Centricity Practice Solution 12 and Centricity EMR … 11 14_Webinar 3_CPS12 CEMR98 Draft HW...

GE Healthcare Centricity Practice Solution 12 and Centricity EMR 9.8: Draft Software/Hardware Requirements November 14, 2013

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Draft HW/SW Requirements November 14, 2013

©2013 General Electric Company – All rights reserved.

This does not constitute a representation or warranty or documentation regarding the product or service featured. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE.

DESCRIPTIONS OF FUTURE FUNCTIONALITY REFLECT CURRENT PRODUCT DIRECTION, ARE FOR INFORMATIONAL PURPOSES ONLY AND DO NOT CONSTITUTE A COMMITMENT TO PROVIDE SPECIFIC FUNCTIONALITY. TIMING AND AVAILABILITY REMAIN AT GE’S DISCRETION AND ARE SUBJECT TO CHANGE AND APPLICABLE REGULATORY CLEARANCE.

Customer is responsible for understanding and meeting the requirements of achieving meaningful use through use of HHS certified EHR technology and associated standards. Customer is responsible for understanding applicable GE documentation regarding Meaningful Use functionality and reporting specifications, and for using that information to confirm the accuracy of meaningful use attestation. Customer is responsible for ensuring an accurate attestation is made and GE does not guarantee incentive payments. Use of the product does not ensure customer will be eligible to receive payments.

* GE, the GE Monogram, Centricity and imagination at work are trademarks of General Electric Company.

General Electric Company, by and through its GE Healthcare division.

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Agenda

• Changing landscape with Meaningful Use (MU) 2014

• Advancements in hardware usage

• Draft hardware requirements

• Service offerings to help with upgrades

• Readiness tools and info

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Changing landscape with MU2014 Data Exchange demands are rising:

• Transitions of care and clinical visit summary

• Immunization data

• Registry exchanges are increasing; syndromic surveillance

• Patient engagement data exchange is rising

External communications for coordinating care are expanding in MU2014

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Changing landscape with MU2014 Response:

• Effectively moving data in and out of the solution becomes key

• To reduce overall hardware needs in response to the new MU requirements, more processing will move from client to service layer

• Improved horizontal scalability for better use of low-cost servers

With more data exchange required for

MU2014, hardware needs must adapt to support more service layer processing

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MU2014 Hardware Advancements Service Layer Improvements: • Shift load from client to JBoss to hold client virtualization HW the

same or slightly better despite the addition of a large set of new features for MU2014

• JBoss scaling with multiple small servers instead of a larger high-cost single server

• Position you for future growth Operating System Improvements: • Support for SQL Server 2012, potentially improves scalability by 10% • Supporting 2 versions of Windows and 2 versions of IE to assist with

transitions across your enterprise

Descriptions of future functionality reflect current product direction, are for informational purposed only and do not constitute a commitment to provide specific functionality. Timing and availability remain at GEHC’s description and are subject to change and applicable regulatory approvals.

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MU2014 Hardware Advancements

Interface Improvements: • New interfaces are JBoss-based web services coupled with either CCG

or QIE • No change in DTS/MIK Hardware • The interface engine (CCG or QIE) will require more CPU/RAM with new

interoperability load – CCG can still be run on-box with DTS/MIK depending on your load

• CDS Gateway replaced with JBoss and an interface engine (CCG or QIE)


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Draft Technical Requirements: CPS / CEMR Client Platforms


Client Platform CPS 12.0 / C-EMR 9.8 CPS 11.0 / C-EMR 9.6/9.5

Windows Client Client OS

Win 8 Professional 32-bit & 64 bit Win 7 Professional 32-bit & 64 bit

Win 7 Professional 32-bit & 64 bit Win Vista Business 32-bit & 64 bit

Embedded Browser IE 10 32-bit IE 9 32-bit IE 9

Web Client (BMAC) Desktop Browser IE 10 32-bit IE 9 32-bit

IE 9

Mobile Client Mobile Device/Browser iPhone - iOS 6.x iPhone - iOS 5.0.1

Client Virtualization

Microsoft Virtualization

App-V Support coming next release n/a

RDS <Windows Server 2012> / RDP 8.0 <Windows Server 2008> / RDP 7.1

<Windows Server 2008> / RDP 7.1

OS See Common Server Platform See Common Server Platform

Citrix

Client

Platform Compatibility: Receiver for Windows 8/RT under

evaluation Receiver for Windows 3.3

Receiver for Windows 3.2

Server Software Platform Compatibility:

XenApp 6.5 64-bit XenApp 7.0 support if 7.0 out by Q1

XenApp 6.0 64-bit

OS See Common Server Platform See Common Server Platform

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Draft Technical Requirements: CPS / CEMR Server Platforms


Server Platform CPS 12 / CEMR 9.8 CPS 11 / CEMR 9.6

Common Server Platform

Windows OS Windows Server 2012 64 bit

Windows Server 2008 R2 64 bit Windows Server 2008 R2 64 bit

CPS Database Server

SQL Server Version SQL Server 2012* SP1 Enterprise & Standard

SQL Server 2008 R2

SQL Server 2008 R2

CEMR Database Server

ORACLE Version 11.2.0.3.0 11gR2 OS Windows See Common Server Platform See Common Server Platform

OS UNIX AIX 6.1

HP-UX 11.31 AIX 5.3, 6.1

HP-UX 11.31

Application Server Server Software JBoss 5.1 with 64-bit JVM JBoss 5.1 with 64-bit JVM

OS See Common Server Platform See Common Server Platform Data Exchange

Server (MIK, DTS, FTS, and

CCG)

Server Software CCG 9.2 CCG 9.1

OS See Common Server Platform See Windows Client - Client OS

See Common Server Platform See Windows Client - Client OS

Server Virtualization Hyper-V

Server Software Microsoft Hyper-V Server 2012

or Windows server option Microsoft Hyper-V Server 2008

or Windows server option OS See Common Server Platform See Common Server Platform

VMWare Server Software Platform Compatibility: VMWare ESX 5.1 VMWare ESX 4.1

OS n/a - We provide no recommendation VMWare VMKernel (Linux)

*Centricity Analytics requires SQL Server 2008

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Draft Technical Requirements: CPS / CEMR Ancillary Solutions


PLEASE NOTE: Most recent versions of ancillary solutions may not be compatible with CPS10/11 and CEMR 9.5/9.6/9.7

Ancillary Solutions CPS 12 / CEMR 9.8 CPS 11 / CEMR 9.6

ePrescribing Centricity Advanced ePrescribing (Kryptiq eScriptMessenger)

3.5 3.3.x, 3.4.x

Document Scanning Centricity DocuTrak (Kryptiq Document Management)

8.9 8.8.x

Clinical Messaging Centricity Clinical Messenger (Kryptiq Integrated Secure Messaging)

6.4

6.2

Patient Portal Centricity Patient Portal (Kryptiq Patient Portal)

6.4

6.2

Faxing Biscom Faxcom

Faxcom CV is 03.01.0000 -or- Faxcom CV Plus is 9.06.0990

Faxcom CV is 03.01.0000 -or- Faxcom CV Plus is 9.06.0990

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Software - versions appropriate for MU2014 MUST HAVE from GE Healthcare or your VAR:

• Centricity Practice Solution 12 – OR – Centricity EMR 9.8 • Advanced ePrescribing 3.5 • Centricity Clinical Messenger 6.4 – OR – (Qvera QIE 2.0 + HISP)

[Not required for MU1. We recommend both for MU2.] • Access to Clinical Quality Reporting 1.0 • Centricity Clinical Gateway 9.2.0 – OR – Qvera QIE 2.0

MUST HAVE appropriate certified version (may be from other vendors): • Certified tools for View Download and Transmit + Secure Messaging MU Requirements

Such as: • Centricity Patient Portal 6.4 – OR –

(Centricity Patient Online 13.03 +Secure Messenger for CEMR-PoL 13.0.3) • And an info-button enabled version of patient education materials such as:

• Truven's Micromedex Carenotes Patient Education Resources 5.27.0

Optional software: • An info-button enabled version of clinician referential information such as

• Truven's Micromedex Clinical Knowledge Suite 5.27.0

NOTE: Centricity Clinical Messenger is also known as Centricity Integrated Secure Messaging

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Upgrade services for direct customers Core Offer Components

Flexible Scheduling

Documentation / Service Portal

Project Management

Remote Technical Assessment

Test Environments

Workflow Assessment (includes MU and ICD-10 functionality review)

Installation

Interface Configuration (Registry)

Application Configuration

Attestation Reporting Consulting

Immunization Consulting

Master Trainer Education

Report Customization o

Meaningful Use Consulting o

Included o Optional Upgrade Services are billed based on time and effort Software included as part of Software Maintenance Agreement

Education

• Computer-Based Training (CBT) modules will be available for CPS12 in 2 subscription packages: • 3 Month or 12 Month Subscriptions

• EMR (Chart) CBTs • PM-Only CBTs • PM/EMR Joint CBTs

• Courses and CPS12 Upgrade Companion Guides will be available on the training website, which can be accessed through the Service Portal

VAR customers: contact your VAR representative for available services

http://www.cpstraining-gehc.com/joomla

https://engage.gehealthcare.com/community/en/cps

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MU preparedness – tools for use • Hardware Calculator

~Also~

• Updated MU User Guide

• Upcoming webinars

• Consulting offerings

Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

Weekly Readiness Webinar Program: MU 2014 and ICD10

All webinars are on Thursdays from 1pm-2pm EST engage.gehealthcare.com

On Demand Now On Demand Now

MU 2014 requirements overview CPS12 & CEMR 9.8 Overview

November 14 November 21 December 5 December 12 December 19 January 9 January 16 January 23 January 30 February 6 February 13 February 20 February 27 March 6

CPS12 & CEMR 9.8: Draft HW & SW requirements ICD-10 Prep and new problem search: CPS customers ICD-10 Prep and new problem search: CEMR customers MU 2014 Prep: Core - Part #1 MU 2014 Prep: Core - Part #2 MU 2014 Prep: Core - Part #3 MU 2014 Prep: Menu & Interfaces MU 2014 Prep: Clinical Content Upgrade and Install Process* ICD-10 Prep: ICD-10 services* MU 2014 Prep: MU Services* Operating New Features in CPS12 Operating New Features in CEMR 9.8 Leveraging New Meaningful Use Reporting Platform for 2014

Slides and Recordings distributed afterwards

Register at the support portal

engage.gehealthcare.com *VAR customers: please contact your VAR representative for relevant information on these topics.

http://cl.exct.net/?ju=fe2617787c61047f7d1171&ls=fdf612747563067b711d7076&m=fefc1672746303&l=fe5215747d600074731d&s=fdf41670776002747311717d&jb=ffcf14&t=






Thank you for joining us.

Questions

NOTE: We will send you an email after this session with a link to the services portal, where you can download the slides and watch the recording.

Appendix

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Scalability Current State Relative change in Hardware Requirements since last CPS/C-EMR release

This is an example for 1000 users, use the HW calculator for more specifics

This represents current projections based upon current internal test results.

We are continuing to make improvements to improve these requirements

We will validate these results during our Early Adopter Program


v12 1000 users v11 1000 users Tier Resource % Change v12 Amount v11 Amount Notes

JBoss vCPU 150% 20 8 # RAM - v11 + .75 GB 24 add .75 GB for all sizes

Database

vCPU 50% 24 16 # RAM 47% 53 36 GB

Storage - v11 + 1 GB varies, e.g.: 250 GB add 1 GB for all sizes IOPS 15% 1795/ 3537 1561 /3076 Read/Write

CCG & DTS/MIK

vCPU 50% 6 4 RAM 50% 24 16

Client Virt.

# Users 0 - 10% 16-17 16 ~10% reduction in cpu utilization (RLF) vCPU 0% 2 2 Per VM RAM 0% 10 10 GB Per VM

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MU2014 Hardware Advancements The movement of code from the client to JBoss allows us to scale more efficiently moving the CPU burden off client virtualization and onto cheaper, more scalable JBoss servers • Have modestly decreased HW on client virtualization, and have increased JBoss HW • Later releases will capitalize on this further

We have added optional support for JBoss horizontal scaling – Scaling more cheaply with multiple small servers instead of buying a larger single server We have added support to CPS for SQL Server 2012 – Early test results have shown that running SQL Server 2012 vs. 2008 same hardware and same load improves scalability by 10% All new interfaces in MU 2014 are built with JBoss based web services and either CCG or QIE • No change in DTS/MIK Hardware • The interface engine (CCG or QIE) will require more CPU/RAM with new interoperability load

– CCG can still be run on-box with DTS/MIK depending on your load • CDS Gateway has been replaced with JBoss and an interface engine (CCG or QIE)


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MU 2014 Hardware Overhead Meaningful Use 2014 adds a number of new features to CPS / C-EMR • As a reflection of scope we added 50% more client and 180% more JBoss load tests

• Interoperability has been the main theme of MU 2014 with all new interfaces using web

services on JBoss to read/write data and an interface engine (CCG or QIE) for data transfer – CCDA’s (generated on JBoss, transferred on CCG or QIE) are used in Clinical Quality

Reporting, DIRECT messaging, Clinical Visit Summary, & Transitions of Care – Immunizations integration is now mandatory and has been re-written to be on JBoss – Syndromic Surveillance is new – Clinical Reconciliation from a CCDA is new

• All features except CCC Basic and Formulary updates leverage JBoss web services

– We have done only select client/server code and the majority is n-tier

• We have moved interaction checking off the client onto web services on JBoss

• We have added new HTML form support hosted on JBoss – We still support MEL based forms which are client based


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Performance Current State We have built-in performance instrumentation in the CPS client and using an updated de-identified customer database run response tests under load

• 110 pre-existing workflows instrumented from CPS v11 – 14 are above 2 sec.

• 87 new instrumentation points from CPS v12 – 19 are above 2 sec.

Existing v11 Workflow Name (in v12)

Peak Duration

v11 Change

% Change

Open Chart - Total 61.80 -70.1 -53% Login 30.69 9.7 46% Open Chart – Part w/ web service 21.09 14.7 230% OpenPatient 16.57 4.2 34% Load Visit Module 14.90 5.3 55% End Chart Update 11.54 9.1 371% Launch base PM application 9.32 7.9 556% Launch Application 9.30 4.4 91% Open Chart – Part with UI Render 8.36 4.7 130% Open Task Management 6.94 6.4 1235% Send Order 6.47 0.6 10% Open New Problem Dialog 6.38 4.5 232% Launch PM Module – Core of all PM 3.56 2.0 132% Start a new Chart Update 2.36 -1.9 -45%

Response times under load with largest data sets


v12 Workflows Peak Duration

Avg Duration

Clinical Visit Summary (CVS) Preview 45.52 11.34 DataMappingSearchOverall 38.44 15.61 MEL_UPDATE_MED_ADMINISTRATION 21.84 11.11 MEL_REMOVE_MED_ADMINISTRATION 21.81 21.81 MEL_ADD_MED_ADMINISTRATION 21.54 14.33 MEL_UPDATE_MED_ADMIN_REQUEST 21.47 21.36 MEL_GET_MED_ADMINISTRATIONS 21.32 21.32 MEL_REMOVE_CONTENT 21.26 10.63 CvsSaveToFile 11.30 3.93 CvsSaveToChart 7.50 0.86 DataMappingEMeasureOverallLoad 5.81 3.02 HttpRequest – InfoButton #1 5.44 2.72 InquiriesAction_ExportPatients 5.34 4.42 MEL_UPDATE_CARE_PLAN 5.18 1.30 DataMappingSearch 3.87 1.53 CDS_HttpRequest 3.66 0.96 HttpRequest – InfoButton #2 2.73 0.80 MEL_ADD_FHX 2.44 0.80 DataMappingValueSetOverallLoad 2.29 1.20

Centricity Practice Solution 12 and Centricity EMR … 11 14_Webinar 3_CPS12 CEMR98 Draft HW...

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