Re: Installing VistA
Comments below.
-- Bhaskar
On , January 9, 2003 at 21:03:43 (GMT-1000), Tim Churches wrote:
> On Wed, 2003-01-08 at 22:36, Andreas Tille wrote:
> > On Wed, 8 Jan 2003, Andrew Ho wrote:
> >
> > > Is anyone working on the VistA Debian package?
> > > Any progress since July?
> > >
> > >
http://lists.debian.org/debian-med/2002/debian-med-200207/msg00033.html
> > Unfortunately I've got no further reply on this issue despite the
> > answers available in this thread.
> >
> > I would really love if somebody would step in here. Perhaps we should
> > start with packaging of GT.M.
>
> Now that I have a better (but still very superficial) insight into the
> nature of the VistA beast, I can understand why no-one has replied.
> VistA is a vast, sprawling collection of modules each resting on shared
> infrastructure. The shared infrastructure needs a _lot_ of
> configuration, even for a demo system - things like system, hospital,
> ward, team and individual identifiers and lots of system-wide and user
> default value to make data entry faster. There don't seem to be defaults
> for these default values (or maybe there are, if you are M-savvy
> enough). Then you have to choose which of the modules (seems like there
> are around 100 odd to choose from) you want to use, and how they relate
> to each other. Then you have to configure each module. Automating all of
> this with "Debian demo" values would be a serious feat of
> post-installation configuration scripting.
[KSB] This picture of VistA is correct. I have made little progress
with doing anything useful with it. From what I have seen, VistA does
not necessarily need M programmers to configure it, but configuring
VistA is a very complex process.
Of course, to use VistA in production will require that an institution
spend money either to hire an expert to configure it to their need,
and/or train their own people to use it. Free software like VistA
means a freedom to use, and not a freedom from cost.
Setting up a demo will also involve some cost (to hire expertise). In
a company, this would be part of a marketing budget, but open source
free software does not have a marketing budget. Funding a VistA demo
is an opportunity for someone who has contacts with a Government and/or
a charitable foundation to unearth a small amount of money.
There are people who make a living out of installing and configuring
VistA, and they can be found at Hardhats (http://hardhats.org) and its
mailing list. Interestingly, VistA has a good database management
system as well (called Fileman), and there are people who have used
Fileman to set up all sorts of applications outside healthcare, such as
a jewellery wholesale ERP system, an aircraft tracking and display
system, etc.
> Certainly packaging GT.M and the various VistA distributions for Debian
> would help a bit, but not that much. Using Todd Smith's instructions, it
> took me about an hour from go-to-whoa to install (but not configure)
> GT.M and VistA, and that includes about 20 minutes sucking the (large)
> files across the Pacific, and another 20 minutes waiting for the VistA
> distribution to unpack itself (within MUMPS - the unzipping of the
> distribution files only takes seconds). So you might save 20 or 30
> minutes of time. But then the would-be punter would still be faced with
> the task of configuring VistA, and it looks to me like that could take
> many hours, days or weeks.
>
> However, both GT.M and VistA sit pretty lightly on the underlying
> operating system - basically everything seems to be contained under one
> subdirectory for GT.M (/usr/local/gtm) and another for VistA
> (/usr/local/vista_gtm), plus a few environment variables. So, if you can
> find an already-configured VistA demo system, then it would seem
> feasible to just create a tarball for each of those two subdirectories.
> Untarring those on a target system and setting the environment variables
> would be all that is required to bring up a configured demo system.
> Perhaps that's what everyone had in mind, anyway. Of course, such an
> installation would only be useful for demonstrating VistA (since it
> would share user names, ID codes and passwords with all other instances
> of itself), not for actually using VistA in patient care. But first you
> need to locate an already configured VistA demo installation. Does
> anyone have one in captivity?
[KSB] Yes, both VistA and GT.M don't use many resources (except disk
space), and are very simply configured to get up and running.
The configuration of GT.M is almost entirely controlled with
environment variables. Of course, you will need to use GT.M utility
programs to create and initialize database files, a global directory,
online backup, etc., but these are controlled by environment variables.
> On the subject of readily-accessible VistA demos, someone asked if a
> Web-enabled version of VistA was available. An alternative would be to
> set up the terminal-mode interface (basically any VT-100 emulator) as
> well as the GUI CPRS and Imaging front-ends on a Windows box (the GUIs
> are Windows-only, I think) connected to the Internet, with the VistA
> back-end on a Linux box connected to the Windows box. VNCserver would be
> installed on the Windows box, which would allow authorised users to play
> with the demo system from the comfort of their own Linux, Unix or
> Windows machines, possibly on the other side of the world, using the VNC
> client. The VNC "remote control" technology is fast enough to work quite
> well across many broadband Internet connections. Obviously would-be
> users of the demo system would need to register with the demo system
> provider, and probably book a session on it. Both the VNC server and
> client are free open source software which run on Linux, Unix and
> Windows, and the client is very easy to install - it is a single
> executable file. Who might be motivated to set up such a facility? Well,
> possibly service providers hoping to make a living out of configuring
> and supporting VistA? Once word got out, hospital IT managers and
> clinical informaticists from around the world would be clamouring for
> their turn on the VistA demo system, perhaps just out of curiosity -
> nevertheless, for the system integration agency it would be a great way
> to get exposure and to get "sales" leads.
[KSB] In my view, a good way to make a demo would be to take a snapshot
of a directory of VistA on GT.M, and put VistA and GT.M on a bootable
CD with something like Knoppix (http://knoppix.org) which will work
even if someone has a Windows PC. When the CPRS GUI is ported to Kylix
(which will hopefully become available in 2003), the GUI can also be on
the CD.
For an Internet accessible character based VistA, you wouldn't need
VNC. SSh (for which there are good clients available for Linux as well
as other popular operating systems) provides an excellent way to
connect even over low bandwidth connections from remote locations. For
security reasons, if I were doing it, I would set up such a demo system
either under user mode Linux, or in a chroot jail. But, the Knoppix
approach seems more promising.
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