ERUG Spring Conference
STIMULUS SET INFRASTRUCTURE AND ADMINISTRATION.
Presented by Cory Jock, Sr. Technical Support Consultant, Allscripts
AGENDA
• Introduction
• Important Vocabulary • Stimulus Set Overview
• Stimulus Set Pre-Requisites • Stimulus Set Install Process • Review
• Questions
INTRODUCTION
3
Cory Jock, Sr. Technical Support Consultant, Allscripts
• 2.5 years experience with Enterprise EHR and upgrades. • Team Lead for the Stimulus Technical Install Team
• Assisted in the development of the Stimulus Set Deployment Process.
Contact Info:
Important Vocabulary
Meaningful Use
•Defined by the US Government as a set of monetary incentives to be achieved by physicians when able to prove the successful use of a certified EHR meeting the measures outlined by the
Government (a.k.a. ARAA)
Stimulus Set
•Product/Solution Allscripts uses to aid physicians in achieving Meaningful Use. Has multiple modules and components.
Important Vocabulary
Transaction HUB
• Infrastructure for many types of transactions. Simplifies interface implementation and sharing of information across applications. Hosted by Allscripts SaaS Operations in "the Cloud".
Communicates to our clients through their Event Bus servers..
SSL Certificate:
•Secure Socket Layer, A networking protocol used for secure communications.
Stimulus Set Overview
• Meaningful Use requirements now means that our EHR needs to aggregate (group) clinical data and send it out in messages and reports to a variety of different entities
• This is very similar to sending claims from the PMS system • The EHR now is more “transaction based”
• Much of the infrastructure and functionality for Stimulus Set does not sit on the client’s server or in their EHR database; it is “in the Cloud”
HUB
Data Warehouse
ETL / Data Mgmt.
Stimulus Set Overview
EEHR Reports/ Messages Immun. Registry Destination/ Syndromic Surv Destination ETL Allscripts Referral Network Intuit Portal PHR Clinical Quality Dash- boards Stimulus Reporting Portal 1. Data is extracted out of the EHR via ETL run nightly
2. Goes into the Data Warehouse; automatically for New; via hard drive for Upgrades initially
3. Reports/Messages Created 4. Sent to destination 5. Customer views/manages End-users interact with EHR and Web Based URL’s *Yellow boxes outside Allscripts Cloud Allscripts Cloud Event Bus
Message Bus
HUB Data Warehouse
ETL / Data Mgmt.
MU Solution Elements – Functional View
xEHR Reports Single SignOn Destination User Manager Allscripts Referral Network (Portal) Registry Dest. Registry Dest. Registry Dest. Pursuit Lists / Syndromic Surv. Operations Backup Monitor/Log/Audit Failover PM Team Praxis Quality Measures Rec. Aggregator HIE Launcher EHR Client Intuit Portal PHR Stimulus Reporting Portal Clinical Rules Editor > > > >
Web Service Link
ETL Discrete Alerts Team Praxis Dash- boards 3rd Party Labs CDS Manager RT CDS Dashboard CDS Client Single SignOn Destination User Manager Stimulus Reporting Portal Portal ARN Service Imm Reg ESB Labs Elig/MH MURCQP eRx CDS For PQRI, not for MU CLOUD
Stimulus Set Pre-Requisites
• EEHR Environment
• Event Bus Server (May be All-In-One for Test Environment) • Microsoft Message Queuing (MSMQ)
• 128 Bit Public SSL Certificate with Fully Qualified Domain Name
• Microsoft .NET 3.5
Stimulus Set Pre-Requisites
EVENT BUS SERVER
• Communication software that facilitates the exchange of
messages between the EEHR and applications in the Allscripts Cloud.
• May be Windows Server 2003 or 2008. • Can be 32 bit or 64 bit operating system
• If 64 bit will need to make sure IIS is in 32 bit mode.
Stimulus Set Pre-Requisites
EVENT BUS SERVER
• Microsoft Message Queuing (MSMQ) must be installed on the Event Bus Server.
• Can be installed using windows components in Add/Remove programs.
• Using the settings:
• Active Directory Integration
• Common
• Core functionality
• Local Storage
Stimulus Set Pre-Requisites
SSL Certificates:
• Must be installed on the Event Bus Server
• Enterprise level 128 bit Public Certificate using a Fully Qualified Domain Name.
• The Allscripts -preferred issuer for SSL certificates is Network Solutions® (http://www.networksolutions.com).
• Allscripts also recommends purchasing the certificate for 4 years so you do not have to renew each year.
Stimulus Set Pre-Requisites
SSL Certificate :
• Private certificates are not acceptable, the certificate must be a public certificate that is able to be reached from an external domain.
• The certificate needs to be installed on the Event Bus Server and added to IIS Default Web Site.
• Both test/live need to have their own certificate.
Stimulus Set Install Process
• Incorporated into the Upgrade Schedule for Client’s that have Go-Live dates after July 15th.
• Client’s will Go-Live with 11.2 and Stimulus Set
• 2- phase approach for clients with a Go-Live before July 15th.
• Client’s will go live and then incorporate the Stimulus Set after Go-Live.
Stimulus Set Install Process (cont)
• The Install process has several components: The Hard Drive Process:
• This process is to send each client a password protected secure external
hard drive to copy their clinical database’s in order to populate the Warehouse.
• The Warehouse must be populated with all the clinical data so that the
warehouse and the client’s system are in synch.
• The warehouse is used to generate the reports for Meaningful Use.
Stimulus Set Process (cont)
The Hard Drive Process (cont):
• Once the warehouse is populated with the external drive then the
information is passed to the warehouse using the Extract, Transfer and Load (ETL).
Stimulus Set Process
Extract, Transfer and Load (ETL):
• The ETL process is how the warehouse is updated with the latest
information from the client’s database.
• It is a SQL job that runs nightly and is initiated from the Allscripts HUB.
• The job runs queries against the works database in 3 minute intervals.
• The job can be scheduled by day and time.
• Example: the job can run Mon – Friday from 2 am – 4 am and Sat and Sunday from 2 am – 8 am.
Stimulus Set Process (cont)
Extract, Transfer and Load (ETL):
• If the ETL does not complete in the timeframe it will continue the next day
from where it left off the night before.
• The ETL will extract patient data, provider data, orders, charges, results,
Medication history, encounters, appointments, etc.
Stimulus Set Process (cont)
Hub/Warehouse Security:
• The HUB/Warehouse are secured using the HUB credentials that are tied
to the account ID of the client and are client specific.
• The hub credentials are a username/password combination that is setup
on the Event Bus Server allowing it to connect to the HUB using the secured firewall port 443.
Review
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•The Stimulus Set is a Product/Solution Allscripts uses to aid
physicians in achieving Meaningful Use. Has multiple modules and components.
•The Pre-requisites for the Stimulus Set is to have
•Microsoft Message Queuing (MSMQ)
•Microsoft .Net 3.5
•128 bit public SSL certificate on the Event Bus servers.
•The Hard Drive Process involves loading the Works and
ChMedispan database’s onto a secure external hard drive and uploading that into the Data Warehouse.
Review
21
•The Transaction Hub is the Infrastructure for many types of
transactions. Simplifies interface implementation and sharing of information across applications. Hosted by Allscripts SaaS
Operations in "the Cloud". Communicates to our clients through their Event Bus servers.
