Cedars-Sinai Import (CSI)

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:	Cedars-Sinai Import (CSI) is a powerful medical image management system that maintains a local database of images and allows you to connect to remote CSI servers, Digital Imaging and Communications in Medicine (DICOM) Query/Retrieve servers such as Picture Archiving and Communication Systems (PACS). Images can be imported directly from a local disk (hard disk, compact disk (CD), and Universal Serial Bus (USB) thumb drive) or a disk mapped from a remote host. CSI gives the ability to maintain an arbitrary hierarchy of tags to organize the data without duplicating files. This technology can use Microsoft Structured Query Language (SQL) or PostgreSQL database to store data. There are two editions of this product: Standalone and Server. This entry covers both editions.
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 v23.3
Decision Date:	03/17/2023 at 17:39:47 UTC
Aliases:	CSI
Introduced By:	TRM Request
Vendor Name:	Cedars-Sinai Medical Center

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
2017.x

Current Decision Matrix (03/13/2023)

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

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Release

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Q1

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Q1

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2017.x

Approved w/Constraints
[1, 2, 3, 4, 5]

Approved w/Constraints
[1, 3, 4, 5, 6]

Approved w/Constraints
[1, 3, 5, 6, 7]

Decision Constraints


[1]	Users must ensure that Microsoft Structured Query Language (SQL) Server is implemented with VA-approved baselines. (refer to the ‘Category’ tab under ‘Runtime Dependencies’). This technology requires using a Universal Service Bus (USB) technology to transfer data into the records. As such, proper precautions need to be taken to protect data. The File Transfer Protocol (FTP) features of this software must not be used as the FTP protocol is prohibited for use on the VA network. (For further information see: VA Policy Memo VAIQ 7615193 on Prohibited Use of File Transfer Protocol (FTP) and Telnet Services Users must not utilize the Secure Sockets Layer (SSL) protocol, as it is unapproved for use on the TRM. Per the Security Assessment Review, users must abide by the following constraints: To mitigate: Administrators must ensure that they have secured all necessary licensing before attempting to install this product. Further testing is required by the project team as, OIS Security Engineering was only able to partially test. Administrators shall update the version of OpenSSL to a TRM approved version. The administrator shall install a TRM approved version of Visual C++. If that is not possible, this technology or standard may 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. The administrator shall install a TRM approved version of Visual C++. If that is not possible, this technology or standard may 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.

[2]	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 VA Handbook 6500.

[3]	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.

[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 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).

[5]	This product can be configured with a PostgreSQL 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. If PostgreSQL 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 PostgreSQL Database TRM entry for more details.

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

[7]	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.

Note:

At the time of writing, version 2017.21 is the most current version and was released on12/19/2022.

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
Vendor Provided*	Knowledge Base		This webpage outlines the knowledge base for the 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
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
Collaboration and Electronic Workplace Productivity Software	File Manager and Viewer
Health Care Health Services	Imaging

Operating Systems Supported by the Technology

Windows Client - Approved w/Constraints
Windows Server - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

No comparable entries have been identified.

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

This technology may improve productivity for specific staff whose responsibilities include maintaining an arbitrary hierarchy of tags to organize the data without duplicating files.
At the time of writing, there are a limited number of TRM options providing this functionality. The addition of this technology will provide end users with multiple viable options.
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 is a well-documented technology.

Adoption Risks

This technology can integrate with and alter database technologies.
The potential of vendor lock exists when utilizing proprietary vendor technology.
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.
The vendor has stated that this technology is not Federal Information Processing Standard (FIPS) 140-2 compliant.
A valid license is required to complete the installation of the software. The vendor stated that they do not provide temporary, test, or any type of unpaid licenses.
A vulnerability exists because CSI version 2017.21 installs an outdated version (1.1.1g) of OpenSSL.
Vulnerability exists because CSI version 2017.21 installed c:\program files\csmc cardiac suite\bin\msvcr80.dll.
Vulnerability exists because CSImport installed c:\program files\csmc cardiac suite\bin\msvcr100.dll.
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.
This product can be configured with a PostgreSQL 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 involves the use Universal Serial Bus (USB) connections and proper security precautions must be taken when used.
This technology can potentially use File Transfer Protocol (FTP), an unapproved protocol.
This technology can potentially use Secure Sockets Layer (SSL), an unapproved protocol.

Architectural Benefits

This technology utilizes Health Level Seven (HL7) integration with pharmacy and hospital information systems.
This technology can use a VA-preferred database.

Architectural Risks

This technology is not portable as it runs only on Windows platforms.

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VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (03/13/2023)

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

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