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TELUS Health Solutions

Certified EMR Offerings

Please note: the information provided below is for research purposes only. EMR Advisor strongly suggests you use this in conjunction with other information sources (e.g. discussions with your peers), and perform a proper RFI (Request for Information) from vendor organizations you wish to consider for your CMS/EMR selection.

This section provides information about the CMS vendor.

NOTE: The information below has been provided by the CMS vendor.


Version Number

Nightingale On Demand v9.0

User Interface

Internet Explorer 7

Local/ASP

Local

Provided Documentation and Media Used

Nightingale provides all software installation services; Documentation is provided via in-system Help module as well as:

  • User Manual
  • Getting Started Guide
  • System Installtion CD (LCS clients only)
  • Billng and Lab processing guide (LCS only)

Other Required Environmental and Support Components

Print Driver, Winblast and Hyperaccess for Billing and Lab interfaces, RAD Editor, SSL Certificate.

Health Card Validation Support (OBEC)

Fully supported.

What other tools and utilities (e.g. Systems Management, Monitoring, Backup, Audit Logging etc.) are required to implement the EMR on the server?

Windows Network Monitor

HTTPMON

MS operations manager agent (for monitoring purposes)

Specify which DBMS(s) are required for the certified version of the Offering. Need to specify all DBMS versions such as: - MS SQL Server - Standard Edition, - MS SQL Server - Enterprise Edition.

Microsoft SQL 2008

Server Operating System

Microsoft Windows 2003

What other software products do you advise physicians to implement?

Anti-virus, Adobe Acrobat, Microsoft Office

What other software products are compatible with your EMR (e.g. Office suites, accounting, research, analysis, etc.)?

Nightingale On Demand is a web based application and can run with any IE compatible products.

Does your Offering support out-of-province billing? If so, please specify.

Reciprocal Billing is available through OHIP claim submission for all provinces except Quebec. Direct electronic claim transactions with provincial ministries of health is available for NB, NS, NL, ON, MB, AB, BC & NWT.

Specify third party interfaces your Offering supports (e.g. laboratories, pharmacies, hospitals, MOHLTC).

MEDITECH (Classic and Client Server or Magic and Vmagic): Lab and DI reports

Cerner - Mount Sinai: Lab, DI, ADT (realtime)

Cerner - Ottawa Hospital: ADT (realtime)

Cerner - London Heath Sciences Centre: Lab, DI, Transcribed Reports, ADT (realtime)

Cerner - Grey Bruce Hospital: Lab, DI, Transcribed Reports

CML Healthcare: Lab (flat file format)

Gamma-Dynacare Medical Laboratories (lab)

LifeLabs: Lab

Medical Labs of Windsor: Lab

Central East LHIN (9): DI, Transcribed Reports

Thunder Bay Regional Health Sciences Centre: Lab, DI, Transcribed Reports

MOHLTC: Billing, OBEC and HCV

Provide a comprehensive list of the out-of-box forms of templates included in your EMR Offering (e.g., SOAP, Annual physical, ante-natal).

Adomen/GI, Ankle Injury, Asthma Assessment, Back Pain, Basic Note, BCCFP Congestive Heart Failure Initial Visit, Congestive Heart Failure Care Record, C.N.S., CDH PRE OP Hx&Px, Chest & Respiratory, Chronic Pain, General Clinical Note, Consultation Record, CPE-Female, CPE-Male, CPX-Male, CPX-Female, CV Systems Review, Depression, Diabetes Management, Dyspepsia, Ears, Endocrine System Review, ENT-Adult, ENT-Child, Eye,G.U. Systems, Gastroesophageal Reflux, Head Injury, Hematology, Hypertension, Knee Injury, Lipid Management, Low Back Pain, Migraine, Mini-Mental Status Exam, Mouth and Throat, MSK, Nose, Nurse Hx/Vitals, Otitis Media, Pediatric Exam, Pharyngitis, Physicial Exam, Plantar's Wart (Treatment), Prostatic Symptoms, Psychiatry, Skin/Hair/Nail, SOAP-Female, SOAP-Male, SOAP, Complete (ROS), Urinary Tract Infection, URTI, Vertigo, Weight Loss, Weight Loss-Female, Weight Loss-Male, Well Baby, Well Baby Check (12-13 Months), Well Baby Check (18 Months), Well Baby Check (1 Month), Well Baby Check (2 Months), Well Baby Check (2 Weeks), Well Baby Check (4 Months), Well Baby Check (6 Months), Well Baby Check (9 Months), Well Bbay Check (Within 1 Week), Well Baby Check (2-3 Years), Well Baby Check (4-5 Years)

Does your EMR operate in both official Ontario languages (e.g. screens, online help, reports)?

Nightingale supports only English at this time.

Describe your approach to supporting patients with multiple different language needs.

N/A

Describe your approach to supporting physicians with multiple different language needs.

N/A

What is the name of the data supplier to support prescription writing and drug interactions?

Cerner Multum.

What is the frequency of updates to the data provided to your clients?

Monthly.

Describe the process for applying updates to the data (e.g. CD-ROM, remote download, etc).

LCS clients are updated remotely. ASP clients get seamless updates

Does your product support structured coding for problems? If so, provide the name(s) and version(s) supported.

Yes, currently support ICD9 v18, ICD10, ICPC.

Does your product support structured coding for interventions? If so, provide the name(s) and version(s) supported.

Yes, currently support DIN (Drug Identification Number) through Cerner Multum's drug database.

Does your product support structured coding for symptoms? If so, provide the name(s) and version(s) supported.

Not currently.

Does your product support structured coding for allergies? If so, provide the name(s) and version(s) supported.

Yes, currently support DIN (Drug Identification Number) through Cerner Multum's drug database.

Does your product support structured coding for adverse reactions? If so, provide the name(s) and version(s) supported.

Not currently.

Does your product support structured coding for immunizations? If so, provide the name(s) and version(s) supported.

Yes, currently support DIN (Drug Identification Number) through Cerner Multum's drug database.

Identify other coded data elements and their schemes where appropriate in the response sheets.

Nightingale aslo supports CPT codes for the recording of procedures.

Describe the recommended hardware configuration required to run your solution for the following scenario: Single physician office; 2 support staff; 2 exam rooms. Include any assumptions that you are making.

1 Dual Core Intel Xeon 3.0 GHz Server, 4GB RAM, Win 2003 Server SE, SQL 2008 R2-SP2 SE, IIS, 300 GB Disk, Antivirus (for LCS clients)

1 Tape Backup System (for LCS clients)

1 UPS

1 or 2 Desktops for support staff (depends on concurrent usage) - Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive

1 Tablet PC for exam rooms - Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive OR 2 additional Desktops for exam rooms.

1 Printer/Scanner

1 Label Printer

1 Card Reader

1 Firewall

1 Wireless Router

Describe the recommended hardware configuration required to run your solution for the following scenario: 8 physician FHN; 4 different geographic locations (physician offices), each with 2 physicians; 3 support staff per physician office; 4 exam rooms per physician office. Include any assumptions that you are making.

1 Dual Core Intel Xeon 3.0 GHz Server, 4GB RAM, Win 2003 Server SE, SQL 2008 R2-SP2 SE, IIS, 300 GB Disk, minimum 2 HDD (mirrored), Antivirus (for LCS clients)

1 Tape Backup System (for LCS clients)

1 UPS

4 to 12 Desktops for support staff (depends on concurrent usage) - Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive

8 Tablet PC for exam rooms - Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive OR 16 additional Desktops for exam rooms

4 Printer/Scanner

4 Label Printers

4 Card Readers

VPN Connection (for LCS clients)

1 Firewall

1 Wireless Router

Describe the recommended hardware configuration required to run your solution for the following scenario: 10 physician FHN all located in 1 clinic (physician office); 10 support staff; 20 exam rooms. Include any assumptions that you are making.

1 Dual Core Intel Xeon 3.0 GHz Server, 4GB RAM, Win 2003 Server SE, SQL 2008 R2-SP2 SE, IIS, 300 GB Disk, minimum 2 HDD (mirrored), Antivirus OR Dual Server Configuration with SAN for storage to provide redundancy and failover capability (for LCS clients)

1 Tape Backup System (for LCS clients)

1 UPS

Up to 10 Desktops for support staff (depends on concurrent usage) -Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive

10 Tablet PCs for exam rooms - Intel Core 2 Duo 3 GHz or better, 2 MB cache; 1 GB MEMORY; 120 GB hard drive OR 20 additional Desktops for exam rooms

2 Printer/Scanner

2 Label Printer

2 Card Readers

1 Firewall

1 Wireless Router

Describe the recommended bandwidth requirements required to run your solution for the following scenarios: Configuration 1; Configuration 2; ASP. Requirements should be broken down by upload bandwidth/user and download bandwidth/user.

Configuration 1:

  • 1 - 5 users: 1 Mbps upload and 6 Mbps download
  • 6 - 20 users: 1 Mbps upload and 10 Mbps download

Configuration 2:

  • 1 - 5 users: 1 Mbps upload and 6 Mbps download
  • 6 - 20 users: 1 Mbps upload and 10 Mbps download

ASP:

  • 1 - 5 users: 1 Mbps upload and 6 Mbps download
  • 6 - 20 users: 1 Mbps upload and 10 Mbps download

Depending on which applications are being used on the network, there may be a need for a higher bandwidth to ensure satisfactory speed when using the application

Do you provide remote server management capabilities? Please list functions provided.

Nightingale provides the following services as part of its enhanced support offering or on a time and material cost as requested by the client:

  • Software & database updates
  • Performance Monitoring Application & server
  • Firewall & VPN Policy Updates
  • Backup Schedules
  • MS patch updates
  • Infrastructure configuration
  • Daily monitoring for lab and billing processes
  • Semi annual fail over and Disaster Recovery testing

Describe how system data is recovered after a system (hard drive) failure. E.g. to the point of failure, last backup, or other.

Nightingale recommends the following backup schedule to its clients, if followed data can be recovered to the last backup. For clients that wish to have recovery to the point of failure, then a daily incremental back would be required to ensure no data loss.

  • Daily (Rotate bi-weekly)
  • Weekly (Rotate every eight weeks)
  • Monthly (Rotate yearly)
  • Annually (Rotate every 2 years)

Do you provide tools to manage the availability of EMR systems? Describe functions.

Depending on the client's system availability requirements, as part of the implementation Nightingale will design and assist the client with the implementation of a fully redundant environment with disaster recovery capabilities that can ensure up to 100% uptime. Nightingale recommends a semi annual fail over and DR testing to ensure system availability and reliability at all times.

Do you provide real-time server monitoring with alerts sent to yourselves or to clients?

Yes, this service is available as part of our enhanced support offering. By default, we setup the alerts to be sent to us. We will then notify the client (additional fees apply).

Other information about EMR offerings:

The following information is provided to assist you:

  • Approved Local EMR Configurations
    Ontario's eHealth strategy includes the use of specific configurations designed to meet Electronic Medical Record (EMR) and eHealth connectivity needs in Physician offices.
  • For more information, please call / email OntarioMD at 1-866-744-8668, emr@ontariomd.com.