SOW Attachment 02 - VA OEHRM Site Infrastructure.pdf

Transforming Health Care for Veterans, Revolutionizing Health Care for All

OEHRM Site Infrastructure and End User Device (EUD) Requirements April 15, 2021 | Version 2.0

OEHRM Site Infrastructure and End User Device Requirements v2.0 | ii

Final Signatures:

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

Paul A. 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

OEHRM Site Infrastructure and End User Device Requirements v2.0 | iii

Pre-Concurrence Signatures:

James D. Bates Chief Engineer Veterans Affairs Office of Electronic Health Record Modernization

Ronald P. Kapise Director, Network Infrastructure Veterans Affairs Office of Electronic Health Record Modernization

James Babe Director, Infrastructure Site Readiness Veterans Affairs Office of Electronic Health Record Modernization

Cynthia A. Doolittle Director, Special Engineering Projects, Healthcare Environmental Facilities Program (HEFP) Veterans Affairs Health Administration

(VHA)

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Table of Contents

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) and Peripherals

2.6.1 Personal Computer (PC) and Tablet Requirements

2.6.2 Other EUD and Peripheral 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 BioMedical Device Requirements

2.8.1 PC and Tablet Requirements

2.9 Physical Security Design Requirements

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 (CBOC) Definitions

E. CBOC and HCC with VAMC Parent Specific Requirements

F. CHAMPVA Meds by Mail Definition

G. Consolidated Mail Order Pharmacy (CMOP) Definition

H. Consolidated Patient Account Center (CPAC) Definition

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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 30

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. Sites with planned Termination or Expiration of lease agreement

R. Call Center Definition

S. Remaining VHA Locations Definition

T. Teleworker with Printer Definition

U. Vet Center, Lease Expiration or Termination, Call Center, Remaining VHA Locations and

Teleworker with Printer Specific 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 the 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 Department of Veterans Affairs (VA) 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) service locations, including Austin Information Technology Center

(AITC) and Philadelphia Information Technology Center (PITC), shall have, at minimum, Dual 10 Gbps circuit with 1 Gbps committed information rate (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 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

Megabits per second (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, the Office of Information & Technology (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.

Figure 1: Minimum Geographic Diversity Circuits with Entry Points

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

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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 Mbps (1 x 100 Mbps) circuit with ≥ 50 Mbps CIR or bandwidth allocation of peak usage plus 50%, whichever is greater for IOC, Wave A, B, C and D

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: (ref. 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) (ref. Technical Architecture Standard Version 2.1, February

13, 2019).

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 (ref. Office of Information & Technology (OIT) Infrastructure Standards for

Telecommunications Spaces, Version 3.0, August 21, 2020).

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E. Performance Service Level Agreements (SLA) 99.99% (per GSA Enterprise Infrastructure

Solutions (EIS) contract 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 (ref. ANSI/TIA-1179 Healthcare Facility

Telecommunications Infrastructure).

1. No immediate action required for existing Category 5e (CAT5e) 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. New installations shall be compliant with ANSI/NECA/BICSI 568, Standard for Installing

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

Telecommunications requiring Category 6A (CAT6A) cable.

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 Power Over Ethernet (PoE) heat accumulation.

i. Alternatively, new unshielded twisted pair (UTP) cabling shall carry a UL listed

"LP" (Limited Power) rating.

D. All patch cables shall be Category 6A for copper, OM4 for multi-mode fiber or OS2 level for single mode fiber.

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. Gigabit Ethernet (GbE) connectivity to desktops, and other EUDs.

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)

(ref. 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 shall 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 shall have an interconnection speed of 10 Gigabits per second (Gbps) or greater.

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

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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. Inside Plant (ISP) Fiber (Horizontal and First Level Backbone).

1. Performance Category: OM4 up to 400M (1312 ft.) in length; OM3 up to 300M (984 ft.)

in length will be grandfathered.

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

ii. Mode: Multimode.

iii. Smoke Rating.

a. Communications Riser (CMR) rated for vertical runs through floors

b. Communications Plenum (CMP) rated for plenum spaces

c. Communications minimum (CM) jacket rating suitable when riser or plenum are not required

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

iv. Jacket Color: Aqua.

v. Termination Method: Pre-terminated (Long run cables and campus network cables will have terminations completed in the field, as required).

vi. Media Connector: Multi-fiber Push On (MPO).

vii. Strand Count: 12 or 24 per assembly.

viii. Bundling: Dielectric, Tight Buffered.

ix. Polarity: Straight (or Type A-Key up one end & key down on the other) for LC cassette breakout.

2. Performance Category: OS1 for distances greater than 400M when used as an alternative to OM4, 300M for OM3.

i. Performance Specifications: Laser Optimized 9/125 µm with effective modal bandwidth of at least 850 MHz∙km at 1310 nm.

ii. Mode: Singlemode.

iii. Combustion Rating.

a. Riser cable for vertical runs through floors

b. Plenum rated for plenum spaces

c. Tight-buffered

d. Or as per AHJ requirement

iv. Jacket Color: Yellow.

v. Termination Method: Factory pre-terminated (Long run cables and campus network cables will have terminations completed in the field, as required).

vi. Media Connector: MPO.

vii. Strand Count: 12 or 24 per assembly.

viii. Bundling Dielectric: Tight Buffered.

ix. Polarity: Straight (or Type A-Key up one end & key down on the other) for LC cassette breakout.

3. For new construction, intrabuilding connectivity needs to be 24 strand fiber on both the

A and B sides diversely routed to each TR in the building.

M. Outside Plant (OSP) Fiber (Backbone).

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1. Performance Category: OS2.

i. Performance Specifications: Laser Optimized 9/125 µm with effective modal bandwidth of at least 850 MHz∙km at 1310 nm.

ii. Mode: Singlemode (SM).

iii. Combustion Rating.

a. Riser cable for vertical runs through floors

b. Plenum rated for plenum spaces

c. Loose-tube gel-filled OS2 riser rated for OSP indoor/outdoor transition

d. Or as per AHJ requirement

iv. Jacket Color: Yellow.

v. Termination Method: Factory pre-terminated (Long run cables and campus network cables will have terminations completed in the field, as required).

vi. Media Connector: MPO.

vii. Strand Count: 12 or 24 per assembly.

viii. Bundling Dielectric: Loose-tube gel-filled.

ix. Polarity: Straight (or Type A-Key up one end & key down on the other) for LC cassette breakout.

x. For new construction, interbuilding connectivity needs to be in 24 strand fiber groups on both the A and B sides diversely routed to each TR in the building.

a. Twenty percent of new fiber shall remain uncommitted to support future need, break/fix and equipment lifecycle management.

N. All Campus Area Network (CAN) fiber connections shall be home run back to the main distribution area/fiber distribution panel (FDP).

1. Fiber connections at building shall not be run through additional buildings unless pass-through; do not use daisy-chained segments.

O. CAN shall have minimum of 10 Gbps LAN links between buildings 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

Gigabit Ethernet (GbE) fiber or better; NOTE: Not required for Go Live at IOC facilities.

Q. New CSC construction, modification and expansion shall conform to TIA 942 Rating 3 (ref. Office of Information & Technology (OIT) Infrastructure Standards for Telecommunications Spaces, Version 3.0, August 21, 2020).

R. Network Infrastructure devices supported by Uninterruptible Power Supply (UPS) and

Emergency Power / Backup Generator.

S. Performance SLA 99.9% excluding scheduled downtime.

2.3 Wireless LAN (WLAN) Design Requirements

Requirements in this section serve to clarify and augment previously signed OEHRM program requirements (ref. Wireless Network Infrastructure Systems Requirements v1.1) In the event there is a conflict the previously signed requirements take precedent.

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A. 802.11ac & 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 Signal-to-

Noise Ratio (SNR) minimum of 25 dB.

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

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

E. End-to-End latency from a connected device to Cerner Data Center of equal to or less than 90ms for Citrix connection.

F. All wireless network infrastructure shall be validated as Federal Information Processing

Standards (FIPS 140-2) compliant.

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

H. PoE, 802.3at PoE+ (30W per channel at PoE source, 25.5W at PoE device).

I. 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 Joint Security Architecture (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 dependent on the Joint Security Architecture that is installed in sequence with the Cerner wave schedule. DMLSS and LogiCole have power requirements that should be considered during scope development of VHA EHRM physical infrastructure upgrades Server equipment is provided by the DMLSS program office.

A. VAMC JSA Security Stack estimated power and space requirements are based on equipment provided to Seattle IOC site as follows:

Expected Continuous Power Consumption - 208VAC, 11.5A, 2,395W2 Maximum Utilization Power Consumption - 208VAC, 15.3A, 3,185W

1. Rack space of 11U, contiguous shall be provided in the Main Distribution Area (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 co-located.

ii. Fiber cabling shall be provided between the JSA, Core switches and FDSS if not co-located.

2 Power estimates allow 20% additional capacity to allow for lifecycle management including supporting infrastructure, such as network switches

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2. Power supporting the JSA Security Stack 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 Power Distribution Units (PDU) 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, 6,876W2 Maximum Utilization Power Consumption - 208VAC, 47.5A, 9,880W

1. Site shall provide:

i. Space for 3, 7.5 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

d. Facilities using high density containment designs dependent upon uniform cabinet styles shall provide or reserve site-compatible empty cabinets sufficient for FDS deployment

ii. Zone PDUs shall be provided to distribute power to cabinet PDUs, one per two cabinets (ref. ref. Office of Information & Technology (OIT) Infrastructure

Standards for Telecommunications Spaces, Version 3.0, August 21, 2020

Appendix B).

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

d. CSCs with busway power distribution systems are exempt from this requirement

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.

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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.

a. 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.

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

Telecommunications Spaces v3.0

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

vii. Provided cabinets shall be at maximum 45RU, 24" nominal width, no more than

48” deep with perforated front and rear door.

a. Facilities using high density containment designs dependent upon uniform cabinet styles shall provide or reserve site-compatible empty cabinets sufficient for FDS deployment

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

ix. Cabinets shall be equipped with seismic mitigation meeting GR-63-CORE seismic

Zone 4 standard 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 are to be functional and adequate providing 10-minute run-time (ref.

Physical Security and Resiliency Design Manual OCTOBER 1, 2020, Revised January 1, 2021, Infrastructure Standard for Telecommunications Spaces Version 3.0 August 21, 2020).

i. Runtime shall be calculated based on 100% of rated UPS Output (kW).

ii. Actual load on the UPS shall be limited to 85% of load capacity.

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

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

ii. End of Life for UPS batteries is 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

OEHRM Site Infrastructure and End User Device Requirements v2.0 | 15 with VHA Directive 1028 FACILITY ELECTRICAL POWER SYSTEMS, dated February 24, 2020.

4. UPS shall support both monitoring and remote management to include:

i. Full compliance with RFC-1628 - UPS Management Information Base.

ii. Support for Simple Network Management Protocol (SNMP) v3.0, BACnet and

Modbus protocols.

5. Be connected to a monitoring system by ethernet (wired or wireless) connection or serial interface (RS-232 or RS-485).

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

i. Overload (critical).

ii. Battery temp (critical).

iii. Low Battery.

iv. Battery Failure (critical.)

v. Other Critical Conditions as available (fan failure, internal fault, bypass).

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

E. All grounding shall comply with ANSI/NECA/BICSI 607-C, Generic Telecommunications Bonding and Grounding (Earthing) for Customer Premises, November 2015. Bonding for telecommunications equipment must be performed per manufacturer's specifications.

Upstream bonding requirements to the SBB or PBB must use two lugs.

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 and 2.4.G.

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 shall 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)

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

i. Environmental Monitoring and Management solution shall be provided for data centers.

2. TR Class B space temperature range 41°F to 95°F, relative humidity: 8 to 80% noncondensing.

i. Racks with powered OIT equipment shall have an environmental monitor sensor within 6 feet of rack.

a. Temperature and Humidity Sensors shall be centrally monitored for compliance with environmental requirements

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 2,395W3.

2. FDS, expected thermal load 6,876W3, potential thermal load 10,500W (3 full cabinets).

3. DMLSS, expected thermal load 320W.

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 shall not exceed 3.5 kW for any existing or additional rack or cabinet.

3 Cooling estimates allow 20% additional capacity to allow for lifecycle management including supporting infrastructure, such as network switches

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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: (ref. Office of Information & Technology (OIT) Infrastructure Standards for Telecommunications Spaces, Version 3.0, August 21, 2020).

2.6 End-User Devices (EUD) and Peripherals

A. All devices assessed as not meeting the requirements in this section shall be replaced with devices meeting or exceeding the most current specification as attached to the OEHRM End

User Device (EUD) Deployment Plan.

2.6.1 Personal Computer (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, 32Gb preferred.

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

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.

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Cerner Validated

Peripheral List v02202020.xlsx

a. Laptops may be requested with up to 17 inch display

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: Personal Identification Verification (PIV) Card Reader in the body of the tablet, or laptop. For EUD desktop PC PIV reader in the keyboard preferable or as an attachment.

11. Other Software: VA Image as appropriate.

2.6.2 Other EUD and Peripheral Requirements

All peripheral devices must be validated for use with Cerner Millennium. Use the Cerner Validated Peripheral List (VPL) to assess compatibility.

Copy of Cerner VPL hosted by OIT (preferred):

OTI Integration SharePoint - Validated Peripheral List The Original Cerner VPL from Cerner’s Support Website:

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

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

A. Laser Printers and Multi-Function Printers (MFP) devices shall be network attached with a static

IP address.

1. Laser printers directly attached to the 724 DTV PC for use during a WAN/LAN outage are exempted from this requirement.

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

A. VA sensitive information, as defined by VA Directive and Handbook 6500, must not be transmitted via wireless technologies unless the data is encrypted by a FIPS 140-2 validated cryptographic library. (VA Directive 6512 - Secure Wireless Technology) Exemptions from this requirement are allowed for IOC and Waves A-H. 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.

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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2.6.2.3 Mobile EUD Requirements

Devices must be on the list of approved mobile devices in the latest signed OEHRM Mobile Devices for Clinical Care Requirements Specifications Document, Mobile Device Requirement 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 PoE, 802.3at PoE+ (30W per channel at

PoE source, 25.5W at PoE device).

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

2.8 BioMedical Device Requirements

2.8.1 PC and Tablet Requirements

A. 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.

B. 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. Monitors:

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.

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

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

9. Access: PIV Card Reader.

C. Anesthesiologist EUD PC and peripherals:

1. Processor: Intel Skylake Quad Core w/HT Technology 2.4 GHz or better, Support for AES-

NI and TPM 2.0.

2. RAM: 32 GB DDR4.

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

4. Display/Graphics: Intel HD Graphics 530 with 512MB memory, Dual Monitor Support.

5. Monitor:

i. 24” touchscreen Resolution of 1920x1080, and 32-bit color.

ii. PCAP multi-touch support.

6. Network: Wireless 802.11a/n/ac (2x2)/ax, 802.11ax preferred, Bluetooth 4.3LE.

7. Enclosure:

i. Meet IP65 standard for protection from dust, oil and other non-corrosive materials from the front.

ii. Meet IPx1 standard for protection from falling or dripping water from the rear.

iii. Antimicrobial and washable.

iv. Fanless Chassis.

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

9. Access: PIV Card Reader.

2.9 Physical Security Design Requirements

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

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

Telecommunications and Special Telecommunications Systems Design Manual, February 2016.

B. Physical Security and Resiliency Design Manual OCTOBER 1, 2020, Revised January 1, 2021 U.S

Department of Veterans Affairs Office of Information & Technology (OIT) Infrastructure

Standards for Telecommunications Spaces Version 3.0 August 21, 2020.

2.10 Joint Security Architecture Requirements

A. 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 technical requirements are found in the OEHRM Joint

Security Architecture (JSA) Requirements Specifications Document (RSD).

B. Power, space and HVAC shall be provided in support of the current “Small” JSA form factor for all assessed locations not receiving Forward Deployed Server equipment.

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1. In the event equipment planned for deployment exceeds Expected Continuous Power

Consumption of 400 W, or 3 Rack Unit (3U) of physical space an assessment of UPS, power distribution and rack configuration shall be required prior to deployment.

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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 or Category 5 enhanced cable

CAT6 Category 6 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

CMP Communications Multipurpose Cable, Plenum

CM Communications Multipurpose Cable, Minimum

CPAC Consolidated Patient Account Center

CRH Clinical Resource Hub

CSC Campus Support Center

CSR Current State Review

CVT Clinical Video Telehealth

CWDM Coarse Wavelength Division Multiplexing

CWT Compensatory-Work Therapy

DCHV Domiciliary Care for Homeless Veterans

DMLSS Defense Medical Logistics Standard Support

DRRTP Domiciliary Residential Rehabilitation Treatment Program

EHR Electronic Health Record

EIS Enterprise Infrastructure Solutions

ESCM Enterprise Supply Chain Modernization

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

OEHRM Site Infrastructure and End User Device Requirements v2.0 | 23

HBPC Home-Based Primary Care

HCC Health Care Center

HD High Definition

HEFP Healthcare Environment and Facilities Programs

HT Home Telehealth

HVAC Heating, Ventilation and Air Conditioning

IOC Initial Operating Capabilities

ISSO Information System Security Officer

ISP Inside Plant

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

OSP Outside Plant

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

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SFP Small Form Pluggable

SFT Store and Forward Telehealth

SLA Service Level Agreements

SNMP Simple Network Management Protocol

SNR Signal-to-Noise Ratio

SM Single Mode

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

OEHRM Site Infrastructure and End User Device Requirements v2.0 | 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 3.0 August 21, 2020 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. VA OEHRM Wireless Network Infrastructure Systems Requirements v1.1 https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/

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. Physical Security and Resiliency Design Manual OCTOBER 1, 2020, Revised January 1, 2021 https://www.cfm.va.gov/til/PhysicalSecurity/dmPhySec.pdf

12. U.S Department of Veterans Affairs Enterprise Infrastructure Standard: Quality Of Service(QoS) version 1.14 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 March 1, 2020 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://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/ https://www.cfm.va.gov/TIL/dGuide/OIT-DGTemplates-CriticalTelecommSpaces.pdf https://www.cfm.va.gov/TIL/dGuide/OIT-DGTemplates-CriticalTelecommSpaces.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) – https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/SitePages/Construction_Admn.a spx

17. OEHRM Mobile Devices for Clinical Care Requirements Specifications Document – https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/SitePages/Construction_Admn.a spx

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

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

(attached)

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

(attached)

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

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

22. 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

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

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

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

26. 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

27. 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

28. 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

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

30. OEHRM End User Device (EUD) Deployment Plan v2.0 March 2020 https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/

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

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

ATTRIBUTES dated March 15, 2016

33. CHAMPVA Pharmacy Benefits – Meds by Mail https://www.va.gov/COMMUNITYCARE/programs/dependents/pharmacy/index.asp 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://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/ https://dvagov.sharepoint.com/sites/VACO.OEHRMoffice/Misc/Construction_ANCMTS/ https://www.cfm.va.gov/til/etc/seismic.pdf https://www.va.gov/COMMUNITYCARE/programs/dependents/pharmacy/index.asp

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34. VA Telehealth Services Fact Sheet…