Requirements for Sharing a Common Noah System 4 Database Between Office Locations (WAN/VPN Support)

HIMSA has published the following list of requirements for offices that wish to share a common Noah System 4 database.

These requirements are published to provide Noah 4 users with a clear understanding of what has been tested by HIMSA. The requirements also provide a foundation for support personnel from HIMSA member companies, so that they can effectively help users with Noah 4 network-related issues.

IMPORTANT: The following are requirements, not guidelines. It is important that each requirement be met in order for technical support to be offered.

IMPORTANT: In Noah 4.10 HIMSA replaced the Noah networking infrastructure based on .Net Remoting with a REST based method, for more stable and robust network communication over both local (LAN) and wide area networks (WAN). This means more reliable communication with remote offices, especially those with less stable networks.

 

Number of client workstations computers supported by Noah 4

Noah 4 was not designed to support an unlimited number of client workstations. Rather it was designed to support up to 40 client computers with the assumption of normal day to day usage of Noah 4. With end user sites being interested in a WAN/VPN setup and have the technical setup to support this feature, HIMSA assumes that a typical company setup would not contain more than 7 remote offices.

Normal activity is defined as:

  • Adding for patients
  • Searching for a patient
  • Saving fittings

Normal activity does not create an excessive workload for the server to deal with. If several workstations try a complex task (e.g. an advanced search on hearing loss) at the same time, then the Noah server will responded slower.

Q: I have a large chain of 80 dispensing locations and 170 client computers that use Noah. Does Noah 4 support this type of setup?

A: No, The amount of data and workload is assumed to be much greater then Noah 4 was designed to handle. HIMSA suggests other more robust options such as using a Noah compatible business system or the possibility of integrating practice management system with Noah 4. Please see here for more details.

 

Connection Speed

Each remote office location must have a connection that will facilitate at least 500kbps bi-directional communication at minimum. For best performance, we recommend a 2 Mbps or higher bi-directional connection. The user site is responsible for determining the speed of the network connection. This information can typically be obtained by contacting your network administrator or Internet Service Provider.

 

Connection Reliability

The client workstation computers connecting to a Noah Server installation must have a reliable connection. If the connection is not present, Noah 4 WILL NOT run automatically in a disconnected mode.

 

Network Performance

The responsiveness (e.g. selecting a patient, running a search) may be slower depending on the speed and quality of your network connection.

Q: What happens if the network speed drops below the minimum stated speed or there are network quality issues?

A: Noah System 4 has an internal network performance tool that runs periodically and checks for an adequate response time between the Noah 4 server and each client workstation. If this tool detects that the performance is too low then the user will be presented with a warning that they may be experiencing problems with Noah 4 due to network performance issues. This does not mean that Noah 4 will cease working but may take longer to finish requested tasks.

 

Module Performance

Noah compatible modules are designed to be installed on each client work station and as such should be less affected by the speed of a network connection. Once a module (e.g. a fitting module) has been opened and is ready to work (e.g. connect to a hearing instrument) there is typically no interaction with Noah 4 or the network until the fitting is complete.

The following is a list of activities where modules do interact with the network

  • When the module is first opened, the module may read data from the patient’s session list (e.g. load the latest audiogram)
  • When the module closes and prompts the user to save the data

The above is a good generalized list but HIMSA will point out that modules have the ability to read and write data at any time.

 

Network Security

For versions of Noah previous to Noah 4.10 , it is the Noah user’s sole responsibility to provide a secure network connection between offices. For example, if you are using an internet connection, HIMSA assumes and highly recommends a Virtual Private Network (VPN) connection. Without an established VPN between locations, transfer of patient data would not be encrypted and could potentially be captured by unintended parties. This is in direct violation of many medical security mandates (e.g. HIPAA).HIMSA will not provide support with VPN setup and configuration at the end user’s site.

With the release of Noah 4.10 the network communication has been updated for Noah and communication is secure by default as we rely upon HTTPS for client server communication. HTTPS encrypts communication between the server and client with TLS cryptographic protocol and ensures that all data exchanged remains private and secure.

Q: Does the HTTPS Noah networking mean I can host my Noah server on a cloud provider like Amazon or Microsoft Azure?

A: With Noah 4.10, it is possible to use a public internet connection to connect remote client workstations to a Noah Server but by doing requires that the Noah Server installation is exposed to the Internet.  The communication between the Noah Server and Client workstations will be secure but exposing a computer to the open Internet requires many other types of protections.   If you are attempting this type of installation HIMSA strongly suggests that you obtain skilled IT advice from an IT consultant of your choice to ensure that your Noah server is properly protected.  In the future HIMSA plans to offer services for securely hosting Noah Server, thus eliminating your need to deal with these security issues.

IMPORTANT: It is possible to configure Noah 4.10 to use the genuine channels protocol instead of the default HTTPS.  In this case the HTTPS security is lost and the location must refer to security precautions listed above.

 

Network Ports

In most cases internal networks or VPN’s do not require special setup in regards to communication ports. If the network is configured to be highly locked down, then Noah must have the following ports open on the server in order to function correctly:

  • TCP Port 8200
  • UDP Port 8300

If you are using Noah 4.10 or later, in addition to the above ports, you must also allow:

  • TCP Port 8206

 

Windows Networking

It is important that the following can be accomplished.

Via the Windows graphical user interface (e.g. Network Neighborhood, Microsoft Windows Network):

  • From the Noah client workstation, the Noah server is visible
  • From the Noah server computer, the Noah client workstation is visible

From a command line prompt:

  • From the client workstation, the server can be pinged via computer name
  • From the server computer, the client workstation can be pinged via computer name

 

Segmented Data

It is important that the following can be accomplished.

Via the Windows graphical user interface (e.g. Network Neighborhood, Microsoft Windows Network):

  • From the Noah client workstation, the Noah server is visible
  • From the Noah server computer, the Noah client workstation is visible

From a command line prompt:

  • From the client workstation, the server can be pinged via computer name
  • From the server computer, the client workstation can be pinged via computer name

 

Installation

When installing Noah 4 System on the client workstations, HIMSA suggests that Noah 4 be installed so that the client workstation has a profile setting to the server database and one to a database located on the client workstation. With this type of setup, the local database can be used in the event that server is not available or network connection is not possible.

For a new installation (not upgrading from NOAH3):

When the Noah Configuration Wizard is run simply choose the “Store my patient records on this computer or on a network computer” option and complete the wizard steps. This option will create a profile to both the network database as well as the local computer.

For a computer which was upgraded from NOAH 3:

Start Noah 4. Select the Setup > Administration > NOAH Server Setup > Server Profiles menu. Create (or edit) profiles so that one profile points to the server computer and one points to the local computer.

 

How many Noah licenses do I need?

Each satellite or remote office in a Noah 4 WAN needs its own unique Noah 4 license. The license will be registered to each remote office and installed on the local computers. This is a site license policy that has always been in place for Noah including Noah 2 and Noah 3.

Q: If I have a central office with a Noah server and database and two branch offices connected to the Noah server how many licenses do I need?
A: You will need 3 licenses

If your company has requirements where the Noah related data is located at a different physical address (e.g. in a centralized data center) and the NOAH features (e.g. adding patients, saving fittings) will not be performed at that location, then HIMSA permits that this location is not required to own a separate license.

Q: My hospital IT department requires that the Noah Server installation be located on a computer in the hospital's data center which is located at a different address then the main Audiological clinic. My company also has 4 additional outreach clinic locations that will share the same database. None of the clinics are located at the same address as the data center. How many Noah 4 licenses does my company need?

A: You will need 5 Noah licenses. If your company has requirements where the Noah related data is located at a different physical address (e.g. in a centralized data center) and the Noah features (e.g. adding patients, saving fittings) will not be performed at that location, then HIMSA permits that this location is not required to own a separate license.