.
I use it as the opening or closing of an email message. I don't think I've ever used it in an actual conversation. I do genuinely hope all is well when I type those words in a message.
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