[Hardhats-members] VistA Community Conference Call

2006-05-05 Thread Maury Pepper
  *** VistA Community Call -- Friday at NOON EDT ***
 
TOPIC: Improving the Image of VistA
  
DATE:  Friday, May 5
TIME:  12:00 Noon EDT
DURATION:  1 hour.
 
CONFERENCE CALL DIAL IN NUMBERS
USA  866-483-4159  (toll free)
Outside USA  706-634-0093
 
Conference ID Number:  6554848
 
!!!
!!!   Please send suggested topics for future calls to:
!!!   mpepper *at* worldvista *dot* org  
!!!
 
 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
Thanks to Hewlett-Packard and Sharon Mobley
for providing the teleconferencing facilities.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~


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Re: [Hardhats-members] Can't ping 2 VistA GT.M implementations

2006-05-05 Thread Ismet Kursunoglu
Thank you for the explanation. Your response is another example of
the first rate help and education that this list provides - from
detailed computer theory to the more mundane, it is one of the finest
sources for help. It would appear that a compilation and editing of 
many of the submissions would provide the content for an introductory 
textbook for VistA users.  

 The concept of HL7 ping was for one Vista client system to verify that a
 remote Vista listener was up and configured properly on the node and
 port defined on the client system. When the high level ping fails, the
 client makes a call to DNS to see if the Vista listener has been moved
 to another node. If DNS returns a list of nodes, each node is pinged in
 sequence. If there is a successful connection on an alternate node, the
 client's local database is updated with the new information. The key is
 to have DNS contain all possible nodes that a listener could run on.
 That way the listener can be moved to a different server when the
 original one is taken out of service.
 
 
 John Clemens
 Mon-Fri, 0730-1600 phone 650.464.7585 (personal cell)
 
-- 
Ismet B. Kursunoglu, MD, FCCP

 Medical Director
 Alaska Clinic, LLC
 3750 E. Country Field Circle, STE B
 Wasilla, Alaska 99654-6659
 [EMAIL PROTECTED]
 voice (907)357-7240


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RE: [Hardhats-members] Can't ping 2 VistA GT.M implementations

2006-05-05 Thread Bhaskar, KS
Usha --

IO command parameters are different for each MUMPS implementation.  I know of 
no known GT.M bugs in this area.  You may well have to break the problem down 
and/or trace the application code to find out why it is not working.

Incidentally, have you checked the error logs.

Regards
-- Bhaskar

-Original Message-
From:   [EMAIL PROTECTED] on behalf of Usha
Sent:   Thu 5/4/2006 11:26 PM
To: hardhats-members@lists.sourceforge.net
Cc: 
Subject:Re: [Hardhats-members] Can't ping 2 VistA GT.M implementations
The same configuration successfully HL7 pings two Cache implementations of
VistA. Then why doesn't it work with GT.M?
Regards
Usha
winmail.dat

RE: [Hardhats-members] Migrating vista console module routines to client side GUIs

2006-05-05 Thread Aylesworth, Marc A Ctr AFRL/IFSE
I think this is the voice of reason, the whole reason for open source is for
choices, there should not be replacement but supplement of user interfaces
so that someone can choose the best interface that fits his/her situation.

Thanks
Marc Aylesworth

RRC C3I Group 
AFRL/IFSE
Systems and Information Interoperability Branch

525 Brooks Rd
Rome, NY 13441-4505

Tel:315.330.2422
Fax:315.330.7009

Email: [EMAIL PROTECTED]


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Greg
Woodhouse
Sent: Thursday, May 04, 2006 6:33 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] Migrating vista console module routines to
cleint side GUIs

I think a big part of the problem is that we're speaking as if GUI
interfaces can all be lumped together as one user interface style. We
all quietly accept that roll and scroll is one style of character based
user interface, but no one stops to consider whether there aer
different styles of GUI interfaces? I'm somewhat at a disadvantage when
it comes to coming up with examples because I'm not a Linux user and so
will not be able to provide examples that are Linux desktop
applications. But consider Outlook with its list of objects (messages)
and separate pane representing the contents of that message, and
compare this with a tabbed propery dialog, or even Word which provides
the ability to highlight changes to a document and then give you the
ability to accept or reject those changes. They are different user
interface models corresponding to different tasks or usage patterns.
Whether you consider these designs to be good or bad isn't really the
point. Rather, it is that user interfaces can be created (possibly
through user customization) to support different usage patterns. Roll
and scroll is just one paradigm: In some cases it may be just what you
want, and in others it may not be. (After all, why do we have ScreenMan
and List Manager? Clearly *someone* thought a different pattern of
interactions was called for in at least some applications!)

===
Gregory Woodhouse  [EMAIL PROTECTED]

The Tao of VistA: If all you see is MUMPS, 
you see nothing.


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[Hardhats-members] Open Source Free Practice Management System Interfaces

2006-05-05 Thread Nancy Anthracite
If anyone knows of any practice management systems out there that are willing 
to have their interfaces to VistA be FLOSS, please let me know as I need some 
examples of what we be facing when it comes time to trying to build them.

-- 
Nancy Anthracite


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Re: [Hardhats-members] Open Source Free Practice Management System Interfaces

2006-05-05 Thread [EMAIL PROTECTED]

Hi Nancy,

Still a rough draft (http://www.unitedswe.com/fll/pms.htm) but I've started
looking at Open Source PMS's. Everyone please let me know of others I need to
review. So far I've looked at the following. These are all closely related and
web-based so far:

FreeMed/OpenEMR/MirrorMed (ClearHealth)

Tim



--- Nancy Anthracite [EMAIL PROTECTED] wrote:

 If anyone knows of any practice management systems out there that are willing
 
 to have their interfaces to VistA be FLOSS, please let me know as I need some
 
 examples of what we be facing when it comes time to trying to build them.
 
 -- 
 Nancy Anthracite
 
 
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Re: [Hardhats-members] Open Source Free Practice Management System Interfaces

2006-05-05 Thread Nancy Anthracite
Thanks!

On Friday 05 May 2006 09:28, [EMAIL PROTECTED] wrote:
Hi Nancy,

Still a rough draft (http://www.unitedswe.com/fll/pms.htm) but I've started
looking at Open Source PMS's. Everyone please let me know of others I need to
review. So far I've looked at the following. These are all closely related
 and web-based so far:

FreeMed/OpenEMR/MirrorMed (ClearHealth)

Tim

--- Nancy Anthracite [EMAIL PROTECTED] wrote:
 If anyone knows of any practice management systems out there that are
 willing

 to have their interfaces to VistA be FLOSS, please let me know as I need
 some

 examples of what we be facing when it comes time to trying to build them.

 --
 Nancy Anthracite


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 easier Download IBM WebSphere Application Server v.1.0.1 based on Apache
 Geronimo
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-- 
Nancy Anthracite


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Re: [Hardhats-members] Can't ping 2 VistA GT.M implementations

2006-05-05 Thread Gregory Woodhouse
On May 4, 2006, at 8:26 PM, Usha wrote:The same configuration successfully HL7 pings two Cache implementations of VistA. Then why doesn't it work with GT.M? Regards Usha As john Clemens said, I suspect the problem is with your listener setup. If you're using a single listener (I don't recommend this), use netstat to verify that the connection is open and running. Otherwise, you probably want to set up a listener using inetd or xinetd. I don't use Linux, but I've done this many times using TCPIP services (a.k.a. UCX) under VMS. That's pretty much the same thing. Gregory Woodhouse[EMAIL PROTECTED]"Those who are enamored of practicewithout theory are like a pilot who goesinto a ship without rudder or compass."--Leonardo da Vinci (1452-1519) 

Re: [Hardhats-members] Open Source Free Practice Management System Interfaces

2006-05-05 Thread Jim Self
Tim Jowers wrote:
Hi Nancy,

Still a rough draft (http://www.unitedswe.com/fll/pms.htm) but I've started
looking at Open Source PMS's. Everyone please let me know of others I need to
review. So far I've looked at the following. These are all closely related and
web-based so far:

FreeMed/OpenEMR/MirrorMed (ClearHealth)

The web page could use a title that mentions PMS. It looks like the beginnings 
of a useful
resource. I haven't had time yet to look much at these offerings, but I intend 
to once we
have gotten a little further along with constructing a web based interface for 
basic VistA
functionalities like patient registration, user registration.

--- Nancy Anthracite [EMAIL PROTECTED] wrote:
 If anyone knows of any practice management systems out there that are willing
 to have their interfaces to VistA be FLOSS, please let me know as I need some
 examples of what we be facing when it comes time to trying to build them.

---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)
---
M2Web Demonstration with VistA
(http://vista.vmth.ucdavis.edu/)
(http://openforum.worldvista.org/~forum/m.cgi)
---


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[Hardhats-members] Sun to Make Java More Linux-Friendly

2006-05-05 Thread Gregory Woodhouse
From ACM Tech News,Sun to Make Java More Linux-Friendly CNet (05/04/06) LaMonica, MartinSun Microsystems will announce changes to its licensing provisions at the upcoming JavaOne conference that will make it easier to package Java Runtime Environment with Linux. Sun is modifying the software that enables PCs to run Java in an effort to reach out to open-source systems, particularly Linux and OpenSolaris. "The intention is to make it easier for distributors and developers to get their hands on the runtime with the operating system," said Sun's Laurie Tolson. Sun has long faced pressure to make the entire Java platform open source to encourage development, and Sun has indeed made significant changes to the Java development process and made the source code more accessible, though it has stopped short of formally opening all Java. Sun is also likely to announce a software development kit for Java EE 5, the most recent upgrade to the Java server standard. Last year Sun announced the GlassFish project, a code-sharing initiative that seeks to create a Java application server built on the Java EE 5 standard. Software built on the standard will support the Enterprise Java Beans 3.0 standard that is designed to facilitate accessing data from Java programs and writing transactional systems. Java EE 5 has also been modified to accelerate Web development and the design of Web services. Prebuilt components packaged in software based on Java EE 5 for creating Web applications will use the AJAX Web development method.Click Here to View Full Article  Gregory Woodhouse[EMAIL PROTECTED]"Those who are enamored of practicewithout theory are like a pilot who goesinto a ship without rudder or compass."--Leonardo da Vinci (1452-1519) 

Re: [Hardhats-members] VistA Community Conference Call

2006-05-05 Thread Gregory Woodhouse
On May 4, 2006, at 11:01 PM, Maury Pepper wrote:  *** VistA Community Call -- Friday at NOON EDT ***  TOPIC: Improving the Image of VistA  I thought it was a good call and an important topic. I was typically outspoken, but think there really is a lot that we can and should do here. Gregory Woodhouse[EMAIL PROTECTED]"Those who are enamored of practicewithout theory are like a pilot who goesinto a ship without rudder or compass."--Leonardo da Vinci (1452-1519) 

[Hardhats-members] New VistA Project

2006-05-05 Thread Matthew King








Wish me Luck! 



My board just approved a small demonstration project using OpenVistA.
I will be the only provider, but using it on real patients in an outpatient
clinic setting. We hope to show that VistA is a high quality, low cost
alternative to commercial EHRs in the Community Health Care setting and to
demonstrate its functionality to other Community Health Centers in our
state (AZ). Its a very small project, but may catch the attention of
other CHCs, especially AZ CHCs. 



My IT director and I have installed HUI OV4 onto a small
server and are configuring it now; except he just went out of town for a
week#%! Ive downloaded CPRS and Putty onto my desktop in my office and
will get it to talk to the VistA server. (That
hasnt happened yet. I received device errors when I started the RPC
Broker, so we will need to troubleshoot that when my IT director returns.) I
must say, however, the OV4 installation (on Suse 9.3) went extremely well and
very fast! It has automated scripts that really simplify the process. 



My plan is to gain proficiency on CPRS on my desktop first
and then use a wireless laptop in the exam room.



Ive been using the CPRS demo to train myself. I am
also heavily using the Hui VistA Institute Documentation and the VA VeHU
e-Xpress Train web site for additional training:



http://www.pacifichui.org

http://www.vehu.med.va.gov/vehu/eXpressTrain.cfm



I did a survey asking the MAs about their comfort level
using a computer. I will need to pick one of them to assist me with the
project.



Kevin graciously agreed to provide some technical assistance
on the project, for which I am thankful. I also would like to thank everyone on
the listserve, the Hui project and WorldVistA wiki for their help and support,
especially Bhaskar, Nancy, Jim, James Gray, Joseph Dal
 Molin, and Norman Dodd. 



I would appreciate any suggestions anyone might have to
ensure the success of the project.





Matthew M. King, MD

Medical Director

Clinica Adelante, Inc

Surprise, Arizona 85374

[EMAIL PROTECTED]










[Hardhats-members] Medication Error tracking

2006-05-05 Thread Ruben Safir
I was reading this today:

While these numbers are impressive, they are likely to be a significant
underestimation of the problem.  First, the two studies from which the
statistics are extracted are believed to offer conservative figures
because they were limited to injuries of a specified level of harm, they
required a high threshold to determine whether an adverse event was
preventable or negligent, and they included only those errors documented
in patient records.2 Second, these statistics represent errors in
hospitals only. More recently, Barker and colleagues observed a
persistence of the problem in defining 19% of doses administered in
health care facilities to be in error and 7% rated as potentially
harmful.3







20% of the doses is impressive.  Who was working with he Pharmacy
modules?  Was that Kevin?  Is there a means for error reporting and
tracking?

Ruben



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Re: [Hardhats-members] New VistA Project

2006-05-05 Thread Kevin Toppenberg


My board just approved a small demonstration project using OpenVistA.


Excellent!
...
I received device

errors when I started the RPC Broker, so we will need to troubleshoot that
when my IT director returns.)


Sounds like something we can help with here too, so why don't you post
a screen log that you get when you try to start the RPC broker (I
assume you are talking about the server side) to this message board
and let us have a go at it.

I must say, however, the OV4 installation (on

Suse 9.3) went extremely well and very fast! It has automated scripts that
really simplify the process.


Great.  I'd like to see how it has changed for the better!


Kevin graciously agreed to provide some technical assistance on the project,
for which I am thankful.


You may find that you develop the skills yourself :-)  That would be
the best way overall, but I'll help however I can, and I know others
will as well.

Keep us in touch.

Kevin


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Re: [Hardhats-members] Medication Error tracking

2006-05-05 Thread Kevin Toppenberg

See below

On 5/5/06, Ruben Safir [EMAIL PROTECTED] wrote:

I was reading this today:

While these numbers are impressive, 


What numbers?  Did you mean to include a link to an article?

they are likely to be a significant

underestimation of the problem.  First, the two studies from which the
statistics are extracted are believed to offer conservative figures
because they were limited to injuries of a specified level of harm, they
required a high threshold to determine whether an adverse event was
preventable or negligent, and they included only those errors documented
in patient records.2 Second, these statistics represent errors in
hospitals only. More recently, Barker and colleagues observed a
persistence of the problem in defining 19% of doses administered in
health care facilities to be in error and 7% rated as potentially
harmful.3

20% of the doses is impressive.


Reuben, I am always very skeptical of these studies.  Does 20% of all
doses make any sense to you?  I have a hard time believing it.  A
typical patient may well be on 8 drugs in the hospital, and TID -- 24
doses a day.  So 20%=5 erroneous does a day?  I bet this is a
statistacal aberration.  Or else I am very nieve.  Perhaps the bigger
the numbers quoted, the more likely that one will get one's paper
published?

Who was working with he Pharmacy

modules?  Was that Kevin?  Is there a means for error reporting and
tracking?


I haven't seen anything about error tracking, but I am very focused on
a small part of the pharmacy package right now ... drug
classifications with the VA classes.  What a headache!  I thought I
was done, and then found 5,000 more drugs in the FDA database that
were completely new to the VA database, so there are no potential
matches that can be used to suggest drug classes for the new drugs. 
Also, I have never seen so many drugs that I have never heard of in my

life.  All kinds of combination tablets with unfamiliar tradenames

Kevin


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Re: [Hardhats-members] New VistA Project

2006-05-05 Thread Chris Richardson
Kevin and Matt;

   I might further suggest that, Matt, you have a community of folks who
have seen many of the challenges you will be facing and that they will be
happy to throw their experience into the discussions if you can articulate
the problems you are seeing.  We would suggest that if you have any
additional insights that may make it easier for the next guy in your
situation,please bring them on to the group, either here or on the wiki.  We
are growing up a massive knowledge base of such lessons learned and want the
community to prosper from these experiences.

   Good luck and you are not alone.

- Original Message -
From: Kevin Toppenberg [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Friday, May 05, 2006 1:38 PM
Subject: Re: [Hardhats-members] New VistA Project



 My board just approved a small demonstration project using OpenVistA.

Excellent!
...
 I received device
 errors when I started the RPC Broker, so we will need to troubleshoot that
 when my IT director returns.)

Sounds like something we can help with here too, so why don't you post
a screen log that you get when you try to start the RPC broker (I
assume you are talking about the server side) to this message board
and let us have a go at it.

I must say, however, the OV4 installation (on
 Suse 9.3) went extremely well and very fast! It has automated scripts that
 really simplify the process.

Great.  I'd like to see how it has changed for the better!

 Kevin graciously agreed to provide some technical assistance on the
project,
 for which I am thankful.

You may find that you develop the skills yourself :-)  That would be
the best way overall, but I'll help however I can, and I know others
will as well.

Keep us in touch.

Kevin


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RE: [Hardhats-members] Migrating vista console module routines to client side GUIs

2006-05-05 Thread Jim Self
Marc Aylesworth wrote:

 the whole reason for open source is for choices,

That is certainly part of it. The essence of it to me is freedom of information,
particularly of the deep knowledge necessary to keep vital systems like VistA 
viable and
moving forward with new technology.

 there should not be replacement but supplement of user interfaces
so that someone can choose the best interface that fits his/her situation.

Certainly, the challenge at this point is to construct a complete non-CHUI 
interface to
VistA so that potential users can choose a richer user interface than can be 
provided by a
VT100 terminal.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Greg
Woodhouse
Sent: Thursday, May 04, 2006 6:33 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] Migrating vista console module routines to
cleint side GUIs

I think a big part of the problem is that we're speaking as if GUI
interfaces can all be lumped together as one user interface style. We

Lumping GUI interfaces together as a matter of style seems like an obvious 
misconception.

The major distinction between GUI and CHUI is simply that CHUI displays are 
limited to an
array of character cells where GUI displays are based on pixels. GUI has a more
fundamental and general basis so that CHUI (terminal emulators for instance) 
can be
represented within GUI.

all quietly accept that roll and scroll is one style of character based
user interface, but no one stops to consider whether there aer
different styles of GUI interfaces?

I would think that most people would be aware of major differences in user 
interface style
even just within web interfaces. And of course, not all web browsers are GUI. 
There are
some very capable CHUI web browsers, they just can't represent images as well 
as GUI
browsers directly. Some can represent images as ASCII art or they can call 
helper
applications to display images separately.

Web interfaces should be considered a separate category independent of GUI and 
CHUI. The
essential features of web applications are simply HTML and HTTP.

The choice between roll-and-scroll and other styles or modes of interaction 
does not have
to be all or nothing in either GUI or CHUI. One of the first things I did in 
defining a
CHUI for VMACS twenty something years ago was to restrict roll-and-scroll 
interactions
from touching regions of the VT display reserved for input forms, menus, and 
status
indicators. This allowed us to use features from classic fileman within a more
sophisticated and higher performance overall CHUI user interface.


Another example is the web based command shell in M2Web. That combines some of 
the best
features of roll-and-scroll with the richer interface capabilities of a web 
browser. You
submit command lines from a text input field (or textarea for multiple command 
lines).
There is a dropdown list that can be used to insert items from your command 
history into
the text field. When you submit a command, the text of it is appended to your 
results
history followed by any output it produces in plain text or HTML (including 
graphics,
tables, hypertext, input forms, Javascript, etc). Each item in the results 
history can be
collapsed or individually removed so that the display is not dominated by long 
listings or
output that is no longer interesting.


---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)
---
M2Web Demonstration with VistA
(http://vista.vmth.ucdavis.edu/)
(http://openforum.worldvista.org/~forum/m.cgi)
---


---
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Re: [Hardhats-members] Medication Error tracking

2006-05-05 Thread Kevin Toppenberg

On 5/5/06, Ruben Safir [EMAIL PROTECTED] wrote:
...

Yes - not only does it make sense, but I've confirmed this rate in my
own studies both in ***ambutitary*** care settings (ir:  at the counter
in Rite-Aid) and in the hospital (following the nurses around).  And
this is while I was watching them.  In fact, my data showed nearly 27%
of the doses to be medically incorrect, and nearly 47% of the IV drugs
given on the floors as being incorrect, and that was just from what I
could see and not accounting for dosing errors, or miss use of drugs by
physicians which my students and I did not catch even before following
the nurse around.


So can you give some examples?  Would this be like using septra DS
once daily instead of the usual BID?  Are these prescription writing
errors that you, the pharmacist, would catch?  I mess up prescriptions
not infrequently, i.e. --forget to put a quantity, forget to specify
direction etc.  But I don't often get the sig wrong in terms of actual
dosing instructions.


At one point it was discussed about what to do with Physician Order
Entry and interaction warnings.  I strongly recommend the inclusion of
those warnings. In addition, if it was me, nobody would ever order a med
without the prescribing information on the screen write next to the drug
and annotation from the department heads and the pharmacy.


Such systems have been designed, and impatient doctors don't usually
tolerate them..


Not a surprise.  My gut tells me that the FDA listing is not the best
place to work off of.


True, but when I was asking around, it was the only database I could
find, and no one had a better suggestion.  So now I am stuck with it. 
But ANY database that is complete will have all this old 'junk' in it.


Kevin


---
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