Software

[Scroggie]

Anybody else out there making their own EMR. I am using MS Access 2000/XP on Windows 2000Pro.

I have split front end and back end. Tried migrating the MSDE (MS SQL lite), but it was a pain in the butt.

What are other folks using.

I'd post a copy of my EMR, but its too big :( .

Maybe if we had an file section . . .

[BigDoc]

I am planning a download area, trying to figure how to link that to membership, I want only members to be able to upload files for obvious reasons, hopefully soon, will have the site ready. I too have plenty of files I've designed that I can share, but placing them on the board makes the SQL file too large.
thanks Scroggie :o

[Scroggie]

If I get a server (with MS server 2003), I might be able to add to you capacity. . .

[Quack]

Scroggie, when do you get time to practice Rheumatology ? ;)

[Scroggie]

Well, I squeeze it in between patients, at home and whenever the programming urge hits me. My current job (military physician) has some built in admin time.

[Kursk]

What are your migration problems? ADO? Table design? SQL syntax?

[Scroggie]

Where to start.
1. table design: minor problems which were easily fixed. I can acutally use the MSDE as a backend from the Access .mdw front end without much problems (linked via ODBC, should try OLE). Still have trouble with the relationships not holding up (dropping one to many)
2. ADO vs DAO: code was actually fairly easy to change, just tedious.
3. SQL syntax: It took a while to figure out how to convert my queries to views and stored procedures (then change the forms to pass through the parameters). This was the biggest challenge: getting a query limited by the data in a temp form to convert to a stored procedure limited by the same field.
4. I got it mostly working, but then though why am I doing this to myself? Its not much faster, sure its more secure, but it can be a pain.

Should I revisit this?

[Kursk]

Scroggie: I feel your pain. Access is pretty weird at times. I tried to skip over ADP to .net and use a web front end but I got bogged down pretty fast and had to put it on the back burner. Just too much to learn too fast. Had to get MSDE, IIS, visual studio all up and running and don't have access to the web server at work. Plus my application is actually working well and I don't have to change anything so the motivation is not there currently. Brought on 2 more users (one partner), one in a seperate location with plans to expand to several others (so now I am tech support, network guy, database guy etc). Feeling a bit challenged at times. But I do have a substanial investment in programming books (Alberto would be disappointed as I bought them all retail and not on E-bay!). :eek:

[Scroggie]

The little changes are enough to occupy me. I don't really want to totally muck things up now.
Two more users, teaching others is the other thing that slows the pace of change. I've got one DB at work that has 8 users and if I make one little change, I gotta explain everything like ten times.

I flirted with the whole web based interface (no need to install office on every computer in the hospital), but didn't want to learn a whole nother language.

We need Al to pop in. I sent him some hints a POL, but no sign yet.

PS, I got my Access to SQL used from Amazon, so I can hold my head high :)

[Scroggie]

Kursk, have you looked at www.utteraccess.com
I visit that site many times a day. Its chock full of tips and code (.net, VBA, et cetera). Solved many a problem there.
My post name there is the same (scroggie)

[Scroggie]

What do you know about Access2000 (9.0) versus AccessXP (10.0)? Should I change my file types?

[Kursk]

Scroggie: how you got things set up for multiuser? secret network or do you have some IS MOS helping to use the base network?

BTW did some time at Fort Sam wayback when. Then they had a war and I got an invitation (more like an offer I couldn't refuse).

[Kursk]

Yes hit utteraccess but also found some good VBA stuff online in microsoft.public.word.VBA.general and other similar Usenets. The MVPS site for Word is good and got some mileage out of the VBA developer's Handbook by Getz. I am what I like to refer to as a "coding neaderthal". I think I have advanced about as far as my restricted cranium will allow, but I have my own art and primitive burial rituals.

[BigDoc]

Scroggie & Kursk, you both good at databases by the looks of it? Any of you do PHP mySQL?

[witchdoc]

What language is all this? :confused:

[Scroggie]

I use a backdoor method, the IT guys wouldn't give me a network drive without 50 signatures, so I just named a directory on my desktop Access$ (the $ creates a shared folder that doesn't show up when you browse the network, you can only access it by typing the file in directly).
I then patched together different security programs to secure the files. Suboptimal, but workable.

I like the Neanderthal analogy.

BigDoc, I haven't in the past, but I'll take a gander at the website.

[Scroggie]

Whilst browsing the mySQL site, I chanced upon this link http://www.convert-in.com/demos/acc2sqld.exe I'll have to see if it works.

Nothing a neanderthal likes more than a new club.

[Scroggie]

BigDoc, where should I start? Here http://www.phpmyadmin.net?

[BigDoc]

Cool, 'been on a PHP crash course the last few months, I think it is the way to go.
BTW, what kind of permission do you have at work, admin? power user?

[Scroggie]

Regular user. I have Secret clearance, but they don't trust me to install a printer here. I have to use guerilla tactics.

[Kursk]

Scroggie: as one insurgent to another, more power to you. Amazing how hard it can be selling clinical IT to the IS department. The whole ownership thing! More discrimination by homo sapiens against us peace loving neaders.

[Kursk]

Scroggie: okay I think I see some subchondral sclerosis, but the image is too small to see erosions. And what's with the toothbrush in the left upper corner? And why did you staple the ring finger to the exam table?

[Scroggie]

The "toothbrush" is the L eft side maker.
There's periarticular osteopenia and erosions in the bare areas, radial side of MCP's.

Neadercoder
(I posted your comment bout the art and death rituals on UA, reading the MySQL/PHP forum.)

[Mike]

THAT is an Xray of a chimpanzee, I was a vet before going to med school

[Scroggie]

Hey, I had to distort it a little to make it fit. its human, neanderthal, but human.

[Scroggie]

I am dodging angry glances from the wife, but I have my fedora Linux box on the build. Its installing as we speak.

I'll set it up as a server. Then convince my wife I need a couple of extra hardrives for storage, then some more memory, then faster processor . . .

BigDoc, how is your hosting set up, can you run a board like this via a cable modem and a coupla extra boxes or are you hosting with a company.

[Kursk]

How'd the Linux build go? Any hardware recognition problems? USB issues? I tried for about a year off and on to get Mandrake to recognize USB flash reader from my digital camera, gave up. Printing to my Epson printer never worked through CUPS and I had to get a driver from TurboPrint. Wife didnt want to move from Paintshop to GIMP so the project died. Kids couldn't play their games either. Bill is my master, Bill is my master, Bill is my master ..... :(

[mel]

Scroggie, u builiding a Linux box? You guys in the wrong business, we are on a virutal server with a hosting co, the kids may knock over a box, or infect one of them downloading games

[Scroggie]

Trying to build is more like it. I'll be working with my new tablet PC (wife signed for it today) for a while. Then I'll go back to the linux.

[ozzie]

sure the kids may be a problem but the server should not be where icky sticky pinkies can poke prod and fill playdo.. :)

nice feature of linux is that unless the admin (root) does stuff all else is controlled..
just never login as root is a good start and leave the box at the command line..lol

Virtual servers are great but not until you really understand whats going on with linux..

When your are learning it's easy to toast stuff so a reinstall is the quick way to start again and with a bare shell it takes maybe 15 minutes..
When you have a hosted server not so easy to do ,...

However if you just want to host stuff and install simple packages most are out there and installed and cheap..



Scroggie, u builiding a Linux box? You guys in the wrong business, we are on a virutal server with a hosting co, the kids may knock over a box, or infect one of them downloading games


oz

I have to make sure it is the best I can find because I'm too poor to buy cheap.

[Scroggie]

i gave up on the linux. had lots of false starts, mostly because i was using "salvage" parts and only had 64 of ram.

next time i'll try using new parts.

[ozzie]

http://www.docsboard.com/forums/showthread.php?t=162
I started a thread there which addresses that problem..

or www.vmware.com is way cool it allows you to run full blown linux inside a shell.. I use it all the time as I have linux images built and I can test blow up.Then just delete a folder and start again..

you need tons of ram 600 meg or so and the faster the hard drives the better..
I use it on a Stinkpad with P111 1200 and 600 meg of ram and I can run 2 linux virtual machines on windows 2003 advanced server..
Way cooool..
oz

[Kursk]

www.vmare.com is way cool it allows you to run full blown linux inside a shell.. I use it all the time as I have linux images built and I can test blow up.Then just delete a folder and start again..

oz
Ozzie - no such page is the link broken or incorrect?

[ozzie]

Ozzie - no such page is the link broken or incorrect?
fixed you may have to refresh your browser can you edit you link too >>
I have a bare debian shell zipped up for vmwaree which you can play with if you want..

oz

[jlively]

Anybody else out there making their own EMR. I am using MS Access 2000/XP on Windows 2000Pro.

I have split front end and back end. Tried migrating the MSDE (MS SQL lite), but it was a pain in the butt.

What are other folks using.

I'd post a copy of my EMR, but its too big :( .

Maybe if we had an file section . . .

OK back on topic. Scroggie, I'd be interested in seeing your work to date. Would you be willing to email me a copy?

I tried to build a practice management solution in access and found it to be WAY TOO slow as I starting adding the necessary features. I shifted to a VB6 front end with a MS SQL back end. Speed was no longer an issue. Here is a link to a website dedicated to a home grown EMR, at first in access 2000 (Access GP) and then vb.net with a SQL backend. It is all open source so you may be able to use some parts that will fit into your application. It is written by an Australian doc so some parts may not be applicable to practices in the USA.


http://www.accessgp.com/dnlds.htm

[Scroggie]

Thanks
I'll zip off a copy to you at some point. I've gotten Access FE working with MySQL back end too. I've done a fair amount with VBA, so I suppose VB6 isn't too far off.
What are the key differences? How does on get VB6 (I know .net is a pain, but isn't VB6 on the office cd?

[jlively]

VBA in access is very similar to VB6. You will have to code your own database connections in VB6. VB.net is not as far off of VB6 as some people would have you believe. Yes, it is object oriented and has a few syntax changes but it is well worth learning if you are going to continue to program. You can pick up an academic version of VB6 to try out and it's relatively inexpensive. Try L&M bookstore down by SAC or the UTSA bookstore. There is an application that can be purchased that will convert an access program to a VB6 program. I tried it and acheived about 60% accuracy. It's a good start if you are commited to porting your application though.

[ozzie]

It is written by an Australian doc so some parts may not be applicable to practices in the USA]
Watch the date Australia use day month year postcode is the zip code and the postcode is 4 characters not 5.. and its all metric.. I playes with this a couple of years ago and it was pretty cool.. But not an Access fan so it got canned..

[BigDoc]

Ozzie, or anyone with some knowledge in the area, I wrote a spreadsheet for following patients without an EMR, I need to clean a few things on it, can you help? It is available here (http://www.docsboard.com/forums/showthread.php?s=&threadid=26)

[alborg]

BigDoc:

Why not go the relational database route? It'll be much more efficient and clean, and eventually will lead to a much smaller overall database footprint. You can always import Excel tables into the Access environment...

Regards,
Al

[BigDoc]

'simple answer Al, I'd be over-extending, I know enough to take on an existing Access project, rather than denovo

[amanco]

Anybody else out there making their own EMR. I am using MS Access 2000/XP on Windows 2000Pro.

I have split front end and back end. Tried migrating the MSDE (MS SQL lite), but it was a pain in the butt.

What are other folks using.

I'd post a copy of my EMR, but its too big :( .

Maybe if we had an file section . . .

Scroggie ... i'm in the process of learnign access to develop EMR with tablet PC, i chose this because there was no EMR that is customizable enough or fit my need + too much, i would really appreciate your experience in this path. and also would benefit from looking at your database structure. have you found a place to upload it yet? if not can you please email it to me gynaecologist@iol.ie

i'd be grateful, cheers :)

[Scroggie]

Look under Ozzie's post further down on this forum. He has a link to it. I don't have the tablet stuff in there, but I recently started using Pen and internet's activepen, which lets you write anywhere http://www.penandinternet.com

Give em a try.

Daren

[amanco]

Look under Ozzie's post further down on this forum.He has a link to it.
Scroggie i couldnt find any link to the file :(



I don't have the tablet stuff in there, but I recently started using Pen and internet's activepen, which lets you write anywhere http://www.penandinternet.com


Does that mean with penrite i can write on MS access and it will add the text to the database without the need for the tablePC SDK?

thanks

[ozzie]

http://www.data2feed.org/emr/
here is scroggies stuff courtesy of the scroggie dude, USAF, and the taxpayers of the USA LOL

oz

[amanco]

http://www.data2feed.org/emr/
here is scroggies stuff courtesy of the scroggie dude, USAF, and the taxpayers of the USA LOL

oz

thanks ozzie for the link :)

[Scroggie]

Yes. rite pen lets you write anywhere one screen and inserts it in the active box (text, combo or listbox). No special codes needed.

[amanco]

Yes. rite pen lets you write anywhere one screen and inserts it in the active box (text, combo or listbox). No special codes needed.

wow this will save my ass. i'm glad i didnt start doing the forms yet ...thanks for the tip :D

[Scroggie]

No problem. Us cave man coders stick together.

[ozzie]

No problem. Us cave man coders stick together.
What this US stuff ??

[ozzie]

Dude / dudette..
Learning access is no trivial task and becomes more trouble than what it is worth..
Did you learn MD stuff to write arcane access stuff ??

Most access apps end up half baked as to get to the next level of sophistication requires much more work..
just like once access gets past a few tables
then oh time to build a front end..
then its time to build a database.
then its time ot build a web front end .
Oh ODBC works sure it does sure it does.. give gobs of bandwidth and VPN
Oh now we need security ,, oh drat have to change stuff as access has no security because it runs on an insecure file system.

You should not create systems around hardware
.. hardware changes system dies.. ask an Newton developer.
Time is money look at 1000 hours or so to get a half baked system up now does it all look so cheap ..
No system is going to be the perfect system even if you make it as there are too many external variables..

First you need to define the system what YOUR needs are etc ..
Keep hardware OUT of the picture as in the end given the better system platform hardware is null..
People rave about PDA's / tablets and they are cool but not the ultimate system, a great in addition too but for sure not a "in replace of".

Toys versus tools.. Toys put a smile on your face, tools put money of your pocket..
So lets see your needs first then look at all the options..
I can give you my list of options but you need to define your needs..

Also remember too dev software is like sleeping with a lady of ill repute should you marry the lady you soon forget what her job used to be..LOL So what was the real reason for the marriage ??? You bought the cow instead of buying fresh milk.. So be wary when buying / making the cow..

just for the records I am NOT an access fan..

oz



Scroggie ... i'm in the process of learnign access to develop EMR with tablet PC, i chose this because there was no EMR that is customizable enough or fit my need + too much, i would really appreciate your experience in this path. and also would benefit from looking at your database structure. have you found a place to upload it yet? if not can you please email it to me gynaecologist@iol.ie

i'd be grateful, cheers :)

[amanco]

No problem. Us cave man coders stick together.

:D




Dude / dudette..
Learning access is no trivial task and becomes more trouble than what it is worth..
Did you learn MD stuff to write arcane access stuff ??

Most access apps end up half baked as to get to the next level of sophistication requires much more work..
just like once access gets past a few tables
then oh time to build a front end..
then its time to build a database.
then its time ot build a web front end .
Oh ODBC works sure it does sure it does.. give gobs of bandwidth and VPN
Oh now we need security ,, oh drat have to change stuff as access has no security because it runs on an insecure file system.

You should not create systems around hardware
.. hardware changes system dies.. ask an Newton developer.
Time is money look at 1000 hours or so to get a half baked system up now does it all look so cheap ..
No system is going to be the perfect system even if you make it as there are too many external variables..

First you need to define the system what YOUR needs are etc ..
Keep hardware OUT of the picture as in the end given the better system platform hardware is null..
People rave about PDA's and they are cool but not the ultimate system, a great in addition too
but for sure not a "in replace of".

Toys versus tools.. Toys put a smile on your face, tools put money of your pocket..
So lets see your needs first then look at all the options..
just for the records I am NOT an access fan..

oz

Ozzie all what i am tryign to do now is to have -history/physical exam/investigation/management reports on the fly.

but ofcourse this will serve me in a different way when using a PC.

for example, having the presenting complaint history and matching this with a diseases database to get the differential diagnosis, most common diagnosis 1st. i have no clue how to do it yet but i am sure it can be done.

PDA Vs Tablet PCs, PDA used to be my choice regarding this matter. but when i researched more in this, i found out Tablet PCs can serve my needs more. further more you can an emulator in the tablet PC to have Palm apps. 2 in 1.

Why did i choose access? well defintely at this stage i am thinking of Visual.NEt with MySQL Database. it is the best choice now (at least). but access is easier and quicker to learn and will set the features for my future program. as i am planning to go for visual.net.

But for now i am not looking for a big management System EMR. just starting with something that can give me reports on the fly and i am sure it will impressive reports at the same time using the technology.

[ozzie]

Ozzie all what i am tryign to do now is to have -history/physical exam/investigation/management reports on the fly.
but ofcourse this will serve me in a different way when using a PC.
for example, having the presenting complaint history and matching this with a diseases database to get the differential diagnosis, most common diagnosis 1st. i have no clue how to do it yet but i am sure it can be done.

Not touching that to me that is NOT an EMR system but artificial Intelligence which means oxymoron to me LOL Data manipulation as in meta data stores etc become a different beast and far from the scope of the average Dr practice.. And IMHO way out from EMR systems. I prefer the judgement of a human rather than intel/ms/linux/sql.
I see an EMR as a patient /office/ dr/management system. But stopping there.. Once you get past there you get real mission creep and into the speciality wars. This is a major problem today as everyone is catering to the speciality wars but still the core EMR was not really that functional to start with..



PDA Vs Tablet PCs, PDA used to be my choice regarding this matter. but when i researched more in this, i found out Tablet PCs can serve my needs more. further more you can an emulator in the tablet PC to have Palm apps. 2 in 1.
The original Copilot for Windows - http://www.hewgill.com/pilot/copilot/index.html
Copilot for Mac OS (PowerPC) - http://members.aol.com/illumesoft/copilot.html
"Zilot" for Mac OS} - http://www.pollet.net
"xcopilot" for Unix/Linux - http://www.isaac.cs.berkeley.edu/pilot/
"PilotCE" for WindowsCE - http://www.geocities.com/SiliconValley/Monitor/8604/Beta/PilotCE/
You can emulate anythign on anything these days..




Why did i choose access? well defintely at this stage i am thinking of Visual.NEt with MySQL Database. it is the best choice now (at least). but access is easier and quicker to learn and will set the features for my future program. as i am planning to go for visual.net..
I think php mysql would be a better mix on apache.. far greater support and scalable and if super anal go postgres on the DB side..
and also being pure https in the end solves many support security and mainainence issues..
last thing I would want to do is create a dependence on Internet Exploder or ANY operating system / browser..


But for now i am not looking for a big management System EMR. just starting with something that can give me reports on the fly and i am sure it will impressive reports at the same time using the technology.
the only diff size wise whould be a hardware issue only .. ie RAM CPU and Hard drive space..

[alborg]

Hi Ozzie:

>>> just for the records I am NOT an access fan..

Blasphemy!!! (G) It gets the job done, is relatively easy to program, and is able to easily connect to numerous softwares through ODBC, including Lytec and Medisoft.

>>> I think php mysql would be a better mix on apache.. far greater support and scalable and if super anal go postgres on the DB side..

Cool- but I find that Jet 4.0 works just fine (i.e. stability and speed) for a small office of less than 10 computers. That said, I haven't pushed that limit yet- most likely it'll also work for larger LANS.

Sure, a Ferari will get you to work faster than a Ford, but unless you enjoy listening to the sweet roar of the motor, you're wasting your money on the more expensive, "robust", car. I personally find that the crash rate for the Jet 4.0 to be minimal.

>>> and also being pure https in the end solves many support security and mainainence issues..

You mean the XML realm? I'll be able to write that language in about 3 years when I truely find the utility of the beast... I know that Microsoft is pushing it, and eCW is programmed into looking like a perpetual website, but a pure relational, somewhat graphical software like MS Access is for now still the standard and most widely used system worldwide.

>>> PDA Vs Tablet PCs, PDA used to be my choice regarding this matter. but when i researched more in this, i found out Tablet PCs can serve my needs more. further more you can an emulator in the tablet PC to have Palm apps. 2 in 1.

Problem: tablet PC's are being phased out by Microsoft (as per eweek.com this week)... think "souped up laptop" 2-3 years from now. I'll buy the tablet PC's when they go on gouge-sale on eBay over the next few months... (G). PDAs have their place, s.a. in your pocket, for patient billing purposes, and for a repository of PDA medical reference books (think "Skyscrape", "ePocrates", etc). Scheduling and memos can also be done efficiently with these small PDA's with less cost. You can print excellent, simple SOAP notes using a PDA. The 2.5 pounds that a tablet PC weighs is just too... heavy!

Then you get into the world of the Windows CE based Airpanel that I mentioned in another discussion- it looks like a tablet PC, works like a tablet PC, and handwriting recognizes like one... but this is no Tablet PC duck. It too costs a fraction of the Tablet PC price to purchase.

When my in-laws go back to Panama next week I'll post my MS Access software that I use on my wireless (for the MD's) +wired (for the staff) LAN to show what can be done with this software. Although not web enabled (I'm not interested in giving the Sassar worm a chance to eat up my files), I do have neat graphics, s.a. when Einstein (i.e. the guy that I use as my Avatar) is programmed to blow up the screen when the software opens up... real neat fluff there!

Regards,
Al

[Kursk]

We must be Ozzie's nightmare - creating nonstandardized code on consumer grade equipement and software that works well enough to delay purchase of a real business grade application. Having spent a lot of time with our network execs/techs I am sympathetic to their dilema. What do you do with crazy docs like us?

[ozzie]

1. access is not free
https is free and totaly platform independant
Sassar worm / any virus/worm has zero impact on any apache system / non MS browser..
Crash rate minimal better no crash rate ???
https is to serve XML is to distribute lets not mix dr with the murses here.
Oh XML started off as open source and MS adopted it because et MS HAD to..
Most apps write XML then serve in http(s)

My response was to someone who wrote of LEARNING access.. Learning access and using a built DB are two different beasts..
And php mysql apache is by far the most " pure relational, somewhat graphical software like MS Access is for now still the standard and most widely used system worldwide." Lets keep this honest now..

I am not a MS lover or hater just there are tools for many jobs and I never have and in the near future believe MS is decent web serving platfrom. And it Db capabilities because of cronic wobbly OS foundations make MS SQL a loser too..
MS have the desktop maket hands down and it very good at that and office publication.. yet their printing still sucks because of basic flaw MS has had ever since NT borrowed print spoolers from VMS.. Except MS forgot that VMS runs each print job under it own spool DOH

When MS start running a major part of the internet maybe they will get my attention, LOL
I am going to 4 days MS security training this week , so as you see I am not an ANTI MS dude ..

In the great picture

I look at the EMR problem from a much broader view, sure the airpanel is a solution but may not be too long term..
Thats why I look at open source solutions that can be changed with no pain but much gain..
So I look at solutions that can be easily mutli language, be be easily cross hardware and software platform. Be able to function on very basic hardware..
So all that kinda kills any MS product and ..
The more Drs get involved in the broader picture by helping create software to meet their needs then the better the product will be..

However when profits take over management and design, don't hold your breath for change. The power to change needs to be in the hands of the users not the corps / suppliers..

[ozzie]

We must be Ozzie's nightmare - creating nonstandardized code on consumer grade equipement and software that works well enough to delay purchase of a real business grade application. Having spent a lot of time with our network execs/techs I am sympathetic to their dilema. What do you do with crazy docs like us?
Well I could say that I hope you love for medicine is greater than your passion for computers..
or maybe even laugh to myself wondering how smart people actually think they REALLY know whats going on in the greater PC picture AKA as silly as me thinking I am was or could ever be a DR..
I could even just take some really cheap shots..

But none of the above
But in the end I know the few crazies don't make the majority and even tho the crazies put up a fight they also know that they married the whore so to speak.. But the IT folks are still the pimps And for the most part know their limitations as statements like (software that works well enough to delay purchase of a real business grade application) and go back to golf fishing reading med books or even riding bicycles..
I would not accept a ' crazy doc ' as a client .. too much overhead and heck let them swim a little in some controlled drowning .....
A taste of reality is good therapy..
My only function is just to keep the crazies inline .
I dont do big corps etc anymore small biz is my specialty so the crazy factor is very limited and when it pops up I move on.. let the crazies drive my competition nuts not me LOL

However when I give software away it kinda blows the wind out of the crazies sails.. my practice has always been about service..
But if the crazies insist then its $750 a day to try to drive me crazy..
By appointment only and payable in advance LOL

But also you crazies make great case studies, and help show the value of a total managed system. Subtitled how not to create a bastard system.. (grin)

In order to define good we must have evil

oz

[Kursk]

<<In order to define good we must have evil>>
Brilliant! At least I am helping in some small way!

I am like Mickey Mouse, when he tried to practice magic .... the wand was too tempting too resist, then endless mops and buckets, water everywhere!

Ah, the curse of user input into the creative process....

[Kursk]

I don't use IM - I see that some of you do. My partner is constantly getting viruses despite router, AVG, Zone alarm. His children use IM extensively. What security risks does IM pose?

[BigDoc]

I don't use IM - I see that some of you do. My partner is constantly getting viruses despite router, AVG, Zone alarm. His children use IM extensively. What security risks does IM pose?
Instant messenger programs require you to open I think 2 ports in your firewall, I forget which, that hackers love, I used the java versions for a while, till I gave up, now I use Verichat (http://www.pdaapps.com/verichat/default.html) which is a unified instant messenger runs on a handheld, which have so far been free largely from viruses.
B

[ozzie]

Overall I am not a IM fan as I found it to be very distracting and as the paper trail per se is easy to lose it can be a problem..
From where I sit IM is good for coffee orders and stationary supplies outside that it can be a horror..
Any patient stuff would be a no no as it is hard to document..
Most IM's are very pervasive like yahoo it can find just any open port and work its way out just about..
Its a great troubleshooting tool LOL..
the danger is many have file push up push down turned on be default and so the weasels make bots ( read snippets of code that can do a repetitive task) to push the virus etc ,,

Also now we have instant messenger what next pre cognitive messenger..
I think that email has put a strain of the life of many and IM just increases that pressure and usually for bullcrap reasons..
It encourages thoughtless questions which require thoughfull answers..

[amanco]

Not touching that to me that is NOT an EMR system but artificial Intelligence which means oxymoron to me LOL

you remind with the consultants who have technophobia and i have to deal with everyday by carrying on my work ;)


Data manipulation as in meta data stores etc become a different beast and far from the scope of the average Dr practice.. And IMHO way out from EMR systems. I prefer the judgement of a human rather than intel/ms/linux/sql.
I see an EMR as a patient /office/ dr/management system.

Who mentioned anything about giving up the Dr's experience? but dont you think: artifical intilligence + Natural intelligence > Natural intelligence alone :)




The original Copilot for Windows - http://www.hewgill.com/pilot/copilot/index.html
Copilot for Mac OS (PowerPC) - http://members.aol.com/illumesoft/copilot.html
"Zilot" for Mac OS} - http://www.pollet.net
"xcopilot" for Unix/Linux - http://www.isaac.cs.berkeley.edu/pilot/
"PilotCE" for WindowsCE - http://www.geocities.com/SiliconValley/Monitor/8604/Beta/PilotCE/
You can emulate anythign on anything these days..

Can you emulate Tablet PC/windows XP on palm OS ? you forgot to include the link for it :)

Palm is a phyician's choice for the availability of medical softwares over PPC. and it is small in size.
and tablet PC suits my need because i can use my medical software as well. however it is heavier. and since you didn't find a link for an emulator to use winXP on Palm OS. i have to choose between:

(1) Palm: palm OS apps + small size
(2) Tablet PC: Windows Apps + Palm apps using emulator + large size (but did i mention it suits me better than a small screen?)

so surprise surprise, i chose number (2)


I think php mysql would be a better mix on apache.. far greater support and scalable and if super anal go postgres on the DB side..
and also being pure https in the end solves many support security and mainainence issues..

True, but i don't want to learn a language and type each function (without WYSIWYG) and suffer as i go along. if i did choose that i would go for Visual.Net with MySQL now not php although i used to have overview about php before, and i prefer excutable files, so MS ACCESS grants the job for me :)


the only diff size wise whould be a hardware issue only .. ie RAM CPU and Hard drive space..

Again i don't care about this, i care about delivering a working system asap.

[alborg]

We must be Ozzie's nightmare - creating nonstandardized code on consumer grade equipement and software that works well enough to delay purchase of a real business grade application. Having spent a lot of time with our network execs/techs I am sympathetic to their dilema. What do you do with crazy docs like us?

Oh that's good! (G) In POL I was pretty much the Che Guevarra / pariah representing the opressed masses of doctor consumers against the expensive EMR sellers. Folks frequently didn't understand that cheaper software titles did exist out there or that (God forbid) you could make your own system! Many a physician would purchase a system for thousands of dollars only to see the software turn into an expensive doorstop.

Usually the EMR company canned response was that we weren't capable of programming a "good" system, or that we should spend our free time in other activities... but some of us actually ENJOY programming and ARE capable of actually building above-average systems ("average" being the $12000.00+ systems being touted out there).

The realities of today's medical careers is that most of us are strapped due to increasing overhead (especially due to salaries of the multiple employees that we are forced to hire due to HMO contracts and also due to the malpractice crisis) and decreased reimbursements. As cost-effective as EMRs could be, their high expense can make them a real financial drain.

That's where off-the-shelf software and cheap hardware infrastructures come in to save the day. We can really end up with a great EMR "for a fraction of the gallery price".

Ozzie- what software do you put out? Is it a pure EMR or EMR+Billing program? Is it expensive? :eek:

Regards,
Al :cool:

[Scroggie]

Oz, you should send al the link to "your" system. www.freemed.com

Al, Oz works with a group of programmers who have developed a FREE, open source EMR based on MySQL, PHP and Apache. It will run on any hardware platform, even a hand-me-down for third world uses. Its currently in beta 0.7. The main structure is there, but it lacks some more sophsticated entry tools. They need/want additional programmers (java) to help with that.

Check it out.

In spite of how it may sound, Oz is more of a humanitarian than an access basher. He's passionate about his baby. He is planning a final release soon, and wants to wait before he hypes it.

Daren

[BigDoc]

Oz, you should send al the link to "your" system. www.freemed.com
Al, Oz works with a group of programmers who have developed a FREE, open source EMR based on MySQL, PHP and Apache. It will run on any hardware platform, even a hand-me-down for third world uses. Its currently in beta 0.7. The main structure is there, but it lacks some more sophsticated entry tools. They need/want additional programmers (java) to help with that.
Check it out.
In spite of how it may sound, Oz is more of a humanitarian than an access basher. He's passionate about his baby. He is planning a final release soon, and wants to wait before he hypes it.
Daren

I did have a look, 'awesome, and open source, good work wizard

[buslick]

I have not looked at FreeMed in about 8 months. Looks like they have made some nice progress since I last looked. Keep up the good work.

[Kursk]

Agree with Brian. Ran through it briefly, will check it more tonight. Looking good so far.
Would love to have something reliable, multiuser, that I don't have to debug.

Hey Oz - can I ship you a case of Moutain Dew for your late night coding? (diet I guess, since you Atkinizing)

[ozzie]

I am not a doctor so I can only guess what it needs..
but I have looked at a bunch of other apps and freemed is pretty close and much cheaper and truly extensable.. <---Note Access dudes (grin)

It's not my part of the job to give out a final date .. But I think 3 - 6 months out is not unreasonable..

It is workable now and Dr's are using it Uber geeks can get it to run OK once you get past the linux parts.. After that it all https and maybe the odd printer battle..

The only thing I ask is that functional reports etc be made so down the road I can use the data as functional test data and for functional demo's later on..

So please if you add data make sure it make good patient care sense..

The server is pretty secure but has not gone thru a full security test cycle and backup test cycle either

So the remote server I have would not be good for production right now.

I know of one bug when printing that I have to fix and I will work on it later on tonight

I have to fix a couple of other things so I will psot the address later

Oz

[alborg]

>>> Oz, you should send al the link to "your" system. www.freemed.com

Cool website, Ozzie! Seems like you're the "Mother Teresa" of EMRs... I'll take a closer look at your program later on. What inspired you guys to get into this? Was it a USA going into Somalia type situation (with us docs as the famine starved Somalians, of course)? (G)

How many active users have you got so far?

Regards,
Al

[ozzie]

i am a late starter in the process there were many more before me one of the key dev dudes just joined the military..

Like I said my main function is to get the product out there..
The greater question is why open source..
For me personally, I think it's the same as why you folks become doctors..
Your heart drives your mind..
You like to help folks

Money is part of it but in the end its the thanks doc you made difference in my life" thats is the real reward.. I know I am preaching to the choir here...
So if I am going to do stuff I want to do stuff that will have the greatest impact for humanity per se..
Sure I can do what I do for many open source projects but few will help the poor, the infirm, the world in general.
My mother was a paraplegic so it was a great lesson for me on humility and compassion.. I guess in a way it's paying back also for all the folks that helped mum enjoy her life to the fullest..
911 wiped me out financially, but because I did not have an office in downtown and all the other BS reasons I just had to start over again.. Fron ground zero..
Thats when I realised that to heck with the corp world. On with the world of helping others . 50 off years of giving now it s 50 odd years of giving back..
I got to tell you than since I worry more about giving and less about money the richer I become.. it drives my wife crazy but each week / month the bills get paid barely but they get paid.
So in time as this program grows so will I personally and financially then I can do other things .. Like help put my kids thru college and stuff and mainly leave a real legacy for them to continue..

http://skoll.socialedge.org/?14@31.bEYhapT1b8P.6292@.ee7e426 you will find some of my "dreamer style rants here" lol
and some geek stuff here http://www.techsoup.org/forums/index.cfm?fuseaction=list&forum=2030&cid=117

oz

[EMRhelp.org]

Truly a gem !

I will do a full evaluation of this top notch Access Based (MSDE) EMR.

I just love the documentation of Review of Systems.

There are a few things missing for a primary care physician, but I might just use this and build on it !

[romelarj]

Scroggie:
I downloaded your EMR but I couldn't open it. I have Access 2000 on Windows XP.
Any ideas why I couldn't open your database EMR?

[mel]

Scroggie:
I downloaded your EMR but I couldn't open it. I have Access 2000 on Windows XP.
Any ideas why I couldn't open your database EMR?

Scroggs been MIA for while, he is waiting for his new DSL line, send a private message to Ozz or Kursk, one of them might have a copy
Welcome to Docboard by the way
Mel

[ozzie]

Scroggie:
I downloaded your EMR but I couldn't open it. I have Access 2000 on Windows XP.
Any ideas why I couldn't open your database EMR?
describe what can't open means ???
what error etcc did you get try lunching ( <-- 4 AL :p ) oops launching access then file open
Oz

[Kursk]

FYI
Been playing with MS web admin tool for MSDE/SQL server - nifty, check it out. You need to be running IIS though.

WEB ADMIN TOOL (http://www.microsoft.com/downloads/details.aspx?FamilyID=c039a798-c57a-419e-acbc-2a332cb7f959&displaylang=en)

Using an Access ADP project has been a good learning tool as well.

[Scroggie]

Don't know why you couldn't open it. Give us some more detail and I'll see if I can help.

BTW Still now word on DSL or Cable modem. Dial up is not fun.

[romelarj]

Scroggie:
when I try to open the database, what I get is a window that says "You can not open this database. Seems that this database was created in a later version of Microsoft access. Upgrade your version and then try to open it".
However, Access 2000, the one I have, was supposed to meet the requierement criteria.

[ozzie]

I use speakeasy (http://www.speakeasy.net/refer/157381) have had them for a while now and when we moved we we offline 2 days start to finish..
The best part about them apart from reasonable pricing is that you can get a warm body 24 @ 7 and the warm bodies know what they clicketh..
And they can add IP addresses pump up the bandwidth online whilst you are on the phone. I know they are in Seattle but DLS is national now so the ISP location means nothing ..
Also you get free dialup account and even a unix shell account for free if you beg enough..

[ozzie]

of course the fly-boy wannabe coders never seem to manage the less important details like version numbers grrrr
so I have to resort to such primitve methods like
2001_be.mdb 6.68 MB (7,012,352 bytes) is that the size of the file you have unzipped ???.
I am running access 2002 so I dont know which version is what but I know the scrog dude ftp'd me a couple of versions..

Scroggie:
when I try to open the database, what I get is a window that says "You can not open this database. Seems that this database was created in a later version of Microsoft access. Upgrade your version and then try to open it".
However, Access 2000, the one I have, was supposed to meet the requierement criteria.

[romelarj]

Ozzie:
I lost the message with your phone.
I looking foward to try scroggie EMR and to give my input.

[Scroggie]

Okay, I think the versions are all 2000, but might be XP.

Oz, sorry bout that.

Anyhow, with the move and all, I haven't done much coding (flyboy or otherwise). Plus with dial up, I'll never be able to upload again :(

Most of my Neaderthal coding skills are going to be directed at using MySQL as back end. I will be starting my new job with system in place in July.

[ozzie]

Most of my Neaderthal coding skills are going to be directed at using MySQL as back end. I will be starting my new job with system in place in July.

And onother one sees the light .. and now just need to work on that pesky access..

lol

[Kursk]

Scroggs et al:

Where do you do data validation? (Access and MSDE)

Form level (input mask/on exit sub) (practical, you can send them right back to the control for correction)

DAO/ADO edit/addnew (you can catch any errors before they are committed to the DB)

DB row restrictions (Access seems to allow a lot of DB restrictions, input masks etc on the DB itself)

All 3?

What is the best practice?
I am learning a lot as I push out my program to more docs and other users.

BTW - Jlively - thanks for the error handling lesson, works well. Nice to have a file from a user with error details rather than "the thingy came up and said something so I shut it off".

[Scroggie]

Data validation? Mostly I trust myself. I do have some input masks set up for phone, SSN et cetera. Also for some labs as well.

I don't know what the best practice would be.

Jlively's error handling is nice.

[Ducknet]

You might want to try creating a new blank data base with your version of Access. After creating the new blank version, import all of the tables, queries, etc. into the new data base. Depending on the code in the data base, this might solve the problem, but then again it may not work depending on the code and modules. Usually when you receive that message, the data base has been created in a version of Access greater than 2000 if this is the version you are using. The creator of the data base can also downgrade the data base to 2000 if it was written in XP or 2003 and resend to you as well. This is easily done from the tool bar and a new data base can be created in 2000 with either the XP or 2003 version.

Access 2000 compared to Access XP and 2003 definitely has some limitations, but not nearly as many as Access 97. There were a number of new run commands added, plus with Access 2000, you cannot take advantage of the built in speech, dictation and inking features. When installing Office XP or 2003, it does NOT install these features by default, but you can easily modify with a custom installation via the control panel to update or via the initial installation. I write in Access 2000 any any version of Access 2000 or greater will work. Be sure to purchase Office XP Pro or Office 2003 pro so you have Access. All the other less expensive versions do not include Access. You can install one license on 2 computers legally per Microsoft, one being a desktop and the other being a notebook.

Hope this might help out.

Barbara Duck

[alborg]

Hi Barbara:

Hmmm...

>>> with Access 2000, you cannot take advantage of the built in speech, dictation and inking features.

My MS Access 2000 based EMR easily accepts the Windows CE inking from my Airpanel without a hitch; I can do speech recognition easily using Naturally Speaking... I have yet to come across any limitations that I really miss! (At least enough to make me want to purchase Access XP or 2003.)

Regards,
Al

[EMRhelp.org]

Is Scroggie's EMR still downloadable ?
Is it going to be updated ?

[Scroggie]

It should be. I haven't updated the version that's downloadable. I am currently using MySQL as the backend and I am not sure how to export the tables and server setup into a downloadable format.

Ozzie, do you know how?

[ozzie]

yes but I am not tellin LOL

you should be able to dump the data and structure then import it via sql

-- MySQL dump 8.22
--
-- Host: localhost Database: monster
---------------------------------------------------------
-- Server version 3.23.53

--
-- Table structure for table 'credit_card'
--
********************************
CREATE TABLE credit_card (
id int(5) NOT NULL auto_increment,
email varchar(40) NOT NULL default '',
Number tinyblob NOT NULL,
expmonth char(2) NOT NULL default '',
expyear varchar(4) NOT NULL default '',
months int(2) NOT NULL default '0',
posted timestamp(8) NOT NULL,
job_id varchar(12) NOT NULL default '',
action varchar(6) NOT NULL default '',
processed varchar(4) NOT NULL default '',
PRIMARY KEY (id)
) TYPE=ISAM PACK_KEYS=1;
***********************
this is what a single table dump looks like

it's not too elegant but I just cut between the ************ and paste right into sql using phpmyadmin and it creates a nice clean table..

now a table with data
would look more like this
*********************************
# phpMyAdmin MySQL-Dump
# version 2.3.0
# http://phpwizard.net/phpMyAdmin/
# http://www.phpmyadmin.net/ (download page)
#
# Host: localhost
# Generation Time: Nov 08, 2004 at 05:03 PM
# Server version: 3.23.58
# PHP Version: 4.3.7
# Database : `ozzie_mojolin`
# --------------------------------------------------------

#
# Table structure for table `link`
#

CREATE TABLE link (
keyid mediumint(9) NOT NULL default '0',
contid mediumint(9) NOT NULL default '0'
) TYPE=MyISAM;

#
# Dumping data for table `link`
#

INSERT INTO link VALUES (1, 1);
INSERT INTO link VALUES (2, 1);
INSERT INTO link VALUES (3, 1);
INSERT INTO link VALUES (4, 1);
INSERT INTO link VALUES (5, 1);
INSERT INTO link VALUES (6, 1);
***********************************

same deal just cut and paste

note i added the *************************

I am sure there are slicker ways to do this but this is the basics the rest is packaging /scripting..

I dont do much on the DB setup my partner in crime does..

oz

[Scroggie]

Thanks Oz
I'm working on a simpler solution: reintegrate the program to Access FE/BE for downloaders and players.

[mpike]

Hi Barbara:

Hmmm...

>>> with Access 2000, you cannot take advantage of the built in speech, dictation and inking features.

My MS Access 2000 based EMR easily accepts the Windows CE inking from my Airpanel without a hitch; I can do speech recognition easily using Naturally Speaking... I have yet to come across any limitations that I really miss! (At least enough to make me want to purchase Access XP or 2003.)

Regards,
Al

It's happened to us several times, and it did again today, when Access reaches a certain size, file corruption is unavoidable. Our dental clinic lost a great deal of information - this is a repeat performace for Access, it did it to telecom a few months ago, and prior to that, it did it for materials management software.

I would avoid Access, or at least have a good contigency plan.

Mike

[buslick]

I stopped using Acces back when it was Access97 due to problems with data loss on a networked version of access. I had heard from Al that the newer versions where better and did not lose data. What version of Access where you using that lost the data?

[Scroggie]

Mike, I've been working with access for a long time. You have to do regular maintinence on it to avoid these things
compact and repair daily (this resets indexes and removes the "deleted" records.
decompile the code monthly and recompile it (removes any lingering code changes/deletions)
This "shrinks" bloated databases and reduces if not eliminates data loss/corruption

That said, I now use MySQL for back end.

Try compacting and repairing.

[mpike]

I stopped using Acces back when it was Access97 due to problems with data loss on a networked version of access. I had heard from Al that the newer versions where better and did not lose data. What version of Access where you using that lost the data?

All versions of Access we have had (all the way up to 2003, which was the failure this week) will almost certainly fail. Especially when you get multiple users online.

Microsoft's solution is to "upgrade to Microsoft SQL"... we are moving it all to MySQL, which is about the best database platform I have seen - and runs on everything.

Mike

[ozzie]

there you go Mike

mysql
Is the way to go acceas ends up in the sending a boy on a mans errand department. Its too easy to get in too deep ..
Once you are past the access local and in the you shoulda used SQL department.. Your are done ..

But many do the same with Excel with multi linked spread sheets when they should be using Access...

I do php mysql http everything now , save a lot of problems, open source and work on any platfrom and very little if any client side issues. And mysql thrives on neglect

Oz

[alborg]

MPIKE>>> It's happened to us several times, and it did again today, when Access reaches a certain size, file corruption is unavoidable. Our dental clinic lost a great deal of information - this is a repeat performace for Access, it did it to telecom a few months ago, and prior to that, it did it for materials management software.

BUSLICK>>> I stopped using Acces back when it was Access97 due to problems with data loss on a networked version of access. I had heard from Al that the newer versions where better and did not lose data. What version of Access where you using that lost the data?

I totally agree- networking is probably the #1 problem causing Access tables to become corrupt.

I've used Access now for 9 years without a hitch attributed to the MS Access software itself. There was a point there where I was using MS Windows P2P LAN that was problematic due to incompatabilities between Win98 and Win2000, but that was it. Many problems with corruption can also be due to the underlying code environment.

MPIKE- How many users did you have online at the same time?

OZZIE >>> And mysql thrives on neglect

I agree... It is a great backend and one day I too will port my software. For now, I guess I'm still too lazy and doing well with the Jet 4.0 backend! :rolleyes:

AL

[ozzie]

loL like all the world wants a mutli user DB that down not like being networked.
\.
SNIP
I totally agree- networking is probably the #1 problem causing Access tables to become corrupt.