Clinical

Can Cardio Server manage other modalities besides ECG data?
Yes, Cardio Server manages data from fifteen different modalities including: resting ECG, 12-lead ECGs from bedside monitoring, Holter, stress testing, PFT, event monitoring, pacemaker follow-up, cardiac rehab, defibrillators, ambulatory blood pressure, EEG, non-invasive vascular, and more. We are eager to add other modalities that you may require.

What device manufacturers can Epiphany accept data from?
Epiphany communicates with over 100 devices from over 40 vendors. Check our compatibility page for the current list of interfaces.

If one of our modalities is not currently supported, will you add it to your integration library?
Yes, we are always looking to expand the list of modalities and vendors that we have integrated. Just introduce us to your vendor and encourage them to work with us to create an interface. We do the rest.

How many ECGs can you store in Cardio Server?
ECG storage is a function of disc space on your servers; you can add space as you desire. Cardio Server can manage millions of ECGs with standard network technology.

What tools does Cardio Server offer to encourage online interpretation?
Cardio Server provides the most comprehensive editing functions in the industry including: drop-down menus with check boxes, free text, acronyms or abbreviations, voice recognition support, electronic calipers, and Intelligent Serial Comparison. Different favorites lists may be created for each physician in each reported modality.

Can our physicians have their own unique custom favorite interpretive phrase list?
Yes, we find physicians utilize around 50 or so interpretive phrases most of the time. We enable each reading physician to easily customize their own list for each supported modality.

Can we use speech recognition software?
Yes, and many of our customers use Dragon NaturallySpeaking medical software.

Does Cardio Server support scanning in of previous ECGs and other diagnostic tests?

Yes, the PDF Naming Wizard enables Cardio Server to import PDFs of diagnostic test results that are randomly named and convert them into well-named exams with patient demographics, modality designations, date and time stamps, and physician interpretations. Once the studies are confirmed, they can be sent to your EHR.

Can Epiphany help determine our current workflow needs?
Yes. Epiphany offers a free workflow analysis utilizing the latest in Lean healthcare initiatives and tactics, process flow charting, and business plan development. This analysis will give you a clear understanding of your current process and assist with your ability to diagnose areas for improvement. Leveraging Epiphany’s ability to support multiple diagnostic modalities through one bidirectional interface to your EHR can represent significant cost savings and enhance productivity.

Can we interface multiple ECG vendors simultaneously across multiple hospitals, clinics, and physician practices?

Yes, and we support modality worklists with all the major ECG vendors.

Can you transfer the 12-lead ECG interpretive algorithm from my cardiograph into Cardio Server?
Yes, if you are transferring ECGs with interpretations from a manufacturer's cardiographs, the statements and measurements pass through to Cardio Server without modification.

Does Epiphany's analysis criteria match the algorithm from third-party cardiographs?
Yes, Epiphany displays the interpretive statements and measurements generated by your existing cardiographs.

Does Cardio Server offer serial comparison reporting for 12-lead ECGs?
Yes, Epiphany’s Intelligent Serial Comparison provides additional information to the reading physician on changes between the current ECG and the most recent tracing as confirmed by the reading physician.

Will Epiphany's serial comparison reporting for 12-lead ECGs work with my migrated ECG data?
Yes, migrated ECG data is received in Cardio Server as though it was originally processed by Epiphany.

Will Epiphany's serial comparison reporting for 12-lead ECGs work with my existing cardiographs (GE, Philips, Mortara, Cardiac Science, Schiller, Nihon Kohden etc.)?
Yes, serial comparison works with legacy cardiographs without interfering with the original interpretations and measurements from those devices.

As we buy and/or upgrade existing equipment, will Cardio Server be compatible and be able to take advantage of the new features?
If your vendors are open in design, and update their export functions to include the new features, then we will continue to be compatible. Cardio Server currently accepts data from over 100 devices, in 15 different modalities, from over 40 vendors.

Can Cardio Server send orders to cardiographs?
Yes. We support modality worklists for GE, Philips, Mortara, Cardiac Science, Schiller, and Nihon Kohden cardiographs. If you prefer another vendor for cardiographs, please encourage them to demonstrate open architecture and share their order formats with us. We are eager to work with all the major suppliers.

Are the current interpretive analyses and measurements from our cardiographs utilized/displayed in Cardio Server?
Yes, Epiphany displays the interpretive statements and measurements generated by your existing cardiographs.

Can Cardio Server display ECGs in our preferred format such as 3x4 with a rhythm strip, 6x2, or 12x10, etc.?
Yes, the format saved by your cardiograph is presented in Cardio Server.

Is Cardio Server just an "electronic, paper-storage database" or does it provide real ECG data management?
Cardio Server is a comprehensive ECG and diagnostic test result data management system. Cardio Server stores the raw ECG file, enhances workflow, allows physician online editing, supports automatic printing, email notification and report distribution, offers electronic calipers, and provides management tools for data analysis.

Does Cardio Server store the raw ECG file or just a picture (PDF) of the 12-lead ECG?
Cardio Server stores the raw ECG file in its original format, in our binary format, and as a vector-scalable PDF.

Can Cardio Server provide online electronic calipers that function with ECGs from my existing cardiographs?
Yes, since we transfer the raw ECG file to Cardio Server new measurements can be made with our online calipers.

If sometime in the future, we decide to replace Cardio Server, can our ECGs be migrated to another ECG management System?
Yes.

Does Epiphany utilize Carl Osborne's Datamed format translators from Engineering Solutions Inc.?
Yes, for some vendors' 12-lead ECG data we utilize Datamed format translators. Datamed translators are fully integrated into Cardio Server and do not require additional hardware. By the way, customers of GE, Philips, Siemens, Heartlab, and Cardiac Science also use Datamed. The patient monitoring customers for GE and Philips are two of the largest users for Datamed because it allows Philips' patient monitoring to export to MUSE and GE patient monitoring to export to TraceMaster.

Information Technology 

Can we provide our own server hardware?
Yes, we utilize your preferred vendor for servers or virtualized servers such as VMware, Citrix XenServer and Windows Server Hyper-V. Epiphany will provide specifications based on your testing volume.

Is Cardio Server compatible with virtual environments? Yes, virtualized servers such as VMware, Citrix XenServer and Windows Server Hyper-V are supported.

How many concurrent users does Cardio Server support?
Cardio Server is scalable from 3 to 250 concurrent users. A concurrent user is not a seat license as with some systems. Concurrent users apply to anyone accessing the application simultaneously. 

How does Epiphany address security?

Epiphany is one of the few vendors whose software has received DIACAP Certification (DoD Information Assurance Certification and Accreditation Process). During the certification process, every line of code was audited by the Epiphany engineering team for (Information Assurance) IA compliance. All points of entry into the system are documented and tested. Cardio Server also provides comprehensive HIPAA logging for actions and changes in interpretations.

Does Cardio Server support large IDNs (independent delivery networks)?
Yes.
Epiphany offers broad flexibility to enterprise medical systems with multiple hospitals, clinics, and physician practices. Cardio Server supports different levels of complexity and workflow between various sized facilities within your IDN 

Does Cardio Server support sites in multiple time zones?
Yes, Cardio Server does support multiple time zones.

Is Cardio Server compatible with Microsoft.Net architecture?
Yes, Cardio Server is compatible with Microsoft.Net but we do not require it.

Is Cardio Server a web-based, true thin client application?
Yes, Cardio Server is web-based pure IIS. All functions such as reading, editing, and printing can be done from any PC on your network subject to user privileges. No downloadable applets are required and all terminals on the network have full functionality.

What does it mean to be "web-based"?
Web-based means Cardio Server runs in a standard web browser environment without ActiveX, Flash, or .Net. Web-based means interventionalists can view STEMI with the previous ECGs on smart devices.

Can we use our existing VPN technology for remote access to Cardio Server?
Yes; VPN is an excellent way to provide physicians and others access to their ECG data from home or office.

Can we use our existing SAN, NAS, tape, etc. backup system with Cardio Server?
Yes; simply add Cardio Server to your regular backup procedures.

Can we use our existing SAN for the live database storage?
Yes.

Does Cardio Server support Active Directory for single sign on and authentication?
Yes.

Is LDAP based authentication compatible with Cardio Server?
Yes.

Is our preferred virus protection plan compatible with Cardio Server?
Yes, Cardio Server is a web application running on your infrastructure.

What database program does Cardio Server use?
Cardio Server utilizes MySQL.

How much system administrator support is required by Cardio Server?
Cardio Server requires little day-to-day maintenance. Chief maintenance tasks include patch management, backup oversight, virus protection maintenance and periodic log review. Note that these recommended practices are generally no different than standard support for any other server – Cardio Server does not require specialized “care and feeding.”

Can Cardio Server take orders from and send results (including waveforms) to our EHR?
Yes, and Cardio Server can support 15 different modality types into your EHR with one bidirectional interface. Cardio Server has its own, internally developed HL7 tool that allows us to customize inbound and outbound HL7 messages to your specifications. Currently deployed interfaces include: Meditech Magic and Client Server, Cerner, McKesson, Siemens, GEMMS, EPIC, Opus, MedWinSys, Duke University Browser, Lumedx Apollo. The interfaces continue to grow; our web site maintains an up-to-date listing.

Can I view ECG data within my cardiology PACS system?
Yes, in most cases. Cardio Server supports an API link and other technologies to receive requests from cardiology PACS to display 12-lead ECGs and other reports within the PACS viewer.

What is an API (application program interface)?
An API is the interface that an application provides in order to allow requests for services to be made of it by other computer programs, and/or to allow data to be exchanged between them. In the case of Cardio Server, an API could be used to access ECGs from your PACS.

Is an extra computer required to interface to cardiographs?
No, all of Cardio Server's interface modules are fully integrated into our application.

Customer Support and Implementation 

Can Epiphany migrate ECG data from other ECG Management systems?
Yes. We have migrated millions of ECGs from MUSE, TraceMaster, Cerner, and Pyramis. For more information on this subject, view the second paragraph of this blog entry.

How many companies are involved in producing, delivering, and supporting Epiphany products?
One. Epiphany is responsible for the development, implementation, and support of our products.

Does Epiphany provide 24/7 support?
Yes, with staff on both coasts.

What does the CAP (Customer Advocacy Program) do for me?

(Holly is working on an answer and we have a blog entry we’ll link to for this, but anything you’d like us to include, Kelli?)

Are upgrades, updates, new versions etc. included in the support agreement?
Yes, all upgrades are included with an active support agreement. Professional service fees are applied for project management and implementation services. Third-party license upgrades such as Microsoft Operating systems and hardware are the user's responsibility.

Do you have local support for our installation?
If you provide your own server hardware, then your IT department is the front line of hardware support and Epiphany provides secure, remote-software support. If Epiphany provides your server hardware, then Dell supports your hardware locally and, as above, Epiphany provides remote-software support. Our entire application can be remotely installed and entirely rebuilt in the event of a catastrophic failure. We support over 600 systems worldwide from our service facility in Durham, NC.

About Epiphany Healthcare 

Does Cardio Server have 510(k) FDA registration?
Yes, Cardio Server received its 510(k) registration as a Class ll device in November, 2005. A copy of the registration is available upon request.

Can a software-only application for ECG management receive a 510(k) from the FDA?
Yes, the first sentence of Cardio Server's 510(k) registration states that it is available as a software-only application.

How long has Cardio Server been in clinical use?
Cardio Server was first deployed for use at Duke University in 2001.

How many employees does Epiphany have?
Our staff numbers over 50 and growing.

Does Epiphany own the license to Cardio Server?
Yes.

Common Misconceptions

Is it true that one company's resting-ECG algorithm is somehow superior to another company's algorithm?
We discuss computerized-ECG findings with physicians every day. The one question that we always ask is, “How often do you agree with the interpretative statements coming from the cardiographs?” We of course hear the occasional extremes “never or 95% of the time.” The most common answer, however, regardless of the cart manufacturer is, “60 to 75% of the time we agree with the computerized interpretation.”

When you transfer ECGs with interpretations from a cardiograph to Cardio Server, the original statements and measurements pass through to Cardio Server without modification. If you like your current algorithm you will still see the same data.

Is it true that transferring from carts to an ECG management system other than that of the cart manufacturer will void your cart warranty?
No. Epiphany has many sites with carts transferring to Cardio Server without voiding the warranty.

Can Cardio Server accept wireless transfer from MAC 5000/5500 cardiographs?
Yes. We have hundreds of GE carts transmitting ECGs wirelessly to Cardio Server.

Can I purchase Silex, wireless modems for my MAC carts from Epiphany?
Yes. The modems come with instructions for installation by Biomed, telephone support, and the original Silex warranty.

Why do the competitors say that Epiphany is either going out of business or going to get acquired?
We have heard a variety of rumors and misinformation over the last nine years. This can happen when you displace older, staid companies in a monopolized market niche. We believe that robust competition benefits the end users with more features at better prices. We are growing, business is strong, and our customers are benefiting.

How does Epiphany import device data?
Most of our modality imports have both alpha/numeric feeds and waveform-PDFs. Supported formats include DICOM, XML, HL7, and PDF. When we receive the alpha/numeric data, we post it into editable fields. This is so much more than simply taking a PDF in for storage.

When we get only a PDF, we are doing much more to support our customers. Our PDF Import Tool allows the importation of any PDF to Cardio Server where we create a new modality in the database and populate all demographics with an ADT or orders feed. Our tool provides you flexible workflow including a cover page for physician interpretation, forms, acronyms, electronic signature, HL7 messaging into the EMR, automated messenger functions, and administrative reporting.

Other Inquiries 

Have a question not answered by our FAQ? Contact us. We will respond to your inquiry as soon as possible.