Attachment 3 - 00 VA OEHRM Site Infrastructure Requirements V1.8.pdf

Transforming Health Care for Veterans, Revolutionizing Health Care for All

OEHRM Site Infrastructure and End User Device (EUD) Requirements September 9, 2020 | Version 1.8 for Signature

Pre-Decisional - OEHRM Site Infrastructure and End User Device Requirements v1.8 Final | ii

Final Signature:

John Short Chief Technology & Integration Officer Veterans Affairs Office of Electronic Health Record Modernization

Paul Tibbits, MD Executive Director, Office of Technology Integration Veterans Affairs Office of Information and Technology

Ed Litvin Deputy to the Assistant Deputy Under Secretary for Health, Administrative Operations Veterans Affairs Veterans Health Administration

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Final OEHRM Pre-Concurrence:

Terry Luedtke Chief Architect Veterans Affairs Office of Electronic Health Record Modernization

Jim Bates Systems Engineer

James Babe Acting Director, Infrastructure Readiness

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Final OEHRM Pre-Concurrence:

Cynthia Doolittle Director, Special Engineering Projects Veterans Affairs, Healthcare Environmental Facilities Program

Gavin Mason Director, Electronic Health Record Modernization Veterans Affairs Office of Information and Technology

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Revision History

Date Version Description Author 11/19/2019 1.1 Initial Release OEHRM

01/24/2020 1.2 draft 1 Updated 2.4,2.5 (Power and Cooling requirements)

Added latency requirement to 2.1, 2.2 (WAN/LAN)

OEHRM

02/13/2020

1.2 draft 2 Inclusion of OIT and VHA comments

OIT

02/29/2020 1.2 draft 3 preview

Added EUD Printers and Peripherals, Appendix C: Site

Type Definitions and Requirements, Appendix D:

Cerner Validated Peripheral List

OEHRM

03/18/2020 1.3 preview Name changed to Site Infrastructure and End User

Device Requirements, Added navigation links from tables in Appendix C. Added revised language from

OCHAMS including seismic rack/cabinet requirement. POAM call-out for FIPS exemption in

EUD requirements

OEHRM

03/25/2020 1.4 pre-release Preliminary site type requirements. Removed comments and tracked changes.

OEHRM

03/27/2020 1.4 pre-release 2 OIT comments, Cerner comments and Seismic information added

OEHRM

03/31/2020 1.5 concurrence review

OIT Adjudication and updates/formatting to Seismic

Rack Requirement list

OIT/OEHRM

04/05/2020 1.5 concurrence with tech edits Tech Edits

OEHRM

04/16/2020 1.6 Final Review Broke out responsibilities for FDS between CFM and

Cerner, added exemption process for FDS power and space requirement

OEHRM

06/26/2020 1.7 for Signature Site Type TeleHealth added, requirements reduced for shared services and call centers. OIT

Adjudication, Wireless requirements update and finalized Power/Space/HVAC exemption process

OEHRM

07/09/2020 1.7 v2 for

Signature Minor concurrence edits

OIT/OEHRM

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09/09/2020 1.8 for Signature Added Appendix F: RACI from OEHRM Infrastructure

Playbook, Seismic Appendix updated to remove original Wave numbers and replace with VISNs, Covid

19 impact statement, DMLSS power and space requirement

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Table of Contents

Final Signature: .................................................................................................................................. ii

1 Overview

2 Requirements

2.1 Wide Area Networking (WAN)

2.1.1 WAN Requirements

2.1.1.1 VA Enterprise Data Centers

2.1.1.2 VAMC Sites

2.1.1.3 Other Site Types as Required

2.1.2 WAN Implementation Specifications and Considerations

2.2 Local Area Networking (LAN)

2.3 Wireless LAN (WLAN) Design Requirements

2.4 Power and Space Design Requirements

2.5 Heating, Ventilation, and Air Conditioning (HVAC) Design Requirements

2.6 End-User Devices (EUD)

2.6.1 PC and Tablet Requirements

2.6.2 Other EUD Requirements

2.6.2.1 Laser Printer and Multi-Function Printers (MFP) Requirements

2.6.2.2 Wireless EUD Requirements

2.6.2.3 Mobile EUD Requirements

2.7 Voice Over Internet Protocol (VOIP) Device Requirements

2.8 Medical Device Requirements

2.9 Physical Security Design Requirements

2.9.1 Mission Critical Facilities

2.9.2 Life Protected Facilities

2.10 Joint Security Architecture Requirements

Appendix A: Acronyms

Appendix B: References

Appendix C: Site Type Definitions and Requirements

A. VA Medical Center (VAMC)

B. Health Care Center (HCC) Definition

C. VAMC and HCC with no VAMC Parent Specific Requirements

D. Community-Based Outpatient Clinic Definitions

E. CBOC and HCC with VAMC Parent Specific Requirements

F. CHAMPVA Meds by Mail Definition

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G. Consolidated Mail Order Pharmacy (CMOP) Definition

H. Consolidated Patient Account Center (CPAC) Definition

I. Extended Care Site Community Living Center (CLC) (Stand-Alone) Definition

J. Residential Care Site (MH RRTP/DRRTP) (Stand-Alone) Definition

K. CHAMPVA Meds by Mail, CMOP, CPAC, CLC and MH RRP/DRRTP Specific Requirements 29

L. Clinical Resource Hub (CRH)

M. Other Outpatient Services (OOS) Definition

N. Shared TeleHealth Services Definition

O. CRH, OOS and Shared TeleHealth Services Site Specific Requirements

P. Vet Center Definition

Q. Call Center Definition

R. Remaining VHA Locations Definition

S. Teleworker with Printer Definition

T. Vet Center, Call Center, Remaining VHA Locations and Teleworker with Printer Specific

Requirements

U. Central Scheduling Solution (CSS) Definition

V. CSS Site Requirements

Appendix D: JSA and FDS Power, Space and HVAC Requirement Exemption Process

Appendix E: Facilities Requiring Seismic Mitigation in Cabinets

Appendix F: RACI Matrix - Organizational Expectations

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1 Overview

The Office of Electronic Health Record Modernization (OEHRM) Program is a large-scale, commercial Electronic Health Record (EHR) implementation. The Department of Veterans Affairs (VA) must ensure that the new EHR is supported by both proper Information Technology (IT) infrastructure and physical (i.e., facilities) infrastructure. This document is intended to outline the current set of OEHRM requirements. Specific items evaluated within this document are: Wide Area Networking (WAN), Local Area Networking (LAN), Wireless LAN (WLAN), Power, Heating, Ventilation, and Air Conditioning (HVAC), End User Devices (EUD), Networking and Voice Over Internet Protocol (VOIP).

Note: Due to the unprecedented impact of COVID-19 on the OEHRM Program schedule special accommodations have been made to adjust the infrastructure readiness schedule as outlined in attached memo ‘OEHRM COVID-19 Revised Deployment Schedule - Infrastructure Readiness Strategy(draft)’

2 Requirements

Sections 2.1 through 2.10 outline the initial set of requirements for support to OEHRM deployment at Initial Operating Capabilities (IOC) and subsequent wave deployments. In combination with other established requirements documents and plans, these high-level requirements need to be communicated across all stakeholders.

This document provides requirements in addition to VA’s existing design guides and enterprise IT requirements. Additional requirements will supplement specific areas, such as wireless networking, that may require further details. Other site-specific requirements may be issued that develop from evaluation of individual locations. This document will be updated annually over the 10-year deployment schedule to incorporate both technology improvements and lessons learned from deployments. In any area of conflict, the more stringent of the two standards will apply. In general, all included requirements apply to VA Medical Centers (VAMC). Other site type requirements are outlined in Appendix C.

2.1 Wide Area Networking (WAN)

2.1.1 WAN Requirements

2.1.1.1 VA Enterprise Data Centers

A. VA Enterprise Cloud (VAEC), Austin Information Technology Center (AITC) and Philadelphia

Information Technology Center (PITC) shall have, at minimum, Dual 10 Gbps circuit with 1 Gbps CIR minimum from the facility to the Cerner Data Center (2 x 1 Gbps)

1. Moving forward, expected utilization of Cerner EHRM plus current circuit utilization will be averaged to determine required committed information rate (CIR) to meet 50% maximum utilization threshold

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2.1.1.2 VAMC Sites

A. Facility shall have, at minimum, dual 1 Gigabits per second (Gbps) interface available with ≥ 500

Mbps CIR (2 x 500 Mbps) circuits or bandwidth allocation of peak usage plus 50%, whichever is greater for IOC, Wave 1, 2, and 3.

1. After that OIT, OEHRM, and Cerner will reassess for these sites and the enterprise;

Moving forward, expected utilization of Cerner EHRM plus current circuit utilization will be averaged to determine required CIR to meet 50% maximum utilization threshold

B. Facility shall have end-to-end, geographically diverse and carrier-diverse circuits with minimum fiber pathways separation: service provider public rights-of-way 75 ft, Egress 20 ft, and cabinet 10 ft. See below Figure 1

1. The preferred entry points 180° apart, or 90° acceptable (protected preferred, unprotected acceptable), with the caveat of Veterans Health Administration (VHA) providing space; all variances to be approved by OEHRM Chief Technology & Integration Officer. See below Figure 2

i. Carrier provided route map shall be used to validate route diversity

Figure 1: Minimum Geographic Diversity Circuits with Entry Points

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Figure 2: Preferred Geographic Diversity Circuits with Entry Points

2.1.1.3 Other Site Types as Required

A. Facility shall have, at minimum, a single 100 Megabits per second (Mbps) (1 x 100 Mbps) circuit with ≥ 50 Mbps CIR or bandwidth allocation of peak usage plus 50%, whichever is greater for IOC, Wave 1, 2, and 3

1. After that OIT, OEHRM, and Cerner will reassess for these sites and the enterprise;

Moving forward, expected utilization of Cerner EHRM plus current circuit utilization will be averaged to determine required CIR to meet 50% maximum utilization threshold

i. Following Go-Live, OIT, OEHRM, and Cerner will assess circuit utilization and adjust CIR accordingly

2.1.2 WAN Implementation Specifications and Considerations

A. Details on Quality of Service (QoS) can be reference in the existing VA document: *Veterans

Affairs Enterprise Infrastructure Standard: Quality of Service (QoS)

B. Active-Active High Availability (HA) Redundancy in accordance with facility type per the VA

Enterprise Local Area Network (LAN) Technical Architecture Standard Version 2.1, February 13, C. Encryption Protocol: OEHRM requires an end-to-end WAN encryption solution such that traffic from VA locations can go directly to Cerner enclave without having the encryption broken and re-encrypted

D. New Campus Support Centers (CSC) construction, modification and expansion shall conform to

TIA 942 Rating 3 (Infrastructure Standards for Telecommunications Spaces)

E. Performance Service Level Agreements (SLA) 99.99% (per Networx SLA)

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F. End-to-End latency from the user desktop to Cerner Data Center of equal to or less than 90ms for Citrix connection

2.2 Local Area Networking (LAN)

A. Horizontal cabling shall be Category 6 (Cat6) or higher (ANSI/TIA-1179 Healthcare Facility

Telecommunications Infrastructure)

1. No immediate action required for existing Category 5e (Cat 5e) cabling. Must be replaced prior to OEHRM project close per Electronic Health Record Modernization

Cabling Infrastructure (VIEWS 01426385) Memorandum - September 23, 2019

B. Telecommunications outlets/connectors and the horizontal cross-connects (patch panels) shall be of equal or greater Category to connected horizontal cable

C. Compliant with the BICSI standards (ANSI/NECA/BICSI 568, Standard for Installing Commercial

Building Telecommunications Cabling and ANSI/TIA-1179-A Healthcare Facility

Telecommunications Infrastructure for new installations)

1. New cable installations additionally shall be compliant with TIA 568.2-D, TIA TSB-184-A, and NFPA-70 Section 725.144 to prevent PoE heat accumulation

i. Alternatively, new UTP cabling shall carry a UL listed "LP" (Limited Power) rating

D. All patch cables shall be of equal or greater Category for copper, OM or OS level for fiber, to the highest in use in the TR or Data Center

E. Cable management shall be implemented for all patch cables in accordance with VA OIT

Infrastructure Standards for Telecommunications Spaces ensuring proper bend radius, bundling, airflow, support and labeling

F. 1 GbE connectivity to desktops, and other EUD

G. End-to-End latency from the user desktop to Cerner Data Center of equal to or less than 90ms for Citrix connection

H. Available data drops and network ports in Telecommunication Rooms (TR) to support addition of required network printers and medical devices per Cerner Current State Review (CSR)1

I. HA Redundancy in accordance with facility type per the VA Enterprise Local Area Network (LAN)

Technical Architecture Standard Version 2.1, February 13, 2019

J. Utilize high-performance network switches with low latency and minimal packet loss for appropriate infrastructure job function and growth per VA business growth forecast

1. No site should go-live with any switch that is within one (1) year of Last Day of Support

(LDoS) or End of Software Maintenance (EoSW)

2. Switches that are “stacked” or daisy-chained together sharing an uplink to the core should have an interconnection speed of 10Gbps or greater

K. Copper structured cabling shall be certified as meeting or exceeding TIA-EIA-568.1-D (max fixed cable length 90M/295Ft) independent of media type

L. Intra-building Fiber (Horizontal and First Level Backbone)

1 Requirement contingent on timely delivery of the CSR as noted in the OEHRM Infrastructure Readiness Playbook

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1. Performance Category: OM4 Laser Enhanced to 40 GbE; OM3 will be grandfathered

2. Performance Specifications: Laser Optimized 50/125 μm fibers with effective modal bandwidth of at least 4,700 MHz∙km at 850 nm

3. Mode: Multimode

4. Smoke Rating

i. Riser cable for vertical runs through floors

ii. Plenum rated for plenum spaces

iii. Not rated for other applications

iv. Or as per Authority Having Jurisdiction (AHJ) requirement

5. Jacket Color: Aqua

6. Termination Method: Pre-terminated with Multi-fiber Push On (MPO) (Long run cables and campus network cables will have terminations completed in the field, as required)

7. Strand Count: 12 or 24 per assembly

8. Bundling: Loose Tube

9. Polarity: Straight (or Type A-Key up one end, and key down on the other)

M. Campus Area Network (CAN) connection by Single Mode (SM) OS2 Fiber 10 GbE or better for building-to-building

1. Single Jacket Non-armored Loose Tube fiber cable for running in conduit

2. Armored fiber for direct-buried or aerial runs

3. All dielectric

4. Outside Plant, Communications Multipurpose Cable, Riser (CMR) “riser-rated cable”

Rating

5. 96 Count (if not enough room, smaller count cables can be used)

6. Field-Terminated

N. All CAN fiber connections may be home run back to intermediate distribution switch/fiber distribution panel (FDP). Fiber connections at building should not be run through additional buildings unless pass-through or mesh; do not use daisy-chained segments

O. CAN – minimum of 10 Gbps LAN links or matched Small Coarse wavelength division multiplexing

(CWDM); VHA responsible for Fiber and OEHRM will fund small form pluggable (SFP) 10Gbps transceivers; NOTE: Not required for Go Live at IOC facilities

P. Connections for Core, Distribution and uplink from Access Switch shall provide a minimum of 10

GbE Fiber or better; VHA responsible for Fiber and OEHRM will fund small form pluggable (SFP)

10Gbps transceivers; NOTE: Not required for Go Live at IOC facilities

Q. New Campus Support Centers (CSC) construction, modification and expansion shall conform to

TIA 942 Rating 3 (Infrastructure Standards for Telecommunications Spaces)

R. Network Infrastructure devices supported by UPS and Emergency Power / Backup Generator as described below in 2.4

S. Performance Service Level Agreements (SLA) 99.9% excluding scheduled downtime

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2.3 Wireless LAN (WLAN) Design Requirements

This section covers basic VA secure WLAN requirements. Detailed WLAN requirements are contained in a supplemental document, Wireless LAN (WLAN) Standard and WLAN Controller - Secure Configuration Baseline

A. 802.11ac Wave 2 & when commercially available next-generation 802.11ax; 802.11g is acceptable to support legacy devices; 802.11b shall be disabled on Access Points (AP)

B. Primary coverage signal strength shall be at least -65 dBm in all patient care areas and SNR minimum of 25 dB

C. Secondary signal strength shall be at least -67 dBm in all patient care areas

D. RTLS shall be configured on APs in patient care areas and require tertiary coverage signal strength of at least -75 dBm

a. RTLS shall deliver accuracy of 10 meters with 90 percent precision in all patient care areas

E. APs shall be configured with 802.11k/v/r to facilitate roaming

F. End-to-End latency from a connected device to Cerner Data Center of equal to or less than

100ms for Citrix connection

G. 802.11i/WPA2 shall be used for authentication to assure FIPS 140-2 compliance

H. APs shall be assigned frequency bands such that adjacent and co-channel interference is minimized

I. Adjacent APs shall be connected to diverse TR switches

J. Power over Ethernet (PoE), 802.3at PoE+ (30W per channel at PoE source, 25.5W at PoE device)

K. CAT6A cable to AP compliant with VA Telecommunications and Special Telecommunications

Systems Design Manual and TIA TBS-162-A, Telecommunication Cabling Guidelines for Wireless

Access Points

2.4 Power and Space Design Requirements

Deployment includes a JSA security stack (also known as Network Protection Suite (NPS)) and a Forward Deployed Server (FDS) equipment element in the overall infrastructure requirement.

“Stack” is defined as each grouping of server and network equipment. FDS equipment is provided by Cerner. JSA security stack is provided by OIT. The Enterprise Supply Chain Modernization (ESCM) program is enterprise-wide deployment of the Defense Medical Logistics Standard Support (DMLSS) supply chain management solution, and its successor, LogiCole. DMLSS and LogiCole are dependencies for the OEHRM overall workflow, as such are required before successful go-live.

Server equipment is provided by the DMLSS program office.

A. JSA Security Stack estimated power and space requirements are based on BOM provided to

Seattle IOC site as follows:

Expected Continuous Power Consumption - 208VAC, 11.5A, 2,395W Maximum Utilization Power Consumption - 208VAC, 15.3A, 3,185W

1. Rack space of 11U, contiguous shall be provided in the MDA, near core switches or with the VA LAN Security stack

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i. WAN demarc must be extended to installation location if the JSA is not colocated

ii. Copper or fiber cabling shall be provided between the JSA and Core switches if not collocated

2. Power supporting the JSA Security Stack (NPS) equipment shall be supplied in accordance with sheet 19 or 20 of the OIT Design Guide templates dated 27 December 2018

i. A/B redundant 3-phase 208V Rack PDUs providing 7 A-branch and 7 B-branch IEC type C-13 outlets

ii. A and B branch shall be attached to diverse data center UPSs, each capable of supporting Expected Continuous Power Consumption in 2.4 A

3. Request for variance shall follow the exemption process outlined in Appendix D: JSA and

FDS Power, Space and HVAC Requirement Exemption Process

B. FDS equipment estimated power and space requirements are based on Seattle IOC deployment as follows:

Expected Power Consumption - 208VAC, 33.5A, 6,876W and Maximum Utilization Power Consumption - 208VAC, 47.5A, 9,880W

1. Local Facilities Management shall provide:

i. Space for 3, 8 ft. maximum height, 24 in wide, up to 48 inches deep cabinets

a. At least 2 cabinet spaces shall be located side by side

b. Cabinets shall be secured to floor at facilities where seismic bracing is required (Appendix E: Facilities Requiring Seismic Mitigation in Cabinets)

c. Cable pathway shall be supplied between JSA, FDS and Core switches to support interconnection in accordance with CFM Telecommunications and Special Telecommunications Systems Design Manual

ii. Zone PDUs shall be provided to distribute power to cabinet PDUs, one per two cabinets

a. Zone PDU shall be configured with dual L21-30P connectors

b. Zone PDU shall provide at least 4 L21-20R outlets to support cabinet

PDUs

c. Zone PDUs shall receive power from L21-30R outlets located within 6 feet of the base of the cabinet

iii. Power distribution configuration shall provide paths to diverse data center

UPSs, each capable of supporting the Expected Continuous Power Consumption of 3.5 kW per cabinet

iv. Request for variance shall follow the exemption process outlined in Appendix D:

JSA and FDS Power, Space and HVAC Requirement Exemption Process

2. Cerner shall provide up to 3 cabinets housing the FDS equipment

i. Estimates of Expected Power Consumption and Maximum Utilization Power

Consumption shall be calculated per cabinet and provided to OEHRM 13 months prior to go-live

ii. The FDS equipment shall be installed with systems mounted in agreed upon locations such that cabinets from different facilities have identical layouts

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1. 2U of contiguous space at the base of Rack 1 (and Rack 3 if necessary) shall be reserved for installation of the Zone PDU

iii. Equipment shall be labeled with environment type and network name

iv. Cabinets shall be used exclusively to support EHRM equipment

v. Installed equipment will not exceed total Expected Power Consumption of 3.5 kW per cabinet

vi. Each cabinet shall provide redundant cabinet PDUs

1. Cabinet PDUs shall be configured with L21-20P connectors, consistent with the power distribution topology in the Infrastructure Standards for

Telecommunications Spaces v2.2

2. Cabinet mounted equipment shall have redundant power supplies that shall be connected to redundant cabinet PDUs

vii. Provided cabinets shall be 45RU, 24" nominal width

viii. Blanking panels shall be installed in all open rack units

ix. Cabinets shall be equipped with seismic mitigation when deployed in facilities categorized as Critical and earthquake risk is confirmed by the VA Seismic Safety

Coordinator (Veterans Affairs OCFM H-18-8 Seismic Design Requirements, November 1, 2019) Note: All qualifying facilities are listed in Appendix E:

Facilities Requiring Seismic Mitigation in Cabinets

C. UPS Functional Requirements

1. All UPS units to be functional and adequate in all Telecommunication Rooms (VAMC with 20-minute run-time; other locations with 30-minute run-time) (Reference. The U.S.

Department of Veterans Affairs, Physical Security Design Manual for Mission Critical

Facilities, January 2015)

2. All units within one (1) year of end of life by Facility Go-Live are to be replaced with new units

i. End of Life for stand-alone units assumed to be six (6) years from date placed into service

ii. End of Life for UPS batteries assumed to be three (3) years from date replaced

3. All equipment in TR shall be connected to the critical electrical branch and Emergency

Power / Backup Generator, where required in Mission Critical facilities, in accordance with VHA Directive 1028 FACILITY ELECTRICAL POWER SYSTEMS, dated February 24,

4. UPS shall be managed and report the following information to a management system

a. Battery age

b. Battery charge

c. Battery faults

d. Run-time estimate

e. Instantaneous and average power load information

f. Line power outages and brown-out or low power conditions

D. All Network Switch, JSA and FDS equipment shall be supported by adequate UPS power whether located in Data Center, MDA or TR

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E. New equipment install must comply with Single point grounding per ANSI/NECA/BICSI 607-C, Generic Telecommunications Bonding and Grounding (Earthing) for Customer Premises

November 2015

F. The main facility power feed to the data center must support additional power requirements listed above at paragraph 2.4.A combined with 2.4.B

G. DMLSS equipment estimated power and space requirements are based on Seattle IOC deployment as follows:

Expected Continuous Power Consumption - 208VAC, 1.5A, 320W Maximum Utilization Power Consumption - 208VAC, 2.4A, 500W

1. Rack space of 4U, contiguous, not in Cerner supplied cabinets, shall be provided in the data center near Cerner Top of Rack switches

2. A/B redundant 208V Rack PDUs providing 2 A-branch and 2 B-branch IEC type C-13 outlets

3. This requirement is superseded by DMLSS Technical Requirements when published and will be deprecated when cloud based platform LogiCole becomes available

2.5 Heating, Ventilation, and Air Conditioning (HVAC) Design

Requirements

A. Room temperature and relative humidity values should adhere to the U.S. Department of

Veterans Affairs Office of Construction & Facilities Management HVAC Design Manual, dated

May 1, 2019

1. VA data center environmental requirements are classified as Environmental Class A1 per

American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE)

TC9.9 modified for the VA operating environment, IT equipment inlet temperature range of 72°F to 81°F, humidity ≤ 60 percent noncondensing

2. TR Wiring Closet Class B space temperature range 41°F to 95°F, relative humidity: 8 to

80% noncondensing

i. TR Wiring Closet Environmental Monitoring Solution for temperature and humidity (e.g. Uninterruptible Power Supply (UPS) with Network Management

Card, Temperature & Humidity Sensor, and Central Monitoring by way of a single network connection is required using a RJ-45 Patch Cable)

ii. In areas where there are environmental issues (e.g., steam pipes, lack of ventilation, etc.), the use of thermal curtains and additional vents will be considered as a temporary alternative, not permanent resolution

B. Provide N+1 redundant cooling capacity for the new total thermal load in data centers; Equal to the existing thermal load plus the following additional heat releases as measured in Watts

1. JSA, expected thermal load 2,395W

2. FDS, expected thermal load 6,876W, potential thermal load 10,500W (3 full cabinets)

3. DMLSS, expected thermal load 320W

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4. Request for variance shall follow the exemption process outlined in Appendix D: JSA and

FDS Power, Space and HVAC Requirement Exemption Process

C. Top-of-rack network equipment shall be configured to receive supply air from the front (cold) face of the cabinet. Airflow control measures shall be used to prevent hot air recirculation to device intakes

D. Continuous thermal load should not exceed 3.5 kW for any existing or additional rack or cabinet

E. Blanking panels shall be installed in all open rack units, in Data Center cabinet and racks, to prevent hot exhaust air recirculating to the cold air equipment intake side of the rack. This requirement is shown in the following figure:

Figure 3. Blanking Panel Applications

Reference: Section 3.1.3.1, Data Center Facility Environment Conditioning Standards, Figure 8, page 42, Office of Information & Technology (OIT) Infrastructure Standards for Telecommunications Spaces, Version 2.2, April 10, 2019

2.6 End-User Devices (EUD)

2.6.1 PC and Tablet Requirements

All EUD PCs and Tablets must meet the recommended or greater requirement levels.

A. General EUD PC and peripherals:

1. Processor: Dual or more Core Processor (i5, i7 or equivalent) running at 2.0GHz or greater, Support for AES-NI

2. RAM: 16GB DDR4 SDRAM 2,400MHz

3. Hard Drive: 512 GB NVMe PCIe M.2 SSD (preferable) or 512 GB SSD

4. Display/Graphics: Integrated High Definition (HD) graphics with of 512 MB shared memory or more provided, dedicated memory preferred, Dual Monitor Support

5. Monitor: 22” (minimum) or 24” (recommended), Resolution of 1920 x 1080 or higher and 32-bit color

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i. Appropriate monitor size for locations where physical limitations restrict the use of recommended monitor sizes will be determined on a case by case basis

ii. Display size for laptops and tablets shall meet the end user’s requirements for their intended use. Must support resolution of at least 1920 x 1080

iii. If a docking station is provided the docked monitor shall meet the requirements stated above

6. Network: Network Port 1 GbE, RJ-45. Wireless interface shall support 802.11a/n/ac

(2x2)/ax, 802.11ax preferred

7. Peripheral: 101-key keyboard and mouse or equivalent

8. O/S: Windows 10 Pro 64 with Internet Explorer 11

9. Citrix Receiver: Workspace 1912 LTSR as required by TRM

10. Access: PIV Card Reader.

11. Other Software: VA Image as appropriate

B. Clinical Imaging-Diagnostic Viewing EUD PC and peripherals:

1. Processor: Intel Skylake Hexa Core w/HT Technology 3.7GHz or better

2. RAM: 32GB

3. Hard Drive: 512 GB PCIe NVMe M.2 SSD

4. Display/Graphics: Barco MXRT-5600 or NVIDIA Quadro P2000, Dual Monitor Support

5. Monitor:

i. 22” (minimum), Resolution of 1920 x 1080 or higher, and 32-bit color

ii. 27” monitors, Resolution of 2560 x 1440 or higher, total of 3 monitors is suggested for the optimal workflow, 2 for viewing images and 1 for charting

iii. Appropriate monitor size for locations where physical limitations restrict the use of recommended monitor sizes will be determined on a case-by-case basis

6. Network: Network Port - 1 GbE RJ-45. Wireless is not recommended

7. Peripheral: 101-key keyboard and mouse or equivalent

8. O/S: Windows 10 64-bit

9. Access: PIV Card Reader

C. Clinical Imaging-Technologist EUD PC and peripherals:

1. Processor: Intel Skylake Quad Core w/HT Technology 3.0GHz or better

2. RAM: 16GB

3. Hard Drive: 512 GB PCIe NVMe M.2 SSD

4. Display/Graphics: Barco MXRT-5600 or NVIDIA Quadro P2000, Dual Monitor Support

5. Monitor:

i. 22” (minimum), Resolution of 1920 x 1080 or higher, and 32-bit color

ii. 27” monitors, Resolution of 2560 x 1440 or higher

iii. Appropriate monitor size for locations where physical limitations restrict the use of recommended monitor sizes will be determined on a case-by-case basis

6. Network: Network Port - 1 GbE RJ-45. Wireless is not recommended

7. Peripheral: 101-key keyboard and mouse or equivalent

8. Operating system (OS): Windows 10 64-bit

9. Access: PIV Card Reader

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Cerner Validated

Peripheral List v02202020.xlsx

2.6.2 Other EUD Requirements

All peripheral devices must be validated for use with Cerner Millennium. Use the Cerner Validated Peripheral List (VPL) to assess compatibility. Follow these steps to assess a device:

1. Verify the device Manufacturer and Model are listed (see Figure 4 below for an example)

2. Verify the associated Status column for the device contains A for ‘Active’ status

3. Verify the associated Applications column shows ‘ML’ signifying Cerner Millennium

Figure 4: Determining Validated Peripherals using the Cerner Validated Peripheral List

The VPL can be accessed from one of the following locations:

A. Copy of Cerner VPL hosted by OIT (preferred):

OTI Integration SharePoint - Validated Peripheral List

B. The Original Cerner VPL from Cerner’s Support Website:

https://wiki.cerner.com/display/public/Peripherals/VPL (Requires login)

C. Version at signing:

2.6.2.1 Laser Printer and Multi-Function Printers (MFP) Requirements

A. Laser Printers and MFP devices shall be network attached with a static IP address

B. Laser Printers and MFP devices shall be compatible with (OIT) Printer and Multifunction Device

Secure Configuration Baseline.

2.6.2.2 Wireless EUD Requirements

VA sensitive information, as defined by VA Directive and Handbook 6500, must not be transmitted via wireless technologies unless Federal Information Processing Standards (FIPS) 140-2 validated encryption is installed and operating as intended (VA DIRECTIVE 6512 - SECURE WIRELESS TECHNOLOGY)

A. Exemptions from this requirement are allowed for IOC and Waves 1-8. A Plan of Action and

Milestones (POAM) must be completed and approved by the facility Information System

Security Officer (ISSO) prior to deploying a non-compliant wireless device

2.6.2.3 Mobile EUD Requirements

If the determination is made that Mobile Devices are required, those requirements will be included in this section.

3.

2.

1.

https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/OIT_Integrate/InfrastructureProjects/Forms/AllItems.aspx?FolderCTID=0x012000E04A050D7B145E49BE7D79BFDFA07225&View=%7BF94B5A38%2D2283%2D4D60%2D9A08%2D413CED8DC2C6%7D&id=%2Fsites%2FVACO%2EOEHRMoffice%2FOIT%5FIntegrate%2FInfrastructureProjects%2FSite%20Support%20Information https://wiki.cerner.com/display/public/Peripherals/VPL

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2.7 Voice Over Internet Protocol (VOIP) Device Requirements

A. VOIP Phone / Device network interface shall be capable of 1GbE pass-through

B. Network switches supporting VOIP Phone / Device shall provide Power over Ethernet (PoE), 802.3at PoE+ (30W per channel at PoE source, 25.5W at PoE device)

C. VOIP Phone / Device shall utilize Category 6 or higher patch cable for both connection of EUD to phone and phone to network

2.8 Medical Device Requirements

If the determination is made that Medical Devices require unique supporting infrastructure those requirements will be included in this section.

2.9 Physical Security Design Requirements

Rooms undergoing modifications and upgrades shall comply with current physical security design requirements as follows:

2.9.1 Mission Critical Facilities

A. U.S. Department of Veterans Affairs Office of Construction & Facilities Management

Telecommunications and Special Telecommunications Systems Design Manual, February 2016

B. U.S. Department of Veterans Affairs Physical Security Design Manual for Mission Critical

Facilities, January 2015

C. U.S Department of Veterans Affairs Office of Information & Technology (OIT) Infrastructure

Standards for Telecommunications Spaces Version 2.2 April 10, 2019

2.9.2 Life Protected Facilities

A. U.S. Department of Veterans Affairs, Physical Security Design Manual for Life Protected

Facilities, January 2015

B. U.S Department of Veterans Affairs Office of Information & Technology Infrastructure Standards for Telecommunications Spaces Version 2.2 April 10, 2019

2.10 Joint Security Architecture Requirements

JSA shall be required to provide network connectivity to the Medical Community of Interest (MEDCOI) network for access to Joint Electronic Health Record system hosted within Cerner's data centers.

Additional functionality includes providing advance network protection and visibility into network traffic. Specific requirement can be found in the OEHRM Joint Security Architecture (JSA) Requirements Specifications Document (RSD)

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Appendix A: Acronyms

Acronym Description

AHJ Authority Having Jurisdiction

AITC Austin Information Technology Center

ANSI American National Standards Institute

ASHRAE The American Society of Heating, Refrigerating and Air-Conditioning Engineers

AP Access Point

BICSI Building Industry Consulting Service International

CAN Campus Area Network

CAT5e Category 5e cable

CAT6A Category 6A cable

CBOC Community Based Outpatient Clinic

CIR Committed Information Rate

CLC Community Living Center

CMR Communications Multipurpose Cable, Riser

CMOP Consolidated Mail Order Pharmacy

CPAC Consolidated Patient Account Center

CRH Clinical Resource Hub

CSC Campus Support Center

CSR Current State Review

CSS Central Scheduling Solution

CVT Clinical Video Telehealth

CWDM Coarse Wavelength Division Multiplexing

CWT Compensatory-Work Therapy

DCHV Domiciliary Care for Homeless Veterans

DRRTP Domiciliary Residential Rehabilitation Treatment Program

EHR Electronic Health Record

EoSW End of Software Maintenance

EUD End User Device

FIPS Federal Information Processing Standards

FDP Fiber Distribution Panel

FDS Forward Deployed Servers

GbE Gigabit Ethernet

Gbps Gigabits per second

HA High Availability

HBPC Home-Based Primary Care

HCC Health Care Center

HD High Definition

HEFP Healthcare Environment and Facilities Programs

HT Home Telehealth

Pre-Decisional - OEHRM Site Infrastructure and End User Device Requirements v1.8 Final | 23

HVAC Heating, Ventilation and Air Conditioning

IOC Initial Operating Capabilities

ISSO Information System Security Officer

IT Information Technology

JSA Joint Security Architecture

LAN Local Area Network

LDoS Last Day of Support

Mbps Megabits per second

MDA Main Distribution Area

MEDCOI Medical Community of Interest Network

MFP Multi-Function Printers

MH RRTP Mental Health Residential Rehabilitation Treatment Program

MPO Multi-fiber Push On

NECA National Electrical Contractors Association

NFPA National Fire Prevention Association

NPS Network Protection Suite

OEHRM Office of Electronic Health Record Modernization

OIT Office of Information & Technology

OOS Other Outpatient Services

OS Operating system

PC Personal Computer

PDU Power Distribution Unit

PITC Philadelphia Information Technology Center

PIV Personal Identification Verification

POAM Plan of Action and Milestones

POE Power Over Ethernet

PRRTP Psychosocial Residential Rehabilitation Treatment Programs

PTSD-RRTP Post-Traumatic Stress Disorder Residential Rehabilitation Program

QoS Quality of Service

RSD Requirements Specifications Document

SARRTP Substance Abuse Residential Rehabilitation Treatment Program

SFP Small Form Pluggable

SFT Store and Forward Telehealth

SIP Session Initiation Protocol

SLA Service Level Agreements

SNR Signal-to-Noise Ratio

SM Single Mode

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TIA Telecommunications Industry Association

TR

Telecommunications Room

Transitional Residence

UPS Uninterruptible Power Supply

UTP Unshielded twisted pair

VA Department of Veterans Affairs

VAEC VA Enterprise Cloud

VAMC VA Medical Centers

VAST VHA Site Tracking

VHA Veteran’s Health Administration

VOIP Voice Over Internet Protocol

VPL Verified Peripheral List

VTP Veterans Transportation Program

WAN Wide Area Network

WLAN Wireless LAN

Pre-Decisional - OEHRM Site Infrastructure and End User Device Requirements v1.8 Final | 25

Cabling

Memo_Signed.pdf

OEHRM COVID-19

Revised Deployment Schedule - Infrastructure Readiness Strategy(draft).pdf

Appendix B: References

The following were used as references for this document:

1. U.S Department of Veterans Affairs Office of Construction & Facilities Management

Telecommunications and Special Telecommunications Systems Design Manual February 2016 https://www.cfm.va.gov/til/dManual/dmTelecomm.pdf

2. U.S Department of Veterans Affairs Office of Information & Technology (OIT) Infrastructure

Standards for Telecommunications Spaces Version 2.2 April 10, 2019 https://www.cfm.va.gov/til/dguide/OIT-InfrastrucStdsTelecommSpaces.pdf

3. ANSI/NECA/BICSI 568, Standard for Installing Commercial Building Telecommunications Cabling

4. ANSI/TIA-1179, ANSI/TIA-1179-A Healthcare Facility Telecommunications Infrastructure

5. TIA TBS-162-A, Telecommunication Cabling Guidelines for Wireless Access Points

6. ANSI/NECA/BICSI 607-C, Generic Telecommunications Bonding and Grounding (Earthing) for

Customer Premises November 2015

7. 802.3at-2009 - IEEE Standard for Information technology-- Local and metropolitan area networks-- Amendment 3: Data Terminal Equipment (DTE) Power via the Media Dependent

Interface (MDI) Enhancements

8. 802.11ac-2013 - IEEE Standard for Information technology--Telecommunications and information exchange between systems— Amendment 4: Enhancements for Very High

Throughput for Operation in Bands below 6 GHz.

9. Wireless LAN (WLAN) Standard and WLAN Controller - Secure Configuration Baseline https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Wireless%20L

AN%20(WLAN)%20Standard%20and%20WLAN%20Controller%20-

%20Secure%20Configuration%20Baseline.pdf

10. U.S Department of Veterans Affairs Office of Information and Technology CFM/OIT DESIGN

GUIDE TEMPLATES FOR CRITICAL TELECOMMUNICATIONS SPACES IN CLINICAL AND NON-

CLINICAL ENVIRONMENTS Dec 27, 2018 https://www.cfm.va.gov/TIL/dGuide/OIT-DGTemplates-

CriticalTelecommSpaces.pdf

11. The U.S. Department of Veterans Affairs, Physical Security Design Manual for Mission Critical

Facilities, January 2015 https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySecMC.pdf

12. U.S Department of Veterans Affairs Enterprise Infrastructure Standard: Quality Of Service(QoS) https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/VA%20Enterpr ise%20IT%20Infrastructure%20(QoS)_1-14.pdf

13. U.S. Department of Veterans Affairs Office of Construction & Facilities Management HVAC

Design Manual dated Revised May 1, 2019 https://www.cfm.va.gov/til/dManual/dmHVAC.pdf

14. U.S Department of Veterans Affairs Enterprise Local Area Network (LAN) Technical Architecture

Standard, Version 2.1, February 13, 2019 https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Supporting_Documents/Enterprise

%20Local%20Area%20Network%20(LAN)%20Technical%20Architecture%20Standard_v2.1.pdf

15. VHA Directive 1028 FACILITY ELECTRICAL POWER SYSTEMS, dated February 24, 2020 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8723

VA Systems Engineering Solution - Cerner EHRM Forward-Deployed Servers.pdf https://www.cfm.va.gov/til/dManual/dmTelecomm.pdf https://www.cfm.va.gov/til/dguide/OIT-InfrastrucStdsTelecommSpaces.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Wireless%20LAN%20(WLAN)%20Standard%20and%20WLAN%20Controller%20-%20Secure%20Configuration%20Baseline.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Wireless%20LAN%20(WLAN)%20Standard%20and%20WLAN%20Controller%20-%20Secure%20Configuration%20Baseline.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Wireless%20LAN%20(WLAN)%20Standard%20and%20WLAN%20Controller%20-%20Secure%20Configuration%20Baseline.pdf https://www.cfm.va.gov/TIL/dGuide/OIT-DGTemplates-CriticalTelecommSpaces.pdf https://www.cfm.va.gov/TIL/dGuide/OIT-DGTemplates-CriticalTelecommSpaces.pdf https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySecMC.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/VA%20Enterprise%20IT%20Infrastructure%20(QoS)_1-14.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/VA%20Enterprise%20IT%20Infrastructure%20(QoS)_1-14.pdf https://www.cfm.va.gov/til/dManual/dmHVAC.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Supporting_Documents/Enterprise%20Local%20Area%20Network%20(LAN)%20Technical%20Architecture%20Standard_v2.1.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Supporting_Documents/Enterprise%20Local%20Area%20Network%20(LAN)%20Technical%20Architecture%20Standard_v2.1.pdf https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8723

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16. OEHRM Joint Security Architecture (JSA) Requirements Specifications Document (RSD) – Draft, not publicly available, expected 09/2020 https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/SitePages/Construction_Admn.a spx

17. U.S Department of Veterans Affairs Electronic Health Record Modernization Cabling

Infrastructure (VIEWS 01426385) Executive Decision Memorandum, dated September 23, 2019

(attached)

18. VA Systems Engineering Solution, Cerner EHRM Forward Deployed Servers, dated April 12, 2019

(attached)

19. VA DIRECTIVE 6500 VA CYBERSECURITY PROGRAM Reissue 4 dated January 29, 2019

20. VA DIRECTIVE 6512 SECURE WIRELESS TECHNOLOGY dated October 12, 2017

21. U.S Department of Veterans Affairs Office of Information & Technology (OIT) Printer and

Multifunction Device Secure Configuration Baseline Version 1.4 August 5, 2019 https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Printer%20an d%20Multifunction%20Devices%20Secure%20Configuration%20Baseline.pdf

22. VHA Handbook 1006.02 VHA SITE CLASSIFICATIONS AND DEFINITIONS dated December 30, 2013

23. U.S Department of Veterans Affairs Pharmacy Benefits Management Services https://www.pbm.va.gov/PBM/CMOP/VA_Mail_Order_Pharmacy.asp

24. Consolidated Patient Account Center (CPAC) Supports VA’s commitment to Veteran Healthcare https://www.va.gov/CBO/cbo/cpac/docs/fs_veterans_01.pdf

25. U.S Department of Veterans Affairs Clinical Resource Hub Training and Operations Guide https://vaww.portal2.va.gov/sites/PERC/CR_HUB/CRH_Documents/CRH%20Guidance%20and%

20Overview/Clinical%20Resource%20Hub%20Training%20and%20Operations%20Guide.docx?W eb=1

26. U.S Department of Veterans Affairs VA Health Now “Your Clinical Contact Center” https://www.visn8.va.gov/VISN8/Documents/V08_CCC_InfoSheet_3.pdf

27. OPM Frequently Asked Questions: “What is telework?”

https://www.opm.gov/FAQs/QA.aspx?fid=b48bf83b-440c-4f1e-a88c-

3cdc9d802ac8&pid=75346675-3b92-4aec-831d-58cf5b0e86d2

28. OEHRM Infrastructure Readiness Playbook v2.0 https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/OEHRM

%20Infrastructure%20Readiness%20Playbook%20v2.0%20_Signed.pdf

29. Veterans Affairs OCFM H-18-8 Seismic Design Requirements, November 1, 2019 https://www.cfm.va.gov/til/etc/seismic.pdf

30. VHA DIRECTIVE 1044 ASSIGNMENT AND MAINTENANCE OF STATION NUMBERS AND

ATTRIBUTES dated March 15, 2016

31. CHAMPVA Pharmacy Benefits – Meds by Mail https://www.va.gov/COMMUNITYCARE/programs/dependents/pharmacy/index.asp

32. VA Telehealth Services Fact Sheet https://www.va.gov/COMMUNITYCARE/docs/news/VA_Telehealth_Services.pdf https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/SitePages/Construction_Admn.aspx https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/SitePages/Construction_Admn.aspx https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Printer%20and%20Multifunction%20Devices%20Secure%20Configuration%20Baseline.pdf https://vaww.vashare.oit.va.gov/sites/itops/svcs/sma/BCM/Approved_Baselines/Printer%20and%20Multifunction%20Devices%20Secure%20Configuration%20Baseline.pdf https://www.pbm.va.gov/PBM/CMOP/VA_Mail_Order_Pharmacy.asp https://www.va.gov/CBO/cbo/cpac/docs/fs_veterans_01.pdf https://vaww.portal2.va.gov/sites/PERC/CR_HUB/CRH_Documents/CRH%20Guidance%20and%20Overview/Clinical%20Resource%20Hub%20Training%20and%20Operations%20Guide.docx?Web=1 https://vaww.portal2.va.gov/sites/PERC/CR_HUB/CRH_Documents/CRH%20Guidance%20and%20Overview/Clinical%20Resource%20Hub%20Training%20and%20Operations%20Guide.docx?Web=1 https://vaww.portal2.va.gov/sites/PERC/CR_HUB/CRH_Documents/CRH%20Guidance%20and%20Overview/Clinical%20Resource%20Hub%20Training%20and%20Operations%20Guide.docx?Web=1 https://www.visn8.va.gov/VISN8/Documents/V08_CCC_InfoSheet_3.pdf https://www.opm.gov/FAQs/QA.aspx?fid=b48bf83b-440c-4f1e-a88c-3cdc9d802ac8&pid=75346675-3b92-4aec-831d-58cf5b0e86d2 https://www.opm.gov/FAQs/QA.aspx?fid=b48bf83b-440c-4f1e-a88c-3cdc9d802ac8&pid=75346675-3b92-4aec-831d-58cf5b0e86d2 https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/OEHRM%20Infrastructure%20Readiness%20Playbook%20v2.0%20_Signed.pdf https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/OEHRM%20Infrastructure%20Readiness%20Playbook%20v2.0%20_Signed.pdf https://www.cfm.va.gov/til/etc/seismic.pdf https://www.va.gov/COMMUNITYCARE/programs/dependents/pharmacy/index.asp https://www.va.gov/COMMUNITYCARE/docs/news/VA_Telehealth_Services.pdf

Pre-Decisional - OEHRM Site Infrastructure and End User Device Requirements v1.8 Final | 27

Appendix C: Site Type Definitions and Requirements

Definitions and requirements for VHA sites are described in the following sections. VBA sites will be covered in a separate document. Sites are assigned an Requirement Type aligning with this appendix in the OEHRM Users by Site List managed here (Currently not hosted online, OEHRMUsersByStation-draftv.1 attached for review)

A. VA Medical Center (VAMC)

A VA medical center is a VA point of service that provides at least two categories of care (inpatient, outpatient, residential, or institutional extended care).

B. Health Care Center (HCC) Definition

The HCC is a VA-owned and leased clinic. It is contracted or shared and operates at least 5 days per week. Services provided include primary care, mental health care, and on-site specialty services. They perform ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.

i. The HCC designated as an ambulatory surgery clinic (ASC) must meet the requirements of the assigned surgical complexity level and provide all associated support infrastructure, such as pharmacy, laboratory, and x-ray, to perform these health care services safely and effectively.

ii. The HCC not designated as an ASC but performing invasive procedures under moderate sedation must meet criteria established by VHA Directive 2006-023, Moderate Sedation by Non-

Anesthesia Providers.

iii. The HCC either assigned an ASC designation or performing invasive procedures under moderate sedation or anesthesia must comply with external accrediting bodies’ standards for ambulatory surgery centers and/or provision of anesthesia or moderate sedation.

C. VAMC and HCC with no VAMC Parent Specific Requirements

Requirement Section Applicable Items

2.1 Wide Area Networking (WAN) 2.1.1.2, 2.2

2.2 Local Area Networking (LAN) All

2.3 Wireless LAN (WLAN) Design Requirements All

2.4 Power and…