QHR Technologies Inc.

Version Number

Accuro® EMR CMS4

User Interface

Accuro® EMR CMS4

Local/ASP

Local

Provided Documentation and Media Used

The Accuro® System documentation is provided electronically and is accessible from within Accuro® to authenticated Users.

Other Required Environmental and Support Components

Accuro® is a standalone EMR application, with dependencies that include DBMS, Hardware, Connectivity, Server, Workstations, and peripherals. The minimum requirements are documented in subcategory 'Hardware Configuration'.

Health Card Validation Support (OBEC)

Accuro® includes and supports OBEC as part of the System.

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

Accuro® requires the folowing software/services on the Server:

• Microsoft SQL Server 2008 R2 DBMS
• Antivirus
• Backup (QHR Technologies Inc. offers a backup product through the Cloudwerx division as an option)
• Microsoft Windows 7 or Server 2008 Operating System
• Internet connectivity and Firewall (could be external)
• Fax Modem

What other software products do you advise physicians to implement?

1. First DataBank for drug contraindications (CMS3+ requirement), procured through Optimed.
2. WinBlast for LifeLabs and CML Lab electronic interfaces, procured through website of WinBlast.
3. Microsoft Fax for receiving and sending of faxes.
4. OHIP 'GoNET' billing submission software (portal access).

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

Accuro has a CSV export option on reports, which is compatible with Microsoft Excel. This is not required.

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

Yes, QHR Technologies Inc. supports Out of Province billing through the standard OHIP electronic claims module. This does not include Quebec.

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

Gamma-Dynacare

Lifelabs

HRM

OLIS

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

QHR Technologies Inc. has a shareable library of Forms that Clients can dowload to and upload from via the Internet directly in Accuro®. The library has approximately 1,500 forms ranging from government forms to adminstrative forms to clinical templates.

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

Accuro supports English.

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

Accuro includes a field in demographics indicating the official and preferred language of the patient and flags so that Users are visually alerted to language needs.

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

Templates and Forms can be developed by the Client in any language that uses English keyboarding characters.

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

First DataBank

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

First DataBank provides updates as often as weekly.

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

Remote pull via the Internet, thorugh a Client action. Alerts of the availablility and content of new updates are sent via fax and email.

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

Accuro uses ICD9-CA, ICD10-CA, ICPC, and SnoMed as problem code table options.

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

Accuro does not provide a coded table for interventions, however, the Clients can build their own table so that the data collected is able to be reported on.

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

First DataBank

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

First DataBank

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

First DataBank. NOTE: Accuro® refers to an 'adverse reaction' as an 'intolerance'.

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

First DataBank (medications table)

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

Other coded elements include:

• OHIP Fee Schedule for billing codes and fees;
  
• Various User controlled coded lists in many areas of the program (no default values).
  

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

A typical infrastructure for this size of a clinic would be 4 workstations and one server, totalling 5 physical machines. In addition, a high speed Internet connection, fax line to the server, a printer, and a small scanner into the front desk machine.

Workstation Requirements:

• Processor speed of 2.0 GHz or faster
  
• 2 GB RAM
  
• Windows OS: Microsoft Windows XP, Vista or 7
  
• Mac OS: OS 10.5 64 bit or later
  
• Ethernet NIC 100/Gigabit or Wireless G/N card
  
• Microsoft Word and Excel, Antivirus software
  
• Server Requirements:
  
• Processor speed of 2.0 GHz or faster
  
• 4+ GB RAM
  
• Redundant Hard Drives (RAID 10), 10,000+ RPM
  
• Hard Drive Size: 60 GB + (Appendix B of Agreement has RAID 10 example)
  
• Ethernet NIC 100/Gigabit
  
• Fax Modem (for paperless office set-up)
  
• Windows 7
  

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

A recommended infrastructure for this organization would be 7 workstations per location, with a single server located at the 'head office' site. A VPN router would connect each of the satellite offices to the head office to support the shared database. Each location would also require a high speed Internet connection, fax line to a workstation, a printer, and a small scanner in to a front desk machine. Essentially, each location would be set up like small standalone clinic, with the data being stored at a single location.

Workstation Requirements:

• Processor speed of 2.0 GHz or faster
  
• 2 GB RAM
  
• Windows OS: Microsoft Windows XP, Vista or7
  
• Mac OS: OS 10.5 64 bit or later
  
• Ethernet NIC 100/Gigabit or Wireless G/N card
  
• Microsoft Word and Excel, Antivirus software
  
• Server Requirements
  
• Dual Processors with speed of 2.0 GHz or faster
  
• 8 GB RAM +
  
• Redundant Hard Drives (RAID 10), 7200+ RPM
  
• Hard Drive Size: 60 GB +
  
• Recommend 6 physical Hard Drives including 2 mirrored pairs in a RAID10 configuration
  
• Ethernet NIC 100/Gigabit
  
• Fax Modem (for paperless office set-up)
  
• Microsoft Windows 7
  

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

A typical infrastructure for this size of a clinic would be 30 workstations and one server, totalling 31 physical machines. In addition, a high speed Internet connection, fax line to the server, multiple printers, and multiple small scanners.

Workstation Requirements:

• Processor speed of 2.0 GHz or faster
  
• 2 GB RAM
  
• Windows OS: Microsoft Windows XP, Vista or7
  
• Mac OS: OS 10.5 64 bit or later
  
• Ethernet NIC 100/Gigabit or Wireless G/N card
  
• Microsoft Word and Excel, Antivirus software
  
• Server Requirements
  
• Dual Processors with speed of 2.0 GHz or faster
  
• 8 GB RAM +
  
• Redundant Hard Drives (RAID 10), 7200+ RPM
  
• Hard Drive Size: 60 GB +
  
• Recommend 6 physical Hard Drives including 2 mirrored pairs in a RAID10 configuration
  
• (See Appendix B of Agreement for RAID 10 example)
  
• Ethernet NIC 100/Gigabit
  
• Fax Modem (for paperless office set-up)
  
• Microsoft Windows Server 2003/2008
  
• Microsoft SQL Server 2005 or 2008
  

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

Configuration 1 is currently not supported.

Configuration 2 requires 60kbps per user both upload and download. Recommended speed is 10mbps down and 5mbps up. Latency is important for good performance and this is recommended at or below 20ms.

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

Optimed does not supply hardware, but will consult with the Client's IT Provider to assist.

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

The backup service through QHR Technologies Inc. is optional, as Clients may elect to implement their own backup system, subject to the Client signing off that the Client assumes responsibility for backups.

Recovery and Restore

Accuro® uses both Microsoft SQL Server and the DS-Client to restore a database. In the event of a failure, the first step is for the IT vendor to restore the server. Once the server is restored, QHR Technologies Inc. installs the DS-Client which then allows the database restore process to begin. The DS-Client is used to download the databases from the data centre, decrypt them, and save them to the server as .BAK files. Microsoft SQL Server is then used to restore the two .BAK files.

Once the databases are restored, it may be required that QHR Technologies Inc. restore the application side in the case of workstation client loss as well. QHR Technologies Inc. retains all versions of the Accuro® application to provide an exact version restore to the Client using SFTP to transfer the files.

The actual restore process is performed utilizing SQL Server restore tools. The restore time is dependent upon the size of the database (e.g. a 10Gb Accuro® database usually takes less than 5 minutes to restore, not including the download time).

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

QHR Technologies Inc. does not supply hardware, but will consult with the Client's IT Provider to assist.

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

QHR Technologies Inc. does not supply hardware, but will consult with the Client's IT Provider to assist.