MedicalDirector Knowledge Base
Environmental Configurations for MedicalDirector Software

This guide assists you in configuring your computer for use of MedicalDirector software. It includes information on:

o      Required Antivirus exclusions

o      Required Firewall rules

o      IP and Host Name Resolution requirements for MedicalDirector Communication Services

o      Configuring Microsoft ISA Proxy Server to allow Medicare Online claiming

o      Configuring Java Environment Variables for Medicare Online Claiming

o      Setting folder permissions

o      SQL naming conventions and installation locations

These configurations are necessary for running MedicalDirector software reliably, and may also help to improve the performance of our applications which can be affected by unnecessary scanning or blocking of MedicalDirector software activity.

Please consider the content as an intentionally-broad overview, applicable to a variety of software and hardware scenarios, but not as an all-encompassing solution. For example, there are many Firewall/Antivirus applications available, each with their own method of handling exceptions, and this guide provides generic information about which files/folders/communications should be permitted. However, if you require assistance with configuring your specific Firewall or Antivirus software, please consult your Systems Administrator. Note also that the procedures outlined within for handling exceptions align with industry norms, where it is expected that the software vendor advises which Port or URL needs to be accessible, but the site’s Systems Administrator is then responsible for interpreting the specific requirements of the environment they are responsible for.

What are Antivirus and Firewall Solutions?

Antivirus software (abbreviated to AV software), also known as anti-malware, is a computer program used to prevent, detect, and remove malware.

Antivirus software was originally developed to detect and remove computer viruses, hence the name. However, with the proliferation of other kinds of malware, antivirus software started to provide protection from other computer threats. In particular, modern antivirus software can protect from: malicious browser helper objects (BHOs), browser hijackers, ransomware, keyloggers, backdoors, rootkits, trojan horses, worms, malicious LSPs, dialers, fraudtools, adware and spyware.  Some products also include protection from other computer threats, such as infected and malicious URLs, spam, scam and phishing attacks, online identity (privacy), online banking attacks, social engineering techniques, advanced persistent threat(APT) and botnet DDoS attacks.

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In computing, a firewall is a network security system that monitors and controls incoming and outgoing network traffic based on predetermined security rules.  A firewall typically establishes a barrier between a trusted internal network and untrusted external network, such as the Internet.  Firewalls are often categorised as either network firewalls or host-based firewalls. Network firewalls filter traffic between two or more networks and run on network hardware. Host-based firewalls run on host computers and control network traffic in and out of those machines.  

Firewalls are generally categorized as network-based or host-based. Network-based firewalls are positioned on the gateway computers of LANs, Wans and intranets. They are either software appliances running on general-purpose hardware, or hardware-based firewall computer appliances. Firewall appliances may also offer other functionality to the internal network they protect, such as acting as a DHCP or VPN server for that network.  Host-based firewalls are positioned on the network node itself and control network traffic in and out of those machines. The host-based firewall may be a daemon or service as a part of the operating system or an agent application such as endpoint security or protection. Each has advantages and disadvantages. However, each has a role in layered security.

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What is an Exception?

In regards to your Antivirus software, an exception is simply defined as a file, folder or website that is flagged as being excluded (ignored) from being restricted or scanned.  In regards to your firewall, an exception is simply defined as a rule to allow a legitimate communication to occur between devices that will typically specify the source, destination, port and protocol for the communication.

Modern antivirus and firewall applications often include advanced threat detection features that go beyond simple file/folder monitoring or allowing/blocking specific communications between devices.  Instead these “next generation” applications observe usage patterns and understand 'normal' behaviours. 'Behaviour Monitoring' constantly monitors endpoints for unusual modifications to the Operating System, installed software, monitored directories, or unusual communication patterns. MedicalDirector is aware that Behaviour Monitoring solutions can be triggered by the installation of MedicalDirector components (such as MDRef) when high-frequency read/write operations are detected in the Windows Installer directory. Furthermore, such solutions can also be triggered by access to encrypted patient correspondence - misinterpreting decryption of documents as patient records are opened, or encryption as they are saved - as abnormal or even malicious.  If you are using the Behaviour Monitoring features of your Antivirus solution, you should work with your System Administrator to configure this appropriately to accept:

o       High-frequency and high-volume read/write operations in the Windows Installer directory by MedicalDirector applications listed in the remainder of this guide.

o       Encryption and decryption of documents in the ManageEzy directory, typically located at C:\ManageEzy\HCN\Document.