Enterprise Health

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:	Enterprise Health is a standard set of comprehensive occupational health and safety programs. This solution combines occupational health, clinical care, and employee engagement capabilities on a single, web-based platform. Standard programs include health surveillance, worksite injury and illness or case management, clinical care, work-related exams, and employee engagement. This technology is available in two solutions, Amazon Web Services (AWS) Managed Services and on-premise. This entry covers both solutions. This technology can use Maria Database (MariaDB) and My Structured Query Language (MySQL) database to store data. The TRM decisions in this entry only apply to technologies and versions owned, operated, managed, patched, and version-controlled by VA. This includes technologies deployed as software installations on VMs within VA-controlled cloud environments (e.g. VA Enterprise Cloud (VAEC)). Cloud services provided by the VAEC, which are listed in the VAEC Service Catalog, and those controlled and managed by an external Cloud Service Provider (i.e. SaaS) are not in the purview of the TRM. For more information on the use of cloud services and cloud-based products within VA, including VA private clouds, please see the Enterprise Cloud Solutions Office (ECSO) Portal at: https://dvagov.sharepoint.com/sites/OITECSO
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 v24.1
Decision Date:	01/24/2024 at 03:39:20 UTC
Introduced By:	TRM Request
Vendor Name:	Enterprise Health

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
6.4.x
202309

Current Decision Matrix (01/19/2024)

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

CY2023

CY2024

CY2025

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

6.4.x

Unapproved

202309

Unapproved

Approved w/Constraints
[8, 9, 10, 11, 12, 13, 14]

Decision Constraints


[1]	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).

[2]	Due to potential information security risks, cloud based technologies may not be used without an Enterprise Security Change Control Board (ESCCB) approval. This body is in part responsible for ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[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]	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).

[5]	Due to potential information security risks, cloud based technologies may not be used without the approval of the VA Enterprise Cloud Services (ECS) Group. This body is in part responsible for ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[6]	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.

[7]	Due to potential information security risks, cloud based technologies may not be used without the approval of the Enterprise Cloud Solution Office (ECSO). This body is in part responsible for ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[8]	Users must not utilize Opera, Memcached and Maria Database (MariaDB), as they are at the time of writing, unapproved in the TRM. Users must not utilize the Secure Sockets Layer (SSL) protocol, as it is unapproved for use on the TRM. Users must ensure that Apache Hypertext Transfer Protocol (HTTP) Server, My Structured Query Language (MySQL) Database - Commercial Editions, Firefox, Google Chrome, and Microsoft Edge are implemented with VA-approved baselines. (Refer to the ‘Category’ tab under ‘Runtime Dependencies’)

[9]	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 ISSO (Information System Security Officer) to ensure compliance with both VA Handbook 6500 and VA Directive 6500.

[10]	Technology must remain patched and operated in accordance with Federal and Department security policies and guidelines in order to mitigate known and future security vulnerabilities.

[11]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 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 or its successor 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 or 140-3 compliant full disk encryption (FOE) must be implemented on the storage device 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 System Security Officer (ISSO) 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). By September 22, 2026, all FIPS 140-2 certificate validations will be placed on the Historical List, please refer to FIPS Transition Effort for further guidance and timeline of changes.

[12]	Due to potential information security risks for cloud-based technologies, users should coordinate closely with their facility ISSO for guidance and assistance on cloud products. If further guidance is needed contact the Enterprise Cloud Solution Office (ECSO), which is the body responsible for new software development in and migration of existing systems to the VA Enterprise Cloud (VAEC) and ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised within the VAEC. For information about Software as a Service (SaaS) products or to submit a SaaS product request, visit the Product Marketplace. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[13]	If this product uses a MySQL database, the product must be configured with a commercial edition of the MySQL Database, which currently has TRM constraints limiting its use for intranet and non-sensitive data only due to its many known security issues. If a commercial edition of MySQL is selected for use with this product, these factors must be considered especially when an instance of this product will be considered a Moderate or High-Risk system. See MySQL Database – Commercial Edition TRM entry for more details.

[14]	The Federal Information Processing standards (FIPS) 140-2 certification status of this technology was not able to be verified. This technology will require a 3rd party FIPS 140-2 or 140-3 certified solution for any data containing PHI/PII or VA sensitive information, where applicable. More information regarding the Cryptographic Module Validation Program (CMVP) can be found on the NIST website.

Note:

At the time of writing, version 202309 is the most current version, released 07/28/2023.

The versioning schema of this technology did not change as the previous version is listed as 6.4 (201709).

References

The following reference(s) are associated with this entry:
Type	Name	Description
Vendor Provided*	Documentation	This website links to the documentation for this technology.
Vendor Provided*	Enterprise Health - Amazon Web Services (AWS) Deployment	This website links to the documentation for the Amazon Web Services (AWS) Managed Services deployment for this technology.
*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
Allergy Injection Management	This module helps clinicians enter, track, and make clinical decisions about allergy injections. The allergy injection information integrates into flow sheets, and each patient`s allergy information is clearly displayed in the chart.
Allergy Intolerance Management	This module displays patient sensitivity data highlighted as an alert. Important allergy information is always displayed in red at the top of each chart tab, including the patient summary.
Case Management	This module consists of worklists to track clinical and occupational health cases by the case manager. Disability information is documented for third-party administrators to track long-term disability. As the case remains open all notes, results, and documents are linked to the case.
Electronic Health Record (EHR)	This module is the heart of the technology. This module has been configured specifically to support the occupational health and compliance needs of enterprise and government clients.
Employee or Patient Portal	This module provides employees with secure web access to health registration information, scheduling, completing health questionnaires, and management tools for patients to use when and where it`s most convenient for them.
E-Sign	This module allows clinicians to add documents, tasks, dictation, and request a co-signer, or multiple signatures.
Injection or Immunization Management	This module helps clinicians forecast, track, and manage historical or current immunizations, therapeutic injections, or allergy injections or vials, and document injection administration.
Task List	This module promotes workflow efficiency and timely task completion through the use of priority ratings for each task, reminder dates to flag tasks requiring attention, and overdue notices.

VA Categories View the VA Categorization Framework

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

Operating Systems Supported by the Technology

Amazon Linux - Approved w/Constraints
Red Hat Enterprise Linux (RHEL) - Approved w/Constraints
Windows Client - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Apache Hypertext Transfer Protocol (HTTP) Server
Maria Database (MariaDB) Server - (required for some configurations)
Memcached - (required for some configurations)
Microsoft Edge.
My Structured Query Language (MySQL) Database - Commercial Editions
Nginx Open Source
Opera (Opera Desktop) - (required for some configurations)
Safari - (required for some configurations)
Terraform

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

This technology does drug interaction checks that alerts staff to preventable adverse medication events through the use of drug-to-allergy checking at the time of prescribing. If a user adds a new allergy, and the patient is currently taking medication that would cause an adverse reaction, a warning will appear.
Incoming documents that are not automatically matched to an existing medical record number are routed to a centralized location. Users with security access are alerted to incoming documents in the queue. The system will search for potential matching patients based upon algorithms and provide a comparison tool to assist with merging documents. Documents that are an exact match may be automatically merged. This process merges documents directly from the queue and may assist in eliminating potentially lost or duplicate inbound documents.
This technology tracks all documents printed or faxed from the system, including the documents sent, who it was sent to, the fax number sent to, number of pages, sender`s name, date/time transmitted and transmission status (if it went through successfully, or if there was an error).
E-signatures can be requested manually, with notes and comments, or can be requested automatically using e-sign routing rules. The e-signature dashboard allows users to review e-signature queues, completed correspondence, transcription reports, lab results, hospital documents, test results, and other documents. Users make the decision to either e-sign, edit, or reject the documents in the queue.
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 has a comprehensive set of documentation.
There are minimal other TRM-approved technologies that provide the same functionality.
This vendor is a Federal Risk and Authorization Management Program (FedRAMP) authorized vendor.

Adoption Risks

This product can be configured with a MySQL Commercial Edition Database, which currently has TRM constraints limiting its use to Red Hat Enterprise Linux (RHEL) only due to its many known security issues on other platforms.
This technology can potentially use Secure Sockets Layer (SSL), an unapproved protocol.
The technology requires the purchase of licenses from vendor, which could potentially lead to vendor lock-in.
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.
This technology can potentially use Opera, Memcached and Maria Database (MariaDB), unapproved technologies.
This technology can integrate with and alter database technologies.
Due to the rapid release schedule of this technology, the VA may be unable to update to the most recent patch and may require a deployment model requiring the use of specific versions.
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 portable as it runs on multiple TRM-approved operating systems.

Architectural Risks

This technology does not use a VA-preferred database to store data.
This technology includes cloud-based functionality which has potential information security risks.

Inside VA

Budget and Performance

Inside the Media Room

National Observances

Special Events

VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (01/19/2024)

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

Architectural Risks

CONNECT

VA HOME

QUICK LIST

RESOURCES

ADMINISTRATION

VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (01/19/2024)

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

Architectural Risks

EMAIL UPDATES