For Servers: 

The server hosts the database for the entire clinic. The performance of the server has the single biggest impact on the performance and reliability of the system. Accuro can be installed on a server located on-site at the clinic or business. Note that the more users you have using the server at one time, the more powerful the server should be. Maintenance of the local server, for example but not limited to the hardware, third party software, SQL databases, backup etc.. is the responsibility of the client.  Many clients choose to go with our Cloud solution as QHR will manage these in our hosted environment for them.

It is highly recommended that you purchase Windows Server and SQL separately and NOT go with one of Microsoft's SQL bundled options. The bundled options are preconfigured with nonessential services that can take up system resources if you’re not using them which can negatively impact performance.

For best performance, SQL Server should be installed on a separate server from any other services on your network, such as a terminal server, domain controller, workstation etc. Not doing so could negatively impact the performance of Accuro. Sites that disregard this recommendation may be asked to separate these servers before QHR can investigate any performance issues.

Although it is possible to run the EMR server on the same machine as the network server, it is not recommended for performance reasons and therefore the below requirements would need to be adjusted for a consolidated server approach. For all workstations and servers, please consult with your hardware provider for other important components like (but not limited to) UPS device, backup (unless QHR backup is chosen), Antivirus, Network Devices, Firewall, SQL and other network/workstation software licensing, and Maintenance Plans. 

For Tablets, Android Phones/Tablets, or iPads/iPhones:

Non-Windows Tablets, iPhones, and Android Phones: Accuro does not run directly on phones or non-Windows tablets. To access your data from these devices, use Accuro Mobile. Accuro Mobile is a web application that can be accessed on your iPhone, iPad, or other tablet and smartphone devices that have web browser capability. Accuro Mobile is not the full version of Accuro but allows viewing of your scheduler, patient records, inbox, plus the ability to record patient notes and billing. 

iPads and Android Tablets: These run Accuro Mobile just like the iPhone, but additionally through applications like "Jump" and "2X", provides remote desktop access to run full Accuro (requires a terminal server or RDP available Windows workstation).

B. Network Requirements

• 10/100/1000 Base T (1000 Base T/Gigabit recommended)

Wireless Network

• Accuro will run over a wireless network, (note that environmental factors may affect performance)
• 54 Mbps (or higher recommended)

Technical Database (SQL) Configuration and Maintenance 

QHR does not directly support your database server. It is the responsibility of the clinic to make sure the database server is healthy. 

Database Configuration:

1. Ensure the correct version of Microsoft SQL Server is installed with appropriate licensing.
2. Accuro requires the database to be set up for connection using the sa account by default.
3. Enable TCP/IP and use port 1433 by default. Alternate ports can be configured on request.
4. The boot drive for SQL must have >10% available drive space for temp files.
5. Set both the Data File and the Log File of the database to use a fixed growth size of 250MB.

Database Maintenance

Database maintenance plans are recommended in order to optimize the performance of the system. QHR does not run these checks on your database so please contact your local IT to arrange maintenance for this. They are not complex steps and can be done directly using Microsoft SQL Server Tools. This is by no means considered a complete maintenance plan and should be modified to meet the needs of your network.  If you are unsure or your local IT has any questions, please contact us.

Database Backups 

It is required that you ensure your data is being backed up regularly. The database server contains all of the data and if anything happens to the server, the backup will be the only way to recover the data. It is best to plan for worst case scenarios such as theft of the server.

QHR offers a backup service that automatically backs up your database daily and stores the data in the QHR secure data centre. In order to have QHR backup, you must first contact QHR to sign up for the service to be installed. There is a monthly fee depending on how much data you have to back up.

Third Party Hardware

Printers - Standard: Accuro works with any modern laser or inkjet printer that can successfully print from the workstation.

Printers - Label: Accuro works best with the Dymo 550 Turbo or Dymo 550 Label printers. For ASP customers, label printing is not supported on Mac workstations. Label printing does work with Windows workstations (can print from a Mac to a PC where the label printer is connected).

Printers - Prescription: Accuro works best with the Epson T88V Receipt printer. Note that standard printers can be used as prescription printers as well. The receipt printer is an alternative that offers a smaller paper size and continuous paper feed.

Scanners: Accuro works with any scanner as it does not directly connect to the scanner. Rather, Accuro requires the scanner to place the scans into a folder on the network, and Accuro displays the contents of the folder in the Documents section for the user to "File". A recommended scanner is the Fujitsu Scansnap due to its low cost, small size, and ease of use.  Given Documents (Scans and Faxes) can take up the most amount of storage space, please ensure your scanners and faxes are being set to reasonable resolutions. High resolutions can create storage ballooning of up to 100x. (i.e.: reasonable file size is 20-50KB per page, and a high res file can be 2,000KB per page.)

Internet Fax: As an alternate to Fax modems, Accuro connects to an Internet Fax web service called UNITE. This allows all faxing to be run through the Internet and no longer requires you to have a fax line, fax machine, or fax modem. For more information, visit www.unite.ca open_in_new .

Modem Fax: Accuro connects to Windows Fax and Scan to send faxes. A modem is required in a single elected workstation (not the server) which will become the new outgoing fax machine for the clinic. Faxing within Accuro is automatically routed through the modem and the fax status can be viewed directly in Accuro (via Fax Manager) or in Windows Fax and Scan. Incoming faxing is set up by configuring Windows Fax and Scan to save the TIFF fax files to a directory on the network (UNC path). Users then use the Documents section of Accuro to upload from the Directory to the patient chart.
NOTE: Windows Fax and Scan on the workstation must run under a single shared user account so that the status of faxes sent and received can be viewed. Logging in to the fax workstation as another user will not display the faxes as the Fax Console is user-specific.

QHR recommends a Serial modem over USB modems as they are more reliable when communicating to other fax machines/modems.

Single line fax modem:
US Robotics 5686G (http://www.usr.com/products/modem/modem-product.asp?sku=USR5686G open_in_new )
Requires a serial port.
DO NOT INSTALL USR DRIVERS, USE MICROSOFT DEFAULT DRIVERS.

All other fax machines should be taken off the same line as the one to be used for Accuro server so no cross-talk or other communication issues can occur on the line preventing either out or incoming faxes.

Swipe Card Readers (currently only available in BC and ON): QHR supports the Magtek Dynamag card reader (Part Number: 21073062) using encryption levels 1 or 2. Encryption level 3 (also known as Triple DES Encryption) is NOT supported. Other card readers may function with Accuro although we cannot guarantee these will work with Local, ASP, and/or Accuro Cloud systems.

Please confirm with the seller that the card reader has NOT been configured past encryption level 2.

Supported swipe card readers are available from the following re-sellers:

• https://www.cdw.ca/product/magtek-dynamag-magnesafe-swipe-reader-centurion-magnetic-card-reader-us/4760411?pfm=srh open_in_new
• https://www.barcodesinc.com/magtek/part-21073062.htm open_in_new
• https://www.directdial.com/ca/item/magtek-magnetic-stripe-reader/21073062 open_in_new

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