Top challenges and IT support requirements in deploying a Hospital Print Fleet that includes:

1. Top challenges and IT support requirements in deploying a Hospital Print Fleet that includes: • Device Reduction/Consolidation • Cost Accounting, Control, and Rules Based Printing • Card Authentication and SecurePrint Release

2. Old MFP Old Network Printer 3 Risk Diagram Device planned for removal due to ‘consolidation’ Print fleet optimizations with goals of Print Device Reduction, SecurePrint and Cost Accounting 1 System print to Windows print queues ‘unknown user’ 4 Print specific to HP output causes problems when new device introduced Electronic Health Record Windows Print Server Application 5 Direct printing to output device 2 Some users logging in anonymously Nurse logged in as ‘shared_user’

3. New MFP 3 Desired Outcome Device planned for removal due to ‘consolidation’ For removed devices, print queues removed, and redirected 1 System print to Windows print queues ‘unknown user’ Intelligent capturing and assignment of print to either users, or specified devices 4 Print specific to HP output causes problems when new device introduced Print converted to print language for new output device Electronic Health Record Application 2 5 Some users logging in anonymously Direct printing to output device New business or technical workflow to capture username All direct printing re-routed through Output Manager Nurse logged in as ‘shared_user’

4. New MFP 3 IT Support Required from Customer Device planned for removal due to ‘consolidation’ For removed devices, print queues removed, and redirected 1 System print to Windows print queues ‘unknown user’ Requires IT to redirect print queues Intelligent capturing and assignment of print to either users, or specified devices Requires IT involvement with EHR staff 4 Print specific to HP output causes problems when new device introduced Print converted to print language for new output device Requires IT to provide sample print stream Electronic Health Record Application 2 5 Some users logging in anonymously Direct printing to output device New business or technical workflow to capture username All direct printing re-routed through Output Manager Requires IT to identify systems with unknown logged in user Requires IT to provide current direct print architecture Nurse logged in as ‘shared_user’

5. New MFP 1 Issue: Some applications, such as EHR systems, print as a system account and do not pass a username in the print header. Analysis Required Use WireShark or other print stream capture solution (such as installing NSi Output Manager). Send the captured print stream to Notable Solutions for analysis and confirmation. NSi Output Manager can capture print streams from a variety of input sources, and can even impersonate to make an application think that NSi OM is a physical printer. Example NSi OM capture sources are below: Solution: NSi Output Manager can be configured to identify the user of a printed document based on a wide range of capabilities, such as extracting the username from a physical location on a printed page (i.e. top right corner), capture the username from an accompanying xml file, etc. Some printed documents (i.e. reports), will never have a username. In such cases, NSi OM can do a direct print to a specified device. Many applications can print as either IP Socket or LPR. In many cases, we may ask that the print be switched to LPR, which often contains the username. System print to Windows print queues ‘unknown user’ Intelligent capturing and assignment of print to either users, or specified devices Requires IT involvement with EHR staff Electronic Health Record Application Nurse logged in as ‘shared_user’

6. New MFP 2 • Issue: Some desktop users use a ‘hot-swap’ log in, typical at nurse stations. If the print stream does not contain the username, we cannot conduct appropriate HIPAA logging and SecurePrint control. • Analysis Required: Identify if any logged in user print submission does not contain username information. Requires IT involvement to provide information, and/or install NSi Output Manager for testing. • Solutions: Various examples that have previously been employed, include: • Prompting for the username at print submission • Writing a script that fires on ‘hot-swap’ log-in, that stores the username in the registry, a database, temp file, or other local or network accessible location • Extracting the username from information on the printed document (i.e. top right of the printed page, etc.) Electronic Health Record Application Some users logging in anonymously New business or technical workflow to capture username Requires IT to identify systems with unknown logged in user Nurse logged in as ‘shared_user’

7. New MFP 3 Issue: Removal of a device impacts printing workflows, such as pre-built workflows in the EHR to print to specific devices. Analysis Required: Identify what devices are be removed and any application print modifications required. Solution: For human/interactive users it is simple: tell users to print to a new print queue. For application changes the following are recommend: Solution 1: Use NSi Output Manager (OM) to redirect print based on business rules (screenshot below). NSi OM business rules are very powerful, with a best example such as what is available in MS Outlook (see video here: http://videos.smartmfp.net/video/146001). Solution 2: Change business rules in the EHR or other applications. Device planned for removal due to ‘consolidation’ For removed devices, print queues removed, and redirected Requires IT to redirect print queues Electronic Health Record Application Nurse logged in as ‘shared_user’

8. New MFP 4 Issue: Many applications print directly to existing devices, and have output configured specifically to that device. Replacing that device with a different hardware platform can have significant changes to output layout (i.e. what was printed as one page, is now printed on two pages, margins cut-off etc). Analysis Required Similar to issue and resolution to use case 1, use WireShark or NSi Output Manager, or other print stream capture solution to capture the applicable print stream. Solution: Based on the print stream captured and the desired new output device, NSi Output Manager may need to be configured to do a transform. Print specific to HP output causes problems when new device introduced Print converted to print language for new output device Requires IT to provide sample print stream Electronic Health Record Application Nurse logged in as ‘shared_user’

9. New MFP 5 Issue: Some environments are doing direct IP based printing, which has cost and security impacts as there are no audit trails and cost controls in the environment. Analysis Required: IT to identify what users, applications, and devices are involved in a direct IP based printing architecture. Solution: Redirect all direct printing workflows through NSi Output Manager. Electronic Health Record Application Direct printing to output device All direct printing re-routed through Output Manager Requires IT to provide current direct print architecture Nurse logged in as ‘shared_user’