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General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	MyAvatar is an American Recovery & Reinvestment Act (ARRA)-certified electronic health record (EHR) specifically for the behavioral health industry. This technology can be used in both inpatient and outpatient settings. This comprehensive electronic medical records (EMR) and practice management (PM) technology can be used in behavioral health environments like substance abuse clinics, psychiatric clinics, community mental healthcare clinics, methadone clinics, managed care organizations, and state mental health institutions. This technology integrates with the Veterans Health Information Systems and Technology Architecture (VistA) and the Computerized Patient Record System (CPRS). This technology can integrate with Intuitive Reliable Interoperative Scalable (IRIS) for Health or Cache database.
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:	This technology has not been assessed by the Section 508 Office. The Implementer of this technology has the responsibility to ensure the version deployed is 508-compliant. Section 508 compliance may be reviewed by the Section 508 Office and appropriate remedial action required if necessary. For additional information or assistance regarding Section 508, please contact the Section 508 Office at Section508@va.gov.
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v24.5
Decision Date:	05/01/2024 at 19:32:14 UTC
Aliases:	NX
Introduced By:	TRM Request
Vendor Name:	Netsmart

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Technology, obtained from the vendor (or from the release source).

Version	Release Date	Vendor End of Life Date	Vendor Desupport Date
2014
2016
2018	01/08/2018
2019	01/07/2019
2020	01/08/2020
2021
2022
2023
2024

Current Decision Matrix (04/24/2024)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VA IT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported. Any major.minor version that is not listed in the VA Decision Matrix is considered unapproved for use.

Legend:

White	Approved: The technology/standard has been approved for use.
Yellow	Approved w/Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Unapproved: This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Divest: VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unapproved may be found on the Decision tab for the specific entry.
Black	Prohibited: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Planning/Evaluation Constraint:The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology approved with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology approved with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

<Past

CY2019

CY2020

CY2021

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

2014

Divest
[4, 6, 7, 8]

Unapproved

2016

Divest
[4, 6, 7, 8]

Divest
[4, 7, 8, 9]

Unapproved

2018

Approved w/Constraints
[4, 6, 7, 8]

Divest
[4, 7, 8, 9]

Divest
[4, 9, 10, 11]

Unapproved

2019

Approved w/Constraints
[4, 6, 7, 8]

Divest
[4, 7, 8, 9]

Unapproved

2020

Unapproved

Approved w/Constraints
[4, 7, 8, 9]

Approved w/Constraints
[4, 9, 10, 11]

2021

Unapproved

2022

Unapproved

2023

Unapproved

2024

Unapproved

Decision Constraints


[1]	In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004 , VA Directive 6517, and VA Directive 6513. The local ISO can advise on the ESCCB review process.

[2]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[3]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[4]	This product is Class 2 or Class 3 VA-designed and built Local Software OR is a commercially-licensed software product purchased or leased that will run in a VA VISTA environment or integrate with Class 1 National VISTA Software. Presence of this software on the One-VA TRM does not equate to designation as a Class 1 National Software product and MUST NOT be assumed to comply with all VA programming standards, namespacing and interface control agreement standards, data management standards, documentation standards, information assurance standards, security standards and 508 compliance standards. As a Class 2 or Class 3 product, it MUST NOT be assumed to having been released into production through all OI&T product release and sustainment process controls for project management; requirements, development and testing management; and configuration, change, and release management necessary to satisfy OI&T process and product compliance. The OI&T Enterprise Program Management Office does not endorse nor support Class 2 and Class 3 products and does not support data usage or application programmer interfaces (APIs) between Class 1 National Software products and Class 2 or Class 3 products. Class 2 or Class 3 products must restrict their interfaces to Class 1 National Software to use of publicly-supported APIs ONLY. VA Directive 6402, Modifications to Standardized National Software, dictates the policy for Class 2 and Class 3 products and modifications to Class 1 National Software products. Local enhancements to, or modifications of, Class 1 Protected National Software (as listed in the Directive), in part or in whole, is PROHIBITED. Local enhancements to, or modifications of, Non-Protected Class 1 National Software is allowed ONLY with an approved waiver by the Software Modification Waiver Committee (SMWC). Class 2 and Class 3 software that does not modify the Class 1 National Software in any way must still adhere to namespacing and interface control agreement standards as well as National Field Operations Processes.

[5]	Due to potential information security risks, cloud based versions of this product are not permitted without a waiver signed by the Deputy CIO of ASD based upon a recommendation from the Architecture and Engineering Review Board (AERB). In addition, cloud based features of this software may not be used without an Enterprise Security Change Control Board (ESCCB) approval to ensure that confidential organization and/or PII/PHI data are not compromised (ref: VA Directive 6004, VA Directive 6517 and VA Directive 6513). Use of public cloud storage requires documented Federal Risk and Authorization Management Program (FedRAMP) compliance and a Memorandum of Understanding / Interconnection Security Agreement (MOU/ISA) between the vendor and VA prior to ESCCB review.

[6]	Cache 2014.1.3 Ad Hoc 14809 is the current approved version for VA - VistA and supported for VA Medical Centers. Configuration and deployment standards for Cache Baseline images and their host Server images are defined and maintained by the Core Systems Engineering organization within VA Enterprise Systems Engineering (ESE) and must be followed and adhered to unless an appropriate waiver is granted. Detailed information can be found at https://vaww.sde.portal.va.gov/svcs/sma/BCM/SitePages/Home.aspx.

[7]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[8]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[9]	Cache 2014.1.3 Ad Hoc 14809 is the current approved version for VA - VistA and supported for VA Medical Centers. Configuration and deployment standards for Cache Baseline images and their host Server images are defined and maintained by the Core Systems Engineering organization within VA Enterprise Systems Engineering (ESE) and must be followed and adhered to unless an appropriate waiver is granted. Detailed information can be found at https://vaww.sde.portal.va.gov/svcs/sma/BCM/SitePages/Home.aspx. Users must ensure that Cache is implemented with VA-approved baselines. (refer to the ‘Category’ tab under ‘Runtime Dependencies’)

[10]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[11]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

Note:

At the time of writing, version 2024 is the most current version.

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
*NOTE: Vendor provided information is subject to the accuracy of the manufacturer.

Technology Components

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Name	Description
No components have been identified for this entry.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Health Care Administrative	Health Delivery Support
Health Care Health Services	Mental Health Services

Operating Systems Supported by the Technology

macOS - Approved w/Constraints
Red Hat Enterprise Linux (RHEL) - Approved w/Constraints
Solaris - Approved w/Constraints
Windows Client - Approved w/Constraints
Windows Server - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Caché - (required for some configurations)
Hyper-V Server (Stand-alone Edition) - (required for some configurations)
Intuitive Reliable Interoperative Scalable (IRIS) for Health - (required for some configurations)
Java Runtime Environment (JRE) - Oracle
Job Access With Speech (JAWS) - (required for some configurations)
Microsoft Edge. - (required for some configurations)
Microsoft Internet Explorer (IE) - (required for some configurations)
VMware vSphere

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

At the time of writing, no National Institute of Standards and Technology (NIST) vulnerabilities had been reported and no VA Cyber Security Operations Center (CSOC) bulletins had been issued for the latest versions of this technology.
This technology may facilitate treatment plans by having patient information available at the point of care.
This technology supports advanced data encryption methods and role-based access control.
The vendor asserts this technology supports Health Insurance Portability and Accountability Act (HIPAA) regulations and protects patient security and confidentiality.

Adoption Risks

The potential exists to store Personally Identifiable Information (PII), Protected Health Information (PHI) and/or VA Sensitive data and proper security standards must be followed in these cases.
There are other approved solutions that provide similar functionality available on the TRM. The use of several similar solutions may increase organization requirements for support and maintenance.
This technology can integrate with and alter database technologies.
Cache, an optional dependency of this technology, is in End of Life status and must no longer be used.
Microsoft Internet Explorer, a dependency of this technology, is in End of Life status and must no longer be used.
This technology relies on Java Runtime Environment (JRE) - Oracle, which has a rapid release and update schedule.
This technology can potentially use Hyper-V Server, an unapproved technology.
This technology does not use a VA-preferred database to store data.
There is no indication based on either the vendor documentation or the Cryptographic Module Validation Program (CMVP) that this technology is Federal Information Processing Standard (FIPS) 140-2 compliant.

Architectural Benefits

This technology is compatible with virtual machines, therefore consistent with the enterprise Server Virtualize First Policy (VAIQ 7266972 08-27-2012).
This technology supports Health Level 7 (HL7) and Digital Imaging and Communications in Medicine (DICOM) options to reduce transcription errors.
This technology can be fully integrated with the Veterans Health Information Systems and Technology Architecture (VistA) and the Computerized Patient Record System (CPRS).
This technology is portable as it runs on multiple TRM-approved operating systems.

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VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (04/24/2024)

Decision Constraints

References

Technology Components

VA Categories View the VA Categorization Framework

Operating Systems Supported by the Technology

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

Adoption Risks

Architectural Benefits

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