An overview of Electronic Medical Records as a Service

Transcription

1 Service Definition The name of the Service is: Electronic Medical Records as a Service An overview of Electronic Medical Records as a Service The Electronic Medical Records as a Service is developed by Cloud Intelligence Services Ltd and delivered as a managed service by our UK services partner Amtex Solutions Ltd. Integration is provided with EMR applications, HL7 engines and databases including Oracle, DB2 and SQL Server. Cloud Intelligence Services Ltd and Amtex Solutions Ltd are working in partnership with DrCloud Healhcare Solutions Inc. to deploy the EMR solution in a secure private UK cloud compliant with CESG security guidelines. Initial deployment is on IL2 but target accreditation level is IL3. All data and transient messages are processed and stored in an IL2 complaint Tier-3 UK sovereign data centre (with plans for IL3 in early 2014). Data is secure (encrypted) and automatically backed up. Data is managed in a private secure cloud with dedicated virtual machine (VM) per organisation. DrCloudEMR is a secure, web-based, ONC-ATCB certified, HIPAA-compliant, EMR with an always on architecture. It takes on the infrastructure responsibility so you can do what you do best take care of patients. DrCloudEMR is available anywhere, anytime. The foundation of DrCloudEMR is the open source OpenEMR application which one of the most popular open source electronic medical records in use today. OpenEMR is supported by a strong community of volunteers and professionals all with the common goal of making OpenEMR a superior alternative to its proprietary counterparts. OpenEMR is released under the GNU General Public License which transfers all ownership of the application rights to the user organisation. The application is being customised for the needs of the NHS Trusts in accordance with the NHS strategy outlined in 'Safer Hospitals, Safer Wards' paper. DrCloud EMR is a fully featured ONC certified EMR with foundation of the OpenEMR platform implemented in United States federal government.

2 Features include: ONC Complete Ambulatory EHR Certified in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services Integrated Practice Management System - Patient Demographics, Patient Scheduling, Electronic Medical Records, Prescriptions, Medical Billing, Clinical Decision Rules, Patient Portal, Reports, Security, Multilanguage Support Centralized Schedule and Calendar Management Group Session Management and Progress Notes Integrated Assessments, Problem Lists, Treatment Plans and Service Notes Multiple Facility Support, CPMS Support Residential, A&D and Mental Health Support Sessions and Services Tracking, Custom Coding Support E-Prescribe Integrated State-approved OSCRI Forms Integrated Electronic Billing Support Integrated Patient Ledger, Document Management Secure, HIPAA Compliant, Role-Based Access Security Multilingual User Interface XoomCharts advanced powerful charts and patient notes Business Intelligence and Analytics platform Enterprise Service Bus including HL7 integration engine and EMR integrations Some of the additional services offered include: Workflow Customization Services - We offer Workflow Customization Services because every individual practice has certain unique needs to help carry out day-to-day activities in an effective and efficient manner. DrCloudEMR is built on a modular architecture. Each customer site is deployed in its own dedicated instance of our best-of-breed EMR cloud solution. As the needs of your practice increase, the system will grow organically to ensure that your users get the same level of services they come to expect. Paper Document Conversion Services - Convert your existing paper documents and import them into DrCloudEMR for easy access and reference. We can optionally enable searching capabilities with metadata for the documents that are imported into the system. Our Paper Document Conversion Services are affordable and are designed for a smooth transition. Extended Technical Support and Phone Support is included with your valid annual subscription. Extended support options are available to ensure that your practice needs are met. Our in-house application upport team will guide you through the implementation process and will provide continued help with your EMR whenever you need it.

3 3rd Party Integration - Interfaces to internal and external systems such as Pharmacy, Lab billing clearinghouses, Radiology, and many more. HL7 and EMR interfaces such as EPIC and VistA Meta Data Services - Extract the data in scanned document images into a database. Report Generation - Assistance with the generation of reports, dashboards and KPIs required Partner Dr Healthcare Solutions Inc is a certified OpenEMR professional support provider DrCloud Healthcare Solutions provides Open source and commercial Electronic Medical Records Solutions to Healthcare Providers: Hospitals, University Practices, Large Physician Groups, Medical Billing Companies, Labs, Medical Imaging Services, and Individual & Group Practices. With qualified professionals positioned in two continents DrCloud Healthcare Solutions is one of the major sponsors and contributors to the OpenEMR code. OpenEMR Services: EnSoftek provides the following OpenEMR services: Consulting, Custom programming, Implementation, Hosting, Private Labeling, Training and Support. Specialists in OpenEMR customizations. Hosted OpenEMR: DrCloud Healthcare Solutions has developed a true-cloud based version of OpenEMR, hosted on Microsoft Azure; EMR-as-a-Service EMRaaS. DrCloud Healthcare Solutions has also developed its own performance enhanced OpenEMR with a brand new user-interface as DrCloudEMR. It is an end-to-end EMR service and solution deployed on Cloud Platforms, current running on Microsoft Azure Platform. It is the only EMR running on Azure. It has received the complete EHR certification so all providers are eligible for Meaningful Use and Stimulus Funds.

4 DrCloudEMR offer you an end-to-end medical record solution to enable your clinic to provide high quality patient care and also qualify you to receive Meaningful Use reimbursement from the Centers for Medicare and Medicaid Services. We offer Nuance Speech Anywhere Dragon Dictation support, integrated faxing using InterFax.net, custom ipad version of DrCloudEMR leveraging the devices advanced capabilities. DrCloud Healthcare Solutions is one of the major contributors to the OpenEMR project both financially and in donated software development. As part of their efforts DrCloud Healthcare Solutions has certified the DrCloudEMR solution through DrFirst and contracted with OEMR to contribute a percentage per prescriber per month back to the project to further additional OpenEMR development.

5 Deployment Models How can the service be deployed? By partnering with Memset Ltd we offer the EMR service on a secure private cloud IL2 accredited for G- Cloud (IL3 scheduled for early 2014). On the secure private cloud deployment each client (organisation) will have a dedicated VM (container) and a dedicated database. The service can be multi-tenant within an organization but with a dedicated container per organization. Networks to which the service is connected (directly)? The EMR service is accessible from a browser with an internet SSL connection. Other networks (PSN, JANET, GSI) can be enabled by working with our partner Memset Ltd. API access available documented and supported? SOAP and REST APIs are available. Open standards documented and supported? Data interchange is supported through XML and JSON formats. Services can be published as REST and SOAP services supporting a number of WS-* standards. Mashups are also supported with other content and portal frameworks. Open source used and documented? Function/Purpose Operating System Application Server EMR ESB Java Libraries Data Services HL7 Business Intelligence Open Source Components Ubuntu Apache Tomcat/WSO2 Application Server OpenEMR WSO2 ExtJS, JQuery, D3.JS, PHP, Javascript WSO2 and MySQL Mirth Pentaho Service Management Technical boundaries/interfaces of the service documented? The EMR service interfaces are fully documented for both the role of administrators and end-users.

6 Services available to other suppliers so they can use them to provide services to government? The EMR service is available to any other suppliers who wish to leverage the G-Cloud framework. On-boarding process e.g moving to the service? An administrator account is created for the organization. The administrator can then create end user accounts. Additionally the on-boarding is provided as a managed service. The SLA for on-boarding is 24 hours. Off-boarding process e.g moving off the service? The administrator can remove the end user accounts and the data. Additionally the off-boarding is provided as a managed service. The SLA for off-boarding is 72 hours. Data extraction/removal criteria met? The criteria are met in accordance with the G-Cloud ITT glossary definition. Data processing and storage locations defined? For the G-Cloud the IaaS option available is Memset (located in Guilford, UK). For an IL2 compliant and UK sovereign G-Cloud solution the preferred model is to use Memset IaaS (IL3 will be available in early 2014). Data location option can be defined by user? This is not possible. The organization purchasing through G-Cloud would only have the option of the Memset cloud which is managed in a UK sovereign Tier-3 data centre. Data centre tier? Tier-3 UK data centre through our partner Memset Ltd. Support boundaries/interfaces documented? This is defined in the support guide. Service roadmap provided? The next release of the EMR service is scheduled for Q and will include:

7 DrCloud EMR roadmap OpenEMR roadmap WSO2 ESB roadmap Mirth HL7 roadmap Pentaho roadmap The service should be IL3 assurance certified PSN and N3 connectivity Tighter integration with VistA Performance attributes defined and documented? Performance uptime and response time are documented in the support guide. EMR Database and VM servers are constantly monitored. Backup & Disaster Recovery? The instance is backed up with nightly snapshots. Databases are constantly monitored. Is a support service provided and documented? The support service is documented in the support guide. Real-Time management information available? Management information is provided in a monthly report. Self service provisioning/de-provisioning? This is partially supported. The service itself is provisioned by vendor. But the end users can be added and removed by the client s administrator. Time for provisioning/de-provisioning documented? 24 hours for on-boarding and 72 hours for off-boarding. Administrators can add end-users in less than a minute. Service desk can be used by 3 rd party suppliers? The service can be used by any 3 rd party suppliers in the G-Cloud framework.

8 Commercial Unit based pricing model? The EMR service pricing is from 75 to 125 per user(staff member) per month depending on functionality deployed. Excluding VAT. Pricing model accommodates unlimited number of patients and services. The platform supports the easy customization of workflows, forms and reports. The EMR database storage is up to 5TB of data. Additional data storage can be added at 550 per month for incremental 5TB. Integration as a Service and Business Intelligence as a Service are optional modules that integrate with the EMR service. Aggregated billing? Billing options can be provided for organizations with multiple departments. Minimum Contract/Billing Period? 12 months at 7,500/month for a minimum 90,000 contract value. Excluding VAT. Free Option? A free option is not standard offering on the G-Cloud Trial Option? A trial option can be provided on public cloud (shared container,muti-tenant). The fee would be 2,500/month. Minimum term for a trial service subscription is 3 months 7,500. Excluding VAT. Termination Costs? If terminated within the 12 month term then the remainder of the annual fees will be billed. If terminated at the end of the term then there is no cost. Trial subscriptions can t be terminated. Important consideration is that at the termination (or end of 1 or 2 year call-off contract term) the customer owns the data and the application. As this solution is built with open source there will be no on-going software maintenance fees or one time license costs in event the customer wishes to bring onpremise. With typical IT systems lifespan 7-10 years this represents a major cost advantage compared to proprietary software offerings. Supplier contract terms/jurisdiction?

9 Cloud Intelligence Services Ltd and Amtex Solutions Ltd are located in the UK under jurisdiction of English law. The IaaS provider is also located in England. Payment Options? Purchase Order and BACS are supported Specialist Cloud Services - Generic Do you provide vendor specific services? EMR Services are provided for the implementation of the Integration service and connectivity. If the vendor(s) have accreditation are you accredited? UK G-Cloud IaaS partner provider Memset Ltd has a number of accreditations and certifications e.g ISO 9001, ISO 14001, ISO Amtex Systems has ISO 9001 certificate for IT enabled services, business process outsourcing, software testing, data integration and reporting. DrCloud Healthcare Solutions is accredited OpenEMR professional support provider and OpenEMR contributor. Vendor accreditation? We will submit the EMR Service for IL3 accreditation in the near future (expected first quarter 2014).

10 Service Levels Platform IaaS provider partner Memset Ltd has a 99.95% uptime guarantee for networks, servers and storage. 24x7 support is provided for the IaaS and this support is wrapped into the EMR service support levels. For the EMR service production support is provided 24x7x365. Incidents are submitted via and/or telephone. The target response and resolution times for incidents are: Severity Level Response Time Resolution Time 1 1 hour 24 hours 2 4 hours 48 hours 3 8 hours 72 hours 4 24 hours None The severity levels are defined based on impact on a production usage of the service in the table below: Production is defined as is one by end users where a failure of the service in production will have immediate economic impact on the client s business operations Severity Level Definition 1 Client s business operations have been disrupted either through a loss of data or a loss of service. 2 Client s business operations can continue in a restricted fashion. Client s business operations are at risk. 3 Some aspects of the service are impaired but client can continue to use the service. Client s business operations are at minimal risk. 4 General usage questions, requests for new features or documentation issues. Termination Options Clients may terminate the production EMR service with 30 days notice for any reason, subject to full payment of remaining SaaS fees for the 12 month subscription period. Trial service cannot be terminated. Client will be invoiced the full amount for the 3 month trial in advance.

11 Vendor can terminate the production service at the end of the initial 12 month subscription period for any reason, with 90 days notice. Government Open Standards, Information Principles for UK Public Sector and Government ICT Strategy The EMR Service is conforming to the published strategy documents and policies. Data Restoration/Service Migration Data restoration is provided by vendor for recovering from backups. Daily snapshots are taken with options to restore from the automated backups. EMR Service migration can be provided as a service through an export of the database environment or a migration of the complete VM onto another cloud instance. Customer Responsibilities The client responsibilities are set out in the support guide. More Information More information on the EMR service can be found at the cloudstore or please contact: Mr. David Watson Managing Director,Cloud Intelligence Services Ltd dave.watson@bigdatagov.org Cloud Intelligence Services Ltd, St John Street, London EC1V 4PY Telephone