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Technology
Architecture Overview
NoteworthyEHR uses a multi-component server application architecture which can be deployed across one or more physical servers. This design enables NoteworthyEHR to be deployed in the way that best suits the scale of a particular customer.
Recommended System Guidelines
Our system requirements are easily met with reasonably current technology, and our engineers will work closely with your staff to determine scaling and sizing of server technology. In order to ensure your staff receives the best application experience possible, we consider several factors including your patient volume, required daily reporting functions, selected NoteworthyEHR features and general workflow.
Deployment Methodologies
All businesses need a way to deploy applications to their many end-user devices. We directly support two models of application provision: Client/Server and Terminal Services/Citrix-based hosting. Our engineers can help you choose the right solution for you.
Client/Server: NoteworthyEHR was designed as a client/server-based application in order to increase performance and functionality for the end-user. As the client application processes data locally, the server handles the many other requests generated by other users. In this type of environment each client PC must have the NoteworthyEHR client installed. Noteworthy packages the client installer using Macrovision's InstallAnywhere technology. The installer is built for simplicity and is easily run by end users with basic documentation.
Terminal Services or Citrix-based ASP solution: Some practices choose to deploy our application through the use of Microsoft's Terminal Services or Citrix technology. Microsoft's Terminal Services server and Citrix's Presentation Server allows administrators to serve a "desktop" or application to any client PC without the application being installed on that PC. In this case, additional dedicated servers provide the processing power to run NoteworthyEHR for each Terminal Services or Citrix connected client. Although the primary advantage of this technique is to centralize the administration of client PCs and installed software, administering Terminal Services or Citrix internally or with a hosting-company requires a specific skill set, as well as added server costs.
Microsoft's Terminal Services behaves in the same way as Citrix and has similar advantages and requirements. Terminal Services does not have all of the features of Citrix, however it is more cost effective. If you are considering this deployment strategy, you should review both Terminal Services and Citrix.
Interfacing
No system stands alone! Our flexible architecture allows us to interface with any practice management solution. Utilizing industry standard protocols such as HL7, we have already implemented clients using a variety of solutions, including:
NextGenPM
Centricity (GE)
NetPractice (MARS Medical Systems)
ExpertPM (Experior)
Promed (Vitalworks)
MDr PracticeManager (DST Health Solutions)
AdvantX (Source Medical)
Intergy (Sage Software)
Groupcast™ (IDX)
PCC
MicroMD (Henry Schein Medical Systems)
NoteworthyEHR can take care of your lab needs, including our ability to interface with Quest Diagnostics and Labcorp, among others.
For Those New To IT
We've selected industry-class components to build our application. We also implement the system to make it easy for you to administer. We'll talk about the skills you'll need to effectively perform your network and system administration duties in each tier of NoteworthyEHR.
Clients: At this level you need to be able to deploy software to your enterprise. You will need to be able to run an InstallAnywhere installer for simple manual installation. If you are deploying across a network then you should be familiar with Windows networking and either batch scripting or Windows Shell scripting. You should also be familiar with printer setup, file level permissions and security, as well as general end-user Windows administration.
Servers: Server and network administration skills are key for maintaining any enterprise application. Depending on the OS your practice has chosen, you or your IT staff should be familiar with Windows 2000 or 2003 Server administration, including networking troubleshooting, DHCP/DNS administration, service control, backup scheduling and implementation, disk and raid array maintenance. If you choose to implement on a Linux/Unix system you will need general Linux skills, network administration, DNS maintenance, service control, disk and RAID array management as well as backup scheduling and implementation.
Application: Specific administration includes monitoring disk space usage and planning for additional space, as well as monitoring and purging rolling logs when necessary.
Interface: Noteworthy's Professional Services team will work with your practice management software vendor and laboratory services to configure and install interfaces between their system and NoteworthyEHR. Noteworthy's interface engine provides a simple web-based interface for your IT staff to monitor the interfaces once they have been put into production.
Database: Your IT staff should have a solid understanding of the general administration duties necessary for your chosen database engine, particularly backup scheduling and maintenance, disk usage, performance monitoring and planned expansion of server capabilities and migration.
Reporting: The clinical data collected and stored by NoteworthyEHR can be used alone or in conjunction with a practice's existing databases to produce reports that help optimize business practices, improve patient care, and meet government reporting requirements. A reporting expert with experience using a standard reporting tool (such as Cognos, Crystal Reports, or other packages) will be able to produce these reports using documentation provided by Noteworthy.
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