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Re: [Gnumed-devel] remote control GNUmed

From: Sebastian Hilbert
Subject: Re: [Gnumed-devel] remote control GNUmed
Date: Tue, 29 Nov 2005 01:58:13 +0100
User-agent: KMail/1.9

On Tuesday 29 November 2005 01:08, Ian Haywood wrote:
> Sebastian Hilbert wrote:
> > It's not like the proprietary guys here give a d*** about interoperating.
> > Fortunately they have to provide some interface since there is a German
> > standard for calling medical equipment like ECG/EKG, urinalysis, peak
> > flow meters. That is called GDT and hands out a flat file to the other
> > application containing patient details and more or less requests like
> > 'start EKG'. The legacy application will then read back the results file
> > and store it some place. That's where we hook into. GNUmed is a 'medical
> > device' for the time being. GNUmed receives and send flat files.
> Do not ask what crimes I would commit to have such a standard over here.
> We have been begging, pleading our government for years to set standards:
> all has fallen on deaf ears.
We are quite lucky I guess. Our standard has been around (unchangend) since 
1994 and is in the process of being transformed into XML. We do all sorts of 
magic with it (not many doctors use it). Send records from doctor to doctor, 
send so called disease management forms to obscure institutions, get lab data 
via modem , interact with smart EKG equiment.

I seriously wonder if it would be possible to sell descriptions of the  
technical infrastructure (documents ) to the Australian government. So they 
just have to say yes or no :-) I gues a major drawback is that those 
documents are in German but most stuff in there is technical anyway 
(descriptions of data formats, server / clients communication, encryption 
methods ) That would be fun. Those documents are freely available from German 
websites. I have no idea about the copyright , though. I would volunteer to 
meet any goverment if they pay my travel expenses and some compensation. Not 
that I am an expert but I speak German . Ok maybe this doesn't belong 
here :-)

> > How do you guys drive in-practice medical equiment ?
> Because of the above, we generally don't.
I can "sell" you GDT. GNUmed could be the first Australian practice management 
software which can talk to peak flow meters, EKGs .... I wonder if one can 
buy those in OZ. 
> > One last question I do have. Tell me a little more about Australian IT.
> > Is it true that you don't have a ecosystem of small IT shop hacking away
> > on software, doing consulting and providing service ? No matter for which
> > OS.
> Most IT shops are 100% Windows and don't do any coding themselves. They and
> their clients are mutually convinced that the other will never use anything
> else.
Who does the coding then ? Over here quite a bit of coding is done by local 
distributors of practice management software. That's one of our sources. 
> Recently, I found it's not as much "doom-and-gloom" as I've made out
> previously: there are 1 or 2 techs who will use support linux for
> mailserver/firewall etc. while keeping the client boxes windows.
Sound ok to me :-) Do you mean 1 or 2 people or 1 or 2 shops. In what area ?
Holy cow. Who attends LinuxWorld Expo in Australia then. Europeans who want to 
see Australia ?

> The only linux client setup I have heard of is Horst's: he uses thin clients 
and runs his clinical software under Win4Lin.
I am a big fan of thin clients. I have one sitting here right besides my desk. 
It's a commercial one. It speaks RDP for Windows sessions, Citrix, nx ( as in 
FreeNX / - check it out or be sorry) , X11 ...
We implemented chipcard support with their help. Other than that I can 
recommend LTSP ( now even part of Ubuntu ) . It just rocks. GNUmed should run 
just fine in nx mode, X11 mode, heck even rdp is possible. NX can talk to 
printer that are connected to the thin client, read from local USB device.  
Tell me what GNUmed lacks in terms of thin clients support and it will be 
considered. Even chipcards can be read off thin clients (via libchipcard)
> I am hopeful at least one of these IT guys could be persuaded to support
> thin linux clients (i.e the no-configure 'shoebox' things) and postgres on
> the server, there's certainly 5-6 clinics who then would be interested in
> his area (New South Wales)
What exactly is missing ? Show me the clients who are really considering this 
and I send you unemployed IT specialists from Germany (Linux folks ). Well 
maybe they won't be permitted to work in OZ. 
> > Is it true that it is too hard or unattractive to set up a small shop
> > yourself ?
> When gnumed goes "prime-time" I would consider sitting the LPI exam so I
> can tout myself as a support person, mainly to counter the "there is no
> support" argument: I would not expect to make any actual money.
That's one statement I don't get. You are talking about prividing services for 
prime-time GNUmed ( we have different views on that) but don't expect to make 
money from that. I am afraid I have a fundamental misunderstanding of how IT 
works in Australia.
> > I guess it might be possible to do so but the chances of gathering
> > clients are equally low as over here. But don't you think it's easier
> > here.
> Would you consider providing remote support in Australia, using VoIP and
> SSH? (seriously)
Tell you what. I have no degree in CS but you give me a Debian Sarge box with 
Internet access and I will install GNUmed for you. Not to talk about 
companies which could service GNUmed stacks.

What is a GNUmed stack ? A GNUmed stack is a GNUmed based on exact specs of 
hardware and an exact , single version of GNUmed. You could even talk to the 
Ubuntu guys. They have something called OEM mode. If you are really paranoid 
you would by a DELL (TM) Server and throw a premade GNUmed(-buntu) OEM image 
at it. Should anything go wrong in remote Australia and there was no internet 
connectivity you could ship another server over there with GNUmed on it and 
have a perfectly known basis for any support you give them over the phone. If 
they have at least internet connectivity you could try to fix it via ssh. The 
clients could be replaced in a matter of minutes if being thin clients.

To give you an example.  My parents have a internet router based on 
IPCOP-Linux. I made it from a Netvista thin client with a flash drive inside 
which holds the OS. Right next to it there is another one just like the first 
one. If anything goes wrong with the router I tell them to plug the cables 
into the other one. It was the best idea I had in a lon time. I have been 
fixing many, many problems during office hours right over ssh orr even vnc. 
They call me and unless it's a hardware problem I can see and fix it. It 
works over a 1MBit ADSL line. It actually works.

So yes I would consider supporting Australian clients. I would even consider 
supporting Australian IT shops until they can pull it off themselves. Which I 
still believe they can if they want. Don't forget our GNUmed KNOPPIX CD. Boot 
off it and you have a GNUmed server and client and you can even connect from 
other PCs. Heck KNOPPIX even includes LTSP (don't know about our CD right 
now) so even thin clients can be fed off the CD.

Testdrive nx via the website and you will see what is possible. 

Sorry if I sound crazy and most of this is off-topic.
Sebastian Hilbert 
Leipzig / Germany
[]  -> PGP welcome, HTML ->/dev/null
ICQ: 86 07 67 86   -> No files, no URL's
VoIP: callto://address@hidden
My OS: Suse Linux. Geek by Nature, Linux by Choice

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