Electronic Health Record Integration Terms

1. Scope. The Electronic Health Record system (“EHR”) integration Deliverables to be deployed consist of the following:

  • PDF and Flowsheets integration. HL7 integration enabling exchanging of PDF reports and Flowsheet Statistics generated in Software into and out of the Client’s EHR system. Available PDF reports include: Summary, Logbook, Overview, Daily Overview, Week View, Overlay, Calendar, Insights, Devices
  • Patient Portal for Professionals. Supports creating a direct link from a patient’s medical record in Epic to the same patient’s profile in the Glooko web application.

Company shall configure the below:

  • Launch of Glooko patient dashboard from EHR patient chart leveraging SMART on FHIR connection with EHR.
  • If an existing Patient of the Client does not exist in the Software, create a new Patient profile in the Software using the Patient’s date of birth and medical record number.

Client shall:

  • create FDI record in EHR to launch Glooko dashboard
  • ensure all patient records in Glooko have unique MRN and valid DOB
  • Single Sign-On. Glooko’s Single-Sign On (“SSO“) supports IDP (Identity Provider) and SP (Service Provider) initiated workflows enabling clinicians and professional users associated with subscribing Clients to log in to the Glooko web application using a single set of account login credentials via the Client’s identity provider. CClient shall provide the relevant IDP metadata files or related Client specifics, such as IDP entity ID, SSO server URL, and SAML signing IDP certificates.

2. Deployment Phases. The project will leverage Glooko’s standard deployment process, which includes the following phases conducted below:

I. Analyze Phase

  • Kick-off/Requirements Meetings. Within three weeks of the Effective Date of this Order Form, a kick-off meeting shall be held between the parties to review and confirm with Client the requirements for executing the Deliverables under this Order Form. Client must have the following personnel assigned for these meetings:
    Clinic Manager/Clinic Representation; Ambulatory Analyst; Network Engineer; Interface Analyst; Project Manager or Owner; Project Sponsor

II. Build Phase

PDF Integration Configuration. Company shall configure the below:

A. In-Clinic Workflow. Client shall:

  • establish connectivity with Redox through a virtual private network tunnel
  • configure an HL7 ADT interface
  • filter the HL7 ADT interface will be to ensure Company only receives messages relevant to its patients
  • configure an HL7 MDM interface to send the PDF to Client’s HE

An ADT^A04 message shall be sent at time of patient check-in. When a patient syncs a device in the clinic, the Software will search for any ADT messages for that patient within the last 12 hours and if any ADT message is found, the Software shall automatically generate a PDF Report and send it into the Client’s EHR.

The PDF Report may be customized from the following sections per provider group site: Summary, Logbook, Overview, Daily Overview, Week View, Overlay, Calendar, Insights, Devices. Currently it cannot be formatted by specific medical device or by a single health care provider.

B. On-Demand Workflow. Client shall:

  • create an order in the EHR to request the generation of a PDF to be sent to the EHR
  • configure an HL7 ORM interface
  • configured an HL7 MDM interface for in clinic workflow to send the PDF to Client EHR

Patient Data Review: Company shall assist in the below listed activities to sanitize and update individual patient records in the EHR before Go-Live (defined below):

  • Ensure medical record numbers (“MRN”) appear on each patient record
  • Clean-up duplicate patient records in the EHR
  • Remove inactive patients who no longer visit Client and have not synced medical devices, in clinic or remotely, in the prior last 2 years

A. Patient Records Sanitization:

  • The parties shall work together to ensure the MRN field is required and forced formatting is enabled
  • Company shall run a script to move all patient records that have not synced in a prior period of time, as determined by Client, to an archived pro connect code. Such records shall be retrievable from the archive.
  • Company shall then run a report to review all patient records remaining and identify any potential duplicates. The parties shall meet as necessary in order to identify and review these records to take necessary actions.
  • Company shall then run a report of the remaining records after duplicate review that includes the Glooko Code and provide to Client. Client may then either input the MRN in a spreadsheet for Company to update or update the MRN manually.
  • Training material for end users. Company shall deliver training materials customized to the workflows defined in the workflow document.
  • Unit testing. Company shall unit test each interface with Client and Redox. Client’s interface team must be present for unit testing.
  • Test Case Documentation. Company shall build out test cases for end to end testing.

III. Certify Phase

  • End to end testing. Client shall perform end to end testing including test case writing and test case execution within no more than four weeks after conclusion of the Build Phase. Company shall support the end to end testing process.

IV. Deploy Phase

  • Production Readiness – Client shall create all interfaces in the production environment after testing is completed. Client must perform an end to end test with Company assistance to ensure production workflows are ready for go live.
  • Training. Four hours of training will be provided to Client’s power users in the key clinics users via web conference technology. Client must participate in the training in order for Company to access portions of the workflow viewable only to Client.
  • Go Live. Go Live is defined as the date the first PDF is successfully sent to EHR in production. Peaks region shall go live in May 2025. Canyons and Desert regions shall go live in September 2025.
  • Go live Support – Company will support Client at go live. Company recommends that Client Power Users round with high volume clinics as part of the go live to engage in feedback on the integration.

V. End Phase

  • Professional Services will support Client for four weeks following Go Live. After this four-week period, Client will be in steady state and will be transitioned to Glooko Support.

3. Project Management and Delivery. Client project manager shall meet weekly with Company through the End Phase. During these meetings the project plan will be reviewed, and any issues that require escalation will be raised. The services Company provides under this EHR SOW shall be delivered remotely using phone calls and web conferencing technology, unless otherwise request by Client and agreed to between the parties, for which email shall suffice. Any additional work outside the scope of this EHR SOW must be agreed to in writing between the parties.

4. Client Cooperation. Client acknowledges that its timely provision of appropriate personnel, equipment, assistance, cooperation, and complete and accurate information and data from its officers, agents, and employees, and suitably configured computer products are essential to Company’s performance under the Agreement. Company shall not be liable for any deficiency in its performance if such deficiency results from Client’s failure to provide full cooperation.

5. Professional Practice Responsibilities. Client shall not rely on the EHR integration as the sole means of verifying critical patient data or communicating life threatening, time sensitive or critically important results. The availability of clinical support tools is provided as a convenience tool only and use of such EHR integrations shall not relieve Client of the responsibility for exercising medical judgment or conducting appropriate medical inquiries. Client accepts sole responsibility for all medical judgments and advice made and provided by the Client based on information available through the EHR integration, in accordance with established standards of professional practice, and for the accuracy, integrity and completeness of the information entered into the EHR by Client.

6. Limited Warranties. Company warranties to Client: (a) the Deliverables will provide documented data as entered in the EHR; (b) the Deliverables will be available during normal business hours; (c) the Deliverables access may be suspended at any time for regular maintenance, updates or to fix reported issues; and (d) the Deliverables are not designed for and should not be relied upon for emergency access.

7. Client warranties. Client warrants to Company that it: (a) has, and will have during the term of this Agreement, all necessary rights, title, and license to enter into and perform its obligations under this Agreement, including the rights to use all the software and EHR data; (b) it complies with all applicable laws and regulations in the use of Company’s software, as well as Client’s clinical and ethical standards, policies and procedures, and industry standards, in handling Protected Health Information (PHI), as defined by privacy regulations issued pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”) as they relate to individuals, and that Client has all necessary rights and consents from individuals whose records are transmitted between the Software and the EHR for the purposes set forth herein; (c) it shall provide any information and/or materials related to the usage of EHR data requested by Company to verify compliance with the Agreement; (d) it shall not copy, reverse engineer, decompile or disassemble the Deliverables or use them for purposes other those expressly authorized herein.

8. Third Party Dependencies. Client understands that the Deliverables provided by Company depend on the third party EHR provider’s continued use and support of the HL7 ADT integration, as determined by such third parties in their sole discretion. Company cannot guarantee the continued availability of the EHR’s interoperability with the API and shall not be liable for any third party failure in its delivery of the APIs.