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Request for Proposals
for
Jurisdictional Laboratory Information System, EHR Desktop
Viewer and Shared Health Record Solutions
Issue Date: July 2, 2010
Response Due Date: July 19, 2010 Time: 2:00PM Newfoundland Time
RFP #: CHI-2010-032 iEHR/Labs Phase 2.2
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
Copyright Notice
This document is fully copyright protected by the
Newfoundland and Labrador Centre for Health Information
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
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Table of Contents 1.0� Introduction ..........................................................................................................4�1.1� About This RFP......................................................................................................4�1.2� Purpose of this RFP ...............................................................................................4�1.3� Background ............................................................................................................5�1.4� The Newfoundland and Labrador EHR ..................................................................6�
2.0� Program Scope...................................................................................................10�2.1� Program Strategy .................................................................................................10�2.2� RFP Deliverables .................................................................................................11�2.3� Business Perspective...........................................................................................12�2.4� Technical Landscape ...........................................................................................13�
3.0� Proposal Requirements and Content ...............................................................32�3.1� Executive Summary .............................................................................................32�3.2� Corporate Profile ..................................................................................................32�3.3� Project Approach..................................................................................................35�
4.0� Functional and Technical Requirements .........................................................39�5.0� Financial Proposal .............................................................................................40�6.0� Evaluation of Proposals ....................................................................................47�7.0� RFP Process and Estimated Timetable............................................................49�8.0� Proposal – Submission Guidelines ..................................................................50�9.0� RFP Terms and Conditions, and Contract Template ......................................52�Attachment A – Acknowledgement of Terms and Conditions..................................53�Attachment B – Functional and Technical Requirements.........................................54�Appendix A - Detailed HIAL Services........................................................................145�Appendix B – Acronyms/Definitions .........................................................................155�Appendix C: Supplementary Information to the RFP ..............................................158�
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
1.0 Introduction
1.1 About This RFP The Centre issued an RFP (#CHI-2010-016) on May 31, 2010 to identify software applications and related professional services for its interoperable Electronic Health Record/Labs (iEHR/Labs) project. The Centre cancelled this RFP on June 30, 2010 after it identified an inadvertent and unfortunate processing error at a partnering RFP distribution facility, which may have compromised the integrity and fairness principles the Centre consistently supports in its procurement and supply chain activity. This RFP document (#CHI-2010-032) contains no changes in functional and technical requirements and remains consistent in its content, overall messages, and submission processes when compared with RFP # CHI-2010-016. Suppliers are encouraged to read Appendix C to this RFP which contains all of the addenda from RFP #CHI-2010-016.
1.2 Purpose of this RFP For further clarity, the scope of this RFP (#CHI-2010-032) remains consistent with its predecessor (circa May 2010). The Newfoundland and Labrador Centre for Health Information (the Centre) is seeking the services of interested organizations to provide and implement ‘commercial off-the-shelf’ (COTS) solutions to fulfill three (3) required components for the interoperable Electronic Health Record/Labs (iEHR/Labs) project.
1. Jurisdictional Laboratory Information System Domain Repository (JLIS);
2. EHR Desktop Viewer (multi-domain viewer); and
3. Shared Health Record Domain Repository (SHR). Note that the exact SHR contents are evolving and will depend on what clinical documents are available electronically and will add value to the healthcare system.
A supplier may respond to one (1), two (2) or all three (3) of the requested components. Although a single supplier or a consortium approach is not a requirement for this proposal, the Centre does see value in the accompanying simplification of co-ordination, communication, project management and the reduced project governance effort required. In addition to providing the information about the three (3) components and their implementation, the Respondents are expected to provide relevant information for a cohesive approach of the EHR program and thus working with other companies and stakeholders in areas such as product integration, testing, issue and defect resolution, data migration, and security. Ideally the Respondent should bring a mix of specialized skills, proven methodologies, and best practices gained from planning, designing, and implementing projects of similar scope and complexity in one or more Canadian
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information jurisdictions. Direct experience with a jurisdictional lab system and/or an interoperable EHR (iEHR) project is considered an asset.
1.3 Background
1.3.1 Newfoundland and Labrador Centre for Health Information The Centre is an agency of the Crown established to provide information to health professionals, the public, researchers, and health system decision makers to improve the health of the population of Newfoundland and Labrador. The Centre has been a pioneer in supporting the vision of an interoperable, standards-based Electronic Health Record (EHR) for the province, in alignment with pan-Canadian EHR standards and architecture. The Centre has established an aggressive goal of implementing all funded components of the EHR, with active adoption by all authorized users. For more information on the Centre’s EHR initiative please refer to the website at www.nlchi.nl.ca. The Newfoundland and Labrador EHR is being developed in a unique environment with comprehensive stakeholder engagement to prepare a solid foundation for province-wide adoption and use. It encompasses multiple domains and point of service (PoS) applications and an evolving suite of Health Level Seven (HL7) EHR/interoperability message specifications and supporting ‘infostructure’. The Newfoundland and Labrador framework is aligned with the architecture and standards being developed by Canada Health Infoway (Infoway) to create a pan-Canadian interoperable EHR. Newfoundland and Labrador is the first Canadian jurisdiction to deploy a provincial Client Registry (CR) and the first to deploy a provincial Drug Information System (DIS) that implements the complete HL7 Canadian Electronic Drug (CeRx) messaging standard specified by the pan-Canadian Standards Group (pCSG).
1.3.2 Other Stakeholders Canada Health Infoway Infoway’s vision is one of a high-quality, sustainable and effective Canadian healthcare system supported by a pan-Canadian health infrastructure that provides residents of Canada and their healthcare providers with timely, appropriate and secure access to the right information whenever and wherever they enter the healthcare system. Respect for privacy is fundamental to this vision. The architectural vision of Infoway is expressed in the Electronic Health Record Solution (EHRS) Blueprint. The EHRS Blueprint presents the business and technical architecture for an interoperable EHR framework across Canada. This architecture has been established in a collaborative setting where all key stakeholder groups involved in the healthcare industry participated to validate and approve the constructs that it promotes. It is, therefore, a pan-Canadian vision for the creation of EHR infostructures (EHRi) and it is used as a criterion for investments by Infoway. The EHRS Blueprint can be accessed or downloaded by registering at the Infoway Knowledge Portal at http://knowledge.infoway-inforoute.ca.
The iEHR/Labs program is being supported by Infoway. Regional Health Authorities
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Effective April 1st, 2005, the province reorganized its healthcare delivery system into four (4) Regional Health Authorities (RHAs); Labrador-Grenfell Health, Western Health, Central Health, and Eastern Health. The RHAs provide a full continuum of integrated health and community services, including public health, long-term care, community services, hospital care, and various provincial programs and services.
Newfoundland and Labrador Public Health Laboratory The Newfoundland and Labrador Public Health Laboratory is the provincial laboratory centre for infectious disease surveillance and control. It provides a comprehensive range of specialized and reference laboratory services in clinical and public health microbiology and infectious disease epidemiology to the province. It pursues research and development activities in the areas of infectious disease epidemiology, immunization, community health, clinical, and public health microbiology. EHR Laboratory Standards Provincial Advisory Group The EHR Laboratory Standards Provincial Advisory Group was formed primarily to support the development and implementation of national and provincial standards in the provincial iEHR/Labs project.
Newfoundland and Labrador’s Health Care System The initial information that will populate the domains will be provided by the RHAs. The following is a list of metrics meant to provide an idea of the size Newfoundland and Labrador’s Health Care System:
� The population estimate for Newfoundland and Labrador for 2008 was 507,895;
� The number of Physicians currently in Newfoundland and Labrador is 1100;
� The number of Nurses currently in Newfoundland and Labrador is 5889; and
� The anticipated clinical activity for the lab repository performed by public sector labs per year is estimated at 20 million lab procedures.
1.4 The Newfoundland and Labrador EHR
1.4.1 The Vision The image below represents the vision of the Newfoundland and Labrador landscape once all currently planned components of the EHR are launched and operational. The EHR enables sharing of subsets of information among health providers which in the past may have not occurred, or if it did occur, it required many time consuming calls and searches through medical records. Ultimately, the EHR will enable sharing among authorized stakeholders at a level that is deemed appropriate for individual patients – e.g. the ability to search for a patient record and find pharmacy, lab, radiology results, and other information deemed important for provision of healthcare.
Vision
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
1.4.2 Current State The Centre was created by the Government of Newfoundland and Labrador in 1996 with a mandate to develop a comprehensive and secure province-wide Health Information Network (HIN). Through strategic planning activities that followed in 1997 and 1998, the vision for a provincial person-specific EHR was developed and opportunities to realize health system benefits by providing access to complete patient information at the point of care were identified. The EHR Strategy is defined in a multi-phase roadmap which is currently being reviewed in order to ensure that the provincial strategy remains current and continues to deliver high value for the Newfoundland and Labrador health system. The current solution architecture is built using leading technologies, best practices and industry standards. The solution comprises of components that lay the foundation necessary to develop an overall jurisdictional EHR. These components include: Health Information Access Layer (HIAL), the Core Drug Information System (DIS), as well as the Client, Provider, and Location Registries. Additionally, the solution provides a robust Data Warehousing (DW) and reporting component. Communications with the solution is through a series of interfaces and Application Programming Interfaces (APIs) utilizing the HL7v3 messaging standard. Solution Component Diagram
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information The available solution components illustrated in the above diagram are summarized below. Client Registry The CR provides the authoritative source of client demographic and identity information. Additional details can be found in Section 2.4.2. Provider/Location Registry The PR is the single source of information about licensed health professionals authorized to use the Newfoundland and Labrador EHR. The PR also includes a location table, used to provision location information. Additional details can be found in Section 2.4.3. Health Information Access Layer The HIAL acts as an abstraction layer to integrate PoS applications with the EHRi. It is comprised of service components, service roles, information models, and messaging standards required for the exchange of EHR Data and the execution of interoperability profiles between EHR Services. It is aligned with Infoway EHRS Blueprint version 2 (www.infoway-inforoute.ca), employing a full Service Oriented Architecture which allows services to be integrated into an overall health solution. Additional details can be found in Section 2.4.6 Picture Archiving and Communications System Newfoundland and Labrador’s first Picture Archiving and Communications System(PACS) was implemented in 1998 with a project goal to provide access to Any patient, Any image, Any report, Anywhere and Anytime (A5). The PACS system enables filmless capture and transmission of a patient’s radiology test results across the province. The PACS project and PACS technology aligns with Newfoundland and Labrador’s ongoing efforts to create an integrated EHR across all healthcare stakeholder levels, programs, and services. PACS contributes to an electronic longitudinal record for all health interactions of a patient in their lifetime. Additional details can be found in Section 2.4.7.
Drug Information System The DIS is the provincial domain repository of prescribed and dispensed medications. It contains a patient specific medication profile. The Newfoundland and Labrador Drug Information System is part of the Province of Newfoundland and Labrador’s EHR. It supports the province to move towards the provincial vision of improving the quality, safety, and delivery of patient care for the citizens of Newfoundland and Labrador through the provision of more complete and timely pharmaceutical information to healthcare providers. Additional details can be found in section 2.4.4. Data Warehouse The DW is an EHRS data repository that stores data and provides a reporting mechanism to support retrospective analysis, research, and audit reporting. The DW stores data from the DIS, HIAL, CR and PR/LR. Additional details can be found in section 2.4.5.
1.4.3 Next Steps The delivery of iEHR/Labs will occur in parallel with other initiatives underway or planned to start in the near term. Of particular note is the Electronic Patient Records project. Note that work related to this project is out of scope for the RFP.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
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Electronic Patient RecordsThe province of Newfoundland and Labrador envisages an environment where clinicians and health administrators can reliably interpret, compare, and consolidate Electronic Patient Record (EPR) information from separate healthcare facilities using information provided in a consistent format, with standardized definitions throughout all regions in the province. This information will be accessible to authorized users on a broad and equitable basis across the province. Achieving this environment is expected to improve the quality, consistency, and accessibility of electronic patient information, leading to improved quality of patient care and reduced medical errors. The EPR (MEDITECH) system is a PoS and primary contributor to the EHR, leveraging the information and investment the province has made to improve patient care. All of the province’s hospitals and many of the healthcare facilities and programs obtain their core clinical and administrative systems services from nine (9) individual instances of the MEDITECH Magic and MEDITECH Client Server Hospital/Clinical Information System (HCIS). There is ongoing work within all regions to implement some level of consolidation of these systems. The province’s goal is consolidation into one MEDITECH system province-wide.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
2.0 Program Scope
2.1 Program Strategy The addition of a jurisdictional lab domain and a SHR domain will complete the primary clinical domains required to support the provincial iEHR. An additional key component of the iEHR to be deployed during Phase 2.2 of the iEHR/Labs project is the EHR Desktop Viewer. This is required to support multiple domains including access to information in the existing DIS domain and the registries (CR, PR, and LR). Procuring, configuring, testing, and deploying these components will require a substantial amount of collaboration and cooperation from all current and future vendors involved with the NL EHR. The conceptual solution view is illustrated below. .
Newfoundland and Labrador Desired Future State (2012)
Ensuring seamless integration and interoperability between these components so that business requirements are fulfilled and the solution is effectively adopted is the principal program objective. Some guiding principles and goals are:
� Deliver a private and secure EHR service complying with legislation and policy;
� Leverage existing RHA investments;
� Incorporate the various functional components and operational structures developed by past and current EHR projects into cohesive provincial architecture and solution;
� Promote broad involvement, participation, and support of appropriate provincial Stakeholders;
� Enable the controlled sharing of EHR data across the continuum of care;
� Acquire, build or leverage, integrate, and deploy the essential components of an EHRi; (including critical HIAL services, a clinical data repository for laboratories, and other shared clinical records);
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� Integrate a variety of jurisdictional systems in order to establish the complete set of services required to create a working EHRi;
� Implement a solution founded on a comprehensive enterprise architecture where business needs and motivations drive the technical solution; and
� Implement workable but extensible standards that align with those established or being developed by the pan-Canadian EHR standards collaboration process.
2.2 RFP Deliverables This RFP scope is the acquisition of solution components and related professional services for three (3) components described in the following sections.
1. Jurisdictional Laboratory Information System (JLIS) – Section 2.2.1;
2. EHR Desktop Viewer (multi-domain viewer) – Section 2.2.2; and
3. Shared Health Record Domain Repository (SHR) – Section 2.2.3.
The JLIS, EHR Desktop Viewer and SHR implementation influence, and are dependent upon the development of other components which are outside the scope of this RFP and are considered part of the HIAL Extension work. The HIAL Extension work includes all PoS communications, EHR Index, Consent Management Services, and DIS Integration.
2.2.1 Jurisdictional Laboratory Information System The JLIS implementation deals with the acquisition of a COTS repository to provide the Newfoundland and Labrador EHR with a Lab Domain. Although it is expected that the JLIS will store all lab related information, the following statements reflect the initial deployment scope:
� It will accept and store lab information on a go forward basis only; there will be no conversion of existing data;
� It will receive lab information from at least one PoS (or more instances of the remaining MEDITECH implementations (after consolidation of the nine (9) MEDITECH systems that are currently integrated with the CR), which excludes the Public Health Lab);
� It will accept and store lab results and orders; and
� It will initially accept and store the following lab results:
o General Hematology;
o Blood Bank;
o Microbiology; and
o Pathology.
2.2.2 EHR Desktop Viewer with Multi-Domain Support The EHR Viewer will provide multi-domain display of patient data contained in the EHR Registries and domain repositories. It is expected that the viewer will use HL7 v3 messaging for data query and response. The domains include the SHR (including Diagnostic Imaging (DI) reports), JLIS (Lab, Microbiology, Pathology, and Blood Bank),
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
and DIS repositories. The registry data includes CR and PR/LR. The existing registries may be used for such functions as:
� Search for patients by a variety of identifiers including demographics;
� Resolve provider identity using the PR; and
� Resolution of service location using the Location Registry (LR).
2.2.3 Shared Health Record Completing the suite of EHR data domain repositories, the project will implement the SHR. As described in the EHR Blueprint, the SHR repository and its associated services are the mechanism for sharing all person-specific, clinically relevant data not held in other domain repositories. The sharing of clinical data in the SHR will align with pan-Canadian nomenclature, terminology, and messaging standards where appropriate, while also exploring opportunities such as synoptic reporting. The following statements define the scope of the SHR:
� It will accept and store information on go forward basis only; there will be no conversion of historical information; and
� It will receive information from PoS systems (e.g. MEDITECH).
The SHR content may include the following information from MEDITECH:
� Patient Encounter information;
� Clinical Reports (e.g. Discharge Summaries, Specialist Reports); and
� DI Reports – the DI domain provides for the provincial PACS solution, the storage of DI and the most current version of the report. In order to provide wider viewing for the DI reports and to provide for viewing report versions like in other jurisdictions, these are being placed in the SHR.
Although the domain is required to store all SHR related data, it is expected that the initial deployment will be constrained to the electronically available data from the health care environment. The initial focus will be on clinically relevant electronic data from the current PoS (MEDITECH) systems.
2.3 Business Perspective The project solution, from a business perspective, will deliver health information in a private and secure manner that enables sharing of EHR data across the continuum of care. The solution architecture and design is driven by the requirements of providers and patients to access relevant health information when and where it is needed to deliver high quality care and to produce improved health outcomes. Patient safety, privacy, quality of care, and process efficiencies are important business drivers and support key health priorities established by the government. From the solutions developed in other provinces and research by Infoway, many clinical and operational benefits can be expected from this fundamental EHR service, including:
� Reducing duplicate laboratory testing;
� Enabling better co-ordination across the care team;
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� Managing concerns about privacy and security of patient’s personal health information;
� Providing immediate electronic access to lab results and history;
� Facilitating efficient delivery of care;
� Supporting chronic disease management;
� Providing a standard vocabulary for results and orders;
� Complying with mandatory public health reporting requirements;
� Reducing resources required at the regional level to provide point-to-point interfaces between the local LIS and physician EMRs;
� Providing better aggregate data for policy analysis and business planning; and
� Research and trend reporting with de-identified data.
Interoperability between registries, domain repositories, and the provider systems are essential for a fully functional patient-centric EHR. Greater emphasis on standards and policies will support greater integration between provider systems to e-Health assets such as EMR and the EHR Desktop Viewer. The value of core health data which can be readily shared, (such as that contained in the SHR), will continue to be stressed. In Newfoundland and Labrador the recently released Commission of Inquiry on Hormone Receptor Testing1 (otherwise referred to as ‘the Cameron Report’) has emphasized the need for an integrated and comprehensive view of patient data – enabling community physicians and specialists to monitor their patients more effectively throughout the continuum of care. This notion is also emphasized in Infoway’s strategic statement about development and investment in foundational components for the next decade, where the integration of the EMR with the EHR is considered fundamental:
Enabling seamless communication across the continuum of care and into community-based settings. This would include integrating primary care physicians, specialists, and community care facilities (e.g. through EMRs).2
2.4 Technical Landscape In order to fully comprehend the three (3) components to be implemented as part of Phase 2.2 and to respond to the requirements outlined in this RFP, an understanding is required of the current Newfoundland and Labrador implementation of the Infoway Blueprint, and specifically the components for which there is dependence. This section is divided into three (3) main subsections
1. Newfoundland and Labrador EHRS – Section 2.4.1;
2. iEHR/Labs Project Integration Components – Section 2.4.2; and
1 Cameron Cameron, Honorable Margaret A. (2009). Commission of Inquiry on Hormone Receptor Testing. St. John’s, NL: Government of Newfoundland and Labrador. 2Canada Health Infoway, 2015: Advancing the Next Generation of Health Care in Canada.
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3. Technical Architecture – Section 2.4.3.
The aim is to provide a comprehensive understanding of the Newfoundland and Labrador EHRS in order for the Respondent to provide an insightful and accurate response to this RFP.
2.4.1 Newfoundland and Labrador EHRS The Newfoundland and Labrador jurisdiction has been adding components to the EHRS since 1998 starting with the PACS system. A conceptual diagram of the current state of the EHRS can be seen below, followed by a description of each component.
2.4.1.1 Client Registry The CR provides the authoritative source of client demographic and identity information. The CR plays three (3) important roles in the EHR Infostructure:
1. A trusted source of personal information. The CR is the single authoritative source and the only source of demographic information about persons recognized as clients/patients of the health system.
2. A reliable cross-reference of all patient identifiers belonging to the same person. The CR provides the capability to resolve the multiple identifiers that may be used across multiple systems to identify a single client.
3. An authoritative source of the unique identifier to be used by the iEHR (e.g. the Enterprise Client Identifier (eCID)). In a typical scenario of a transaction between a PoS application and an EHR, the CR service will always be queried to resolve the identity of the client involved in the transaction. In the response to this query, upon a successful resolution, the CR will provide an eCID that will then be used in the context of the individual transaction that is to be completed in the EHRi. The eCID is an internally generated identifier available to the systems that participate inside an
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
EHRi. This process ensures that the management of client identifiers between systems that participate in the EHRi can be optimized, and that data integrity challenges associated with client identification merge/unmerge and link/unlink operations can be adequately managed within the EHRi.
The CR currently integrates information into an individual’s record from the demographic and administrative data from the regional MEDITECH systems, the Client and Referral Management System (CRMS) used in community health, and the provincial health insurance plan (Medical Care Plan (MCP)), as further detailed below:
� Client and Referral Management System: The CR interaction with CRMS allows for adding demographics, updating demographics, merging persons, and adding event information from an Oracle table in the CRMS database. Two-way passive updates are sent to an Oracle table in the CRMS database.
� Medical Care Plan: The CR interaction with MCP allows for adding demographics, updating demographics, and merging persons through a batch file. Two-way passive updates are sent to MCP via a batch process.
� MEDITECH: The CR Interaction with the nine (9) MEDITECH systems allow for adding demographics, updating demographics, merging persons, unmerging persons, and adding event information from MEDITECH via HL7v2.1 Transmission Control Protocol/Internet Protocol (TCP/IP) transactions. Active-mode query and response use a multi-threaded interface to and from MEDITECH via HL7v2.1 TCP/IP transactions.
� Health Information Access Layer: The HIAL can add demographics, update demographics, merge persons, unmerge persons, add event information, and query/response multi-threaded interface to and from the HIAL via HL7v3 XML transactions. The CR sends Revise and Merge notifications to the HIAL via HL7v3 XML transactions. The CR currently communicates with the HIAL via HL7v3 messages, while the remainder communications are a combination of ad-hoc communications and HL7v2.x messages.
� Digital Imaging/Picture Archiving and Communications System: The CR interacts with the Integrating the Healthcare Enterprise (IHE) Patient Identifier Cross-Reference (PIX) adaptor through a query/response multi-threaded interface to and from GE PACS as well as an update notification to GE PACS via HL7v2.5 TCP/IP transactions.
2.4.1.2 Provider and Location Registry The PR and LR provide the unique identification of care providers and provider locations. The Newfoundland and Labrador PR is targeted as the application solution to fulfill the PR and LR functions within Newfoundland and Labrador. The PR provides consistent, timely and accurate information about healthcare providers and how they can be contacted for communication and information exchange. The LR function provides for the unique identification of all locations in Newfoundland and Labrador where health services are provided. The Newfoundland and Labrador PR will contain this location information for the purpose of identifying every location in the province where healthcare practitioners provide health services. The PR is accessed by PoS systems via the HIAL using HL7v3 messages.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
The PR, an essential component of the EHRi, was implemented as part of the Pharmacy Network deployment, and communicates with the HIAL via HL7v3 messages. Information included in the PR is supplied by the regulatory organizations for each profession. Daily imports from licensing bodies are accomplished through a two (2) step transfer and Extract, Transform, Load (ETL) process. The source organizations initiate a secure File Transfer Protocol (FTP) session to transfer a flat file to the Newfoundland and Labrador PR demilitarized zone (DMZ) server. The flat files are retrieved from the DMZ by the PR Application server and are loaded into the Provider/Location registries.
2.4.1.3 Drug Information System Domain The DIS provides a complete summary of prescribed and dispensed drug information for clients. The DIS also stores allergy and immunization information for clients. The core drug information services support a high-availability configuration and are housed in multiple schemas on an Oracle database. The schemas represent the drug master information, the patient drug/drug utilization review history, privacy access records, and consent records. The DIS provides decision support capabilities by monitoring prescriptions against the patient’s active medications and their personal profile. Pharmacy Practice Management Systems (PPMS) and the Care Provider Portal (CPP) integrate with the DIS Domain via the HIAL using HL7v3 CeRx messages.
2.4.1.4 Data Warehouse The DW provides an infrastructure for storing, analyzing and reporting on data extracted from the EHR. The infrastructure provides data warehousing for data that will be used in analysis including public health reporting. Data is fed to the Reporting Infrastructure by the HIAL as appropriate and stored in a structure suitable for reporting. The reporting infrastructure includes:
� The extraction, transformation, cleansing, and loading of data into the DW;
� The creation and management of metadata;
� The ability to generate pre-defined graphical reports on an ad-hoc or scheduled basis;
� Delivery of reports through HTTP download, FTP, or secure e-mail;
� Generation of reports in Excel, flat file formats, HTML, XML, and PDF;
� The ability to limit access to view and/or create reports to groups of users;
� The ability to monitor and manage the creation and delivery of reports; and
� The ability to create Online Analytical Processing (OLAP) cubes (on a scheduled basis) and make these cubes available to defined users when reports are run.
The DW receives data on a nightly basis from the DIS, HIAL, and Client, Provider and Location Registries. The data is collected by the HIAL and sent to the DW for extraction, transfer, and load.
2.4.1.5 Health Information Access Layer The HIAL, as the central processing point for all Newfoundland and Labrador EHR transactions, provides numerous services. At a high level, the HIAL provides the interactions between the PoS systems and the components of the iEHR. HIAL services
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
include the protocol, messaging, and integration services used to implement the HL7v3 interfaces that support communication with the EHRS components. The conceptual service layer diagram below illustrates the HIAL service offering:
A summary of the HIAL services are defined in Appendix A and listed in the following sections:
2.4.1.6 Data Services Interface Services: The primary interfaces use HL7v3 messages communicated using simple object access protocol (SOAP) over HTTPs; however, the HIAL Protocol, Messaging, and Integration services allow it to support import and export data in a wide variety of formats including HL7v3 or other XML dialects, HL7v2.X, EDI, and other structured and flat file formats provided the appropriate transformations are defined and built. This capability along with the web services integration tools, message queuing, and workflow services, which are also part of the HIAL, are utilized to integrate third-party vendor software and build the interfaces required to interact with them. The interfaces currently supported by the HIAL include:
� Core DIS Interface;
� Drug Utilization Review Interface;
� Adverse Drug Reaction Interface;
� eTherapeutics Interface;
� Operations Interface;
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� Admin Interface;
� ETL Interface;
� Metadata Services; and
� Replication Services.
2.4.1.7 Common Services Several common services are provided by the HIAL, which are defined in Appendix A, and listed below:
� Integration Services;
� Queuing Services;
� Mapping Services;
� Broker Services; and
� Service Catalog.
2.4.1.8 General Services The general services provided by the HIAL are defined in Appendix A, and listed below:
� Audit Services;
� Log Management Services; and
� Exception/Error Handling Services.
2.4.1.9 Context Services The current context management services provided by the HIAL can be defined as the Session Management Service: The architecture provides a means to disable user sessions that have been idle for a considerable amount of time; future communication from that user will require re-authentication. The default time out period is configurable and specified by the system administrator.
2.4.1.10 Interoperability Services The following interoperability services are available within the HIAL, and further described in Appendix A:
� Client Registry Service;
� Provider Registry Service;
� Location Registry Service; and
� Longitudinal Record Services (LRS).
2.4.1.11 Privacy Services The following security and privacy controls are integrated within the EHRS architecture currently in place:
� Consent;
� Masking;
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� Registration;
� Role-Based Authentication & Authorization;
� Audit & Logging;
� Certificate Support; and
� Network Security.
The following privacy services are provisioned by the HIAL:
� Right to Use Services;
� Consent Management Services; and
� Privacy Audit Services.
2.4.1.12 Security Services The security services provided by the HIAL include:
� Digital Signature Services;
� Electronic Signatures;
� Two-Factor Authentication;
� Identity Management Services; and
� Access Control Services
2.4.1.13 System Authentication Services The system authentication services provided by the HIAL include:
� User Authentication Services;
� Alert and Notification Services; and
� Publish and Subscribe Services.
2.4.1.14 Communication Services The HIAL supports several communication services, listed below, and further defined in Appendix A:
� HIAL Rx API;
� Batch API;
� RxDesktop API;
� Messaging Services;
� Transformation Services;
� Parser Services;
� Routing Services;
� Encoding/Decoding Services;
� Serialization Services; and
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� HIAL Business Services.
2.4.1.15 HIAL Workflow Services The BPM workflows are defined using a graphical design tool which allows a number of steps to be coordinated in order to complete the required business functionality. Steps can be completed sequentially, in parallel and can be synchronized as necessary. The HIAL workflow services include:
� Normalization Services; and
� Assembly Services.
2.4.1.16 PACS The PACS architectural solution involves the integration and interaction of the network and PACS infrastructure architecture across regions, and the creation of a single provincial system and structure. A single, central repository of all diagnostic images and report results is available to authorized users in all regions of the province. The PACS system communicates using the Health Information Network (HIN), which is a private network using MPLS technology. PACS currently interacts with the Client Registry directly using HL7V2.5 messages. The PACS aims to make more than 95% of all provincial Diagnostic Imaging department managed exams and reports available to all provincial Radiologists and physicians 98% of the time, predominantly on site, but also off-site as much as is currently necessary by these same timelines.
2.4.1.17 Health Information Network The HIN is composed of two (2) distinct comprehensive and secure province-wide networks that are provisioned using Multiprotocol Label Switching (MPLS), one that connects the RHAs and one that connects the Pharmacies to the EHRS.
2.4.1.18 Admin Portal The AP provides the web pages through which the government and related agencies interact with the Pharmacy Network. The AP is implemented using the webMethods portal and BEA WebLogic products. The Portal provides a flexible GUI framework into which the required Administration functionality can be integrated and through which a standardized authentication framework is deployed. The Portal provides the framework for integrating and personalizing pages from third-party applications (portlet-level integration), while the WebLogic application server provides the base for new pages and business logic that will be developed following the J2EE standard. The WebLogic application server hosts an RxDesktop API-like software component written in JAVA that handles the creation and consumption of HL7v3 messages. GUI components call this server side application that then interacts with the HIAL Rx API to complete the requests. Audit, Error, and Event Handling events within the portal however utilize the existing components within HIAL. The functions provided by the AP include:
� Profile Request Handling;
� Management of masking/un-masking;
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� Management of clinical access control keywords;
� Management of Broadcast Messages;
� Management of Consent;
� Management of ADR Reports;
� Prescription/Dispense Error Resolution;
� Access to retrospective reporting functions (DW);
� AP user management including RSA Secure Token administration; and
� Searching (Client, Provider, and Location Registries).
2.4.2 iEHR/Labs Project Integration Components As part of the Newfoundland and Labrador iEHR/Labs project, a number of EHRS components will be added to the Newfoundland and Labrador existing infostructure to progress the EHRS objective. The three (3) components (JLIS, EHR Desktop Viewer, and SHR) described below are the components required as part of this RFP. The remaining components fall under the HIAL Extension work which is; all PoS communications, EHR Index, Consent Management Services, and DIS Integration. The HIAL Extension is required to support the iEHR/Labs project however out of scope for this RFP.
2.4.2.1 Jurisdictional Laboratory Information System The major domain repository to be completed in Newfoundland and Labrador is the JLIS. It will contain information on a go forward basis concerning laboratory tests performed in the province. The JLIS is envisioned to support the storage and retrieval of lab orders.
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The JLIS repository will initially be populated with laboratory results generated from MEDITECH HIS systems that include (but are not limited to) Laboratory, Microbiology, Pathology, and Blood Bank transaction modules. The JLIS repository will also provide an outbound HL7v3 message containing the metadata that will be used to populate the EHR Index for each inbound JLIS add/update/nullify transaction.
2.4.2.2 EHR Desktop Viewer The EHR Desktop Viewer will provide multi-domain display of patient data contained in the domain repositories using an HL7v3 messaging interface. The domains include the SHR (including DI reports), JLIS (Lab, Microbiology, Pathology, and Blood Bank), and DIS repositories. This inherently includes registry data (CR, PR, and LR). The existing registries will be utilized to:
� Search for patients by a variety of identifiers including demographics;
� Resolve provider identity using the PR; and
� Resolution of service location using the LR.
2.4.2.3 Shared Health Record As described in the EHR Blueprint, the SHR repository and its associated services are the mechanism for sharing of all person-specific, clinically relevant data not held in other domain repositories. The sharing of clinical data in the SHR will align with pan-Canadian nomenclature, terminology, and messaging standards where appropriate while also exploring opportunities such as synoptic reporting for the sharing of clinical data in the SHR domain. The SHR influences and is dependent upon the developments within two (2) other areas:
1. PoS Integration – new HL7v3 interfaces have to be developed and implemented in order to provide the information to the SHR domain repository via the HIAL; and
2. HIAL Extension – the HIAL has to be enhanced in order to create the new SHR I-IP that will orchestrate the necessary services that will allow the information in these new messages to be processed by the SHR repository.
The components described in the next sections are out of scope for this RFP. They are provided for information purposes to convey the work that iEHR Phase 2 will contain. Specifically, these sections are:
1. HIAL Extension – Section 2.4.2.4
2. EHR Index Communications– Section 2.4.2.5
3. Consent Management Services – Section 2.4.2.6
4. DIS Integration – Section 2.4.2.7
2.4.2.4 HIAL Extension PoS Communications: New HL7v3 messages from POS systems (e.g. MEDITECH) will be sent to the HIAL. The HIAL will have to process these messages and deliver them to the applicable EHRi component. The HIAL will have to deal with the inbound messages for types of data including, but not limited to:
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� Patients;
� Patient Encounters;
� Clinical Reports;
� DI Orders;
� DI Reports;
� Lab Orders; and
� Lab Results.
Domain Communications: The HIAL will have to process and deliver the following types of messages to the new SHR Domain:
� Patient Encounters;
� Clinical Reports;
� DI Reports; and
� DI Orders.
The HIAL will have to process and deliver the following types of messages to the new Lab (JLIS) Domain:
� Lab Orders; and
� Lab Results.
The HIAL LRS services will have to maintain entries to the new EHR Index and keep them synchronized with the entries that are placed within the EHRi Data Domains. The HIAL will have to perform validations against the CR, PR, and LR as part of verifying new messages for the SHR and Lab (JLIS) Data Domains. The HIAL will perform updates to the EHR Index based upon any eCID notifications received from the CR, so that entries in the Data Domains are attributed to the correct patient. The HIAL has to support additional query/responses messages for the new EHR Desktop Viewer to acquire and display information from the EHRi Data Domains. The HIAL will receive query/response messages from the viewer for the following repositories:
� CR;
� PR;
� LR;
� SHR Domain;
� Lab (LIS) Domain; and
� DIS Domain.
The HIAL will also have to be enhanced to provide additional Terminology Services to support the display of information in the EHR Desktop Viewer. In situations such as Logical Observation Identifiers Names and Codes (LOINC) used in Lab Results, the
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result is stored with just the applicable code, with no code description. The HIAL will have to invoke the Terminology Service in order to provide code description lookups to support data viewing.
2.4.2.5 EHR Index EHR Index is a HIAL component that provides both a summary of the patient’s clinical results as well as pointers to where the detailed data is maintained. The index could possibly hold an indicator for the ‘existence of consent directives’ – allowing consent processing to occur only when directives are known to exist.
2.4.2.6 Consent Management Services Currently, consent is implemented within the drug information system domain and is not a full HIAL service. The upgrade of Consent Management is another key enhancement to the current HIAL. The level of granularity and the deployment model will be concluded in Phase 2.1, so that it can then be designed and implemented in the HIAL. Consent Management components of the HIAL will need to be added to support the addition of the SHR, JLIS, and EHR Desktop Viewer. Consent directives must be stored centrally and applied either on the outbound view request or on the inbound result data.
2.4.2.7 DIS Integration DIS integration consists of enabling the EHR Desktop Viewer to access the data held in the drug information system to contribute to the patient’s longitudinal health record. The existing system must be expanded to include:
� An outbound HL7v3 message to convey the metadata to the EHR Index for each inbound DIS patient related transaction; and
� Query capability (get/list) for providing drug information to the EHR Desktop Viewer that will provide the details of the DIS transactions to the viewer through the HIAL.
� The DIS may require changes to adapt to the implementation of consent management at the HIAL.
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2.4.3 Technical Architecture
2.4.3.1 Overview The diagram below, EHR Network Zones, depicts the security zone segregation of EHRS components for Newfoundland and Labrador. EHR Network Zones
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
The architecture is designed as a tiered model, providing the appropriate separation of processing, controls, and monitoring. The data centre in which the Pharmacy Network Solution runs is connected to the HIN. The solution supports a tiered model within the data centre with the following zones: Untrusted, Semi-trusted, Trusted, and Management. In each zone, further segregation is provided with Virtual LAN’s (VLAN). The security zones are further described below: Untrusted Zone: The purpose of this zone is to provide the infrastructure transport that will allow users or systems to access the EHRS. Redundant Layer 2 switches plug into the various routers and switches that are used as transport infrastructure to the Untrusted zone. Semi-Trusted Zone: The purpose of this zone is to host the portions of the EHRS that are client facing (e.g. users and/or systems connect to a component hosted within the Semi-Trusted zone). This zone is separated between it and the Untrusted zone by a Sidewinder Firewall. Access through this firewall is restricted by both IP (e.g. only allow from pre-defined source IP addresses) and port. Redundant Layer 3 switches are used as transport infrastructure within the Semi-Trusted zone. These redundant switches use Access Control Lists (ACLs) to control access between Semi-Trusted subnets by only allowing defined IP-to-IP communication across defined ports. Trusted: The purpose of this zone is to host the portions of the EHRS that are not client-facing. Connections to servers within the trusted zone may only be made from servers in the semi-trusted zone (e.g. users and/or systems residing in the Untrusted zone cannot connect to a component hosted within the Trusted zone). This zone is separated from the Semi-Trusted zone by a Sidewinder firewall. Access through this firewall is restricted by both IP (e.g. only allow from predefined source IP addresses) and port. Redundant Layer 3 switches are used as transport infrastructure within the Trusted zone. These redundant switches use ACLs to control access between Trusted subnets by only allowing defined IP-to-IP communication across defined ports. Management: The purpose of this zone is to host the portions of the EHRS that are of an operational nature (e.g. backups, consoles, etc.). Connections to servers within the management zone may only be made from trusted sources involved with the day-to-day operation of the EHRS components.��This zone is separated from the other zones by a Layer 3 switch. Redundant Layer 3 switches are used as transport infrastructure within the Trusted zone. These redundant switches use ACLs to control access between all other zones by only allowing defined IP-to-IP communication across defined ports.
2.4.3.2 Environment Overview The Newfoundland and Labrador EHRS is currently provisioned using four (4) distinct environments, described below: 1. Production: The production environment is the live environment where the actual
transaction and messages are delivered and processed. The Newfoundland and Labrador Pharmacy Network solution production environment is designed to support, at minimum, 99.9% availability Service Level Agreement (SLA). All core systems, software and network devices are redundant both internally within the individual equipment items (e.g. power supplies, hard drives, etc.) and externally within
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functional groups of equipment (e.g. active/active clustered servers, active/passive network equipment, etc.).
2. Disaster Recovery: The disaster recovery (DR) or failover environment is a “warm
stand-by” environment in the event that the Production environment at the primary data centre is rendered unavailable for an extended period. The Newfoundland and Labrador EHRS DR environment is designed to support the anticipated transaction volumes. However, to maintain a robust yet simple and cost-effective failover design, only internal redundancy within the individual equipment items is utilized.
3. Staging: The pre-production or staging environment is used for acceptance testing
of the Newfoundland and Labrador EHRS prior to “going live” in the production environment. The design approach in the pre-production environment is to provide a staging environment where the solution “looks, feels and behaves” in the same manner as it will function in production. While maintaining the same behaviour as production, several key differences from a technical architecture perspective are used in the design:
� As a staging environment, no “live” data (e.g. actual messages with identifiable private health information) is used during testing;
� Data sets are significantly smaller than those that exist in production;
� Only internal redundancy within the individual equipment items is utilized (e.g. use redundant components within systems such as power supplies and hard drives but do not utilize clustered or failover equipment); and
� Servers are always of the same class as Production, however some server sizing will have a slightly lower capacity (e.g. reduced processor power, smaller amounts of physical memory, etc.).
4. Development and Testing: The development and testing environments are used to develop, assemble, and test the Newfoundland and Labrador EHR components prior to the release into the pre-production (staging) environment. These environments have the same design, utilizing identical network topology, server classes, but not the high-availability approaches as the production environment. As with pre-production, these environments provide a test bed where the solution “looks, feels and behaves” in the same manner as it will function within production. It is expected that multiple virtual environments will be provisioned within this environment, to facilitate multiple initiatives without any impacts or constraints.
Performance Characteristics of the Environments
System Availability All server-based hardware is equipped with multiple power supplies, multiple network and Storage Area Network (SAN) cards (with supporting multi-pathing software) and mirrored on-board disks in order to sustain a localized component failure.
Clustering hardware (e.g. load balancer) and software (e.g. Veritas Cluster and Oracle Real Application Cluster) is utilized to handle a node failure. Specifically heartbeat monitors within the build-in cluster software react when a node goes offline and directs all traffic to the on-line node. When the off-line node comes back on-line, the heart-beat
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Performance Characteristics of the Environments
returns the nodes to a clustered state.
Network Availability All network components (switches, firewalls, and routers) are deployed in a failover network configuration with additional availability options such as redundant power supplies. As all firewalls, load balancers and servers are multi-homed (plugged into both primary and failover switches), in the event of a failure of one component, the failover component will be automatically engaged through CiscoWorks management software thus maintaining a constant service to the network layer. In addition, redundant telco links from the Pharmacy Network to the PR and LR host (Medavie) are provided.
Storage Availability An enterprise class SAN is used that employs mirrored disks with hot spares, redundant controllers and multiple power supplies with a multi-path SAN network fabric. A RAID-10 configuration is used for disk configuration to allow for sustained uptime in the event of a disk failure whereby a hot spare disk is added to the affected storage logical unit.
Application Availability All HIAL based solutions benefit from the clustering features supported by the core components. The system is configured as a number of independent nodes, with each node running a copy of the operating system and one or more instances of the application components. Once multiple instances of the application components are running on nodes within the solution, these nodes are then clustered together to form a fully redundant solution whereby the failure of any node leaves the solution with at least one copy of each of the application components still running. Node and application component instance failures are detected in real-time through built-in heart-beat monitors in order to allow system reconfiguration such that the work load is taken over by the remaining nodes or application component instances in the cluster. There are service monitor daemons running which feed information to an up front load balancer. If there is no response for requests made to a particular application component instance within a specified time, the load balancer will consider that instance non-operational and remove it from the available list. When the load balancer detects that the instance is back on-line it is added back to the list.
In addition this architecture allows a group of nodes to be transparently put online or taken off-line for scheduled or unscheduled maintenance, while the rest of the cluster continues to provide database service.
Database Availability Database availability is achieved through use of Oracle’s Real Application Clusters (RAC). RAC provides a single database system that spans multiple hardware systems yet appears to the application as a single database system. Since the physical nodes run on separate server nodes, the failure of one or more nodes will not affect other nodes in the cluster.
In addition, this architecture allows a group of nodes to be transparently put online or taken off-line for scheduled or unscheduled maintenance, while the rest of the cluster continues to provide database service.
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2.4.3.3 System and Network Monitoring System monitoring & reporting provides insight into the operation and status of the EHRS domain and HIAL components and the connectivity and communications with such other components such as the CR. Agents installed on all components within the system provide live monitoring for such metrics as network, applications, CPU utilization, and disk capacity, among others. The system is capable of producing specific reports showing key measures for distinct components. Data collected by the monitoring system is loaded nightly into the DW where the common reporting infrastructure can then produce additional reports as required. The systems monitoring solution includes the various tools and processes, to ensure that all application and network systems operate at their peak on a day-to-day basis. The following systems management services and associated tools will be utilized:
� System Monitoring;
� Fault Management;
� Configuration Management;
� Performance Management; and
� Security Management.
The primary monitoring and reporting tools used within the EHRS are HP OpenView Operations for UNIX module and Cisco’s CiscoWorks Suite. In addition Oracle Enterprise Manager and Mercury Site Scope are used as secondary monitoring tools. A brief overview of highlights within the two (2) primary tools is as follows:
1. HP OpenView Operations for UNIX module
� Provides a single-pane-of-glass management that monitors, filters, correlates and responds to events, enabling central management control over the environments and provides at-a-glance overall availability, performance, and reliability statistics;
� Colour coding of events into six different states indicates the severity of a failure or performance degradation. Operators can drill down to information about available actions and annotations attached to a message; and
� A central data repository stored within a local Oracle database holds all information necessary for running reports, audits and for maintaining the environment. It stores data about active and historical events and configurations. Further, it logs any activities, such as performed actions.
2. Cisco’s CiscoWorks Suite
� Provides a browser representation of Cisco router and switch devices, colour-coded to indicate operational states, to provide visibility into the health and capability of the network, and identification/localization of network trouble;
� Includes operationally focused tools capable of fault management, scalable topology views, sophisticated configuration, Layer 2 and 3 path analysis, WAN performance troubleshooting, end station tracking, and device troubleshooting; and
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� Intelligently analyzes fault conditions, detecting problems before they become network disruptions. Smart Plug-ins provided by HP Open View allow for data collected by Cisco Works to be stored within the Open View central data repository.
2.4.3.4 Business Monitoring and Reporting The monitoring of Business Processes, which manages the flow of messages between the domains and the registries through the HIAL, will be managed utilizing webMethods Monitor. Monitor has the capacity to graphically monitor the business process flow of a message through the system in real-time. Monitor captures business and performance metrics of message events and can be configured to capture additional information within the message to aid in statistical analysis. webMethods Monitor will monitor and capture data to support the required Operational Reports. Reports will be produced either directly from the Monitor database or from the DW depending on the complexity of the report requested. To support this, a nightly extract from the webMethods Monitor database within the HIAL will be extracted and loaded into the DW.
2.4.3.5 Disaster Recovery The DR approach is to use a “warm site” whereby an allowance for the recovery of all critical services will be required in a 12-24 hour recovery time period with near-zero data loss. This is achieved by having dedicated equipment at the alternate site. All alternate site equipment is running and operationally monitored from the primary site. Applications are pre-installed but not operational. While the DR solution requires business integration to validate target Return Time Objectives (RTO)/Recovery Point Objectives (RPO) objectives, on a technical level, the architecture is designed to support the following:
� RTO: 24 hours or less; and
� RPO: seconds to minutes.
The recovery environment is architected to support production-level performance and capacity requirements; however no redundancy will be utilized at the failover site to maintain cost-effectiveness of the implementation and take a simple approach to maintenance. It is designed to support a worst-case scenario where all components at the primary site become unavailable. The production environment is networked to the recovery centre by a high-speed communications link. A combination of hardware and software perform real time replication between the two sites providing the ability to recover to the point of failure, ensuring near-zero data loss. All database changes are immediately replicated to the alternate site. Application integrity is maintained through the standard change management process where code, configuration and parameter files are first installed at the primary site and once confirmed to be successful, migrated to the alternate site. To replicate data from the SAN volumes in production to the SAN volumes at the DR site, Sun’s Storage Availability Management remote mirror software maintains data synchronization in an asynchronous mode on the volumes at all times. In asynchronous mode, once data files have been added or changed on the production SAN, they are replicated across the dedicated network link to the SAN at the DR site. This remote mirroring software resides on the Management server.
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31
In the event of a planned or unplanned outage, remote mirror software maintains per device bitmap volumes that are marked to indicate changed blocks with a granularity of 32 kilobytes (KB) per segment. This helps speed and optimize resynchronization because the software only has to resynchronize blocks that have changed. Geographically dispersed Domain Name System (DNS) servers combined with low Network Time-to-Live (TTL) values allow global IP redirection to occur in a matter of hours.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
3.0 Proposal Requirements and Content
This section outlines the requirements and RFP content that the Centre will use to evaluate the Respondent’s business, proposed solution and a description of how it meets the more detailed requirements in Section 4. In addition to the specific requirements, responses will be evaluated on their quality, clarity and briefness.
The Respondent should use the following checklist to ensure that all submission requirements have been fulfilled and to cross reference the location within their RFP response. Respondents must complete all sections.
Submission Requirement RFP Reference � and Respondent
Cross Reference
Executive Summary (not to exceed 3 - 4 pages) 3.1
Corporate Profile (References should be attached as an appendix)
3.2
Project Approach 3.3
Functional and Technical Requirements 4
Financial Proposal 5
Attachment A – Acknowledgement of Terms and Conditions Attachment A
3.1 Executive Summary Provide a short summary of the key features of the proposal, and a general description of how your proposed solution(s) aligns with Program Scope described in Section 2. Identify any advantages which are unique to your proposed solution and why this is the best for Newfoundland and Labrador iEHR/Labs project needs.
3.2 Corporate ProfileThis requirement (Section 3.2) provides the Centre with the information needed to evaluate the Respondents’ business with regards to initiating and maintaining a long term relationship with the supplier(s) during the implementation and ongoing support of the key components of the overall iEHR/Labs project. Respondents must respond to each of the specific requirements indicated in this section.
3.2.1 Project Governance Preference will be given to the solution that provides the Centre with an effective project governance structure while efficiently delivering the requirements during implementation and ongoing support.
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Respondents must confirm that the lead organization, in the case of a consortium, will liaise with the Centre and must have the authority to sign on behalf of the partnership and bind the partnership with respect to all statements, undertakings, actions, and agreements made on behalf of the partnership.
Respondents must describe their project governance strategy for their proposed solution, including, yet not limited to:
� How the governance structure will ensure the appropriate review of issues encountered within the project;
� How it will ensure that required approvals and direction for the project is obtained at each appropriate stage of the project;
� How it will ensure the implementation of necessary policies and standards as they apply to the Centre;
� How it will provide leadership for the management and operations of the iEHR project; and
� How communication will flow to the appropriate stakeholders throughout the project.
3.2.2 Respondent (s) Profile Prime (or Sole) Respondent Profile The Respondent must present a concise corporate profile highlighting:
� A summary of the Respondent’s experience relative to the scope of this RFP and proposed software solution;
� A brief profile of the Respondent (# of staff, years in business, core competencies);
� A description of any third-party alliances/relationships (as it pertains to the solution being proposed);
� Any recent mergers or acquisitions involving the product line of the proposed solution;
� A description of the Respondent’s financial viability and sustainability (i.e.: Total revenue for the past 2 years, sales history and projections etc.); and
� Any additional corporate information that the Respondent considers pertinent to add value to their response.
Consortium Member(s) Profile If applicable, for a multi-supplier solution, the Respondent must provide a vendor profile for each Consortium member and describe how each supports the following objectives:
� To enhance project success;
� To take advantage of existing vendor community knowledge and experience; and
� To highlight previous engagements where the members have worked together to provide an integrated service.
Technical Capability Strong technical capability is fundamental to supplementing and supporting the Centre’s complex initiative. The Respondent must indicate how their technical capabilities will benefit the project through their proposed resources, use of additional subject matter experts, best practices, standards involvement, training, knowledge transfer, etc.
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Respondents must describe how they foster competence and indicate where they contribute to the success of the industry through participation in associations, committees, forums, collaboration, etc. and how they are applied to similar projects in the following areas:
� Competence with enterprise architecture development;
� Demonstrated experience with e-Health infostructure design and specification (per Infoway’s EHRS blueprint and Privacy and Security Architecture (P&SA));
� Demonstrated compliance of products, solutions and services with pan-Canadian standards and protocols as set out in Infoway’s EHRS Blueprint relating to architecture and interoperability standards as approved by the Infoway EHR Standards Collaboration Process;
� Best practices from previous e-Health implementation engagements;
� Subject matter expertise in lab information systems at regional and provincial level;
� Standards expertise (HL7v3 and pan Canadian EHR standards, IHE profiles, TLI, etc.);
� Infrastructure planning, business continuity;
� Expertise in Privacy Impact Assessments (PIA) and Threat Risk Assessments (TRA); and
� Understanding of provincial level e-Health privacy and policy issues.
3.2.3 Maturity and History of Product The Centre is anticipating that the solution will be built upon an existing COTS package. To address this, Respondents must provide appropriate information in support of their proposed solution as being a proven, stable and continuously improving solution applicable to the Centre’s needs. As well as to provide:
� Product release schedule and patch management strategy;
� Number of production installations of the version of software being proposed;
� Number of installations that have been in Canada; and
� Description of the product’s five (5) year roadmap and how the proposed solution fits within the overall strategy of the Infoway Blueprint.
3.2.4 Corporate References Respondents must provide a minimum of three (3) written corporate references for whom they have completed a similar project. Provide the following information for each of the three (3) referenced projects:
� Client name and address;
� Contact name/title and phone number;
� Typical involvement/role in past projects; and
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� Brief description of nature of project, scope, and services rendered.
3.3 Project Approach This section provides the Centre with information upon which to evaluate how the Respondent’s approach to pre-implementation, implementation and post implementation meets the needs of Phase 2.2. Respondents will be evaluated on how well they fit, leverage each other’s skills and expertise and contribute to the overall success of the initiative. As described below, the project will break the work down into major stages common to all teams on the project. Each stage is intended to build upon the functionality of the overall solution. As each is completed and tested, additional functionality is elaborated upon and planned for the next stage, until the solution is fully developed, deployed and transitioned to operations. Phase 2.1 – Initiate and Plan
� Initiation Stage: In parallel with the final stages of Respondent selection and contract negotiation, the final conceptual and design deliverables for Phase 2.1 will be completed, MEDITECH development will start, and TELUS will begin work on the HIAL extensions.
Phase 2.2 - Implementation Project
� Early in 2011, the successful Respondent(s) and the iEHR/Labs project team will hold a planning affirmation session which will include validating and elaborating the work breakdown until the activities, tasks, dependencies and schedules are sufficient to begin the actual work.
� Commencing in the 1st Quarter of 2011 through to the end of 2012, the teams will work together to deliver upon the following stages.
o Stage 1 Infrastructure Installation: Implement the foundation required to install and unit test the infrastructure; deploy and QA test the repository and Viewer software, while addressing the highest technical risks of the project.
For all the remaining stages, Respondent(s) will be called upon for consultation on other collective integration initiatives, defect resolution and detailed planning for the next stage as necessary.
o Stage 2 System Configuration: Implement the configuration required for initial deployment. Perform additional HW unit testing and software QA testing as required to confirm the operational configuration required.
o Stage 3 Testing: Implement a baseline of functionally for the overall solution and complete some level of Conformance testing. In addition, begin developing Training and Adoption material.
The remaining 3 stages (4, 5 & 6) will be delivered somewhat in parallel.
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o Stage 4 Develop User Training and Complete Configuration: Training and adoption activities begin, including the finalization of training materials.
o Stage 5 UAT and User Training: Formal end-to-end integration and UA testing (respectively). Load/performance testing and disaster recovery testing. Start user testing.
o Stage 6 Production Deployment: Actual deployment and implementation into production.
3.3.1 Work PlanGiven the high level schedule described above, explain how your solution fits within that framework. Responses to this section will be evaluated based on the Respondent’s compatibility with overall project approach, completeness and quality of the proposed work plan, confirmation that they can provide resources at the appropriate times as well as any constructive feedback or suggestions that (based on your experience) should be considered in the planning and kick off session to improve the timeline without compromising quality. Specific to your proposed solution, the response must include a Work Plan with step-by-step instructions for constructing deliverables within each Objective, managing the project, sequence and dependencies, schedule, including assigning resources and estimating the work. Note that all associated costs must be included in the completed cost table as presented in Section 5, Financial Proposal. The Respondent is required to briefly describe other Project Management Plan topics and how they relate to the project such as:
� Dependencies;
� Key risks, their possible impact and mitigation;
� Key assumptions;
� Constraints; and
� Critical success factors.
This information will be evaluated and also used to provide input to discussion topics for the planning validation and Phase 2.2 kick off.
3.3.2 Delivery Methodology Given the high level work plan previously described, the respondent is required to briefly (maximum of 4 pages) describe the methodology they would follow in performing their responsibilities. For example, but not limited to:
� Project Management and Team Lead;
� Defect tracking and resolution;
� Issue, Risk Management and escalation;
36
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
� Requirements Management;
� Quality Management;
� Resource Management;
� Communication Plan (status and progress reporting, etc.);
� Configuration Management;
� User adoption of product; and
� Adoption of lessons learned from previous engagements.
Also, some aspects of the project’s delivery are anticipated to be shared between all the teams in the project. Using the list above, but not limited to, the Respondent is required to describe to what level they can integrate their methodologies into the project without compromising their own quality.
3.3.3 Team ResourcesDuring the course of 2.1 phase of the project, the project team will establish a framework upon which the 2.2 phase is anticipated to play out. The framework will include a template of the project’s organization structure outlining the hierarchy of teams reporting to the Centre’s project oversight and governance structure. Respondents are required to describe how they would structure and resource their teams for success. Responses will be evaluated based on the appropriate team size and effective use of resources, plan to perform work onsite and/or remotely. In addition, the responses will be evaluated on the level of experience the resources have with EHR projects with an emphasis on LIS, SHR, iEHRs, and EHR Desktop Viewers. Experience working on a previous iEHR or labs project(s) will be a significant asset. Highlight situations where resources have worked together on similar related projects. The Respondents must provide a detailed organization chart of the areas applicable to their solution indicating, role, person and addressing the efficient flow of information regarding the project activities to all stakeholders. The Respondent must summarize the resources’ qualifications and experience and attach as an appendix. The resource summaries (maximum two (2) pages) must include:
� The role and responsibility on the proposed solution;
� Years of experience (if more than one specialization, state years for each);
� Education, professional certifications/affiliations;
� Proposed role on project; and
� Two (2) recent deployment related experiences.
For the response to the above requirement, the Respondent must provide evidence of the resources and availability for the time periods indicated in the Project Approach section.
37
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
The Respondent must indicate where and when the Centre’s resources will be required to support the delivery of the proposed solution.
3.3.4 Project Services It is expected that the Respondent will provide project services during the course of the project. Mostly, these will involve consultation and subject matter expertise in support of the deliverables being created by other teams. It is expected that onsite presence will be required throughout the duration of the project. Respondents must anticipate their involvement with working with the project manager to provide input into project work products or to attend meetings to be kept up-to-date on progress of project tasks or deliverables. Respondents must describe their team membership and how their project services will be used to deliver a COTS solution. Respondents will be evaluated based on how their experience from previous projects of similar scope has provided an understanding of the challenges and issues this project faces and how based on these previous experiences the project can benefit.
3.3.5 Multiple Vendor Compatibility Collaboration is an extremely important evaluation criteria and requirement. The ability to work within the framework of the Project and with other companies and stakeholders in areas such as product integration, testing, issue and defect resolution, data migration, and security is crucial. Respondents must clearly describe:
� How they will ensure project success with other vendors and Centre staff within the project;
� How confidential information and intellectual property and licensing (etc.) will not impede progress;
� Collaboration or long term relationships during the implementation or post-implementation of the Project; and
� Examples of other projects they participated in that were comprised of multi-vendors and/or governed by a projects’ Project Management Office.
38
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
39
4.0 Functional and Technical Requirements The functional and technical requirements are presented by component (JLIS, EHR Desktop Viewer, and SHR) in Attachment B. Respondents must reply to component requirements for which they are proposing a solution. Guidelines for completing the Requirements Matrix are provided in Attachment B.
Respondents must complete the Requirements Matrix for proposed components to receive further consideration.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
5.0 Financial Proposal Completed cost summaries must be sealed in a separate envelope.
Respondents must detail any assumptions made in the preparation of their quotes, and dependence on existing infrastructure shall be clearly noted and any expectations stated. It is the duty of each Respondent to ask the necessary questions to ensure that they have a complete understanding of the requirements before submitting their proposals. Financial proposals will be evaluated on capital, and annual maintenance costs. The financial proposal must be specified in Canadian dollars and remain in effect for nine (9) months after the proposal due date. The cost summaries must include all pricing aspects. Consortium and/or Single Vendor Responses This RFP is seeking three (3) additional components for the Newfoundland and Labrador Electronic Health Record (EHR); (1) Jurisdictional Laboratory Information System, (2) Shared Health Record repository, and (3) EHR Viewer. As noted the evaluation and selection is structured to allow the Centre to engage separate entities to deliver their respective component. It is expected that engaging a single company or consortium to deliver the three (3) components may deliver additional value. Respondents should identify additional value that the Province may realize by packaging and awarding the RFP to a single company/consortium. Examples of value may include; enhanced communications, simplified management, easier integration, leveraging volume, reduced cost, etc. Where value may have a tangible cost savings the respondent should indicate those savings. These discounts may be used were applicable in the financial evaluation of the Bidder’s response. Alternate Financial Proposals The Financial Proposal section is structured to support consistent evaluation and comparison of responses. Respondents may suggest alternate financial proposals that the Centre may consider however these will only be entertained during negotiations, if the Respondent is successful with their response. Respondents offering alternative options MUST still complete the provided tables.
5.1 Cost Summary Template Instructions To ensure that the Centre can appropriately evaluate financial proposals, three (3) Cost Summary templates have been provided for each of the solution components (JLIS, SHR, and EHR Desktop Viewer) in Section 5.2. If a cell in the table is not relevant, please indicate “N/A”. DO NOT LEAVE CELLS BLANK. The Respondent must supply the cost to provide the components and/or services in each of the described environments for each of the components being proposed: Production, Staging, DR, and Development/Test as described in Section 2.4.3.2.
Application Software Respondents must provide cost estimates for each of the components offered as part of their response, inclusive of licenses, third-party and database software and middleware.
40
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
41
Implementation Services Considering that these services may be required in each of the four (4) environments as well as in several of the six (6) stages as described in the Project Approach section in 3.3, Respondents must provide the costs to fully implement their proposed solution including the following:
� Physical system implementation (unpack, rack, cable, power, make ready for software install);
� HIAL integration;
� Customization (e.g. jurisdiction specific requirements);
� Configuration; and
� Testing support for Centre lead testing including but not limited to, unit, quality assurance, user acceptance, conformance, load, performance, interoperability, and disaster recovery.
Project Services As per Section 3.3.4, Respondents must provide project services costs associated with the development, implementation and post go-live support for the proposed solution. TrainingRespondents must provide the training costs to accommodate a train-the-trainer approach as well as costs associated with training support staff/system administrators. Respondent must highlight training options (e.g. CBT, web-based, instructor lead, etc.). � DocumentationRespondents must provide training and technical documentation costs. Travel and Lodging Respondents must provide estimates for travel and lodging. OtherRespondents must provide any other relevant costs that are not captured in the template. In Section 5.3 below, Respondents must provide a list of their recommended hardware as well as an estimate of the costs required to run their proposed solution including the costs for operating system licensing and any third-party licenses. While hardware estimates are to be included as part of the RFP response, the Centre reserves the right to tender any or all hardware requirements and operating software in a separate process. In Section 5.4 below, service rates for team members must be entered. .
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5.4 Service Rates Costs must include all fees associated with providing the required and/or additional services from each resource to complete the project.
Core Team Resource Rates
Hourly Rate Comments
Project Manager �� ��
Architect �� ��
Analysts �� ��
Programmers �� ��
Application Support �� ��
Change Management �� ��
Training Resources �� ��
Implementation Services �� ��
Additional Resources, (other) �� ��
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
6.0 Evaluation of Proposals
6.1 Evaluation Process The Centre’s evaluation team will review all qualified Respondent offers and score them based on the evaluation criteria detailed below. The Respondents whose evaluation score meets or exceeds 70% on each non-financial evaluation category (noted by shaded sections in the table) will be short listed. From there, financial proposals will be reviewed.
6.2 Evaluation Criteria The following categories and weights will be used to evaluate proposals:
Evaluation Category RFP Reference Weighting
Executive Summary
Corporate Profile
Project Approach
3.1
3.2
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25%
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4 40%
Financial Proposal 5 25%
Oral/Demonstration Presentation 6.4 10%
Maximum Possible Score 100%
6.3 Respondent Selection Process The Respondent selection process will be conducted as follows:
1. The Centre will receive Respondent submission(s) to the RFP and will determine if any of the submissions are noncompliant from a procedural point of view as outlined in Section 8.
2. The Evaluation Team will evaluate and score each compliant Respondent’s submission on how well its components meet the criteria and weighting allotted to the corporate profile and project approach combined, and functional and technical requirements.
3. A short list of Respondents will be identified and invited solely at the discretion of the Centre to present oral presentations/demonstrations in order to complete and finalize the Respondent selection process.
4. For selected Respondents, the Centre will evaluate and score the financial information.
6.4 Oral Presentations/Demonstrations Oral presentations and solution demonstrations will occur at the Centre’s offices in St. John’s, Newfoundland in August 2010 – see schedule of events Section 7.1. Respondents should have in attendance the key staff/personnel proposed in their response to the RFP. Respondents will be provided with a defined script stating the functionality and transactions that must be
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
Page 48
demonstrated. In addition, Respondents will be provided with questions and clarifications from their proposals that must be addressed. The script will be provided to final Respondents in advance. During the presentation and demonstration, Respondents will be offered an opportunity to provide any information that they would like to clarify or emphasize from their proposal.
6.5 Award The preferred Respondent will be notified upon selection and invited to enter into discussions leading to an agreement to undertake the project. In the event that there is failure to come to an agreement within three (3) weeks of the original notification of selection, the Centre reserves the right to terminate negotiations and enter into discussions with the second ranked Respondent in the evaluation process.
6.6 Additional Phases of Work The Centre reserves the right to retain the successful qualified Respondent who is awarded this RFP to complete any additional work related to this project as identified by its stakeholders (if Respondent performance matches expectations). For further clarity, no additional procurement process will occur for subsequent phases of work. This additional work, however, would be completed under a separate contract.
6.7 Vendor Debriefing Following the Centre’s announcement of the successful Respondent(s), any unsuccessful Respondent may contact the Centre and request a debriefing meeting which will be scheduled by the Centre.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
7.0 RFP Process and Estimated Timetable The Centre intends to enter into negotiations and ultimately reach an agreement with a Respondent who demonstrates the best combination of approach, skills, experience, and value for money.
7.1 Schedule of EventsThe Centre intends to adhere to the following schedule for RFP issuance, evaluation, and Respondent selection. Any variance from this will be posted on the Centre’s website in the form of an addendum.
Event Scheduled Dates Advance Notice of RFP Opportunity March 24 RFP issued July 2 Notification of intent to bid July 9 Deadline for questions July 12 Final date for RFP addenda and answers July 14 RFP Responses due July 19 Proposal Evaluations (Note 1) July 20 – August 11 Notification of short-listed Respondents (Note 1) August 18 Oral presentations/Demonstrations (Note 1) August 30 Negotiations (Note 1) September Final contract in place (Note 2) November Work commences (Note 2) January
Notes:
1. Best estimates, subject to change.
2. Final contract award and work commencement subject to Cabinet approval
7.2 Intent to BidInterested organizations are requested to submit their intent to bid by 2:00 PM Newfoundland Time on the date identified in the Schedule of Events, by electronic mail to: procurement@nlchi.nl.ca. Please include company name and primary contact name with address, phone number and email.
7.3 Questions and Additional InformationQuestions can be directed to the RFP’s Administrator, at: procurement@nlchi.nl.ca. Oral responses to questions will not be provided. Responses to written questions will be posted as addenda on the website: http://www.nlchi.nl.ca/about_rfp.php. It is the Respondent’s responsibility to ensure they have all relevant information by regularly checking the web site. The Centre will not disclose the source of any questions submitted by Respondents. Questions will be received until 2:00 PM Newfoundland Time on the date indicated in the Schedule of Events. Questions raised past this deadline will not be answered.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
8.0 Proposal – Submission Guidelines Respondents should note that failure to follow the format requirements listed in this section will result in disqualification of their proposal.
8.1 General Format of Submission To be eligible for consideration, Respondents must provide a signed and dated proposal (for each of financial and non-financial responses) as follows:
� One (1) original signed paper-based Master Copy;
� Ten (10) complete printed copies of the proposal and ten (10) complete copies of the separate financial proposal. Double-sided printing is encouraged for hardcopy responses;
� The financial proposal to be in a separate, sealed envelope, clearly marked with the RFP number and: “Financial Proposal”; and
� One (1) electronic copy of both the financial and non-financial proposals. The electronic version will be on an USB Flash Drive.
Proposals must be submitted in sealed packages, clearly marked with the RFP number and “NL Centre for Health Information – Phase 2.2 of the interoperable Electronic Health Record/Labs (iEHR/Labs) Project”. It will be delivered to the following address no later than 2:00 PM Newfoundland Time on the closing day as indicated on the cover page of this RFP:
Attention: Business Services Officer
Newfoundland and Labrador Centre for Health Information
70 O’Leary Avenue
St. John’s, NL A1B 2C7
The soft copy must contain information identical to the hard copies. In the event of any discrepancies, the contents of the signed Master Copy will apply. Faxed or email submissions will not be accepted.
8.2 Style Proposals must be written in clear, succinct language and allow ease of retrieval and understanding of proposal information by the Evaluation Committee.
8.3 PresentationProposals must be on 8½ x11" paper (except where a larger format is required for diagrams, spreadsheets, etc.), use a 10-point (or larger) font, minimum 2.5 cm margins, and bound in such a manner as to lay flat when opened.
8.4 Ordering and Titles of Content Sections Proposals must be presented in the same order, using the same titles of sections, as identified in Section 3 Proposal – Proposal Requirements and Content. The use of “tabs” to separate various sections is strongly encouraged.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
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8.5 Supporting Materials All supporting material must be attached in Appendices and clearly referenced in the section of the Proposal that they support. Appendices and attachments are an integral part of this RFP and must be considered or completed by the Respondent in their submission.
8.6 Mandatory Requirements Proposals that do not adhere to the mandatory requirements will be rejected and not considered for evaluation.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
9.0 RFP Terms and Conditions, and Contract TemplateRespondents must review and acknowledge the Request for Proposal’s Terms and Conditions: http://www.nlchi.nl.ca/about_rfp.php. Respondents must sign the Acknowledgement of Terms and Conditions in Attachment A. Respondents must review the Centre’s contract template and identify any clauses they wish to negotiate with proposed changes should they be the successful respondent. The Centre reserves the right to terminate negotiations, reject the Respondent’s proposal and proceed with selecting another Respondent and/or cancel the RFP should both parties fail to negotiate a contract within a reasonable period of time (e.g. not exceeding the timelines listed in the RFP). The contract template is at the following location: http://www.nlchi.nl.ca/about_rfp.php.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
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Attachment A – Acknowledgement of Terms and Conditions
Vendor Information:
Company Name: ______________________________ Web Address: ______________________________ Primary Contact Person for this RFP: ________________________________ Email: ____________________________________ By signing below, I authorize that: � I have read and accept all of the Terms and Conditions listed in this RFP (RFP # CHI-2010-
032 iEHR/Labs Phase 2.2) and all addenda posted on the Centre’s website relative to this RFP.
� The submission of my company’s proposal does not present any potential conflict of interest or what could be perceived as a conflict of interest if my company was selected as the contracting party.
_________________________________________________ Authorized Company Representative Signature _________________________________________________ Authorized Company Representative Title _________________________________________________ Authorized Company Representative Print ______________________________________________________ Date
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Attachment B – Functional and Technical Requirements
Table of Contents�10.0� Functional and Technical Requirements .........................................................55�10.1� Requirements Matrix Guidelines ..........................................................................55�10.2� JLIS Requirements Matrix ....................................................................................56�10.3� EHR Desktop Viewer Requirements Matrix .........................................................79�10.4� SHR Requirements Matrix..................................................................................117�
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
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10.0 Functional and Technical Requirements
10.1 Requirements Matrix Guidelines The Respondents must complete the Requirements Matrix according to the instructions provided. If a component (JLIS, SHR, EHR Desktop Viewer) is not part of the Respondent’s RFP response, please check the “Not Applicable” checkbox at the beginning of the respective component’s requirements section. These matrices have been provided to enable Respondents to reply with minimal effort. The columns provided are as follows: The Requirement column states the needs of the iEHR/Labs project. Each requirement is numbered for reference purposes. Proposals should retain this numbering sequence for referencing purposes and clarity. The demonstration script (Oral Presentations) will use and identify requirements using the numbering shown. The Priority column contains an indication of the importance of the requirement:
� Mandatory - the solution must offer this capability, minimum qualifications, or acceptable level of response.
� High - these requirements are important for a successful implementation.
� Medium - a solution that offers these requirements would be preferred.
� Low - this is a “Nice to Have” feature or it could be a future consideration.
The Response column is included to enable the Centre to assess the functionality of the proposed solution and to determine how well it fits the requirements. Please indicate by entering one of the following on the appropriate line:
(F) Full Full capability for this requirement is currently provided by your proposed solution.
(P) Partial Partial functionality is currently provided or functionality is not exactly as described, however the system may be able to be modified or enhanced to comply. If additional costs are required, cross reference to the Cost Summary table and enter the cost details as an Other line item.
(N) No The proposed solution is unable to comply in any way.
The Comments column should be used to describe any additional information or functionality the Respondent feels is relevant. It should also be used to respond to the requirements that require further information or clarification. If additional space is required, please note this in the Comments section and attach the relevant documentation referencing the requirement number. If applicable, provide high-level diagrams to clarify your response.
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rmat
ion
10
.2JL
IS R
equi
rem
ents
Mat
rix
N
ot A
pplic
able
– c
heck
if re
spon
se d
oes
not a
ddre
ss th
e JL
IS R
equi
rem
ents
Req
uire
men
t Pr
iorit
y R
espo
nse
F / P
/ N
C
omm
ents
J-1.
Th
e JL
IS s
tore
s hu
man
lab
test
resu
lts.
Man
dato
ry
J-1.
1.
The
JLIS
sto
res
gene
ral l
abor
ator
y te
st re
sults
(a
fter F
inal
Ver
ifica
tion
of th
e te
st o
r pan
el).
H
igh
J-1.
1.1.
Th
e JL
IS s
tore
s ge
nera
l lab
orat
ory
test
re
sults
incl
udin
g (b
ut n
ot li
mite
d to
) Che
mis
try,
Bio
chem
ical
Gen
etic
s, Im
mun
olog
y, U
rinal
ysis
, B
lood
gas
, Che
mis
try U
rine
and
Spe
cial
C
hem
istry
.
Hig
h
J-1.
1.2.
Th
e JL
IS s
tore
s st
ruct
ured
, cod
ified
an
d te
xtua
l gen
eral
labo
rato
ry te
st re
sults
in
clud
ing
(but
not
lim
ited
to) H
emat
olog
y an
d C
oagu
latio
n.
Hig
h
J-1.
2.
The
JLIS
sto
res
stru
ctur
ed, c
odifi
ed a
nd te
xtua
l (C
DA
is n
ot u
tiliz
ed) m
icro
biol
ogy
labo
rato
ry te
st
resu
lts (a
fter P
relim
inar
y V
erifi
ed a
nd F
inal
Ver
ified
).
Hig
h
J-1.
3.
The
JLIS
sto
res
stru
ctur
ed, c
odifi
ed a
nd te
xtua
l bl
ood
bank
info
rmat
ion.
H
igh
J-1.
3.1.
Th
e JL
IS s
tore
s bl
ood
bank
resu
lted
test
s.
Hig
h
J-1.
3.2.
Th
e JL
IS s
tore
s 'tr
ansf
used
onl
y'
stat
us (n
o pr
oduc
t or c
ross
-mat
ch
trans
actio
ns) e
vent
s.
Hig
h
J-1.
4.
The
JLIS
sto
res
stru
ctur
ed, c
odifi
ed a
nd te
xtua
l (C
DA
is n
ot u
tiliz
ed) p
atho
logy
and
cyt
olog
y la
bora
tory
te
st re
sults
(afte
r pre
limin
ary
sign
ed o
ut a
nd e
lect
roni
c si
gnat
ure
or s
ign-
out).
Hig
h
Pag
e 56
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foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
1.5.
Th
e JL
IS s
tore
s la
b te
st re
sult
info
rmat
ion.
H
igh
J-1.
5.1.
Th
e JL
IS s
tore
s pe
rform
ing
labo
rato
ry
faci
lity
ID.
Hig
h
J-1.
5.2.
Th
e JL
IS s
tore
s or
derin
g la
bora
tory
fa
cilit
y ID
. H
igh
J-1.
5.3.
Th
e JL
IS s
tore
s as
soci
ated
pro
vide
r ID
s (e
.g.,
orde
ring,
adm
ittin
g, a
ttend
ing,
re
ferri
ng, c
onsu
lting
, fam
ily).
Hig
h
J-1.
5.4.
Th
e JL
IS s
tore
s LO
INC
/pC
LOC
D c
ode
whe
re a
pplic
able
(inc
ludi
ng th
e 3
char
acte
r pC
LOC
D o
r pro
vinc
ial p
refix
to th
e LO
INC
co
de re
quire
d fo
r loc
aliz
ed te
st c
odes
).
Hig
h
J-1.
5.5.
Th
e JL
IS s
tore
s S
NO
ME
D-C
T (e
.g.,
orga
nism
cod
es) w
here
app
licab
le.
Hig
h
J-1.
5.6.
Th
e JL
IS s
tore
s ob
serv
atio
n / r
esul
t w
ith a
ssoc
iate
d no
rmal
rang
e an
d un
its o
f m
easu
re (i
f app
licab
le).
Hig
h
J-1.
5.7.
Th
e JL
IS s
tore
s ob
serv
atio
n / v
erifi
ed
date
, tim
e an
d tim
e zo
ne.
Hig
h
J-1.
5.8.
Th
e JL
IS s
tore
s sp
ecim
en, g
roup
, pr
ofile
and
test
sta
tuse
s.
Hig
h
J-1.
5.9.
Th
e JL
IS s
tore
s ab
norm
ality
sta
tus.
H
igh
J-1.
5.10
. Th
e JL
IS s
tore
s ex
tern
al c
omm
ents
. H
igh
J-1.
5.11
. Th
e JL
IS s
tore
s te
st v
erifi
er.
Hig
h
J-
1.5.
12.
The
JLIS
sto
res
refle
x in
dica
tor.
H
igh
J-1.
5.13
. Th
e JL
IS s
tore
s m
etho
d (o
ptio
nal
whe
re re
leva
nt).
H
igh
J-1.
5.14
. Th
e JL
IS s
tore
s ac
cess
ion
/ spe
cim
en
num
ber.
H
igh
J-1.
5.15
. Th
e JL
IS s
tore
s co
llect
ion
date
, tim
e an
d tim
e zo
ne.
Hig
h
Pag
e 57
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foun
dlan
d an
d La
brad
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ealth
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rmat
ion
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e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
1.5.
16.
The
JLIS
sto
res
spec
imen
rece
ive
date
, tim
e an
d tim
e zo
ne.
Hig
h
J-1.
5.17
. Th
e JL
IS s
tore
s pr
int n
umbe
r.
Hig
h
J-
2.
JLIS
info
rmat
ion
is re
visa
ble
and
corr
ecta
ble.
H
igh
J-2.
1.
Nul
lifie
d JL
IS in
form
atio
n is
iden
tifia
ble
(i.e.
, not
de
lete
d).
Hig
h
J-2.
2.
The
JLIS
is re
spon
sive
to p
atie
nt id
entif
icat
ion
chan
ges.
D
escr
ibe
how
the
corre
ct p
atie
nt is
mai
ntai
ned
with
in
the
JLIS
in th
e ev
ent o
f a p
atie
nt id
entif
icat
ion
chan
ge
as a
resu
lt of
a c
lient
mer
ge u
nmer
ge/ l
ink/
unlin
k an
d ho
w s
uch
a ch
ange
is id
entif
iabl
e.
Hig
h
J-2.
3.
The
JLIS
is re
spon
sive
to re
assi
gnm
ent o
f tes
t in
form
atio
n to
the
corre
ct p
atie
nt.
Hig
h
J-2.
4.
The
JLIS
is re
spon
sive
to c
orre
ctio
n of
test
in
form
atio
n fro
m th
e so
urce
sys
tem
s.
Hig
h
J-3.
Th
e JL
IS s
uppo
rts p
oint
-in-ti
me
data
arc
hite
ctur
e (i.
e., a
t de
fined
poi
nt in
tim
e a
view
of t
he E
HR
dat
a ca
n be
re
cons
truct
ed).
Des
crib
e ho
w th
e JL
IS h
andl
es th
e sc
enar
io w
here
a L
ab
Res
ult w
as p
lace
d on
the
wro
ng p
atie
nt a
nd h
ow th
is
corr
ectio
n is
iden
tifia
ble.
Hig
h
J-3.
1.
The
JLIS
util
izes
ver
sion
ing
whe
n pe
rform
ing
reco
rd u
pdat
es.
Hig
h
J-3.
1.1.
Th
e JL
IS s
tore
s a
new
reco
rd w
ith th
e up
date
d in
form
atio
n (e
.g.,
due
to a
revi
sed
test
re
sult)
.
Hig
h
J-3.
1.2.
Th
e JL
IS in
activ
ates
the
old
reco
rd
(i.e.
, no
phys
ical
del
etio
n of
reco
rds)
. H
igh
J-3.
2.
The
JLIS
mai
ntai
ns a
ver
sion
his
tory
of
info
rmat
ion
chan
ges.
H
igh
Pag
e 58
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foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
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e R
equi
rem
ent
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rity
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men
ts
F / P
/ N
J-
3.3.
Th
e JL
IS re
cord
his
torie
s ar
e re
triev
able
. H
igh
J-4.
Th
e JL
IS d
ata
arch
itect
ure
supp
orts
futu
re e
xten
sion
s an
d m
odifi
catio
ns (e
.g.,
upda
ted
stan
dard
s).
Des
crib
e ho
w th
e JL
IS h
andl
es th
e sc
enar
io o
f a
com
plet
ed la
b re
sult
was
repl
aced
with
a n
ew la
b re
sult
and
how
this
cor
rect
ion
is id
entif
iabl
e.
Des
crib
e ho
w th
e JL
IS h
andl
es th
e sc
enar
io o
f a
com
plet
ed la
b re
sult
was
upd
ated
and
how
this
cor
rect
ion
is id
entif
iabl
e w
ithin
the
JLIS
.
Hig
h
J-5.
Th
e JL
IS s
uppo
rts a
ssoc
iate
d pa
tient
, pro
vide
r and
lo
catio
n id
entif
iers
. M
anda
tory
J-5.
1.
The
JLIS
sup
ports
the
loca
l clie
nt id
entif
iers
, but
no
t the
ir eC
ID (t
he e
nter
pris
e cl
ient
iden
tifie
r m
aint
aine
d by
the
Clie
nt R
egis
try).
If th
e JL
IS d
oes
stor
e eC
IDs,
des
crib
e th
e fu
nctio
nalit
y th
at is
util
ized
to k
eep
thes
e en
tries
in s
ynch
roni
zatio
n w
ith th
e C
lient
Reg
istry
as
a re
sult
of re
gist
ry
chan
ges.
Hig
h
J-5.
2.
The
JLIS
sup
ports
the
loca
l pro
vide
r ide
ntifi
ers,
bu
t not
thei
r eP
ID (t
he e
nter
pris
e pr
ovid
er id
entif
ier
mai
ntai
ned
by th
e P
rovi
der R
egis
try).
If th
e JL
IS d
oes
stor
e eP
IDs,
des
crib
e th
e fu
nctio
nalit
y th
at is
util
ized
to k
eep
thes
e en
tries
in s
ynch
roni
zatio
n w
ith th
e P
rovi
der R
egis
try a
s a
resu
lt of
regi
stry
ch
ange
s.
Hig
h
Pag
e 59
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foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
5.3.
Th
e JL
IS s
uppo
rts th
e lo
cal l
ocat
ion
iden
tifie
rs,
but n
ot th
eir e
LID
(the
ent
erpr
ise
loca
tion
iden
tifie
r m
aint
aine
d by
the
Loca
tion
Reg
istry
). If
the
JLIS
doe
s st
ore
eLID
s, d
escr
ibe
the
func
tiona
lity
that
is u
tiliz
ed to
kee
p th
ese
entri
es in
syn
chro
niza
tion
with
the
Loca
tion
Reg
istry
as
a re
sult
of re
gist
ry
chan
ges.
Hig
h
J-6.
A
ll da
ta p
ersi
sted
in th
e JL
IS is
sto
red
as it
was
pro
vide
d (i.
e., w
ithou
t tra
nsfo
rmat
ion
or a
ltera
tion
but d
oes
not
prec
lude
the
addi
tion
of tr
ansf
orm
ed n
orm
aliz
ed v
ersi
ons
of o
rigin
al d
ata
prov
ided
the
orig
inal
dat
a st
ill re
mai
ns).
Hig
h
J-7.
P
atie
nt-to
-pro
vide
r rel
atio
nshi
ps (a
s de
fined
with
in th
e m
essa
ging
) are
mai
ntai
ned
with
in th
e JL
IS.
Hig
h
J-8.
Th
e JL
IS s
uppo
rts la
b m
essa
ging
. H
igh
J-8.
1.
The
JLIS
sup
ports
HL7
v3
(MR
2009
) int
erac
tion
mes
sagi
ng fo
r Lab
Res
ult (
put)
indi
vidu
ally
(not
ba
tche
d).
Iden
tify
the
inte
ract
ion
mes
sage
s ut
ilized
for:
o S
torin
g co
mpl
eted
resu
lts.
o S
torin
g re
vise
d re
sults
. o
Nul
lifyi
ng re
sults
. o
Ack
now
ledg
emen
ts.
Iden
tify
any
othe
r int
erac
tion
mes
sage
s th
at a
re
supp
orte
d fo
r sto
ring
JLIS
dat
a.
Des
crib
e an
y de
pend
enci
es fo
r sto
ring
lab
resu
lts. F
or
exam
ple,
- D
oes
a pa
tient
enc
ount
er h
ave
to e
xist
?
- Doe
s a
lab
orde
r hav
e to
exi
st?
Hig
h
Pag
e 60
New
foun
dlan
d an
d La
brad
or
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ealth
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e R
equi
rem
ent
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rity
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men
ts
F / P
/ N
J-
8.2.
Th
e JL
IS s
uppo
rts H
L7 v
3 (M
R20
09) i
nter
actio
n m
essa
ging
for L
ab R
esul
t Que
ry (g
et/li
st).
Iden
tify
the
inte
ract
ion
mes
sage
util
ized
for q
uery
ing
resu
lts b
y pa
tient
. Id
entif
y th
e in
tera
ctio
n m
essa
ge u
tiliz
ed fo
r que
ryin
g re
sults
by
prov
ider
/ lo
catio
n.
Iden
tify
any
othe
r int
erac
tion
mes
sage
s ut
ilized
for
quer
ying
JLI
S da
ta.
Hig
h
J-9.
Th
e JL
IS s
uppo
rts H
L7 v
3 re
gist
ry m
essa
ges
as p
er
MR
2007
. H
igh
J-9.
1.
The
JLIS
sup
ports
Clie
nt R
egis
try H
L7 v
3 m
essa
ges
for e
CID
bas
ed s
ynch
roni
zatio
n.
Hig
h
J-9.
2.
The
JLIS
sup
ports
Pro
vide
r Reg
istry
HL7
v3
mes
sage
s fo
r eP
ID b
ased
syn
chro
niza
tion.
H
igh
J-9.
3.
The
JLIS
sup
ports
Loc
atio
n R
egis
try H
L7 v
3 m
essa
ges
for a
ny e
LID
-bas
ed s
ynch
roni
zatio
n.
Hig
h
J-10
. Th
e JL
IS h
as d
ata
extra
ctio
n ca
pabi
litie
s.
Iden
tify
the
supp
orte
d ex
tract
form
ats
plus
any
tool
s (in
clud
ed o
r thi
rd p
arty
) and
lice
nsin
g ar
rang
emen
ts.
Hig
h
J-11
. Th
e JL
IS h
as F
TP s
ervi
ces
(inbo
und,
out
boun
d, s
ftp).
H
igh
J-12
. Th
e JL
IS p
roce
sses
mes
sage
s in
real
-tim
e.
Hig
h
J-
13.
The
JLIS
inte
rope
rate
s w
ith th
e H
IAL
erro
r han
dlin
g pr
oces
s.
Hig
h
J-13
.1.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
TLI
m
essa
ging
sta
ndar
d, in
clud
e: H
TTP
leve
l err
ors.
H
igh
J-13
.2.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
TLI
m
essa
ging
sta
ndar
d, in
clud
e: S
OA
P le
vel e
rrors
. H
igh
Pag
e 61
New
foun
dlan
d an
d La
brad
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equi
rem
ent
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rity
Com
men
ts
F / P
/ N
J-
13.3
. Th
e er
ror t
ypes
sen
t, as
per
the
appl
icab
le H
L7
mes
sagi
ng s
tand
ards
, inc
lude
: HL7
Tra
nspo
rt le
vel
erro
rs.
Hig
h
J-13
.4.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
HL7
m
essa
ging
sta
ndar
ds, i
nclu
de: H
L7 A
pplic
atio
n le
vel
erro
rs.
Hig
h
J-14
. Th
e JL
IS c
ontin
ues
to o
pera
te a
fter r
ecei
ving
exc
eptio
ns
and
erro
rs (i
n st
ruct
ure
or c
onte
nt).
Indi
cate
whe
ther
this
can
be
cont
rolle
d vi
a a
thre
shol
d se
tting
.
Hig
h
J-15
. Th
e JL
IS c
onfo
rms
to th
e C
anad
a H
ealth
Info
way
iEH
R T
LI
spec
ifica
tion
1.02
. H
igh
J-15
.1.
The
JLIS
is a
ble
to im
plem
ent t
he W
S-*
sp
ecifi
catio
ns a
nd a
ltern
ate
appr
oach
es b
ased
on
the
curre
nt H
IAL
trans
port
spec
ifica
tions
in u
se in
NL
Hig
h
J-15
.2.
The
JLIS
sup
ports
SO
AP
1.1
(the
HIA
L do
es n
ot
supp
ort S
OAP
ver
sion
s hi
gher
than
1.1
).
Hig
h
J-15
.3.
The
JLIS
con
form
s to
the
WS
-I B
asic
Pro
file
1.1.
H
igh
J-15
.4.
The
JLIS
is c
ompl
iant
with
the
WS
-Add
ress
ing
spec
ifica
tion.
H
igh
J-15
.4.1
. Th
e JL
IS c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Mes
sage
ID.
Hig
h
J-15
.4.2
. Th
e JL
IS c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r To.
H
igh
J-15
.4.3
. Th
e JL
IS c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Rep
lyTo
. H
igh
J-15
.4.4
. Th
e JL
IS c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Act
ion.
H
igh
J-15
.4.5
. Th
e JL
IS c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Rel
ates
To.
Hig
h
Pag
e 62
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
15.5
. Th
e JL
IS is
abl
e to
impl
emen
t WS
-Sec
urity
usi
ng
a se
curit
y to
ken,
dig
ital s
igna
ture
, and
XM
L en
cryp
tion
(pas
swor
d ba
sed)
.
Hig
h
J-15
.5.1
. Th
e JL
IS d
eriv
es th
e si
gnat
ure/
encr
yptio
n ke
ys u
tiliz
ing
the
met
hod
spec
ified
in th
e TL
I.
Hig
h
J-15
.5.2
. Th
e JL
IS d
igita
lly s
igns
a m
essa
ge
afte
r all
requ
ired
elem
ents
are
enc
rypt
ed.
Hig
h
J-15
.5.3
. Th
e JL
IS o
nly
encr
ypts
the
Pat
ient
X
ML
elem
ent (
CM
ET)
whe
n co
mm
unic
atin
g w
ith th
e N
L H
IAL.
Hig
h
J-15
.6.
The
JLIS
sup
ports
the
Infra
stru
ctur
e ve
rsio
ning
st
ruct
ure
as d
efin
ed in
the
Info
way
Tra
nspo
rt La
yer
Inte
rope
rabi
lity
spec
ifica
tion.
Hig
h
J-15
.7.
The
JLIS
pop
ulat
es th
e S
OA
PA
ctio
n an
d W
A-A
A
ctio
n us
ing
the
follo
win
g na
min
g co
nven
tion:
In
tera
ctio
n ID
+ “.
” + “L
E” (
Loca
l) or
“NE”
(Nor
mat
ive)
+
YY
YY
MM
DD
For
exa
mpl
e: u
rn:h
l7-
org:
v3:R
EP
C_I
N00
0041
CA
.LE
2006
0911
Hig
h
J-15
.8.
The
JLIS
sup
ports
the
follo
win
g na
mes
pace
s:
• hl7
- ur
n:hl
7-or
g:v3
• x
sd -
http
://w
ww
.w3.
org/
2001
/XM
LSch
ema
• soa
p - h
ttp://
sche
mas
.xm
lsoa
p.or
g/so
ap/e
nvel
ope/
• w
sa -
http
://w
ww
.w3.
org/
2005
/03/
addr
essi
ng
• wss
e - h
ttp://
docs
.oas
is-
open
.org
/wss
/v1.
1/20
04/0
1/oa
sis-
2004
01-w
ss-
wss
ecur
ity-s
ecex
t-1.0
.xsd
• w
su -
http
://do
cs.o
asis
-op
en.o
rg/w
ss/v
1.1/
2004
/01/
oasi
s-20
0401
-wss
-w
ssec
urity
-util
ity-1
.0.x
sd
• xen
c - h
ttp://
ww
w.w
3.or
g/20
01/0
4/xm
lenc
# • s
ig -
http
://w
ww
.w3.
org/
2000
/09/
xmld
sig#
• w
si -
http
://w
s-i.o
rg/p
rofil
es/b
asic
/1.1
/sw
aref
.xsd
Hig
h
Pag
e 63
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
15.9
. Th
e JL
IS is
abl
e to
com
mun
icat
e w
ith th
e H
IAL
utiliz
ing
eith
er im
med
iate
or q
ueue
d m
ode.
For
qu
eued
mod
e, o
nly
pollin
g in
tera
ctio
ns a
re s
uppo
rted.
Fo
r im
med
iate
mod
e, re
ques
t int
erac
tions
and
no
tific
atio
n in
tera
ctio
ns a
re s
uppo
rted.
Hig
h
J-15
.10.
Th
e JL
IS u
tiliz
es W
SDLs
as
reco
mm
ende
d in
HL7
v3
Sta
ndar
d: T
rans
port
Spe
cific
atio
n –
Web
Ser
vice
s P
rofil
e, R
elea
se 2
(WS
DLs
will
be p
rovi
ded
prio
r to
impl
emen
tatio
n).
Hig
h
J-15
.10.
1.
The
JLIS
com
mun
icat
es u
sing
a
requ
est-r
espo
nse
mes
sage
exc
hang
e pa
ttern
. H
igh
J-15
.10.
2.
The
JLIS
util
izes
nom
encl
atur
e fo
r W
SD
L ar
tefa
cts
type
def
initi
ons
follo
win
g re
com
men
datio
ns in
the
TLI s
peci
ficat
ion.
Hig
h
J-15
.10.
3.
The
JLIS
soa
p m
essa
ges
use
wra
pped
/lite
ral d
ocum
ent s
tyle
. H
igh
J-15
.10.
4.
The
JLIS
ser
vice
bin
ding
s fo
llow
re
com
men
datio
ns in
the
TLI s
peci
ficat
ion.
H
igh
J-15
.11.
Th
e JL
IS h
andl
es e
rrors
in th
e pr
otoc
ol th
ey a
re
asso
ciat
ed w
ith (e
.g.,
HTT
P, S
OA
P, H
L7 tr
ansp
ort,
or
HL7
app
licat
ion)
.
Hig
h
J-15
.12.
Th
e JL
IS is
abl
e to
inte
rpre
t the
sta
ndar
d H
TTP
er
rors
and
pre
sent
to th
e en
d us
er fo
llow
ing
HTT
P 1
.1
guid
elin
es.
Hig
h
J-15
.13.
Th
e JL
IS is
abl
e to
par
se a
nd in
terp
ret t
he S
OA
P
faul
tcod
e an
d fa
ults
tring
par
amet
ers
and
pres
ent t
o th
e en
d us
er if
app
licab
le.
Hig
h
J-15
.14.
Th
e JL
IS is
abl
e to
incl
ude
two
cust
om e
lem
ents
(E
HR
Rol
e an
d la
ngua
ge) i
n th
e S
OA
P h
eade
r. H
igh
J-15
.15.
Th
e JL
IS is
abl
e to
set
the
mes
sage
ID a
s a
UU
ID
gene
rate
d us
ing
a ce
rtifie
d al
gorit
hm, a
nd p
refix
the
valu
e w
ith "u
uid:
"
Hig
h
Pag
e 64
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
15.1
5.1.
Th
e JL
IS e
nsur
es th
at th
e m
essa
ge ID
is
uni
que.
H
igh
J-15
.15.
2.
The
JLIS
onl
y re
uses
mes
sage
IDs
whe
n su
bmitt
ing
a du
plic
ate
requ
est.
Hig
h
J-16
. A
ll da
ta s
ent b
etw
een
EH
R c
ompo
nent
s is
ver
ified
for
inte
grity
. H
igh
J-17
. Th
e JL
IS o
pera
tes
with
in th
e N
L E
HR
env
ironm
ent
stan
dard
s.
Hig
h
J-17
.1.
The
JLIS
is a
ble
to u
tiliz
e: S
un S
olar
is 1
0.
Hig
h
J-
17.2
. Th
e JL
IS is
abl
e to
util
ize:
Ora
cle
11i.
Hig
h
J-
17.3
. Th
e JL
IS is
abl
e to
util
ize:
Sun
har
dwar
e.
Hig
h
J-
17.4
. Th
e JL
IS is
abl
e to
util
ize:
Jav
a.
Hig
h
J-
17.5
. Th
e JL
IS p
orta
ls a
re a
ble
to u
tiliz
e: js
r168
or w
srp
portl
ets.
H
igh
J-17
.6.
The
JLIS
util
izes
a te
chni
cal a
rchi
tect
ure
that
in
tegr
ates
with
the
exis
ting
NL
envi
ronm
ent.
Id
entif
y al
l app
licat
ion
serv
er te
chno
logy
and
co
mpo
nent
s re
quire
d by
the
solu
tion.
Whe
re th
ere
are
mul
tiple
, pro
vide
all
optio
ns a
nd th
e re
com
men
ded
appl
icat
ion
tech
nolo
gy.
Iden
tify
any
data
base
tech
nolo
gy re
quire
men
t of t
he
prop
osed
sol
utio
n in
clud
ing
all s
uppo
rted
data
base
te
chno
logi
es a
nd a
ny re
com
men
ded
tech
nolo
gies
. Id
entif
y al
l har
dwar
e an
d so
ftwar
e re
quire
d by
the
prop
osed
sol
utio
n (in
clud
ing
third
par
ty to
ols
such
as
data
bac
kup
softw
are
and
all l
icen
sing
). Id
entif
y an
y V
M te
chno
logy
requ
ired
or s
uppo
rted
and
desc
ribe
its im
pact
on
each
pro
pose
d en
viro
nmen
t.
Hig
h
Pag
e 65
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
17.7
. Th
e JL
IS s
uppo
rts m
ultip
le e
nviro
nmen
ts fo
r m
aint
enan
ce, o
pera
tions
and
rele
ase
man
agem
ent.
Iden
tify
the
num
ber a
nd ty
pes
of e
nviro
nmen
ts
reco
mm
ende
d to
mai
ntai
n an
d op
erat
e th
e pr
opos
ed
solu
tion
(e.g
., te
st, Q
A, p
rodu
ctio
n).
Hig
h
J-18
. Th
e JL
IS s
uppo
rts a
utom
ated
test
ing.
Id
entif
y th
e te
stin
g m
etho
ds re
com
men
ded
for t
he s
olut
ion.
Iden
tify
any
test
ing
tool
s pr
ovid
ed (i
nclu
ding
the
avai
labi
lity
of te
st s
crip
ts o
r oth
er fo
rms
of te
stin
g au
tom
atio
n).
Iden
tify
all t
est t
ools
sup
porte
d by
the
solu
tion
(e.g
., B
orla
nd).
Hig
h
J-19
. Th
e JL
IS a
ssoc
iate
s a
user
ID w
ith a
pro
vide
r’s id
entit
y.
Hig
h
J-
20.
The
JLIS
ass
ocia
tes
a us
er ID
with
a lo
catio
n (fa
cilit
y).
Hig
h
J-
21.
JLIS
dat
a is
enc
rypt
ed.
Des
crib
e to
wha
t lev
el o
f gra
nula
rity
encr
yptio
n ca
n be
ap
plie
d.
Rec
omm
end
an a
ppro
ach
to d
ata
encr
yptio
n in
clud
ing
tech
nolo
gy, t
echn
ique
s an
d da
ta g
ranu
larit
y.
Hig
h
J-22
. Th
e JL
IS s
uppo
rts th
e ab
ility
to p
rodu
ce a
pat
ient
repo
rt of
co
rrec
ted
info
rmat
ion
(incl
udin
g ol
d an
d re
vise
d in
form
atio
n) b
y da
te ra
nge.
Med
ium
J-22
.1.
The
JLIS
sup
ports
the
abilit
y to
pro
duce
a p
rinte
d co
py o
f a p
atie
nt’s
EH
R u
pon
requ
est (
as p
er P
HIA
). H
igh
J-22
.2.
The
JLIS
sup
ports
the
abilit
y to
pro
duce
a p
rinte
d co
py o
f acc
esse
s to
a p
atie
nt's
EH
R u
pon
requ
est (
as
per P
HIA
).
Hig
h
Pag
e 66
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
23.
The
JLIS
is s
ecur
e by
des
ign.
D
escr
ibe
the
stra
tegi
es a
nd s
afe
guar
ds p
rovi
ded
with
the
prop
osed
sol
utio
n.
Hig
h
J-23
.1.
All
mes
sage
tran
sact
ions
are
ack
now
ledg
ed w
ith
a st
atus
resu
lt (s
ucce
ss o
r fai
lure
with
an
erro
r res
ult
code
).
Hig
h
J-23
.2.
The
JLIS
sup
ports
mut
ual n
ode
auth
entic
atio
n (e
nsur
ing
the
auth
entic
ity o
f rem
ote
node
s) w
hen
com
mun
icat
ing
pers
onal
hea
lth in
form
atio
n ov
er th
e In
tern
et o
r oth
er k
now
n op
en n
etw
orks
usi
ng o
pen
prot
ocol
(e.g
., TL
S, I
PS
ec, X
ML
sig,
S/M
IME
).
Hig
h
J-24
. Th
e JL
IS g
ener
ates
an
audi
t rec
ord
whe
n au
dita
ble
even
t oc
curs
. Id
entif
y th
e ty
pes
of e
vent
s ca
ptur
ed b
y th
e so
lutio
n au
dit
tabl
es (i
nclu
ding
inap
prop
riate
acc
esse
s).
Hig
h
J-24
.1.
Aud
itabl
e ev
ents
are
a c
onfig
urab
le s
yste
m
para
met
er.
Hig
h
J-24
.1.1
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: sy
stem
sta
rt/st
op.
Hig
h
J-24
.1.2
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: us
er lo
gin/
logo
ut.
Hig
h
J-24
.1.3
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: no
de-a
uthe
ntic
atio
n fa
ilure
.
Hig
h
J-24
.1.4
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: an
y us
er/s
yste
m a
cces
s or
upd
ate
to p
atie
nt
and/
or c
linic
al d
ata.
Hig
h
Pag
e 67
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
24.1
.5.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
over
ridde
n co
nsen
t dire
ctiv
es.
Hig
h
J-24
.1.6
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: in
form
atio
n ex
port
(e.g
. prin
t).
Hig
h
J-24
.1.7
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: in
form
atio
n im
port.
Hig
h
J-24
.1.8
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: sy
stem
adm
inis
tratio
n ch
ange
to a
use
r co
nfig
urat
ion.
Hig
h
J-24
.1.9
. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: pa
ssw
ord
chan
ge.
Hig
h
J-24
.1.1
0.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
acce
ss to
aud
it re
cord
s.
Hig
h
J-24
.1.1
1.
Aud
itabl
e ev
ents
incl
ude:
use
r acc
ount
tim
e ou
ts.
Hig
h
J-24
.1.1
2.
Aud
itabl
e ev
ents
incl
ude:
all
auth
entic
atio
n de
cisi
ons.
H
igh
J-24
.1.1
3.
Aud
itabl
e ev
ents
incl
ude:
cre
atin
g us
er
acce
ss ri
ghts
. H
igh
J-24
.1.1
4.
Aud
itabl
e ev
ents
incl
ude:
ass
igni
ng
user
acc
ess
right
s.
Hig
h
J-24
.1.1
5.
Aud
itabl
e ev
ents
incl
ude:
upd
atin
g a
user
's o
wn
acce
ss ri
ghts
. H
igh
J-24
.1.1
6.
Aud
itabl
e ev
ents
incl
ude:
all
auth
oriz
atio
n de
cisi
ons.
H
igh
Pag
e 68
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
J-
24.1
.17.
A
udita
ble
even
ts in
clud
e: a
ll m
essa
ge
traffi
c.
Hig
h
J-24
.1.1
8.
Aud
itabl
e ev
ents
incl
ude:
bat
ch
proc
essi
ng o
utco
mes
(e.g
., er
rors
, suc
cess
ful
com
plet
ion)
.
Hig
h
J-24
.1.1
9.
Aud
itabl
e ev
ents
incl
ude:
all
adm
inis
trativ
e ev
ents
(e.g
. con
figur
atio
n ch
ange
s, q
uerie
s ag
ains
t the
aud
it ta
bles
). Id
entif
y th
e da
ta c
aptu
red
with
in th
e JL
IS a
udit
tabl
es.
Hig
h
J-24
.2.
The
JLIS
aud
it re
cord
s ar
e A
TNA
com
plia
nt (A
udit
Trai
l and
Nod
e A
uthe
ntic
atio
n, R
FC 3
881)
. H
igh
J-24
.2.1
. Th
e au
dit r
ecor
d in
clud
es: d
ate,
tim
e an
d tim
e zo
ne.
Hig
h
J-24
.2.2
. Th
e au
dit r
ecor
d in
clud
es: u
ser I
D.
Hig
h
J-
24.2
.3.
The
audi
t rec
ord
incl
udes
: use
r's ro
le.
Hig
h
J-
24.2
.4.
The
audi
t rec
ord
incl
udes
: use
r's
orga
niza
tion.
H
igh
J-24
.2.5
. Th
e au
dit r
ecor
d in
clud
es: p
atie
nt ID
. H
igh
J-24
.2.6
. Th
e au
dit r
ecor
d in
clud
es: f
unct
ion
perfo
rmed
(vie
w, e
dit,
prin
t).
Hig
h
J-24
.2.7
. Th
e au
dit r
ecor
d in
clud
es: p
rovi
der
loca
tion.
H
igh
J-24
.2.8
. Th
e au
dit r
ecor
d in
clud
es: c
onse
nt
over
ride
with
the
reas
on (i
f acc
ess
is a
n ov
errid
e ev
ent).
Hig
h
J-24
.2.9
. Th
e au
dit r
ecor
d in
clud
es: c
onse
nt
dire
ctiv
e ch
ange
by
subs
titut
e de
cisi
on m
aker
–
ID o
f dec
isio
n m
aker
.
Hig
h
J-24
.2.1
0.
The
audi
t rec
ord
incl
udes
: sou
rce
syst
em a
ddre
ss a
nd ID
. H
igh
Pag
e 69
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-24
.2.1
1.
The
audi
t rec
ord
incl
udes
: des
tinat
ion
syst
em a
ddre
ss a
nd ID
. H
igh
J-24
.2.1
2.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
deta
il (e
.g.,
com
plet
e H
L7 m
essa
ge).
Hig
h
J-24
.2.1
3.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
type
. H
igh
J-24
.2.1
4.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
stat
us (e
.g.,
proc
ess
outc
ome)
. H
igh
J-24
.2.1
5.
The
audi
t rec
ord
incl
udes
: au
then
ticat
ion
sour
ce.
Hig
h
J-24
.2.1
6.
The
audi
t rec
ord
incl
udes
: app
licat
ion
iden
tity.
H
igh
J-24
.2.1
7.
The
audi
t rec
ord
incl
udes
: pat
ient
fla
gged
for a
dditi
onal
priv
acy
audi
ting.
H
igh
J-24
.2.1
8.
The
audi
t rec
ord
incl
udes
: fla
gged
us
er a
cces
s to
a p
atie
nt w
here
no
prev
ious
re
latio
nshi
p w
as e
stab
lishe
d.
Hig
h
J-24
.2.1
9.
The
audi
t rec
ord
incl
udes
: met
adat
a fo
r sea
rchi
ng.
Hig
h
J-24
.3.
The
audi
t rec
ord
data
can
not b
e de
lete
d.
Hig
h
J-
24.4
. Th
e au
dit r
ecor
d da
ta c
anno
t be
mod
ified
. H
igh
J-24
.5.
The
JLIS
sup
ports
tim
e sy
nchr
oniz
atio
n w
ith a
n ex
tern
al N
etw
ork
Tim
e P
roto
col (
NTP
) and
reco
rd
time
stam
ps u
sing
UTC
bas
ed o
n IS
O 8
601-
2000
(e
.g.,
1994
-11-
05T0
8:15
:30-
05:0
0 co
rres
pond
s to
N
ovem
ber 5
, 199
4, 8
:15:
30 a
m, U
S E
aste
rn S
tand
ard
Tim
e).
Hig
h
J-24
.6.
JLIS
ope
ratio
n di
scon
tinue
s w
hen
the
logg
ing
is
non-
func
tiona
l. H
igh
J-24
.7.
The
JLIS
onl
y pe
rmits
read
acc
ess
to a
udit
logs
to
spec
ific
user
s.
Hig
h
Pag
e 70
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-24
.8.
The
audi
t log
s in
tegr
ate
with
the
exis
ting
EH
R
cent
ral a
udit
serv
ice.
H
igh
J-25
. Th
e JL
IS s
uppo
rts b
acku
p fu
nctio
nalit
y.
Des
crib
e th
e re
com
men
ded
appr
oach
for m
inim
izin
g th
e im
pact
to u
sers
and
dat
abas
e pe
rform
ance
.
Hig
h
J-25
.1.
The
JLIS
bac
kup
func
tiona
lity
oper
ates
co
ncur
rent
with
ope
ratio
n.
Iden
tify
any
third
par
ty to
ols
utiliz
ed a
nd d
escr
ibe
thei
r ro
le.
Hig
h
J-25
.2.
The
JLIS
bac
kup
func
tiona
lity
is s
ecur
e fro
m
unau
thor
ized
acc
ess.
D
escr
ibe
the
mec
hani
sms
avai
labl
e to
ens
ure
the
conf
iden
tialit
y an
d in
tegr
ity o
f bac
kup
files
aga
inst
un
auth
oriz
ed a
cces
s.
Hig
h
J-25
.3.
The
JLIS
bac
kups
sup
port
auto
mat
ion.
H
igh
J-25
.4.
The
JLIS
bac
kups
sup
port
sche
dulin
g.
Hig
h
J-
25.5
. Th
e JL
IS re
stor
e pr
oced
ures
resu
lt in
a fu
lly
oper
atio
nal a
nd s
ecur
e st
ate.
Id
entif
y if
the
JLIS
is a
ble
to re
stor
e fro
m th
e po
int o
f fa
ilure
and
indi
cate
exp
ecte
d da
ta lo
ss.
Hig
h
J-25
.5.1
. R
esto
ratio
n in
clud
es J
LIS
dat
a.
Hig
h
J-
25.5
.2.
Res
tora
tion
incl
udes
app
licat
ion
data
. H
igh
J-25
.5.3
. R
esto
ratio
n in
clud
es s
ecur
ity
cred
entia
ls.
Hig
h
J-25
.5.4
. R
esto
ratio
n in
clud
es a
uxilia
ry fi
les
(e.g
., au
dit a
nd lo
g fil
es).
Hig
h
J-25
.6.
Invo
ked
syst
em s
hutd
own
is o
rder
ly (e
.g.,
non-
dest
ruct
ive
with
dat
a in
tegr
ity m
aint
aine
d) w
ith n
o da
ta
loss
.
Hig
h
Pag
e 71
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-26
. Th
e JL
IS in
stal
ls a
nd o
pera
tes
all n
eces
sary
ser
vice
s an
d pr
otoc
ols
with
the
leas
t priv
ilege
pos
sibl
e.
Pro
vide
a d
etai
led
list o
f fun
ctio
ns a
nd a
pplic
atio
ns th
at
requ
ire a
dmin
or r
oot p
rivile
ges.
Hig
h
J-27
. JL
IS s
yste
m a
dmin
istra
tion
is p
erfo
rmed
thro
ugh
a co
mm
on G
UI i
nter
face
. H
igh
J-27
.1.
EH
R c
ompo
nent
adm
inis
tratio
n is
pro
vide
d th
roug
h w
eb-b
ased
tool
s su
ppor
ting
eith
er js
r168
or
wsr
p po
rtlet
s.
Hig
h
J-27
.2.
EH
R c
ompo
nent
adm
inis
tratio
n po
rtlet
s al
low
in
tegr
atio
n in
to a
com
mon
sys
tem
adm
inis
tratio
n to
ol.
Hig
h
J-28
. Th
e JL
IS a
dmin
istra
tion
porta
l sup
ports
use
r man
agem
ent.
Hig
h
J-
28.1
. Th
e JL
IS a
dmin
istra
tion
porta
l sup
ports
use
r ac
coun
t cre
atio
n, a
ctiv
atio
n an
d de
activ
atio
n.
Hig
h
J-28
.2.
The
JLIS
adm
inis
tratio
n po
rtal s
uppo
rts u
ser
pass
wor
d m
anag
emen
t. H
igh
J-28
.3.
The
JLIS
adm
inis
tratio
n po
rtal i
nteg
rate
s w
ith th
e ju
risdi
ctio
nal E
HR
aut
hent
icat
ion
and
auth
oriz
atio
n se
rvic
e.
Hig
h
J-28
.4.
The
JLIS
adm
inis
tratio
n po
rtal s
uppo
rts ro
le
base
d ac
cess
con
trol.
Hig
h
J-29
. Th
e JL
IS a
dmin
istra
tion
porta
l sup
ports
vie
win
g ba
tch
proc
ess
activ
ity.
Med
ium
J-29
.1.
The
JLIS
adm
inis
tratio
n po
rtal d
ispl
ays
a sc
hedu
le o
f upc
omin
g ba
tch
proc
esse
s.
Med
ium
J-29
.2.
The
JLIS
adm
inis
tratio
n po
rtal d
ispl
ays
batc
h pr
oces
sing
out
com
es fr
om th
e au
dit l
og.
Med
ium
J-30
. Th
e JL
IS a
dmin
istra
tion
porta
l pro
vide
s E
HR
com
pone
nt
oper
atio
nal f
eedb
ack
to c
entra
lized
mon
itorin
g ca
pabi
lity.
H
igh
Pag
e 72
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-30
.1.
The
JLIS
adm
inis
tratio
n po
rtal s
uppo
rts
oper
atio
nal r
epor
ting
of E
HR
com
pone
nt o
pera
tions
an
d bu
sine
ss p
roce
sses
(e.g
., us
age
met
rics)
.
Hig
h
J-30
.2.
The
JLIS
adm
inis
tratio
n po
rtal i
s ab
le to
acc
ess
and
disp
lay
the
cont
ents
of t
he a
udit
logs
. H
igh
J-30
.3.
The
JLIS
adm
inis
tratio
n po
rtal i
s ab
le to
acc
ess
and
disp
lay
erro
r log
ent
ries.
H
igh
J-30
.4.
The
JLIS
adm
inis
tratio
n po
rtal s
uppo
rts s
earc
h an
d fil
ter f
unct
iona
lity
(e.g
., by
pat
ient
iden
tifie
r, te
st
resu
lt, d
ate
rang
e, p
rovi
der,
faci
lity
and
cons
ent
over
ride
reas
on) w
hen
pres
entin
g au
dit l
og h
isto
ries.
Hig
h
J-31
. A
ll se
curit
y an
d ad
min
istra
tive
user
s ar
e st
rong
ly
auth
entic
ated
with
mul
ti-fa
ctor
aut
hent
icat
ion.
H
igh
J-31
.1.
All
secu
rity
and
adm
inis
trativ
e us
ers
have
uni
que
user
IDs
(incl
udin
g ve
ndor
s).
Hig
h
J-32
. Th
e JL
IS a
lerts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
whe
n pr
eset
eve
nts
occu
r. H
igh
J-32
.1.
Out
boun
d m
essa
ge e
rrors
pro
mpt
not
ifica
tion
to
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
. Id
entif
y th
e sc
ope
of e
rrors
sup
porte
d an
d th
e no
tific
atio
n ch
anne
ls a
vaila
ble.
Hig
h
J-32
.2.
The
JLIS
ale
rts th
e ap
prop
riate
sys
tem
ad
min
istra
tion
auth
ority
whe
n pr
eset
que
ue th
resh
olds
ha
ve b
een
reac
hed.
D
escr
ibe
aler
t cap
abili
ties
incl
udin
g al
ert d
eliv
ery
chan
nels
(e.g
., pa
ge, e
mai
l, de
liver
y of
mes
sage
to a
qu
eue
whi
ch is
per
iodi
cally
che
cked
).
Hig
h
Pag
e 73
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
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2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-32
.3.
The
JLIS
ale
rts th
e ap
prop
riate
sys
tem
ad
min
istra
tion
auth
ority
whe
n a
pred
efin
ed a
nd
conf
igur
able
erro
r con
ditio
n oc
curs
(eith
er w
ith a
sp
ecifi
c m
essa
ge o
r with
spe
cific
sys
tem
s co
mpo
nent
s).
Des
crib
e er
ror a
nd a
lert
capa
bilit
ies
incl
udin
g al
ert
deliv
ery
chan
nels
.
Hig
h
J-32
.4.
The
JLIS
pro
activ
ely
mon
itors
per
form
ance
and
al
erts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
w
hen
a pr
eset
thre
shol
d ha
s be
en e
xcee
ded.
D
escr
ibe
the
avai
labl
e JL
IS c
apab
ilitie
s, to
ols
and
proc
esse
s fo
r mon
itorin
g (p
roac
tive
and
reac
tive)
in
clud
ing
erro
r mes
sage
ana
lysi
s (e
.g.,
trend
ing)
and
al
ert d
eliv
ery
chan
nels
. D
escr
ibe
any
tool
s or
tem
plat
es th
at a
re a
vaila
ble
for
the
JLIS
to s
uppo
rt ca
paci
ty p
lann
ing.
Hig
h
J-33
. Th
e JL
IS s
uppo
rts d
ata
arch
ival
and
retri
eval
func
tiona
lity.
D
escr
ibe
the
capa
bilit
ies,
tool
s an
d pr
oces
ses
requ
ired
to
conf
igur
e ar
chiv
ing,
incl
udin
g ab
ility
to s
peci
fy h
ow lo
ng th
e pr
oces
sed
mes
sage
s ar
e ke
pt.
Hig
h
J-34
. Th
e JL
IS a
chie
ves
the
avai
labi
lity
targ
ets
(as
iden
tifie
d in
th
is R
FP S
ectio
n 2)
. D
escr
ibe
the
appr
oach
, arc
hite
ctur
e an
d pr
oces
ses
for
achi
evin
g th
e av
aila
bilit
y ta
rget
s.
Iden
tify
any
addi
tiona
l (e.
g., t
hird
par
ty) h
ardw
are
and
softw
are
requ
ired
for h
igh
avai
labi
lity.
Des
crib
e an
y to
ols
or te
mpl
ates
that
are
ava
ilabl
e fo
r the
JL
IS to
sup
port
busi
ness
con
tinui
ty p
lann
ing.
Hig
h
Pag
e 74
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
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2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-35
. Th
e JL
IS p
roce
sses
tran
sact
ions
with
in th
e pe
rform
ance
ta
rget
s ou
tline
d by
the
Cen
tre.
Des
crib
e th
e ap
proa
ch, a
rchi
tect
ure
and
proc
esse
s fo
r ac
hiev
ing
thes
e ta
rget
s.
Iden
tify
any
perfo
rman
ce tu
ning
tool
s an
d fu
nctio
ns
reco
mm
ende
d fo
r the
JLI
S (in
dica
te w
hich
are
incl
uded
w
ith th
e JL
IS a
nd w
hich
the
Cen
tre is
to a
cqui
re).
Hig
h
J-35
.1.
The
JLIS
retu
rns
the
resu
lts o
f a d
eter
min
istic
qu
ery
with
in 0
.5 s
econ
ds, 9
5% o
f the
tim
e.
Hig
h
J-35
.2.
The
JLIS
retu
rns
the
resu
lts o
f a n
on-d
eter
min
istic
qu
ery
(ret
urni
ng u
p to
25
reco
rds)
with
in 1
.5 s
econ
ds,
95%
of t
he ti
me.
Hig
h
J-36
. Th
e JL
IS p
roce
sses
and
sto
res
20+
milli
on la
b re
sults
an
nual
ly (b
ased
on
2010
est
imat
es) w
ith a
ccom
mod
atio
n fo
r ann
ual i
ncre
ases
.
Hig
h
J-37
. A
ppro
pria
te d
ocum
enta
tion
is in
clud
ed fo
r all
com
pone
nts
Hig
h
J-
37.1
. D
ocum
enta
tion
is c
urre
nt
Hig
h
J-
37.2
. D
ocum
enta
tion
is m
aint
aine
d by
the
vend
or
Hig
h
J-
37.3
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to T
echn
ical
A
rchi
tect
ure.
H
igh
J-37
.3.1
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to P
hysi
cal H
ardw
are
Des
ign
Hig
h
J-37
.3.2
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to V
irtua
lizat
ion
Hig
h
J-37
.3.3
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to N
etw
orki
ng D
esig
n H
igh
J-37
.4.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Dat
abas
e D
esig
n H
igh
Pag
e 75
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-37
.4.1
. JL
IS d
ata
mod
el d
ocum
enta
tion
desc
ribes
maj
or e
ntiti
es a
nd re
latio
nshi
ps.
Pro
vide
a d
escr
iptio
n of
how
mod
els
will
be
elab
orat
ed d
urin
g th
e de
tail
requ
irem
ents
and
de
sign
of t
he J
LIS
.
Hig
h
J-37
.5.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
SH
R
Arc
hite
ctur
e/D
esig
n (e
.g.,
diag
ram
s fo
r the
app
licat
ion
arch
itect
ure
tier d
iagr
ams,
com
pone
nt in
terfa
ce
desc
riptio
ns, i
EH
R c
ompo
nent
des
crip
tions
).
Hig
h
J-37
.5.1
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to a
pplic
atio
n de
ploy
men
t mod
el.
Hig
h
J-37
.6.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Bus
ines
s C
ontin
uity
. H
igh
J-37
.6.1
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to B
acku
p P
roce
ss.
Hig
h
J-37
.6.2
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to D
isas
ter R
ecov
ery.
H
igh
J-37
.7.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
M
aint
enan
ce a
nd S
uppo
rt C
ontra
cts.
H
igh
J-37
.7.1
. D
ocum
enta
tion
incl
udes
app
licab
le
Ser
vice
Lev
el A
gree
men
ts (e
.g.,
supp
ort
leve
ls, s
uppo
rt ho
urs,
resp
onse
tim
es, s
uppo
rt te
am lo
catio
ns).
Hig
h
J-37
.7.2
. D
ocum
enta
tion
incl
udes
sup
port
mod
el (e
.g.,
esca
latio
n pr
oced
ures
, ITI
L co
mpl
ianc
e, in
tegr
atio
n w
ith T
ier 1
sup
port
at
the
Cen
tre).
Iden
tify
the
reso
urce
s th
at a
re re
quire
d to
pe
rform
ope
ratio
ns, m
aint
enan
ce, s
uppo
rt an
d tro
uble
-sho
otin
g.
Hig
h
J-37
.7.3
. D
ocum
enta
tion
iden
tifie
s ve
ndor
su
ppor
t obl
igat
ions
for p
revi
ous
vers
ions
. H
igh
Pag
e 76
New
foun
dlan
d an
d La
brad
or
R
FP#:
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entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-37
.7.4
. D
ocum
enta
tion
iden
tifie
s pr
oduc
t no
tific
atio
n an
d ad
viso
ry p
roce
sses
. H
igh
J-37
.8.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
O
pera
tions
and
Mai
nten
ance
H
igh
J-37
.8.1
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to A
pplic
atio
n In
stal
latio
n H
igh
J-37
.8.2
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to O
pera
ting
Sys
tem
Inst
alla
tion
Hig
h
J-37
.9.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Sec
urity
. H
igh
J-37
.9.1
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
ecur
ity P
roce
dure
s H
igh
J-37
.9.2
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
yste
m H
arde
ning
H
igh
J-37
.10.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to R
elea
se
Man
agem
ent
Hig
h
J-37
.10.
1.
Doc
umen
tatio
n in
clud
es a
form
al
prod
uct r
elea
se s
ched
ule.
H
igh
J-37
.10.
2.
Doc
umen
tatio
n in
clud
es s
tand
ards
ad
optio
n an
d co
nfor
man
ce s
ched
ule.
H
igh
J-37
.10.
3.
Doc
umen
tatio
n in
clud
es S
oftw
are
Rel
ease
Not
es fo
r all
appl
ied
patc
hes
or
softw
are
upda
tes
Hig
h
J-37
.10.
4.
App
licat
ion
sour
ce c
ode
(if s
uppl
ied)
is
docu
men
ted
Hig
h
J-37
.10.
5.
Pro
mot
ion
proc
esse
s us
ed fo
r ap
plic
atio
n m
igra
tion
betw
een
envi
ronm
ents
is
docu
men
ted.
Id
entif
y th
e m
etho
ds a
nd to
ols
prov
ided
with
th
e JL
IS.
Hig
h
J-37
.10.
6.
The
JLIS
gat
ing
docu
men
tatio
n in
clud
es a
n up
date
d op
erat
ions
gui
de.
Hig
h
Pag
e 77
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
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2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
J-37
.10.
7.
The
JLIS
gat
ing
docu
men
tatio
n in
clud
es a
n up
date
d S
ervi
ce d
esk
troub
lesh
ootin
g gu
ide.
Hig
h
J-37
.10.
8.
The
JLIS
gat
ing
docu
men
tatio
n in
clud
es a
n im
plem
enta
tion
plan
. H
igh
J-37
.10.
9.
The
JLIS
gat
ing
docu
men
tatio
n in
clud
es a
test
ing
plan
and
resu
lts s
umm
ary.
H
igh
J-37
.11.
D
ocum
enta
tion
incl
udes
rele
vant
trai
ning
mat
eria
l (e
.g.,
busi
ness
pro
cess
cha
nges
, bro
chur
e-w
are,
op
erat
iona
l bes
t pra
ctic
es).
Hig
h
J-38
. A
ppro
pria
te p
roje
ct d
ocum
enta
tion
is in
clud
ed fo
r the
initi
al
impl
emen
tatio
n (e
.g.,
risk
man
agem
ent,
proj
ect p
lan,
tra
nsiti
on p
lan,
impl
emen
tatio
n pl
an, k
now
ledg
e tra
nsfe
r, te
stin
g pl
an).
Hig
h
J-39
. Th
e JL
IS s
tore
s hu
man
lab
test
ord
ers.
M
ediu
m
J-39
.1.
The
JLIS
sto
res
gene
ral l
abor
ator
y te
st o
rder
s.
Med
ium
J-
39.2
. Th
e JL
IS s
tore
s m
icro
biol
ogy
labo
rato
ry te
st
orde
rs.
Med
ium
J-39
.3.
The
JLIS
sto
res
bloo
d ba
nk o
rder
s.
Med
ium
J-
39.4
. Th
e JL
IS s
tore
s pa
thol
ogy
and
cyto
logy
la
bora
tory
test
ord
ers.
M
ediu
m
Pag
e 78
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
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ealth
Info
rmat
ion
10
.3EH
R D
eskt
op V
iew
er R
equi
rem
ents
Mat
rix
N
ot A
pplic
able
– c
heck
if re
spon
se d
oes
not a
ddre
ss th
e EH
R D
eskt
op V
iew
er R
equi
rem
ents
Req
uire
men
t Pr
iorit
y R
espo
nse
F / P
/ N
C
omm
ents
V-1
. Th
e us
er "h
ome
page
" pro
vide
s us
er-c
entri
c fu
nctio
nalit
y.
Hig
h
V
-1.1
. Th
e us
er "h
ome
page
" is
user
con
figur
able
with
in
the
cont
ext o
f the
ir ro
le.
Hig
h
V-1
.2.
The
user
"hom
e pa
ge" p
rovi
des
for d
ispl
ayin
g no
tific
atio
ns.
Hig
h
V-1
.2.1
. N
otifi
catio
ns m
ay in
clud
e E
HR
sys
tem
no
tific
atio
ns.
Hig
h
V-1
.2.2
. N
otifi
catio
ns m
ay in
clud
e un
read
re
sults
and
repo
rts th
at a
re s
ort-a
ble
and
filte
rabl
e by
sta
tus
and
date
.
Hig
h
V-2
. Th
e vi
ewer
sup
ports
pat
ient
sea
rche
s.
Man
dato
ry
V-2
.1.
The
view
er s
uppo
rts d
eter
min
istic
pat
ient
se
arch
es.
Man
dato
ry
V-2
.2.
The
view
er s
uppo
rts p
roba
bilis
tic p
atie
nt s
earc
hes.
M
anda
tory
V
-2.3
. P
atie
nt s
earc
hing
is b
ased
upo
n a
spec
ific
patie
nt
(i.e.
, pat
ient
cen
tric
vers
us m
ultip
le p
atie
nts)
. H
igh
V-2
.4.
Pat
ient
sea
rche
s ut
ilize
the
NL
Clie
nt R
egis
try.
Des
crib
e th
e sc
ope
of a
ny p
revi
ous
expe
rienc
e w
ith
clie
nt re
gist
ries.
Hig
h
V-2
.5.
All
patie
nt s
earc
h fie
lds
are
re-in
itial
ized
(i.e
., al
l se
arch
fiel
ds a
re b
lank
and
do
not c
onta
in a
ny d
efau
lt or
cac
hed
valu
es).
Med
ium
Pag
e 79
New
foun
dlan
d an
d La
brad
or
R
FP#:
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entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-2.6
. Th
e vi
ewer
dis
play
s a
war
ning
mes
sage
to th
e us
er if
the
min
imum
sea
rch
crite
ria fo
r a p
atie
nt
sear
ch h
ave
not b
een
met
.
Med
ium
V-2
.7.
The
type
s of
pat
ient
sea
rch
crite
ria a
vaila
ble
to a
us
er a
re c
ontro
lled
by th
eir r
ole.
H
igh
V-2
.8.
Vie
wer
fiel
ds (e
.g.,
patie
nt s
earc
h) th
at h
ave
a fin
ite s
et o
f per
mis
sibl
e us
er re
spon
ses
use
a se
lect
able
list
.
Hig
h
V-2
.9.
An
audi
t ent
ry is
cre
ated
of t
he s
earc
h cr
iteria
use
d w
hile
per
form
ing
a pa
tient
sea
rch.
H
igh
V-2
.10.
Th
e vi
ewer
dis
play
s a
war
ning
mes
sage
to th
e us
er if
the
max
imum
num
ber o
f sea
rch
resu
lts is
ex
ceed
ed.
Des
crib
e ho
w u
sers
are
mad
e aw
are
that
the
sea
rch
has
been
lim
ited
(i.e.
mor
e is
ava
ilabl
e).
Hig
h
V-2
.11.
Th
e nu
mbe
r of s
earc
h re
sults
dis
play
ed a
t any
one
tim
e is
a s
yste
m c
onfig
urab
le n
umbe
r.
Hig
h
V-2
.12.
Th
e vi
ewer
allo
ws
user
s to
nav
igat
e ba
ck a
nd fo
rth
thro
ugh
the
retu
rned
sea
rch
resu
lts a
ccor
ding
to th
e di
spla
y m
axim
um.
Med
ium
V-2
.13.
Th
e vi
ewer
dis
play
s th
e se
arch
cou
nt o
f rec
ords
fo
und.
M
ediu
m
V-2
.14.
P
atie
nt d
ata
is d
ispl
ayed
for e
ach
patie
nt s
earc
h re
sult.
H
igh
V-2
.14.
1.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt ar
e sy
stem
con
figur
able
. H
igh
V-2
.14.
2.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt m
ay in
clud
e (b
ut a
re n
ot
limite
d to
): pa
tient
iden
tifie
rs.
Hig
h
V-2
.14.
3.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt m
ay in
clud
e (b
ut a
re n
ot
limite
d to
): pa
tient
nam
e.
Hig
h
Pag
e 80
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-2.1
4.4.
Th
e da
ta e
lem
ents
dis
play
ed fo
r a
patie
nt s
earc
h re
sult
may
incl
ude
(but
are
not
lim
ited
to):
age
and
date
of b
irth.
Hig
h
V-2
.14.
5.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt m
ay in
clud
e (b
ut a
re n
ot
limite
d to
): ge
nder
.
Hig
h
V-2
.14.
6.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt m
ay in
clud
e (b
ut a
re n
ot
limite
d to
): ad
dres
s.
Hig
h
V-2
.14.
7.
The
data
ele
men
ts d
ispl
ayed
for a
pa
tient
sea
rch
resu
lt m
ay in
clud
e (b
ut a
re n
ot
limite
d to
): ph
one
num
ber.
Hig
h
V-2
.14.
8.
The
view
er s
uppo
rts m
aske
d pa
tient
se
arch
resu
lt da
ta.
Hig
h
V-2
.14.
9.
Pat
ient
sea
rch
resu
lts a
re s
ort-a
ble
(e.g
., so
rt in
asc
endi
ng o
r des
cend
ing
orde
r by
clic
king
the
colu
mn
head
ing)
.
Med
ium
V-2
.15.
A
n au
dit e
ntry
is c
reat
ed fo
r the
pat
ient
list
re
turn
ed to
a u
ser f
ollo
win
g a
patie
nt s
earc
h.
Hig
h
V-2
.16.
A
n au
dit e
ntry
is c
reat
ed fo
r the
pat
ient
list
di
spla
yed
to a
use
r fol
low
ing
a pa
tient
sea
rch.
H
igh
V-3
. Th
e vi
ewer
pro
vide
s th
e us
er w
ith p
atie
nt li
sts
for q
uick
ac
cess
to p
atie
nts
of in
tere
st.
D
escr
ibe
how
thes
e lis
ts a
re s
ervi
ced.
Med
ium
V-3
.1.
The
view
er a
llow
s us
ers
to a
dd a
pat
ient
(whe
n in
co
ntex
t) to
a p
atie
nt li
st.
Med
ium
V-3
.2.
The
view
er a
llow
s us
ers
to re
mov
e pa
tient
s fro
m a
pa
tient
list
. M
ediu
m
V-3
.3.
The
view
er a
llow
s us
ers
to a
dd a
pat
ient
list
. M
ediu
m
V-3
.4.
The
view
er a
llow
s us
ers
to re
mov
e a
patie
nt li
st.
Med
ium
Pag
e 81
New
foun
dlan
d an
d La
brad
or
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-3.5
. Th
e vi
ewer
cre
ates
an
audi
t ent
ry fo
r eac
h pa
tient
ad
ded
or re
mov
ed fr
om a
pat
ient
list
. M
ediu
m
V-4
. Th
e vi
ewer
dis
play
s a
patie
nt s
umm
ary
page
whe
n a
patie
nt is
sel
ecte
d.
Hig
h
V-4
.1.
The
patie
nt s
umm
ary
scre
en is
sys
tem
co
nfig
urab
le.
Hig
h
V-4
.2.
The
patie
nt s
umm
ary
scre
en u
tiliz
es in
form
atio
n fro
m th
e E
HR
Inde
x an
d re
posi
torie
s.
Hig
h
V-4
.2.1
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: p
atie
nt d
emog
raph
ics.
H
igh
V-4
.2.2
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: e
ncou
nter
his
tory
. H
igh
V-4
.2.3
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: la
b re
sults
and
repo
rts.
Hig
h
V-4
.2.4
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: c
linic
al re
ports
. H
igh
V-4
.2.5
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: a
ctiv
e m
edic
atio
n pr
ofile
. H
igh
V-4
.2.6
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: d
iagn
ostic
imag
ing
resu
lts a
nd
repo
rts.
Hig
h
V-4
.2.7
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: a
llerg
ies.
H
igh
V-4
.2.8
. P
atie
nt s
umm
ary
info
rmat
ion
may
in
clud
e: im
mun
izat
ions
. H
igh
V-5
. Li
sts
of c
linic
al re
sults
, rep
orts
and
doc
umen
ts c
an b
e m
anip
ulat
ed b
y th
e us
er.
Hig
h
V-5
.1.
Clin
ical
resu
lt/do
cum
ent l
ists
are
sor
t-abl
e (e
.g.,
by
date
). H
igh
V-5
.2.
Clin
ical
resu
lt/do
cum
ent l
ists
are
filte
rabl
e.
Hig
h
Pag
e 82
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foun
dlan
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rmat
ion
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e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-5.2
.1.
The
view
er a
llow
s us
ers
to fi
lter
labo
rato
ry re
ports
for c
ritic
al re
sults
. H
igh
V-5
.3.
Clin
ical
resu
lt/do
cum
ent l
ists
are
col
laps
ible
and
ex
pand
able
. H
igh
V-5
.4.
The
view
er d
ispl
ays
the
late
st v
ersi
on o
f re
sults
/doc
umen
ts.
Hig
h
V-5
.4.1
. Th
e vi
ewer
dis
play
s a
link
to p
revi
ous
vers
ions
of r
esul
ts/d
ocum
ents
. H
igh
V-5
.5.
The
view
er v
isua
lly d
istin
guis
hes
canc
elle
d re
sults
/doc
umen
ts.
Hig
h
V-5
.6.
The
view
er v
isua
lly d
istin
guis
hes
unre
ad
resu
lts/d
ocum
ents
. H
igh
V-5
.6.1
. Th
e vi
ewer
vis
ually
dis
tingu
ishe
s re
sults
/doc
umen
ts th
at w
ere
view
ed in
the
past
bu
t hav
e si
nce
been
mod
ified
.
Hig
h
V-5
.6.2
. Th
e vi
ewer
allo
ws
a us
er to
mar
k re
sults
/doc
umen
ts a
s ei
ther
read
or u
nrea
d.
Hig
h
V-5
.6.3
. Th
e vi
ewer
has
the
abilit
y to
filte
r la
bora
tory
repo
rts b
y re
ad s
tatu
s (e
.g.,
all,
read
, unr
ead)
.
Hig
h
V-5
.7.
The
view
er v
isua
lly d
istin
guis
hes
abno
rmal
resu
lts
on th
e lis
t of r
esul
ts a
wai
ting
revi
ew.
Hig
h
V-5
.8.
The
view
er v
isua
lly d
istin
guis
hes
criti
cal (
dang
er)
resu
lts o
n th
e lis
t of r
esul
ts a
wai
ting
revi
ew.
Hig
h
V-5
.9.
Clin
ical
resu
lts/re
ports
/doc
umen
ts a
re o
rgan
ized
in
to c
ateg
orie
s (e
.g.,
labo
rato
ry, d
iagn
ostic
imag
ing,
ca
rdio
logy
, neu
rolo
gy a
nd c
linic
al d
ocum
ents
) and
su
b-ca
tego
ries.
Hig
h
V-5
.9.1
. Th
e vi
ewer
dis
play
s th
e ‘C
ateg
ory’
and
'S
ub C
ateg
ory'
ass
ocia
ted
with
the
resu
lt/re
port
in th
e m
essa
ge c
omin
g fro
m th
e S
HR
to g
roup
the
resu
lts/re
ports
in th
e vi
ewer
.
Hig
h
Pag
e 83
New
foun
dlan
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ealth
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rmat
ion
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e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-5.9
.2.
Labo
rato
ry re
sults
are
sub
-cat
egor
ized
in
to g
roup
s (e
.g.,
Che
mis
try, H
aem
atol
ogy,
C
oagu
latio
n, T
rans
fusi
on M
edic
ine,
M
icro
biol
ogy,
Pat
holo
gy, C
ytol
ogy,
Ser
olog
y,
Mol
ecul
ar P
atho
logy
, Cha
lleng
e, a
nd O
ther
).
Hig
h
V-5
.9.3
. D
iagn
ostic
Imag
ing
repo
rts a
re s
ub-
cate
goriz
ed in
to g
roup
s (e
.g.,
Bon
e D
ensi
ty, X
-R
ay, U
ltras
ound
, CT
Sca
n, M
amm
ogra
m, M
RI,
Nuc
lear
Med
icin
e, In
terv
entio
nal R
adio
logy
an
d O
ther
).
Hig
h
V-5
.9.4
. C
ardi
olog
y re
ports
are
sub
-ca
tego
rized
into
gro
ups
(e.g
., E
CG
, E
choc
ardi
ogra
m, C
ardi
ac C
ath/
EP
Stu
dies
, P
acem
aker
/ICD
, Stre
ss T
est/D
SE
/ES
E, H
olte
r or
Arrh
ythm
ia M
onito
r, A
mbu
lato
ry B
P M
onito
r an
d O
ther
).
Hig
h
V-5
.9.5
. N
euro
logy
repo
rts a
re s
ub-c
ateg
oriz
ed
into
gro
ups
(e.g
., E
EG
, EM
G, E
voke
d R
epor
ts,
and
Oth
er).
Hig
h
V-5
.9.6
. R
emai
ning
clin
ical
doc
umen
ts a
re s
ub-
cate
goriz
ed in
to g
roup
s (e
.g.,
Con
sulta
tions
, D
isch
arge
Sum
mar
ies,
His
tory
and
Phy
sica
ls,
Dia
gnos
tic P
roce
dure
s, O
pera
tive
Rep
orts
, C
linic
, Men
tal H
ealth
and
Add
ictio
n S
ervi
ces,
E
mer
genc
y D
epar
tmen
t Vis
its, a
nd O
ther
).
Hig
h
V-5
.9.7
. Th
e vi
ewer
dis
play
s al
l re
sults
/repo
rts/d
ocum
ents
with
in e
ach
cate
gory
in d
esce
ndin
g se
rvic
e da
te o
rder
.
Hig
h
V-5
.9.8
. Th
e vi
ewer
vis
ually
dis
tingu
ishe
s an
y ca
tego
ry, s
ub-c
ateg
ory,
tab
or fo
lder
co
ntai
ning
unr
ead
repo
rts.
Hig
h
V-6
. Th
e vi
ewer
dis
play
s pa
tient
dem
ogra
phic
s fo
r the
pat
ient
in
cont
ext,
whe
n se
lect
ed.
Hig
h
Pag
e 84
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foun
dlan
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ion
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e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-6.1
. Th
e pa
tient
dem
ogra
phic
dat
a el
emen
ts d
ispl
ayed
w
ithin
the
view
er a
re s
yste
m c
onfig
urab
le.
Hig
h
V-6
.2.
The
patie
nt d
emog
raph
ic d
ata
elem
ents
util
ize
the
NL
EH
R C
lient
Reg
istry
. H
igh
V-6
.2.1
. P
atie
nt d
emog
raph
ic d
ata
may
incl
ude
(but
not
lim
ited
to):
patie
nt n
ames
. H
igh
V-6
.2.2
. P
atie
nt d
emog
raph
ic d
ata
may
incl
ude
(but
not
lim
ited
to):
patie
nt id
entif
iers
(all)
. H
igh
V-6
.2.3
. P
atie
nt d
emog
raph
ic d
ata
may
incl
ude
(but
not
lim
ited
to):
cont
act i
nfor
mat
ion
(suc
h as
add
ress
and
pho
ne n
umbe
r).
Hig
h
V-6
.2.4
. P
atie
nt d
emog
raph
ic d
ata
may
incl
ude
(but
not
lim
ited
to) s
econ
dary
crit
eria
suc
h as
: ge
nder
.
Hig
h
V-6
.2.5
. P
atie
nt d
emog
raph
ic d
ata
may
incl
ude
(but
not
lim
ited
to) s
econ
dary
crit
eria
suc
h as
: da
te o
f birt
h an
d ag
e.
Hig
h
V-7
. Th
e vi
ewer
dis
play
s en
coun
ter h
isto
ry d
etai
l for
the
patie
nt
in c
onte
xt, w
hen
sele
cted
. H
igh
V-7
.1.
The
patie
nt e
ncou
nter
det
ail d
ata
elem
ents
are
sy
stem
con
figur
able
. H
igh
V-7
.2.
The
patie
nt e
ncou
nter
det
ail d
ata
elem
ents
util
ize
a S
HR
repo
sito
ry.
Hig
h
V-7
.2.1
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r em
erge
ncy
and
outp
atie
nt
enco
unte
rs):
Reg
iste
r dat
e.
Hig
h
V-7
.2.2
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r em
erge
ncy
and
outp
atie
nt
enco
unte
rs):
Dep
art d
ate.
Hig
h
V-7
.2.3
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r em
erge
ncy
and
outp
atie
nt
enco
unte
rs):
Leng
th o
f sta
y.
Hig
h
Pag
e 85
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foun
dlan
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ealth
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ion
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e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-7.2
.4.
Pat
ient
enc
ount
er d
etai
l dat
a el
emen
ts
may
incl
ude
(for e
mer
genc
y an
d ou
tpat
ient
en
coun
ters
): V
isit
reas
on.
Hig
h
V-7
.2.5
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r em
erge
ncy
and
outp
atie
nt
enco
unte
rs):
Faci
lity.
Hig
h
V-7
.2.6
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r em
erge
ncy
and
outp
atie
nt
enco
unte
rs):
Prim
ary
care
phy
sici
an.
Hig
h
V-7
.2.7
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r adm
itted
/inpa
tient
or o
ther
en
coun
ters
): A
dmis
sion
dat
e.
Hig
h
V-7
.2.8
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r adm
itted
/inpa
tient
or o
ther
en
coun
ters
): D
isch
arge
dat
e.
Hig
h
V-7
.2.9
. P
atie
nt e
ncou
nter
det
ail d
ata
elem
ents
m
ay in
clud
e (fo
r adm
itted
/inpa
tient
or o
ther
en
coun
ters
): Le
ngth
of s
tay.
Hig
h
V-7
.2.1
0.
Pat
ient
enc
ount
er d
etai
l dat
a el
emen
ts
may
incl
ude
(for a
dmitt
ed/in
patie
nt o
r oth
er
enco
unte
rs):
Vis
it re
ason
.
Hig
h
V-7
.2.1
1.
Pat
ient
enc
ount
er d
etai
l dat
a el
emen
ts
may
incl
ude
(for a
dmitt
ed/in
patie
nt o
r oth
er
enco
unte
rs):
Faci
lity.
Hig
h
V-7
.2.1
2.
Pat
ient
enc
ount
er d
etai
l dat
a el
emen
ts
may
incl
ude
(for a
dmitt
ed/in
patie
nt o
r oth
er
enco
unte
rs):
Atte
ndin
g ph
ysic
ian.
Hig
h
V-7
.3.
The
view
er d
ispl
ays
all S
HR
and
JLI
S re
sults
as
soci
ated
with
a s
peci
fic e
ncou
nter
(if t
he li
nkag
e ex
ists
).
Low
V-8
. Th
e vi
ewer
dis
play
s la
b re
sult
deta
il fo
r the
pat
ient
in
cont
ext,
whe
n se
lect
ed.
Hig
h
V-8
.1.
The
view
er h
as th
e ab
ility
to d
ispl
ay a
sin
gle
resu
lt.
Hig
h
Pag
e 86
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ealth
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rmat
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e R
equi
rem
ent
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rity
Com
men
ts
F / P
/ N
V
-8.2
. Th
e la
b re
sult
deta
il da
ta e
lem
ents
are
sys
tem
co
nfig
urab
le.
Hig
h
V-8
.3.
The
lab
resu
lt de
tail
data
ele
men
ts u
tiliz
e a
JLIS
re
posi
tory
. H
igh
V-8
.3.1
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Per
form
ing
labo
rato
ry fa
cilit
y ID
. H
igh
V-8
.3.2
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Ord
erin
g la
bora
tory
faci
lity
ID.
Hig
h
V-8
.3.3
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Ass
ocia
ted
prov
ider
IDs
(e.g
., or
derin
g, a
dmitt
ing,
atte
ndin
g, re
ferri
ng,
cons
ultin
g, fa
mily
).
Hig
h
V-8
.3.4
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
LO
INC
/pC
LOC
D c
ode.
H
igh
V-8
.3.5
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
SN
OM
ED
-CT
(e.g
., or
gani
sm c
odes
). H
igh
V-8
.3.6
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Obs
erva
tion
/ res
ult w
ith a
ssoc
iate
d no
rmal
rang
e an
d un
its o
f mea
sure
(if
appl
icab
le).
Hig
h
V-8
.3.7
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Obs
erva
tion
/ ver
ified
dat
e, ti
me
and
time
zone
.
Hig
h
V-8
.3.8
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Spe
cim
en, g
roup
, pro
file
and
test
st
atus
es.
Hig
h
V-8
.3.9
. La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Abn
orm
ality
sta
tus.
H
igh
V-8
.3.1
0.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: E
xter
nal c
omm
ents
. H
igh
V-8
.3.1
1.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: T
est v
erifi
er.
Hig
h
Pag
e 87
New
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-8.3
.12.
La
b te
st re
sult
data
ele
men
ts m
ay
incl
ude:
Ref
lex
indi
cato
r.
Hig
h
V-8
.3.1
3.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: M
etho
d (o
ptio
nal w
here
rele
vant
). H
igh
V-8
.3.1
4.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: A
cces
sion
/ sp
ecim
en n
umbe
r.
Hig
h
V-8
.3.1
5.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: C
olle
ctio
n da
te, t
ime
and
time
zone
. H
igh
V-8
.3.1
6.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: S
peci
men
rece
ive
date
, tim
e an
d tim
e zo
ne.
Hig
h
V-8
.3.1
7.
Lab
test
resu
lt da
ta e
lem
ents
may
in
clud
e: P
rint n
umbe
r.
Hig
h
V-8
.4.
The
view
er p
rovi
des
the
abilit
y to
sel
ect a
test
re
sult
and
view
ass
ocia
ted
orde
r inf
orm
atio
n.
Hig
h
V-8
.5.
The
view
er d
ispl
ays
both
dis
cret
e an
d te
xtua
l re
sult
form
ats
for t
est r
esul
ts.
Hig
h
V-8
.6.
The
view
er s
uppo
rts P
an-C
anad
ian
term
inol
ogy
stan
dard
s vi
a a
HIA
L te
rmin
olog
y se
rvic
e (w
here
ap
plic
able
).
Hig
h
V-8
.7.
The
view
er d
istin
guis
hes
‘Pre
limin
ary
Ver
ified
’ re
ports
from
‘Fin
al V
erifi
ed’ r
epor
ts u
sing
dat
e fo
r m
icro
biol
ogy
resu
lts.
Hig
h
V-8
.8.
The
view
er a
llow
s th
e us
er to
nav
igat
e be
twee
n a
sing
le a
nd a
cum
ulat
ive
resu
lt vi
ew.
Med
ium
V-8
.9.
The
view
er h
as th
e ab
ility
to d
ispl
ay c
umul
ativ
e re
sults
acr
oss
mul
tiple
lab
repo
rts.
Hig
h
V-8
.10.
Th
e vi
ewer
has
the
abilit
y to
dis
play
cum
ulat
ive
resu
lts in
asc
endi
ng o
r des
cend
ing
orde
r. M
ediu
m
V-8
.11.
Th
e vi
ewer
is a
ble
to d
ispl
ay u
nits
of m
easu
re a
s su
pplie
d by
the
dom
ain
repo
sito
ries.
H
igh
Pag
e 88
New
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dlan
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-8.1
2.
The
view
er s
houl
d pr
ovid
e th
e ab
ility
to
colla
pse/
expa
nd a
ll te
st re
sults
ass
ocia
ted
with
a
prof
ile o
r pan
el.
Low
V-8
.13.
Th
e pa
nel r
esul
t seq
uenc
e fo
llow
s th
e sa
me
sequ
ence
as
spec
ified
by
the
perfo
rmin
g fa
cilit
y (u
sing
M
edite
ch p
rint n
umbe
r).
Hig
h
V-9
. Th
e vi
ewer
is c
apab
le o
f tre
ndin
g/gr
aphi
ng/ta
bula
ting
resu
lts a
nd th
eir r
efer
ence
rang
es.
D
escr
ibe
repo
rting
cap
abilit
ies.
Med
ium
V-1
0. T
he v
iew
er d
ispl
ays
clin
ical
repo
rt de
tail
for t
he p
atie
nt in
co
ntex
t, w
hen
sele
cted
. H
igh
V-1
0.1.
Th
e cl
inic
al re
port
deta
il da
ta e
lem
ents
are
sys
tem
co
nfig
urab
le.
Hig
h
V-1
0.2.
Th
e cl
inic
al re
port
deta
il da
ta e
lem
ents
util
ize
the
SH
R re
posi
tory
. H
igh
V-1
0.3.
Th
e vi
ewer
dis
play
s th
e di
agno
stic
imag
e as
soci
ated
with
a s
peci
fic D
I rep
ort e
ither
inte
rnal
ly o
r th
roug
h an
ext
erna
l vie
wer
com
patib
le w
ith th
e N
L PA
CS.
D
escr
ibe
how
the
SH
R c
an b
e us
ed t
o su
ppor
t th
is
inte
grat
ion
with
the
GE
Imag
e V
iew
er, o
r re
com
men
d an
othe
r app
roac
h.
Med
ium
V-1
1. T
he v
iew
er d
ispl
ays
med
icat
ion
deta
il fo
r the
pat
ient
in
cont
ext,
whe
n se
lect
ed.
D
escr
ibe
the
DIS
info
rmat
ion
disp
lay
capa
bilit
ies.
Hig
h
V-1
1.1.
Th
e m
edic
atio
n pr
escr
iptio
n de
tail
data
ele
men
ts
utiliz
e th
e D
IS re
posi
tory
. H
igh
V-1
1.2.
Th
e vi
ewer
inte
grat
es e
xter
nal p
ortle
ts fo
r di
spla
ying
DIS
med
icat
ion
info
rmat
ion.
H
igh
Pag
e 89
New
foun
dlan
d an
d La
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-12.
The
vie
wer
invo
kes
conn
ectiv
ity to
ext
erna
l clin
ical
in
form
atio
n so
urce
s (e
.g.,
refe
renc
e kn
owle
dge-
base
s,
Med
itech
).
Med
ium
V-1
3. T
he v
iew
er c
onsi
sten
tly p
rese
nts
info
rmat
ion.
H
igh
V-1
3.1.
Th
e vi
ewer
dis
play
s th
e pa
tient
's a
ge a
ccor
ding
to
a pr
edef
ined
alg
orith
m.
Hig
h
V-1
3.1.
1.
Whe
re p
atie
nt a
ge is
less
than
30
days
, the
n di
spla
yed
in d
ays.
H
igh
V-1
3.1.
2.
Whe
re p
atie
nt a
ge is
bet
wee
n 30
and
12
0 da
ys, t
hen
disp
laye
d in
wee
ks.
Hig
h
V-1
3.1.
3.
Whe
re p
atie
nt a
ge is
bet
wee
n 12
1 da
ys a
nd 2
yea
rs, t
hen
disp
laye
d in
mon
ths.
H
igh
V-1
3.1.
4.
Whe
re p
atie
nt a
ge is
bet
wee
n 2
and
18 y
ears
, the
n di
spla
yed
in y
ears
and
mon
ths.
H
igh
V-1
3.1.
5.
Whe
re p
atie
nt a
ge is
gre
ater
than
18
year
s, th
en d
ispl
ay in
yea
rs.
Hig
h
V-1
3.1.
6.
If th
e pa
tient
is d
ecea
sed
then
the
patie
nt a
ge is
sta
tic a
nd b
ased
on
the
date
of
deat
h.
Med
ium
V-1
3.2.
Th
e vi
ewer
sup
ports
gen
der c
lass
ifica
tions
as
per
the
NL
EH
R c
lient
regi
stry
. H
igh
V-1
3.3.
Th
e vi
ewer
dis
play
s tim
e us
ing
a sy
stem
co
nfig
urab
le fo
rmat
(e.g
., 24
-hou
r clo
ck).
Hig
h
V-1
3.4.
Th
e vi
ewer
dis
play
s da
te u
sing
a s
yste
m
conf
igur
able
form
at (e
.g.,
DD
-MM
M-C
CYY
, CC
YY
-M
M-D
D).
Hig
h
V-1
3.5.
Th
e vi
ewer
vis
ually
dis
tingu
ishe
s al
l man
dato
ry
data
inpu
t fie
lds.
H
igh
V-1
3.6.
Th
e vi
ewer
dis
play
s th
e de
scrip
tion
asso
ciat
ed
with
a c
linic
al c
ode
(e.g
., th
roug
h qu
erie
s to
the
HIA
L te
rmin
olog
y se
rvic
e fo
r pC
LOC
D d
escr
iptio
ns).
Hig
h
Pag
e 90
New
foun
dlan
d an
d La
brad
or
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-13.
7.
The
view
er d
ispl
ays
the
asso
ciat
ed p
atie
nt
iden
tifie
r typ
e (e
.g.,
MC
P n
umbe
r) w
hene
ver t
he
iden
tifie
r is
disp
laye
d.
Hig
h
V-1
3.8.
Th
e vi
ewer
cle
arly
iden
tifie
s th
e pa
tient
on
all
scre
ens
that
dis
play
pat
ient
info
rmat
ion.
M
anda
tory
V-1
3.9.
Th
e vi
ewer
vis
ually
dis
tingu
ishe
s a
dece
ased
pa
tient
on
all s
cree
ns th
at d
ispl
ay p
atie
nt in
form
atio
n.
Med
ium
V-1
3.10
. Th
e vi
ewer
acc
omm
odat
es le
ngth
y (e
.g.,
60+
char
acte
r) st
anda
rdiz
ed te
st d
escr
iptio
ns.
Med
ium
V-1
3.11
. Th
e vi
ewer
sup
ports
diff
eren
t fie
ld fo
rmat
s (e
.g.,
zip
code
for U
.S. a
nd p
osta
l cod
e fo
r Can
adia
n ad
dres
ses)
whe
re a
pplic
able
.
Med
ium
V-1
4. T
he v
iew
er p
rovi
des
onlin
e he
lp to
use
rs.
Hig
h
V
-14.
1.
Con
text
sen
sitiv
e he
lp is
ava
ilabl
e fo
r eac
h fie
ld o
n ea
ch s
cree
n.
Hig
h
V-1
4.2.
C
onte
xt s
ensi
tive
help
is a
vaila
ble
for e
ach
user
fu
nctio
n.
Hig
h
V-1
4.3.
H
elp
cont
ent i
s re
visa
ble
by th
e ad
min
istra
tion
porta
l. H
igh
V-1
5. T
he v
iew
er s
uppo
rts th
e di
spla
y of
use
r not
ifica
tions
from
th
e ad
min
istra
tion
porta
l. Lo
w
V-1
6. T
he v
iew
er c
ompo
nent
s in
tero
pera
te w
ith th
e H
IAL
erro
r ha
ndlin
g pr
oces
s.
Hig
h
V-1
6.1.
Th
e er
ror t
ypes
sen
t, as
per
the
appl
icab
le T
LI
mes
sagi
ng s
tand
ard,
incl
ude:
HTT
P le
vel e
rror
s.
Hig
h
V-1
6.2.
Th
e er
ror t
ypes
sen
t, as
per
the
appl
icab
le T
LI
mes
sagi
ng s
tand
ard,
incl
ude:
SO
AP
leve
l erro
rs.
Hig
h
V-1
6.3.
Th
e er
ror t
ypes
sen
t, as
per
the
appl
icab
le H
L7
mes
sagi
ng s
tand
ards
, inc
lude
: HL7
Tra
nspo
rt le
vel
erro
rs.
Hig
h
Pag
e 91
New
foun
dlan
d an
d La
brad
or
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-16.
4.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
HL7
m
essa
ging
sta
ndar
ds, i
nclu
de: H
L7 A
pplic
atio
n le
vel
erro
rs.
Hig
h
V-1
7. T
he v
iew
er c
ontin
ues
to o
pera
te a
fter r
ecei
ving
exc
eptio
ns
and
erro
rs (i
n st
ruct
ure
or c
onte
nt).
Indi
cate
whe
ther
thi
s ca
n be
con
trolle
d vi
a a
thre
shol
d se
tting
.
Hig
h
V-1
8. T
he v
iew
er is
abl
e to
det
erm
ine
if re
latio
nshi
p ex
ists
be
twee
n th
e us
er a
nd th
e pa
tient
bas
ed o
n da
ta c
onta
ined
w
ithin
the
dom
ain
repo
sito
ries.
Des
crib
e ho
w t
he v
iew
er s
uppo
rts r
elat
ions
hips
bet
wee
n us
ers
and
patie
nts
(e.g
., ro
le, l
ocat
ion
and
prov
ider
).
Hig
h
V-1
9. T
he v
iew
er c
onfo
rms
to th
e C
anad
a H
ealth
Info
way
iEH
R
TLI s
peci
ficat
ion
1.02
. H
igh
V-1
9.1.
Th
e vi
ewer
is a
ble
to im
plem
ent t
he W
S-*
sp
ecifi
catio
ns a
nd a
ltern
ate
appr
oach
es b
ased
on
the
curre
nt H
IAL
trans
port
spec
ifica
tions
in u
se in
NL
Hig
h
V-1
9.2.
Th
e vi
ewer
sup
ports
SO
AP 1
.1 (t
he H
IAL
does
not
su
ppor
t SO
AP v
ersi
ons
high
er th
an 1
.1).
H
igh
V-1
9.3.
Th
e vi
ewer
con
form
s to
the
WS
-I B
asic
Pro
file
1.1.
H
igh
V-1
9.4.
Th
e vi
ewer
is c
ompl
iant
with
the
WS
-Add
ress
ing
spec
ifica
tion.
H
igh
V-1
9.4.
1.
The
view
er c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Mes
sage
ID.
Hig
h
V-1
9.4.
2.
The
view
er c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r To.
H
igh
V-1
9.4.
3.
The
view
er c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Rep
lyTo
. H
igh
V-1
9.4.
4.
The
view
er c
an fo
llow
spe
cific
in
stru
ctio
ns fo
r Act
ion.
H
igh
Pag
e 92
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-19.
4.5.
Th
e vi
ewer
can
follo
w s
peci
fic
inst
ruct
ions
for R
elat
esTo
. H
igh
V-1
9.5.
Th
e vi
ewer
is a
ble
to im
plem
ent W
S-S
ecur
ity u
sing
a
secu
rity
toke
n, d
igita
l sig
natu
re, a
nd X
ML
encr
yptio
n (p
assw
ord
base
d).
Hig
h
V-1
9.5.
1.
The
view
er d
eriv
es th
e si
gnat
ure/
encr
yptio
n ke
ys u
tiliz
ing
the
met
hod
spec
ified
in th
e TL
I.
Hig
h
V-1
9.5.
2.
The
view
er d
igita
lly s
igns
a m
essa
ge
afte
r all
requ
ired
elem
ents
are
enc
rypt
ed.
Hig
h
V-1
9.5.
3.
The
view
er o
nly
encr
ypts
the
Pat
ient
X
ML
elem
ent (
CM
ET)
whe
n co
mm
unic
atin
g w
ith th
e N
L H
IAL.
Hig
h
V-1
9.6.
Th
e vi
ewer
sup
ports
the
Infra
stru
ctur
e ve
rsio
ning
st
ruct
ure
as d
efin
ed in
the
Info
way
Tra
nspo
rt La
yer
Inte
rope
rabi
lity
spec
ifica
tion.
Hig
h
V-1
9.7.
Th
e vi
ewer
pop
ulat
es th
e S
OA
PA
ctio
n an
d W
A-A
A
ctio
n us
ing
the
follo
win
g na
min
g co
nven
tion:
In
tera
ctio
n ID
+ “.
” + “L
E” (
Loca
l) or
“NE”
(Nor
mat
ive)
+
YY
YY
MM
DD
For
exa
mpl
e: u
rn:h
l7-
org:
v3:R
EP
C_I
N00
0041
CA
.LE
2006
0911
Hig
h
Pag
e 93
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-19.
8.
The
view
er s
uppo
rts th
e fo
llow
ing
nam
espa
ces:
• h
l7 -
urn:
hl7-
org:
v3
• xsd
- ht
tp://
ww
w.w
3.or
g/20
01/X
MLS
chem
a • s
oap
- http
://sc
hem
as.x
mls
oap.
org/
soap
/env
elop
e/
• wsa
- ht
tp://
ww
w.w
3.or
g/20
05/0
3/ad
dres
sing
• w
sse
- http
://do
cs.o
asis
-op
en.o
rg/w
ss/v
1.1/
2004
/01/
oasi
s-20
0401
-wss
-w
ssec
urity
-sec
ext-1
.0.x
sd
• wsu
- ht
tp://
docs
.oas
is-
open
.org
/wss
/v1.
1/20
04/0
1/oa
sis-
2004
01-w
ss-
wss
ecur
ity-u
tility
-1.0
.xsd
• x
enc
- http
://w
ww
.w3.
org/
2001
/04/
xmle
nc#
• sig
- ht
tp://
ww
w.w
3.or
g/20
00/0
9/xm
ldsi
g#
• wsi
- ht
tp://
ws-
i.org
/pro
files
/bas
ic/1
.1/s
war
ef.x
sd
Hig
h
V-1
9.9.
Th
e vi
ewer
is a
ble
to c
omm
unic
ate
with
the
HIA
L ut
ilizin
g ei
ther
imm
edia
te o
r que
ued
mod
e. F
or
queu
ed m
ode,
onl
y po
lling
inte
ract
ions
are
sup
porte
d.
For i
mm
edia
te m
ode,
requ
est i
nter
actio
ns a
nd
notif
icat
ion
inte
ract
ions
are
sup
porte
d.
Hig
h
V-1
9.10
. Th
e vi
ewer
util
izes
WS
DLs
as
reco
mm
ende
d in
H
L7 v
3 S
tand
ard:
Tra
nspo
rt S
peci
ficat
ion
– W
eb
Ser
vice
s P
rofil
e, R
elea
se 2
(WS
DLs
will
be p
rovi
ded
prio
r to
impl
emen
tatio
n).
Hig
h
V-1
9.10
.1.
The
view
er c
omm
unic
ates
usi
ng a
re
ques
t-res
pons
e m
essa
ge e
xcha
nge
patte
rn.
Hig
h
V-1
9.10
.2.
The
view
er u
tiliz
es n
omen
clat
ure
for
WS
DL
arte
fact
s ty
pe d
efin
ition
s fo
llow
ing
reco
mm
enda
tions
in th
e TL
I spe
cific
atio
n.
Hig
h
V-1
9.10
.3.
The
view
er s
oap
mes
sage
s us
e w
rapp
ed/li
tera
l doc
umen
t sty
le.
Hig
h
V-1
9.10
.4.
The
view
er s
ervi
ce b
indi
ngs
follo
w
reco
mm
enda
tions
in th
e TL
I spe
cific
atio
n.
Hig
h
Pag
e 94
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
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2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-19.
11.
The
view
er h
andl
es e
rror
s in
the
prot
ocol
they
are
as
soci
ated
with
(e.g
., H
TTP
, SO
AP
, HL7
tran
spor
t, or
H
L7 a
pplic
atio
n).
Hig
h
V-1
9.12
. Th
e vi
ewer
is a
ble
to in
terp
ret t
he s
tand
ard
HTT
P
erro
rs a
nd p
rese
nt to
the
end
user
follo
win
g H
TTP
1.1
gu
idel
ines
.
Hig
h
V-1
9.13
. Th
e vi
ewer
is a
ble
to p
arse
and
inte
rpre
t the
SO
AP
fa
ultc
ode
and
faul
tstri
ng p
aram
eter
s an
d pr
esen
t to
the
end
user
if a
pplic
able
.
Hig
h
V-1
9.14
. Th
e vi
ewer
is a
ble
to in
clud
e tw
o cu
stom
ele
men
ts
(EH
R R
ole
and
lang
uage
) in
the
SO
AP
hea
der.
Hig
h
V-1
9.15
. Th
e vi
ewer
is a
ble
to s
et th
e m
essa
geID
as
a U
UID
gen
erat
ed u
sing
a c
ertif
ied
algo
rithm
, and
pre
fix
the
valu
e w
ith "u
uid:
"
Hig
h
V-1
9.15
.1.
The
view
er e
nsur
es th
at th
e m
essa
ge
ID is
uni
que.
H
igh
V-1
9.15
.2.
The
view
er o
nly
reus
es m
essa
ge ID
s w
hen
subm
ittin
g a
dupl
icat
e re
ques
t. H
igh
V-2
0. A
ll da
ta s
ent b
etw
een
EH
R c
ompo
nent
s is
ver
ified
for
inte
grity
. H
igh
V-2
1. T
he v
iew
er s
uppo
rts li
st/g
et m
essa
ges
usin
g pa
n-C
anad
ian
HL7
v3
mes
sagi
ng s
tand
ards
. H
igh
V-2
1.1.
Th
e vi
ewer
sup
ports
CR
/ P
R /
LR (a
s pe
r M
R20
07) l
ist/g
et m
essa
ges.
H
igh
V-2
1.2.
Th
e vi
ewer
sup
ports
Lab
/ iE
HR
(clin
ical
repo
rt) a
s pe
r MR
2009
(pre
ferre
d) li
st/g
et m
essa
ges.
H
igh
V-2
1.3.
Th
e vi
ewer
sup
ports
enc
ount
er (a
s pe
r the
Nov
a S
cotia
dra
ft m
essa
ge s
peci
ficat
ions
) lis
t/get
m
essa
ges.
Hig
h
V-2
1.4.
Th
e vi
ewer
sup
ports
dia
gnos
tic im
agin
g re
port
(to
be d
eter
min
ed) l
ist/g
et m
essa
ges.
H
igh
Pag
e 95
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-21.
5.
The
view
er s
uppo
rts p
harm
acy
CeR
x v0
1r4.
3 lis
t/get
mes
sage
s.
Hig
h
V-2
2. T
he v
iew
er m
anag
es th
e pa
tient
con
text
with
out t
he u
se o
f th
e en
terp
rise
clie
nt id
entif
ier (
i.e.,
eCID
). M
ediu
m
V-2
3. T
he v
iew
er o
pera
tes
with
in th
e N
L E
HR
env
ironm
ent
stan
dard
s.
Hig
h
V-2
3.1.
Th
e vi
ewer
is a
ble
to u
tiliz
e: S
un S
olar
is 1
0.
Hig
h
V
-23.
2.
The
view
er is
abl
e to
util
ize:
Ora
cle
11i.
Hig
h
V
-23.
3.
The
view
er is
abl
e to
util
ize:
Sun
har
dwar
e.
Hig
h
V
-23.
4.
The
view
er is
abl
e to
util
ize:
Jav
a.
Hig
h
V
-23.
5.
The
view
er p
orta
ls a
re a
ble
to u
tiliz
e: js
r168
or
wsr
p po
rtlet
s.
Hig
h
V-2
3.6.
The
vie
wer
util
izes
a te
chni
cal a
rchi
tect
ure
that
in
tegr
ates
with
the
exis
ting
NL
envi
ronm
ent.
Iden
tify
all
appl
icat
ion
serv
er
tech
nolo
gy
and
com
pone
nts
requ
ired
by t
he v
iew
er.
Whe
re t
here
ar
e m
ultip
le,
prov
ide
all
optio
ns
and
the
reco
mm
ende
d ap
plic
atio
n te
chno
logy
.
Iden
tify
any
data
base
tec
hnol
ogy
requ
irem
ent
of
the
view
er
incl
udin
g al
l su
ppor
ted
data
base
te
chno
logi
es a
nd a
ny re
com
men
ded
tech
nolo
gies
.
Iden
tify
all h
ardw
are
and
softw
are
requ
ired
by t
he
view
er (
incl
udin
g th
ird p
arty
too
ls s
uch
as d
ata
back
up s
oftw
are
and
all l
icen
sing
).
Iden
tify
any
VM
tec
hnol
ogy
requ
ired
or s
uppo
rted
and
desc
ribe
its
impa
ct
on
each
pr
opos
ed
envi
ronm
ent.
Hig
h
Pag
e 96
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-23.
7. T
he v
iew
er s
uppo
rts m
ultip
le e
nviro
nmen
ts fo
r m
aint
enan
ce, o
pera
tions
and
rele
ase
man
agem
ent.
Id
entif
y th
e nu
mbe
r an
d ty
pes
of e
nviro
nmen
ts
reco
mm
ende
d to
mai
ntai
n an
d op
erat
e th
e vi
ewer
(e
.g.,
test
, QA
, pro
duct
ion)
.
Hig
h
V-2
4. T
he v
iew
er s
uppo
rts a
utom
ated
test
ing.
Iden
tify
the
test
ing
met
hods
reco
mm
ende
d fo
r the
vie
wer
.
Iden
tify
any
test
ing
tool
s pr
ovid
ed (i
nclu
ding
the
avai
labi
lity
of te
st s
crip
ts o
r oth
er fo
rms
of te
stin
g au
tom
atio
n).
Iden
tify
all
test
to
ols
supp
orte
d by
th
e vi
ewer
(e
.g.,
Bor
land
).
Hig
h
V-2
5. T
he v
iew
er s
uppo
rts C
CO
W c
apab
ilitie
s to
pro
vide
for
cont
ext s
harin
g be
twee
n vi
ews.
Des
crib
e th
e vi
ewer
's C
CO
W c
apab
ilitie
s.
Hig
h
V-2
6. T
he v
iew
er s
uppo
rts c
urre
nt v
ersi
ons
of in
tern
et b
row
sers
.
Iden
tify
all b
row
sers
and
ver
sion
s su
ppor
ted
by th
e vi
ewer
.
Hig
h
V-2
7. T
he v
iew
er p
erfo
rms
adeq
uate
ly in
are
as w
ith li
mite
d ba
ndw
idth
.
Iden
tify
the
min
imal
ban
dwid
th re
quire
d by
the
view
er.
Hig
h
V-2
8. T
he v
iew
er a
pplic
atio
n is
flex
ible
eno
ugh
to fu
nctio
n ac
ross
a
rang
e of
scr
een
reso
lutio
ns.
Id
entif
y th
e m
inim
um a
nd re
com
men
ded
scre
en re
solu
tions
re
quire
d by
the
view
er.
Hig
h
V-2
9. T
he v
iew
er s
uppo
rts u
ser i
dent
ity m
anag
emen
t. H
igh
Pag
e 97
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-29.
1.
The
view
er s
uppo
rts u
ser r
egis
tratio
n an
d en
rolm
ent.
D
escr
ibe
the
view
er’s
use
r en
rolm
ent
proc
ess
(e.g
., se
lf-re
gist
ratio
n).
Hig
h
V-2
9.2.
V
iew
er u
sers
are
stro
ngly
aut
hent
icat
ed.
Hig
h
V
-29.
3.
Eac
h vi
ewer
use
r has
a u
niqu
e us
er ID
. H
igh
V-2
9.4.
E
ach
view
er u
ser i
s au
then
ticat
ed b
y th
e E
HR
S
info
stru
ctur
e.
Hig
h
V-2
9.5.
Th
e vi
ewer
sup
ports
cas
e in
sens
itive
use
r ID
s th
at
cont
ain
alph
a an
d/or
num
eric
cha
ract
ers.
H
igh
V-2
9.6.
Th
e vi
ewer
pro
vide
s lim
ited
feed
back
dur
ing
user
au
then
ticat
ion
(i.e.
, uns
ucce
ssfu
l log
ins
do n
ot
spec
ify if
the
pass
wor
d or
the
user
ID is
inco
rrect
).
Hig
h
V-2
9.7.
Th
e vi
ewer
pro
vide
s th
e ab
ility
for t
he u
ser t
o in
voke
logo
ut.
Hig
h
V-2
9.8.
Th
e vi
ewer
sup
ports
the
use
of tw
o-fa
ctor
au
then
ticat
ion
mec
hani
sms.
D
escr
ibe
how
th
e vi
ewer
in
corp
orat
es
two-
fact
or
auth
entic
atio
n an
d pr
ovid
e ex
ampl
es
of
spec
ific
hard
war
e us
ed in
a p
rodu
ctio
n en
viro
nmen
t.
Hig
h
V-2
9.9.
Th
e vi
ewer
sup
ports
sin
gle
sign
on
func
tiona
lity
Low
V
-29.
10.
The
view
er d
ispl
ays
a sy
stem
con
figur
able
di
scla
imer
dur
ing
the
user
iden
tific
atio
n an
d au
then
ticat
ion
proc
ess.
Hig
h
V-2
9.11
. A
use
r acc
ount
may
be
lock
ed th
roug
h in
activ
ity o
r un
succ
essf
ul lo
gin
atte
mpt
s.
Hig
h
V-2
9.11
.1.
Lock
ed a
ccou
nts
prev
ent t
he u
ser
from
pro
gres
sing
pas
t the
log
in s
cree
n an
d th
us a
cces
sing
the
EH
R.
Hig
h
Pag
e 98
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-29.
11.2
. Th
e vi
ewer
dis
play
s lo
ck o
ut m
essa
ge
to u
sers
who
se a
ccou
nts
are
lock
ed.
Med
ium
V-2
9.11
.3.
A u
ser a
ccou
nt is
lock
ed if
it is
not
us
ed in
a c
onfig
urab
le ti
me
fram
e (e
.g.,
90
days
).
Med
ium
V-2
9.11
.4.
Con
secu
tive
unsu
cces
sful
log
in
atte
mpt
s th
at e
xcee
d a
conf
igur
able
thre
shol
d w
ithin
a c
onfig
urab
le ti
me
fram
e au
tom
atic
ally
lo
cks
the
user
acc
ount
.
Hig
h
V-2
9.11
.5.
The
unsu
cces
sful
log
in a
ttem
pt
thre
shol
d is
a c
onfig
urab
le s
yste
m p
aram
eter
. H
igh
V-2
9.11
.6.
The
unsu
cces
sful
log
in ti
me
fram
e th
resh
old
is a
con
figur
able
sys
tem
par
amet
er.
Hig
h
V-2
9.12
. Loc
ked
user
acc
ount
s ar
e on
ly re
leas
ed b
y an
ad
min
istra
tor.
Hig
h
V-3
0. T
he v
iew
er a
ssoc
iate
s a
user
ID w
ith a
pro
vide
r’s id
entit
y.
Hig
h
V
-31.
The
vie
wer
ass
ocia
tes
a us
er ID
with
a lo
catio
n (fa
cilit
y).
Hig
h
V
-32.
Vie
wer
pas
swor
ds a
re p
rote
cted
and
man
aged
. H
igh
V-3
2.1.
V
iew
er u
sers
are
stro
ngly
aut
hent
icat
ed w
ith
pass
wor
ds th
at h
ave
at le
ast:
8 ch
arac
ters
, 1 s
peci
al
char
acte
r or n
umbe
r, 1
uppe
r cas
e ch
arac
ter,
and
1 lo
wer
cas
e ch
arac
ter.
Des
crib
e ho
w u
ser r
oles
can
be
stro
ngly
aut
hent
icat
ed
and
reco
mm
end
pass
wor
d st
reng
th.
Hig
h
V-3
2.2.
Th
e vi
ewer
enc
rypt
s pa
ssw
ords
(i.e
., do
es n
ot
trans
port
pass
wor
ds in
pla
in te
xt).
Hig
h
V-3
2.3.
Th
e vi
ewer
mas
ks th
e di
spla
y of
pas
swor
d ch
arac
ters
as
they
are
bei
ng k
eyed
. H
igh
V-3
2.4.
P
assw
ords
may
be
reus
ed a
fter a
con
figur
able
nu
mbe
r of i
tera
tions
and
a c
onfig
urab
le p
erio
d of
tim
e (e
.g.,
1 ye
ar) h
ave
pass
ed.
Hig
h
Pag
e 99
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-32.
5.
Pas
swor
ds m
ay b
e ch
ange
d by
use
rs /
rese
t by
syst
em a
dmin
istra
tors
H
igh
V-3
2.5.
1.
Whe
n ch
angi
ng p
assw
ords
, bot
h th
e ol
d an
d ne
w p
assw
ord
char
acte
rs a
re m
aske
d.
Hig
h
V-3
2.5.
2.
Whe
n ch
angi
ng p
assw
ords
, the
new
pa
ssw
ord
is re
-ent
ered
for v
erifi
catio
n.
Hig
h
V-3
2.5.
3.
Use
r pas
swor
ds m
ay b
e re
-cha
nged
af
ter 2
4 ho
urs
have
ela
psed
. Lo
w
V-3
2.5.
4.
Use
r pas
swor
d ch
ange
s ar
e en
forc
ed
at a
regu
lar i
nter
val (
e.g.
, eve
ry 3
mon
ths)
. H
igh
V-3
2.5.
5.
Use
rs a
re re
quire
d to
cha
nge
thei
r in
itial
sys
tem
-gen
erat
ed p
assw
ords
at t
he fi
rst
succ
essf
ul lo
g in
.
Hig
h
V-3
2.5.
6.
Pas
swor
ds a
re re
set t
o a
syst
em-
gene
rate
d ra
ndom
val
ue.
Hig
h
V-3
2.5.
7.
Pas
swor
d re
sets
requ
ire th
e us
er to
ch
ange
the
rese
t pas
swor
d at
the
next
su
cces
sful
log
in.
Hig
h
V-3
2.6.
Th
e vi
ewer
sup
ports
use
r sel
f-ser
vice
for r
eset
ting
forg
otte
n pa
ssw
ords
. M
ediu
m
V-3
3. T
he v
iew
er o
nly
allo
ws
auth
oriz
ed u
sers
to a
cces
s pa
tient
re
cord
s.
D
escr
ibe
how
the
vie
wer
pre
vent
s un
auth
oriz
ed a
cces
s in
clud
ing
whe
n th
e au
thor
ized
us
er
is
away
fro
m
the
term
inal
.
Hig
h
V-3
3.1.
Th
e vi
ewer
inte
grat
es w
ith th
e H
IAL
Aut
hent
icat
ion
and
Aut
horiz
atio
n S
ervi
ce (S
un O
ne D
irect
ory)
for
auth
oriz
atio
n.
Hig
h
V-3
3.2.
Th
e vi
ewer
sup
ports
acc
ess
cont
rols
(i.e
., lim
iting
us
ers
to s
peci
fic fu
nctio
ns a
nd li
miti
ng th
e da
ta w
ithin
th
ose
func
tions
).
Hig
h
Pag
e 10
0
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-33.
2.1.
A
cces
s co
ntro
ls m
ay b
e us
er-b
ased
(a
cces
s rig
hts
assi
gned
to e
ach
user
). Lo
w
V-3
3.2.
2.
Acc
ess
cont
rols
may
be
role
-bas
ed
(use
rs a
re g
roup
ed a
nd a
cces
s rig
hts
assi
gned
to
thes
e gr
oups
).
Hig
h
V-3
3.2.
3.
Acc
ess
cont
rols
may
be
cont
ext-b
ased
(a
dditi
onal
acc
ess
right
s as
sign
ed o
r res
trict
ed
base
d on
the
cont
ext o
f the
tran
sact
ion
such
as
tim
e-of
-day
, dom
ain
and
sub-
dom
ain)
.
Hig
h
V-3
3.2.
4.
Acc
ess
cont
rols
may
be
loca
tion-
base
d (a
dditi
onal
acc
ess
right
s as
sign
ed o
r re
stric
ted
base
d on
use
r sel
ecte
d lo
catio
n).
Des
crib
e ho
w lo
catio
ns a
re d
eter
min
ed.
Hig
h
V-3
3.2.
5.
Acc
ess
cont
rols
may
be
polic
y-ba
sed
(con
ditio
nal e
valu
atio
n of
com
bina
tions
of t
he
abov
e).
Hig
h
V-3
3.3.
U
sers
with
mul
tiple
role
s se
lect
one
role
per
se
ssio
n at
log
in a
fter a
uthe
ntic
atio
n.
Hig
h
V-3
3.4.
U
sers
with
mul
tiple
loca
tions
sel
ect o
ne lo
catio
n pe
r ses
sion
at l
og in
afte
r aut
hent
icat
ion.
H
igh
V-3
3.5.
V
iew
er a
dmin
istra
tion
supp
orts
bat
ch u
ploa
d of
us
er ID
, rol
e an
d se
curit
y co
nfig
urat
ions
. Lo
w
Pag
e 10
1
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-33.
6.
Vie
wer
acc
ess
to p
erso
nal h
ealth
info
rmat
ion
is
cont
rolle
d by
the
prov
ider
-pat
ient
rela
tions
hip
(e.g
., at
tend
ing
phys
icia
n, fa
mily
phy
sici
an, s
ame
loca
tion
of
care
).
Des
crib
e ho
w th
e vi
ewer
def
ines
pat
ient
rela
tions
hips
. D
escr
ibe
how
the
view
er c
ontro
ls a
cces
s to
pro
tect
ed
heal
th in
form
atio
n.
Des
crib
e ho
w th
e vi
ewer
acc
omm
odat
es a
nd c
ontro
ls
dele
gate
acc
ess
(e.g
., ph
ysic
ian
secr
etar
y ac
cess
ing
patie
nts)
. D
escr
ibe
how
the
vie
wer
acc
omm
odat
es p
hysi
cian
ac
cess
to a
ll pa
tient
s w
ithin
thei
r cal
l gro
up.
Hig
h
V-3
3.7.
Th
e vi
ewer
allo
ws
a us
er to
acc
ess
the
pers
onal
he
alth
info
rmat
ion
of p
atie
nts
with
who
m th
ey h
ave
an
exis
ting
rela
tions
hip
in a
dom
ain
repo
sito
ry.
Hig
h
V-3
3.8.
Th
e vi
ewer
sup
ports
use
r acc
ess
to p
erso
nal
heal
th in
form
atio
n w
here
no
prev
ious
use
r-pat
ient
re
latio
nshi
p ex
ists
(e.g
., E
mer
genc
y R
oom
s) w
ith a
re
ason
for a
cces
s.
Des
crib
e ho
w
the
view
er
gran
ts
cris
is
acce
ss
(incl
udin
g th
e le
ngth
of
tim
e th
at
the
rela
tions
hip
exis
ts).
Hig
h
V-3
3.8.
1.
Use
rs s
elec
t the
reas
on fo
r acc
essi
ng
patie
nt in
form
atio
n (fo
r pat
ient
s w
ho a
re n
ot
asso
ciat
ed w
ith th
e us
er) f
rom
a s
yste
m
conf
igur
able
list
.
Hig
h
V-3
3.9.
Th
e vi
ewer
refe
renc
es th
e pa
tient
's c
onse
nt
dire
ctiv
e fro
m th
e H
IAL
Con
sent
Man
agem
ent
Ser
vice
.
Hig
h
Pag
e 10
2
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-33.
9.1.
Th
e vi
ewer
indi
cate
s to
the
user
whe
n th
e cu
rrent
vie
w c
onta
ins
mas
ked
data
. H
igh
V-3
3.9.
2.
The
user
ent
ers
the
patie
nt c
onse
nt
pass
wor
d to
acc
ess
mas
ked
pers
onal
hea
lth
info
rmat
ion
if a
patie
nt c
onse
nt d
irect
ive
is in
pl
ace.
Hig
h
V-3
3.9.
3.
The
user
ove
rrid
es th
e co
nsen
t di
rect
ive
with
a s
peci
fic re
ason
to a
cces
s m
aske
d pe
rson
al h
ealth
info
rmat
ion
if a
patie
nt
cons
ent d
irect
ive
is in
pla
ce.
Hig
h
V-3
3.9.
4.
Use
rs s
elec
t the
reas
on fo
r ove
rrid
ing
cons
ent f
rom
a s
yste
m c
onfig
urab
le li
st.
H
igh
V-3
4. T
he v
iew
er a
llow
s th
e us
er to
prin
t con
tent
. H
igh
V-3
4.1.
P
rinte
d co
nten
t pre
sent
s th
e sa
me
on p
aper
as
in
the
view
er.
Hig
h
V-3
4.2.
P
rinte
d m
ater
ials
incl
ude
info
rmat
ion
that
iden
tifie
s th
e pa
tient
, use
r, an
d tim
esta
mp
plus
add
ition
al
priv
acy
and
conf
iden
tialit
y st
atem
ents
.
Hig
h
V-3
4.2.
1.
The
page
hea
der a
nd fo
oter
are
co
nfig
urab
le b
y th
e sy
stem
adm
inis
trato
r. H
igh
V-3
4.2.
2.
Hea
der i
nfor
mat
ion
may
incl
ude:
P
atie
nt N
ame,
Pat
ient
Iden
tifie
r, D
OB
and
R
epor
t Titl
e.
Hig
h
V-3
4.2.
3.
Foot
er in
form
atio
n m
ay in
clud
e: P
rint
Dat
e, P
age
Num
ber a
nd U
ser N
ame.
H
igh
V-3
4.3.
P
rint a
dmin
istra
tion
incl
udes
the
optio
n fo
r add
ing
a sy
stem
con
figur
able
wat
erm
ark.
M
ediu
m
V-3
4.4.
Th
e vi
ewer
prin
t fun
ctio
n ut
ilizes
the
user
's p
rinte
r lis
t. H
igh
V-3
4.5.
Th
e vi
ewer
prin
t fun
ctio
n ac
cess
is li
mite
d by
role
ty
pe.
Hig
h
Pag
e 10
3
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
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2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-34.
6.
The
view
er p
rint f
unct
ion
is c
ontro
lled
and
limite
d as
app
ropr
iate
. D
escr
ibe
the
appr
oach
app
lied
with
in t
he v
iew
er t
o co
ntro
l bro
wse
r-bas
ed p
rintin
g.
Hig
h
V-3
4.7.
Th
e vi
ewer
prin
t fun
ctio
n re
quire
s a
reas
on fo
r pr
intin
g.
Hig
h
V-3
4.7.
1.
Use
rs e
nter
the
reas
on fo
r prin
ting
from
a d
rop
dow
n lis
t.
Hig
h
V-3
4.7.
2.
The
reas
ons
for p
rintin
g ar
e sy
stem
co
nfig
urab
le.
Hig
h
V-3
5. T
he v
iew
er s
uppo
rts th
e ab
ility
to p
rodu
ce a
pat
ient
repo
rt of
cor
rect
ed in
form
atio
n (in
clud
ing
old
and
revi
sed
info
rmat
ion)
by
date
rang
e.
Med
ium
V-3
5.1.
Th
e vi
ewer
sup
ports
the
abilit
y to
pro
duce
a
prin
ted
copy
of a
pat
ient
’s E
HR
upo
n re
ques
t (as
per
P
HIA
).
Hig
h
V-3
5.2.
Th
e vi
ewer
sup
ports
the
abilit
y to
pro
duce
a
prin
ted
copy
of a
cces
ses
to a
pat
ient
's E
HR
upo
n re
ques
t (as
per
PH
IA).
Hig
h
V-3
6. T
he v
iew
er is
sec
ure
by d
esig
n.
D
escr
ibe
the
stra
tegi
es a
nd s
afe
guar
ds p
rovi
ded
with
the
view
er.
Hig
h
V-3
6.1.
Th
e vi
ewer
has
ses
sion
man
agem
ent c
apab
ilitie
s (e
.g.,
user
id, r
ole,
cur
rent
pat
ient
) D
escr
ibe
the
view
er’s
se
ssio
n m
anag
emen
t ca
pabi
litie
s in
det
ail.
Hig
h
V-3
6.1.
1.
Upo
n de
tect
ion
of v
iew
er in
activ
ity,
user
s ar
e pr
ohib
ited
from
furth
er v
iew
er
acce
ss to
the
EH
R.
Hig
h
Pag
e 10
4
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-36.
1.2.
Th
e vi
ewer
inac
tivity
thre
shol
d is
a
conf
igur
able
sys
tem
par
amet
er.
Hig
h
V-3
6.1.
3.
The
view
er in
activ
ity th
resh
olds
are
co
nfig
urab
le b
y ro
le.
Hig
h
V-3
6.1.
4.
To re
-est
ablis
h ac
cess
, use
rs re
-au
then
ticat
e.
Hig
h
V-3
6.1.
5.
The
view
er d
ispl
ays
an In
activ
ity
Tim
eout
mes
sage
whe
n th
e vi
ewer
inac
tivity
th
resh
old
is a
bout
to b
e re
ache
d an
d be
gins
a
coun
tdow
n (e
.g.,
20 s
econ
ds).
Med
ium
V-3
6.2.
A
ll vi
ewer
act
ive
func
tions
and
tran
sact
ions
for a
us
er a
re h
alte
d im
med
iate
ly (i
.e.,
not a
t the
nex
t log
in
) whe
n th
eir u
ser I
D is
sus
pend
ed.
Des
crib
e ho
w th
e us
er a
ctiv
ity is
hal
ted.
Hig
h
V-3
6.3.
D
ata
is e
ncry
pted
whi
le in
tran
spor
t bet
wee
n th
e ap
plic
atio
n se
rver
and
the
view
er a
pplic
atio
n (i.
e.,
user
's d
eskt
op).
Hig
h
V-3
6.4.
A
ll m
essa
ge tr
ansa
ctio
ns a
re a
ckno
wle
dged
with
a
stat
us re
sult
(suc
cess
or f
ailu
re w
ith a
n er
ror r
esul
t co
de).
Hig
h
V-3
6.5.
Th
e vi
ewer
sup
ports
mut
ual n
ode
auth
entic
atio
n (e
nsur
ing
the
auth
entic
ity o
f rem
ote
node
s) w
hen
com
mun
icat
ing
pers
onal
hea
lth in
form
atio
n ov
er th
e In
tern
et o
r oth
er k
now
n op
en n
etw
orks
usi
ng o
pen
prot
ocol
(e.g
., TL
S, I
PS
ec, X
ML
sig,
S/M
IME
).
Hig
h
V-3
7. T
he v
iew
er g
ener
ates
an
audi
t rec
ord
whe
n au
dita
ble
even
t occ
urs.
Iden
tify
the
type
s of
eve
nts
capt
ured
by
the
view
er a
udit
tabl
es (i
nclu
ding
inap
prop
riate
acc
esse
s).
Hig
h
V-3
7.1.
A
udita
ble
even
ts a
re a
con
figur
able
sys
tem
pa
ram
eter
. H
igh
Pag
e 10
5
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-37.
1.1.
A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot
limite
d to
) the
suc
cess
, atte
mpt
, or f
ailu
re o
f: sy
stem
sta
rt/st
op.
Hig
h
V-3
7.1.
2.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
user
logi
n/lo
gout
.
Hig
h
V-3
7.1.
3.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
node
-aut
hent
icat
ion
failu
re.
Hig
h
V-3
7.1.
4.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
any
user
/sys
tem
acc
ess
or u
pdat
e to
pat
ient
an
d/or
clin
ical
dat
a.
Hig
h
V-3
7.1.
5.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
over
ridde
n co
nsen
t dire
ctiv
es.
Hig
h
V-3
7.1.
6.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
info
rmat
ion
expo
rt (e
.g. p
rint).
Hig
h
V-3
7.1.
7.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
info
rmat
ion
impo
rt.
Hig
h
V-3
7.1.
8.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
syst
em a
dmin
istra
tion
chan
ge to
a u
ser
conf
igur
atio
n.
Hig
h
V-3
7.1.
9.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
pass
wor
d ch
ange
.
Hig
h
V-3
7.1.
10.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
acce
ss to
aud
it re
cord
s.
Hig
h
Pag
e 10
6
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-37.
1.11
. A
udita
ble
even
ts in
clud
e: u
ser a
ccou
nt
time
outs
. H
igh
V-3
7.1.
12.
Aud
itabl
e ev
ents
incl
ude:
all
auth
entic
atio
n de
cisi
ons.
H
igh
V-3
7.1.
13.
Aud
itabl
e ev
ents
incl
ude:
cre
atin
g us
er
acce
ss ri
ghts
. H
igh
V-3
7.1.
14.
Aud
itabl
e ev
ents
incl
ude:
ass
igni
ng
user
acc
ess
right
s.
Hig
h
V-3
7.1.
15.
Aud
itabl
e ev
ents
incl
ude:
upd
atin
g a
user
's o
wn
acce
ss ri
ghts
. H
igh
V-3
7.1.
16.
Aud
itabl
e ev
ents
incl
ude:
all
auth
oriz
atio
n de
cisi
ons.
H
igh
V-3
7.1.
17.
Aud
itabl
e ev
ents
incl
ude:
all
mes
sage
tra
ffic.
H
igh
V-3
7.1.
18.
Aud
itabl
e ev
ents
incl
ude:
bat
ch
proc
essi
ng o
utco
mes
(e.g
., er
rors
, suc
cess
ful
com
plet
ion)
.
Hig
h
V-3
7.1.
19.
Aud
itabl
e ev
ents
incl
ude:
all
adm
inis
trativ
e ev
ents
(e.g
. con
figur
atio
n ch
ange
s, q
uerie
s ag
ains
t the
aud
it ta
bles
).
Hig
h
V-3
7.1.
20.
Aud
itabl
e ev
ents
incl
ude:
all
prin
ted
repo
rts.
Hig
h
V-3
7.2.
Th
e vi
ewer
aud
it re
cord
s ar
e A
TNA
com
plia
nt
(Aud
it Tr
ail a
nd N
ode
Aut
hent
icat
ion,
RFC
388
1).
Hig
h
V-3
7.2.
1.
The
audi
t rec
ord
incl
udes
: dat
e, ti
me
and
time
zone
. H
igh
V-3
7.2.
2.
The
audi
t rec
ord
incl
udes
: use
r ID
. H
igh
V-3
7.2.
3.
The
audi
t rec
ord
incl
udes
: use
r's ro
le.
Hig
h
V
-37.
2.4.
Th
e au
dit r
ecor
d in
clud
es: u
ser's
or
gani
zatio
n.
Hig
h
V-3
7.2.
5.
The
audi
t rec
ord
incl
udes
: pat
ient
ID.
Hig
h
Pag
e 10
7
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-37.
2.6.
Th
e au
dit r
ecor
d in
clud
es: f
unct
ion
perfo
rmed
(vie
w, e
dit,
prin
t).
Hig
h
V-3
7.2.
7.
The
audi
t rec
ord
incl
udes
: pro
vide
r lo
catio
n.
Hig
h
V-3
7.2.
8.
The
audi
t rec
ord
incl
udes
: con
sent
ov
errid
e w
ith th
e re
ason
(if a
cces
s is
an
over
ride
even
t).
Hig
h
V-3
7.2.
9.
The
audi
t rec
ord
incl
udes
: con
sent
di
rect
ive
chan
ge b
y su
bstit
ute
deci
sion
mak
er
– ID
of d
ecis
ion
mak
er.
Hig
h
V-3
7.2.
10.
The
audi
t rec
ord
incl
udes
: sou
rce
syst
em a
ddre
ss a
nd ID
. H
igh
V-3
7.2.
11.
The
audi
t rec
ord
incl
udes
: des
tinat
ion
syst
em a
ddre
ss a
nd ID
. H
igh
V-3
7.2.
12.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
deta
il (e
.g.,
com
plet
e H
L7 m
essa
ge).
Hig
h
V-3
7.2.
13.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
type
. H
igh
V-3
7.2.
14.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
stat
us (e
.g.,
proc
ess
outc
ome)
. H
igh
V-3
7.2.
15.
The
audi
t rec
ord
incl
udes
: au
then
ticat
ion
sour
ce.
Hig
h
V-3
7.2.
16.
The
audi
t rec
ord
incl
udes
: app
licat
ion
iden
tity.
H
igh
V-3
7.2.
17.
The
audi
t rec
ord
incl
udes
: pat
ient
fla
gged
for a
dditi
onal
priv
acy
audi
ting.
H
igh
V-3
7.2.
18.
The
audi
t rec
ord
incl
udes
: fla
gged
us
er a
cces
s to
a p
atie
nt w
here
no
prev
ious
re
latio
nshi
p w
as e
stab
lishe
d.
Hig
h
Pag
e 10
8
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-37.
2.19
. Th
e au
dit r
ecor
d in
clud
es: m
etad
ata
for s
earc
hing
. Id
entif
y th
e da
ta c
aptu
red
with
in t
he v
iew
er
audi
t tab
les.
Hig
h
V-3
7.3.
Th
e au
dit r
ecor
d da
ta c
anno
t be
dele
ted.
H
igh
V-3
7.4.
Th
e au
dit r
ecor
d da
ta c
anno
t be
mod
ified
. H
igh
V-3
7.5.
Th
e vi
ewer
sup
ports
tim
e sy
nchr
oniz
atio
n w
ith a
n ex
tern
al N
etw
ork
Tim
e P
roto
col (
NTP
) and
reco
rd
time
stam
ps u
sing
UTC
bas
ed o
n IS
O 8
601-
2000
(e
.g.,
1994
-11-
05T0
8:15
:30-
05:0
0 co
rres
pond
s to
N
ovem
ber 5
, 199
4, 8
:15:
30 a
m, U
S E
aste
rn S
tand
ard
Tim
e).
Hig
h
V-3
7.6.
V
iew
er o
pera
tion
disc
ontin
ues
whe
n th
e lo
ggin
g is
no
n-fu
nctio
nal.
Hig
h
V-3
7.7.
Th
e vi
ewer
onl
y pe
rmits
read
acc
ess
to a
udit
logs
to
spe
cific
use
rs.
Hig
h
V-3
7.8.
Th
e au
dit l
ogs
inte
grat
e w
ith th
e ex
istin
g E
HR
ce
ntra
l aud
it se
rvic
e.
Hig
h
V-3
8. T
he v
iew
er s
uppo
rts b
acku
p fu
nctio
nalit
y.
D
escr
ibe
the
reco
mm
ende
d ap
proa
ch f
or m
inim
izin
g th
e im
pact
to u
sers
and
dat
abas
e pe
rform
ance
.
Hig
h
V-3
8.1.
Th
e vi
ewer
bac
kup
func
tiona
lity
oper
ates
co
ncur
rent
with
ope
ratio
n.
Iden
tify
any
third
par
ty to
ols
utiliz
ed a
nd d
escr
ibe
thei
r ro
le.
Hig
h
V-3
8.2.
Th
e vi
ewer
bac
kup
func
tiona
lity
is s
ecur
e fro
m
unau
thor
ized
acc
ess.
D
escr
ibe
the
mec
hani
sms
avai
labl
e to
ens
ure
the
conf
iden
tialit
y an
d in
tegr
ity o
f ba
ckup
file
s ag
ains
t un
auth
oriz
ed a
cces
s.
Hig
h
Pag
e 10
9
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
V
-38.
3.
The
view
er re
stor
e pr
oced
ures
resu
lt in
a fu
lly
oper
atio
nal a
nd s
ecur
e st
ate.
Id
entif
y if
the
view
er is
abl
e to
rest
ore
from
the
poin
t of
failu
re a
nd in
dica
te e
xpec
ted
data
loss
.
Hig
h
V-3
8.3.
1.
Res
tora
tion
incl
udes
vie
wer
dat
a.
Hig
h
V
-38.
3.2.
R
esto
ratio
n in
clud
es a
pplic
atio
n da
ta.
Hig
h
V
-38.
3.3.
R
esto
ratio
n in
clud
es s
ecur
ity
cred
entia
ls.
Hig
h
V-3
8.3.
4.
Res
tora
tion
incl
udes
aux
iliary
file
s (e
.g.,
audi
t and
log
files
). H
igh
V-3
8.4.
In
voke
d sy
stem
shu
tdow
n is
ord
erly
(e.g
., no
n-de
stru
ctiv
e w
ith d
ata
inte
grity
mai
ntai
ned)
with
no
data
lo
ss.
Hig
h
V-3
9. T
he v
iew
er in
stal
ls a
nd o
pera
tes
all n
eces
sary
ser
vice
s an
d pr
otoc
ols
with
the
leas
t priv
ilege
pos
sibl
e.
P
rovi
de a
det
aile
d lis
t of
fun
ctio
ns a
nd a
pplic
atio
ns t
hat
requ
ire a
dmin
or r
oot p
rivile
ges.
Hig
h
V-4
0. V
iew
er s
yste
m a
dmin
istra
tion
is p
erfo
rmed
thro
ugh
a co
mm
on G
UI i
nter
face
. H
igh
V-4
0.1.
E
HR
com
pone
nt a
dmin
istra
tion
is p
rovi
ded
thro
ugh
web
-bas
ed to
ols
supp
ortin
g ei
ther
jsr1
68 o
r wsr
p po
rtlet
s.
Hig
h
V-4
0.2.
E
HR
com
pone
nt a
dmin
istra
tion
portl
ets
allo
w
inte
grat
ion
into
a c
omm
on s
yste
m a
dmin
istra
tion
tool
. H
igh
V-4
1. T
he v
iew
er a
dmin
istra
tion
porta
l sup
ports
use
r m
anag
emen
t. H
igh
V-4
1.1.
Th
e vi
ewer
adm
inis
tratio
n po
rtal s
uppo
rts u
ser
acco
unt c
reat
ion,
act
ivat
ion
and
deac
tivat
ion.
H
igh
V-4
1.2.
Th
e vi
ewer
adm
inis
tratio
n po
rtal s
uppo
rts u
ser
pass
wor
d m
anag
emen
t. H
igh
Pag
e 11
0
New
foun
dlan
d an
d La
brad
or
R
FP#:
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entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-4
1.3.
Th
e vi
ewer
adm
inis
tratio
n po
rtal i
nteg
rate
s w
ith th
e ju
risdi
ctio
nal E
HR
aut
hent
icat
ion
and
auth
oriz
atio
n se
rvic
e.
Hig
h
V-4
1.4.
Th
e vi
ewer
adm
inis
tratio
n po
rtal s
uppo
rts ro
le
base
d ac
cess
con
trol.
Hig
h
V-4
2. T
he v
iew
er a
dmin
istra
tion
porta
l sup
ports
vie
win
g ba
tch
proc
ess
activ
ity.
Med
ium
V-4
2.1.
Th
e vi
ewer
adm
inis
tratio
n po
rtal d
ispl
ays
a sc
hedu
le o
f upc
omin
g ba
tch
proc
esse
s.
Med
ium
V-4
2.2.
Th
e vi
ewer
adm
inis
tratio
n po
rtal d
ispl
ays
batc
h pr
oces
sing
out
com
es fr
om th
e au
dit l
og.
Med
ium
V-4
3. T
he v
iew
er a
dmin
istra
tion
porta
l pro
vide
s E
HR
com
pone
nt
oper
atio
nal f
eedb
ack
to c
entra
lized
mon
itorin
g ca
pabi
lity.
H
igh
V-4
3.1.
Th
e vi
ewer
adm
inis
tratio
n po
rtal s
uppo
rts
oper
atio
nal r
epor
ting
of E
HR
com
pone
nt o
pera
tions
an
d bu
sine
ss p
roce
sses
(e.g
., us
age
met
rics)
.
Hig
h
V-4
3.2.
Th
e vi
ewer
adm
inis
tratio
n po
rtal i
s ab
le to
acc
ess
and
disp
lay
the
cont
ents
of t
he a
udit
logs
. H
igh
V-4
3.3.
Th
e vi
ewer
adm
inis
tratio
n po
rtal i
s ab
le to
acc
ess
and
disp
lay
erro
r log
ent
ries.
H
igh
V-4
3.4.
Th
e vi
ewer
adm
inis
tratio
n po
rtal s
uppo
rts s
earc
h an
d fil
ter f
unct
iona
lity
(e.g
., by
pat
ient
iden
tifie
r, te
st
resu
lt, d
ate
rang
e, p
rovi
der,
faci
lity
and
cons
ent
over
ride
reas
on) w
hen
pres
entin
g au
dit l
og h
isto
ries.
Hig
h
V-4
4. T
he v
iew
er a
dmin
istra
tion
porta
l sen
ds s
yste
m n
otifi
catio
ns
to u
sers
. Lo
w
V-4
4.1.
U
ser n
otifi
catio
ns m
ay b
e se
nt to
all
user
s.
Low
V
-44.
2.
Use
r not
ifica
tions
may
be
sent
to a
sel
ecte
d gr
oup
of u
sers
(e.g
., al
l use
rs lo
gged
in).
Low
V-4
5. T
he p
erm
issi
ble
resp
onse
s fo
r use
r-se
lect
able
list
s (e
.g.,
for p
atie
nt s
earc
h) a
re c
onfig
urab
le.
Hig
h
Pag
e 11
1
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-4
6. A
ll se
curit
y an
d ad
min
istra
tive
user
s ar
e st
rong
ly
auth
entic
ated
with
mul
ti-fa
ctor
aut
hent
icat
ion.
H
igh
V-4
6.1.
A
ll se
curit
y an
d ad
min
istra
tive
user
s ha
ve u
niqu
e us
er ID
s (in
clud
ing
vend
ors)
. H
igh
V-4
7. T
he v
iew
er a
lerts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
whe
n pr
eset
eve
nts
occu
r. H
igh
V-4
7.1.
O
utbo
und
mes
sage
err
ors
prom
pt n
otifi
catio
n to
th
e ap
prop
riate
sys
tem
adm
inis
tratio
n au
thor
ity.
Iden
tify
the
scop
e of
er
rors
su
ppor
ted
and
the
notif
icat
ion
chan
nels
ava
ilabl
e.
Hig
h
V-4
7.2.
Th
e vi
ewer
ale
rts th
e ap
prop
riate
sys
tem
ad
min
istra
tion
auth
ority
whe
n pr
eset
que
ue th
resh
olds
ha
ve b
een
reac
hed.
D
escr
ibe
aler
t cap
abili
ties
incl
udin
g al
ert d
eliv
ery
chan
nels
(e.g
., pa
ge, e
mai
l, de
liver
y of
mes
sage
to a
qu
eue
whi
ch is
per
iodi
cally
che
cked
).
Hig
h
V-4
7.3.
Th
e vi
ewer
ale
rts th
e ap
prop
riate
sys
tem
ad
min
istra
tion
auth
ority
whe
n a
pred
efin
ed a
nd
conf
igur
able
erro
r con
ditio
n oc
curs
(eith
er w
ith a
sp
ecifi
c m
essa
ge o
r with
spe
cific
sys
tem
s co
mpo
nent
s).
Des
crib
e er
ror
and
aler
t ca
pabi
litie
s in
clud
ing
aler
t de
liver
y ch
anne
ls.
Hig
h
Pag
e 11
2
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-4
7.4.
Th
e vi
ewer
pro
activ
ely
mon
itors
per
form
ance
and
al
erts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
w
hen
a pr
eset
thre
shol
d ha
s be
en e
xcee
ded.
D
escr
ibe
the
avai
labl
e vi
ewer
cap
abilit
ies,
too
ls a
nd
proc
esse
s fo
r m
onito
ring
(pro
activ
e an
d re
activ
e)
incl
udin
g er
ror
mes
sage
ana
lysi
s (e
.g.,
trend
ing)
and
al
ert d
eliv
ery
chan
nels
. D
escr
ibe
any
tool
s or
tem
plat
es th
at a
re a
vaila
ble
for
the
view
er to
sup
port
capa
city
pla
nnin
g.
Hig
h
V-4
8. T
he v
iew
er s
uppo
rts d
ata
arch
ival
and
retri
eval
fu
nctio
nalit
y.
D
escr
ibe
the
capa
bilit
ies,
too
ls a
nd p
roce
sses
req
uire
d to
co
nfig
ure
arch
ivin
g, in
clud
ing
abili
ty to
spe
cify
how
long
the
proc
esse
d m
essa
ges
are
kept
.
Hig
h
V-4
9. T
he v
iew
er a
chie
ves
the
avai
labi
lity
targ
ets
(as
iden
tifie
d in
th
is R
FP S
ectio
n 2)
.
Des
crib
e th
e ap
proa
ch,
arch
itect
ure
and
proc
esse
s fo
r ac
hiev
ing
the
avai
labi
lity
targ
ets.
Iden
tify
any
addi
tiona
l (e
.g.,
third
par
ty)
hard
war
e an
d so
ftwar
e re
quire
d fo
r hig
h av
aila
bilit
y.
Des
crib
e an
y to
ols
or t
empl
ates
tha
t ar
e av
aila
ble
for
the
view
er to
sup
port
busi
ness
con
tinui
ty p
lann
ing.
Hig
h
Pag
e 11
3
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-5
0. T
he v
iew
er a
chie
ves
the
perfo
rman
ce ta
rget
s (a
s id
entif
ied
in th
is R
FP).
D
escr
ibe
the
appr
oach
, ar
chite
ctur
e an
d pr
oces
ses
for
achi
evin
g th
ese
targ
ets.
Iden
tify
any
perfo
rman
ce
tuni
ng
tool
s an
d fu
nctio
ns
reco
mm
ende
d fo
r th
e vi
ewer
an
d in
dica
te
if th
ey
are
incl
uded
with
vie
wer
.
Des
crib
e ho
w th
e vi
ewer
pro
vide
s fo
r sca
labi
lity.
Hig
h
V-5
1. A
ppro
pria
te d
ocum
enta
tion
is in
clud
ed fo
r all
com
pone
nts
Hig
h
V
-51.
1.
Doc
umen
tatio
n is
cur
rent
H
igh
V-5
1.2.
D
ocum
enta
tion
is m
aint
aine
d by
the
vend
or
Hig
h
V
-51.
3.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Tec
hnic
al
Arc
hite
ctur
e.
Hig
h
V-5
1.3.
1.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Phy
sica
l Har
dwar
e D
esig
n H
igh
V-5
1.3.
2.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Virt
ualiz
atio
n H
igh
V-5
1.3.
3.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Net
wor
king
Des
ign
Hig
h
V-5
1.4.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to D
atab
ase
Des
ign
Hig
h
V-5
1.5.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
olut
ion
Arc
hite
ctur
e/D
esig
n:
• Sol
utio
n ar
chite
ctur
e (in
clud
ing
diag
ram
s fo
r the
ap
plic
atio
n ar
chite
ctur
e tie
rs);
• Com
pone
nt in
terfa
ce d
escr
iptio
ns;
• iE
HR
com
pone
nt d
escr
iptio
ns;
Hig
h
V-5
1.5.
1.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
app
licat
ion
depl
oym
ent m
odel
. H
igh
Pag
e 11
4
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-5
1.6.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to B
usin
ess
Con
tinui
ty.
Hig
h
V-5
1.6.
1.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Bac
kup
Pro
cess
. H
igh
V-5
1.6.
2.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Dis
aste
r Rec
over
y.
Hig
h
V-5
1.7.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
Mai
nten
ance
and
Sup
port
Con
tract
s.
Hig
h
V-5
1.7.
1.
Doc
umen
tatio
n in
clud
es a
pplic
able
S
ervi
ce L
evel
Agr
eem
ents
(e.g
., su
ppor
t le
vels
, sup
port
hour
s, re
spon
se ti
mes
, sup
port
team
loca
tions
).
Hig
h
V-5
1.7.
2.
Doc
umen
tatio
n in
clud
es s
uppo
rt m
odel
(e.g
., es
cala
tion
proc
edur
es, I
TIL
com
plia
nce,
inte
grat
ion
with
Tie
r 1 s
uppo
rt at
th
e C
entre
).
Iden
tify
the
reso
urce
s th
at
are
requ
ired
to
perfo
rm o
pera
tions
, mai
nten
ance
, sup
port
and
troub
le-s
hoot
ing.
Hig
h
V-5
1.7.
3.
Doc
umen
tatio
n id
entif
ies
vend
or
supp
ort o
blig
atio
ns fo
r pre
viou
s ve
rsio
ns.
Hig
h
V-5
1.7.
4.
Doc
umen
tatio
n id
entif
ies
prod
uct
notif
icat
ion
and
advi
sory
pro
cess
es.
Hig
h
V-5
1.8.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to O
pera
tions
an
d M
aint
enan
ce
Hig
h
V-5
1.8.
1.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
App
licat
ion
Inst
alla
tion
Hig
h
V-5
1.8.
2.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Ope
ratin
g S
yste
m In
stal
latio
n H
igh
V-5
1.9.
D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
ecur
ity.
Hig
h
Pag
e 11
5
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-5
1.9.
1.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Sec
urity
Pro
cedu
res
Hig
h
V-5
1.9.
2.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Sys
tem
Har
deni
ng
Hig
h
V-5
1.10
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to R
elea
se
Man
agem
ent
Hig
h
V-5
1.10
.1.
Doc
umen
tatio
n in
clud
es a
form
al
prod
uct r
elea
se s
ched
ule.
H
igh
V-5
1.10
.2.
Doc
umen
tatio
n in
clud
es s
tand
ards
ad
optio
n an
d co
nfor
man
ce s
ched
ule.
H
igh
V-5
1.10
.3.
Doc
umen
tatio
n in
clud
es S
oftw
are
Rel
ease
Not
es fo
r all
appl
ied
patc
hes
or
softw
are
upda
tes
Hig
h
V-5
1.10
.4.
App
licat
ion
sour
ce c
ode
(if s
uppl
ied)
is
docu
men
ted
Hig
h
V-5
1.10
.5.
Pro
mot
ion
proc
esse
s us
ed fo
r ap
plic
atio
n m
igra
tion
betw
een
envi
ronm
ents
is
docu
men
ted.
Id
entif
y th
e m
etho
ds a
nd to
ols
prov
ided
with
th
e vi
ewer
.
Hig
h
V-5
1.10
.6.
The
view
er g
atin
g do
cum
enta
tion
incl
udes
an
upda
ted
oper
atio
ns g
uide
. H
igh
V-5
1.10
.7.
The
view
er g
atin
g do
cum
enta
tion
incl
udes
an
upda
ted
Ser
vice
des
k tro
uble
shoo
ting
guid
e.
Hig
h
V-5
1.10
.8.
The
view
er g
atin
g do
cum
enta
tion
incl
udes
an
impl
emen
tatio
n pl
an.
Hig
h
V-5
1.10
.9.
The
view
er g
atin
g do
cum
enta
tion
incl
udes
a te
stin
g pl
an a
nd re
sults
sum
mar
y.
Hig
h
Pag
e 11
6
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
V-5
2. D
ocum
enta
tion
incl
udes
rele
vant
trai
ning
mat
eria
l (e.
g.,
busi
ness
pro
cess
cha
nges
, bro
chur
e-w
are,
ope
ratio
nal
best
pra
ctic
es).
Hig
h
V-5
3. A
ppro
pria
te p
roje
ct d
ocum
enta
tion
is in
clud
ed fo
r the
initi
al
impl
emen
tatio
n (e
.g.,
risk
man
agem
ent,
proj
ect p
lan,
tra
nsiti
on p
lan,
impl
emen
tatio
n pl
an, k
now
ledg
e tra
nsfe
r, te
stin
g pl
an).
Hig
h
V-5
4. T
he v
iew
er s
uppo
rts u
p to
100
0 co
ncur
rent
use
rs
Hig
h
V
-55.
The
vie
wer
is c
apab
le o
f sup
porti
ng o
rder
man
agem
ent f
or
the
patie
nt in
con
text
. Lo
w
V-5
6. T
he v
iew
er p
roce
sses
tran
sact
ions
with
in th
e pe
rform
ance
ta
rget
s ou
tline
d by
Can
ada
Hea
lth In
fow
ay in
Blu
eprin
t v2
- S
ectio
n 4.
3.9.
7 E
HR
Vie
wer
Req
uire
men
ts.
Hig
h
V-5
6.1.
Th
e vi
ewer
por
tion
of th
e lo
gin
proc
esse
s co
mpl
ete
with
in 2
.0 s
econ
ds, 8
0 pe
rcen
t of t
he ti
me
(exc
lusi
ve
of e
xter
nal p
roce
sses
suc
h as
the
user
dire
ctor
y).
Hig
h
V-5
6.2.
Th
e vi
ewer
dis
play
s th
e us
er h
ome
page
with
in 3
.0
seco
nds,
80
perc
ent o
f the
tim
e.
Hig
h
V-5
6.3.
Th
e vi
ewer
det
erm
inis
tic s
earc
h pr
oces
s (i.
e., u
pon
user
requ
est,
form
ulat
e m
essa
ge a
nd s
ubm
it to
HIA
L pl
us u
pon
rece
ipt f
rom
HIA
L, d
ispl
ay th
e re
sults
to th
e us
er) c
ompl
etes
with
in 1
.0 s
econ
ds, 8
0 pe
rcen
t of t
he
time.
Hig
h
V-5
6.4.
Th
e vi
ewer
pro
cess
es a
nd d
ispl
ays
data
from
up
to
thre
e re
posi
torie
s (i.
e., u
pon
user
requ
est,
form
ulat
e m
essa
ge a
nd s
ubm
it to
HIA
L pl
us u
pon
rece
ipt f
rom
H
IAL,
dis
play
the
resu
lts to
the
user
) with
in 2
.0
seco
nds,
80
perc
ent o
f the
tim
e.
Hig
h
10.4
SHR
Req
uire
men
ts M
atrix
P
age
117
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Not
App
licab
le –
che
ck if
resp
onse
doe
s no
t add
ress
the
SHR
Req
uire
men
ts
Req
uire
men
t Pr
iorit
y R
espo
nse
F / P
/ N
C
omm
ents
S-1
. Th
e S
HR
sto
res
text
ual c
linic
al d
ocum
enta
tion.
Res
pond
ents
are
to id
entif
y an
y ot
her t
ypes
of c
onte
nt th
at
the
SH
R s
uppo
rts th
at is
not
list
ed in
Req
uire
men
ts S
-1.1
th
roug
h S
-3.3
.
Man
dato
ry
S-1
.1.
The
SH
R s
tore
s co
nsul
tatio
ns.
Hig
h
S-1
.2.
The
SH
R s
tore
s di
scha
rge
sum
mar
ies.
H
igh
S-1
.3.
The
SH
R s
tore
s le
tters
(e.g
., cl
inic
, ref
erra
l).
Hig
h
S-1
.4.
The
SH
R s
tore
s no
n-ph
ysic
ian
clin
ical
ass
essm
ents
(e
.g.,
nurs
ing,
oth
er c
linic
al d
isci
plin
es).
Med
ium
S-1
.5.
The
SH
R s
tore
s pa
tient
alle
rgie
s.
Low
S-1
.6.
The
SH
R s
tore
s pa
tient
imm
uniz
atio
ns.
Low
S-2
. Th
e S
HR
sto
res
patie
nt e
ncou
nter
info
rmat
ion
(e.g
., ad
mit,
di
scha
rge,
tran
sfer
s, re
gist
ratio
ns a
nd a
ny a
ssoc
iate
d ca
ncel
s).
Hig
h
S-2
.1.
The
SH
R s
tore
s pa
tient
enc
ount
er c
reat
ion
info
rmat
ion.
M
ediu
m
S-2
.2.
The
SH
R s
tore
s pa
tient
enc
ount
er re
visi
on
info
rmat
ion.
M
ediu
m
S-2
.3.
The
SH
R s
tore
s pa
tient
enc
ount
er c
ompl
etio
n in
form
atio
n.
Med
ium
S-2
.4.
The
SH
R s
tore
s pa
tient
enc
ount
er c
ance
llatio
n in
form
atio
n.
Med
ium
S-3
. Th
e S
HR
sto
res
diag
nost
ic im
agin
g in
form
atio
n.
Hig
h
S-3
.1.
The
SH
R s
tore
s di
agno
stic
imag
ing
orde
r. M
ediu
m
S-3
.2.
The
SH
R s
tore
s di
agno
stic
imag
ing
repo
rts.
Hig
h
Pag
e 11
8
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
.3.
The
SH
R s
tore
s th
e P
AC
S im
age
loca
tor (
but n
ot th
e ac
tual
imag
e) a
ssoc
iate
d w
ith th
e st
ored
dia
gnos
tic
imag
ing
repo
rt.
Med
ium
S-4
. S
HR
info
rmat
ion
is re
visa
ble
and
corr
ecta
ble.
H
igh
S-4
.1.
Nul
lifie
d S
HR
info
rmat
ion
is id
entif
iabl
e (i.
e., n
ot
dele
ted)
. H
igh
S-4
.2.
SH
R c
linic
al d
ocum
enta
tion
info
rmat
ion
is re
visa
ble
and
corre
ctab
le.
Hig
h
S-4
.2.1
. Th
e S
HR
is re
spon
sive
to p
atie
nt id
entif
icat
ion
chan
ges.
Des
crib
e ho
w t
he c
orre
ct p
atie
nt i
s m
aint
aine
d w
ithin
th
e S
HR
in
th
e ev
ent
of
a pa
tient
id
entif
icat
ion
chan
ge
as
a re
sult
of
a cl
ient
m
erge
/unm
erge
/link
/unl
ink
and
how
su
ch
a ch
ange
is id
entif
iabl
e.
Hig
h
S-4
.2.2
. Th
e S
HR
is re
spon
sive
to re
assi
gnm
ent o
f cl
inic
al d
ocum
enta
tion
to th
e co
rrect
pat
ient
.
Des
crib
e ho
w t
he S
HR
han
dles
the
sce
nario
w
here
a c
linic
al d
ocum
ent
was
pla
ced
on t
he
wro
ng
patie
nt
and
how
th
is
corr
ectio
n is
id
entif
iabl
e.
Hig
h
Pag
e 11
9
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-4
.2.3
. Th
e S
HR
is re
spon
sive
to c
linic
al d
ocum
ent
corre
ctio
ns fr
om s
ourc
e sy
stem
s.
D
escr
ibe
how
the
SH
R h
andl
es t
he s
cena
rio
whe
re
a co
mpl
eted
cl
inic
al
docu
men
t w
as
repl
aced
with
a n
ew d
ocum
ent
and
how
thi
s co
rrect
ion
is id
entif
iabl
e.
D
escr
ibe
how
the
SH
R h
andl
es t
he s
cena
rio
whe
re
a co
mpl
eted
cl
inic
al
docu
men
t w
as
upda
ted
and
how
thi
s co
rrect
ion
is i
dent
ifiab
le
with
in th
e S
HR
.
Hig
h
S-4
.3.
SH
R p
atie
nt e
ncou
nter
info
rmat
ion
is re
visa
ble
and
corr
ecta
ble.
H
igh
S-4
.3.1
. Th
e S
HR
pat
ient
enc
ount
er in
form
atio
n is
re
spon
sive
to p
atie
nt id
entif
icat
ion
chan
ges.
Des
crib
e ho
w t
he c
orre
ct p
atie
nt i
s m
aint
aine
d w
ithin
th
e S
HR
in
th
e ev
ent
of
a pa
tient
id
entif
icat
ion
chan
ge
as
a re
sult
of
a cl
ient
m
erge
/unm
erge
/link
/unl
ink
and
how
su
ch
a ch
ange
is id
entif
iabl
e.
Hig
h
S-4
.3.2
. Th
e S
HR
is re
spon
sive
to re
assi
gnm
ent o
f pa
tient
enc
ount
er in
form
atio
n to
the
corr
ect
patie
nt.
D
escr
ibe
how
the
SH
R h
andl
es t
he s
cena
rio
whe
re a
pat
ient
enc
ount
er w
as p
lace
d on
the
w
rong
pa
tient
an
d ho
w
this
co
rrec
tion
is
iden
tifia
ble.
Hig
h
Pag
e 12
0
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-4
.3.3
. Th
e S
HR
pat
ient
enc
ount
er in
form
atio
n is
re
spon
sive
to e
rror c
orre
ctio
ns fr
om th
e so
urce
sy
stem
s.
D
escr
ibe
how
the
SH
R h
andl
es t
he s
cena
rio
whe
re a
pat
ient
enc
ount
er w
as r
epla
ced
with
a
new
en
coun
ter
and
how
th
is
corr
ectio
n is
id
entif
iabl
e.
Des
crib
e ho
w t
he S
HR
han
dles
the
sce
nario
w
here
a p
atie
nt e
ncou
nter
was
upd
ated
and
how
th
is c
orre
ctio
n is
iden
tifia
ble.
Hig
h
S-4
.4.
SH
R d
iagn
ostic
imag
ing
info
rmat
ion
is re
visa
ble
and
corr
ecta
ble.
H
igh
S-4
.4.1
. Th
e S
HR
dia
gnos
tic im
agin
g in
form
atio
n is
re
spon
sive
to p
atie
nt id
entif
icat
ion
chan
ges.
Des
crib
e ho
w t
he c
orre
ct p
atie
nt i
s m
aint
aine
d w
ithin
th
e S
HR
in
th
e ev
ent
of
a pa
tient
id
entif
icat
ion
chan
ge
as
a re
sult
of
a cl
ient
m
erge
/unm
erge
/link
/unl
ink
and
how
su
ch
a ch
ange
is id
entif
iabl
e.
Hig
h
S-4
.4.2
. Th
e S
HR
is re
spon
sive
to re
assi
gnm
ent o
f di
agno
stic
imag
ing
info
rmat
ion
to th
e co
rrect
pa
tient
.
Des
crib
e ho
w t
he S
HR
han
dles
the
sce
nario
w
here
a d
iagn
ostic
imag
ing
repo
rt w
as p
lace
d on
th
e w
rong
pat
ient
and
how
thi
s co
rrec
tion
is
iden
tifia
ble.
Hig
h
Pag
e 12
1
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
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2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-4
.4.3
. Th
e S
HR
is re
spon
sive
to d
iagn
ostic
imag
ing
info
rmat
ion
erro
r cor
rect
ions
from
sou
rce
syst
ems.
Des
crib
e ho
w t
he S
HR
han
dles
the
sce
nario
w
here
a d
iagn
ostic
imag
ing
repo
rt w
as r
epla
ced
with
a n
ew r
epor
t an
d ho
w t
his
corr
ectio
n is
id
entif
iabl
e.
Des
crib
e ho
w t
he S
HR
han
dles
the
sce
nario
w
here
a d
iagn
ostic
imag
ing
repo
rt w
as u
pdat
ed
and
how
this
cor
rect
ion
is id
entif
iabl
e.
Hig
h
S-5
. Th
e S
HR
sup
ports
poi
nt-in
-tim
e da
ta a
rchi
tect
ure
(i.e.
, at
defin
ed p
oint
in ti
me
a vi
ew o
f the
EH
R d
ata
can
be
reco
nstru
cted
).
Hig
h
S-5
.1.
The
SH
R u
tiliz
es v
ersi
onin
g w
hen
perfo
rmin
g re
cord
up
date
s.
Hig
h
S-5
.1.1
. Th
e S
HR
sto
res
a ne
w re
cord
with
the
upda
ted
info
rmat
ion
(e.g
., du
e to
a re
vise
d te
st re
sult)
. H
igh
S-5
.1.2
. Th
e S
HR
inac
tivat
es th
e ol
d re
cord
(i.e
., no
ph
ysic
al d
elet
ion
of re
cord
s).
Hig
h
S-5
.2.
The
SH
R m
aint
ains
a v
ersi
on h
isto
ry o
f inf
orm
atio
n ch
ange
s.
Hig
h
S-5
.3.
The
SH
R re
cord
his
torie
s ar
e re
triev
able
. H
igh
S-6
. Th
e S
HR
dat
a ar
chite
ctur
e su
ppor
ts fu
ture
ext
ensi
ons
and
mod
ifica
tions
(e.g
., up
date
d st
anda
rds)
. H
igh
S-7
. Th
e S
HR
sup
ports
ass
ocia
ted
patie
nt, p
rovi
der a
nd
loca
tion
iden
tifie
rs.
Man
dato
ry
Pag
e 12
2
New
foun
dlan
d an
d La
brad
or
R
FP#:
CH
I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-7
.1.
The
SH
R s
uppo
rts lo
cal c
lient
iden
tifie
rs, b
ut n
ot th
eir
eCID
(the
ent
erpr
ise
clie
nt id
entif
ier m
aint
aine
d by
the
Clie
nt R
egis
try).
If th
e S
HR
do
es
stor
e eC
IDs,
de
scrib
e th
e fu
nctio
nalit
y th
at i
s ut
ilized
to
keep
the
se e
ntrie
s in
sy
nchr
oniz
atio
n w
ith th
e C
lient
Reg
istry
as
a re
sult
of
regi
stry
cha
nges
.
Hig
h
S-7
.2.
The
SH
R s
uppo
rts lo
cal p
rovi
der i
dent
ifier
s, b
ut n
ot
thei
r eP
ID (t
he e
nter
pris
e pr
ovid
er id
entif
ier
mai
ntai
ned
by th
e P
rovi
der R
egis
try).
If th
e S
HR
do
es
stor
e eP
IDs,
de
scrib
e th
e fu
nctio
nalit
y th
at i
s ut
ilized
to
keep
the
se e
ntrie
s in
sy
nchr
oniz
atio
n w
ith th
e Pr
ovid
er R
egis
try a
s a
resu
lt of
regi
stry
cha
nges
.
Hig
h
S-7
.3.
The
SH
R s
uppo
rts lo
cal l
ocat
ion
iden
tifie
rs, b
ut n
ot
thei
r eLI
D (t
he e
nter
pris
e lo
catio
n id
entif
ier m
aint
aine
d by
the
Loca
tion
Reg
istry
). If
the
SH
R d
oes
stor
e eL
IDs,
res
pond
ents
are
to
desc
ribe
the
func
tiona
lity
that
is u
tiliz
ed to
kee
p th
ese
entri
es i
n sy
nchr
oniz
atio
n w
ith t
he L
ocat
ion
Reg
istry
as
a re
sult
of re
gist
ry c
hang
es.
Hig
h
S-8
. A
ll da
ta p
ersi
sted
in th
e SH
R is
sto
red
as it
was
pro
vide
d (i.
e., w
ithou
t tra
nsfo
rmat
ion
or a
ltera
tion
but d
oes
not
prec
lude
the
addi
tion
of tr
ansf
orm
ed n
orm
aliz
ed v
ersi
ons
of o
rigin
al d
ata
prov
ided
the
orig
inal
dat
a st
ill re
mai
ns).
Hig
h
S-9
. P
atie
nt-to
-pro
vide
r rel
atio
nshi
ps d
efin
ed w
ithin
the
mes
sagi
ng a
re m
aint
aine
d w
ithin
the
SH
R.
Hig
h
S-1
0. T
he S
HR
sup
ports
mes
sagi
ng fo
r upd
ates
. H
igh
S-1
0.1.
The
SH
R s
uppo
rts p
atie
nt e
ncou
nter
mes
sage
s (a
s pe
r the
Nov
a S
cotia
dra
ft m
essa
ge s
peci
ficat
ions
). H
igh
Pag
e 12
3
New
foun
dlan
d an
d La
brad
or
R
FP#:
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
0.1.
1. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r Pat
ient
E
ncou
nter
Put
indi
vidu
ally
(not
bat
ched
).
Iden
tify
the
inte
ract
ion
mes
sage
s ut
ilized
for
� cr
eatin
g pa
tient
enc
ount
ers.
�
revi
sing
pat
ient
enc
ount
ers.
�
com
plet
ing
patie
nt e
ncou
nter
s.
� nu
llifyi
ng p
atie
nt e
ncou
nter
s.
� ac
know
ledg
emen
ts.
Id
entif
y an
y ot
her
inte
ract
ion
mes
sage
s ut
ilize
d fo
r sto
ring
patie
nt e
ncou
nter
s.
Hig
h
S-1
0.1.
2. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r Pat
ient
E
ncou
nter
Que
ry (g
et/li
st).
Iden
tify
inte
ract
ion
mes
sage
s su
ppor
ted
for
quer
ying
pat
ient
enc
ount
ers.
Hig
h
S-1
1. T
he S
HR
sup
ports
clin
ical
doc
umen
tatio
n m
essa
ges.
H
igh
S-1
1.1.
1. T
he S
HR
sup
port
HL7
v3
(MR
2009
) mes
sage
s fo
r sto
ring
clin
ical
doc
umen
tatio
n (p
ut).
Id
entif
y th
e in
tera
ctio
n m
essa
ges
utiliz
ed fo
r 1.
st
orin
g cl
inic
al d
ocum
enta
tion;
2.
st
orin
g cl
inic
al re
ports
; 3.
ac
know
ledg
emen
ts.
Iden
tify
any
othe
r in
tera
ctio
n m
essa
ges
utili
zed
for s
torin
g cl
inic
al d
ocum
enta
tion
or re
ports
. D
escr
ibe
any
depe
nden
cies
for
sto
ring
clin
ical
do
cum
enta
tion
data
:
- D
oes
a P
atie
nt E
ncou
nter
hav
e to
exi
st?
- O
ther
dep
ende
ncie
s?
Hig
h
Pag
e 12
4
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
1.1.
2. T
he S
HR
sup
ports
HL7
v3
(MR
2009
) mes
sagi
ng
for q
uery
ing
clin
ical
doc
umen
tatio
n (g
et/li
st).
Id
entif
y th
e in
tera
ctio
n m
essa
ges
supp
orte
d fo
r qu
eryi
ng c
linic
al d
ocum
enta
tion
Iden
tify
the
inte
ract
ion
mes
sage
s su
ppor
ted
for
quer
ying
clin
ical
repo
rts.
Iden
tify
any
othe
r in
tera
ctio
n m
essa
ges
supp
orte
d fo
r qu
eryi
ng c
linic
al d
ocum
enta
tion
or
repo
rts.
Hig
h
S-1
1.2.
The
SH
R s
uppo
rts p
atie
nt a
llerg
y m
essa
ges.
Lo
w
S-1
1.2.
1. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r sto
ring
patie
nt a
llerg
ies
(put
).
Iden
tify
the
inte
ract
ion
mes
sage
s su
ppor
ted
for
stor
ing
alle
rgie
s.
Iden
tify
the
inte
ract
ion
mes
sage
ut
ilized
fo
r ac
know
ledg
emen
ts.
Des
crib
e an
y de
pend
enci
es fo
r sto
ring
alle
rgy
or
imm
uniz
atio
n da
ta. F
or e
xam
ple,
-
Doe
s a
Pat
ient
Enc
ount
er h
ave
to e
xist
? -
Oth
er d
epen
denc
ies?
Low
S-1
1.2.
2. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r qu
eryi
ng p
atie
nt a
llerg
ies
(get
/list
). Id
entif
y th
e in
tera
ctio
n m
essa
ges
supp
orte
d fo
r qu
eryi
ng
alle
rgie
s.
Low
S-1
1.3.
The
SH
R s
uppo
rts p
atie
nt im
mun
izat
ion
mes
sage
s.
Low
Pag
e 12
5
New
foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
1.3.
1. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r sto
ring
patie
nt im
mun
izat
ions
(put
).
Iden
tify
the
inte
ract
ion
mes
sage
s su
ppor
ted
for
stor
ing
imm
uniz
atio
ns.
Iden
tify
the
inte
ract
ion
mes
sage
s ut
ilized
fo
r ac
know
ledg
emen
ts.
Des
crib
e an
y de
pend
enci
es fo
r sto
ring
alle
rgy
or
imm
uniz
atio
n da
ta. F
or e
xam
ple,
-
Doe
s a
Pat
ient
Enc
ount
er h
ave
to e
xist
? -
Oth
er d
epen
denc
ies?
Low
S-1
1.3.
2. T
he S
HR
sup
ports
HL7
v3
mes
sagi
ng fo
r qu
eryi
ng p
atie
nt im
mun
izat
ions
(get
/list
). Id
entif
y th
e in
tera
ctio
n m
essa
ges
supp
orte
d fo
r que
ryin
g im
mun
izat
ions
.
Low
S-1
1.4.
The
SH
R s
uppo
rts H
L7 d
iagn
ostic
imag
ing
mes
sage
s.
Des
crib
e th
e in
tera
ctio
n m
essa
ges
supp
orte
d by
the
S
HR
for d
iagn
ostic
imag
ing.
D
escr
ibe
your
pl
an
for
mig
ratin
g to
a
new
pa
n-C
anad
ian
HL7
sta
ndar
d.
Hig
h
Pag
e 12
6
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
1.4.
1. T
he S
HR
sup
ports
mes
sage
s fo
r sto
ring
diag
nost
ic im
agin
g re
ports
and
ass
ocia
ted
PA
CS
im
age
loca
tors
.
Iden
tify
the
mes
sage
s ut
ilized
fo
r st
orin
g di
agno
stic
imag
ing
info
rmat
ion.
Des
crib
e an
y de
pend
enci
es:
- D
oes
a P
atie
nt E
ncou
nter
hav
e to
exi
st?
- D
oes
a di
agno
stic
imag
ing
orde
r hav
e to
ex
ist?
-
Oth
er d
epen
denc
ies?
Hig
h
S-1
1.4.
2. T
he S
HR
sup
ports
mes
sagi
ng fo
r que
ryin
g di
agno
stic
imag
ing
repo
rts a
nd P
AC
S im
age
loca
tors
(get
/list
).
Iden
tify
the
inte
ract
ion
mes
sage
s su
ppor
ted
for
quer
ying
imm
uniz
atio
ns.
Hig
h
S-1
1.5.
The
SH
R s
uppo
rts H
L7 v
3 re
gist
ry m
essa
ges
as p
er
MR
2007
. H
igh
S-1
1.5.
1. T
he S
HR
sup
ports
Clie
nt R
egis
try H
L7 v
3 m
essa
ges
for e
CID
bas
ed s
ynch
roni
zatio
n.
Hig
h
S-1
1.5.
2. T
he S
HR
sup
ports
Pro
vide
r Reg
istry
HL7
v3
mes
sage
s fo
r eP
ID b
ased
syn
chro
niza
tion.
H
igh
S-1
1.5.
3. T
he S
HR
sup
ports
Loc
atio
n R
egis
try H
L7 v
3 m
essa
ges
for a
ny e
LID
-bas
ed s
ynch
roni
zatio
n.
Hig
h
S-1
2. T
he S
HR
has
dat
a ex
tract
ion
capa
bilit
ies.
Iden
tify
the
supp
orte
d ex
tract
fo
rmat
s pl
us
any
tool
s (in
clud
ed o
r thi
rd p
arty
) and
lice
nsin
g ar
rang
emen
ts.
Hig
h
S-1
3. T
he S
HR
has
FTP
ser
vice
s (in
boun
d, o
utbo
und,
sftp
).
Hig
h
S-1
4. T
he S
HR
pro
cess
es m
essa
ges
in re
al-ti
me.
H
igh
Pag
e 12
7
New
foun
dlan
d an
d La
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or
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
5. T
he S
HR
inte
rope
rate
s w
ith th
e H
IAL
erro
r han
dlin
g pr
oces
s.
Hig
h
S-1
5.1.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
TLI
m
essa
ging
sta
ndar
d, in
clud
e: H
TTP
leve
l err
ors.
H
igh
S-1
5.2.
The
erro
r typ
es s
ent,
as p
er th
e ap
plic
able
TLI
m
essa
ging
sta
ndar
d, in
clud
e: S
OA
P le
vel e
rrors
. H
igh
S-1
5.3.
The
err
or ty
pes
sent
, as
per t
he a
pplic
able
HL7
m
essa
ging
sta
ndar
ds, i
nclu
de: H
L7 T
rans
port
leve
l er
rors
.
Hig
h
S-1
5.4.
The
err
or ty
pes
sent
, as
per t
he a
pplic
able
HL7
m
essa
ging
sta
ndar
ds, i
nclu
de: H
L7 A
pplic
atio
n le
vel
erro
rs.
Hig
h
S-1
6. T
he S
HR
con
tinue
s to
ope
rate
afte
r rec
eivi
ng e
xcep
tions
an
d er
rors
(in
stru
ctur
e or
con
tent
).
Indi
cate
whe
ther
this
can
con
trolle
d vi
a a
thre
shol
d se
tting
.
Hig
h
S-1
7. T
he S
HR
con
form
s to
the
Can
ada
Hea
lth In
fow
ay iE
HR
TL
I spe
cific
atio
n 1.
02.
Hig
h
S-1
7.1.
The
SH
R is
abl
e to
impl
emen
t the
WS
-* s
peci
ficat
ions
an
d al
tern
ate
appr
oach
es b
ased
on
the
curr
ent H
IAL
trans
port
spec
ifica
tions
in u
se in
NL
Hig
h
S-1
7.2.
The
SH
R is
sup
ports
SO
AP 1
.1 (t
he H
IAL
does
not
su
ppor
t SO
AP v
ersi
ons
high
er th
an 1
.1).
H
igh
S-1
7.3.
The
SH
R c
onfo
rms
to th
e W
S-I
Bas
ic P
rofil
e 1.
1.
Hig
h
S-1
7.4.
The
SH
R is
com
plia
nt w
ith th
e W
S-A
ddre
ssin
g sp
ecifi
catio
n.
Hig
h
S-1
7.4.
1. T
he S
HR
can
follo
w s
peci
fic in
stru
ctio
ns fo
r M
essa
geID
. H
igh
S-1
7.4.
2. T
he S
HR
can
follo
w s
peci
fic in
stru
ctio
ns fo
r To.
H
igh
S-1
7.4.
3. T
he S
HR
can
follo
w s
peci
fic in
stru
ctio
ns fo
r R
eply
To.
Hig
h
Pag
e 12
8
New
foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
7.4.
4. T
he S
HR
can
follo
w s
peci
fic in
stru
ctio
ns fo
r A
ctio
n.
Hig
h
S-1
7.4.
5. T
he S
HR
can
follo
w s
peci
fic in
stru
ctio
ns fo
r R
elat
esTo
. H
igh
S-1
7.5.
The
SH
R is
abl
e to
impl
emen
t WS
-Sec
urity
usi
ng a
se
curit
y to
ken,
dig
ital s
igna
ture
, and
XM
L en
cryp
tion
(pas
swor
d ba
sed)
.
Hig
h
S-1
7.5.
1. T
he S
HR
der
ives
the
sign
atur
e/en
cryp
tion
keys
ut
ilizin
g th
e m
etho
d sp
ecifi
ed in
the
TLI.
Hig
h
S-1
7.5.
2. T
he S
HR
dig
itally
sig
ns a
mes
sage
afte
r all
requ
ired
elem
ents
are
enc
rypt
ed.
Hig
h
S-1
7.5.
3. T
he S
HR
onl
y en
cryp
ts th
e P
atie
nt X
ML
elem
ent
(CM
ET)
whe
n co
mm
unic
atin
g w
ith th
e N
L H
IAL.
H
igh
S-1
7.5.
4. T
he S
HR
sup
ports
the
Infra
stru
ctur
e ve
rsio
ning
st
ruct
ure
as d
efin
ed in
the
Info
way
Tra
nspo
rt La
yer I
nter
oper
abilit
y sp
ecifi
catio
n.
Hig
h
S-1
7.5.
5. T
he S
HR
pop
ulat
es th
e S
OA
PA
ctio
n an
d W
A-A
A
ctio
n us
ing
the
follo
win
g na
min
g co
nven
tion:
In
tera
ctio
n ID
+ “.
” + “L
E” (
Loca
l) or
“NE”
(N
orm
ativ
e) +
YY
YY
MM
DD
For
exa
mpl
e:
urn:
hl7-
org:
v3:R
EP
C_I
N00
0041
CA
.LE2
0060
911
Hig
h
Pag
e 12
9
New
foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
7.5.
6. T
he S
HR
sup
ports
the
follo
win
g na
mes
pace
s:
• hl7
- ur
n:hl
7-or
g:v3
• x
sd -
http
://w
ww
.w3.
org/
2001
/XM
LSch
ema
• soa
p -
http
://sc
hem
as.x
mls
oap.
org/
soap
/env
elop
e/
• wsa
- ht
tp://
ww
w.w
3.or
g/20
05/0
3/ad
dres
sing
• w
sse
- http
://do
cs.o
asis
-op
en.o
rg/w
ss/v
1.1/
2004
/01/
oasi
s-20
0401
-wss
-w
ssec
urity
-sec
ext-1
.0.x
sd
• wsu
- ht
tp://
docs
.oas
is-
open
.org
/wss
/v1.
1/20
04/0
1/oa
sis-
2004
01-w
ss-
wss
ecur
ity-u
tility
-1.0
.xsd
• x
enc
- http
://w
ww
.w3.
org/
2001
/04/
xmle
nc#
• sig
- ht
tp://
ww
w.w
3.or
g/20
00/0
9/xm
ldsi
g#
• wsi
- ht
tp://
ws-
i.org
/pro
files
/bas
ic/1
.1/s
war
ef.x
sd
Hig
h
S-1
7.5.
7. T
he S
HR
is a
ble
to c
omm
unic
ate
with
the
HIA
L ut
ilizin
g ei
ther
imm
edia
te o
r que
ued
mod
e. F
or
queu
ed m
ode,
onl
y po
lling
inte
ract
ions
are
su
ppor
ted.
For
imm
edia
te m
ode,
requ
est
inte
ract
ions
and
not
ifica
tion
inte
ract
ions
are
su
ppor
ted.
Hig
h
S-1
7.6.
The
SH
R u
tiliz
es W
SDLs
as
reco
mm
ende
d in
HL7
v3
Sta
ndar
d: T
rans
port
Spe
cific
atio
n –
Web
Ser
vice
s P
rofil
e, R
elea
se 2
(WS
DLs
will
be p
rovi
ded
prio
r to
impl
emen
tatio
n).
Hig
h
S-1
7.6.
1. T
he S
HR
com
mun
icat
es u
sing
a re
ques
t-re
spon
se m
essa
ge e
xcha
nge
patte
rn.
Hig
h
S-1
7.6.
2. T
he S
HR
util
izes
nom
encl
atur
e fo
r WSD
L ar
tefa
cts
type
def
initi
ons
follo
win
g re
com
men
datio
ns in
the
TLI s
peci
ficat
ion.
Hig
h
S-1
7.6.
3. T
he S
HR
soa
p m
essa
ges
use
wra
pped
/lite
ral
docu
men
t sty
le.
Hig
h
S-1
7.6.
4. T
he S
HR
ser
vice
bin
ding
s fo
llow
re
com
men
datio
ns in
the
TLI s
peci
ficat
ion.
H
igh
Pag
e 13
0
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foun
dlan
d an
d La
brad
or
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ealth
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rmat
ion
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pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-1
7.7.
The
SH
R h
andl
es e
rrors
in th
e pr
otoc
ol th
ey a
re
asso
ciat
ed w
ith (e
.g.,
HTT
P, S
OA
P, H
L7 tr
ansp
ort,
or
HL7
app
licat
ion)
.
Hig
h
S-1
7.8.
The
SH
R is
abl
e to
inte
rpre
t the
sta
ndar
d H
TTP
erro
rs
and
pres
ent t
o th
e en
d us
er fo
llow
ing
HTT
P 1
.1
guid
elin
es.
Hig
h
S-1
7.9.
The
SH
R is
abl
e to
par
se a
nd in
terp
ret t
he S
OA
P
faul
tcod
e an
d fa
ults
tring
par
amet
ers
and
pres
ent t
o th
e en
d us
er if
app
licab
le.
Hig
h
S-1
7.10
. Th
e S
HR
is a
ble
to in
clud
e tw
o cu
stom
ele
men
ts
(EH
R R
ole
and
lang
uage
) in
the
SO
AP
hea
der.
Hig
h
S-1
7.11
. Th
e S
HR
is a
ble
to s
et th
e m
essa
geID
as
a U
UID
ge
nera
ted
usin
g a
certi
fied
algo
rithm
, and
pre
fix th
e va
lue
with
"uui
d:"
Hig
h
S-1
7.11
.1.
The
SH
R e
nsur
es th
at th
e m
essa
ge ID
is
uni
que.
H
igh
S-1
7.11
.2.
The
SH
R o
nly
reus
es m
essa
ge ID
s w
hen
subm
ittin
g a
dupl
icat
e re
ques
t. H
igh
S-1
8. A
ll da
ta s
ent b
etw
een
EH
R c
ompo
nent
s is
ver
ified
for
inte
grity
. H
igh
S-1
9. T
he S
HR
ope
rate
s w
ithin
the
NL
EH
R e
nviro
nmen
t st
anda
rds.
H
igh
S-1
9.1.
The
SH
R is
abl
e to
util
ize:
Sun
Sol
aris
10.
H
igh
S-1
9.2.
The
SH
R is
abl
e to
util
ize:
Ora
cle
11i.
Hig
h
S-1
9.3.
The
SH
R is
abl
e to
util
ize:
Sun
har
dwar
e.
Hig
h
S-1
9.4.
The
SH
R is
abl
e to
util
ize:
Jav
a.
Hig
h
S-1
9.5.
The
SH
R p
orta
ls a
re a
ble
to u
tiliz
e: js
r168
or w
srp
portl
ets.
H
igh
Pag
e 13
1
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foun
dlan
d an
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ent
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rity
Com
men
ts
F / P
/ N
S-1
9.6.
The
SH
R u
tiliz
es a
tech
nica
l arc
hite
ctur
e th
at
inte
grat
es w
ith th
e ex
istin
g N
L en
viro
nmen
t. Id
entif
y al
l ap
plic
atio
n se
rver
te
chno
logy
an
d co
mpo
nent
s re
quire
d by
the
SH
R.
Whe
re t
here
are
m
ultip
le,
prov
ide
all
optio
ns a
nd t
he r
ecom
men
ded
appl
icat
ion
tech
nolo
gy.
Iden
tify
any
data
base
tec
hnol
ogy
requ
irem
ent
of t
he
SH
R i
nclu
ding
all
supp
orte
d da
taba
se t
echn
olog
ies
and
any
reco
mm
ende
d te
chno
logi
es.
Iden
tify
all
hard
war
e an
d so
ftwar
e re
quire
d by
the
S
HR
(in
clud
ing
third
par
ty to
ols
such
as
data
bac
kup
softw
are
and
all l
icen
sing
). Id
entif
y an
y V
M te
chno
logy
requ
ired
or s
uppo
rted
and
desc
ribe
its im
pact
on
each
pro
pose
d en
viro
nmen
t.
Hig
h
S-1
9.7.
The
SH
R s
uppo
rts m
ultip
le e
nviro
nmen
ts fo
r m
aint
enan
ce, o
pera
tions
and
rele
ase
man
agem
ent.
Iden
tify
the
num
ber
and
type
s of
en
viro
nmen
ts
reco
mm
ende
d to
mai
ntai
n an
d op
erat
e th
e S
HR
(e.g
., te
st, Q
A, p
rodu
ctio
n).
Hig
h
S-2
0. T
he S
HR
sup
ports
aut
omat
ed te
stin
g.
Id
entif
y th
e te
stin
g m
etho
ds re
com
men
ded
for t
he S
HR
.
Iden
tify
any
test
ing
tool
s pr
ovid
ed (i
nclu
ding
the
avai
labi
lity
of te
st s
crip
ts o
r oth
er fo
rms
of te
stin
g au
tom
atio
n).
Iden
tify
all t
est t
ools
sup
porte
d by
the
SH
R (e
.g.,
Bor
land
).
Hig
h
S-2
1. T
he S
HR
ass
ocia
tes
a us
er ID
with
a p
rovi
der’s
iden
tity.
H
igh
S-2
2. T
he S
HR
ass
ocia
tes
a us
er ID
with
a lo
catio
n (fa
cilit
y).
Hig
h
Pag
e 13
2
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
0-03
2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
3. T
he S
HR
dat
a is
enc
rypt
ed.
D
escr
ibe
wha
t le
vel
of g
ranu
larit
y th
at e
ncry
ptio
n ca
n be
ap
plie
d.
Rec
omm
end
an a
ppro
ach
to d
ata
encr
yptio
n in
clud
ing
tech
nolo
gy, t
echn
ique
s an
d da
ta g
ranu
larit
y.
Hig
h
S-2
4. T
he S
HR
sup
ports
the
abilit
y to
pro
duce
a p
atie
nt re
port
of
corr
ecte
d in
form
atio
n (in
clud
ing
old
and
revi
sed
info
rmat
ion)
by
date
rang
e.
Med
ium
S-2
4.1.
The
SH
R s
uppo
rts th
e ab
ility
to p
rodu
ce a
prin
ted
copy
of a
pat
ient
’s E
HR
upo
n re
ques
t (as
per
PH
IA).
Hig
h
S-2
4.2.
The
SH
R s
uppo
rts th
e ab
ility
to p
rodu
ce a
prin
ted
copy
of a
cces
ses
to a
pat
ient
's E
HR
upo
n re
ques
t (as
pe
r PH
IA).
Hig
h
S-2
5. T
he S
HR
is s
ecur
e by
des
ign.
Des
crib
e th
e st
rate
gies
and
saf
e gu
ards
pro
vide
d w
ith th
e S
HR
.
Hig
h
S-2
5.1.
All
mes
sage
tran
sact
ions
are
ack
now
ledg
ed w
ith a
st
atus
resu
lt (s
ucce
ss o
r fai
lure
with
an
erro
r res
ult
code
).
Hig
h
S-2
5.2.
The
SH
R s
uppo
rts m
utua
l nod
e au
then
ticat
ion
(ens
urin
g th
e au
then
ticity
of r
emot
e no
des)
whe
n co
mm
unic
atin
g pe
rson
al h
ealth
info
rmat
ion
over
the
Inte
rnet
or o
ther
kno
wn
open
net
wor
ks u
sing
ope
n pr
otoc
ol (e
.g.,
TLS
, IP
Sec
, XM
L si
g, S
/MIM
E).
Hig
h
S-2
6. T
he S
HR
gen
erat
es a
n au
dit r
ecor
d w
hen
audi
tabl
e ev
ent
occu
rs.
Id
entif
y th
e ty
pes
of e
vent
s ca
ptur
ed b
y th
e S
HR
aud
it ta
bles
(inc
ludi
ng in
appr
opria
te a
cces
ses)
.
Hig
h
S-2
6.1.
Aud
itabl
e ev
ents
are
a c
onfig
urab
le s
yste
m
para
met
er.
Hig
h
Pag
e 13
3
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
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2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
6.1.
1. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
syst
em
star
t/sto
p.
Hig
h
S-2
6.1.
2. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
user
lo
gin/
logo
ut.
Hig
h
S-2
6.1.
3. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
node
-au
then
ticat
ion
failu
re.
Hig
h
S-2
6.1.
4. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
any
user
/sys
tem
acc
ess
or u
pdat
e to
pat
ient
and
/or
clin
ical
dat
a.
Hig
h
S-2
6.1.
5. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
over
ridde
n co
nsen
t dire
ctiv
es.
Hig
h
S-2
6.1.
6. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
info
rmat
ion
expo
rt (e
.g. p
rint).
Hig
h
S-2
6.1.
7. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
info
rmat
ion
impo
rt.
Hig
h
S-2
6.1.
8. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
syst
em
adm
inis
tratio
n ch
ange
to a
use
r con
figur
atio
n.
Hig
h
S-2
6.1.
9. A
udita
ble
even
ts in
clud
e (b
ut a
re n
ot li
mite
d to
) th
e su
cces
s, a
ttem
pt, o
r fai
lure
of:
pass
wor
d ch
ange
.
Hig
h
S-2
6.1.
10.
Aud
itabl
e ev
ents
incl
ude
(but
are
not
lim
ited
to) t
he s
ucce
ss, a
ttem
pt, o
r fai
lure
of:
acce
ss to
aud
it re
cord
s.
Hig
h
S-2
6.1.
11.
Aud
itabl
e ev
ents
incl
ude:
use
r acc
ount
tim
e ou
ts.
Hig
h
Pag
e 13
4
New
foun
dlan
d an
d La
brad
or
R
FP#:
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I-201
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2 C
entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
6.1.
12.
Aud
itabl
e ev
ents
incl
ude:
all
auth
entic
atio
n de
cisi
ons.
H
igh
S-2
6.1.
13.
Aud
itabl
e ev
ents
incl
ude:
cre
atin
g us
er
acce
ss ri
ghts
. H
igh
S-2
6.1.
14.
Aud
itabl
e ev
ents
incl
ude:
ass
igni
ng
user
acc
ess
right
s.
Hig
h
S-2
6.1.
15.
Aud
itabl
e ev
ents
incl
ude:
upd
atin
g a
user
's o
wn
acce
ss ri
ghts
. H
igh
S-2
6.1.
16.
Aud
itabl
e ev
ents
incl
ude:
all
auth
oriz
atio
n de
cisi
ons.
H
igh
S-2
6.1.
17.
Aud
itabl
e ev
ents
incl
ude:
all
mes
sage
tra
ffic.
H
igh
S-2
6.1.
18.
Aud
itabl
e ev
ents
incl
ude:
bat
ch
proc
essi
ng o
utco
mes
(e.g
., er
rors
, suc
cess
ful
com
plet
ion)
.
Hig
h
S-2
6.1.
19.
Aud
itabl
e ev
ents
incl
ude:
all
adm
inis
trativ
e ev
ents
(e.g
. con
figur
atio
n ch
ange
s, q
uerie
s ag
ains
t the
aud
it ta
bles
).
Hig
h
S-2
6.2.
The
SH
R a
udit
reco
rds
are
ATN
A c
ompl
iant
(Aud
it Tr
ail a
nd N
ode
Aut
hent
icat
ion,
RFC
388
1).
Hig
h
S-2
6.2.
1. T
he a
udit
reco
rd in
clud
es: d
ate,
tim
e an
d tim
e zo
ne.
Hig
h
S-2
6.2.
2. T
he a
udit
reco
rd in
clud
es: u
ser I
D.
Hig
h
S-2
6.2.
3. T
he a
udit
reco
rd in
clud
es: u
ser's
role
. H
igh
S-2
6.2.
4. T
he a
udit
reco
rd in
clud
es: u
ser's
org
aniz
atio
n.
Hig
h
S-2
6.2.
5. T
he a
udit
reco
rd in
clud
es: p
atie
nt ID
. H
igh
S-2
6.2.
6. T
he a
udit
reco
rd in
clud
es: f
unct
ion
perfo
rmed
(v
iew
, edi
t, pr
int).
H
igh
S-2
6.2.
7. T
he a
udit
reco
rd in
clud
es: p
rovi
der l
ocat
ion.
H
igh
Pag
e 13
5
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
6.2.
8. T
he a
udit
reco
rd in
clud
es: c
onse
nt o
verri
de w
ith
the
reas
on (i
f acc
ess
is a
n ov
errid
e ev
ent).
H
igh
S-2
6.2.
9. T
he a
udit
reco
rd in
clud
es: c
onse
nt d
irect
ive
chan
ge b
y su
bstit
ute
deci
sion
mak
er –
ID o
f de
cisi
on m
aker
.
Hig
h
S-2
6.2.
10.
The
audi
t rec
ord
incl
udes
: sou
rce
syst
em a
ddre
ss a
nd ID
. H
igh
S-2
6.2.
11.
The
audi
t rec
ord
incl
udes
: des
tinat
ion
syst
em a
ddre
ss a
nd ID
. H
igh
S-2
6.2.
12.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
deta
il (e
.g.,
com
plet
e H
L7 m
essa
ge).
Hig
h
S-2
6.2.
13.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
type
. H
igh
S-2
6.2.
14.
The
audi
t rec
ord
incl
udes
: tra
nsac
tion
stat
us (e
.g.,
proc
ess
outc
ome)
. H
igh
S-2
6.2.
15.
The
audi
t rec
ord
incl
udes
: au
then
ticat
ion
sour
ce.
Hig
h
S-2
6.2.
16.
The
audi
t rec
ord
incl
udes
: app
licat
ion
iden
tity.
H
igh
S-2
6.2.
17.
The
audi
t rec
ord
incl
udes
: pat
ient
fla
gged
for a
dditi
onal
priv
acy
audi
ting.
H
igh
S-2
6.2.
18.
The
audi
t rec
ord
incl
udes
: fla
gged
us
er a
cces
s to
a p
atie
nt w
here
no
prev
ious
re
latio
nshi
p w
as e
stab
lishe
d.
Hig
h
S-2
6.2.
19.
The
audi
t rec
ord
incl
udes
: met
adat
a fo
r sea
rchi
ng.
Id
entif
y th
e da
ta c
aptu
red
with
in t
he S
HR
aud
it ta
bles
.
Hig
h
S-2
6.3.
The
aud
it re
cord
dat
a ca
nnot
be
dele
ted.
H
igh
S-2
6.4.
The
aud
it re
cord
dat
a ca
nnot
be
mod
ified
. H
igh
Pag
e 13
6
New
foun
dlan
d an
d La
brad
or
R
FP#:
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2 C
entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
6.5.
The
SH
R s
uppo
rts ti
me
sync
hron
izat
ion
with
an
exte
rnal
Net
wor
k Ti
me
Pro
toco
l (N
TP) a
nd re
cord
tim
e st
amps
usi
ng U
TC b
ased
on
ISO
860
1-20
00
(e.g
., 19
94-1
1-05
T08:
15:3
0-05
:00
corr
espo
nds
to
Nov
embe
r 5, 1
994,
8:1
5:30
am
, US
Eas
tern
Sta
ndar
d Ti
me)
.
Hig
h
S-2
6.6.
SH
R o
pera
tion
disc
ontin
ues
whe
n th
e lo
ggin
g is
non
-fu
nctio
nal.
Hig
h
S-2
6.7.
The
SH
R o
nly
perm
its re
ad a
cces
s to
aud
it lo
gs to
sp
ecifi
c us
ers.
H
igh
S-2
6.8.
The
aud
it lo
gs in
tegr
ate
with
the
exis
ting
EH
R c
entra
l au
dit s
ervi
ce.
Hig
h
S-2
7. T
he S
HR
sup
ports
bac
kup
func
tiona
lity.
Des
crib
e th
e re
com
men
ded
appr
oach
for
min
imiz
ing
the
impa
ct to
use
rs a
nd d
atab
ase
perfo
rman
ce.
Hig
h
S-2
7.1.
The
SH
R b
acku
p fu
nctio
nalit
y op
erat
es c
oncu
rrent
w
ith o
pera
tion.
Id
entif
y an
y th
ird p
arty
tool
s ut
ilized
and
des
crib
e th
eir
role
.
Hig
h
S-2
7.2.
The
SH
R b
acku
p fu
nctio
nalit
y is
sec
ure
from
un
auth
oriz
ed a
cces
s.
Des
crib
e th
e m
echa
nism
s av
aila
ble
to e
nsur
e th
e co
nfid
entia
lity
and
inte
grity
of
back
up f
iles
agai
nst
unau
thor
ized
acc
ess.
Hig
h
S-2
7.3.
The
SH
R b
acku
ps s
uppo
rt au
tom
atio
n.
Hig
h
S-2
7.4.
The
SH
R b
acku
ps s
uppo
rt sc
hedu
ling.
H
igh
Pag
e 13
7
New
foun
dlan
d an
d La
brad
or
R
FP#:
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2 C
entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-2
7.5.
The
SH
R re
stor
e pr
oced
ures
resu
lt in
a fu
lly
oper
atio
nal a
nd s
ecur
e st
ate.
Id
entif
y if
the
SH
R is
abl
e to
res
tore
from
the
poin
t of
failu
re a
nd in
dica
te e
xpec
ted
data
loss
.
Hig
h
S-2
7.5.
1. R
esto
ratio
n in
clud
es S
HR
dat
a.
Hig
h
S-2
7.5.
2. R
esto
ratio
n in
clud
es a
pplic
atio
n da
ta.
Hig
h
S-2
7.5.
3. R
esto
ratio
n in
clud
es s
ecur
ity c
rede
ntia
ls.
Hig
h
S-2
7.5.
4. R
esto
ratio
n in
clud
es a
uxilia
ry fi
les
(e.g
., au
dit
and
log
files
). H
igh
S-2
7.6.
Invo
ked
syst
em s
hutd
own
is o
rder
ly (e
.g.,
non-
dest
ruct
ive
with
dat
a in
tegr
ity m
aint
aine
d) w
ith n
o da
ta
loss
.
Hig
h
S-2
8. T
he S
HR
inst
alls
and
ope
rate
s al
l nec
essa
ry s
ervi
ces
and
prot
ocol
s w
ith th
e le
ast p
rivile
ge p
ossi
ble.
Pro
vide
a d
etai
led
list
of f
unct
ions
and
app
licat
ions
tha
t re
quire
adm
in o
r roo
t priv
ilege
s.
Hig
h
S-2
9. S
HR
sys
tem
adm
inis
tratio
n is
per
form
ed th
roug
h a
com
mon
GU
I int
erfa
ce.
Hig
h
S-2
9.1.
EH
R c
ompo
nent
adm
inis
tratio
n is
pro
vide
d th
roug
h w
eb-b
ased
tool
s su
ppor
ting
eith
er js
r168
or w
srp
portl
ets.
Hig
h
S-2
9.2.
EH
R c
ompo
nent
adm
inis
tratio
n po
rtlet
s al
low
in
tegr
atio
n in
to a
com
mon
sys
tem
adm
inis
tratio
n to
ol.
Hig
h
S-3
0. T
he S
HR
adm
inis
tratio
n po
rtal s
uppo
rts u
ser m
anag
emen
t. H
igh
S-3
0.1.
The
SH
R a
dmin
istra
tion
porta
l sup
ports
use
r acc
ount
cr
eatio
n, a
ctiv
atio
n an
d de
activ
atio
n.
Hig
h
S-3
0.2.
The
SH
R a
dmin
istra
tion
porta
l sup
ports
use
r pa
ssw
ord
man
agem
ent.
Hig
h
Pag
e 13
8
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
for H
ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
0.3.
The
SH
R a
dmin
istra
tion
porta
l int
egra
tes
with
the
juris
dict
iona
l EH
R a
uthe
ntic
atio
n an
d au
thor
izat
ion
serv
ice.
Hig
h
S-3
0.4.
The
SH
R a
dmin
istra
tion
porta
l sup
ports
role
bas
ed
acce
ss c
ontro
l. H
igh
S-3
1. T
he S
HR
adm
inis
tratio
n po
rtal s
uppo
rts v
iew
ing
batc
h pr
oces
s ac
tivity
. M
ediu
m
S-3
1.1.
The
SH
R a
dmin
istra
tion
porta
l dis
play
s a
sche
dule
of
upco
min
g ba
tch
proc
esse
s.
Med
ium
S-3
1.2.
The
SH
R a
dmin
istra
tion
porta
l dis
play
s ba
tch
proc
essi
ng o
utco
mes
from
the
audi
t log
. M
ediu
m
S-3
2. T
he S
HR
adm
inis
tratio
n po
rtal p
rovi
des
EH
R c
ompo
nent
op
erat
iona
l fee
dbac
k to
cen
traliz
ed m
onito
ring
capa
bilit
y.
Hig
h
S-3
2.1.
The
SH
R a
dmin
istra
tion
porta
l sup
ports
ope
ratio
nal
repo
rting
of E
HR
com
pone
nt o
pera
tions
and
bus
ines
s pr
oces
ses
(e.g
., us
age
met
rics)
.
Hig
h
S-3
2.2.
The
SH
R a
dmin
istra
tion
porta
l is
able
to a
cces
s an
d di
spla
y th
e co
nten
ts o
f the
aud
it lo
gs.
Hig
h
S-3
2.3.
The
SH
R a
dmin
istra
tion
porta
l is
able
to a
cces
s an
d di
spla
y er
ror l
og e
ntrie
s.
Hig
h
S-3
2.4.
The
SH
R a
dmin
istra
tion
porta
l sup
ports
sea
rch
and
filte
r fun
ctio
nalit
y (e
.g.,
by p
atie
nt id
entif
ier,
test
resu
lt,
date
rang
e, p
rovi
der,
faci
lity
and
cons
ent o
verri
de
reas
on) w
hen
pres
entin
g au
dit l
og h
isto
ries.
Hig
h
S-3
3. A
ll se
curit
y an
d ad
min
istra
tive
user
s ar
e st
rong
ly
auth
entic
ated
with
mul
ti-fa
ctor
aut
hent
icat
ion.
H
igh
S-3
3.1.
All
secu
rity
and
adm
inis
trativ
e us
ers
have
uni
que
user
ID
s (in
clud
ing
vend
ors)
. H
igh
S-3
4. T
he S
HR
ale
rts th
e ap
prop
riate
sys
tem
adm
inis
tratio
n au
thor
ity w
hen
pres
et e
vent
s oc
cur.
Hig
h
Pag
e 13
9
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foun
dlan
d an
d La
brad
or
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entre
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
4.1.
Out
boun
d m
essa
ge e
rrors
pro
mpt
not
ifica
tion
to th
e ap
prop
riate
sys
tem
adm
inis
tratio
n au
thor
ity.
Iden
tify
the
scop
e of
er
rors
su
ppor
ted
and
the
notif
icat
ion
chan
nels
ava
ilabl
e.
Hig
h
S-3
4.2.
The
SH
R a
lerts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
whe
n pr
eset
que
ue th
resh
olds
hav
e be
en
reac
hed.
D
escr
ibe
aler
t ca
pabi
litie
s in
clud
ing
aler
t de
liver
y ch
anne
ls (
e.g.
, pag
e, e
mai
l, de
liver
y of
mes
sage
to a
qu
eue
whi
ch is
per
iodi
cally
che
cked
).
Hig
h
S-3
4.3.
The
SH
R a
lerts
the
appr
opria
te s
yste
m a
dmin
istra
tion
auth
ority
whe
n a
pred
efin
ed a
nd c
onfig
urab
le e
rror
cond
ition
occ
urs
(eith
er w
ith a
spe
cific
mes
sage
or
with
spe
cific
sys
tem
s co
mpo
nent
s).
Des
crib
e er
ror
and
aler
t ca
pabi
litie
s in
clud
ing
aler
t de
liver
y ch
anne
ls.
Hig
h
S-3
4.4.
The
SH
R p
roac
tivel
y m
onito
rs p
erfo
rman
ce a
nd a
lerts
th
e ap
prop
riate
sys
tem
adm
inis
tratio
n au
thor
ity w
hen
a pr
eset
thre
shol
d ha
s be
en e
xcee
ded.
D
escr
ibe
the
avai
labl
e SH
R c
apab
ilitie
s, t
ools
and
pr
oces
ses
for
mon
itorin
g (p
roac
tive
and
reac
tive)
in
clud
ing
erro
r m
essa
ge a
naly
sis
(e.g
., tre
ndin
g) a
nd
aler
t del
iver
y ch
anne
ls.
Des
crib
e an
y to
ols
or te
mpl
ates
that
are
ava
ilabl
e fo
r th
e S
HR
to s
uppo
rt ca
paci
ty p
lann
ing.
Hig
h
S-3
5. T
he S
HR
sup
ports
dat
a ar
chiv
al a
nd re
triev
al fu
nctio
nalit
y.
D
escr
ibe
the
capa
bilit
ies,
too
ls a
nd p
roce
sses
req
uire
d to
co
nfig
ure
arch
ivin
g, in
clud
ing
abili
ty to
spe
cify
how
long
the
proc
esse
d m
essa
ges
are
kept
.
Hig
h
Pag
e 14
0
New
foun
dlan
d an
d La
brad
or
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entre
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ealth
Info
rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
6. T
he S
HR
ach
ieve
s th
e av
aila
bilit
y ta
rget
s (a
s id
entif
ied
in
this
RFP
Sec
tion
2).
D
escr
ibe
the
appr
oach
, ar
chite
ctur
e an
d pr
oces
ses
for
achi
evin
g th
e av
aila
bilit
y ta
rget
s.
Iden
tify
any
addi
tiona
l (e
.g.,
third
par
ty)
hard
war
e an
d so
ftwar
e re
quire
d fo
r hig
h av
aila
bilit
y.
Des
crib
e an
y to
ols
or t
empl
ates
tha
t ar
e av
aila
ble
for
the
SH
R to
sup
port
busi
ness
con
tinui
ty p
lann
ing.
Hig
h
S-3
7. T
he S
HR
ach
ieve
s th
e pe
rform
ance
targ
ets
(as
iden
tifie
d in
th
is R
FP).
D
escr
ibe
the
appr
oach
, ar
chite
ctur
e an
d pr
oces
ses
for
achi
evin
g th
ese
targ
ets.
Iden
tify
any
perfo
rman
ce
tuni
ng
tool
s an
d fu
nctio
ns
reco
mm
ende
d fo
r th
e S
HR
(in
dica
te w
hich
are
inc
lude
d w
ith th
e S
HR
and
whi
ch th
e C
entre
is to
acq
uire
).
Hig
h
S-3
8. T
he S
HR
pro
cess
es a
nd s
tore
s 10
+ m
illio
n re
cord
s an
nual
ly w
ith a
ccom
mod
atio
n fo
r ann
ual i
ncre
ases
. H
igh
S-3
9. A
ppro
pria
te d
ocum
enta
tion
is in
clud
ed fo
r all
com
pone
nts
Hig
h
S-3
9.1.
Doc
umen
tatio
n is
cur
rent
H
igh
S-3
9.2.
Doc
umen
tatio
n is
mai
ntai
ned
by th
e ve
ndor
H
igh
S-3
9.3.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Tec
hnic
al
Arc
hite
ctur
e.
Hig
h
S-3
9.3.
1. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to P
hysi
cal
Har
dwar
e D
esig
n H
igh
S-3
9.3.
2. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
Virt
ualiz
atio
n H
igh
Pag
e 14
1
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foun
dlan
d an
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or
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entre
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
9.3.
3. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
Net
wor
king
Des
ign
Hig
h
S-3
9.4.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Dat
abas
e D
esig
n H
igh
S-3
9.4.
1. S
HR
dat
a m
odel
doc
umen
tatio
n th
at d
escr
ibes
m
ajor
ent
ities
and
rela
tions
hips
.
Pro
vide
a
desc
riptio
n of
ho
w
mod
els
will
be
el
abor
ated
dur
ing
the
deta
il re
quire
men
ts a
nd
desi
gn o
f the
SH
R.
Hig
h
S-3
9.5.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
JLI
S
Arc
hite
ctur
e/D
esig
n (e
.g.,
diag
ram
s fo
r the
app
licat
ion
arch
itect
ure
tier d
iagr
ams,
com
pone
nt in
terfa
ce
desc
riptio
ns, i
EH
R c
ompo
nent
des
crip
tions
).
Hig
h
S-3
9.5.
1. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
appl
icat
ion
depl
oym
ent m
odel
. H
igh
S-3
9.6.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Bus
ines
s C
ontin
uity
. H
igh
S-3
9.6.
1. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to B
acku
p P
roce
ss.
Hig
h
S-3
9.6.
2. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to D
isas
ter
Rec
over
y.
Hig
h
S-3
9.7.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Mai
nten
ance
an
d S
uppo
rt C
ontra
cts.
H
igh
S-3
9.7.
1. D
ocum
enta
tion
incl
udes
app
licab
le S
ervi
ce L
evel
A
gree
men
ts (e
.g.,
supp
ort l
evel
s, s
uppo
rt ho
urs,
re
spon
se ti
mes
, sup
port
team
loca
tions
).
Hig
h
Pag
e 14
2
New
foun
dlan
d an
d La
brad
or
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FP#:
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entre
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ealth
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rmat
ion
Res
pons
e R
equi
rem
ent
Prio
rity
Com
men
ts
F / P
/ N
S-3
9.7.
2. D
ocum
enta
tion
incl
udes
sup
port
mod
el (e
.g.,
esca
latio
n pr
oced
ures
, ITI
L co
mpl
ianc
e,
inte
grat
ion
with
Tie
r 1 s
uppo
rt at
the
Cen
tre).
Id
entif
y th
e re
sour
ces
that
ar
e re
quire
d to
pe
rform
ope
ratio
ns,
mai
nten
ance
, su
ppor
t an
d tro
uble
-sho
otin
g.
Hig
h
S-3
9.7.
3. D
ocum
enta
tion
iden
tifie
s ve
ndor
sup
port
oblig
atio
ns fo
r pre
viou
s ve
rsio
ns.
Hig
h
S-3
9.7.
4. D
ocum
enta
tion
iden
tifie
s pr
oduc
t not
ifica
tion
and
advi
sory
pro
cess
es.
Hig
h
S-3
9.8.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Ope
ratio
ns
and
Mai
nten
ance
H
igh
S-3
9.8.
1. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
App
licat
ion
Inst
alla
tion
Hig
h
S-3
9.8.
2. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to
Ope
ratin
g S
yste
m In
stal
latio
n H
igh
S-3
9.9.
Doc
umen
tatio
n co
vers
topi
cs re
late
d to
Sec
urity
. H
igh
S-3
9.9.
1. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
ecur
ity
Pro
cedu
res
Hig
h
S-3
9.9.
2. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to S
yste
m
Har
deni
ng
Hig
h
S-3
9.10
. D
ocum
enta
tion
cove
rs to
pics
rela
ted
to R
elea
se
Man
agem
ent
Hig
h
S-3
9.10
.1.
Doc
umen
tatio
n in
clud
es a
form
al
prod
uct r
elea
se s
ched
ule.
H
igh
S-3
9.10
.2.
Doc
umen
tatio
n in
clud
es s
tand
ards
ad
optio
n an
d co
nfor
man
ce s
ched
ule.
H
igh
S-3
9.10
.3.
Doc
umen
tatio
n in
clud
es S
oftw
are
Rel
ease
Not
es fo
r all
appl
ied
patc
hes
or s
oftw
are
upda
tes
Hig
h
Pag
e 14
3
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dlan
d an
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ealth
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rmat
ion
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age
144
R
equi
rem
ent
Prio
rity
Res
pons
e F
/ P /
N
Com
men
ts
S-3
9.10
.4.
App
licat
ion
sour
ce c
ode
(if s
uppl
ied)
is
docu
men
ted
Hig
h
S-3
9.10
.5.
Pro
mot
ion
proc
esse
s us
ed fo
r ap
plic
atio
n m
igra
tion
betw
een
envi
ronm
ents
is
docu
men
ted.
Iden
tify
the
met
hods
and
tool
s pr
ovid
ed w
ith th
e S
HR
.
Hig
h
S-3
9.10
.6.
The
SH
R g
atin
g do
cum
enta
tion
incl
udes
an
upda
ted
oper
atio
ns g
uide
. H
igh
S-3
9.10
.7.
The
SH
R g
atin
g do
cum
enta
tion
incl
udes
an
upda
ted
Ser
vice
des
k tro
uble
shoo
ting
guid
e.
Hig
h
S-3
9.10
.8.
The
SH
R g
atin
g do
cum
enta
tion
incl
udes
an
impl
emen
tatio
n pl
an.
Hig
h
S-3
9.10
.9.
The
SH
R g
atin
g do
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
Appendix A - Detailed HIAL Services
Table of Contents��
11.0� Health Information Access Layer ................................................................... 146�11.1� Data Services ........................................................................................ 146�11.2� Common Services ................................................................................. 148�11.3� General Services................................................................................... 149�11.4� Context Services ................................................................................... 149�11.5� Interoperability Services ........................................................................ 149�11.6� Privacy Services.................................................................................... 150�11.7� Security Services................................................................................... 151�11.8� System Authentication Services............................................................ 152�11.9� Communication Services....................................................................... 153�11.10� HIAL Workflow Services........................................................................ 154�
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11.0 Health Information Access Layer The HIAL, as the central processing point for all Newfoundland and Labrador EHR transactions, provides numerous services. At a high level, the HIAL provides the interactions between the PoS systems and the components of the iEHR. HIAL services include the protocol, messaging, and integration services used to implement the HL7v3 interfaces that support communication with the EHRS components. The conceptual service layer diagram below illustrates the HIAL service offering:
A summary of the HIAL services are provided in the following sections:
11.1 Data Services The primary interfaces use HL7v3 messages communicated using simple object access protocol (SOAP) over HTTPs; however, the HIAL Protocol, Messaging, and Integration services allow it to support import and export data in a wide variety of formats including HL7v3 or other XML dialects, HL7v2.X, EDI, and other structured and flat file formats provided the appropriate transformations are defined and built. This capability along with the web services integration tools, message queuing, and workflow services, which are also part of the HIAL, are utilized to integrate third-party vendor software and build the interfaces required to interact with them. The interfaces currently supported by the HIAL include:
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information � Core DIS Interface: The Core DIS interface is the internal interface between the HIAL and
the Core DIS component. This interface is HL7v3 CeRx-based and will forward messages validated (e.g. security, validation of provider, patient IDs, etc.) by the HIAL that were received through the HIAL Rx API.
� Drug Utilization Review Interface: The Drug Utilization Review (DUR) Interface is the internal interface between the HIAL and the DUR Engine. This interface is HL7v3 CeRx-based and will forward messages validated (security, validation of provider, patient IDs, etc.) by the HIAL that were received through the HIAL Rx API.
� Adverse Drug Reaction Interface: The Adverse Drug Reaction (ADR) interface is the internal interface between the HIAL and the method of delivery for ADR reports to Health Canada. ADR Reports will be generated by the reporting application and then delivered to the fax gateway via simple mail transfer protocol (SMTP). The fax gateway will then automatically fax the report to Health Canada.
� eTherapeutics Interface: This architecture is required to support two different interfaces with eTherapeutics. The first, a portlet-level interface, integrates into the CPP and is accessible through the HIN. The second, a web services interface, manages the interaction with the eTherapeutics suite of tools being development by the Canadian Pharmacists Association (CPhA) utilizing the web services developed for eTherapeutics for integration with external applications.
� Operations Interface: The operations interface utilizes the existing operations interfaces within the HIAL as provided by the webMethods (wM) Monitor and operations interfaces. The wM Monitor retrieves information about processes, services, and documents by querying the audit logs. The audit logs maintain a permanent record of certain types of activity on the integration platform.
� Admin Interface: The admin interface is a logical interface representing the integration points between the Admin Portal (AP) and the HIAL components. It includes the HIAL Rx API since, whenever possible, functionality available through this API will be used, but also includes more direct integration with other solution components.
� ETL Interface: The management of the transformation and loading of data from HIAL to the DW will use secure file transfer protocol (SFTP) to move flat files from source systems to the DW.
Metadata Services: Using the wM JDBC Adapter, the HIAL can hold multiple data sources over separate connection pools. Each data source connection is defined with a unique connection name. Using the appropriate JDBC Adapter connection, abstract data access services for specific database management system can be created. The HIAL Integration Server provides all the necessary metadata templates using wM Developer. The Metadata template is a form of XML document and provided to business services as an internal format. Metadata population can be done through abstract data services. In the HIAL, the JDBC Adapter service is the terminology representing the abstract data service. It can insert data for operations that are carried out on repositories into a local data store. It also can search and retrieve the required data from a local data store. The JDBC Adapter services
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information define a common set of input parameters for query and output parameters for retrieving metadata during runtime. Once metadata is retrieved using JDBC Adapter services, metadata will be saved in the runtime pipeline within the Business Process Module (BPM). The BPM pipeline is a global transaction context that is available to all BPM steps until the transaction terminated. Since metadata can be accessible anytime over the BPM through the pipeline, each business service running within a different domain will be synchronized to each other through the same transaction context. Replication Services: The wM JDBC Adapter registers the following notification services on source databases within the HIAL:
� Insert Notification;
� Update Notification;
� Delete Notification; and
� Stored Procedure Notification.
Each Notification service will insert a trigger in the table of the source database automatically when the service is added through wM Developer. A buffer table is also created at the same time when the trigger on the table is created. The trigger will copy the data from the source table to this buffer table, then compose an XML document and publish it to the HIAL Broker Server. Once the XML document has been published, any subscriber who is listening for this particular document (that was published from the source database table) will receive the XML document through the HIAL Trigger Service.
11.2 Common Services Integration Services: integration services are invoked to assist in message handling. Integration profiles will be developed to carry out the mapping and translation services required to bridge gaps between standards, business rules and vocabulary in various applications. Queuing Services: The HIAL Integration Server has two different queuing mechanisms. The Broker Queue is used for messages that are delivered for any internal publishing or subscribing purpose. The Trading Network Queue is for stored and forward purposes towards external Trading Partners. It is scheduled using the wM Trading Network console. Mapping Services: Mapping is a native feature of the HIAL that will manage the document transformations from:
� XML to flat file;
� Flat file to XML; and
� XML to XML.
At design time, the source document template is prepared by loading an XML file or flat file. The destination document is also be created by loading a sample message of the destination form, and in some cases an XML schema or flat file schema is also attached to the document template. Within wM Developer, the source document (displayed in a nested XML Document Object Model (DOM) tree form) is mapped to the destination document template (also in a nested XML DOM tree). If required, transformations can then be applied within the mapping by linking the input parameters to the appropriate source document field and linking the corresponding field in the destination document to the output field of the transformer.
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Broker Services: Broker works as a transition event handler in the middle of BPM or within the workflow. Each step defined within the BPM or workflow can run within the different runtime environments as a loosely-coupled pattern. When a BPM or workflow step is completed, a transition event will be published to Broker and Broker will dispatch the document to the next step that is subscribing to the transition event. A transition event contains a canonical form of business message as the output of the previous BPM step, that will be delivered to the next step as an input document. Broker provides a fault-tolerant queuing mechanism by maintaining an internal data store. A delivered message will be persist within the Broker queue until the subscriber sends an ACK (acknowledgement) message upon successful receipt of the message.
Service Catalog: wM ServiceNet provides a standard Universal Description, Discovery, and Integration (UDDI) Repository to internal or external web service clients which will be used to discover published web services. When a service is published from the HIAL to ServiceNet via wM Developer, a new service catalog along with a new Web Service Definition Language (WDSL) is automatically registered in the UDDI Repository of ServiceNet. ServiceNet also provides a web-based administration tool to maintain published services via a web browser.
11.3 General Services Audit Services: Audit Services are managed within the HIAL utilizing wM Monitor which maintains it own audit data store within a separate schema within an Oracle database. The Monitor package provides all the necessary built-in services and lower level APIs for accessing the audit data store to search for log events. Log Management Services: HIAL’s Log Management Service has the capacity to log events in over 200 built-in components within the HIAL that are being monitored with a level of logging detail being specified at the component level. Logs will persist within the audit data store and analyzed using native APIs and other logging services. The Alerts/Notifications Service will also be integrated with the log management service utilizing the native wM Monitor, Graphical User Interface (GUI) services, and API. Exception/Error Handling Services: The HIAL component maintains its own level of Exception and Error Handling Services at the application level.
11.4 Context Services Session Management Services: The architecture provides a means to disable user sessions that have been idle for a considerable amount of time; future communication from that user will require re-authentication. The default time out period is configurable and specified by the system administrator.
11.5 Interoperability Services Client Registry Service: This is the internal Interface for the CR, which isolates the rest of the solution from the actual interface provided by the CR. This approach isolates the core solution from the CR functionality available in a given jurisdiction. This interface also handles notification messages from the CR indicating that link/merges or unlink/un-merges must be carried out. Provider Registry Service: This is the internal interface for the PR. This approach isolates the core solution from the PR functionality available in a given jurisdiction. When a PR message is received through the Pharmacy Network, this interface is used to forward the request on to the
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Provider Registry. In addition, any internal Provider Registry requests — for example, to validate a Provider Identifier in a Create Prescription Message — also use this interface to communicate with the Provider Registry Location Registry Service: This is the internal interface for the LR, which isolates the rest of the solution from the actual interface provided by the LR. This approach isolates the core solution from the LR functionality available in a given jurisdiction. When a LR message is received through the Pharmacy Network, this interface is used to forward the request on to the LR. In addition, any internal LR requests (e.g. to validate a Location Identifier in a Create Prescription Message) also use this interface to communicate with the LR. The HIAL LR Interface is exposed as a web service that invokes the LR web service utilizing HL7v3 messages. Longitudinal Record Services (LRS) The LRS contains I-IPs, allowing the sequence of activities and services interactions that are required within the EHRi in order to fulfill Put, List, and Get requests.
11.6 Privacy Services The following security and privacy controls are integrated within the EHRS architecture currently in place:
� Consent: The architecture provides functionality to record patient consent status and directives;
� Masking: The architecture provides the ability to mask elements of a patient’s profile upon request as described below;
� Registration: The architecture defines a means to bring users into a centrally managed Authorization and Authentication (A&A) subsystem;
� Role-Based Authentication & Authorization: Each message and web session will be authenticated and executed based on the privileges assigned to the user via a role;
� Audit & Logging: All access requests to personal data and activities, such as submission or revocation of consent, will be logged;
� Certificate Support: The architecture will support certificates for a number of purposes including electronic digital signatures; and
� Network Security: The architecture is designed as a tiered model, to provide appropriate separation of processing, controls, and monitoring. There is also use of Transport Layer Security (TLS) and Internet Protocol Security (IPSec) for transport security.
Right to Use Services: Currently for the DIS, patients have the right to request that data elements within their health record be masked so that they are not visible to users of the system. However, masked data is still used for centralized DUR checks. This is possible as the Personal Health Information (PHI), the Consent Directives, and the DUR engine are centralized in the EHRS architecture. Requests for access to PHI from the CPP or PoS software through the RxDesktop API are validated through the HIAL where checks will be performed for Consent Directives with regard to masking. If there are elements that are marked to be masked they will be used in the DUR interrogation and masked in the response delivered to the End User GUI. Alerts resulting from DUR reviews are delivered to the GUI.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Consent Management Services: At the present time, the consent model for Newfoundland and Labrador is one of “implied consent” – all citizens will participate in the program and have their Personal Identifying Information (PII) and PHI recorded in the DIS Domain without a requirement for the provider to obtain consent from the patient for collection. Patients have the ability to “limit” consent through masking and the ability to override consent limitations (i.e. ‘Break the Glass’) is supported. The present consent model requires that regular auditing be performed to ensure that information is not used or disclosed inappropriately, and that overrides of consent limitations are done for valid reasons. Functions are provided so that Pharmacists, Physicians, Government workers or third parties could be involved in the consent process. Messages are included in the HIAL Rx API and screens are included in the Admin and Care Provider Portals to help record consent. Privacy Audit Services: In order to satisfy the current DIS requirements for activity tracking and historical review, the current solution has detailed auditing capabilities provided by the secure audit subsystem. To meet the critical nature of reporting on users, patients, providers and healthcare transactions the system is flexible enough to record the following general items:
� Authentication attempts; and
� Access requests (successful and unsuccessful).
Each audit record contains information relevant to the record itself, as well as date, time, system involved, and users involved. Any access to a patient’s medication information within the system will be logged in the database. Access includes reads and updates to information. The information logged is sufficient to determine who accessed the information, when it was accessed, and for what purpose. The access logs themselves do not have protected health information, just pointers to it. For example, it is acceptable for system administrators to access the logs as no protected health information is present in the logs.
11.7 Security Services Digital Signature Services: The architecture supports the use of X.509 certificates in the following instances:
� Authentication for Users;
� Authentication for devices and applications;
� Signing of data to support no repudiation;
� Server certificates to permit secure channels (SSL/TLS);
� Client certificates to permit mutual authentication over SSL/TLS; and
� To support secure network communications by authenticating VPNs.
In particular, the HIAL wM core is the only WS-Security Security Assertion Markup Language (SAML) provider that is interoperable with SAML-compliance systems (e.g. it has been tested extensively with Microsoft, among others) and is fully Web Service Interoperability Basic Profile (WS-I BP) 1.1 compliant. WebService level security includes such things as:
� SAML support in the wM Portal;
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� Full WS-Security support including SAML tokens;
� X.509 certificate tokens (XKMS); and
� Username/Password over wM Glue or wM Servicenet.
Electronic Signatures: The architecture includes support for electronic signatures in these areas:
� Messages in the HIAL Rx API can accept signatures that are generated by third-party vendor software at the pharmacy, hospital or physician location as they are generated by the RxDesktop API; and
� In the CPP for online prescribing and dispensing events. When a message is constructed via the RxDesktop API or physician management software the message will be constructed and then could be signed.
Two-Factor Authentication: The architecture also integrates technology to authenticate administrators and providers at the AP and CPP using two factors of authentication. Identity Management Services: The solution will operate under what is known as the “EHRi Trusted User Management” model as described in the Privacy and Security Conceptual Architecture v.1 (http://knowledge.infoway-inforoute.ca/ar/default.aspx?r=1). That is, users are centrally registered and managed within the solution completely. Access Control Services: The current solution supports a role based access control model. The role-based access control system available from the proposed solution can make it possible to:
� Provide access to the appropriate detail of information to a user;
� Permit mask and unmask activities to occur;
� Enable similar access from a portal interface and the local API interface; and
� Identify where and when a user is fulfilling a specific role.
11.8 System Authentication Services The system authentication is composed of three areas:
� Secure communications between architecture components. These communications are done using dedicated LAN segments, as all components are co-located;
� Secure communications between points of service and the core architecture. These communications use HL7 messages, secured in accordance with the Infoway Transport Layer Interface (TLI) specification; and
� Secure communication with additional components such as MEDITECH Lab results. These communications are implemented using HL7 messaging in accordance with the Infoway TLI specification.
User Authentication Services: The solution bases its authentication and authorization capabilities upon the identity and access management product suite from Sun Microsystems. The Sun Java System Access Manager and Sun Directory Server are leveraged to provide the Lightweight Directory Access Protocol (LDAP) repository and administration functions for that directory. In addition to the Sun components the Authentication and Authorization solution also
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information includes the use of the RSA SecurID token solution for users accessing the portals as described earlier in this document. Alert and Notification Services: Broadcast messages are messages that are sent out to a particular community of users. These messages are configured and added through the AP and are then retrieved either directly through the HIAL Rx API or indirectly through the CPP. Publish and Subscribe Services: The core HIAL includes publish and subscribe functionality as provided by wM Broker. This allows notifications to be generated when certain events occur within the system. Additional messages can be added to use this functionality to register and un-register for notification on particular events and the messages would be delivered through Broadcast Messaging.
11.9 Communication Services HIAL Rx API: The HIAL Rx API is the API through which external systems will communicate with the EHRS and will be provisioned through SOAP-based web services using HL7v3 messages. This architecture extends the in-production API that currently processes HL7v3 National e-Claims Standard (NeCST) messages. In addition, this API supports both synchronous and asynchronous communication.
Batch API: The batch API supports the messages in the HIAL Rx API in a batch manner. The messages are transferred to/from the solution using secure FTP. Within the files transferred, the same message formats will be supported as defined for the HIAL Rx API. RxDesktop API: The RxDesktop API is an extension of the existing API which is provided, installed and used as an in-process Component Object Model (COM) supporting automation and usable on Windows platform. It provides a local interface that can be used by software vendors to easily integrate with the Pharmacy Network through the HIAL. Messaging Services: The entry point for provider systems (Core DIS and registry messages is the HIAL and the message routing identifiers (e.g. receiving application IDs) will point to the common services application. A trading partner identifier is in the control act wrapper of HL7v3 messages, and is used as a pointer to business and routing rules. The trigger event and application roles associated with a given interaction together with the trading partner rules will determine the precise message flow. Using the pointer, the routing and business logic will be executed by the EHR services built as workflows and services to be employed within the HIAL. For example, a single request from a provider could result in one or more messages being generated to various applications in order to carry out the request. The responses or various components within the responses would then be consolidated and subsequently routed to the requestor using appropriate messaging. Transformation Services: Transformations will occur to and from the XML canonical format which is based on HL7v3 formats. The standard to be used for communicating with external systems will be preserved. The transformation services currently include:
� Message transformation from original format to XML canonical format;
� Message transformation to canonical format to original format;
� Mapping services; and
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� Generation of new messages as required.
Parser Services: Parsing services will be used by all incoming and outgoing messages. It will be necessary to carry out parsing mechanisms in order to retrieve relevant data and to successfully process messages. Routing Services: The HIAL routes messages based upon the routing rules for the Trading Partner profile associated with the specific message. Encoding/Decoding Services: The HIAL encodes and/or decodes messages into the required coding formats based upon the rules required by the Trading Partner profile associated with a specific message. The HIAL accepts any standard encoding format, and through applying an encoding or decoding transformation rule can transform the message from the source encoding format to the target or destination coding format. Serialization Services: HIAL Business Services: Business services are not shown in the component view but form a component of the EHR services built on the HIAL to support the business processes and logic that is required to support the current Pharmacy Network requirements. These business services are built on standard Java application servers, and store persistent data within the Oracle database that is part of the HIAL infrastructure.
11.10 HIAL Workflow Services The BPM workflows are defined using a graphical design tool which allows a number of steps to be coordinated in order to complete the required business functionality. Steps can be completed sequentially, in parallel and can be synchronized as necessary. Normalization Services: Normalization Services are implemented within the HIAL in the following manner on the HIAL Enterprise Services Platform-Integration Server. At design time, internal format document templates as well as source/target message types are loaded into the Engine using wM Developer. Using the MAP feature within wM Developer, a field from a source document can be linked to a field of the target document. Additionally, some field values can be converted into an internal representation. For example, a date field YY-DD-MM can be converted into YYYY-MM-DD through this mapping. At runtime, the Engine normalizes incoming data from the source document into the internal data representation using the saved MAP step. Once the internal data representation is acquired through the MAP step, it can be used for any other common functionality such as storing them in the EHR’s data store. Assembly Services: Assembly Services are implemented within HIAL in the following manner:
� Process Level: HIAL BPM – Process Runtime Engine; and
� Component Level: HIAL Enterprise Services Platform – Integration Server.
Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
Appendix B – Acronyms/Definitions Term / Acronym Definition
A&A Authorization and Authentication ACLs Access Control Lists ADR Adverse Drug Reaction AP Admin Portal APIs Application Programming Interfaces BCP Business Continuity Planning BPM Business Process Module CeRx Canadian Electronic Drug messaging standard CHI or Infoway Canada Health Infoway CICA Canadian Institute of Chartered Accountants CMS Consent Management System COM Component Object Model COTS Commercial, off-the-shelf CPhA Canadian Pharmacists Association CPP Care Provider Portal CR Client Registry CRMS Client and Referral Management System DI Diagnostic Imaging DIS Drug Information System DMZ Demilitarized zone DOM Document Object Model DR Disaster Recovery DUR Drug Utilization Review DW Data Warehouse eCID Enterprise Client Identifier EHR Electronic Health Record EHRS Electronic Health Record Solution EHRi EHR infostructures EKG Electrocardiogram EMR Electronic Medical Record EPR Electronic Patient Record FTP File Transfer Protocol GUI Graphical User Interface HCIS Hospital/Clinical Information System HIAL Health Information Access Layer HIN Health Information Network
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Term / Acronym Definition
HIS Health Information System HL7 Health Level Seven I-IP Infostructure-Interoperability Profile IEP Information Exchange Profile iEHR Interoperable Electronic Health Record IHE Integrating the Healthcare Enterprise IPSec Internet Protocol Security JAD Joint Application Development JLIS Jurisdictional Laboratory Information System LDAP Lightweight Directory Access Protocol LIS Laboratory Information System LOINC Logical Observation Identifiers Names and Codes LR Location Registry LRS Longitudinal Record Services MCP Medical Care Plan MPLS Multiprotocol Label Switching NeCST National e-Claims Standard NL Newfoundland and Labrador The Centre Newfoundland and Labrador Centre for Health Information OID Object Identifier (used in the Registries) OLAP Online Analytical Processing PACS Picture Archiving and Communications System PAQC Patient Access to Quality Care pCLOCD Pan Canadian Laboratory Observation Code Database pCSG Pan-Canadian Standards Group PHI Personal Health Information PHS Public Health Surveillance PIA Privacy Impact Assessment PII Personal Identifying Information PIX Patient Identifier Cross-Reference PIPEDA Personal Information Protection and Electronic Documents Act
(Canada) PMBOK Project Management Body of Knowledge PMO Project Management Office PoS Point of Service PPMS Pharmacy Practice Management System RAC Real Application Clusters Respondents Suppliers who are invited to submit proposals for services which will
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Term / Acronym Definition meet the Centre’s requirements as defined herein
RHA Regional Health Authority RFP Request for Proposal SAN Storage Area Network SAML Security Assertion Markup Language SCWG Standards Collaborative Working Group Services RFP This Request for Proposal SFTP Secure File Transfer Protocol SHR Shared Health Record SLA Service Level Agreement SME Subject Matter Expert SMTP Simple mail transfer protocol SOA Service Oriented Architecture SOAP Simple object access protocol TCP/IP Transmission Control Protocol/Internet Protocol TLI Transport Layer Interface TLS Transport Layer Security TRA Threat Risk Assessment UAT User Acceptance Testing UDDI Universal Description, Discovery, and Integration UPI Unique Person Identifier VLAN Virtual LAN WDSL Web Service Definition Language wM webMethods XML Extensible Markup Language
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Appendix C: Supplementary Information to the RFP The Centre issued an RFP (#CHI-2010-016) on May 31, 2010 to identify software applications and related professional services for its interoperable Electronic Health Record/Labs (iEHR/Labs) project. The Centre cancelled this RFP on June 30, 2010 after it identified an inadvertent and unfortunate processing error at a partnering RFP distribution facility, which may have compromised the integrity and fairness principles the Centre consistently supports in its procurement and supply chain activity. There were a number of addenda associated with RFP #CHI-2010-016 which are included in this Appendix. The addenda are relevant to be included as this RFP document (#CHI-2010-032) contains no changes in functional and technical requirements and remains consistent in its content, overall messages, and submission processes when compared with RFP # CHI-2010-016. For further clarity, the content in this Appendix C forms part of this RFP document (# CHI-2010-032) and suppliers must use the information in forming their responses. Notes:
1. Although Question #1 below was asked as part of the procurement process for RFP # CHI-2010-016, this question only does not form part of this RFP (#CHI-2010-032)
2. New questions received relative to CHI-2010-032 will be issued in the form of an
addendum(s) and will be posted on the Centre’s web site.
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Key Supplementary Information to the RFP Q1. Given the complexity of the RFP, which includes product and services for three
important iEHR components, the timeline given seems excessively short. Is it possible to extend the deadline by another 2 weeks?
A1. The Centre will extend the RFP Responses due date to July 7th. Note: Although Question #1 was asked as part of the procurement process for RFP # CHI-2010-
016, this question only does not form part of this RFP (#CHI-2010-032) Q2. Is it possible to obtain the Cost Summary Template in Excel format? A2. The Cost summary Template is available via request at procurement@nlchi.nl.ca.
Q3. Is it possible to obtain the functional and technical requirements matrix (Attachment B) in Excel format?
A3. The Functional and Technical Requirements Matrix is available via request at procurement@nlchi.nl.ca
Q4. Requirement J-15: Is it possible to obtain more details about the “current HIAL transport
specifications in use in NL”?
A4. The Centre is assembling these details to the current HIAL transport specifications in use in NL and will post them within the next few days.
Q5. Requirement J-17: Can you clarify if non-Sun/Solaris solutions (i.e. Microsoft platform) can be proposed and what is the negative impact (if any) in the scoring for the solution in this case?
A5. The Centre is seeking proposals that provide the best solution for the Province’s
Electronic Health Record. The requirement is not written as “Mandatory” therefore, other platforms can be proposed.
Q6. Requirement V-21.3: Is it possible to obtain more details about the “Nova Scotia draft message specifications”?
A6. This is a draft message specification that the Centre will be promoting through the Standards Working Collaborative Group with NS. The draft message specification will be available at www.nlchi.nl.ca over the next few days. (Please refer to Question 16)
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Q7. We have reviewed the RFP and it appears to be very focused on the functional needs of
the three components you ask for in the RFP, with their installation, configuration and testing having much less emphasis. Is it NLCHI's intention that this RFP is intended for product vendors rather than for a system integrator who can bring together software solutions and act as a single prime for the project?
A7. The intention of the RFP is to seek Commercial-off-the-Shelf (COTS) solutions for three components to expand the province’s Electronic Health Record. The Centre expects the respondent to supply the COTS system in addition to installation, integration, configuration, and testing services for the system. This being said, some vendors may choose to partner with a system integrator who will assist in their software solution installation, configuration and testing. Please refer to Section 3.3 Project Approach, and Section 5.0 Financial Proposal, specifically Implementation Services.
Further to the preceding, do you see the integration, implementation and deployment services for the three EHR components in this RFP being part of this bid, or is there an RFP planned for these services separate from this one?
Yes. Integration, implementation and deployment services for the three EHR components in this
RFP are part of this bid. There is no plan to procure these services separately. See answer above in A7.
Q8. Please confirm the document titled “Blank Contract Template_FEB 2010" located on the
Centre’s website is the appropriate contract template. This is for professional services only and does not address the purchase of hardware, software, professional services and ongoing support.
A9. Yes. This is the current version of the Centre’s contract template. Adjustments will be
made, if necessary, for the purchase of hardware, software and on-going support. Q9. Please confirm if the “RFP Terms and Conditions” available at the Centre’s website, is
to be reviewed as per section 9.0 and be considered in the acknowledgement of Attachment A-Terms & Conditions, page 52.
A10. Yes, these are the Centre’s most recent RFP Terms and Conditions and they must be
reviewed and acknowledged in your response. Q10. Please confirm if the attached "Tender_TermsConditions_March2010_UPDATE "
available at the Centre’s website, is to be reviewed as per section 9.0 and be considered in the acknowledgement of Attachment A -Terms & Conditions, page 52.
A11. No, the Centre’s Tender Terms and Conditions do not need to be reviewed. This
opportunity must follow the Terms outlined in the RFP Terms and Conditions.
Q11. The Introduction section of the RFP states that a “supplier may respond to one (1), two (2) or all three (3) of the requested components.” In the case that a supplier were to chose to respond to less than the three (3) requested components, can you clarify how the evaluation of section 4 (Functional and Technical Requirements) and 5 (Financial Proposal) will be weighed? Section 6.2 of the RFP allots 40% and 25% to these two categories which encompass all three components.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information A11. The evaluation will be conducted on the separate components with the Sections 3.1, 3.2
and 3.3 (vendor Score) repeated for each were appropriate. In the example below Vendor A has proposed all three components, Vendor B has proposed a JLIS and Viewer, etc. As indicated in the RFP, (Section 6.3) scores for Oral Presentations, and Financial Proposals will only be awarded to Respondents that are successful meeting the evaluation of Section 3, and Section 4.
Vendor Score JLIS Score JLIS Financial JLIS Oral Total Vendor A 25% 40% 25% 10% 100% Vendor B 25% 40% 25% 10% 100% Vendor C 25% 40% 25% 10% 100% Vendor Score SHR Score SHR Financial SHR Oral Total Vendor A 25% 40% 25% 10% 100% Vendor D 25% 40% 25% 10% 100% Vendor E 25% 40% 25% 10% 100% Vendor Score Viewer Score Viewer
Financial
Viewer Oral Total
Vendor A 25% 40% 25% 10% 100% Vendor B 25% 40% 25% 10% 100% Vendor D 25% 40% 25% 10% 100% Q12. In light of the allowance that a supplier may respond to less than all three (3) of the
requested components, is it correct to assume that the Centre reserves the right to select only one (1) or two (2) components from the proposal of a supplier/consortium who has bid on all three(3) components?
A12. Correct, the Centre expects to select the optimal solution for the Province to deliver the
remaining primary domains and viewer. Q13. Can a supplier submit more than one proposal as a prime, and similarly, can a
subcontractor appear as a partner in more than one consortium responding to this RFP? A13. There is nothing in the RFP or the Centre’s procurement process that would prevent a
supplier submitting more than one proposal. As noted in Section 5.0 Financial Proposal the option for alternate financial proposals is positioned. It is assumed that the question is directed more from a system integrator as the prime proposing various COTS systems, which again is acceptable. The partnering agreements and subcontract arrangements are the responsibility of the consortium. Similar to the previous there is nothing in the RFP or the Centre’s procurement process that would prevent such a response.
Q14. Are any organizations, companies or individuals other than the applicable resources of
the Centre considered ineligible to participate in this procurement?
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information A14. The consortium that is engaged in iEHR/Labs Phase 2.1 is ineligible. This was agreed
as part of the earlier engagement as this group is intimately involved with the solution design and requirements, and therefore unfair influence.
Q15. In section 5.2 Cost Summary Tables, Annual Maintenance and support costs are
requested. Could you clarify the intended length of the support and maintenance contract?
A15. The time period that a government agency operates under is annual. Our assumption is
that these costs would remain the consistent with increments to support typical inflation percentages. Should your Annual Maintenance and Support be dependent on a multi-year arrangement this should be identified as it will influence the approval process – committing funds from future governments.
Q16. Requirement V-21.3: Is it possible to obtain more details about the “Nova Scotia draft
message specifications”? A16: For purposes of this RFP, 17 ADT messages listed in the following table (HL7V3) are
currently proposed for use. These are based on messages developed by Nova Scotia and we will be reviewing them to ascertain Newfoundland and Labrador nuances that may need to be applied.
Full specifications will be part of the Conformance Profile Specification Document and in collaboration with the other jurisdictions, we will make them available to the Standards Working Groups.
�
ADT Messages
Patient Admit Notification PRPA_IN402001CA
Patient Admit Notification PRPA_IN402001CA
Discharge Notification PRPA_IN402003CA
Patient Encounter Revised PRPA_IN402002CA
Patient Encounter Revised PRPA_IN402002CA
Patient Encounter Nullified PRPA_IN402006CA
Patient Discharge Nullified PRPA_IN402007CA
Patient Encounter Revised PRPA_IN402002CA
Patient Transferred to New Location PRPA_IN302011CA
Patient Transfer to New Location Canceled PRPA_IN302012CA
Patient Transferred to New Location PRPA_IN302011CA
Unsolicited Lab Test Results Notification POLB_IN224200CA
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
Revised Results Notification POLB_IN224201CA
Revised Results Request POLB_IN224202CA
Laboratory Order Status Notification POLB_IN211000CA
Record Patient Discharge/Care Summary REPC_IN000076CA
Record Patient Clinical Observation Document REPC_IN000079CA
Q17. The RFP refers to training and communications activities throughout, but there is no
reference to stakeholder identification and management, stakeholder relationship management, stakeholder engagement, etc. Are these activities that NLCHI will take on their own or have there been activities taking place to date that fill this essential change management requirement? Should the vendor for this RFP phase include effort for these activities?
A17. These activities have been taking place through current phase 2.1 Change
Management planning & implementation and will continue to be managed by the Centre and established Provincial Change Management model/roles. The Centre will require the services of the supplier for these activities as it relates to its product only.See A37.
Q18. If there has been work done that includes documentation regarding the stakeholders,
size and distribution of possible user base, target user populations, can we have that information now in the bid process?
A18. Current user base for clinicians would include; 1100 Physicians and 6000 Nurses
and Nurse Practitioners and, Labs staff. Q19. What kind of communication around this initiative has gone out to the user base at this
time? Should the vendor assume that they would be involved in the creation of the communication strategy and execution of the communication strategy?
A19. The Centre will be the lead on communication initiatives; however, suppliers will be
consulted based on their experience from similar engagements in a multi-vendor environment. As such, proposals in response to this RFP should include effort and costing for this consultation work.
Q20. Will NLCHI be creating the Overall Testing Strategy and Master Test Plan for this
project? A20. Yes. However, the supplier is requested to provide information relative to their
experience in terms of a typical implementation for their product. Q21. Will NLCHI be responsible for creation of all System Integration Test cases, what level of
involvement can the vendor expect to have in SIT test planning and execution?
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information A21. The successful vendor will be instrumental in the creation of the integration test cases.
The execution of those cases will also require the vendor’s involvement, with interpretation and resulting dashboards coming from the Centre. This does not include any conformance initiatives but does involve low level message integration. Overall, the supplier is requested to provide information relative to its experience with its product in terms of typical testing requirements and available documentation.
Q22. Will NLCHI put in place testing tools including a defect management system that can be
used by the vendor? A22. Yes. The Centre uses Borland Suite as its testing product. It includes a defect
management system. Q23. Will NLCHI be responsible for defining the performance/load testing test plan? A23. Yes.
Q24. Will NLCHI be responsible for execution of the performance test phase including preparation of any testing data and required testing tools for performance/load testing?�
A24. Yes. However, the supplier will be consulted relative to its experience with testing its product and available documentation.
Q25. Is more complete documentation with respect to the Nova Scotia draft message
specifications available for review? Specifically, will documentation describing the unique messages associated with the Nova Scotia draft specifications be available? The Answer to Question 16 in the Q&A process documentation only identifies Interactions and does not include any documentation about the messages associated with these interactions. Will the RFP process provide this documentation or is there a link where it can be obtained directly?
A25. This documentation will not be available by the RFP closing date; however, the Centre is
working with other jurisdictions to make the specifications available so that suppliers have the necessary information relative to connectivity to the HIAL.
Q26. Supplementary to the previous question, the Nova Scotia draft message specification is
focused on ADT-type messages. The requirement asks for other HL7 V3 interaction messages utilized for storing patient encounters. Can a definition of the scope of "patient encounters" please be provided expressed in terms of transactions included in the pan-Cdn MR2009 Volume 7 - Shared Health Record?
A26. The following interactions could be used for recording the encounter events (subject to
further analysis):
REPC_IN000070CA - Record care composition request REPC_IN000071CA - Record care composition request accepted REPC_IN000072CA - Record care composition request refused REPC_IN000073CA - Update care composition request REPC_IN000074CA - Update care composition request accepted REPC_IN000075CA - Update care composition request refused
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Q27. The Nova Scotia draft message specifications, which are described in the RFP as the
source for patient encounter messages and listed in Answer 16, does not define any query messages. This question is similar to our question with respect to S-10.1.1, can a definition of the scope of "patient encounters" please be provided expressed in terms of transactions included in the pan-Cdn MR2009 Volume 7 - Shared Health Record?
A27. The following interactions could be used for querying the encounter events (subject to
further analysis):
REPC_IN041100CA - Patient care composition summaries query REPC_IN041200CA - Patient care composition summaries query response REPC_IN040100CA - Patient care composition details query REPC_IN040200CA - Patient care composition details query response
Q28. The pan-Cdn Shared Health Record transactions,interactions, and messages are
defined in MR2009 Volume 7 - Shared Health Record artifacts. "Clinical documentation" is not defined in those documents which includes transactions in topic areas such as Clinical Observations (Measured, Coded, Clinical Observation), Patient Notes, Care Compositions, Referral and Referral Note, Health Conditions, and others. Can a definition of the scope of "clinical documentation" please be provided expressed in terms of the transactions included in pan-Cdn Volume 7 - Shared Health Record?
�A28. The available reports from Meditech utilize two specific put interactions and their
corresponding responses:
REPC_IN000076CA - Record discharge/ care summary request REPC_IN000077CA - Record discharge / care summary request accepted REPC_IN000078CA - Record discharge/ care summary request refused REPC_IN000079CA - Record clinical observation document request REPC_IN000080CA - Record clinical observation doc. request accepted REPC_IN000081CA - Record clinical observation doc. request refused�
Q29. To our knowledge there are no stable for use pan-Cdn HL7 V3 message specifications
for storing and querying patient immunization events. Can you please provide guidance and documentation on the specifications that should be used in preparing our response and estimates for these requirements?
A29. See below table.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Immunization C14.01 Add Patient Immunization POIZ_IN01Record
immunization request
Requests that a particular immunization be added to a patient's record.
Immunization C14.01 Add Patient Immunization POIZ_IN01Record immunization request accepted
Indicates that the requested immunization information has been successfully added to the patient's record.
Immunization C14.01 Add Patient Immunization POIZ_IN01Record immunization request refused
Indicates that the request to add an immunization to the patient record has been denied.
Immunization C14.05 Update Patient Immunization POIZ_IN01Update immunization request
Request that information about a previously recorded immunization be changed.
Immunization C14.05 Update Patient Immunization POIZ_IN01Update immunization request accepted
Indicates that information about a change to a previously recorded immunization has been successfully recorded.
Immunization C14.05 Update Patient Immunization POIZ_IN01Update immunization request refused
Indicates that the request to record a change to information about a previously recorded immunization has been refused.
Immunization C14.06 Retract Immunization Record POIZ_IN01Retract immunization request
Asks that a previously recorded immunization should be "removed" from the record; (Information may be retained for audit purposes).
Immunization C14.06 Retract Immunization Record POIZ_IN01Retract immunization request accepted
Indicates that a previously recorded immunization has been "removed" from the record as requested; (Information may have been retained for audit purposes).
Immunization C14.06 Retract Immunization Record POIZ_IN01Retract immunization request refused
Indicates that the requested previously recorded immunization will not be "removed" from the record;
Immunization Query C14.02 Patient Immunization Query POIZ_IN02Immunizations query
Requests retrieval of detailed information about a patient's immunizations, potentially filtered by time-range of the immunization, time-range the immunization was last updated, and/or type of immunization.
Immunization Query C14.02 Patient Immunization Query POIZ_IN02Immunizations query response
Returns detailed information about a patient's immunizations.
Q30. A list of ADT and Lab message interactions were provided in Addendum #4. Please
clarify if these message interactions represent the complete list for JLIS, and for SHR or if other message interactions will be added to the list? Please provide a complete list all message interactions required.
A30. This is not an exhaustive list of all ADT and Lab messages, as the design has not been
finalized. There is an ongoing process to determine the complete message set. Addendum #4 outlines the message set forecasted to date. The Centre is open to additional message sets proposed by the supplier that are in alignment with overall project requirements.
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information Q31. In the Viewer Requirements Matrix, V-48 states the viewer supports data archival and
retrieval functionality; and to describe the archival process. Is this really the EHR viewer’s responsibility? If it is, and assuming archiving is the responsibility of the component that owns the data, please specify what data would be owned and archived by the Viewer component.
A31. The viewer is required to support archiving of data (potentially administration data such
as viewer configuration, user configuration and viewer audit data), specifically meaning it has to adhere to configurable retention periods directed by jurisdictional policy. The second part of the statement "...and retrieval functionality" ensures the solution can allow access to any locally stored data and logs. It should be noted that the solution should be capable of external log storage, support. The viewer does not need to provide an archiving solution.
Q32. In the Viewer Requirements Matrix, V-33.6 states viewer access to personal health
information is controlled by the provider-patient relationship (e.g., attending physician, family physician, same location of care). In the JLIS Requirements Matrix, J-7 states “Patient-to-provider relationships (as defined within the messaging) are maintained within the JLIS. These requirements imply that a provider-patient relationship table must be created in the JLIS and that the EHR Viewer must retrieve this information from JLIS prior to initiating a users request to access information in the SHR? Is this truly the intended functionality? Should this functionality be implemented as part of the existing Consent model?
A32. Yes. There is a requirement to lookup and present to the end user (provider) the patient-
provider relationship following login, and the viewer is expected to use this information appropriately to determine the access control for a provider, and alert on any inappropriate action, in accordance with privacy requirements. Patient - Provider relationship information is foreseen to be derived from information in the repositories, and is not a consent directive set by individual patients.
Q33. In the Viewer Requirements Matrix, V-20 states all data sent between EHR components
is verified for integrity. Please define and elaborate on the definition of “integrity “and clarify whether this is the responsibility of the HIAL, Viewer or both?
A33. In accordance with the Infoway TLI specification, all communications between PoS and
HIAL MUST be encrypted, ensuring confidentiality, integrity and availability. The HIAL does employ certificates for this purpose, enforcing HTTPS to be used. The POS must ensure compatibility with using certificates to encrypt communications with the HIAL.
Q34. The RFP states that the identity access and authentication security services are
provided within the HIAL yet additional security requirements are stated within the Requirements Matrices; such as J-31 “All security and administrative users are strongly authenticated with multi-factor authentication”. Please clarify that our solution should use the existing security services provided by the HIAL (Sun One Directory). Please provide details describing the security architecture and all security services provided.
A34. Any administrative interface should have the ability to enforce two-factor authentication.
Support for two-factor authentication is provided by the NL RSA SecurID appliances, and it is expected that any solution introduced would leverage the RSA SecurID appliances for this purpose. All identification and authentication capabilities required as
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Newfoundland and Labrador RFP#: CHI-2010-032 Centre for Health Information
part of the solution are required to integrate with Sun Access Manager, Sun Directory Server (LDAP), and RSA SecurID to ensure strong authentication for administrators. Please see the section titled "2.4.6.8 System Authentication Services" in the RFP for details.
Q35. In Section 5.2, the three (3) Cost Summary Tables are divided into columns representing
the four (4) environments, and into rows dividing Implementation, Training and Documentation into sub items. As per instructions, if a column is not relevant, we should indicate “N/A” instead of leaving it blank. How should we indicate an item whose cost is included in the cost of another item?
A35. Use “incl” and reference, via note, where the costs are included. Q36. In Section 5.3 we are requested to provide a list of “recommended software as well as
an estimate of the costs required to run (the) (…) proposed solution.” It also states that “the Centre reserves the right to tender any or all hardware requirements and operating software in a separate process”.
a) Are the recommended hardware costs included in the Financial Proposal evaluation? b) Is a resale of this hardware expected or is the cost provided for indicative purposes only?
A36. No. The recommended hardware costs are not included in the Financial Proposal
evaluation. The costs are being provided for indicative purposes. A resale arrangement is not required, however, if such a model exists, identify where it can provide value.
Q37. Project Services are described in 3.3.4 as involving “subject matter expertise in support
of the deliverables being created by other teams.” In section 5.0 describing the Pricing, Project Services are defined as “costs associated with the development, implementation and post go-live support for the proposed solution”, and the costing grids in 5.2 have a line-item for their cost per product component, per environment. Our understanding is that project services was a time & materials on an ad-hoc basis to consult on parallel projects within the program and that the rates would be represented by the 5.4 Services Rates table. Could you please clarify?
A37. This project is a complex, multi-vendor engagement requiring collaboration, synergy and
integration amongst all stakeholders. Given the environment, project services can generally be categorized as those not previously identified. An example could be the necessary effort to engage in “Root Cause Analysis” and achieving consensus on the most efficient solution to resolve issues. The Centre is looking for the supplier base to leverage its experience with similar large scale engagements to respond to this question.
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ClarificationOrals Evaluation
______________________________________________________________________________
Section 6.1 Evaluation Process “The Centre’s evaluation team will review all qualified Respondent offers and score them based on the evaluation criteria detailed below. The Respondents whose evaluation score meets or exceeds 70% on each non-financial evaluation category (noted by shaded sections in the table) will be short listed. From there, financial proposals will be reviewed.” The requirement that Respondents must meet or exceed 70% also applies to the oral presentations (if selected). That is, they must score 7 (that is, 7/10) or higher in the orals to receive any further consideration. For further clarity, if a respondent scores below 70% in the oral presentation, they will NOT advance in this RFP process and, therefore, will NOT be considered for award.
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