S02 - ATTACHMENT 10 - Help Guide CBOC RLP Development.pdf

Based on draft VA OEHRM Site Infrastructure Requirements 1.7v2 for signature, 20200909, Doolittle

ELECTRONIC HEALTH RECORD MODERNIZATION Help Guide for CBOC RLPs

Appendix C: Non-VAMC Site Type Definitions and Requirements (CBOCs) VA OEHRM Site Infrastructure Requirements 1.7v2 for signature

Requirement Section Applicable Items

Error! Reference source not found. Error! Reference source not found. 2.1.1.3 A, 2.1.2 A,C,F

0 2.2 Local Area Networking (LAN) 2.2.A- H, J-K, P, R-S

0 2.3 Wireless LAN (WLAN) Design Requirements 2.3 A-C, E-K

0 2.4 Power and Space Design Requirements 2.4 C,E-F 0 2.5 Heating, Ventilation, and Air Conditioning (HVAC) Design Requirements 2.5.A.2

0 2.6 End-User Devices (EUD) 2.6.1 A-C, 2.6.2 All

0 2.7 Voice Over Internet Protocol (VOIP) Device Requirements All

0 2.8 Medical Device Requirements None Applicable

0 2.9 Physical Security Design Requirements 2.9.2

0 2.10 Joint Security Architecture Requirements None Applicable

WAN:

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

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) 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. -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. Performance Category: OM4 Laser Enhanced to 40 GbE; OM3 will be grandfathered 2.

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

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

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. -

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

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.

FDS equipment is provided by Cerner. JSA security stack is provided by OIT.

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

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

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 Telecommunications Infrastructure Specification v.2.2

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

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

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

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. 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. on of 1920 x 1080 or higher and 32-bit color

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 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: 14.9 or later 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. -bit color ii.

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. -bit color ii.

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

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. The version of VPL at time of creation of this document is included in Appendix E: with a link to the most current version. Follow these steps to assess a device:

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

3.

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

3.

1.

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 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.

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: N/A

2.9 Physical Security Design Requirements

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

1.1.1 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: N/A