HPF 61 Principles of Operations

Horizon
Horizon Patient Folder and

Horizon Business Folder
Horizon Patient Folder Workstation
Principles of Operations Manual
Release 6.1
August 2003
Document ID
HPFXXPO0406101
Copyright notice
Copyright 2003 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
Use of this documentation and related software is governed by a license agreement. This documentation
and related software contains confidential, proprietary and trade secret information of McKesson
Information Solutions and is protected under United States and international copyright and other
intellectual property laws. Use, disclosure, reproduction, modification, distribution, or storage in a retrieval
system in any form or by any means is prohibited without the prior express written permission of
McKesson Information Solutions. This documentation and related software is subject to change without
notice.
United States Government Restricted Rights: This documentation and the related software are provided
with Restricted Rights. Use, duplication or disclosure is subject to restrictions as set forth in contract
subdivision (c)(1)(ii) of The Rights in Technical Data and Computer Software clause at DFARS 252.2277013 or subparagraphs (a) through (d) of the Commercial Computer Software Restricted Rights clause at
48 CFR 52.227-14, as applicable, in addition to the limitations set forth in the license agreement governing
this software. Manufacturer is listed below. Unpublished rights are reserved under the copyright laws of the
United States.
The software described in this documentation cannot substitute for the knowledge, skill and experience of
the competent medical personnel who are its intended users. Its use as such a substitute is prohibited.
Publication date
Original Release: August 2003
Product and version

Horizon Patient Folder 6.1
Publication number
HPFXXPO0406101
Reader comments
Any comments or suggestions regarding this publication are welcomed and should be forwarded to the
attention of:
Enterprise Imaging Documentation Team
McKesson Information Solutions
Mail Stop ATHQ-2304
5995 Windward Parkway
Alpharetta, GA 30005-4184
Trademarks
Horizon Business Folder and Horizon Patient Folder are trademarks of McKesson Information
Solutions LLC.
All other trademarks are the property of their respective owners.
Patents
U.S. Pat. No. 5,319,543
McKesson
Contents
About This Manual ................................................................................................................................. iii
Chapter 1: Product Information .........................................................................................................11
Introduction.............................................................................................................................................11
HPF Workstation ................................................................................................................................11
How HPF Workstation Works ................................................................................................................13
Open Technology................................................................................................................................13
SQL Engine Independence .................................................................................................................13
Device Independence..........................................................................................................................14
Wide Area Implementation.................................................................................................................14
Horizon Patient Folder System Components..........................................................................................15
Server Components.............................................................................................................................15
Client Workstation Components.........................................................................................................16
System Administration Components ..................................................................................................16
Chapter 2: Horizon Patient Folder Functional Overview ................................................................21
Introduction.............................................................................................................................................21
Functional Areas .................................................................................................................................21
Input Functions .......................................................................................................................................23
Document Capture/QC Index Workstation.........................................................................................24
COLD Agent.......................................................................................................................................24
Fax Input Server..................................................................................................................................25
Transaction Agent...............................................................................................................................25
Report Agent.......................................................................................................................................26
Batch Compiler ...................................................................................................................................26
Release/Upload Functions ......................................................................................................................27
Release Components...........................................................................................................................28
Archive Agent.....................................................................................................................................28
Index Upload.......................................................................................................................................28
Index Correction Utility (ICU) ...........................................................................................................28
Storage/Retrieval Functions....................................................................................................................29
HPF Database Server ........................................................................................................................210
Object Storage Servers......................................................................................................................210
Advanced Image Server....................................................................................................................210
HPF Storage Server ..........................................................................................................................210
Schedule Agent .................................................................................................................................211
User/System Functions .........................................................................................................................212
Workflow Agent ...............................................................................................................................213
HPF Workstation ..............................................................................................................................213
Signature Server................................................................................................................................213
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Text Editing Server .......................................................................................................................... 213

Web Server....................................................................................................................................... 214
Output Server ................................................................................................................................... 214
Purge Utility..................................................................................................................................... 215
Outbound Agent............................................................................................................................... 215
System Administration Functions ........................................................................................................ 216
Image Engine System Administration Workstation......................................................................... 217
Workflow Manager .......................................................................................................................... 217
COLD Manager................................................................................................................................ 217
Schedule Manager............................................................................................................................ 217
Transaction Manager........................................................................................................................ 217
HPF Console .................................................................................................................................... 218
AIS Object Manager ........................................................................................................................ 218
OSS Administrator........................................................................................................................... 218
Chapter 3: Flow of Information.......................................................................................................... 31
Introduction ............................................................................................................................................ 31
Information Input ................................................................................................................................... 32
ADT Input .......................................................................................................................................... 32
ANSI X12N Input .............................................................................................................................. 33
Document Input.................................................................................................................................. 34
Magnetic Release ............................................................................................................................... 37
Chart Completion............................................................................................................................. 310
Archiving ......................................................................................................................................... 312
Retrieving and Displaying Documents ............................................................................................ 315
Printing and Faxing.......................................................................................................................... 317
Chapter 4: Horizon Patient Folder Workflow .................................................................................. 41
Introduction ............................................................................................................................................ 41
Work Objects ......................................................................................................................................... 42
Workflow Programs ........................................................................................................................... 42
Assignments and Tables..................................................................................................................... 43
Chapter 5: Horizon Patient Folder Workstation COLD.................................................................. 51
Introduction ............................................................................................................................................ 51
Computer Output to Laser Disk ............................................................................................................. 52
Indexing ............................................................................................................................................. 52
COLD Components............................................................................................................................ 52
Release ............................................................................................................................................... 54
COLD Process Flow .............................................................................................................................. 55
Appendix A: Monitoring the Web Server and Text Editing Server ...............................................A1
Introduction ............................................................................................................................................A1
Monitoring the Web Server................................................................................................................A1
Monitoring the Text Editing Server ...................................................................................................A1
Index ...............................................................................................................................................Index1
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About This Manual

ATTENTION!
This document is effective with the Horizon Patient Folder and Horizon Business
Folder products except where specifically noted. For easier reading, this document
may cite only Horizon Patient Folder or HPF when referring to system
components, and readers should assume the information is applicable to either
product.
For stand-alone Horizon Business Folder applications: In this manual, sections
addressing Release of Information (ROI) and deficiency processing (or chart
completion) do not apply. They are used in the Horizon Patient Folder environment
for clinical information only.
Purpose
This manual provides an in-depth functional description of each of the components
of the Horizon Patient Folder Workstation (HPF Workstation) product and how they
interact with each other and with Image Engine functions.
Audience
This manual is intended for management personnel who are responsible for
evaluating and selecting information management solutions. This document assumes
you are familiar with Microsoft Windows user interface principles and terms.
Organization
This document is organized into the following chapters:
Chapter 1: Product Information describes the Horizon Patient Folder product
suite and its components.
Chapter 2: HPF Workstation Functional Overview describes the system
components that comprise HPF Workstation and groups them into functional
areas to present the interaction among these components.
Chapter 3: Flow of Information describes how information is entered into HPF
Workstation, initially released, moved from temporary (magnetic) storage to
permanent (optical) storage for archival, retrieved (depending upon whether it is
in cache), and routed to print and fax queues for printing and faxing.
Chapter 4: Horizon Patient Folder Workflow describes how the workflow
process operates within the HPF Workstation application
Chapter 5: Horizon Patient Folder COLD (HPF COLD) explains COLD
processing, COLD components, Release components, and COLD process flow.
Appendix A: Monitoring the Web Server and Text Editing Server provides
information about the flow of Web-based transactions through the system.
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Related Documentation
This manual is part of a documentation set developed for the HPF Workstation
product. In addition, the HPF Workstation product is used in conjunction with
McKessons Image Engine and Workflow Engine. You should receive a
documentation set for each product you purchase. Contact your Customer Service
representative if you do not have appropriate product documentation.
Publication Number
HPFXXPO0406101
Contacting Support
If you have questions about this software, do not hesitate to phone your support
organization. Contact the McKesson Enterprise Imaging Group Support Center at
800.711.7284, option 4, option 4.
In addition, McKesson Information Solutions maintains a For Customers website at
https://mckesson.com. A valid user account is required to access this Web site. The
site offers executive messages, company news, product documentation, detailed
product support information, product education course offerings, and resources such
as white papers and release overviews and guides.
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Chapter 1: Product Information

Introduction
The McKesson Horizon Patient Folder Workstation (HPF Workstation) product is
one component of the McKesson Horizon Patient Folder Release 6.0 series product
suite.
The McKesson Horizon Patient Folder is an enterprise document management
imaging solution. Horizon Patient Folder helps organizations overcome the barriers
of physical documents and manual processes by consolidating patient chart and
record information within a healthcare enterprise. Horizon Patient Folder provides an
information management solution by integrating current and historical data with
existing information management systems.
Horizon Patient Folder complements existing clinical and financial Healthcare
Information Systems by extending their range to include historical patient
information and business operations data. Horizon Patient Folder modules and
foundation components capture, store, and retrieve computer-generated or scanned
documents electronically, while structuring the flow of information to increase
productivity.
Horizon Patient Folder is comprised of these products:
Image Engine (a foundation component)
Workflow Engine (a foundation component)
Horizon Patient Folder Workstation TM (HPF Workstation)
HPF Workstation
HPF Workstation integrates patient Healthcare Information System (HIS) data,
ancillary system reports, and images of paper-based documents into a consolidated
electronic patient record for the Medical Records Department and for patient-centric
documents in the Business Office. It provides the functional tools for managing the
patients medical record and financial information in a paperless environment.
Healthcare application functions supported by the HPF Workstation include:
Chart creation and completion
Chart deficiency management
Physician electronic signatures and annotation
Patient record archival on optical disk
Workflow management
Direct user access and query of electronic patient record information
User security management
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How HPF Workstation Works
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System audit trails

System administration
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Open Technology
HPF Workstation is a Microsoft Windows-based application developed in the
client/server model. In addition to a user interface, Windows serves as the operating
environment used by the application to access network resources. HPF Workstation
software operates with network-based servers and the Windows 2000 operating
system.
HPF Workstation employs the entire Horizon Patient Folder suite of services:
integration tools: Computer Output to Laser Disk (COLD) Agent, Transaction
Manager, Image Engine, and Workflow Engine.
SQL Engine Independence

Application software is insulated from the vendor specifics of SQL implementation
by using a software layer.
The SQL database server contains the following five databases:
HIS (Hospital Information System) database. Patient data is the core of the
patients record. The minimum data set required by HPF Workstation is patient
demographic and encounter data that identifies the patient and the encounter
history. This data typically originates from the institutions Admission,
Discharge, and Transfer (ADT) system.
AUDIT database. The AUDIT database contains a log of encounter-based
activities. This area of the database is dynamic and can become quite large. The
audit trail is maintained in this separate database to maintain optimum system
performance and scalability.
CABINET database. This database contains document-related information
pertaining to all encounters and the operating parameters for the Transaction
Manager. In addition, it contains workflow rules, status tables and COLD
processing parameter tables. The Transaction Managers parameters map each
ADT transactions HL-7 formatted fields into the various tables and fields of
the HIS database.
WFE (Workflow Engine) database. The Workflow Engine database contains
attributes and components used to process queues and assignments.
EIWDATA (Image Engine) database. The Image Engine database is an extended,
distributed database that contains: user indexing information and location tables
to associate external indexing information with internal document location
information. It also contains system-level definitions of subsystem entities,
system usage, and utility processes.
HBF (Horizon Business Folder) database. The HBF database stores ANSI 835
and 837 data. Transaction Manager reads the data and populates the HBF
database tables.
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Device Independence
HPF Workstation uses peripheral devices that are available with a Windows driver,
such as client PCs, monitors, laser printers, magnetic disk arrays, and network
interface cards.
Note: Other devices used with HPF Workstation, such as scanners and optical
storage media, must be configured for device compatibility.
Wide Area Implementation

HPF Workstation can be accessed from multiple locations by extending the local
area network (LAN) into the wide area network (WAN) environment. This is
accomplished by normal networking without additional integration effort by the HPF
Workstation application. The patients chart can be accessed using HPF Workstation
anywhere on the WAN. This functionality is subject to minimum throughput
requirements as discussed with your technical integration team.
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Horizon Patient Folder System Components

Horizon Patient Folder includes a series of components that are configured to
manage the patients medical record and financial folder information in a paperless
environment. HPF Workstation integrates information from HIS systems, ancillary
systems (such as laboratory or transcription systems), and scanned paper documents
into a consolidated patient record.
This section contains a list of system components in HPF Workstation and Image
Engine. For more information about the functionality of these components, refer to
Chapter 2: HPF Workstation Functional Overview.
Server Components
The following are the server-based components of Horizon Patient Folder. A server
is an Horizon Patient Folder component that runs in an unattended mode and
supports a single function or provides a dedicated service.
ADT Interface Engine (Transaction Agent)
Advanced Image Server (AIS)
Archive Agent Server
Archive Release Server
Batch Compiler
COLD Agent
Fax Input Server
HPF Database Server (includes Image Engine and HPF Workstation databases)
HPF Storage Server
Index Upload Server
Magnetic Release Server
Object Storage Server (OSS), optical media
Outbound Agent
Output Server (print, outbound fax, e-mail)
Purge Utility
Report Agent
Schedule Agent
Signature Server
Text Editing Server
Web Server
Workflow Agent
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Client Workstation Components

The following are the HPF Workstation and Image Engine client workstation
components. Client refers to a PC workstation that requires frequent or constant
human interaction to perform the function.
Document Capture (DCS) workstation
HPF Workstation
ICU (Index Correction Utility)
Quality Control/Index (QCI) workstation
System Administration Components

Following are the Horizon Patient Folder system administration components:
AIS Object Manager
COLD Manager
HPF Console (EPRS Console)
Image Engine System Administration Workstation
Object Manager
OSS Administrator
Schedule Manager
Transaction Manager
Workflow Manager module
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Chapter 2: Horizon Patient Folder Functional Overview
Chapter 2: Horizon Patient Folder Functional

Overview
Introduction
This chapter identifies the system components that make up Horizon Patient Folder
and groups them into functional areas to present the interaction among these
components.
Functional Areas
The following table lists each functional area and the components that it includes:
Function
Input
Component
ADT Interface Engine (Transaction Agent)
Batch Compiler
COLD Agent
Document Capture Workstation
Fax Input Server
Report Agent
Release/Upload

Archive Agent
Index Upload
Storage/Retrieval
HPF Database Server (includes IE and HPF Workstation

databases)
Object Storage Server (OSS)
HPF Storage Server
Schedule Agent
User/System
HPF Workstation
Workflow Agent
Output Server (print, outbound fax, e-mail)
Signature Server
Text Editing Server
Web Server
Purge Utility
Outbound Agent
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Input Functions
Function
System Administration
Component
IE System Administration Workstation application
Workflow Manager
HPF Console (EPRS Console)
COLD Manager
Schedule Manager
Transaction Manager
AIS Object Manager
OSS Administrator
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Input Functions
Information enters Horizon Patient Folder through components that support Input
functions.
These components include the following:
Document Capture workstation (DCS); attached to a scanner
Quality Control/Index workstation (QCI); not attached to a scanner
COLD Agent
Fax Input Server
Batch Compiler
Report Agent
Transaction Agent
The following diagram illustrates the components in their functional areas.
Input Functions
Scanner
Quality Control/Index
Document Capture
Workstation
Workstation
COLD Agent
Report Agent
Batch Compiler
Fax Input Server
Transaction Agent
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Input Functions
These components are discussed in this section.
Document Capture/QC Index Workstation

Documents are scanned at Document Capture/QC Index (DCS/QCI) workstations,
which can be one workstation or several, depending upon the volume of capture.
With high volume capture, it is more efficient to separate the scanning function from
the indexing function.
With a medium/high speed paper scanner attached, the DCS workstation offers the
following:
Color scanning
Variable scanning resolutions and densities
Single (simplex) or double-sided (duplex) scanning (depending on scanner
capabilities)
Barcode recognition for automated document indexing
Automatic deletion of blank sides/pages
Automatic detection of document splitting through barcode recognition
Automated writing, reading, and sending batches to designated queues
Automatic splitting of multi-patient Explanation of Benefits (EOB) statements
when DCS/QCI is used in the Business Office.
Documents are scanned, digitized, and enhanced using image processing techniques.
They are then converted to TIFF images and stored in compressed form on magnetic
or optical media.
The QCI workstation includes features such as image rotation, page navigation, and
data entry for document indexing. The indexing process identifies a document for
subsequent retrieval. Document information, such as Document Name, Facility, and
Encounter Number, is entered in fields on the QCI window either manually or
automatically.
COLD Agent
The Computer Output to Laser Disk (COLD) Agent accepts computer-generated
report-formatted documents (for example, Facesheets, Lab Reports, Transcription)
from the ADT and ancillary systems. It then adds them automatically to the patients
electronic record.
COLD Agent reads the original ancillary system output (in ASCII or PostScript) and
performs the following functions:
Identifies the patient (encounter) account number/document type/facility
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Identifies any signature deficiency processing needed. Creates work queue

entries for assignments.
Provides Index Upload with the information to route the document to the
physicians signature queue, if necessary; if no user ID is available, Index Upload
creates an unlinked deficiency and a corresponding assignment
Based on COLD template rules, identifies whether to append, replace, or insert a
document if a prior version exists
Formats the index information to be processed by Release Server
Refer to Chapter 5: Horizon Patient Folder COLD for additional information.
Fax Input Server

Horizon Patient Folder provides the ability to import faxes. The Fax Input Server is a
dedicated server that manages the inbound fax function. A fax received by the Fax
Input Server is placed into a queue for manual quality assurance and indexing into
the patient chart at the QCI workstation. From the QCI workstation, it is released as
if it were scanned at the DCS workstation.
Transaction Agent
Another method of introducing data into Horizon Patient Folder is through the
interface provided by the Transaction Agent. The Transaction Agent updates the
HPF databases based on HL-7, X12N (ANSI 835 and 837 data for HPF 6.1 and
above), or proprietary transactions received from an interface engine. Translation
tables defined in Transaction Manager (Transman) enable Transaction Agent to map
incoming data into corresponding fields in the various databases. Source transactions
are identified and the data is defined in terms of Type of Transaction, Field Name(s),
Type of Field, and Size. The source transaction is cross-referenced to the SQL
Database identifying the target table, location in the table, and transaction type.
Additionally, Transman can be used to configure special HL7 transactions
(embedded HL7) to extract COLD files. These extracted files can be processed by
COLD Agent.
The following diagram shows the interface:
TCP/IP Feed
Transaction
Agent
Databases
COLD Agent
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Input Functions
Report Agent
Report Agent allows you to generate Patient Remittance (835) Explanation of
Benefits (EOB) reports using predefined formats. You can preview or print the
report, or export it to a text file for processing by COLD Agent. During processing,
COLD Agent is able to index and produce an image file of the report. The image is
then stored in the individual patient folder. Report Agent also processes 837 data.
Batch Compiler
Batch Compiler creates batches from ASCII or TIFF images using IERL script
information. During the batch creation process, Batch Compiler creates dcs_data
files (temporary storage in EIW_STORE) and doc_set files (all index information).
Release Server then copies the files from dcs_data temporary storage to permanent
magnetic or optical storage.
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Release/Upload Functions
The release/upload functions support the release and upload of electronic objects to
magnetic and optical media. This is accomplished through database object location
tables and application-specific indexing information.
Release/Upload components include the following:
Archive Agent
Index Upload
Magnetic Release
Server
Archive Agent
Index Upload
Archive Release
Server
Index Correction
Utility
These components are discussed on the following pages.
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Release Components
The Release components support the transfer of images from temporary storage on a
file server to the appropriate permanent storage media. This includes updating the
index values that are used by Index Upload when updating the CABINET database.
The Release component writes images to magnetic and/or optical media. There are
two release components:
Magnetic Release Server. The Magnetic Release Server moves images from the
QCI workstation to magnetic storage for immediate viewing. Functions
supported include writing images to a magnetic server, creating and updating
document index and location data, and making application index data available
for upload.
Archive Release Server. The Archive Release Server stores magnetic images on
permanent optical media. This agent allows the enterprise to mirror information
on several optical platters at the same time. It also allows patient records to be
grouped together on the same optical platters through the use of volume
allocation rules. The Archive Release Server processes batches created by
Archive Agent.
Archive Agent
The Archive Agent creates batches of completed patient charts and prepares the
batches for archiving by the Archive Release Server. A user or an automated
workflow process initiates archiving.
Index Upload
Index Upload populates the CABINET database with document index information
(for example, encounter, document, page). Logical pointers to the document are
created by the Magnetic Release Server or Archive Release Server. Index Upload
links these logical pointers to the index information for the associated object. When a
chart is archived to optical from magnetic storage, Index Upload marks the magnetic
document for deletion and inserts the optical pointers into the CABINET database.
Index Correction Utility (ICU)

The Index Correction Utility (ICU) allows you to repair error documents identified
by Index Upload. The ICU displays a subset of QC/Index application fields and
permits you to correct missing or invalid indexing information. Within ICU you can
view either all pending errored documents or only expired pending documents.
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Storage/Retrieval Functions
The storage/retrieval functions support the storage and retrieval of electronic objects
on magnetic and optical media. The Horizon Patient Folder hierarchical information
management techniques stage this information from long-term retention media to
magnetic media for optimum response time.
Storage and retrieval components include the following:
Object Storage Server (OSS)
HPF Database Server (includes Image Engine and HPF Workstation databases)
HPF Storage Server
Schedule Agent
OSS
Optical
Jukebox
Advanced
Image Server
HPF
Database
Server
HPF Storage
Server
Schedule Agent
These components are discussed on the following pages.
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HPF Database Server

The HPF Database Server includes the Image Engine (IE) and the HPF Workstation
databases. Tables in these databases are managed by a Microsoft SQL Server
database.
HPF Database Server - Image Engine Functions
The Image Engine (EIWDATA) storage and retrieval functions of the HPF Database
Server, manage the AIS cache tables. The AIS cache tables store information about
images that are temporarily staged on magnetic servers to quickly service retrieval
requests for active documents. This information includes the physical location of the
image files and attributes that determine how long the files remain on magnetic
storage before being purged.
HPF Database Server - HPF Workstation Functions
The HPF Workstation functions manage HPF Workstation application data. The HPF
Workstation functions store patient demographics, information objects associated
with the patients encounter, and work queue assignments.
Object Storage Servers

The Object Storage Servers (OSS) store and retrieve document images to and from
optical media. To efficiently service subsequent requests for the same document, the
compressed image is stored in AIS cache. The OSS: receives requests from AIS,
retrieves an image, places the image in AIS cache, and notifies AIS of the image
location. The OSS also includes cache management of images using a Least Recently
Used algorithm.
Advanced Image Server

The Advanced Image Server (AIS) prefetches information objects from devices, such
as optical jukeboxes, and caches them on high-speed magnetic arrays for immediate
user access. The AIS retrieves image path information from the OSS and sends the
path to the calling application (such as, HPF Workstation, Archive Agent).
HPF Storage Server

The HPF Storage Server (HPFSTORE) provides temporary magnetic storage for
images scanned during document capture and prior to release to archive. The HPF
Storage Server also provides configuration files. This magnetic storage
accommodates scanners, inbound faxes, and incoming COLD data feeds from
ancillary systems.
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Schedule Agent
Schedule Agent receives transactions from the scheduling system that identify which
records will be needed based on the admission of patients to the facility. Schedule
Agent uses AIS to prefetch these records and stages them on fast-access magnetic
cache.
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User/System Functions
The user/system functions support the delivery of information to the client
workstations and the output of information objects. The user functions include the
application user interface and all presentation, display, or viewing functions. System
output encompasses both print and fax functions.
User and system components include the following:
Workflow Agent
HPF Workstation
Signature Server
Text Editing Server
Web Server
Output Server (print, outbound fax)
Purge Utility
Outbound Agent
Output Server
HPF
Workstation
Workflow
Agent
Text Editing
Server
Signature Server
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These components are described in this section.
Workflow Agent
Horizon Patient Folder Workflow is activated by the Workflow Agent. Workflow
Agent polls for changes in queue status and routes workflow objects from one user or
work queue to subsequent queues. Its primary function is routing of electronic patient
record information for action by users. Workflow Agent uses rules that are defined in
Workflow Manager.
HPF Workstation
The HPF Workstation allows users to query the database for patient records, to
retrieve relevant information (for example, documents), and to complete chart
deficiencies. It is integrated with the workflow module to allow users to access
assigned cases and to forward cases to other users or workflow queues.
HPF Workstation Administration Functions
The HPF Workstation administration functions define operational rules and security
policies within HPF Workstation. They also control access to user functions through
system security. Users require administrative permissions to access these functions.
The administration functions support:
System-wide control parameters such as the Document Master List, Record
Views, and fax numbers.
Dynamic maintenance of the master document file, which applies revisions to
document characteristics across the entire chart library. For example, if the order
of the document in the chart is changed, that change is applied across all existing
charts.
Chart assembly order defined by the institution.
Various levels of detail maintained and reported within the audit trail defined by
the institution.
Signature Server
The Signature Server is a background process that allows the system to flag signature
deficiencies as complete following physician review. The physician reviews
documents in the system and is prompted to sign all pages with deficiencies that have
been displayed. Signature Server modifies all appropriate document images with the
correct signature authentication string.
Text Editing Server

Text editing is a process that allows the physician to add, update, or delete text when
completing a signature deficiency on an ASCII text COLD document in HPF
Workstation.
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When a document is text edited, the physician completes the deficiency and the
system creates a new image with the added text. The Text Editing Server creates a
batch that re-releases the text edited document into the system. The document is
processed through the Text Editing Server, Release Server, Index Upload, and
Signature Server (to raster the signature text).
About Text Edited Versions
The enterprise can elect to retain prior versions of text edited documents or replace
the original (and any other predecessor versions). Version creation and control is an
Index Upload function.
Web Server
The Web Server handles all http requests for Web-based chart completion activities
in HPF Workstation. The Web Server can exist as its own stand-alone machine or
run with other applications.
Output Server
The Output Server handles print and fax requests submitted by client workstations.
Output requests are typically initiated by client applications through the Object
Broker. An output request, also referred to as a job, is composed of one or more
pages. Each item in the job can reference either a multi-page document through the
64-byte document unique ID (Duid) or a single page through a 22-byte DocID. The
job is created on one of the print/fax queues and is usually associated with an IERL
script that controls the format of the output.
As a print server, it can handle one or more printers and it services only those print
queues to which it has permissions. Print queues are administered through the
System Administration Workstation application. The server sends print jobs either to
a default printer or to a specific printer (if multiple printers are mapped at the
workstation). Each printer can be mapped to a specific print queue. All jobs on that
queue will be sent to the assigned printer.
As a fax server, it services only those fax queues to which it has permissions. It
currently uses RightFax to fax documents to the appropriate destinations.
Typically, an Output Server is configured to route faxes to a specific phone line
(channel) on a RightFax server. However, multiple fax channels may be set up at
each Output Server and each channel configured to route faxes to a specific channel
on one of the RightFax servers.
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The Output Server selects print and fax jobs from the database that are in a ready
status. Each job may contain one or more job items. The server then sends
commands to the AIS to get the physical location of the images referenced by the
64-byte document unique ID (Duid). After all the images in the job have been
located or the paths have been determined using AIS, the job is ready for output. The
server interprets an associated IERL script and acts upon the keywords contained in
the script. The server then fetches each image, decompresses it and prepares it for
output. This may involve converting COLD files to bitmaps, merging text, scaling,
and so forth. After the image has been prepared, it is sent to the appropriate print or
fax device.
Purge Utility
The Purge Utility is used to physically delete images from magnetic media. Images
can be flagged for deletion:
After a copy is archived to optical for permanent storage.
During image replacement (by Index Upload).
Resulting from an Adjust Document Indexes transaction.
Resulting from an Index Correction Utility (ICU) transaction.
Using the Purge Utility in an Optical Archive Scenario
When a chart is archived to optical from magnetic, Index Upload creates a new entry
for the location of the optical image. The entry for the magnetic image is then
marked for deletion. At this point, HPF Workstation has access to the optical pointer.
The enterprise configures Purge Utility to wait <x> number of days before deleting
the magnetic image and pointer database entry.
Outbound Agent
Index Upload creates entries for Outbound Agent to send HL7 transactions back to
the host system. Pointers to the page and document ID allows the host system to
fetch images and be image enabled.
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System Administration Functions

The system administration functions support the management of information objects
within HPF Workstation and Image Engine.
System administration components include the following:
COLD Manager
HPF (EPRS) Console
IE System Administration Workstation
Schedule Manager
Transaction Manager
Workflow Manager
IE System
Administration
Workstation
HPF Console
Transaction
Manager
COLD
Manager
Workflow
Manager
Schedule Manager
System Administration
Functions
These components are discussed on the following pages. The following background
components in System administration are not included in the above illustration, but
are also described in this section:
AIS Object Manager
OSS Administrator
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Image Engine System Administration Workstation

The IE System Administration Workstation application defines operational rules and
security policies in Image Engine. It also controls access to user functions through
system security.
The IE System Administration Workstation application allows you to maintain:
Resources such as: users, scanning and indexing queues, volumes, units, and
servers relating to optical storage and mirroring.
Queue management: print/fax, upload.
The indexing form that specifies the index set and attributes to use, as well as the
document processing rules to use. You can: create customized forms, copy or
rename forms and indexes, and specify index-to-form field mapping.
Security, including: user permissions, DCS/QCI queue permissions, and SQL
Server permissions.
Volume allocation and mirroring rules.
Workflow Manager
The Workflow Manager module is the administrative tool that allows the enterprise
to automate its business processes using a graphical approach. Workflow Manager
provides a library of 14 Workflow objects to develop unique automated workflow
rules that Workflow Agent uses to route the electronic medical record. Each
Workflow object has its own icon and performs a specific type of work.
Workflow Manager supports:
Electronic work queues. These to do lists can be accessed from within the HPF
Workstation application.
Rules for populating work queues by: interface transactions from third party
systems, entry of documents into the system, database query, Workflow rules, or
manual entry of items.
COLD Manager
COLD Manager is used to create the templates and rules used by COLD Agent to
process document files.
Schedule Manager
Allows you to configure Schedule Agent parameters, including intervals for
retrieving documents, Workflow queues, and default facilities.
Transaction Manager
Allows you to configure the Inbound and Outbound agents and specify layout
preferences for output.
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HPF Console
Provides a graphical user interface that allows you to view log files for Schedule
Agent, Outbound Transaction Agent, Inbound Transaction Agent.
AIS Object Manager

Allows you to control AIS cache by purging cache files as needed.
OSS Administrator
Allows you to view log files for OSS and manage volumes by loading and unloading
platters in the jukebox.
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Chapter 3: Flow of Information

Introduction
This chapter describes how information enters HPF Workstation, is initially released,
moved from temporary (magnetic) storage to permanent (typically optical) storage
for archival, retrieved (depending upon whether it is in cache), and routed to print
and fax queues for printing and faxing. Workflow processes, COLD input and
output, and system administration functions are described in later chapters.
IMPORTANT!
The HPF Database Server includes both Image Engine and the HPF Workstation
databases.
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Information Input
Information Input
Information is entered into HPF Workstation from ADT or from document input
including scanning, fax input, magnetic release, and COLD. Data can also be entered
directly into HPF Workstation by functions such as ROI (Release of Information.)
ADT Input
This information is most commonly sent in an ADT feed from the healthcare
providers host application (HIS). The HIS transmits information to HPF Transaction
Agent, which defines and reformats the HL7 data transactions and updates the HIS
database. The data is defined in terms of type of transaction, field name, type of field
and size, and is cross-referenced to the associated tables in the CABINET database.
This cross-reference identifies the target table, location in the table, and transaction
type. The information in the HIS database is also used by the EPFQCI Extension
when it makes standard SQL queries into the database to check field validation.
Transaction Agent uses the rules created in Transaction Manager to populate the
database.
The following diagram represents the flow of information from ADT input.
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Host - ADT
Transaction Agent
HPF
Database
Server
QCI Workstation
with EPF Extension lookup
ADT Input
ANSI X12N Input
ANSI X12N input is similar to the ADT feed, except the input format is X12N. The
data is typically placed in the HBF database. The rules used to process the
transactions are defined in Transaction Manager. X12N input includes ANSI 835 and
837 data; for HPF 6.1 and above.
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Information Input
Document Input
Document input occurs through:
Scanning
Fax input
COLD feed
Batch Compiler
DCS Input
Documents are scanned into Image Engine using a Document Capture (DCS)
workstation. The DCS workstation offers scanning through flatbed, manual, or ADF
options, variable scanning and scanning resolutions and densities, and single- or
double-sided scanning. It also offers bar code recognition (optional), immediate or
deferred display during document capture, and system workflow operations such as
writing, reading, and sending batches.
When DCS/QCI is used in the Business Office, the application has the ability to take
the multi-patient Explanation of Benefits (EOB) paper statements and create
individual patient statements, which can include simple headers and footers.
Fax Input
External sources can fax documents directly to the Image Engine. The Fax Input
Server places the faxed documents into a queue for manual quality assurance and
indexing into the patient chart, which occurs at the QCI workstation.
COLD Input
COLD input is made up of ASCII or PostScript files, such as computer-generated
report-formatted documents (for example, Facesheets or Lab Reports) from the ADT
and Ancillary systems. Based on rules created in COLD Manager, COLD Agent
receives indexing information (Encounter number, Facility, and Document Type)
from the document. It parses the file into individual pages and creates a batch to be
released into the system (relmagq).
Batch Compiler
COLD input is made up of ASCII or PostScript files, such as computer-generated
report-formatted documents (for example, Facesheets or Lab Reports) from the ADT
and Ancillary systems. A COLD Forms Layout window accepts field names such as
Encounter, Facility, and Document Type that identify a document.
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Temporary Storage
All the input functions temporarily store images before releasing them to magnetic
storage. Input functions write batch information for images to queues located in the
EIWDATA database using the same batch format.
Batch information consists of the:
Generated BatchID
User-supplied batch label
Complete path to the SetInfo file
Total number of documents in the batch
Total number of pages in the batch
Name of the user who created the batch
Batch Creation
The DCS workstation places batch information in the qcindexq, the Fax Input Server
places batch information in faxinq, and the COLD Agent places batch information in
relmagq. This batch information causes the following fields to be initialized in the
new input queue table record:
Queue name. This is set to a name that has been predefined in the queue table.
Queue status. This is initialized to a ready status (2).
Queue ID. This contains the batch ID and batch directory path.
Queue message. This contains a note entered by the indexer before writing the
batch.
Release Process
Batch information for COLD input is sent to the Magnetic Release Server (relmagq)
for release.
Batches initiated by DCS workstation and Fax Input Server are created for QCI in
the qcindexq or the faxinq. A QCI operator logs into the QCI workstation to look at
the specific queue into which the batch was delivered. When the QCI operator reads
a batch, the input queue table record is modified so that the status is set to inprogress. This prevents another user from reading this batch while it is in use. After
the batch is indexed, QCI releases it to the relmagq.
Batch information for the Fax Input function is sent to the faxinq.
Batch information for the Batch Compiler function is sent to the relmagq to be
released.
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Information Input
The following flow diagram shows the information being input into IE and the
images moving to temporary storage on the HPF Storage Server, the input queue
table being updated, and the images indexed and ready for release. Upon completion
of QCI, the entire batch is ready for release of the images and index information.
HPF Storage Server
Scanner
COLD Agent
Document Capture
Workstation
Fax Input Server
relmagq
qcindexq
faxinq
HPF Database Server

(Image Engine)
EIWDATA
qcindexq
faxinq
relmagq
Batch Compiler
QCI Workstation
Document Input and EPFQCI Extension
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Magnetic Release
The batch must be released to make its contents available for general retrieval and
display. The batch is first stored on magnetic media until all of the components of the
chart are completed and released. The basic objectives of the release process are:
Select the proper magnetic storage for each document
Commit document images to magnetic disk
Update document location data in the CABINET database
Create application index data and location data for each document available for
processing in Workflow
The release server polls the relmagq in the HPF Database Server for batches that are
ready for magnetic release. If it finds a batch, it marks the batch entry in relmagq as
in progress to prevent other Magnetic Release Servers from processing the same
batch. For each document, the server selects the proper magnetic storage to store the
document based on the volume allocation rules, releases the images to magnetic, and
creates an index file containing document index information. Index Upload then
creates a corresponding 22-byte ID (page level) and 64-byte unique document ID
(Duid). The index file is located in a configurable directory on the HPF Storage
Server. The Magnetic Release Server then makes an entry for the batch in the
uploadq indicating that the batch is ready for uploading index data to the CABINET
database.
Index Upload periodically queries the database for batches. Index Upload checks the
uploadq for batches and, for each batch, returns the batch label, batch ID, total
number of documents, total number of pages, total number of documents released,
and the path to the index file. Index Upload polls the uploadq for batches to upload.
Index Upload opens the index file, reads the index information, and updates the
CABINET database with the new 22-byte ID (page level) and 64-byte unique
document ID (Duid), if needed.
Index Upload also performs one of the following actions, depending on the
configuration of the COLD template rules, EPF Options in DCS, the Document Type
properties, including Document Succession, in HPF Workstation:
Appends the new document to the existing document.
Replaces the existing document with the new document. (The existing document
is marked for deletion by the Purge Utility.)
Inserts the new document into the existing document.
After the upload process, HPF has the necessary document type, key indexes, and
image address information needed to relate each image to its corresponding
document name, Encounter Number, and Facility record.
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Information Input
The following also occurs:

The system creates an entry into the Audit table for the action.
Index Upload creates a linked or unlinked signature deficiency as specified in the
Document Type rules.
Index Upload creates a work queue entry as specified in the Document Type
rules.
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The following illustration shows the magnetic release process of images and the
uploading of index information.
Magnetic Release
images,
index information

uploadq
HPF Storage Server
relmagq
HPF Database Server

(Image Engine)
Index Upload Agent
HPF Database Server
(HPF Workstation)
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Information Input
Chart Completion
The next step is chart completion. The chart is completed after all the documents
associated with an encounter have been released to HPF Workstation and all
deficiencies have been satisfied. The completion process places the encounter record
in the archive object as the last step of a Workflow thread. The archive object places
an entry in the Archiving table in the CABINET database. Archive Agent queries the
Archiving table in the CABINET database to find all the documents associated with
that encounter. It then uses Object Broker to create a batch of completed patient
charts and puts the batch on the relarcq in the input queue table. Here, relarcq is the
configurable name for the release queue dedicated for batches containing documents
to be archived. Images are stored on the HPF Storage Server. The Archive Release
Server is configured to poll the relarcq in the EIWDATA database to check if there
are batches ready for optical storage.
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The following illustration shows the chart completion process starting with an
archive object through the Archive Release Server waiting to release the batch to
optical or permanent media.
Chart Completion
Archive
Object
Workflow
Process
HPF Workstation Database
encounter
HPF Database Server

(Image Engine)
relarcq
Archive Agent
Archive Release
Server
HPF Storage Server
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Information Input
Archiving
After completion, the chart is archived. This procedure, also called the release
process, transfers files from temporary magnetic storage to permanent storage on
optical disk or other media. The Object Storage Server (OSS) stores and retrieves
document images to and from the optical disk and manages the platter volumes and
devices within the jukebox.
The release process includes two important features: Volume Allocation and Volume
Mirroring, both of which involve writing images to multiple volumes.
Volume Allocation
Volume Allocation allows different patient records to be grouped together on the
same optical platters. This is done by applying a set of rules based on certain
document index criteria. The rules are defined in Image Engine System
Administration Workstation.
Volume Mirroring
Volume Mirroring is the process of writing records simultaneously to multiple
volumes as part of a disaster-recovery backup scheme. Records then exist on a
primary volume as well as one or more other volumes. The OSS maintains a database
table that correlates the volumes, enabling retrieval of images from backup volumes
if the primary volume is unavailable. Volume mirroring can also be used to establish
alternate paths to stored images to improve system performance and load balancing
for caching.
Release Process
The Archive Release Server polls the relarcq for batches that are ready for
archiving. If it finds a batch, it marks the batch in the uploadq as in progress (3) to
prevent other Archive Release Servers from working on the same batch. It then goes
through each document in the batch, selects the proper optical storage to store the
document based on the volume allocation rules, and releases the images to the OSS.
The Archive Release Server then creates an index file containing document index
information. The name of the upload index file is the same as the batch name. The
index file is located in a configurable directory on the HPF Storage Server. The
Archive Release Server then deletes the entry in the relarcq and creates an entry for
the batch in the uploadq indicating that the batch is ready for Index Upload.
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Index Upload periodically queries the EIWDATA database for batches. Index
Upload checks the uploadq for ready batches and, for each batch, returns the batch
label, batch ID, total number of documents, total number of pages, total number of
documents released, and the path to the index file. Index Upload polls the uploadq
for batches to upload. Index Upload opens the index file, reads the index
information, and updates the Page table in the CABINET database with the new
64-byte document ID (Duid). After the indexes have been successfully loaded to the
CABINET database, Index Upload marks the images to be deleted. The Purge Utility
is run to delete the images. After these steps are completed, HPF Workstation has the
necessary document type, key indexes, and image address information needed to
relate each image to its corresponding Document Name (Doc Type), Encounter
Number, and Facility record.
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Information Input
The following illustration shows the flow of information for archiving documents,
which changes the 22-byte magnetic DocID to a 22-byte optical DocID. The frame
number is the physical location on the optical platter.
Archive
frame #
images
Archive Release
Server
OSS 1
Optical
Jukebox 1
OSS 2
Optical
Jukebox 2
images
frame #
uploadq
images
delete
batch
Index Upload
HPF Storage
Server
HPF Database
Server
(Image Engine)
HPF Database
Server (HPF
Workstation)
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Retrieving and Displaying Documents

The retrieval process depends upon whether the requested page already exists in
cache. A 22-byte DocID references each page of a document in the Page table of the
CABINET database. This ID is used to determine the physical location of the page.
To display a page, the HPF Workstation issues a request to Object Broker to fetch
the page using the 22-byte DocID. It also passes a file path for the Object Broker to
copy the page then sends an image fetch request to the AIS for the page needed.
Retrieval/Display from AIS Cache
Using the object ID, the AIS first checks the Cache table. If the image has already
been cached internally, the AIS returns the complete path to the cached file as a
Universal Naming Convention (UNC) path. (For example,
\\server\volume\pathname.) Using this UNC path, the Object Broker copies the file
from the AIS cache to the location that HPF Workstation had requested.
HPF Workstation
path
HPF Database
Server
path build
AIS and cache
Retrieve from
Cache
HPF Storage Server
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Information Input
Retrieval/Display Not In AIS Cache

If the AIS does not find the requested image in cache, it examines the CABINET
database tables and obtains the name of the optical platter containing the image and
the OSS where the platter is mounted. It then instructs the OSS to copy the image
from the optical platter to the AIS cache. Once the image is placed in cache, the
image location is returned to the requesting HPF Workstation. The HPF Workstation
then retrieves the file directly from cache as described in the previous section.
HPF Workstation
path
HPF Database
Server
path build
image
AIS and cache
path
image
HPF Storage Server
OSS
Optical
Jukebox
Retrieval/Display Not in Cache
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Printing and Faxing

An output (print/fax/e-mail) request is initiated by the user or workflow object
through the print options available in the HPF Workstation. Each output request
consists of one or more documents and is directed to one of the output queues
defined in the EIWDATA database. The request includes data such as the object
type, priority, date and time of request, and userID of the user making the request.
This data is entered into the EIWDATA database queue tables by the workstations
local Object Broker. The EIWDATA database queue table entries require a database
login into the Image Engine database.
Output occurs at either a printer or a fax machine or by e-mail. The Output Servers
(Print, Fax, E-mail) on the LAN are configured to poll the print, fax, and e-mail
queues periodically for any print, fax, or e-mail requests.
A local print option is also available that requires a default network printer defined
for the workstation.
Print Server
The Print Server reads print requests from the EIWDATA database according to
request priority. The highest priority is 1 and the lowest priority is 99. The priority
applies across all queues for a server. All high priority requests across all queues are
serviced before any lower priority requests.
The Print Server expands each print job into its components and issues requests to
the AIS to fetch all the pages into the AIS cache. After all the pages of the request
have been cached, the Print Server queues the images to the Windows print driver.
After the request has been processed, the server marks the corresponding output
queue entry in the database as done. Jobs can be deleted upon completion. If any
errors were encountered either during image fetching or printing, the output queue
entry is marked as error (0).
The Print Server continues processing other requests in a similar manner until a
configured number of requests have been output. This number is referred to as the
output-cycle-depth. The Print Server then reads more requests from the queues and
performs prefetch processing as described above. The Print Server also enables the
administrator to map print queues to specific printers to direct all the jobs on a print
queue to its assigned printer.
E-mail
Horizon Patient Folder supports MAPI (Microsoft Messaging API) compliant secure
e-mail. The e-mail function is a form of output that is part of the Print Server feature
of Output Server.
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Information Input
The e-mail request is submitted to third-party software (MAPI) along with the e-mail
address and other details. The selected images are copied, the banner page and
images are encrypted, then zipped and compressed. The resulting files are included
as an attachment to the e-mail. The system sends e-mails to a host system, MAPIcompliant, e-mail service.
Fax Server
Like the Print Server, the Fax Server reads output requests from fax queues to which
it has permissions and faxes them to the appropriate destinations. The Fax Server is
used with multiple supported fax boards. The Fax Server issues a request through
AIS to the appropriate OSS to place all requested images in AIS cache. The server
then retrieves each image from the AIS and expands it to a disk file. The request is
submitted to third-party software along with the telephone number and other details.
At some configurable interval of time, the Fax Server queries the fax software to
check whether the fax transmission is complete.
The following illustration shows the interaction between the components of HPF
Workstation to print, fax, and e-mail documents.
HPF Workstation
print/fax request
Output Server
HPF Database
Server
E-mail
Fax
Print
Print/Fax/E-mail
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Chapter 4: Horizon Patient Folder Workflow

Introduction
Workflow is a means of automating business processes within an organization. The
Workflow module within Horizon Patient Folder allows you to define the
relationship between various procedures, rules, workflows, and business goals. These
relationships, depicted by graphic workflow icons, are translated into a visual
workflow map that is converted into the computer instructions that direct the
workflow process within Horizon Patient Folder.
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Work Objects
Work Objects
Horizon Patient Folder Workflow provides a library of work objects that perform
specific tasks. An icon represents each work object. Work objects can be linked as
required to form logical processes that are called workthreads.
The Horizon Patient Folder Workflow module supports:
Electronic Work queues (electronic to do lists)
Multiple users accessing work assigned to a queue
Security controlling user access to queues
Work queue population by interface transactions from third-party systems,
scanning documents into the system, Workflow Rules, or manual entry
Workflow Programs
The following programs are required to implement Workflow:
Workflow Manager. This program allows an administrator to define work objects
and graphically link them into workthreads.
Workflow Agent. This program executes all assignments for work items not
processed by users.
Workflow Manager
Workflow Manager allows users to design and maintain a Workflow map using
graphical work objects to form workthreads. This program allows the system
administrator to create workflow threads by defining, modifying, and deleting work
objects and linking work object icons in a logical sequence.
Workflow Manager uses SQL logic to automate business rules. A SQL fragment is a
descriptive reference that points to a specific SQL syntax (usually the syntax
associated with the WHERE clause). The SQL fragment extends the power of
workflow by allowing workthreads to use captured data that is not required by
Horizon Patient Folder.
SQL fragments control the following Workflow Agent processes:
Routing items to specific work queues
Performing database queries
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Workflow Agent
The Workflow Agent systematically processes workflow threads in the production
environment. It tracks workflow queues and tasks. It checks for changes in queue
status and routes work from one queue to another based on the defined workflow
process. It processes objects defined in the workflow threads (except for the Work
Queue Object) in a predetermined order based on the type of object. Workflow
Agent recognizes new encounter records and initiates required activities. It runs
continuously.
Workflow Agent processes are controlled by work object parameter settings.
Assignments are created or routed to designated work object queues. Once all
Workflow Agent assignments are processed, Workflow Agent begins again and
processes in a continuous loop.
The Workflow Agent uses specific patient database values. These values determine
where a Calculation and Decision Object sends an assignment.
Assignments and Tables

An assignment is a representation of a work task to be processed in Workflow. It is
one unit of work assigned to a Workflow object. Workflow assignments and how
they are processed are directly related to certain CABINET database tables. For
example, work is performed for the patients listed in the Patients and Encounter
tables in the HIS database. These same tables are also accessed when using SQL
statements from the SQL Query Object to create assignments and from the Decision
and Calculation Object when a rules-based routing decision is needed.
The WFE database contains tables that define Intelligent Business Components
(IBC). These components allow the user to create logical definitions of Workflow
objects that build on their physical definitions in the CABINET and HIS databases.
Workflow tables in the CABINET database contain the Workflow rules. As
Workflow is being defined, the following tables are updated in temporary storage:
WQ_Definition (provides attributes of the objects)
WQ_Linkage (provides SQL fragment information used to connect/link objects)
WQ_Users (defined in HPF Workstation, Workflow Activities/Group)
When the Workflow process is finalized, these tables are copied into production. The
tables in temporary storage are emptied.
An individual assignment is defined by its entry in the CABINET database,
Assignments table. SQL fragments store the SQL logic used by decision and
database query objects.
Auditing of work assignments processed by users is captured in the AUDIT database.
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Chapter 5: Horizon Patient Folder COLD
Chapter 5: Horizon Patient Folder Workstation

COLD
Introduction
This chapter provides information on Computer Output to Laser Disk (COLD) and
explains COLD processing, COLD components, Release components, and COLD
process flow.
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Horizon Patient Folder stores Computer Output to Laser Disk (COLD) data in ASCII
text format. Because COLD information is captured and stored as ASCII data,
storage requirements are significantly less than for bitmap images. ASCII text does
not retain formatting such as font face/size, bolding, or italics. A typical ASCII text
COLD document requires 5 kilobytes of storage space versus 60 kilobytes for a
document image.
The contents of COLD files are often merged with a bitmap overlay at the time of
output (display/print/fax). This bitmap is called the COLD Overlay Form. A COLD
file has a proprietary header that contains information such as font name, font size,
inter-character spacing, line spacing, and the ID of the COLD Overlay Form.
The COLD data and formatting information are merged on output. When a user
requests a COLD document from the HPF Workstation, the document
displays/prints/faxes just like any other document image; therefore, the COLD
process is transparent to the imaging system users.
The COLD Agent can also accept PostScript files. COLD PostScript files are
converted to TIFF images before they are put into a batch and sent to the Release
Server. (PostScript files retain formatting such as font face/size, bolding, or italics,
and are almost as large as scanned images. In other words, they require the same
storage space.)
Note: Elan software from Elan Technologies, Inc. is required to convert PostScript to
TIFF.
Indexing
The COLD process allows document data to be captured and indexed automatically.
The input to a COLD process is typically an ASCII text file. Index fields are
automatically extracted from the ASCII text file and stored in the HPF Workstation
database. At a minimum, the patient Encounter Number, Facility, and Document
Type index fields are required for document identification. Therefore, no manual
document indexing process is required.
COLD Components
COLD processing has two modules: the COLD Manager and the COLD Agent.
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COLD Manager
The COLD Manager allows you to specify index definitions, data repository
location, font size, and image overlays of the COLD documents. The COLD
Manager also allows the system administrator to configure document attributes for
each document type, including:
Document code set.
PostScript or ASCII.
The beginning of a document, the end of a document, and page breaks.
How to file the document (Insert, Replace, Append).
Location of the document identifier in the ASCII or PostScript file (row, column)
if searching by text, or in which directory to find a particular document type if
searching by directory. (The document identifier is a unique string in the file that,
when matched to the template, provides the document type.)
Location of other document indexing information (row, column) in the ASCII or
PostScript file.
Definition of the underlying template (COLD Overlay Form).
Definition of the COLD ASCII overlay parameters: font file, font rotation,
number of lines per page.
Print properties.
Where to find the physician codes (row, column) for automatic signature
deficiency assignment.
COLD Manager stores all the template information in the CABINET database.
COLD Agent
COLD Agent sends document information to Image Engine through the Object
Broker. Processing is described in the following text.
The COLD Agent creates batches of COLD documents from ASCII or PostScript
data files stored in a predefined configurable directory. The COLD Agent
periodically polls data repository locations for available work. When it finds new
ASCII/PostScript files in these locations, it processes each data file as a batch. The
processing involves parsing the data file for documents, pages, and index
information.
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While processing the data file, the COLD Agent uses template information stored by
the COLD Manager in the CABINET database. This information contains markers,
which may include end-of-page, end-of-document, and locations of the various index
fields. The COLD Agent processes each ASCII or PostScript data file and creates a
batch of documents similar to the output of a Document Capture Workstation. While
creating each document the COLD Agent checks the CABINET database and the
HIS database to verify the presence of the document type and the encounter and
whether the document type is included in the document code set for the facility.
COLD Agent then creates the batch in the DCS_DATA directory area and makes an
entry for it in the relmagq. If the COLD process fails, the agent writes the
ASCII/PostScript data file to a configurable error directory.
The COLD Agent can set flags for Index Upload to create signature deficiencies for
COLD documents for those physicians in the physicians cross-reference table. This
table is updated manually by the system administrator. If a signature reference is not
valid, the COLD Agent has the ability to send the document to a Workflow queue for
manual assignment of the physician signature deficiency. Index Upload adds
assignments and creates unlinked deficiencies.
The following system actions also occur during COLD processing:
Places copies of the processed COLD files (successful and error) in the Done
directory identified by COLD Manager.
Copies the errored COLD files to the Error directory defined in COLD Manager.
COLD Agent creates a log of all documents processed.
Release
A COLD batch appears to the release process as a batch created from a Document
Capture (DCS) workstation. The release process picks up the COLD batch from the
relmagq and does the following:
Releases the COLD files to the appropriate media according to the rules of
volume allocation, typically magnetic storage (set_info file).
Creates an ASCII file containing the index information for each document.
Creates an entry in the uploadq.
Index Upload subsequently uploads the index file.
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COLD Process Flow

The COLD process consists of a well-defined sequence of steps. The steps are
illustrated in the following diagram:
Raw
Data
File
COLD Manager
releaseq
COLD Agent
uploadq
COLD
Database Table
deletes files if
successful
DCS Data
Release Server
AIS and OSS
Index Upload
Cabinet
Database Table
Magnetic Volume
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COLD Process Flow

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Appendix A: Monitoring the Web Server and Text Editing Server
Appendix A: Monitoring the Web Server and Text

Editing Server
Introduction
This appendix provides information about monitoring the processing flow of
transactions through the Web Server and Text Editing Server used by the HPF
system.
Figure 1: Web Application Server and Text Editing Server in this appendix
illustrates the high-level interaction of Web-based components and how to locate
errored transactions. Error files/directories and event logs are indicated in red.
Monitoring the Web Server

Web Server errors can be monitored in two places: the browser and the Web
Application Server itself.
The browser writes errors to the Java Console Log. This contains viewer errors only.
The Web Application Server writes errors to:
Pim.log<x>
Server.log
To monitor errors in these files, capture the log files and make a copy of the error
message. Send these to the EIG Support organization.
In the pim.log file, you should search for Java exception errors.
Note: Purging of the pim.log file (based on size) is set in the pim.properties file. The
file is purged automatically based on the pim.properties file setting. (If the setting is
too high for the volume of work at your site, the disk may fill quickly.) You can also
specify how many logs are to be retained.
Monitoring the Text Editing Server

The Text Editing Server has two associated files that can be checked for errors:
Text Editing Server log file
IEDK event log (for IEDK errors)
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The Text Editing Server log file is automatically purged based on the following
settings in the pim.properties file:
Log.maxfilesize. Maximum size of each log file in kilobytes.
Log.backupcount. When the log file reaches the maximum size specified, a new
file is created and the current file is backed up. This parameter specifies the
number of back-ups to keep.
Since the log file is purged based on these settings, you need only back up a log file
manually when you find a problem. (If you do not, it will be purged automatically
based on the above schedule.)
Troubleshooting the Text Editing Server
To troubleshoot errors on the Text Editing Server, it is important to understand the
flow of edited documents through the system.
Stage 1: When the physician edits text on a document with a signature deficiency,
the Application Web Server creates an object of all pages and indexes for the
changed document.
Stage 2: This object is then passed to the Text Editing Server. The Text Editing
Server saves the object to the local drive based on the textediting.localpagepath
parameter in pim.properties.
Stage 3: During processing, the Text Editing Server saves the edited pages from the
object.
Stage 4: After processing the edited pages, the Text Editing Server deletes all pages
(if the deleted flag in pim.properties is set to 1) and moves or deletes the saved
object, based on whether the object was processed successfully. It saves the footer
lines with new page numbers, if configured in HPF Workstation.
A2
If the original
document has
And after text

editing it has
The directory structure after

text editing is
Page 1
Page 1
\batch<ID>\p1.txt
Page 2
Page 2
\batch<ID>\p2.txt
Page 3
\batch<ID>\p3.txt

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Text Editing Server Directories to Monitor

Under the directory structure for the Text Editing Server you will find the following
directories:
\In_progress
\Ready
\Error
As part of daily maintenance, the Error directory entries should be reviewed based on
the following steps:
1. Determine if the entry is legitimate. For example, if you are running test
transactions, they can be deleted.
2. If the entry is legitimate, attempt to resolve the problem. For example, if the AIS
is not running, restart the AIS.
3. When the problem is resolved, move the files from the Error directory to the
Ready directory. The background processor (explained below) will then process
these files.
Note: It is important to move these files rather than copying them. This clears the
Error directory.
The In_progress directory often contains many files. This is merely a back-log that
will be picked up by the foreground processor. If your site wants faster processing,
you can increase the number of threads in the pim.properties file
(textediting.foregroundmaxthread parameter). One or two threads should be
adequate. The foreground processor thread count should be larger than the
background processor thread count.
Text Editing Server Processors
During processing, the Text Editing Server uses the following two processors:
Foreground processor: monitors the In_progress directory. If an error occurs
during this stage of the text editing process, errored files are moved to the Error
directory. This serves to save the text the physician entered on the document.
Background processor: monitors the Ready directory and moves files to the next
processing step.
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Physician
A-4
Browser
event
log
Java
Console
log
DAL
pim.log
server.log
AIS
Text Editing
Server
Web
Application
Server

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IEDK
log file
Object
(Pages
Indexes)
Figure 1: Web Application Server and Text Editing Server
August 2003
Errored objects in progress are

moved to the \Error\ directory to
retain text entered by the
physician.
2. Background Thread:
monitors the \Ready\
directory
1. Foreground Thread:
monitors the \In_progress\
directory
Text Editing Server Processors
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McKesson
Index
Index
A
Adjust Document Indexes, 215

Advanced Image Server, 210
administration functions, for HPF, 213
ADT input, 32
ADT interface, 25
ANSI 835 and 837 data, 25, 32
Archive Agent, 28
Archive Release Server, 27, 311
archiving, 312
arcrelq, 38, 310
ASCII, 26
AUDIT database, 13
Audit table, 38
B
background processor, A3
Batch Compiler, 23, 26, 34
Business Office, 34
Business Office functions, 24
C
CABINET database, 13, 37, 313
chart completion, 310
client, 16
client workstation components, 16
COLD Agent, 23, 24, 52, 53
COLD components, 52
COLD data objects, 52
COLD feed, 34
COLD Manager, 217, 53
COLD Overlay Form, 53
COLD process flow, 55
COLD template rules, 37
components, HPF Workstation, 15
Computer Output to Laser Disk (COLD), 24, 51
Fax Input, 34
Fax Input Server, 23, 25
Fax Server, 318
foreground processor, A3
G
graphical user interface, 11
H
HBF database, 13
HIS data, 11
HL7 data, 25
Hospital Information System, 13
Horizon Patient Folder, 11
HPF Workstation administration functions, 213
HPF Workstation Database Server, 210
HPF Workstation, 213
I
IEDK event log, A1
IE System Administration Workstation, 217
Image Engine database, 13
Image Engine Database Server, 210
Index Correction Utility (ICU), 28, 215
Index Upload, 28
indexing, 52
input functions, 23
input queue table, 35
J
Java Console Log, A1, A4
Document Capture Workstation, 23

Document Capture/QC Index, 24
document input, 34
E
EIWDATA database, 13, 35
EIW Storage Server, 28
Electronic Work queues, 42
e-mail, 317
EPFQCI Extension, 32
Explanation of Benefits (EOB) reports, 24, 25, 34
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logbackupcount, A2
logmaxfilesize, A2
magnetic release, 37
Magnetic Release Server, 28
MAPI (Microsoft Messaging API), 317

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Index
O
Object Storage Server, 210

operating systems used, 13
Outbound Transaction Agent, 218
output (print/fax) request, 317
Output Server, 214, 215
P
Patient Remittance (835), 25
pim.log file, A1
pim.properties file, A2
Print Server, 317
Purge Utility, 215, 37
Text Editing Server, 214, A1

Text Editing Server log file, A1, A2
TIFF, 26
troubleshooting, A2
Transaction Agent, 23, 25
Transaction Manager, 217
Transman, 25
U
uploadq, 37, 312, 313
user/system services, 212
Q
Quality Control/Index Workstation, 23
queue ID, 35
queue message, 35
queue name, 35
queue status, 35
R
relarcq, 312
related documentation, iii
Release components, 28
release of COLD files, 54
release process, 312
Release/Upload components, 27
release/upload services, 27
releaseq, 54, 37
Report Agent, 26
RightFax, 214
Volume Allocation, 312

Volume Mirroring, 312
W
WAN, 14
Web Server, 214, A1
WFE (Workflow Engine) database, 13
Work objects, 42
Workflow, 41
module, 42
programs, 42
Rules, 42
Workflow Agent, 213, 42
Workflow Manager module, 217, 42
X
X12N data, 25, 32
Y-Z
S
scanning, 34
Schedule Agent, 211
Schedule Manager, 217
server, 15
server-based components, 15
servers used with Horizon Patient Folder, 15
Signature Server, 210, 213
SQL fragment, 42
storage/retrieval services, 29
support organization, iv
system administration, 216
system administration components, 16
Index 2

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August 2003

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Horizon Patient Folder and

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Horizon Patient Folder Workstation Principles of Operations

Text Editing Server .......................................................................................................................... 213

Horizon Patient Folder Workstation Principles of Operations

About This Manual

Horizon Patient Folder Workstation Principles of Operations

Horizon Patient Folder Workstation Principles of Operations

Chapter 1: Product Information

Chapter 1: Product Information

Horizon Patient Folder Workstation Principles of Operations

How HPF Workstation Works

System audit trails

Horizon Patient Folder Workstation Principles of Operations

Chapter 1: Product Information

How HPF Workstation Works

SQL Engine Independence

Horizon Patient Folder Workstation Principles of Operations

How HPF Workstation Works

Wide Area Implementation

Horizon Patient Folder Workstation Principles of Operations

Chapter 1: Product Information

Horizon Patient Folder System Components

Horizon Patient Folder Workstation Principles of Operations

Horizon Patient Folder System Components

Client Workstation Components

System Administration Components

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

Chapter 2: Horizon Patient Folder Functional

Magnetic Release Server

HPF Database Server (includes IE and HPF Workstation

Horizon Patient Folder Workstation Principles of Operations

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

Fax Input Server

Horizon Patient Folder Workstation Principles of Operations

These components are discussed in this section.

Document Capture/QC Index Workstation

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

Identifies any signature deficiency processing needed. Creates work queue

Fax Input Server

Horizon Patient Folder Workstation Principles of Operations

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

Horizon Patient Folder Workstation Principles of Operations

Index Correction Utility (ICU)

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

These components are discussed on the following pages.

Horizon Patient Folder Workstation Principles of Operations

HPF Database Server

Object Storage Servers

Advanced Image Server

HPF Storage Server

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

Horizon Patient Folder Workstation Principles of Operations

Horizon Patient Folder Workstation Principles of Operations

Chapter 2: Horizon Patient Folder Functional Overview

These components are described in this section.

Text Editing Server