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

[Sebastian Hilbert]

On Friday 07 May 2004 00:15, Karsten Hilbert wrote:
> > 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
What is a tandem mirrored server ?
> > 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 $Can 600.
Well hardware firewalls are pretty cheap and feature packed these days.
I urge you to make sure that the factory provided default account is disbaled 
once you have it all running. I still have access to a consumer router in 
IOWA because these non-technical folks don't even know that there is a 
default password on the device they bought at WalMart. Just google around.
We even have some 'open' Cisco' here in our University network.
>
> Sounds reasonable, technically.
>
> > As far as where to set up a server my situation is a bit complicated as
> > I sublet space inside its hospital. For remote access and computer
> > support the network and firewall would have to be crossed. Possibly the
> > hospital has a DMZ (demilitarized zone) of server space outside its
> > firewall but likely not so would have to decide the conditions if at
> > all it would permit, through its firewall, a web (app) server and also
> > remote shell (SSH) access, ports 80 (http),443(ssl), 22 (ssh) [else
> > 3389 for windows terminal access] enabled. The hospital may require the
> > server to be isolated on the network but may not be prepared to do or
> > allow it.
>
> If you can put a server in your hospital rooms and if you have
> access to that via SSH it is fairly straightforward the
> establish an encrypted connection to it from anywhere with
> decent internet access by using port forwarding with SSH. I
> would NOT recommend running GnuMed or OSCAR unencrypted if on
> a public wire. In principle the database connection can be run
> over SSL but I don't know how laborious it is to tell the
> libpq to use SSL.
>
> > Setting up a server at my home would be an option, but they warned that
> > consumer-level ADSL or cable-modem connections could prove frustrating,
> > and so would recommend at least a business class ADSL line ~$Can
> > 100/mo.
Nah, Take a look at the nx technology at www.nomachine.com. They claim that 
one can access a full featured KDE-desktop via half an ISDN-line (33k/s) 
without a lag. 
>
> 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.
>
Personally I wouldn't do it. Depends on your legal system but you still need 
backups of this data in case the data center burns down or someone likes the 
machine an steals it.
> Karsten

-- 
Sebastian Hilbert 
Leipzig / Germany
[www.openmed.org] -> PGP welcome, HTML ->/dev/null
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My OS: Suse Linux. Geek by Nature, Linux by Choice

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