greenway medical technologies primesuite® integrated ehr ... - technical review... · primesuite®...

October 25, 2010, version 3

Greenway Medical Technologies PrimeSuite® Integrated EHR, PM and Interoperability Solution

Technical Review and Hardware/Software Requirements

Contents

Technical Review Application Architecture Application Security Deployment Models Deployment Options Installation Environment Installation Management

Hardware/Software Requirements

Client and Server Hardware Configurations Client and Server Software Platforms

Confidential Property of Greenway Medical Technologies, Inc. SM UNAUTHORIZED REPRODUCTION OR DISTRIBUTION PROHIBITED

© 2010 Greenway Medical Technologies, Inc. All rights reserved. Version 20101025.003 of 23

Application Architecture

PrimeSuite® is a scalable multi-layer, 3-tier, web application. The solution’s EHR, PM and interoperability components share one codebase in addition to one database. This represents a major advantage over traditional client/server applications where the EHR and PM offerings commonly employ two dissimilar codebase languages and two dissimilar database platforms, requiring a dedicated interface engine for real time workflow requirements.

Presentation Layer

Business Logic Layer

Data Access Layer

Database

Integrated Development Environment (IDE): Microsoft Visual Studio (C# / Visual Basic)Software Framework: Microsoft .NETWeb Application Framework: Microsoft ASP.NETWeb Server: Microsoft Internet Information Services (IIS)

Client

Application/Web

Server(s)

DatabaseServer(s)

User

Versions 7 and 8{

{

{



Application Security

Client

Successful Login- User launches the PrimeSuite web client (Client)- User supplies the PrimeSuite credentials (username/password) (Client)- Microsoft Internet Information Services (IIS) authenticates the web client request (Server)- Microsoft Internet Information Services (IIS) provides the access to respective PrimeSuite ASP.NET resources (Server)- PrimeSuite ASP.NET resources authenticate to Microsoft SQL Server and connect to the PrimeSuite database (Server)- PrimeSuite ASP.NET resources authenticate the supplied PrimeSuite credentials (Server)- User is granted access to the appropriate PrimeSuite feature/functionality

Application/Web

Server(s)

DatabaseServer(s)

User

Versions 7 and 8{

{

{



Deployment Models PrimeSuite® can be deployed via Thick Client and Thin Client or via a combination of the two. Use of the Thin Client model is encouraged when multiple locations are part of the overall network topology. For example, when remote locations are connected to the main office via ‘public’ Internet based Virtual Private Network (VPN) tunnels or via heavily used ‘private’ media connections where additional applications, telephony and the Internet may also be accessed from the main office. The Thin Client option is also beneficial in environments where client hardware and software configurations do not meet those required for a Thick Client deployment. Greenway Medical Technologies recommends the use of Microsoft Windows Server 2008 R2 Remote Desktop Services (RDS). Estimated bandwidth for basic calculations (thick client): 300Kbps per session (excludes additional applications, telephony and Internet traffic)

Thick Client

Printer ScannerDatabaseServer(s)

Local Area Network(private)

Application/Web/DatabaseServer

- or -

Inclusive

Distributed

Hypertext Transfer Protocol (HTTP)

Client MachinesPrimeSuite Web Client

Peripherals

Application/WebServer(s)



Thin Client

Estimated bandwidth range for basic calculations (thin client): 35 to 60Kbps per session (excludes additional applications, telephony and Internet traffic)

Local Area Network(private)

Wide Area Network(private)

Virtual Private Network (VPN)(public media/private tunnel)

Remote Desktop Protocol (RDP)



Remote Desktop ServicesServer(s)

PrimeSuite Web Client

Printer Scanner

Client Machines

Peripherals


- or -

Inclusive

Distributed

RemoteDesktop

Connection

DatabaseServer(s)

Application/WebServer(s)



Deployment Options

PrimeSuite® can take advantage of industry standard technical offerings including the use of load balancing, clustering, virtualization, medical devices, faxing, printing, scanning and transcription. This applies to both the Thick Client and Thin Client deployment models. *Note: While both hardware and software based load balancing solutions offer the ability to distribute HTTP traffic, Greenway Medical Technologies recommends the use of industry standard hardware based load balancing devices. *Note: The use of Virtualization requires on premise expertise for proper installation and ongoing maintenance. Greenway Medical Technologies recommends that all Database servers reside on dedicated physical hardware, however the organization also recognizes the direction of Virtualization and will continue to test with Microsoft and VMware based solutions as they progress forward. All Application/Web, Database and Remote Desktop Services servers should be appropriately configured to match (as closely as possible) to the recommended physical server configurations notated in this document.

Load Balancing

Hardware Based Load Balancing- or -

Software Based Load BalancingHypertext Transfer Protocol (HTTP) Traffic

Distributed

DatabaseServer(s)

Application/WebServer





Clustering (Microsoft Failover Cluster)


DatabaseServer

Application/Web Servers(Load Balanced)(Not Clustered)

Database Servers(Clustered)

Node B (Passive)

Quantity 2 (local) – RAID 1Operating System


C:\ (OS)

C:\ (OS)



C:\ (OS)

Node A (Active)

DatabaseServer


C:\ (OS)

Quantity 2 (DAS/SAN) – RAID 1Quorom

Quantity 2 (DAS/SAN) – RAID 1MSDTC

Quantity 2 (DAS/SAN) – RAID 1SQL Server Backups

Quantity 2 (DAS/SAN) – RAID 1SQL Server Transaction Logs

Quantity 4 (DAS/SAN) – RAID 10SQL Server Data

Q:\ (Quorom)

M:\ (MSDTC)

D:\ (SQL Data)

L:\ (SQL TL’s)

F:\ (SQL BU’s)

Direct Attached Storage (DAS)/Storage Area Network (SAN)

Distributed

Distributed



Virtualization (Microsoft Hyper-V/VMware ESX – Stand Alone)

Quantity 2 (local) – RAID 1Operating System with Hyper-V Role (core/full)

C:\ (OS)

Hyper-VServer

Remote Desktop ServicesServer VM(s)

Quantity 4 (local) – RAID 10Virtual Machine Data

D:\ (VM Data)

ESXServer

Quantity 4 (local) – RAID 10Virtual Machine Data

Application/Web/DatabaseServer VM

-or-Application/Web

Server VM


DatabaseServer (Physical)*

*Note: Physical Database server recommended in large environments.

-and-


-or-Application/Web

Server VMDatabase

Server (Physical)*-and-



Virtualization (Microsoft Hyper-V – High Availability)

Node A (Active)


Cluster DisksDirect Attached Storage (DAS)/Storage Area Network (SAN)

Quantity 2 (DAS/SAN) – RAID 1Quorom

Quantity 2 (DAS/SAN) – RAID 1MSDTC

Quantity 4 (DAS/SAN) – RAID 10Virtual Machine Data

C:\ (OS) Q:\ (Quorom)

M:\ (MSDTC)

D:\ (VM Data)

Hyper-VServer

Node B (Active)


Hyper-VServer



Mic

roso

ft F

ailo

ver

Clu

ste

r



-or-Application/Web

Server VMDatabase



-or-Application/Web

Server VMDatabase




Virtualization (WMware ESX – High Availability)

Node A (Active)


Direct Attached Storage (DAS)/Storage Area Network (SAN)

Quantity 4 (DAS/SAN) – RAID 10Virtual Machine Data

C:\ (OS)

D:\ (VM Data)

ESXServer

Node B (Active)


ESXServer



Vm

war

e v

Sph

ere

En

viro

nm

en

t



-or-Application/Web

Server VMDatabase



-or-Application/Web

Server VMDatabase




Medical Devices

PrimeSuite® can communicate with many popular medical devices that supply ECG, Spiro, Holter, Stress and Vitals information. Please inquire with a Greenway Medical Technologies representative for specific information regarding compatible/supported manufacturers and associated models.

Faxing

PrimeSuite® natively supports the use of the Equisys Zetafax fax server solution (http://www.equisys.com/). Incoming and outgoing fax requests are addressed directly within the PrimeSuite® application. Alternative solutions such as OpenText RightFax may also be utilized.


(with Fax Server software)

Inclusive

Fax ModemAnalog Phone Line



Incoming Fax

Outgoing Fax


Thick Client

Thin Client

LAN

/WA

N/V

PN

LAN

http://www.equisys.com/



Printing

PrimeSuite® makes use of standard Microsoft Windows printing calls. In addition to local, network and centrally shared network printer access capabilities, the Microsoft Windows Server 2008 R2 Remote Desktop Services Easy Print feature may also be introduced within the Thin Client deployment model. This feature provides the advantage of auto created client side printers which use the single Easy Print printer driver, regardless of their specific make and model.

Easy Print(single driver)

Driver Specific

Driver Specific




Thick Client

Thin Client

LocalPrinter(s)

Client Machines

NetworkPrinter(s)

Centrally Shared NetworkPrinter(s)

Driver Specific

NetworkPrinter(s)

Centrally Shared NetworkPrinter(s)

LocalPrinter(s)

Easy Print(single driver)

Easy Print(single driver)Remote

DesktopConnection

LAN

/WA

N/V

PN

LAN



Scanning PrimeSuite® supports card and document scanning in both the Thick Client and Thin Client deployment models. Thin Client scanning is implemented via the use of the RemoteScan scanning client/server solution (Link). RemoteScan operates within the Microsoft Remote Desktop Protocol (RDP) virtual channels and provides compression capabilities.


PrimeSuite Web ClientRemoteScan Client


Thick Client

Thin Client

Client MachinesRemoteScan Server

Scanner

Scanner

Local Access

Remote Access

RemoteDesktop

Connection

LAN

/WA

N/V

PN

LAN

http://www.remote-scan.com/



Transcription PrimeSuite® supports transcription in both the Thick Client and Thin Client deployment models. This offering is called PrimeSpeech®. Each request is sent securely out to Greenway Medical Technologies in voice format and returns back to the PrimeSuite® solution in text format.


(with transcription capability)

Thick Client


The Internet(secure)

Incoming Transcription (text)

Outgoing Transcription (voice)



Installation Environment The health of the PrimeSuite® installation environment is critical. Variables such as cooling, power, security, wired/wireless networking and remote connectivity all must be in place and continuously managed.

Cooling

For best overall performance and lifespan, all server and networking equipment must be kept at the manufacturer’s respective operating and storage temperature & humidity specifications. Please inquire with a Greenway Medical Technologies representative for specific technical information regarding Greenway supplied hardware.

Power

All server and networking equipment must reside in a dedicated area with appropriately configured/supplied power. In addition, use of battery backup technologies commonly known as Uninterruptible Power Supply (UPS) devices are required to provide continuing power during unplanned outages. Please inquire with a Greenway Medical Technologies representative for specific technical information regarding Greenway supplied hardware.

Security

Access to all server and networking equipment must be restricted to authorized persons. Dedicated areas should be secured at all times by an appropriate locking mechanism.

Wired/Wireless Networking

Both wired and wireless networks are commonly utilized during each installation. All wired networking must be in place and tested prior to the installation of all server and networking equipment. Wireless networks should be configured and tested per industry standard specifics and must employ wireless encryption techniques. Please note that certain medical devices such as imaging related equipment may interfere with wireless signals. Always locate wireless access points in areas where the highest level of wireless access is needed.



Remote Connectivity

In order for Greenway Medical Technologies to maintain the best client support in the industry, high speed full time remote connectivity is required to provide Application and Technical Support and to deliver application upgrades. This remote connectivity, via a full time/dedicated Virtual Private Network (VPN) tunnel, is also commonly used in conjunction with Greenway’s complimentary offerings such as PrimeEnterprise®, PrimeExchange®, PrimeRCM® and PrimeResearch®. A full time Internet connection with a minimum upward/downward bandwidth allotment of 384Kbps is required along with a firewall/VPN concentrator capable of establishing a full time VPN link to Greenway’s data center. Please inquire with a Greenway Medical Technologies representative for specific technical information regarding Greenway supplied hardware.



Installation Management

Operating System/Database Platform/Application Updates

All Application/Web, Database and Remote Desktop Services servers should be properly configured for the use of Microsoft Update. Critical updates should be installed as they become available. Please contact a Greenway Medical Technologies Application or Technical Support representative prior to incorporating any major Operating System or Database Platform Service Packs into the PrimeSuite® environment, as these are individually tested and certified. PrimeSuite® application updates are automatically delivered to the on premise PrimeSuite® environment. Post update of all Application/Web and Database servers, web client software is automatically upgraded on each applicable client machine only when necessary (an advantage within the industry).

Malware Protection

Use of an industry standard Anti-Virus/Anti-Spyware solution is required within the PrimeSuite® environment. This solution will prevent, detect and remove malware, including viruses, from all client and server machines. Adware and spyware may also be dealt with. For best overall performance, all Microsoft SQL Server database (*.mdf) and transaction log (*.ldf) files should be excluded from all real time Anti-Virus/Anti-Spyware scanning processes.

Backups

Application and database file backup protection is required within the PrimeSuite® environment. An industry standard solution such as Symantec Backup Exec in conjunction with its Backup Exec Agent for Microsoft SQL Server is recommended to provide such protection. This is in addition to daily/hourly complete and transaction log backup-to-disk database backups obtained via the Microsoft SQL Server SQL Server Agent. Greenway Medical Technologies supports both the use of tape and disk backup media. Media should be taken offsite on a regular basis and test restorations performed once per quarter.



Performance Monitoring

Overall performance monitoring of the PrimeSuite® environment can be done with a combination of Microsoft tools and other available third party solutions. The following utilities are either included by default within the Application/Web/Database and Remote Desktop Services server(s) environment or can be easily downloaded from Microsoft. Built-In (client and Application/Web/Database server level) Tools:

Microsoft Windows Task Manager Built-In (Application/Web/Database server level) Tools:

Microsoft Windows Task Manager Microsoft Windows Performance Monitor Microsoft SQL Server Profiler

Downloadable Tools:

Microsoft Sysinternals (Link) Process Monitor

Process Explorer Microsoft SQL Server Performance Dashboard Reports (Link)

Security

Access to Protected Health Information (PHI) is restricted to authorized PrimeSuite® users via built-in application security. All access to PHI from outside the PrimeSuite® application must be carefully granted to approved administrators, analysts and end users. Direct access to Application/Web and Database servers at both the Microsoft Windows Server and Microsoft SQL Server levels should be limited to administrative users only. Microsoft password policies should be used to enforce password history variables, to set minimum/maximum password age, to set minimum password length and to set complexity requirements.

http://technet.microsoft.com/en-us/sysinternals/default.aspx

http://www.microsoft.com/downloads/details.aspx?FamilyId=1d3a4a0d-7e0c-4730-8204-e419218c1efc&displaylang=en



Client and Server Hardware Configurations

*Note: Greenway Medical Technologies recommends the use of industry standard 6Gb/s SAS whenever possible.

Server Type Application/Web/Database (Inclusive) (1 – 10 Users) CPU (1) Intel Xeon Quad Core RAM 4GB Disk (4) 146GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape Application/Web/Database (Inclusive) (11 – 49 Users) CPU (1) Intel Xeon Six Core RAM 12GB Disk (4) 450GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape



Application/Web (Distributed) (80 Users Per) CPU (1) Intel Xeon Quad Core RAM 4GB Disk (4) 146GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Database (Distributed) (50 – 80 Users) CPU (1) Intel Xeon Six Core RAM 12GB Disk (4) 450GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape Database (Distributed) (81 – 149 Users) CPU (1) Intel Xeon Six Core RAM 16GB Disk (4) 450GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape



Database (Distributed) (150 – 200 Users) CPU (2) Intel Xeon Six Core RAM 24GB Disk (4) 450GB 15K RPM SAS RAID Configuration RAID 5 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape Database (Distributed) (201 – 400 Users) CPU (2) Intel Xeon Six Core RAM 32GB Disk (2) 300GB 15K RPM SAS - OS RAID Configuration RAID 1 Disk (6) 450GB 15K RPM SAS – SQL TL’s, BU’s, Data RAID Configuration RAID 10 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape Database (Distributed) (401 – 600 Users) CPU (2) Intel Xeon Six Core RAM 48GB Disk (2) 300GB 15K RPM SAS – OS RAID Configuration RAID 1 Disk (6) 450GB 15K RPM SAS – SQL TL’s, BU’s, Data RAID Configuration RAID 10 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter Backup Disk Cartridge or Tape



Remote Desktop Services (25 Users Per) CPU (1) Intel Xeon Quad Core RAM 4GB Disk (2) 146GB 15K RPM SAS RAID Configuration RAID 1 Optical DVD-ROM Power Redundant Networking (2) Gigabit Ethernet Remote Management Remote Management Adapter

Client Type Desktop CPU (1) Intel Core 2 Duo Dual Core RAM 4GB Disk 160GB Networking (1) Gigabit Ethernet

Notebook

CPU (1) Intel Core i5 Dual Core RAM 4GB Disk 250GB Networking (1) Gigabit Ethernet, (1) Wireless 802.11 b/g/n Tablet CPU (1) Intel Core i7 Dual Core RAM 4GB Disk 320GB Networking (1) Gigabit Ethernet, (1) Wireless 802.11 b/g/n



Client and Server Software Platforms

Server Type Application/Web Operating System Microsoft Windows Server 2003 R2 Std. Edt. SP2

(x86) Microsoft Windows Server 2003 R2 Ent. Edt. SP2

(x86) Browser Platform Microsoft Internet Explorer 7/8 (32-bit)

Database Operating System Microsoft Windows Server 2008 R2 Std. Edt.

(x64) Microsoft Windows Server 2008 R2 Ent. Edt.

(x64) Database Platform Microsoft SQL Server 2008 R2 Std. Edt. (x64) Microsoft SQL Server 2008 R2 Ent. Edt. (x64)

Remote Desktop Services Operating System Microsoft Windows Server 2008 R2 Std. Edt.

(x64) Microsoft Windows Server 2008 R2 Std. Edt.

(x64) Browser Platform Microsoft Internet Explorer 7/8 (x64)

Client Type Thick Client Operating System Microsoft Windows XP Professional SP3

(x86/x64) Microsoft Windows Vista Business SP2 (x86/x64) Microsoft Windows 7 Professional (x86/x64) Browser Platform Microsoft Internet Explorer 7/8 (x86/x64)

Thin Client Operating System Microsoft Windows XP Professional SP3

(x86/x64) Microsoft Windows Vista Business SP2 (x86/x64)

Microsoft Windows 7 Professional (x86/x64) Wyse ThinOS

Microsoft Windows CE Linux Microsoft Windows XPe Microsoft Windows Embedded Standard 2009 Microsoft Windows Embedded Standard 7

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