E-MDs Solution Series 7.2 Installation Guide R00 - 20110713

e-MDs Solution Series
Installation Guide
Version 7.2
CHARTING THE FUTURE OF HEALTHCARE
e-MDs 9900 Spectrum Drive. Austin, TX 78717 Phone 512.257.5200 Fax 512.335.4375 e-MDs.com 2011 e-MDs, Inc. All rights reserved. Product and company names are trademarks or trade names of their respective corporations. No part of this manual shall be reproduced or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise without written permission from e-MDs. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this manual, e-MDs assumes no responsibility for errors or omissions. Neither is any liability assumed for damages resulting from the use of the information contained herein.
e-MDs Solution Series Installation Guide 7.2 R00
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Table of Contents
1 Getting Started ...........................................................................................................................1 USING THIS GUIDE ............................................................................................................................................2 RELATED DOCUMENTATION ..............................................................................................................................2 GETTING ADDITIONAL HELP AND INFORMATION ..............................................................................................3 Help Screens..................................................................................................................................................3 User Guides...................................................................................................................................................3 Using the e-MDs Support Center ..................................................................................................................4 2 Important Steps Before Installation ...........................................................................................5 INSTALLATION IN SQL CLUSTERED ENVIRONMENTS ........................................................................................6 DATABASE INFORMATION .................................................................................................................................6 PRE- AND POST-INSTALLATION STEPS ..............................................................................................................7 INSTALLATION REQUIREMENTS.........................................................................................................................7 INSTALLATION TIME ESTIMATES.......................................................................................................................7 ENSURING DATABASE SECURITY ......................................................................................................................8 PRE-INSTALLATION CHECKLIST FOR SOLUTION SERIES 7.2 ..............................................................................9 3 Installing SQL 2008 Server Standard Edition...........................................................................10 4 Applying Microsoft's 2008 SQL Server Service Pack 1............................................................20 5 Installing e-MDs Solution Series 7.2 TopsFDB Database........................................................24 6 Installing e-MDs Solution Series 7.2 TopsData Database .......................................................30 7 Installing e-MDs Solution Series 7.2 Applications on Workstations .........................................38 8 Licensing the 7.2 e-MDs Database ..........................................................................................46 9 Setting a Database Maintenance Plan in SQL Server 2008 ....................................................54 10 e-MDs 7.2 Solution Series Post-Installation Tasks ................................................................63 PERFORM SERVER TASKS ................................................................................................................................64 CITRIX PUBLISHED APPLICATIONS SETTINGS..................................................................................................64 TIFF PRINTER SETTINGS .................................................................................................................................64 INSTALL AND CONFIGURE THE CONTENT UPDATE MANAGER ........................................................................64 COMPLETE FINAL CLEAN UP TASKS ...............................................................................................................65
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Getting Started
From the entire staff at e-MDs: Congratulations! We know you could have purchased your electronic medical record software from a variety of vendors. We want to assure you that you have made the right choice in choosing to purchase from e-MDs: a world-wide leader in medical software development. We are not only excited to have you as a customer, but look forward to developing a relationship with you and your clinic. Through this relationship we want to ensure that you have the best possible success with your purchase.
Continued on the next page ...
Using This Guide

This document guides you through the installation of your new e-MDs Solution Series software version 7.2. Listed below is a summary of the steps needed to complete the installation: You will: Complete the Pre-installation checklist. The checklist contains items to be checked and tasks to be completed before you can safely begin the 7.2 Installation. These include: Ensuring your hardware and software meets or exceeds the e-MDs minimum requirements. Checking for adequate storage space and system memory. Ensuring the system on which you are installing has a DVDROM drive. e-MDs installation discs are provided on DVD discs that are not recognized by CDROM drives.
Suggestion: Share the DVDROM drive used for installation so it can be accessed from all
workstations where you are installing licensed e-MDs applications. Doing this enables you to perform each workstation installation from a centralized location. Also, consider copying the contents of the e-MDs 7.2 Installation DVD to a centralized location on the network where it can be shared and accessed during the installation process. Assuring you have access to e-MDs Support Center (www.e-MDs.com > Support > Customer Support Portal) to download needed files. If they exist for whatever reason, uninstall all previous versions of the e-MDs applications from each workstation. Install the software following the instructions provided in this installation guide. Verify you have installed the e-MDs 7.2 Solution Series applications only on the number of workstations for which you have purchased SQL licenses (Microsoft Run Time Licenses, or RTLs) or (Microsoft Client Access Licenses, or CALs). Complete the post-installation tasks (see "e-MDs 7.2 Solution Series Post-Installation Tasks") after successful installation. These include: Rebooting your SQL servers. Ensuring the latest e-MDs updates have been run. Note: Full release notes and a copy of this document are included in Documentation folder on the Solution Series 7.2 Installation DVD. See "Related Documentation" below for an overview of other available documentation.
Related Documentation
Documentation for Solution Series modules is provided in PDF (Portable Document Format) files for viewing and printing individually, and in Help format for easy access from each product module. Both formats and access methods provide the same information. The documentation library is updated extensively for each major product release as well as updated and corrected periodically, as needed. For the latest version of any Solution Series documentation, go to the documentation section of the e-MDs Support site at Online Support > Downloads > Documentation. The following documents are available to all Solution Series users: e-MDs Solution Series Administration Guide is your starting point for initializing and customizing Solution Series modules for use in your organization. This guide provides step-by-step instructions for licensing your software, adding system users and defining access levels, adding and modifying user groups, and setting up default handling of various module tasks.
e-MDs Solution Series Bill User Guide provides instructions for working with insurance codes and electronic claims, setting fee schedules and rules, defining policies, posting and billing transactions and reversals, and performing numerous other practice management tasks. e-MDs Solution Series Chart User Guide leads you from the beginning of an office visit through the visit conclusion when billing is enabled. Using Chart you can track and code a patients medical information and provide prenatal, maternity and postnatal care. This guide also details Chart's prescription processing, lab interfaces, and telephone interactions with patients. e-MDs Formulary Benefits User Guide describes how to determine the pharmacy benefits and drug copays for a patients health plan, determine if a prescribed medication is covered (in formulary) under a patients plan, display therapeutic alternatives with preference rank (if available) within a drug class for non-formulary medications, determine if a patients health plan allows electronic prescribing to mail order pharmacies, and download a historic list of all medications prescribed for a patient by any provider. e-MDs Solution Series Schedule and Rounds User Guide leads you through scheduling and tracking appointments, setting up and modifying patient accounts, blocking time on the calendar to restrict appointment scheduling, checking patients into the facility and tracking their progress through each encounter with a provider, checking eligibility, and using the Rounds program on a Personal Digital Assistant (PDA) to work with patients offline. e-MDs Solution Series Patient Portal Administration Guide provides instructions for maintaining user access on a Patient Portal, working with patient appointments scheduled through the Portal, communicating with patients through a Portal e-mail interface, processing prescription refill requests, and auditing Patient Portal usage. e-MDs Solution Series Patient Portal User Guide instructs patients on the use of the Patient Portal to communicate with their healthcare provider, view their own healthcare information, and submit requests for appointments and prescription refills. This document can be provided on your Patient Portal for easy online viewing or printing by patients. e-MDs Solution Series Reports User Guide lists the reports available through Solution Series. A description of each report is provided, along with the location of the report within Solution Series modules, the available fields and filters used to select specific data for the report, and samples of most reports, illustrating what you can expect when running a report at your facility.
Additional documentation is also available on the e-MDs Support site for performing specific tasks and for using e-MDs interface products for working with labs and other organizations. See the e-MDs Support site for access to the latest versions of these documents.
Getting Additional Help and Information

e-MDs realizes that one of the most important elements of any software system is the support services backing it up. There are a number of support resources available to help you optimize the use of your system and participate in the e-MDs community.
Help Screens
Help is accessible on each Solution Series application and module by going to Help > Search Topic on each application's top toolbar. Related help files, such as this guide, the Utilities Guide, and the Reports User Guide, are generally accessible from the same help screen. After opening each help file, you can use the table of contents, index or search function to locate the specific information you need.
User Guides
The e-MDs Solution Series user guides contain comprehensive information about all standard product functions. This includes dealing with many of the complex situations that can arise in a medical office. Use the table of contents, index or search option to locate items of particular interest. These guides are
very similar to the application help screens. See "Related Documentation" for a brief description of the Solution Series user guides available. Solution Series guides are always available in electronic format (Adobe .pdf files). You can put copies on each computer in the network. You can download the Adobe Acrobat Reader for free from www.adobe.com. Updated user guides are included on the DVD-ROMs you will receive with each upgrade, as well as on the support pages at www.e-mds.com. To download files from the e-MDs Support site, you will need your clinic password. Instructions on how to apply for a password are on the Web site. Only one password is issued per customer account, so please ensure you communicate this to your staff.
Using the e-MDs Support Center

The e-MDs Support Center is an online customer meeting place for clients with an active account. It is accessed from the Support pages at www.e-MDs.com or http://supportcenteronline.com/ics/support/default.asp?deptID=3222 . If you dont have an account, you can request one by using the Request New Account button on the login page. We strongly encourage each staff member in a clinic to have their own logins instead of one generic one for all people. The primary reason for this is that when we need to push information such as update notifications it is sent to everyone meaning there is a smaller chance that the information will not be disseminated such as if someone is sick or ignores the message. Support Center includes the following tools that can be of great assistance to helping your practice work more efficiently with the e-MDs Software: Forums/Newsgroups: The online forums are an e-MDs User Community where you can post messages related to support, general discussions, suggestions, tips and more. It is a great nonurgent support tool and is also searchable. You can subscribe to various forums that interest you and get an e-mail notification if someone posts to them. You can also elect to get an e-mail if someone posts to a specific message. This is really useful if you post a question and want to know when it is answered. Support forums are monitored by the e-MDs support team and a number of our customers also chip in with their knowledge. Downloads: Downloads include shared templates for Chart, Word Forms, reports, updates to content such as ICD and CPT codes, bug patches, etc. Knowledge Base: The knowledge base includes an extensive list of articles that you can use for troubleshooting, setup and so on. These are generally posted based on questions from customers. Troubleshooter: This search utility makes it easy to quickly locate the information youre looking for. It cross-references multiple parts of the support center and returns hyperlinks to articles, downloads and the like. Surveys: Occasionally e-MDs will gauge your opinions about something via surveys which can be distributed via Support Center. Push e-mails: If we want to let you know about something, we can push information to you from Support Center.
Important Steps Before Installation

This section contains important steps that should be performed before beginning your installation. Verify that your available hardware and software meet the basic requirements for installing and running the Solution Series database and application. Preparation time taken now can save both time and expense later.
Installation in SQL Clustered Environments

This section pertains only to users who are installing a database hosted by a named instance of SQL (or a SQL Cluster environment). In order to install the 7.2 database to a named instance of SQL, simply perform the installation from a command line interface.
On the SQL Server where the e-MDs database is hosted: go to Windows: Start > Run (the Run window displays). In the Run Window, browse to the location where you have stored the 7.2 e-MDs installation files. (Example: locate the TopsDataDb folder and select Setup.exe). Before running this file, add a space plus the characters -a [ \Setup.exe a ] after the last
quote in the Run window. Example: C:\Documents and Settings\yourservername.yourdomainname\Desktop\TopsDataDb\Setup.exe a
Note: During the installation process you will receive an additional screen that will prompt you to provide the changed SQL instance name and a database name. For more assistance contact the e-MDs IT Support Team. Technical assistance is available Monday through Friday from 7am to 7pm CST. Call (800) 565-5564, or if you are located in Central Texas, call (512) 250-3929.
Notes:
If you have never accessed e-MDs Support Center, copy or enter this link into your web browser: https://supportcenteronline.com/ics/support/default.asp?deptID=3222 From this location, you can request an e-MDs Support Center account (needed for the download). If you have forgotten your account password, use this location to have the password sent to you. New login requests take from one to two business days for e-MDS to set up. If you are installing the e-MDs 7.2 FaxServer application, follow the FaxServer 7.2 Installation Guide included in the documentation folder contained on your e-MDs 7.2 Solution Series installation DVD.
Installation Tip: To speed the client installation, consider sharing your DVDROM drive over the
network so it can be accessed from the workstations needing to be updated. In addition, you can also copy the contents of the e-MDs 7.2 DVD to a folder that is shared on your network to be accessed by all workstations needing to be installed. A shared folder will make it easier to install the e-MDs Solution Series applications to each workstation because it allows centralized access to installation files. This also negates the need to burn a DVD and walk it around to each workstation in your facility, also, please note that many workstations are not equipped with DVDROM drives. More than one person can also work on updating workstations at the same time.
Database Information
Solution Series 7.2 can run successfully under either SQL version 2005 or SQL version 2008 databases. Note that these installation instructions only describe steps for installing SQL 2008. This software release will not function correctly with any version prior to SQL version 2005. SQL version 2008 should be installed using the Mixed Mode option. Be aware that Solution Series 7.2 requires creation of two SQL databases. They are named TopsData and TopsFDB.
Pre- and Post-Installation Steps

It is imperative that all items on the "Pre-Installation Checklist for Solution Series" have been completed before beginning the installation steps. Failure to do so can cause installation problems. This in turn can significantly impact your practices productivity as well as result in substantial IT consulting costs to remedy the error! Once you have completed the e-MDs installation, it is CRITICAL to the success of the installation to 7.2 that you also run all pertinent post 7.2 Solution Series upgrade scripts and updates (see: "e-MDs 7.2 Solution Series Post-Installation Tasks" for specifics). Failure to implement these additional updates will likely result in lost productivity and unexpected system behavior.
Installation Requirements
In order to install 7.2, you must be using equipment that is robust enough to efficiently run the e-MDs applications. Make sure your network and hardware meet the e-MDs minimum requirements for version 7.2. Minimum requirements are found in the document: What are the current hardware and software specifications for e-MDs? located on the e-MDs Support Center site (www.e-mds.com).
Installation Time Estimates

This table lists examples of the time taken to install the e-MDs Solution Series applications. Please be aware that each workstation installation time may vary depending on hardware and installation requirements. The installation/upgrade can take over 30 minutes to complete. Your actual installation time will vary based on factors such as the amount of data in your database, hardware resources, user habits, and the number of applications being installed. If you have further questions, please contact eMDs.
Microsoft SQL 2008 Server Installation Time Estimates

Processor O/S RAM Installation Time Costs Disc Cost Installation times may vary. Please refer to http://www.microsoft.com/sqlserver/2008/en/us/default.aspx
e-MDs Solution Series 7.2 Installation Time Estimates

Processor O/S e-MDs Database Size Installation Time Estimate (Database) 10: 00 Minutes N/A Installation Time Estimate (Solution Series) on workstation. 15 minutes 20 minutes
1.86 GHz XP Pro, 2.97 GB of RAM XP sp2/P4, 1 GHZ/512Mb RAM
2.0 GB N/A
Ensuring Database Security

Important Security Statement From e-MDs: e-MDs recommends clinics have a strong sa (SQL Systems Administrator) password in place and that you, your clinic, and your Certified IT Professional follow standard IT best practices. e-MDs has observed that some of our customers do not have adequate security measures in place to resist increasingly sophisticated hacker attacks. Hackers can cause significant disruption to your business. As technology has become more sophisticated, so have these attacks. Please consult with your IT professional to ensure that your system is secured. Important: Best IT practices suggest, and e-MDs recommends, clinics have a Certified IT Professional verify that the clinic network infrastructure is properly implemented. This includes: Closing your security device(s) to ANY non essential traffic (i.e. port 1433). Making certain virus protection is in installed and updated regularly Ensuring Spyware protection is in place and up-to-date. Verifying the clinic has published policies on acceptable computer usage, and these policies have been clearly communicated to all staff. All users create and maintain strong passwords for their log in.
To learn about characteristics of Strong Passwords, access this link provided by Microsoft: http://www.microsoft.com/protect/yourself/password/create.mspx Microsoft also makes a Password Checker available for download to check the relative strength of any password. This can be accessed here: http://www.microsoft.com/protect/yourself/password/checker.mspx
Pre-Installation Checklist for Solution Series 7.2

Important! All tasks on this checklist must be completed prior to beginning the e-MDs Installation! Step-by-step installation instructions are provided for the purpose of installing the e-MDs Solution Series 7.2 applications as well as SQL 2008 Server. This documentation contains clear and easy to understand directions, including screen-shots, to guide users through the installation process. It is the sole responsibility of the clinic and the clinic's Certified IT Professional to install the e-MDs database and applications, as well as to apply any ensuing patches, hot fixes, or updates. Installation assistance for the e-MDs 7.2 Solution Series suite of applications can be scheduled by appointment with the e-MDs IT Services Team. The team can provide guidance for resolving installation questions. This service is available for $125 per hour (minimum one hour billing) and must be scheduled at least 48 hours in advance. Completed
Task Description
Verify installation of an appropriate Operating System that is compatible with running Solution Series 7.2. Refer to the article: What is new in 7.2? When will 7.2 ship to my office? Where are the 7.2 Release Notes? Where are the 7.2 User Guides? located on the e-MDs Support Center site (www.e-mds.com ). Confirm you have the SQL 2008 Installation DVD. Check that you have obtained the latest Service Packs for SQL 2008. Currently e-MDs recommends SQL 2008 SP1. Check that you have obtained and installed the latest Service Packs for Windows. Currently e-MDs recommends Windows 2003 Server R2 SP2. Confirm you have access (i.e.: a login and password) to e-MDs Support Center (www.eMDs.com > Support > Customer Support Portal). Make sure you have temporarily disabled (or turned off) real-time antivirus protection before beginning the installation procedure. Real-time antivirus protection, such as Norton Antivirus, can interfere with proper installation of e-MDs Solution Series or component such as Fax Server. Do not re-enable the real-time antivirus protection until the installation is complete. You have obtained a copy of the e-MDs Solution Series 7.2 installation DVD. Note: A shared folder on the network will make it easier to install on your workstations because it allows centralized access to update scripts for all workstations. In addition, share the DVDROM drive and access it from each workstation over the network. Do not run the database install from a shared network path. This must be installed locally, otherwise the install will fail. You have downloaded (from e-MDs Support Center) the post upgrade scripts and executables to apply to your SQL server. (See "e-MDs 7.2 Solution Series Post-Installation Tasks" for specifics.) You have verified your server has at least 10 GB of free space (where the SQL databases reside) needed to run the 7.2 installation program. You have verified that all users are logged out of all e-MDs applications (if previously installed).
Note: e-MDs strongly recommends making the server unavailable during the installation to minimize the possibility a workstation remains logged in, or you have staff remotely accessing the system. Section IV includes instructions on making the server unavailable once it is loaded. Important! Always log in to the server or workstation with full Windows Administrator privileges when running this installation, failure to do so will result in files being installed to the wrong directories or not being deleted/overwritten when they should be. This will cause access violations and other unexpected system behavior. Your system administrator or IT consultant should be able to provide you with the correct Windows logins.
Installing SQL 2008 Server Standard Edition

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Insert the SQL Server 2008 Standard Edition Installation CD into the CDROM or DVDROM drive on your server.
If .net 3.5 has not been installed on your system, the .net Setup window displays. If this window does not display, go to step 4 of this section. Select I have read and ACCEPT the terms of the License Agreement, then click Install >.
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When the Setup completes, click Exit.
From the SQL2008 Splash window, click Installation in the left column.
Select the option: New SQL Server stand-alone installation or add features to an existing installation in the right pane of the SQL Server Installation Center window.
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The system may require several moments for this (and other) operations to complete.
When finished, the Setup Support Rules window displays. The Operation Complete text line indicates if there are any failed, missed, or steps that issued a warning. Click the Show details >> button for more information.
For any rule that did not complete successfully, click that row in the Status column to remedy. Once all problems are corrected, click OK. The Product Key window displays.
Click the Enter the Product Key button.
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Enter your 25-character key (provided by Microsoft) in the field provided, then click Next. Note: If you are using an e-MDs provided SQL disk, this key will auto populate.
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Read the License Terms. If you agree with the terms, click I accept the license terms, then click Next.
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The Setup Support Files window displays the support files needed as part of this installation. To create these files, click Install.
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A progression bar displays as the Setup Support files are created. No action is required. When completed, the Setup Support Rules window displays.
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This window helps identify problems that might occur when installing the SQL Server Setup support files. Click Show Details >> to locate and remedy any problems.
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Check the Status of each file displayed. (In this example, note the Microsoft .NET Application Security file is not applicable for this installation.). Click the link in the Status column for any entry that requires remedy and correct the problem. Once all pertinent problems have been corrected, click Next. The Feature Selection window displays.
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The Feature Selection window is used to mark which features will be used in the install. Click each feature shown to include it. Note: e-MDs recommendations for which features to select appear in the next step.
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These are the features e-MDs recommends our users select for the SQL 2008 Installation: - Database Engine Services - Client Tools Connectivity - Integration Services - Management Tools Basic - Management Tools Complete
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At the bottom of the Shared Selection window, check the location of the Shared Feature Directory. To change the location from that shown, click the ellipsis button to the right of the field and select another location. Once all features have been selected and the Shared Service Directory location selected, click Next. The Instance Configuration window displays. Note: e-MDs recommends selecting Default Instance on the Instance Configuration window. Click Next. The Disk Space Requirement window displays.
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This window lists the space requirements for the SQL Server features selected. After reviewing, click Next. The Server Configuration window displays.
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Provide the required information for configuring service accounts. This information is specific for each installation. Note: e-MDs recommends using your Domain Admin account for all services.
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In the lower grid of the Server Configuration window, review the Startup Type and change if needed. After indicating the desired selections on this screen, click the Collation tab on the Server Configuration window.
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Review the Collation settings. When finished, click Next. The Database Engine Configuration window displays.
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On the Database Engine Configuration window, e-MDs recommends selecting Mixed Mode as the Authentication mode.
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After selecting Mixed Mode, enter and confirm a password (SA password) for the Built-in SQL Server system administrator account.
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Click Add Current User to add the current account as an SQL Server Administrator. Click the Data Directories tab.
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e-MDs recommends that the temp db and temp db log be moved to different drives to increase performance. Click the FILESTREAM tab.
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No changes are required in the FILESTREAM tab. Click Next. The Error and Usage Reporting window displays.
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On the Error and Usage Reporting window, review the available options and select if desired. Click Next. The Installation Rules window displays and begins processing.
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The setup is running a check of installation rules to determine if the installation will be blocked. This may take several moments to complete the check. When the check is complete, click the Show Details button. The Rules Detail grid displays.
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Review the status of all rules. Fix any errors by clicking the specific link appearing in the Status column. When all errors have been corrected, click Next. The Ready to Install window displays.
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Check that all the install features selected in previous steps are correct. Once all features have been verified, click Install.
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During the installation, various messages and progression bars display. No user input should be required during the Installation Progress.
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Once the installation is complete, the Complete window displays. Review the information displayed about the install, then click Close.
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Reboot the SQL 2008 server prior to beginning the next section.
Please refer to http://www.microsoft.com/sqlserver/2008/en/us /default.aspx for the latest SQL 2008 updates.
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Applying Microsoft's 2008 SQL Server Service Pack 1

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Obtain SQL 2008 Service Pack 1 from the Microsoft Website (www.microsoft.com). Select the Download button to the right of the service pack highlighted below. The Open File Security Warning window displays. Click Run to download the SP1 files to your system.
The SP1 download and file extraction takes several moments. No user interaction is required during the download. When the download has completed, the Welcome window displays.
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On the Welcome window, click the Show Details button. The Rules grid now displays in the Welcome window.
Review the status of each rule listed. Correct any errors by clicking the appropriate link in the Status column and resolve the problem. Once all pertinent problems have been addressed, click Next. The License Terms window displays.
Review the license terms for this Service Pack. If you accept these terms, click I accept the license terms, then click Next. The Select Features window displays.
Review the features to update selected. After making any changes, click Next. The Check Files in Use window displays and launches the check.
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The Check Files in Use function requires several moments to complete. No user interaction is required.
Once the file check has completed, click Next. The Ready to Update window displays. Note: If there are files in use, click Next, but you must also reboot the server. Verify the list of features to be updated. When satisfied, click Update.
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Application of the Service Pack takes several moments to complete. No user interaction is required during the update.
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After the update completes successfully, click Next. The Complete window displays.
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Review the information presented on the Complete window, then click Close.
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Installing e-MDs Solution Series 7.2 TopsFDB Database

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Important! For SQL clustered environments, see "Installation in SQL Clustered Environments."
The e-MDs TopsFDB database is used for ScriptWriter-related functions within the Chart application. You must install both the TopsFDB and TopsData database (in "Installing e-MDs Solution Series 7.2 TopsData Database") for Solution Series 7.2to work. Insert the e-MDs 7.2 Solution Series Installation DVD received from e-MDs into the DVDROM drive on your server. If the server does not have a DVD drive, please create a copy of the ENTIRE disk contents to your server. You can then run the installation from there. Click to select the option Install New TopsData Database or First Data Bank Database. Note: If the window below does not auto-launch, right-click the Windows Start tab and select Explore. In the root folder menu that appears, locate the contents of your DVDROM. In the Installation folder, click the file Launch.exe.
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The SQL setup requires several moments to complete. No user action is required. When complete, the InstallShield Wizard welcome window displays.
Click Next. The e-MDs previous version warning message displays.
Read the e-MDs warning message concerning removal of previous versions of Solution Series prior to proceeding. If required, take action before continuing. Click Next.
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Select an authentication method. Important! For SQL Server authentication (default), enter the SQL (sa) Administrator login and password. If logged into the system with Windows Administrator permissions, select Windows Authentication. Click Next. The Setup Type window displays.
Select First DataBank, then click Next. The Choose Destination Location window displays.
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Check the location where the TopsFDB will be installed. Use the Browse... button to select a different location. Note: You must install TopsData database (next section) on the same server where TopsFDB is installed. When satisfied, click Next. The Setup Type (for login) window displays.
Select No, do not create a login option. Click Next. The Ready to Install the Program window displays.
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If necessary, to review or change settings prior to installing, click the Back button Click Install. The Setup Status window displays.
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The e-MDs database Setup Status window displays. There is no need to take any action. When finished, the InstallShield Wizard Complete window displays.
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The e-MDs 7.2 TopsFDB database has been successfully installed to your system Click Finish.
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Installing e-MDs Solution Series 7.2 TopsData Database

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Important! For SQL clustered environments, see "Installation in SQL Clustered Environments".
The e-MDs TopsData database contains clinical data. (It is critical that the TopsData database is backed up and safeguarded This database must be installed to use the e-MDs applications.) Insert the e-MDs 7.2 Solution Series Installation DVD received from e-MDs into the DVDROM drive on your server. If the server does not have a DVD drive, please create a copy of the ENTIRE disk contents to your server. You can then run the installation from there.
Click to select the option Install New TopsData Database or First Data Bank Database. Note: If the window below does not auto-launch, right-click the Windows Start tab and select Explore. In the root folder menu that appears, locate the contents of your DVDROM. In the Installation folder, click the file Launch.exe.
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The database setup requires several moments to complete. No user action is required. When complete, the InstallShield Wizard welcome window displays.
Click Next. The e-MDs previous version warning message displays.
Read the e-MDs warning message concerning removal of previous versions of Solution Series prior to proceeding. If required, take action before continuing. Click Next.
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Select an authentication method.
Important! For SQL Server authentication (default), enter the SQL (sa) Administrator login and password. If logged into the system with Windows Administrator permissions, select Windows Authentication.
Click Next. The Setup Type window displays.
Select TopsData, then click Next. The Choose Destination Location window displays.
Check the location where the TopsData will be installed. Use the Browse... button to select a different location. Note: You must install TopsData on the same server where TopsFDB (previous section) is installed. When satisfied, click Next. The Setup Type (for login) window displays.
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Select No, do not create a login option. Click Next. The Ready to Install the Program window displays.
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Note: To review or change settings prior to installing, click the Back button Click Install. The Setup Status window displays.
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No user interaction is required. When finished, the InstallShield Wizard Complete window displays.
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The e-MDs 7.2 TopsData database has been successfully installed to your system. Click Finish. Note: e-MDs recommends rebooting your SQL Server.
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To verify the e-MDs TopsFDB and TopsData database installed properly, go to the Windows Start > All Programs > Microsoft SQL Server 2008 > SQL Server Management Studio. The Connect to Server window displays.
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Authenticate to SQL Server 2008 using either Windows Authentication or SQL Server Authentication (The SQL username and password created during the installation of SQL). Select Connect. The Microsoft SQL Server Management Studio console displays.
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To prevent someone accidentally accessing the database prior to the completion of this installation, you will make the server unavailable for remote access. Remember you will need to allow access once the post installation steps are completed. Right-click the server. A menu displays.
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16
Right-click Properties The Server Properties window displays.
17
Click Connections. The Connections options display in the right pane of the Server Properties window.
36
18
Click to remove the check in front of Allow remote connections to the server. Remember you will need to allow access once the post installation steps are completed. Click OK.
37
Installing e-MDs Solution Series 7.2 Applications on Workstations

1 2
Either insert the e-MDs 7.2 Solution Series Installation DVD received from e-MDs into your servers DVDROM drive or access the folder you created where you copied the ENTIRE contents of the DVD.
Select the Install e-MDs Solution Series Modules, the Preparing Setup window displays. Note: If the window below does not auto-launch, right-click on the Windows Start tab and select Explore. In the root folder menu that appears, locate the contents of your DVDROM, in the Installation folder, click a file called Launch.exe. This will launch the e-MDs Solution Series installation screen below. In addition, this installation can also be performed from the shared location you created on your server in the previous step.
38
The Preparing Setup window displays. No user interaction is required. When complete, the Welcome to the InstallShield Wizard for e-MDs Solution Series window displays.
Select Next. The License Agreement window displays.
Select I accept the terms of the license agreement to accept the eMDs licensing terms. Click Next. The Setup Type window displays.
39
Ensure the Complete option is selected. Note: The Custom option is used to install custom applications such as eMDs License Manager and Secure Email. Click Next to continue.
If you receive a software installation security alert, please note that e-MDs has thoroughly tested the print driver across multiple platforms and in different environments so you can trust the application and click through the security alert. Continuing the installation, the Database Server selection window displays next.
40
Note: Enter the correct name of your SQL server in the Database Server field. Select Windows authentication. Click Next to continue. The Select Database window displays.
Click Next to continue. The Ready to Install the Program window displays.
41
10
Select Install. The Setup Status window displays.
11
The Setup Status window displays the progress of the e-MDs applications being installed. No user action is required. During the installation process, users will also see the e-MDs Support Libraries being installed window as shown in step eleven.
12
The e-MDs Support Libraries window displays displaying installation progress. Again, no action is required. When completed, the InstallShield Wizard Complete window displays.
42
13
In the InstallShield Wizard Complete window, select Finish. The window closes.
14
Close the e-MDs Solution Series installation screen by clicking Exit Installer. The e-MDs Solution Series Installation screen closes.
15
Launch the e-MDs Solution Series by double clicking the e-MDs Solution Series icon on the desktop. The e-MDs sign on screen displays.
43
16
Verify the correct version number displays on the sign on screen. It should read: Version: 7.2.0.98
17
In the User Name field, type administrator. In the Password field, type administrator. Click the Expand button.
18
The login screen consists of seven fields for data entry.
Window User Name Password Login Group Server Database User Name Password
Description User Name for the user Password for the user Security Feature (leave as default) The name of the clinics server TopsData SQL Database Login Credentials SQL Database Login Credentials
44
19
Click OK to login to e-MDs. The e-MDs Dashboard displays.
20 !
Close the application by clicking the X in the upper right corner.
AM I THERE YET?
Not until you have repeated steps 1 through 19 of this section on each workstation. Also remember that once youve completed the workstation installations, you must continue to the next sections.
45
Licensing the 7.2 e-MDs Database

1
e-MDs Solution Series software must be licensed before it can be used. The e-MDs database is licensed by the number of providers a clinic has purchased for use in the system. To license your database, you must first install the e-MDs Activation Manager. This module can be installed on a workstation, however, e-MDs recommends installing it to your SQL Server. To install, Insert the Solution Series 7.2 installation DVD. The Solution Series installation screen displays. Note: Users will not have full system functionality until receiving and activating the annual key from e-MDs Licensing Department. This process can take up to one business day.
In the e-MDs Solution Series window, select the Install e-MDs Solution Series Modules option. The Welcome to the InstallShield Wizard for e-MDs Solution Series window displays. Note: If the window below does not auto-launch, right-click the Windows start tab and select Explore. In the root folder menu that appears, locate the contents of your DVDROM, in the Installation folder, click on a file titled Launch.exe. This launches the e-MDs Solution Series installation screen shown below. Click the Install e-MDs Solution Series Modules option. The Welcome to the InstallShield Wizard for e-MDs Solution Series window displays.
46
Select Next. The Setup Type window displays. Click Next.
In the License Agreement window, read the Software and Documentation User Agreement statement. If you agree, select I accept the terms of the license agreement. Click Next. The Setup Type (install options) window displays.
Select Custom. Click Next. The Setup Type (uninstall options) window displays.
47
Leave the box for Yes, uninstall previous versions clear (not checked). Note: If a previous version of Solution Series has been installed, click the check box to uninstall a previous version. Click Next. The Choose Destination Location window displays.
Select a drive where the setup will install the license files. Click Next. The Select Features window displays.
Ensure the License Manager box is checked. Note: This step presumes the e-MDs Solution Series applications have never been installed on the server. If they have, the Modify, remove, or repair the program window displays. Select the Modify option. Click Next. The Database Server window displays.
48
Enter the correct name of your SQL server in the Database Server field. Select Windows authentication. Click Next. The Select Database window displays.
10
Leave the default name (TopsData) displayed. Click Next. The Ready to Install the Program window displays.
11
No user action is required during the installation process. When complete, the Maintenance Complete window displays.
49
12
Select Finish. The Activation Manager is now installed.
13
To launch the e-MDs License Manager: Go to Start > All Programs > e-MDs > License Manager. The e-MDs Activation Manager login window launches. Note: If desired, you can right-click License Manager here to create a desktop short cut to this function.
14
Log into the e-MDs Activation Manager again. In the User Name field, type administrator. In the Password field, type administrator. Click OK. The e-MDs Activation Manager window displays.
50
15 16 17 18
Select License management>Reference key>New. An e-MDs Warning message displays.
The Warning message states that generating a new key request will override any existing keys, rendering an existing e-MDs database unlicensed. Select Yes. A second e-MDs Warning message displays. The second warning message restates the first message. Select Continue. The Save New Reference Key window displays. Expand the Save in: dropdown box, browse to the location where you would like to save your new reference key. Enter the clinics main phone number in the File name field. Select Open. The Information window displays.
19
The Information window states that a new reference key has been generated. It also lists where the key request was saved. Select OK.
51
20
Log into your email account, create a new email, and select attach. Browse to the location where you saved the activation package. Email the key request to licensing@e-mds.com and include the following information in your email: Contact Name Office Name Office Phone Number Number of Provider(s) Notes: Please make certain the Save as type: field remains set to Reference key file (*.dat). Please do not use a hotmail email account as they tend to corrupt the key during transit.
21
Within 24 hours you will receive a reply email which includes your new Activation Package. Log into your email account and locate the reply from the e-MDs Licensing Department.
22
Software developed by email providers vary, however, in one form or another, you will receive the option to Download Attachments. Save the attachment to the same location where you saved the initial key request.
52
23
If you are not still logged into the eMDs Activation Manager, please follow the directions in steps 13 and 14 of this section and login before continuing. The e-MDs Activation Manager launches. Select License management>Activate installation. In the Open (browse) window, click the Yourclinicphonenumber.dat.Activati onPackage file, it will auto-populate into the File name: field. Select Open.
24
25
The Information window appears stating your installation has been activated. The message will also state the duration of the activation, as well as the number of providers your database is licensed for. Click OK. In the e-MDs Activation Manager window go to File and select Exit. You have successfully licensed the eMDs database.
26
53
Setting a Database Maintenance Plan in SQL Server 2008

1
Clinical data is valuable. It is imperative that clinics have a Certified IT Professional create and document an industry standard backup and disaster recovery plan to protect their data! Users can configure Microsofts Database Maintenance Plan in SQL 2008 Server to create daily copies of the e-MDs database and save it to a folder on your server. They would then set an automated backup plan to copy this folder to tape.
e-MDs is not responsible for configuring or maintaining a clinics database maintenance plan or backups. Please consult with your IT Professional regarding this setup and configuration.
54
Use Microsoft SQL 2008 Database Maintenance Plan to create a backup in conjunction with a method for transferring it to a media which can be stored off-site (Preferably a tape Grandfather-Father-Son rotation).
More information about disaster recovery can be found online or through your local IT Professional.
Click Start>All Programs>Microsoft SQL Server 2008>SQL Server Management Studio. The Connect to Server window displays.
Click Connect.
55
Locate the Management folder and Expand (click the + icon to the left of the folder).
Right-click on the Maintenance Plans folder, then click Maintenance Plan Wizard. The SQL Server Maintenance Plan Wizard window displays.
Click Next. The Select Plan Properties window displays.
56
Enter the name of your maintenance plan in the Name field. If desired, add a description of the plan in the Description field. Click Change. The Job Schedule Properties window displays.
Schedule type: should be set to recurring, and the Enabled box is checked. Select the frequency for the backup and recurring date. Note: e-MDs recommends running daily backups and implementing an off site, rotational backup plan. Please consult with your IT Professional on a proper backup plan.
10
In the Daily frequency section, indicate a time for the backup to begin by clicking Occurs once at and providing a start time in the field to its right. Click OK. The Select Plan Properties window redisplays.
57
11
Click Next. The Select Maintenance Tasks window displays.
12
Place a check to the left of each maintenance task to be performed. eMDs recommends selecting the maintenance tasks shown in the next step.
58
13
These are e-MDs recommended maintenance tasks to be set up. Once tasks are selected, click OK. The Select Maintenance Task Order window displays.
14
The order maintenance task run is a user preference. To change the order, click a task, then use the Move Up or Move Down buttons to relocate that task in the list. When complete, click Next. The Define Shrink Database Task window displays.
15
Click the down arrow to display and select which databases to include in the Define Back Up Database (Full) task. The drop down menu displays.
59
16
Click These databases:, then Select both Topsdata and TopsFDB. Click OK. The Define Back Up Database (Full) Task window redisplays.
17
Note: The backup folder under Create a backup file for every database can be changed if needed. Select Verify backup integrity. Click Next. The Define Maintenance Cleanup Task window displays.
18
Select a folder destination to delete .bak files.
60
19
Select and set the Delete files based on the age of the file at task run time. This is a user preference decision made on the amount of disk space available. Click Next. The Select Report Options window displays.
20
Review the options displayed, then click Next. The Complete the Wizard window displays.
21
Review the list of actions selected. When satisfied, click Finish. The Maintenance Plan Wizard Progress window displays.
61
22
Setting up the Maintenance Plan takes several moments. A Progress screen displays during this process.
23
When the maintenance set up is complete, the Success message displays. To view a Maintenance Plan generation report, click the Report tab. Click Close to finish the setup.
24
SQL Agent must be running. Verify that Maintenance Plan is working and check regularly.
62
e-MDs 7.2 Solution Series Post-Installation Tasks

Important!
After completing the 7.2 installation, you MUST run all post-update scripts and updates. Failure to do so will most likely result in unstable system behavior and lost clinic productivity.
10
Note: All users must remain out of the e-MDs system while completing these PostInstallation tasks to ensure that no one accesses the SQL Server while it is being updated.
63
Perform Server Tasks

Perform the following tasks to your server: 1. Reboot the SQL Server. 2. Back up the databases. 3. Once rebooted, DOWNLOAD AND RUN the most current Consolidated Script for Solution Series 7.2. 4. Access the Knowledge Base article, Where can I find the 7.2 Consolidated Script? on the eMDs Support Center: www.e-MDs.com. Click the Knowledge Base link on the home page, and then click the article under e-MDs Scripts. 5. Log into e-MDs Support Center and ensure that all currently available e-MDs database updates (items such as ICD, RVU, CPT, HCPC, CCI, Drug updates, Meaningful Use Crystal Reports, most current 7.2 Consolidated script, etc.) have been applied.
Note: To verify that your e-MDs database content is as up to date as possible:

a. Log into the e-MDs Support Center (www.e-MDs.com).
b.
Click the Latest Updates link on the home page to view available updates for e-MDs Solution Series
version 7.2.
c.
Download/Run any updates published since 12/15/2010. This is the date on which the content in the 7.2 Installation disk was compiled.
Citrix Published Applications Settings

To avoid possible screen layout issues, e-MDs recommends that published applications in a Citrix environment be configured with a predefined screen size slightly less than the native resolution instead of 'maximize upon opening. Doing so will permit the resizing of the window.
TIFF Printer Settings

When using Fax Monitor and the TIFF printer to fax documents, the second page of the fax may be all black. To avoid this occurrence, on the TIFF Printer Properties > TIFF Options tab, change the settings to the following: In the Compression section, select LZW, set the Quality (Jpeg) to 100, and select Multi Page. In the Color section, select Monochrome.
For complete steps to Setting up a TIFF printer, see the 7.2 Utilities Guide, Chapter 4, Printing and Faxing Information.
Install and Configure the Content Update Manager

Failure to update content routinely may result in inaccurate claims. The e-MDs Content Update Manager is an application that is run to automatically download and install updates for an e-MDs database. This function is included on the 7.2 install DVD. On the DVD, locate the document: e-MDs Solution Series Content Update Manager Installation Guide 7.2 for instructions on installing this feature.
64
Complete Final Clean Up Tasks

Remember to re-enable (or turn on) any real-time antivirus protection you disabled (or turned off) during the upgrade process. Also, make the server available again to remote users (see Section 6: Steps 13-18, except check the option: Allow remote connections to the server. in Step 18).
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e-MDs Solution Series

CHARTING THE FUTURE OF HEALTHCARE

e-MDs Solution Series Installation Guide 7.2 R00

e-MDs Solution Series Installation Guide 7.2 R00

Using This Guide

e-MDs Solution Series Installation Guide 7.2 R00

Getting Additional Help and Information

e-MDs Solution Series Installation Guide 7.2 R00

Using the e-MDs Support Center

e-MDs Solution Series Installation Guide 7.2 R00

Important Steps Before Installation

e-MDs Solution Series Installation Guide 7.2 R00

Installation in SQL Clustered Environments

e-MDs Solution Series Installation Guide 7.2 R00

Pre- and Post-Installation Steps

Installation Time Estimates

Microsoft SQL 2008 Server Installation Time Estimates

e-MDs Solution Series 7.2 Installation Time Estimates

1.86 GHz XP Pro, 2.97 GB of RAM XP sp2/P4, 1 GHZ/512Mb RAM

e-MDs Solution Series Installation Guide 7.2 R00

Ensuring Database Security

e-MDs Solution Series Installation Guide 7.2 R00

Pre-Installation Checklist for Solution Series 7.2

e-MDs Solution Series Installation Guide 7.2 R00

Installing SQL 2008 Server Standard Edition

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When the Setup completes, click Exit.

e-MDs Solution Series Installation Guide 7.2 R00

Click the Enter the Product Key button.

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e-MDs Solution Series Installation Guide 7.2 R00

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Applying Microsoft's 2008 SQL Server Service Pack 1

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Installing e-MDs Solution Series 7.2 TopsFDB Database

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Click Next. The e-MDs previous version warning message displays.

e-MDs Solution Series Installation Guide 7.2 R00

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Installing e-MDs Solution Series 7.2 TopsData Database

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Click Next. The e-MDs previous version warning message displays.

e-MDs Solution Series Installation Guide 7.2 R00

Select an authentication method.

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e-MDs Solution Series Installation Guide 7.2 R00

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Right-click Properties The Server Properties window displays.

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e-MDs Solution Series Installation Guide 7.2 R00

Installing e-MDs Solution Series 7.2 Applications on Workstations