EMDAT INSYNC 1INTERFACING WITH EMDAT INSYNC IS AN

EMDAT INSYNC 1INTERFACING WITH EMDAT INSYNC IS AN




Technical Design: User Interface



Emdat InSync


EMDAT INSYNC 1INTERFACING WITH EMDAT INSYNC IS AN



1Interfacing with Emdat

InSync is an Emdat developed product that securely moves data between a client’s PC or server and the Emdat servers. It uses a 128-bit Twofish encryption with private key to move data over an internet connection. Its primary purpose is to move voice files resulting from client’s dictations; either from a dictator’s hand-held digital dictation devices or from an organization’s stand-alone dictation server. InSync security allows multiple copies to be running at a client site including a running copy at the dictator’s workstation in the office and at home.

InSync can also be used to move patient demographic and appointment information, Associate information (list of outside providers who are copied on transcriptions) to the Emdat servers and can return transcriptions from Emdat to the client’s server. ShadowLink, another Emdat product, is the preferred method to move this type of data between the client and Emdat, but InSync may be used based on specific client circumstances.

InSync runs on a client’s PC or server under Microsoft’s 2000, 2003, XP, or Vista operating system.

1.1Local Resources

InSync is a service application written using the C++ programming language. It runs as an application on the desktop, but resides in the system tray to be unobtrusive. There is a user interface which is used when configuring the application. Access to the interface requires the client code and password. InSync has a small footprint on the client machine (less than 12 MB); however, additional hard drive space is recommended for temporary storage of dictation files.

1.2Communication

InSync communicates with the Emdat servers over outbound ports 42001, 42002, 42003, and 42004. It creates a connection whenever it has something to communicate to the Emdat server; either voice dictations or data files, or sends a request to the Emdat servers to see if data is available to be downloaded. InSync terminates the connection at the end of each communication.

InSync uses the client ID and password to log into the Emdat servers. All communications use the 128-bit Twofish algorithm with a private key to encrypt messages. The advantage of this method is that all communications are performed using the secured connection which can be established inside of the client’s network; either on the client side of the firewall or within the firewall DMZ zone.

2Dictation Files for Hand-Helds

InSync supports the following hand-held dictation devices.

Recorder Model

Olympus DS-2

Olympus DS-2200

Olympus DS-3300

Olympus DS-330

Olympus DS-2300

Olympus DS-4000

Olympus DS-660

Olympus DS-3000

Olympus DS-5000

Philips 9400i, 9350, 9450, 9600

Configuration of the Olympus is a four-step process and takes 5 minutes. Initially, the Olympus DDS software that came with the recorder is installed. The auto-start DSS application is removed from the Start Folder. Next, the InSync software is downloaded and installed on the PC or server, and finally, InSync is configured with the recorder. This includes identifying the dictator who will use the recorder and the document types. There are also configuration options that allow the recorder to be shared by multiple dictators; when synced with the PC, InSync can ask who’s dictations these are for.

Installation of the Philips recorder is similar except that it uses an Emdat runtime component instead of the Olympus DSS software.

When the hand-held digital recorder is plugged into the PC running InSync with the USB cable, InSync copies the dictations to the PC. It encrypts them and sends them to the Emdat server. When it receives the receipt for the dictations, InSync removes the dictations from the recorder and copies the dictations on the PC to a defined storage folder. This option is configurable with not saving, saving for a specific number of days, or forever. An InSync option can also display the receipt results on the PC screen with the ability for the user to print them for their records.

3Dictation Files for Dictation Servers

InSync also supports moving dictation files from the following dictation servers: DVI, AllScripts, Cerner / Quadris, IQMax, Milner Voice, SRSSoft, Dictaphone, XML Header (formerly AllScripts), Dynamic Voice, DigiRouter, Telewave, Crescendo DigiScribe, Medflow. InSync automatically grabs audio files from a specified folder on the server.

To support these servers, InSync is downloaded and installed. Configuration involves selecting the dictation server and defining where InSync should look for the audio files.

4Messages in a HL/7 Environment

InSync can also move patient demographic and appointment information to the Emdat servers and moves transcriptions from the Emdat servers to the client’s EMR system using the HL7 message format.

For the appointment and demographic information, InSync will listen on a port for incoming messages. It will encrypt and forward these messages to the Emdat servers, where they will be decrypted, parsed, and loaded in the client-specific patient and appointment tables. When receiving data from the client’s system, Emdat is able to accept the fairly standard HL/7 formats. The typical messages used to extract the information are A04 (Outpatient Registration), A01 (Inpatient Admission), A03 (Inpatient Discharge), A06 (Transfer Outpatient to Inpatient), and A08 (Patient information update) messages. Other messages, such as O01 and O02 (order messages), and various SCH (scheduling messages) can also be used.

In a similar fashion, the Emdat transcription exports can be produced in a variety of HL/7 flavors. Some clients prefer flat text with a separate line for every 65 characters of text, each in a unique OBX segment. Others prefer a single OBX segment with linefeeds designated by a tilde character (~). Some require the body of the report in an HTML format; others in an RTF format. Emdat can produce each of these as well as other customized formats.

The Emdat servers produce the proper HL/7 export message at a specific trigger point within the Emdat InQuiry application. The message is encrypted and is queued for delivery. At the client site, InSync queries the Emdat server at recurring intervals and pulls down these HL/7 messages when available. It decrypts the message and then passes it to a specific client-defined IP address and port.

5Other file formats

InSync is also configurable to accept demographic and appointment information in an Emdat-defined fixed-field width text (.TXT) format, a customized fixed-field width text, or a .CSV format. Emdat can also accept many report formats that can be parsed for required information. Instead of listening to a port for an HL/7 message, InSync is configured to look in a specific directory for the file or to look into a network share. When the file is present, the file is encrypted and sent to the Emdat server which decrypts the file, parses the required information, and stores it in the client-specific patient and appointment tables.

Similarly, the transcription export can be created on the Emdat servers in a variety of file formats including Microsoft Work (97-2003), .RTF, and .PDF formats. Patient demographic information from the transcription can be encoded into the file name, file header, or fields such that the EMR system can automatically import and properly post the transcription. The Emdat Server encrypts the transcription and queues the result. InSync queries the server on a recurring basis and, when a file is present, moves the file to the clients system, decrypts it, and stores the file in a specified directory or network share.

6Associate information

Most clients send transcriptions to outside referring physicians, insurance companies, and government or court organizations. The Emdat system saves this address information in a client-specific Associate database. While this database may be updated by hand via Emdat InQuiry or by the transcriptionist in the InScribe application, the InSync product allows this database to be updated from the client’s EMR system’s database of contacts.

The EMR system would produce a fixed-width ASCII .TXT file of all new associates or associate records that have changed. InSync will look for this file in a specified directory at recurring intervals and, if present, will encrypt the file and move it to the Emdat Servers. The file is decrypted at the Emdat servers and the records are added to or updated in the Client’s Associate database.

7Requirements

InSync runs on a client-supplied Server or PC running Microsoft operating system 2000, 2003, or XP, or Vista. The client is responsible for:

The installation involves downloading the InSync installation software from an Emdat website, installing the software, entering a client-specific ID and password into the configuration, and notifying Emdat of the installation.

Emdat is responsible for:



InSync Overview

EMDAT INSYNC 1INTERFACING WITH EMDAT INSYNC IS AN

Emdat, Inc. InSync Overview Page 5





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