1. Added Value to the Medical and Public Health Communities: 16This appendix to the Raptor Overview will provide the reader with additional information on the Raptor System Offering as it relates to the Healthcare Industry.

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Table of Contents

1. Added Value to the Medical and Public Health Communites: 16
2. Electronic Primary Source Verification of Licensure and Certification: 16
3. Interoperability with the Enterprise Environment and with other Federally Compliant Programs: 17
4. Interoperability with Physical Access Control Systems throughout the Enterprise Installation: 18
5. Enhancement of Productivity especially in Human Resources and Continuing Education: 19
6. Protection of Patients by Identity and Licensure Verification at a High Assurance Level

combined with Advanced Response Concepts's Total Security Approach: 20

7. Beyond ESAR-VHP: 20
8. Why Choose RAPTOR ID?: 22

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part for any purpose other than to evaluate the VUANCE offerings, until a contract is awarded or purchase order issued. After either action the recipient
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The VUANCE home page can be found at: http://www.VUANCE.com Copyright 2008


Added Value to the Medical and Public Health Communities

Why is a decision to implement the RAPTOR system in the hospital, clinic and public health sectors a sound one? Raptor is the premier credentialing system in the country today. The system has an exhaustive list of features making it the logical choice for First Responders, Health Care, and Critical Infrastructure. The system is unique in that it manages both the identity and the attributes of an individual. Raptor functions through an encrypted Smart Card and Web Accessible database foundation and is compliant and/or interoperable with all existing applicable federal standards. Some areas in which Raptor can have a positive impact on the efficiency of hospital and public health operations include:

• Electronic Primary Source Verification of Licensure and Certification
• Interoperability within the enterprise environment and with other federally compliant programs
• Interoperability with physical access control systems throughout the enterprise installation.
• A higher level of security and accountability in the distribution of controlled substances.
• Enhancement of productivity especially in human resources and continuing education.
• Compliant with the National ESAR-VHP program and ability to interface with first responder systems.
• Protection of patients by identity and licensure verification at a high assurance level.
• Integration of criminal background checks and ongoing monitoring of licensure status.

VUANCE has chosen to separate ourselves from our competition by making our unique and robust skills comparison application a part of the RAPTOR ID system. This is an ongoing investment since curriculums, standards, Guidelines, and legislation changes occur frequently so our system is continually updated to ensure our customers are always in compliance.

Electronic Primary Source Verification of Licensure and Certification


The RAPTOR system was originally designed to serve as a portal for verifiable information at a high level of trust in an emergency situation. That exceptional foundation has been leveraged to provide immediate access to critical licensing and privileges data for the non profit and commercial health care market. Today a patient’s healthcare experience is seldom limited to a single physician or hospital. Similarly the professionals and paraprofessionals who ensure the smooth and effective operation of inpatient and outpatient medical facilities and private practices are often affiliated with multiple institutions and organizations. Conversely many formerly independent health care providers and institutions have come

together into organizations that consist of multiple locations that can be spread over several states. The human resources challenges alone are challenging. Adding the dynamic issues of professional licensing, practicing privileges and mandatory continuing education, can make management of your resources a truly daunting task.

RAPTOR helps you both verify and manage these important data sets and share the information across your healthcare network. Imagine a physician comes into your facility with a request for practicing privileges and you can pull his complete educational, specialty and sub specialty certification, DEA registration, licensure, and practice history with the simple swipe of his photo ID credential. A nurse anesthetist transfers from another hospital in another state within your corporate network, a read of the card and you have her entire professional history with information so up to date it shows the 2 hour CMU program she took the previous evening! This is just a small part of what RAPTOR offers. The initial entry and subsequent validation of the datasets can be handled in accordance with your organization’s requirements administrative validation of legacy information according to JCAHO standards, or near real time electronic primary source verification for new records or records you wish to reconfirm. RAPTOR is capable of retrieving and or validating a broad spectrum of information to include State and Federal criminal history checks. Regularly scheduled automated monitoring of licensure and certification status can also be handled by the system.

Interoperability within the enterprise environment and with other federally compliant programs


Interoperability is the cornerstone of products and services that serve the first responder marketplace. The VUANCE-RAPTOR program was designed with interoperability in mind and is the most complete solution of its kind in the country. The first issue of interoperability is based on the question "Who can use the program". The RAPTOR program was designed with all first responders and healthcare professionals in mind. Where some credentialing programs and offerings serve various components of the first responder community the RAPTOR program serves them all, and if a new one is identified the system is designed to be rapidly configured to meet the new needs. We are unique among our competition in this

aspect.

Although it is true that the Department of Health and Human Services was the first to look at the credentialing process through their ESAR-VHP program supporting only that program is unacceptable. Global Secure, Collaborative Fusion and EMSystems, all have ESAR-VHP programs. However the goal behind HSPD-12 was to have one card that could be used anywhere. Meeting only the ESAR-VHP program needs is unacceptable when it means that two or more different programs need to be supported in the same jurisdiction when multiple types of responders converge on the scene.

Beyond interoperability between different first responders disciplines VUANCE-RAPTOR provides for interoperability with other Federal Identification program initiatives. Our program has architecture to meet all the requirements of HSPD-6, 8, and 12 as well as the Federal Information Processing Standard (FIPS) 201 PIV I and II. VUANCE is a member of the Federation for Identification and Cross Credentialing Solutions (FiXs™) and has a seat on both the executive committee and Board of Directors. Through this organization VUANCE is the only provider of verified Professional Profile First responder credentials to have a MOU with the Department of Defense and be interoperable with the Defense Manpower Data Center. The VUANCE system can read federally compliant identity information and digital certificates from DoD, TSA/TWIC, the National Capitol Region and other Federal Identity projects. Through FiXs VUANCE can facilitate interoperability with programs developed by Northrop Grumman, Lockheed Martin, EDS, SRA, Wells Fargo, RSA, and many other major integration companies. No other provider of first responder credentials can make that claim.

Even outside of the FiXs Network VUANCE has worked to establish working relationships with other major integrators such as Motorola, General Dynamics and IBM. In point of fact VUANCE can even claim interoperability with many of its competitors so long as their programs have been developed to meet the requirements of the federal government specified in the standards published by the National Institute of Standards and Technology.

Interoperability with Physical Access Control Systems Throughout the Enterprise Installation

Today electronic access control is more than just controlling who goes where and when. Today’s electronic access control can be anything from a simple door control system to a platform for facility management and business enhancement. Physical security is important, protecting people and assets, but it is becoming so much more. This security, at a minimum, needs to allow your healthcare facility to function effectively and, when done right, can be used to enhance your business by helping you to effectively manage your people and resources, prevent wasteful loss, and providing useful information about how your facility and personnel operate most effectively.

VUANCE works to help you evaluate your security needs and determine the best way to use technology and methods to protect your personnel and provide effective use of your resources. Whether it is a small office or retail location, a larger campus or collection of offices, or a global enterprise, VUANCE has the technology and know-how to help you transform security problems into business enhancement.

VUANCE provides a sophisticated, enterprise-level access control system. Its true PLC programming capability allows the MASC system the ultimate flexibility only promised by other systems. Any security rules that can be imagined can be quickly implemented with ladder logic, a programming technique widely known to control system integrators and electrical installers. The graphical user interface (GUI) provides operators with a visual representation of the facility. Symbols, icons, sounds and text are dragged and dropped onto imported maps or floor plans and display the real-time status of one or many points. More than 50 different operator control functions can be linked to these objects and automatically executed with a click of the mouse or touch of the screen. All of this provides unique flexibility in user interface design. With only five main screens in the entire application, the status of a facility is always at the operator’s fingertips - not hidden under layers of menus or multiple screens.

MASC operates with VUANCE MAC series controllers. These controllers use Echelon’s LonTalk® (ANSI 709.1) protocol to provide a highly flexible communications topology. Peer-to-peer communications allows a robust system that does not have to depend on PCs. These features provide the opportunity to implement a layered approach to security with true distributed processing.

A Higher Level of Security and Accountability in the Distribution of Controlled Substances


Automated medication dispensing systems provide health care facilities with flexible systems to manage medications and to help ensure patient safety by enabling health care professionals to reduce medication errors, monitor, and control medication dispensing. These systems also help hospitals comply with Joint Commission and regulatory standards and ultimately improve patient care. The majority of the systems on the market today are computer controlled and work off of a database system. Access is allowed based on password or pin number authentication managed by the database. With minimal integration many of these systems can be enhanced using RAPTOR. The problem with passwords is the unfortunate tendency to share the information among “trusted” colleagues. With RAPTOR, extra levels of authentication can be added to include token required authentication and biometric authentication. An added advantage is the RAPTOR systems ability to allow for near instantaneous suspension or revocation of an Attribute, like access to a dispensing system, or complete revocation or suspension of a credential.





Enhancement of Productivity especially in Human Resources and Continuing Education

Raptor’s web based program allows unparalleled secure ease of access to administrators. A single source for Human resource records combined with the most extensive training and education records management available today. Issues of integration or import of existing system records can be handled by the VUANCE government solutions development team in close cooperation with the customer. Reducing the administrative load so that more time can be focused on patient care is a primary reason for implementing the RAPTOR system. The tiered administrative functions of RAPTOR allow for reasonable span of control. Spreading out the load often means that full time employees are not required to manage traditional record keeping tasks.

Managing continuing education is often a tedious and time consuming task. End of year scrambles to secure the appropriate number of CME, CEU and risk management credits are common among practitioners. With Raptor all of the Continuing education and professional development programs are not only tracked but the system sends reminders to users and administrators when it appears requirements will not be met or expirations are drawing near. Responsibility for managing training and education records can be shared by user and administrators or restricted to administrators alone. As with every transaction occurring in the RAPTOR system strict audit logs are kept and custom reports can be designed and integrated.

Protection of Patients by Identity and Licensure Verification at a High Assurance Level combined with VUANCE's Total Security Approach

Hospitals large and small alike are very busy places. For those of us who have been patients over night, or over several days it seems as though every eight hours brings a new face. With all the stresses of being a patient the last thing you want to worry about is “exactly who is this person in the scrubs again?”. On a more serious note individuals impersonating hospital staff for nefarious purposes seems to have become more and more prevalent as of late. Imagine the comfort level of an elderly patient or a new mother when the ID hanging from the staff person pocket is run through a card reader and the picture and profile of that staff person appears at their bedside or even on the TV screen overhead. With RAPTOR this type of comfort and protection is possible and integrated with other VUANCE security systems this visual display is proof of the multi-layered security designed to protect the patient, and for that matter the practitioner. Infant tracking and infant to mother matching are handled by the VUANCE Pure RF Technology. Active RF systems keep watch over your high value assets. RAPTOR takes care of your staff, volunteers, and with the New Medical Record Card your patients. MASC brings all the

programs together along with your access control systems, camera systems, environmental systems and much more, run from a single control application. VUANCE is serious about security.

Beyond ESAR-VHP

As the federal government’s credentialing efforts become more mature they are realizing that there is a significant amount of effort duplication. The federal government is currently running several different programs designed to correct the failures in credentialing during 9/11 and Hurricanes Katrina and Rita.

The first are the mandates; Homeland Security Presidential Directive 12 (HSPD 12) and its brother Federal Information Processing Standard 201 (FIPS 201). These have lead to the General Services Administration (GSA) issuing category 132

62 of Schedule 70 Homeland Security Presidential Directive 12 (HSPD-12) Product and Service Components. By issuing this contract industry then begins to develop products and services that government agencies can then use to implement the requirements of HSPD-12 and FIPS-201.

Secondly, the National Integration Center (NIC) Incident Management Systems Division, which is under the Department of Homeland Security’s Federal Emergency Management Agency (FEMA). NIC is in charge of the National Incident Management System (NIMS), which is a project, “Developed so responders from different jurisdictions and disciplines can work together better to respond to natural disasters and emergencies, including acts of terrorism. ” (WELCOME to the National Integration Center (NIC) Incident Management Systems Division, Retrieved September 5th, 2007, from http://www.fema.gov/emergency/nims/index.shtm)

To facilitate multi-jurisdictional responses NIC is in the process of defining the job titles and rolls of responders to create the National Emergency Responder Credentialing System (NERCS). The NERCS, “Will document minimum professional qualifications, certifications, training and education requirements that define the standards required for specific emergency response functional positions.” (Resource Management, Retrieved September 6, 2007, from
http://www.fema.gov/emergency/nims/rm/credentialing.shtm)

Then finally Congress passed Title 42, Chapter 6A, Sub-Chapter II, Part B, § 247d-7b, Emergency System for Advanced Registration of Health Professions Volunteers, and tasked the Department of Health and Human Services, Health Resources and Services Administration (HRSA) with its implementation. HRSA was charged to “Establish provisions …of the system in collecting, storing, updating, and disseminating information on the credentials, licenses, accreditations, and hospital privileges of volunteers.” (Emergency System for Advanced Registration of Health Professions Volunteers. Title 42, Chapter 6A, Sub-Chapter II, Part B, § 247d-7b, Retrieved September 4th, 2007 from
www4.law.cornell.edu/uscode/html/uscode42/usc_sec_42_00000247---d007b)

HRSA established the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) program as a state-based system. HRSA has to date issued interim guidelines and let each state handle the program in their own way. The goal of the system according to HRSA of the ESAR-VHP systems will be to, “Form a National system that will allow efficient utilization of health professional volunteers in emergencies by providing verifiable, up-to-date information regarding …identity and credentials.” (Emergency System for Advance Registration of Volunteer Health Professionals, Retrieved September 6, 2007, from http://www.hrsa.gov/esarvhp/)

Between HSPD-12/FIPS-201, ESAR-VHP, and NIMS there are three paths to the same goal; being able to trust the identity and skills of the person standing in front of me. Congress realized that there was a duplication of effort in the current process and included a solution in the Implementing Recommendations of the 9/11 Commission Act of 2007 (Public Law 110-53) in Title IV, Section 401- Definitions, § (a) (3). This section lays out Congress’ vision as to how credentialing should be done. In Title IV, Section 401- Definitions, § (a) (3) the Act defines ‘credentialing’ as:

Having provided, or providing, respectively, documentation that identifies personnel and authenticates and verifies the qualifications of such personnel by ensuring that such personnel possess a minimum common level of training, experience, physical and medical fitness, and capability appropriate for a particular position in accordance with standards created under section 510. (PUBLIC LAW 110–53- Implementing Recommendations of the 9/11 Commission Act of 2007, TITLE IV, SEC. 401- DEFINITIONS, § (a) (3), Retrieved from
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_public_laws&docid=f:publ053.110.pdf,
October 10, 2007)

Why is all this important to ESAR-VHP programs? Because the act also states, “Consultation on Health Care Standards.—in developing standards for credentialing health care professionals under this section, the Administrator shall consult with the Secretary of Health and Human Services.” (Id) In pulling these programs together, most likely ESAR-VHP will become part of this effort.

Why Choose RAPTOR ID

• RAPTOR ID was developed to meet FIPS 201, HSPD-12, and ESAR-VHP.
• VUANCE is a member of, and can access the network of, the Federation for Identity and Cross
Credentialing Systems (FiXs), whose network verifies and authenticates the identity of personnel
seeking to enter U.S. military installations and other government-controlled areas, as well as
commercial sites tied to the network.
• VUANCE is a member of the American National Standards Institute (ANSI) and is participating in
the ANSI Homeland Security Standards Panel Workshop on Credentialing and Access Control for
Disaster Management. And finally
• VUANCE’s development team has begun incorporating the NIMS definitions into RAPTOR ID.

Choosing RAPTOR ID means you are choosing not only an ESAR-VHP solution for today, but a dynamic value added tool that Medical Care Institutions and Public Health will be able to use into the future.