Cardio Server ECG Management System

• Question: Can Cardio Server manage other modalities besides ECG data? 

• Answer: Yes. Cardio Server manages data from 25 different modalities including resting ECG, 12-lead ECGs from bedside monitoring, Holter, stress testing, pulmonary function testing, event monitoring, pacemaker follow-up, cardiac rehab, defibrillators, ambulatory blood pressure, EEG, non-invasive vascular and more. We are eager to add other modalities that you may require. 

   

• Question: What device manufacturers can Cardio Server accept data from? 
• Answer: We communicate with over 260 devices from over 80 vendors. Check our compatibility page for the current list of interfaces.

• Question: If one of our modalities is not currently supported, will you add it to your integration library? 
• Answer: Yes, we are always looking to expand the list of our integrated modalities and vendors. Just introduce us to your vendor and encourage them to work with us to create an interface. We’ll do the rest.

• Question: How many ECGs can you store in Cardio Server? 
• Answer: ECG storage is a function of disk space on your servers; you can add space as you desire. Cardio Server can manage millions of ECGs with standard network technology. 

• Question: What tools does Cardio Server offer to encourage online interpretation? 
• Answer: Cardio Server provides the most comprehensive editing functions in the industry and includes drop-down menus with favorite check boxes, free text, macros, voice-recognition support, electronic calipers and intelligent serial comparison. Different favorites lists may be created for each physician in each reported modality. 

• Question: Can our physicians have their own unique, customized favorite interpretive phrase list? 
• Answer: Yes. We find that physicians use about 50 interpretive phrases most of the time. We enable each reading physician to easily customize their own list for each supported modality. 

• Question: Does Cardio Server support scanning in previous ECGs and other diagnostic tests? 
• Answer: Yes. The PDF Naming Wizard enables Cardio Server to import PDFs of diagnostic test results that are randomly named and convert them into well-named exams with patient demographics, modality designations, date and time stamps, and physician interpretations. Once the studies are confirmed, they can be sent to your EMR. 

• Question: Can we interface multiple ECG vendors simultaneously across multiple hospitals, clinics, and physician practices? 
• Answer: Yes, and we support modality worklists with all the major ECG vendors. 

• Question: Can you transfer the 12-lead ECG interpretive algorithm statements from my cardiograph into Cardio Server? 
• Answer: Yes. If you are transferring ECGs with interpretations from a manufacturer's cardiographs, the statements and measurements pass through to Cardio Server without modification. 

• Question: Does Cardio Server’s analysis criteria match the algorithm from third-party cardiographs? 
• Answer: Yes. It will display the interpretive statements and measurements generated by your existing cardiographs. 

• Question: Does Cardio Server offer serial comparison reporting for 12-lead ECGs? 
• Answer: Yes. Our intelligent serial comparison tool provides additional information to the reading physician indicating changes between the current ECG and the most recent tracing as confirmed by the reading physician. 

• Question: Will Cardio Server’s serial comparison reporting for 12-lead ECGs work with my migrated ECG data? 
• Answer: Yes. Migrated ECG data is received in Cardio Server as though it was originally processed by our system. 

• Question: Will serial comparison reporting for 12-lead ECGs work with my existing cardiographs (GE, Philips, Mortara, Welch Allyn, Burdick, Cardiac Science, Schiller, Nihon Kohden, etc.)? 
• Answer: Yes. Serial comparison works with legacy cardiographs without interfering with the original interpretations and measurements from those devices. 

• Question: As we buy and/or upgrade existing equipment, will Cardio Server be compatible and be able to take advantage of the new features? 
• Answer: If your vendors are open in design and update their export functions to include the new features, then we will continue to be compatible. Cardio Server currently accepts data from over 260 devices, in 25 different modalities, from more than 80 vendors. 

• Question: Are the current interpretive analyses and measurements from our cardiographs used and displayed in Cardio Server? 
• Answer: Yes. We support modality worklists for Baxter (legacy Welch Allyn/Mortara) GE, Philips, Schiller and Nihon Kohden cardiographs. If you prefer another vendor for cardiographs, please encourage them to demonstrate open architecture and share their order formats with us. We are eager to work with all the major suppliers. 

• Question: Can Cardio Server send orders to cardiographs? 
• Answer: Yes. The system displays the interpretive statements and measurements generated by your existing cardiographs. 

• Question: Can Cardio Server display ECGs in our preferred format such as 3x4 with a rhythm strip, 6x2, 12x10, etc.? 
• Answer: Yes. The format saved by your cardiograph is presented in Cardio Server. 

• Question: Is Cardio Server just an "electronic, paper-storage database" or does it provide real ECG data management? 
• Answer: Cardio Server is a comprehensive ECG and diagnostic test result data management system. Cardio Server stores the raw ECG file; enhances workflow; allows physician online editing; supports automatic printing, email notification and report distribution; offers electronic calipers; and provides management tools for data analysis. 

• Question: Does Cardio Server store the raw ECG file or just a picture (PDF) of the 12-lead ECG? 
• Answer: The raw ECG files are kept for a short period of time; we render the PDF file as needed in real time. We store the raw ECG data in our binary format. 

• Question: Can Cardio Server provide online electronic calipers that function with ECGs from my existing cardiographs? 
• Answer: Yes. Since we transfer the raw ECG file to Cardio Server, new measurements can be made with our online calipers. 

• Question: If we decide to replace Cardio Server in the future, can our ECGs be migrated to another ECG management system? 
• Answer: Yes. 

• Question: Does Cardio Server use Carl Osborne's Datamed format translators from Engineering Solutions, Inc.? 
• Answer: Yes. For some vendors' 12-lead ECG data, we use Datamed format translators. Datamed translators are fully integrated into Cardio Server and do not require additional hardware.  

Customers of GE, Philips, Siemens, Heartlab and Cardiac Science also use Datamed. The patient monitoring customers for GE and Philips are two of the largest users for Datamed because it allows Philips' patient monitoring to export to MUSE and GE patient monitoring to export to Philips IntelliSpace ECG. 

• Question: Is Cardio Server compatible with virtual environments? 
• Answer: Yes. Virtualized servers such as VMware, Citrix XenServer and Windows Server Hyper-V are supported. 

• Question: How many concurrent users does Cardio Server support? 
• Answer: Cardio Server is scalable from three to 250 concurrent users. A concurrent user is not a seat license as with some other systems. Instead, a concurrent user is anyone accessing the application simultaneously with others. 

• Question: How does Baxter (formerly Epiphany) address security? 
• Answer: We contract with consultants to identify system vulnerabilities. Those vulnerabilities that can be patched are released for the current version. Those that cannot be patched are addressed in the next release. This is an ongoing process to keep up with the evolving security threats. 

• Question: Does Cardio Server support large independent delivery networks? 
• Answer: Yes. We offer broad flexibility to enterprise medical systems with multiple hospitals, clinics and physician practices. Cardio Server supports different levels of complexity and workflow between various sized facilities within your network. 

• Question: Does Cardio Server support sites in multiple time zones? 
• Answer: Yes. 

• Question: Is Cardio Server compatible with Microsoft.Net architecture? 
• Answer: Yes. Cardio Server is compatible with Microsoft.Net, but we do not require it. 

• Question: Is Cardio Server compatible with Microsoft.Net architecture? 
• Answer: Yes. Cardio Server is compatible with Microsoft.Net, but we do not require it. 

• Question: Is Cardio Server a web-based, true thin client application? 
• Answer: Yes, Cardio Server is web-based pure internet information service. All functions such as reading, editing and printing can be done from any PC on your network, subject to user privileges. No downloadable applets are required, and all terminals on the network have full functionality. 

• Question: What does it mean for Cardio Server to be "web-based"? 
• Answer: Web-based means Cardio Server runs in a standard web browser environment without ActiveX, Flash or .Net. It also means interventionalists can view STEMI with the previous ECGs on iOS smart devices. 

• Question: What are Cardio Server Mobile’s capabilities? 
• Answer: Cardio Server Mobile is a responsive web technology that enables providers to access and edit ECG data from anywhere with iOS or Android devices. 

• Question: Can we use our existing VPN technology for remote access to Cardio Server? 
• Answer: Yes. VPN is an excellent way to provide physicians and others access to their ECG data from home or office. 

• Question: Can we use our existing SAN, NAS, tape or other backup system with Cardio Server? 
• Answer: Yes. Simply add Cardio Server to your regular backup procedures. 

• Question: Can we use our existing SAN for the live database storage? 
• Answer: Yes.  

• Question: Does Cardio Server support Active Directory for single sign on and authentication? 
• Answer: Yes.  

• Question: Is LDAP-based authentication compatible with Cardio Server? 
• Answer: Yes.  

• Question: Is our preferred virus protection plan compatible with Cardio Server? 
• Answer: Yes. Cardio Server is a web application running on your infrastructure. 

• Question: What database program does Cardio Server use? 
• Answer: Cardio Server uses MySQL. 

• Question: How much system administrator support is required by Cardio Server? 
• Answer: Cardio Server requires little day-to-day maintenance. Chief maintenance tasks include patch management, backup oversight, virus protection maintenance and periodic log review. Note that these recommended practices are generally no different than standard support for any other server; Cardio Server does not require specialized “care and feeding.” 

• Question: Can Cardio Server take orders from and send results (including waveforms) to our EMR? 
• Answer: Yes. Cardio Server can support 25 different modality types into your EMR with one bidirectional interface. Cardio Server has its own internally developed HL7 tool that allows us to customize inbound and outbound HL7 messages to your specifications. It is currently deployed to all major EMRs, including Affinity, Allscripts, Athena, Centricity, Cerner, Clinview, CPSI, eClinical, Eclipsys, Epic, HMS, Iatric, Keane, McKesson, Medhost, NextGen, Opus, Prognosis, Pulse, Quadramed, Vista, Siemens, Meditech, Heartland and ChartMaxx. 

• Question: Can I view ECG data within my cardiology PACS system? 
• Answer: Yes, in most cases. Cardio Server supports an application program interface (API) link and other technologies to receive requests from cardiology PACS to display 12-lead ECGs and other reports within the PACS viewer. 

• Question: What is an application program interface (API)? 
• Answer: An API is the interface that an application provides to allow other computer programs to request services as well as allow data to be exchanged between them. In the case of Cardio Server, an API could be used to access ECGs from your PACS. 

• Question: Is an extra server required to interface to cardiographs? 
• Answer: Yes. Two manufacturers’ devices that Cardio Server integrates with do require ELI Link or GE DICOM Gateway Pro. 

• Question: Can legacy Epiphany (now Baxter) migrate ECG data from other ECG management systems? 
• Answer: Yes. We have also migrated millions of ECGs from MUSE, TraceMaster/IntelliSpace, Cerner and Pyramis. 

• Question: Does Baxter provide 24/7 support? 
• Answer: Yes. 

• Question: Are upgrades, updates, new versions etc. included in the support agreement? 
• Answer: Yes. All upgrades are included with an active support agreement. Professional service fees are applied for project management and implementation services. Third-party license upgrades, such as Microsoft Operating systems, and hardware are the user's responsibility, however. 

• Question: Do you have local support for our installation? 
• Answer: You provide your own server hardware. Your IT department is the front line of hardware support, and we provides secure, remote software support. Our entire application can be remotely installed and entirely rebuilt in the event of a catastrophic failure. We support over 1,100 systems worldwide. 

• Question: Do I need to print and scan the rhythm strips? 
• Answer: No. Baxter’s RSM solution imports the rhythm strips without the need for paper printing, duplicating or manual scanning. 

• Question: Does RSM support multiple-format rhythm strips? 
• Answer: Yes. Report format is configured by the monitoring system. RSM will accept the format your hospital most commonly uses. 

• Question: Will I be able to see the rhythm strips in the patient’s chart in Epic? 
• Answer: Yes. RSM will export the rhythm strips automatically as a PDF file. This is handled as a non-solicited order. 

• Question: Can I search in RSM for a patient’s rhythm strips and print them for clinical evaluation? 
• Answer: Yes. RSM will keep all rhythm strips for a predetermined number of days; this number is set at the time of implementation. The strips can be printed as well. Most often, clinical evaluation is done within the EMR. 

• Question: How long will strips remain in RSM? 
• Answer: Yes. Rhythm strips may be sent directly to the EMR and/or retained in Cardio Server's RSM solution for a specified number of days. Based on the volume of studies processed daily and the storage capacity allocated by the hospital’s IT team during project implementation, the strips may be retained by RSM for as long as needed. 

• Question: How much will our hospital save if we implement RSM? 
• Answer: Hospital workflows vary, and every department has its unique way of managing rhythm strips. By reducing, or in many cases eliminating, the need to print the rhythm strips, the hospital saves substantially on the cost for thermal paper and 8.5” x 11” copy paper. The hospital also saves labor costs by eliminating the manual work necessary for printing, cutting, pasting, photocopying and scanning the rhythm strips into the hospital’s EMR. 

• Question: Our hospital already has Cardio Server. Can RSM be installed on the same server? 
• Answer: Yes. Please contact your representative to confirm your specific configuration. 

• Question: Can RSM handle more than one rhythm strip per patient? 
• Answer: Yes. RSM supports an unlimited number of rhythm strips per patient. 

• Question: Does RSM support a mixed environment of Philips PIIC Classic and PIIC Information Centers? 
• Answer: Yes. Hospitals may have a combination of Philips Information Centers. RSM will support both Philips PIIC Classic and Philips PIIC iX systems. 

• Question: Can RSM send the rhythm strips directly to the EMR? 
• Answer: Yes. RSM is configured as a pass-through system, enabling the strips to be sent directly to the EMR and eliminating the need for the user to log-in to RSM to retrieve or validate a rhythm strip. 

• Question: Can any other hospitals see my data? 
• Answer: No, our cloud implementation is single tenancy meaning one hospital system to a virtual server. 

• Question: Who is the cloud service provider? 
• Answer: Microsoft Azure is our cloud service provider. 

• Question: Do you provide “high availability” server technology in the cloud? 
• Answer: Yes. 

• Question: Where would my data be located? 
• Answer: Your production environment and storage would be in the Azure server farm located centrally to your hospital system. https://azure.microsoft.com/en-us/. 

• Question: Is a test environment available? 
• Answer: Yes. A test system is available during implementation, testing and upgrades. Continuous availability is an option. 

• Question: Who manages backups and disaster recovery? 
• Answer: Baxter is responsible for managing your system. An image of your system is maintained at an alternate Azure location from your production system. 

• Question: Is my data encrypted in the cloud? 
• Answer: Yes, it is encrypted in the cloud and when transmitted through the VPN. 

• Question: Are anti-virus and malware protection tools included? 
• Answer: Yes. We use Microsoft Azure’s anti-virus and malware protection tools. 

• Question: What happens if I am not satisfied with Cardio Server in the cloud? 
• Answer: We will roll your system to your in-house server technology at no additional expense. 

• Question: Is Cardio Server in the cloud HIPAA compliant? 
• Answer: Yes. Baxter has strict HIPAA compliance throughout our organization, and that includes the cloud. 

• Question: How is the system accessed in the cloud? 
• Answer: There is an encrypted VPN from the hospital to Cardio Server and another encrypted VPN from Baxter to the system for support. 

• Question: Will I need any server technology installed at our hospital? 
• Answer: Maybe. Some cardiograph vendors use a gateway server that would need to be on site. 

• Question: Are there any additional expenses beyond the Cardio Server Cloud subscription cost and onsite training? 
• Answer: There may be minimal additional expenses. The VPN and possibly the gateway server are required by some cardiograph vendors. Patches, upgrades, third-party software and hardware updates are included, however. 

• Question: Is it true that transferring from carts to an ECG management system other than that of the cart manufacturer will void your cart warranty? 
• Answer: No. We have many sites with carts transferring to Cardio Server without voiding the warranty. 

• Question: Can Cardio Server accept wireless transfer from MAC 5000/5500 cardiographs? 
• Answer: Yes. We have hundreds of GE carts transmitting ECGs wirelessly to Cardio Server. 

• Question: How does Cardio Server import device data? 
• Answer: Most of our modality imports have both alpha/numeric feeds and waveform PDFs. Supported formats include DICOM, XML, HL7 and PDF. When we receive the alpha/numeric data, we post it into editable fields. This is so much more than simply taking a PDF in for storage. 

When we get only a PDF, we are doing much more to support our customers. Our PDF import tool allows the importation of any PDF to Cardio Server where we create a new modality in the database and populate all demographics with an ADT or orders feed. Our tool provides a flexible workflow, including a cover page for physician interpretation, forms, acronyms, electronic signature, HL7 messaging into the EMR, automated messenger functions and administrative reporting.