Centricity Cardio Workflow (CCW)

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:	Centricity Cardio Workflow (CCW) is an information system software solution for storing and retrieving patient cardiology Electronic Medical Record (EMR). CCW interfaces with Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Cardiac Catheterization (Cath), Echocardiography (Echo), Electrophysiology (EP), Electrocardiography (ECG), Stress, Holter, and Cardiac Surgery. The software also communicates with other Hospital Information Systems (HIS), Picture Archiving and Communication Systems (PACs), and devices through standard Health Level Seven (HL7) interfaces and Digital Imaging and Communications in Medicine (DICOM) standards. Centricity Cardio Workflow is a component of Centricity Cardio Enterprise (CCE). CCW is a stand-alone software solution intended to be installed on medical Information Technology (IT) networks. CCW connects to modalities via standard DICOM communication (X-ray and Ultrasound). These connections are used to send the DICOM Modality Worklist from the servers to the modalities and to send the images from the modalities to the servers. Interfaces from the servers to the Veterans Information Systems and Technology Architecture (VistA) and Computerized Patient Record System (CPRS) are standard HL7 communication. CCW stores all data in a Microsoft Structured Query Language (SQL) Server database. The database can be configured for encryption of the data using Transparent Data Encryption (TDE) with SQL Server. No patient data or Protected Health Information (PHI) is stored to the client once the application is closed. The data that is transferred between the client and servers can be encrypted using Secure Sockets Layer (SSL) with the SQL Server, which will encrypt the data communication.
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 v23.4
Decision Date:	04/04/2023 at 02:07:15 UTC
Introduced By:	TRM Request
Vendor Name:	GE Healthcare

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
6.0 SP4	07/01/2016
7.0 SP3.0.1
7.0 SP4.1.1
7.0 SP5.0
7.0 SP8.2
7.0 SP8.3

Current Decision Matrix (03/27/2023)

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

CY2023

CY2024

CY2025

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

6.0 SP4

Unapproved

7.0 SP3.0.1

Divest
[9, 10, 11, 12]

Unapproved

7.0 SP4.1.1

Divest
[9, 10, 11, 12]

Divest
[10, 11, 12, 13, 14]

Unapproved

7.0 SP5.0

Divest
[9, 10, 11, 12]

Divest
[10, 11, 12, 13, 14]

Unapproved

7.0 SP8.2

Approved w/Constraints
[9, 10, 11, 12]

Divest
[10, 11, 12, 13, 14]

Divest
[10, 12, 13, 14, 15]

Divest
[10, 13, 14, 15, 16]

Unapproved

7.0 SP8.3

Unapproved

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

Approved w/Constraints
[10, 12, 13, 14, 15]

Approved w/Constraints
[10, 13, 14, 15, 16]

Decision Constraints


[1]	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.

[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]	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]	Users must ensure that Microsoft .NET Framework, Microsoft Internet Explorer (IE), Microsoft Internet Information Services (IIS) and Microsoft Structured Query Language (SQL) Server are implemented with VA-approved baselines. (refer to the ‘Category’ tab under ‘Runtime Dependencies’)

[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]	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]	Users must ensure that VMware vSphere, Microsoft .NET Framework, Microsoft Internet Explorer (IE), Microsoft Internet Information Services (IIS) and Microsoft Structured Query Language (SQL) Server are 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. Users must not utilize Secure Sockets Layer (SSL) as it is, at the time of writing, unapproved in the TRM.

[9]	Users must ensure that VMware vSphere, Microsoft .NET Framework, Microsoft Internet Explorer (IE), Microsoft Internet Information Services (IIS), Google Chrome and Microsoft Structured Query Language (SQL) Server are 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. Users must not utilize Secure Sockets Layer (SSL) as it is, at the time of writing, unapproved in the TRM. Users must Divest the use of Internet Explorer with this technology. Other approved internet browsers are available. See Category Tab for details.

[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]	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.

[12]	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).

[13]	Users must ensure that VMware vSphere, Microsoft Internet Information Services (IIS) and Microsoft Structured Query Language (SQL) Server are 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. Users must not utilize Secure Sockets Layer (SSL) as it is, at the time of writing, unapproved in the TRM. Users must Divest the use of Internet Explorer with this technology. Other approved internet browsers are available. See Category Tab for 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.

[15]	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.

[16]	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 7.0 Service Pack 8.3 is the latest 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
Cardiac Rhythm Management (CRM) Follow-up	The Cardiac Rhythm Management (CRM) Follow-up module is designed to document the follow-up visits of implantable devices, such as Implantable Cardioverter-Defibrillators (ICDs) and Pacemakers also from Biotronik, Medtronik, Boston Scientific, and St. Jude.
Cardio Workflow Adult Echo	The Cardio Workflow Adult Echo module offers a complete exam management and reporting solution for procedural documentation and reporting of clinical content and workflow features for adult echocardiography.
Cardio Workflow Cardiac Rhythm Management (CRM) Implant	The Cardio Workflow Cardiac Rhythm Management (CRM) Implant module provides a solution for the electrophysiology clinical space focused on device implants tilt tables, and cardioversions, including clinical content, workflow features, and reporting.
Cardio Workflow Cath	The Cardio Workflow Cath module enables all clinical content and workflow features for cardiac catheterization lab procedures and acts as a hub of information related to the patient encounter. This module provides tools for clinical data entry and procedural information related to the patient events. It also provides a graphic tool for representing patient coronary anatomy and image annotation that can be included in the final physician report.
Cardio Workflow Charge Capture	The Cardio Workflow Charge Capture module provides the capability to assign procedure codes for each patient encounter while reporting on the outcome of the procedure at the point of care. Codes can be uploaded to accommodate new or modified code sets through the administrative component of the application.
Cardio Workflow Electrophysiology (EP) Studies and Ablations	The Cardio Workflow EP Studies and Ablations module provides a solution for the electrophysiology clinical space focused on EP studies and ablation procedures, including clinical content, workflow features and reporting. The procedural documentation includes EP studies, Ablations, and three-dimensional (3D) Mapping. This module can be utilized with or without the integration of an EP recording system.
Cardio Workflow Inventory Management	The Cardio Workflow Inventory Management module represents a set of stock management tools designed to track inventories of cardiac departments. The module offers the ability to manage master supply lists, procedural inventory documentation, and stock.
Cardio Workflow Nuclear Medicine	The Cardio Workflow Nuclear Medicine module supports physicians, nurses, and technicians in recording relevant data during cardiology examinations in the Nuclear Medicine department. The Nuclear Medicine module allows capturing data related to stress test nuclear studies and Gated Blood Pool (MUGA) imaging as well as creating and submitting reports for these examinations.
Cardio Workflow Pediatric Echo	The Cardio Workflow Pediatric Echo module offers a complete exam management and reporting solution for procedural documentation and reporting of clinical content and workflow features for pediatric echocardiography.
Cardio Workflow Scheduling	The Cardio Workflow Scheduling module offers users a time/task management asset designed for clinical and administrative aspects of cardiology department workflow.
Invasive Peripheral Vascular (IPV)	The Invasive Peripheral Vascular (IPV) module provides tools for capturing clinical content, procedural documentation, and reporting. The module offers a complete dataset to document and manage relevant data in the IPV clinical environment. A graphics package is also included in this module to assist with the presentation of a visual diagram and/or annotations to mark regions of interest.
Non-Invasive Peripheral Vascular Reporting (NIPV)	The Non-Invasive Peripheral Vascular (NIPV) module provides tools for capturing clinical content, procedural documentation, and reporting. The module offers a complete dataset to document and manage relevant data in the NIPV clinical environment. A graphics package is also included in this module to assist with the presentation of a visual diagram and/or annotations to mark regions of interest.
Stress Electrocardiography (EKG)	The Stress EKG module enables storage and management of discrete stress EKG data.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Information Management Technologies Data Integration	Data at Rest
Collaboration and Electronic Workplace Productivity Software	Health Care
Health Care Health Services	Medicine Services

Operating Systems Supported by the Technology

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

Technologies/Standards Relationships

Runtime Dependencies:

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 has a comprehensive set of documentation.
This technology may improve productivity for specific staff whose responsibilities include imaging.

Adoption Risks

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 technology can integrate with and alter database technologies.
Microsoft Internet Explorer, an optional dependency of this technology, is in a divested state at the time of writing.
There is no indication based on available vendor documentation that this technology is Federal Information Processing Standard (FIPS) 140-2 compliant.
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 involves the use Universal Serial Bus (USB) connections and proper security precautions must be taken when used.
This technology can potentially use Secure Sockets Layer (SSL), an unapproved protocol.

Architectural Benefits

This technology can use a VA-preferred database.
This technology is compatible with virtual machines, therefore consistent with the enterprise Server Virtualize First Policy.
This technology can integrate with hospital systems and existing workflows.

Architectural Risks

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

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