Re: [Gnumed-devel] Gnumed early usability? (was: Lab data support in OSCAR)

[Jim Busser]

On May 6, 2004, at 10:44 AM, Karsten Hilbert wrote:

> Do you need to access the data remotely or will you carry
> around and installation of GnuMed/OSCAR and PostgreSQL/MySQL
> on a laptop ?

A laptop would work ONLY for the period of time in which I use 
OSCAR/GnuMed ONLY for lab data. It may be more forward-thinking to 
start with a server because when I rehire a secretary (mine quit - too 
busy), neither she nor my wife (who may do my blling) can effectively 
access data if I am carrying it around on a laptop.

A local computer company that installed and supports OSCAR recommends 
for 1-2 doctors and 4-5 concurrent users a RAID, tandem-mirrorred 
server putting emphasis on reliable fast hard drives i.e. using 2 
Western Digital Raptor drives ($Can 180 ea, 5 y warrantee sustaining 
150MBPS vs ATA parallel drives only 50-75MBPS) for a cost of around 
$Can 2000 for the server. They also propose that if remote access is to 
be enabled, they would sleep better from a security view by inserting a 
 a Netscreen hardware firewall device around $Can 600.

As far as where to set up a server my situation is a bit complicated as 
I sublet space inside its hospital. For remote access and computer 
support the network and firewall would have to be crossed. Possibly the 
hospital has a DMZ (demilitarized zone) of server space outside its 
firewall but likely not so would have to decide the conditions if at 
all it would permit, through its firewall, a web (app) server and also 
remote shell (SSH) access, ports 80 (http),443(ssl), 22 (ssh) [else 
3389 for windows terminal access] enabled. The hospital may require the 
server to be isolated on the network but may not be prepared to do or 
allow it.

Setting up a server at my home would be an option, but they warned that 
consumer-level ADSL or cable-modem connections could prove frustrating, 
and so would recommend at least a business class ADSL line ~$Can 
100/mo.

They further recommended I could sidestep the need to take up more 
space in my home by co-locating the server at a data centre and that 
this would almost certainly provide me with a higher-speed and more 
reliable internet connection. A rack-style physical configuration would 
cost more up front, but would reduce space charges. They estimate a few 
Gigs per mo for 2-4 concurrent users. They didn't know whether physical 
vulnerability (security) would be a reason against choosing server 
co-location.

They estimate 30-40 hrs for setup of OSCAR counting formatting, OS and 
package installation, OSCAR installation, local configuration including 
the importing of locally relevant tables and additional setup of the 
individual physicians, potentially also some data importing from the 
legacy system. They suggest that after the inital set-up, I might need 
only a couple of hours per month (maybe not even) of hourly support at 
$Can 60 in leu of a more costly, flat monthly support fee (for example 
$Can 600 per month which is the arrangement to service OSCAR and the 
computers in a local clinic having 6 full-time docs and 2 Nurse 
Practitioners.

> Can you be more specific on your *exact* requirements ? Eg.
> what format data do you download, exactly how do you plan to
> use that data, how would you want to enter patients into
> GnuMed, how do you associate samples to the lab with the
> results received from the lab. Give me someone who knows your
> technical details and we can work out the issues easily.

I know it is HL7 that is locally supported. Will report back when I 
have more info.