Cypress Initial Setup

Cypress Bundle Install

You will need an NLM VSAC account to download value set definitions and finalize the installation of the VM. You can sign up for an NLM VSAC account at https://uts.nlm.nih.gov/home.html. Click the 'Sign Up' link in the upper right of the page.

Bundles are now installed through the Cypress web interface:

1. Download your bundle of choice. You will be prompted for your UMLS credentials before the download begins. These credentials are your UMLS username and UMLS API KEY. Note: previously, these credentials were your UMLS username/password.

• Cypress bundle for the 2023 Reporting/Performance period (eCQM value sets as of May 5, 2022) (2022.1.1): https://cypressdemo.healthit.gov/measure_bundles/bundle-2022.zip

• Cypress bundle for the 2024 Reporting/Performance period (eCQM value sets as of May 4, 2023) (2023.0.0): https://cypressdemo.healthit.gov/measure_bundles/bundle-2023.zip

• Cypress bundle for the 2025 Reporting/Performance period (eCQM value sets as of May 2, 2024) (2024.0.0): https://cypressdemo.healthit.gov/measure_bundles/bundle-2024.zip

• Looking for a specific bundle? See the full listing here https://cypressdemo.healthit.gov/measure_bundles/

2. Navigate to the IP address/URL of your Cypress install. This will vary based on your installation method.
3. Sign into the Cypress web application.
4. Select the "Bundles" tab and then the "Import Bundle" button.
5. In the file selector, select the bundle downloaded in Step 1, then click the "Import Bundle" button.
6. Cypress will import the bundle in the background. In Cypress 6 the bundle import process performs eCQM calculation for all patients in the bundle, this can require a significant amount of time (depending on system performance). When it is done, you will be able to begin testing in Cypress.

Don't see the admin button?

In order to grant a user account admin access, you will need access to the underlying server.

1. Once you have installed the Cypress application, you will need to SSH into the server. You can connect to the server using the following username and password:

   Username: ubuntu Password: CypressPwd

2. Navigate to /opt/cypress and grant the permissions using the follow command. Replace EMAIL with the email address of the Cypress user account.

sudo cypress run rake cypress:add_admin[EMAIL]

Need TLS/SSL?

If you are deploying Cypress to a publicly available server, it is recommended you use TLS/SSL encryption to protect user data. The Cypress VMs and AMIs use NGINx to proxy requests to the Cypress tool and CVU (if installed). The following instructions will walk you through setting up SSL on your server.

1. Get a SSL Certificate from the provider of your choice. For any instructions that ask for information about your web server, choose NGINX.
2. Follow the instructions from your provider to build the certificate bundle.
3. Update your config file located at /etc/nginx/sites-enabled/default as follows, replacing yourdomain.com with your the domain you have purchased the SSL certificates for.

For Cypress Standalone

  upstream primary {
    server localhost:8000;
  }
  server {
    listen         80;
    server_name    yourdomain.com;
    return         301 https://$server_name$request_uri;
  }

  server {
    listen 443;

    ssl on;
    ssl_certificate    /etc/ssl/yourdomain.pem; # (or yourdomain.crt)
    ssl_certificate_key    /etc/ssl/yourdomain.key;

    server_name yourdomain.com;

    root /opt/cypress/public; # This should be /home/cypress/cypress/public if you installed via the custom install instructions.

    try_files $uri/index.html $uri @app;

    location @app {
      proxy_pass http://primary;
      proxy_set_header X-Forwarded-For $proxy_add_x_forwarded_for;
      proxy_set_header Host $http_host;
      proxy_set_header X-Forwarded-Ssl on;
      proxy_redirect off;
    }

    error_page 500 502 503 504 /500.html;
    client_max_body_size 4G;
    keepalive_timeout 10;
  }

4. Once you have updated your configuration, run sudo systemctl restart nginx in order to reload the NGINX server.