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

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1 GE Healthcare Centricity Practice Solution 12 and Centricity EMR 9.8: Draft Software/Hardware Requirements

2 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. 2

3 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 3

4 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 4

5 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 5

6 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. 6

7 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) 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. 7

8 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 Embedded Browser Win 8 Professional 32-bit & 64 bit Win 7 Professional 32-bit & 64 bit IE bit IE 9 32-bit Win 7 Professional 32-bit & 64 bit Win Vista Business 32-bit & 64 bit Web Client (BMAC) Desktop Browser IE bit IE 9 32-bit IE 9 Mobile Client Mobile Device/Browser iphone - ios 6.x iphone - ios App-V Support coming next release n/a Microsoft <Windows Server 2012> / RDP 8.0 RDS Virtualization <Windows Server 2008> / RDP 7.1 <Windows Server 2008> / RDP 7.1 OS See Common Server Platform See Common Server Platform Client Virtualization Client Platform Compatibility: Receiver for Windows 8/RT under evaluation Receiver for Windows 3.3 Receiver for Windows 3.2 Citrix Platform Compatibility: Server Software XenApp bit XenApp 7.0 support if 7.0 out by Q1 XenApp bit OS See Common Server Platform See Common Server Platform IE 9 8 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.

9 Draft Technical Requirements: CPS / CEMR Server Platforms Server Platform CPS 12 / CEMR 9.8 CPS 11 / CEMR 9.6 Common Server Platform CPS Database Server CEMR Database Server Application Server Data Exchange Server (MIK, DTS, FTS, and CCG) Server Virtualization Windows OS Windows Server bit Windows Server 2008 R2 64 bit Windows Server 2008 R2 64 bit SQL Server Version SQL Server 2012* SP1 Enterprise & Standard SQL Server 2008 R2 SQL Server 2008 R2 ORACLE Version gR2 OS Windows See Common Server Platform See Common Server Platform OS UNIX AIX 6.1 AIX 5.3, 6.1 HP-UX HP-UX 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 Server Software CCG 9.2 CCG 9.1 Hyper-V VMWare OS See Common Server Platform See Windows Client - Client OS See Common Server Platform See Windows Client - Client OS Server Software Microsoft Hyper-V Server 2012 Microsoft Hyper-V Server 2008 or Windows server option or Windows server option OS See Common Server Platform See Common Server Platform 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 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.

10 Draft Technical Requirements: CPS / CEMR Ancillary Solutions Ancillary Solutions CPS 12 / CEMR 9.8 CPS 11 / CEMR 9.6 eprescribing Document Scanning Clinical Messaging Patient Portal Faxing Centricity Advanced eprescribing (Kryptiq escriptmessenger) Centricity DocuTrak (Kryptiq Document Management) Centricity Clinical Messenger (Kryptiq Integrated Secure Messaging) Centricity Patient Portal (Kryptiq Patient Portal) Biscom Faxcom x, 3.4.x x Faxcom CV is or- Faxcom CV Plus is Faxcom CV is or- Faxcom CV Plus is PLEASE NOTE: Most recent versions of ancillary solutions may not be compatible with CPS10/11 and CEMR 9.5/9.6/ 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.

11 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 HISP) [Not required for MU1. We recommend both for MU2.] Access to Clinical Quality Reporting 1.0 Centricity Clinical Gateway 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 Secure Messenger for CEMR-PoL ) And an info-button enabled version of patient education materials such as: Truven's Micromedex Carenotes Patient Education Resources Optional software: An info-button enabled version of clinician referential information such as Truven's Micromedex Clinical Knowledge Suite NOTE: Centricity Clinical Messenger is also known as Centricity Integrated Secure Messaging 11

12 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 Meaningful Use Consulting Included o Optional Upgrade Services are billed based on time and effort Software included as part of Software Maintenance Agreement o o 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 12

13 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 13 commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

14 Weekly Readiness Webinar Program: MU 2014 and ICD10 On Demand Now On Demand Now 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 MU 2014 requirements overview CPS12 & CEMR 9.8 Overview 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 *VAR customers: please contact your VAR representative for relevant information on these topics. Slides and Recordings distributed afterwards Register at the support portal engage.gehealthcare.com All webinars are on Thursdays from 1pm-2pm EST engage.gehealthcare.com

15 Thank you for joining us. Questions NOTE: We will send you an after this session with a link to the services portal, where you can download the slides and watch the recording.

16 Appendix

17 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 v users v users Tier Resource % Change v12 Amount v11 Amount Notes JBoss vcpu 150% 20 8 # RAM - v GB 24 add.75 GB for all sizes vcpu 50% # Database RAM 47% GB Storage - v GB varies, e.g.: 250 GB add 1 GB for all sizes IOPS 15% 1795/ /3076 Read/Write CCG & vcpu 50% 6 4 DTS/MIK RAM 50% # Users 0-10% ~10% reduction in cpu utilization (RLF) Client vcpu 0% 2 2 Per VM Virt. RAM 0% GB Per VM 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 17 Descriptions of future functionality reflect current product direction, are for informational purposed only and do not constitute a commitment November to 14, 2013 provide specific functionality. Timing and availability remain at GEHC s description and are subject to change and applicable regulatory approvals.

18 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 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) 18 Descriptions of future functionality reflect current product direction, are for informational purposed only and do not constitute a commitment November to 14, 2013 provide specific functionality. Timing and availability remain at GEHC s description and are subject to change and applicable regulatory approvals.

19 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 19 Descriptions of future functionality reflect current product direction, are for informational purposed only and do not constitute a commitment November to 14, 2013 provide specific functionality. Timing and availability remain at GEHC s description and are subject to change and applicable regulatory approvals.

20 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. Peak v11 % Existing v11 Workflow Name (in v12) Duration Change Change Open Chart - Total % Login % Open Chart Part w/ web service % OpenPatient % Load Visit Module % End Chart Update % Launch base PM application % Launch Application % Open Chart Part with UI Render % Open Task Management % Send Order % Open New Problem Dialog % Launch PM Module Core of all PM % Start a new Chart Update % Response times under load with largest data sets v12 Workflows Peak Duration Avg Duration Clinical Visit Summary (CVS) Preview DataMappingSearchOverall MEL_UPDATE_MED_ADMINISTRATION MEL_REMOVE_MED_ADMINISTRATION MEL_ADD_MED_ADMINISTRATION MEL_UPDATE_MED_ADMIN_REQUEST MEL_GET_MED_ADMINISTRATIONS MEL_REMOVE_CONTENT CvsSaveToFile CvsSaveToChart DataMappingEMeasureOverallLoad HttpRequest InfoButton # InquiriesAction_ExportPatients MEL_UPDATE_CARE_PLAN DataMappingSearch CDS_HttpRequest HttpRequest InfoButton # MEL_ADD_FHX DataMappingValueSetOverallLoad Descriptions of future functionality reflect current product direction, are for informational purposed only and do not constitute a commitment November to 14, 2013 provide specific functionality. Timing and availability remain at GEHC s description and are subject to change and applicable regulatory approvals.

21

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