American Well 250 Technical Readiness Guide

 

The American Well C250 is an FDA Class 1 registered medical device designed to create an immersive  telemedicine experience with seamless integration with the American Well workflow and collaboration software. This one-of-a-kind solution features an intuitive touch-screen interface to streamline patient intake, start a video consultation, and share diagnostic data – all from a single device.
With multiple form factors, the American Well C250 can be tailored to fit the unique needs of your  referring sites and clinical use cases.


• American Well C250 Tabletop (base model)
• American Well C250 Cart (option)
• American Well C250 Cart with 10x zoom PTZ Camera (option)
• American Well C250 Cart with 20x zoom PTZ Camera (option)

 

System architecture and security

The American Well C250 operates in a secured kiosk mode to initiate and conduct telehealth visits with the American Well platform. No PHI is stored or accessible from the C250.

The American Well C250 uses a proprietary embedded OS utilizing security controls designed for a
clinical environment.


Video system compatibility

The American Well C250 is designed to work seamlessly with the American Well software platform. Accordingly, all video calls must be performed from the American Well platform. Direct dial from SIP or other video systems is not supported.

 

Application standards and specifications

  • The American Well C250 application embedded in the device is web-based
    • Traffic is encrypted using SSL and all content is encrypted
  • All American Well solutions are tested against W3 standards.


Firewall requirements

The C250 must be placed on a network that follows the rules listed below to allow for the appropriate incoming and outgoing traffic. Please supply your network administrator with these details. 

The following mandatory firewall permissions are needed for application functionality.

  • Firewall and Domain Permissions:
    • See the table below for specific domains and IP’s (where available) that need to be whitelisted on your network
  • Ports:
    • The firewall must be configured for outbound HTTP/HTTPS requests on ports listed in the table below

The American Well C250 employs an explicit firewall whitelisting protocol that restricts all traffic on the
device to specific domains and ports.

Required Service Host Protocol Ports Resource Rule

Mandatory

Standard web, redirect to HTTPS *.avizia.com / *.avizia.io TCP 80 WebRTC calls, case creation, American Well Clinical Module Outgoing, established
Mandatory Secure Web

*.avizia.com / *.avizia.io

  • 54.172.60.0-54.172.61.255
  • 34.203.250.0-34.203.251.255
  • 54.244.51.0 - 54.244.51.255
TCP 443 Secure WebRTC calls Outgoing, Inbound
Mandatory    Update Service *.s3.amazonaws.com TCP 443 Application Update Service  Outgoing, Inbound
Mandatory DNS

Google DNS Servers:

  • 8.8.8.8
  • 4.4.4.4
UDP 53 Domain Name Service Outgoing
Recommended TCP

*.clamav.net

UDP 53, 80 Antivirus Signature Database updates (ClamAV Antivirus) Outgoing
Mandatory (Select One)

Preferred - Media (RTP / RTCP ) 

 

  • 18.204.64.0-31
  • 18.207.64.121
  • 34.197.115.173
  • 34.197.150.170
  • 34.227.122.4
  • 34.227.122.4
  • 52.45.34.112
  • 52.45.39.156
UDP & TCP 40000-49999 Use for best performance and quality Outgoing, Inbound

Media (STUN/TURN)*

 

  • 54.172.60.0-54.172.61.255
  • 34.203.250.0-34.203.251.255
  • 54.244.51.0 - 54.244.51.255
UDP & TCP 443, 3478 (UDP & TCP) 5349 (TCP) Reduces number of ports required, however, increases connection time.  Outgoing, Inbound

 

* Fail-over in case 40000-49999 cannot establish connection.
** If using the C250 outside of the United States, please consult your Implementation Manager.
† For the most restrictive networks. Note that you will see a performance degradation in video
quality.

Remote management

The C250 can be remotely managed using American Well’s Fleet Monitoring platform that is supplied with your purchase of the device. These remote management capabilities include:
• Alerts for offline or low battery events (SMS and/or email)
• Web-accessible dashboard showing important device details for your entire fleet
• Remote reboot and shutdown commands
• Seamless remote OS and Application updates
• Workflow configuration

System updates

The American Well C250 can be updated remotely using the American Well Fleet Monitoring platform. OS updates are downloaded and installed in the background and do not interrupt any operation of the cart. A simple restart is all that is required to activate the new update (no downtime). Configuration options include automatic updates and manual updates that need to be triggered using the Fleet Monitoring software.

Physical specifications

The American Well C250 can be set upon a tabletop, mounted on a basic cart with a vertical lift mechanism, or mounted on a cart with a PTZ camera and a vertical lift mechanism.

mceclip1.png

Power specifications

The American Well C250 can be powered and operated using:

  • AC power input: 100-240VAC, 50-60Hz, 135W

NOTE: We recommend that you plug into hospital grade outlet.

  • Rechargeable batteries within the device:
    • DC Input: 19V, 3A (90W MAX): powers the cradle and tablet, recharges all batteries within the device
    • Battery: Approx. 2 hours call time
      • Internal (Tablet): 14.8VDC 1880 mAh 27.8 Wh: powers tablet only
      • External (Tablet): 14.8 VDC 1880 mAh 27.8 Wh: adds to tablet battery capacity
      • Internal (Cradle): 14.8 VDC 1880 mAh 27.8 Wh: powers speakers, USB, LAN,
        and PTZ camera (on PTZ-enabled devices) — dedicated to cradle only.
      • Charge time from fully depleted to fully charged is ~6 hours

 

Network connections

  • Network Adapters
    • WiFi (dual-band 802.11 a/b/g/n/ac)
    • Ethernet (Cat 6) (5m cable provided)
  • Security
    • Encryption: 64-bit and 128-bit AES-CCMP, TKIP
    • Authentication: WPA and WPA2, 802.1X (PEAP)
    • MAC address (found on system label and in the application)
      • Ethernet network interface card
      • WiFi network interface card
    • “Guest” networks with a redirect splash page are NOT supported
  • Video bandwidth
    • Minimum video bandwidth: 768 kbps
    • Recommended video bandwidth: 1 Mbps (SD). 3 Mbps (HD)
      • NOTE: HD video transmission requires the PTZ camera option
  • Jitter and Packet Loss (recommended)
    • Packet loss < 2%
    • Jitter < 15ms


The system hostname can be modified from the application.

American Well C250 technical specifications

Dimensions 
  • American Well C250 Tabletop: 13.25" W x 12.5" H x 3" D
  • American Well C250 Cart: 19” W x 21” D x 52.5” H (up to 62.5” at max vertical lift)
    • Worksurface: 16.5” x 16.25”
    • Worksurface height from floor: 38” H
  • American Well C250 Cart with PTZ Camera: 19” W x 21” D x 62” H (up to 72” H at max vertical lift)
    • Worksurface: 16.5” x 16.25”
    • Worksurface height from floor: 34” up to 44” at max vertical lift
    • Vertical lift range: 10”
Weight
  • American Well C250 Tabletop: 6 lbs / 2.7kg
  • American Well C250 Cart: 82.5 lbs / 37.4kg
  • American Well C250 Cart with PTZ Camera: 84 lbs / 38.1 kg
Safe Worksurface working load
  • 25 lbs / 11.3kg
Display
  • Touchscreen
  • 13.3” Full HD Resolution (1920x1080)
Operating System
  • Proprietary embedded OS
System Updates
  • Automatic or Manual system updates
    • Remotely managed via American Well Fleet Monitoring
  • Over-the-air seamless updates
Camera
  • Integrated camera
  • 10x zoom 1080p Pan-Tilt-Zoom (PTZ) camera (optional upgrade)
  • 20x zoom 1080p Pan-Tilt-Zoom (PTZ) camera (optional upgrade)
Control Options
  • Touch screen interface
  • User supplied USB keyboard (optional)
Network
  • Wired Ethernet (10/100/1000 Mbps)
  • Integrated Wireless: 2.4 GHz and 5 GHz, 802.11 a/b/g/n/ac
    • Encryption: 64-bit and 128-bit AES-CCMP, TKI
    • Authentication: WPA and WPA2-PSK, WPA2-Enterprise 802.1X (PEAP)
  • 867 Mbps max speed
  • Bandwidth Requirements:
    • Minimum 768 kbps
    • Recommended (SD) 1 Mbps
    • Recommended (HD) 3 Mbps
USB I/O
  • 4x USB 2.0
Audio Inputs
  • 3.5mm Microphone (included)
  • User supplied external USB microphone (optional)
Audio Outputs
  • Speakers (integrated)
  • User supplied external USB Speakers (optional)
Power Input
  • 100-240VAC, 50-60Hz, 135W
  • Cord length: 16’ 5” / 5m
Power
  • DC Input: 19V, 3A (90W MAX): powers the cradle and tablet, recharges all batteries within the device
  • Battery: Approx. 2 hours call time
  • Internal (Tablet): 14.8VDC 1880 mAh 27.8 Wh: powers tablet only
  • External (Tablet): 14.8 VDC 1880 mAh 27.8 Wh: adds to tablet battery
    capacity
  • Internal (Cradle): 14.8 VDC 1880 mAh 27.8 Wh: powers speakers, USB,
    LAN, and PTZ Camera — dedicated to cradle only.
Storage
  • Lockable Peripheral drawer (with cart option)
Options
  • American Well C250 Cart
    • Work surface
    • Tilting device mount (pitch and yaw)
    • Lockable peripheral drawer
    • Locking wheels
    • 19”W x 21”D
  • American Well C250 PTZ Upgrade
    • 10x zoom 1080p camera
    • 20x zoom 1080p camera (optional upgrade)
Cleanability
  • Easy-to-clean surfaces
Operating temperature and humidity
  • 50 to 95°F (10 to 35°C) ambient temperature
  • 20 to 90% relative humidity (RH)
  • Atmospheric pressure: 700 to 1060 hPa
Storage temperature
  • 14 to 140°F (-10 to 40°C) at RH 10 to 80% (noncondensing) at
    RH20to90%
  • Atmospheric pressure: 700 to 1060 hPa
Approvals and Compliance
  • FDA Class 1 Medical Device Data System (MDDS)
  • IEC 6061
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