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

[Karsten Hilbert]

> 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.
Certainly true. However, with GnuMed billing may still be
quite some ways off as is other stuff besides lab/doc archive.
Also, it is relatively easily possible to move data from the
laptop to the server once you do a switch later on. And yet
another option would be to just carry the lab data while
handling billing via OSCAR, perhaps on a server.

> 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.
Sounds reasonable, technically.

> 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.
If you can put a server in your hospital rooms and if you have
access to that via SSH it is fairly straightforward the
establish an encrypted connection to it from anywhere with
decent internet access by using port forwarding with SSH. I
would NOT recommend running GnuMed or OSCAR unencrypted if on
a public wire. In principle the database connection can be run
over SSL but I don't know how laborious it is to tell the
libpq to use SSL.

> 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.
Just try it. I don't think it'll make too much of a
difference. You can always test against my server which is on
a consumer level DSL. Remember that it is on extremely
low-end hardware (133 MHz, 32 MB RAM). That is the bottleneck
I experience with it, not the DSL line.

> 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.
You'd need to use an encrypted file system for patient data
I'd assume and even then they can root the running machine.

Karsten
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