Cimar’s Cloud hosting is located at UK Cloud and IOMART Data Centers.  Both DCs are Tier 3 and serve numerous central Government public services including DVLA, HMRC, Defense Services, numerous NHS hospitals, and various BigData health projects of national significance (e.g. 100k Genome Project and UK BioBank). Both DCs have N3 connectivity, UK Cloud being an N3 Aggregator provider). Cimar’s entire server-system runs on Linux Ubuntu 14.04 with its considerable in-built security capability, hosted on our own Private cloud with elastic storage architectures.
From the server side, Ubuntu IPtables creates one tier of Firewalls between architectural components. This is inside a Cisco ASA 5512 Firewall environment. All ports are closed, and all unused system services are disabled by default. Each connecting organisation then has its own firewall architecture as well. All comms is outbound from your network over HTTPS/SSL by default.
Yes – Cisco ASA 5512 Firewall with Proactive Monitoring and Alerting. In addition Ubuntu 14.04 IPtables.

Yes. The system is robustly firewalled, and only enables essential/restricted direct encrypted access only. All ports are closed/blocked unless specifically required. All unessential services are disabled. IP Whitelisted access for users can also be configured per account if required.
Nessus Vulnerability Scanner and Metasploit are running.

The ability to transfer/share or even request data is dependent on the user’s rights and permissions according to their role on the system, and its permitted functions. This is called Role Based Access Control (RBAC). This is mandatory access control (MAC) managed by your Org’s admin. For logging, the cloud application captures, records, and makes available to permitted users, any and all user and study/data activity. This is captured and logged for each study (everything that happens to it), and in addition, per user (everything a user sees or does – and when).

This is a clustered server instance, load balanced and mirrored enabling HA 99% uptime with fully RAID’d storage across multiple nodes. Each application tier is duplicated and load-balanced.

The UK instance is a clone of the US cloud which concurrently serves over 2000 hospitals and 1m+ clinical user logins per month. Scalability is not an issue. It’s dynamically expandable in response to demand

The Host system runs Linux Ubuntu 14.04 as the core web platform OS. Gateways run on Win7 or Win server 2012 or later (.Net 4.5 or later). There is no client-side user software. Client-side user OS can be Apple, MS, or Android. The systems DICOM Viewer is HTML 5 zero-footprint, compliant (as is the application) with multiple versions of IE, Chrome, Firefox, Safari and Opera (mobile or desktop). For older browsers a simple viewer loads automatically. User access from all mobile platforms (responsive) is also supported.

Substantial and ongoing and schedule. Every 6 weeks, new feature releases are deployed platform wide involving thorough preliminary testbed system testing before deployment and systemwide patch and testing as required. Independent pen-testing is commissioned by clients as required as scope for such tests varies according to client internal policies.
Please see above and Cimar Security Brief V3.30 - Web Application Security Policy – 2. Tests are run monthly. Should an issue be identified this is escalated to developer services to rectify according to the SLA provided.

eSet NOD32 Linux runs across our host systems. The entire platform runs on Ubuntu 14.04 Anti-Virus/Anti-Maul-ware with Ubuntu IPtables firewall. For clients that run our DICOM Automation Gateway, (a Windows service) we require our client’s to run their own standard/approved anti-virus software on their provided hardware and locally administered policies including security patch maintenance.
Nagios and Sumo Logic monitoring software is in place which in combination, looks for patterns and provides robust intrusion defence.

Yes, using AES256. And more importantly: For each image record, the database contains only prime PHI, and no image data. Conversely, all corresponding stored at rest images contain no PHI data. The two are split in RAM for doubled security and stored separately, then coalesced in real-time when accessed. This is the purpose of our patented Split/Merge technology.

All imaging data hosted on the system is a copy of the clients original at source. And since most data will be held for a few days max before system record purge rules run, data volume at risk is extremely low. For long term archives, backups are stored near-line on disc and can optionally be auto replicated to object storage managed and owned by our clients at our data centers.

No - However, if DICOM automation is to be implemented, the Trust/Hospital will need to provide a virtual or physical server/PC running Win7 or Win Server 2012 or later. Cimar provides the DICOM Gateway for this routing host which may or may not have a cost implication depending on study volume/traffic. In essence this is a SaaS service, pay per use. HL7 connections may incur an additional integration cost from which ever vendor our cloud is to be auto-connected to.

Yes – to PACS/Modalities – (DICOM node communication via AET). And to RIS/PAS – HL7 – (document interchange). We also provide a complete REST API enabling deep integration with other systems and platforms. HL7 integration will enable advanced workflow configs for reporting between systems, or we are able to integrate reports into imaging and rely on DICOM communications alone. Many options are available to enable intersystem connectivity. Cimar is an open application communicator across all systems from any vendor where DICOM and HL7 standards are assured.

Yes if full (end to end) workflow automation is required – Cimar provides a DICOM Gateway for this. A small software installation that brokers communication between PACS, RIS, PAS, Apps and Cimar – bi-directional. Your organisation provides a virtual or physical host server/PC on which Cimar installs our small comms broker service. We require an AET connection to automate comms.

No – this is not permitted for security reasons. No external access to Cimar’s SQL databases, RDF Triplestore, WADO, XDSi or Hadoop indexes are permitted.

Cimar’s RESTfull API only permits encrypted JSON hash external query structures. These can be at simple and high-level worklist query level to retrieve study links and can include query filters (including custom field values). The system responds with likewise encrypted JSON hash strings. To enable these exchanges, an AES or DES encryption secret is generated by our client and registered against their cloud account, via our API config, for this purpose. Our API extends to include all UI functionality as external application calls in the same secure way/model.