Medflow Field Guide Technical Requirements Overview

Transcription

2 Medflow Field Guide 07/01/2013 You are about to embark on a journey. This guide provides a full picture of the technical requirements needed to support the Medflow application for optimal performance. The guide has been broken up into 5 sections: 3 Start your journey with Medflow SECTION I: Your Practice s Medflow Landscape SECTION II: Imaging & Diagnostic Devices 6 Tips on imaging and diagnostics SECTION III: Personnel Roles SECTION IV: Requirements & Specifications SECTION V: Glossary 8 Success depends on having the right team 11 What your clinic needs to get off to the right start

3 SECTION I: Your Practice s Medflow Landscape 5 This section is designed to help you choose the best technical environment for your office. Includes a description of types of environments, and different types of servers you may need depending on the size of your practice. Have a large practice with multiple locations? Check out page 17 with information about the Multi-site server layout. SECTION II: Imaging & Diagnostic Devices 6 This section has all the information you need about connecting diagnostic devices to the Medflow EHR system. SECTION III: Personnel Roles 8 Medflow has a knowledgeable staff to help you thorough your implementation process. This section provides an overview of the roles and responsibilities required for a successful implementation. SECTION IV: Requirements & Specifications 11 This section includes the technical specifications to run the Medflow System in your practice. SECTION V: Glossary 20 Confused by some of the technical jargon? This section includes definitions that will be helpful during the process of choosing and installing an EHR. 3

4 Your Practice s Medflow Landscape The Medflow solution is scalable to organizations of all sizes. Below is a guide to assist your organization s IT team in choosing the environment best suited for your organization. TYPES OF ENVIRONMENTS Thin Client Medflow Recommended Both desktop and laptop computers can be used Medflow installed on terminal server Application processes occur on the terminal server Terminal server will command the database server to execute certain procedures. Pros Cost effective Simple maintenance Less bandwidth required for remote sites. Cons Powerful Terminal servers required. Thick Client Only desktop computers can be used Medflow installed locally Application processes occur on the desktop Desktop commands the database server to execute certain procedures. Pros Dedicated processing power to application Cons More expensive than thin client Updates must be done on each client Maintenance can be time consuming Requires very high speed internet connection dedicated to Medflow. Client must supply dedicated onsite technical support when updates are applied. Medflow Thin Client Terminal Server (Medflow Application Installation) Medflow SQL Server (Data Storage) Medflow Thick Client Medflow SQL Server (Data Storage) If there are multiple locations within your practice, you will be required to use Medflow in Thin Client Environment. Medflow File Server (Image and Document Storage) 4 Medflow File Server (Image and Document Storage)

5 Diagnostic and Screening Devices Diagnostic (Imaging) devices must be able to communicate with the EHR system, and the way Medflow does this is through DICOM, a computer language for transferring and storing images from a device to the EHR system. TYPES OF DEVICE INTERFACES The two primary ways devices are interfaced with Medflow s EHR system are through Direct DICOM and MFCapture. Direct DICOM requires devices have true DICOM compatibility. Devices using direct DICOM will interface into the network directly. While no additional workstations will be required for the interface with Medflow, there may be additional software updates from the device manufacturer to complete the interface. There is no price difference for Medflow for being a DICOM site; however there may be an additional cost if you choose to purchase the DICOM license from your device manufacturers. WHAT IS DICOM? DICOM is an international standard for medical image communications between devices and an EHR. To learn more about the DICOM standard visit: MFCapture was developed by Medflow to enable interfaces between Medflow and diagnostic devices that do not have true DICOM capability. A workstation will be required to use the MFCapture software for each device interfaced with Medflow. Medflow EHR and MFCapture can be installed and run on the same workstation. PRIMARY INTERFACE METHOD FOR SCREENING DEVICES Screens devices do not transfer images, they simply send data to the EHR through Interfaces. Interfaces is the proprietary name of a Medflow developed program to enable direct input from a screen device directly into the Medflow exam. A workstation will be required to use the Interfaces software for each device interfaced with Medflow. Medflow EHR and Interfaces can be installed and run on the same workstation. 5

6 Supported Devices Medflow supports a wide array of diagnostic devices through one of the methods described on the previous page. The list below includes some of the devices that can be interfaced with Medflow. If you do not see one of your devices listed here, please talk to your Medflow sales representative to determine if the device can be interfaced with Medflow. DIAGNOSTIC 3-DX-F Stereo Fundus Camera Atlas Topography B&L Wavefront 240PTX Epic Refractive Station ERG Espion Eyesys Topography FDT Visual Field Screener GDX Imaging HFA Visual Field II I-Series HRT II/ HRA/ Spectralis Imaging IOLMaster Ascan Lenstar Nidek Fundus Camera OCT/OPD Imaging Octopus Perimeter OIS Winstation (MFCapture only) Optos Imaging System Orbscan Topography Pentacam PHP Quantel or Accutome Retcam II Specular Microscope Talia RTA Topcon ImageNet Visucam Visx Wavescan SCREENING Auto-lensmeter Autorefractor Computer Phoroptor Epic Refractive Station Marco NCT Lensometer Retinometer 6

7 Project Roles A successful implementation depends on having the right team. Below is a list of the primary players on your EHR team. MEDFLOW Project Manager The initial point of contact between the client s Executive Sponsor and Medflow. The Project Manager is responsible for ensuring the project stays on track with the agreed upon project timeline and all project tasks are fulfilled by their defined dates. Project Coordinator The day to day operational contact between Medflow and the Client. Project Coordinators monitor all tasks to completion and ensure that the project progress is thoroughly documented. Implementation Specialist Works with qualified Client IT support resources on the installation, interfacing, and testing of the software. elearning Coordinator This person ensures client s staff is setup in the Medflow elearning system and communicates status of client s elearning progress on a regular basis. Trainer Trainers are responsible for training your clinicians and staff as designated in the project plan. All Medflow Trainers are experts in the software and have clinic experience. All are JCAHPO certified as COA, COT, or COMT. Customer Support Team Once a client has gone live with Medflow, clients are transferred from their Project Team to Medflow s Customer Support Team for application inquires and resolution for software issues. CLIENT Executive Sponsor The decision maker in the practice that is responsible for the overall success of the project. This person will sign project documents such as the statement of work and project timeline indicating their agreement and responsibility in their organizations fulfilling the tasks by their defined dates. Project Owner The primary client contact that works collaboratively with the Medflow Project Team from project initiation to activation. This person is empowered by the project s Executive Sponsor to make decisions committing the client s staff to completion of project deadlines. IT Support Client s IT Support team is responsible for understanding all technical requirements provided within this Medflow Field Guide. Client must have IT resources available to assist the Medflow team with the technical aspects of the project. Super Users Super Users are members are staff members designated to learning the application thoroughly and become responsible for training the remainder of the client staff. As experts on the Medflow application they are responsible for setting up options, adding users and training the end users in the practice. End Users All staff members and doctors in the practice that will use the Medflow software. 7

8 Customer Responsibilities As you implement and maintain the Medflow solution in your clinic the Medflow team is here to support you. Below are areas of customer responsibility that are critical to your on-going success. PROJECT RESPONSIBILITIES Client project responsibilities will be reviewed with the client s Executive Sponsor by your project management team during the initial project planning calls. The responsibilities will be documented in the Medflow Statement of Work. Clients will work collaborate with the Medflow project team to define a project timeline that will be signed by the client s Executive Sponsor prior to Medflow resources being assigned. MAINTENANCE RESPONSIBILITIES While Medflow supports its applications on client s workstations and servers, Medflow does not support the maintenance of the operating system or hardware components in those devices. All recommended maintenance activities will be reviewed with client s IT support team during the project implementation. BACKUP RESPONSIBILITIES A successful backup of Medflow Databases, images, and related software is necessary to ensure protection in case of a failure of any hardware. Unless client has chosen to contract with Medflow for backup services it is not Medflow s responsibility to configure software, hardware solution, or to ensure that it is working properly. elearning RESPONSIBILITIES All Super Users are required to complete their elearning courses a week prior to onsite Super User training. All End Users are required to complete their elearning courses at least a week prior to All Staff training (provided by Super Users before activation.) 8

9 Requirements and Specifications This section identifies technical requirements for running the Medflow system. SECTION I: Server Requirements GENERAL SERVER DATABASE SERVERS STORAGE SERVERS TERMINAL SERVICES SERVER(S) OR CITRIX SERVER MULTI-SITE SERVER MAP SECTION II: Room Requirements SECTION III: Workstation Requirements SECTION IV: Peripheral Devices SECTION V: Optical Shop Requirements 9

10 General Server Requirements Medflow will accommodate your environment needs based on the size of your practice and number of locations. The following types of servers will be used to architect a solution that works best for your practice. Database server Storage Server Terminal Service(s) or Citrix Server Below is a general guide for server requirements for Medflow servers: Operating System: Microsoft Windows Server 2008 R2 (64-bit) (Microsoft Windows Server 2012 not supported at this time) Processors: 2x Quad Core 2.33 GHz or faster. Memory: Minimum 8 GB or higher Hard Drives: Drive 1: 150 GB RAID 1 (OS/SQL Log) Drive 2: 320 GB RAID 5 (Medflow APP/SQL DB) 10

11 Database Server Requirements While Medflow requires at least one dedicated server, your organization s size and configuration will determine the total number of servers needed. Below are specifications related to the servers Medflow utilizes. SQL SERVER Each practice will need a database server running a licensed copy of Microsoft SQL Server. The SQL server stores all data related to Medflow. This includes patient demographics, scheduled appointments, exam data, image information, etc. The Medflow databases installed on the SQL server are fully supported by Medflow. SQL SERVER SPECIFICATIONS FOR CLINICS WITH 1-20 USERS. For clients over 20 Users, contact your sales representative for Specifications Operating System: Microsoft Windows Server 2008 R2 (64-bit) (Microsoft Windows Server 2012 not supported at this time) Processors: 2x Quad Core 2.33 GHz or faster. DVD ROM: 16X Network Card: 1.0 Gbps Suggested Backup: External Hard drive or SCSI Tape Drive Remote Access: Terminal Services- Admin account provided to Medflow Monitor: 1024 x 768 Required Software: Microsoft SQL Server 2008 R2 Standard (64-bit) (Microsoft SQL Server 2012 not supported at this time) Microsoft.NET Framework 3.5 SP1 & 4.0 Extended Microsoft Visual C Runtime (X86) Memory: Minimum 8 GB or higher Hard Drives: Drive 1: 150 GB RAID 1 (OS/SQL Log) Drive 2: 320 GB RAID 5 (Medflow APP/SQL DB) 11

12 Storage Server If your practice has over three providers and three devices, Medflow recommends using a separate storage server. The storage server will house all exam documents and images. Larger groups will run SQL server on their storage server as well. This ensures that you will not experience any system slowness or application degradation due to space limitations. The specifications for the storage server are below. Drive space is not specified below because it is based on the number and types of devices at your practice multiplied by the number of exams performed on those devices per day. If it is determined that a storage server is needed, reach out to your Medflow sales representative. STORAGE SERVER SPECIFICATIONS Operating System: Microsoft Windows Server 2008 R2 (64-bit) (Microsoft Windows Server 2012 not supported at this time) Processors: Quad Core 2.33 GHz or faster Memory: Minimum 8 GB Hard Drives: Drive 1: RAID 1 (OS), Drive 2: RAID 5 (Medflow Storage) DVD-ROM: 16X COMBINATION SERVERS For practices less than three providers and three devices, server roles may be combined, meaning that the SQL, Storage and Terminal servers can all reside on a single server. If this configuration is desired, the SQL Server minimum specifications are the standard. Before this option is selected, a discussion with your Medflow sales representative will be necessary to ensure that your practice can employ this configuration. An upgrade will be required if the practice gains users in the future. All upgrade time will be billable. Network Card: 1.0 Gbps Suggested Backup: External Hard drive or SCSI Tape Drive Remote Access: Terminal Services- Admin account must be provided to Medflow Monitor: 1024 x 768 Required Software: Microsoft.NET Framework 3.5 SP1 & 4.0 Extended Microsoft Visual C Runtime (X86) 12

13 Terminal Services Server(s) or Citrix Server A Terminal Server allows users to run the application from a hosted server rather than having the application installed on the local workstation. This has the advantage of not having to upgrade every workstation when an updated is needed. It also allows remote offices to connect to the main site using less bandwidth than thick client configurations. At least one standalone terminal server is required. Additional terminal servers may be required if your practice has a large number of remote users. TERMINAL SERVER SPECIFICATIONS (Multiple servers may be required based on the number of users.) Operating System: Microsoft Windows Server 2008 R2 (64-bit) (Microsoft Windows Server 2012 not supported at this time) Memory: (Minimum 8 GB) + 512MB per Terminal Server User. Required Software: Microsoft.NET Framework 3.5 SP1 & 4.0 Extended Microsoft Visual C Runtime (X86) 13

14 Multi-Site Server Map Below is a representative diagram of a typical multi-site clinic. Your clinic s configuration may be different, with more Remote Offices or additional Terminal Servers. Medflow Thin Client (Remote Office) Terminal Server (Medflow Application Installation) Medflow SQL Server (Data Storage) Medflow File Server (Image and Document Storage) Remote Office Shared Connection Between Offices Main Office Medflow Thin Client (Main Office) Medflow Fat Client (Main Office) 14

15 Room Requirements Each room where the Medflow application will be used will need to be equipped with the components listed below. Any facility with more than 10 users and 6 devices will need to contact their Medflow s sales representative to discuss connectivity. POWER Standard 15 amp circuit. NETWORK CONNECTION Any room or workspace where any Medflow application (EMR, Imaging, etc.) will be accessed requires a minimum network connection speed of 100 Mbps. VPN CONNECTION For multi-site clinics, a VPN Connection from the remote site to the main site is required. Remote hosted client will need to follow up with Medflow technical services. INTERNET All connections must be wired connections and be used solely for Medflow. Single Site Clinics High speed connection, 3.0Mbps send and receive Multi-Site Clinics Remote sites must use thin client configuration. For those clients who have installed multi-site clinics with Thick client configuration significantly higher bandwidth is required to support the Medflow EHR. 1-5 Users, 1-3 Imaging devices: High speed, 3.0Mbps send and receive 6-10 Users, 4-6 imaging devices: High speed, 4.5Mbps send and receive Offices that plan to use tablet devices will also need wireless access in the room, however a wireless connection cannot take the place of the wired connection. Internet can be provided through cable, T1 line with a static IP address assigned by the Internet provider. A clinic s internet needs are dependent upon the size and configuration of the clinic. 15

16 Workstation Requirements Each workstation using the Medflow application will need the components listed below: OPERATING SYSTEM Windows XP Professional 32-bit Windows 7 Professional, Enterprise, or Ultimate 32-bit or 64-bit PROCESSORS Intel Core i5 2.5 GHz or higher MEMORY 4 GB HARD DRIVES 5.0 GB of Available Hard Drive Space NETWORK CARD 1.0 Gbps VIDEO CARD Supports 1280*800 or 1280*768 MONITOR Monitor 22 or Larger Aspect Ratio: 1.6:1 (1280*800) or 1.7:1 (1280*768) REQUIRED SOFTWARE Microsoft Dot Net 3.5 SP1 & 4.0 Microsoft Visual C Runtime (X86) ADDITIONAL SOFTWARE Additional software may be required dependent upon any other installed programs apart from Medflow EHR, ASC, or Optical, i.e., Peripheral and/or Imaging device interfaces. - Ask your Medflow Sales Representative if this is required. 16

17 Peripheral Devices Below is a listing of peripheral devices tested and supported by Medflow. Any peripheral devices outside of those listed below may not be supported. PRINTERS HP Color Desk Jet and LaserJet Printers **Note All Prescriptions must be printed on blank 8.5 by 11 paper. ID CARD SCANNERS Scan Shell 800N single side and 800DXN dual-side scanners for Insurance Cards/Patient ID DOCUMENT SCANNERS HP flatbed scanners, Fujitsu fi-5110c, Fujitsu fi-6110, and Fujitsu fi-6130 Scan Resolution 75 x 75 Greyscale 100 x 100 Color Photos REMOTE SCANNING Third-party software. This will need to be purchased to allow scanning of documents over a Terminal Services session. FRONT DESK CAMERAS Microsoft web cameras (LifeCam VX model family), Logitech QuickCam Orbit AF SIGNATURE PAD Topaz Electronic Signature Pad T-LBK-462-BSB (This model is required if using Signature Pads) FAXING To fax with Medflow GFI Fax Maker software and fax cards or an Etherfax package is required. *Etherfax package recommended. A single dedicated analog fax line is required and is the responsibility of the client to have provision prior to Go Live. Supported Fax Cards (Ensure the fax card is the correct interface for your server before ordering. i.e., PCI, PCI Express.) Examples of Supported Cards: Brooktrout TR1034 (2 or 4 Analog loop-start lines [Channels] ) TR1034-P2-2L-R HALF 2 Channel Analog, V.34, Universal PCI half-size TR1034+P4-4L-R 4 Channel Analog, V.34, Universal PCI Brooktrout TR1034 (2 or 4 Analog loop-start lines [Channels] PCIe) TR1034+E2-2L HALF 2 Channel Analog, V.34, PCI Express half-size TR1034+E4-4L 4 Channel Analog, V.34, PCI Express BIOMETRIC READERS Futronics Fingerprint Reader FS-80 purchased through Medflow, no other BIO Metric readers are supported at this time. 17

18 Optical Shop Requirements This information pertains to clients who have included the optical shop module in their Medflow system. BARCODE SCANNER Wireless Honeywell Voyager 1202g Wired Metrologic Voyager MK A38 FRAME SPEX UPC CD SUBSCRIPTION Your SPEX UPC Subscription Includes: 12 monthly issues of SPEX UPC provided on CD-Rom. Access to FRAMES Date Online, our online database of frames. To order call When requesting the CD subscription please make sure you ask for the SPEX CD, not the FramesData CD. Please allow 2 to 4 weeks for delivery. Single location licenses cost $ plus $19.95 S&H Multiple licenses will be necessary if you are using SPEX UPC at multiple locations, using a centralized server or if you are using SPEX UPC at one location to manage the inventory of multiple locations. To select an appropriate multiple location license please contact Angela Carroll at x7831, acarrol@jacobson.com. LABEL PRINTER Dymo LabelWriter 450 Turbo Medflow currently supports 330, 400, and 450 models. LabelWriter_450_Turbo.html For locations utilizing terminal services to access Medflow an optional Print Server may be purchased to allow the Dymo printers to function as network printers. Otherwise, Medflow must be locally installed on the workstation to which the Dymo printer is attached. LABELS Custom Dymo Labels These adhesive Optical labels are custom designed and require a minimum order of 5000 labels. Please notify Customer Service that your labels are for use with the Medflow system. To order contact customlabels@dymo.com and provide the following information: SAP Item# Cat # Description Labels/Roll X 1.25 in KL Tags for Labels are optional. Tags slide on the temple of the frame and the label is placed on the tag to allow for clean removal. Recommended tag: Archcrown Op-tag SO

19 Glossary Combination Server Server that is set up to run more than one application or program. Dedicated Server A server that is set up to only run a specific application or program. DICOM: DICOM is an international standard for medical image storage and communication between devices and an EHR. Direct DICOM: Devices using direct DICOM will hook up to the network directly. No additional computer will be required for the interface with Medflow. HL7 Messages Part of the American National Standards Institutes accredited Standard Developing Organization (SDO);the Health Level 7 domain is the standard for electronic interchange of clinical, financial and administrative info among healthcare oriented computer systems. A not-for-profit volunteer organization, it develops specifications, the most widely used of which is the messaging standard that enables disparate health care applications to exchange key sets of clinical and administrative data. HL7 promotes the use of standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery. HL7s international community of healthcare subject matter experts and information scientists are dedicated to the creation of a standard architecture for the exchange and transmission of clinical data. MFCapture: Medflow s imaging solution. MFCapture allows devices not configured for direct DICOM to communicate with the imaging server for querying and storing images. Peripheral Devices: A computer device, such as a CD-ROM drive or printer, that is not part of the essential computer, i.e., the memory and microprocessor. Production Environment The setup of the system (hardware, software and office environment) where the software will be used in the business. Storage Server The server where the patient images are stored. SQL Server Stores all data related to the Medflow EHR including patient demographics, scheduled appointment, exam data, image information, etc. Thick Client: Medflow is installed directly on the workstation. Thin Client: Medflow is not installed on the workstation but is installed on a terminal server. Also known as a Dummy Terminal, this is a network computer without a hard-drive which requires a constant connection to a server for operation. Terminal Server: A robust server allowing multiple sessions of applications open simultaneously under different users Third Party Software Any software not developed by Medflow that can be used within the Medflow environment. Workstation: A computer that will be hooked into the network and run Medflow software. Network Connection A wired or wireless communication link between a group of computers or devices for the purpose of sharing information and resources. 19