Re: [Hardhats-members] == VistaWeb Missing Apps ==

[steven mcphelan]

I purchased, installed, and managed an entire hospital system with over 1500
MS workstations consisting of laptops and desktops.  I hired experienced,
knowledgeable network staff.  In general, I did not have any of the problems
you mentioned here.  Of course we had occasional problems, but given the
size of the total deployment, it was nothing.

- Original Message - 
From: Ruben Safir [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 12:32 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 On Mon, 2005-06-13 at 12:20, Kevin Toppenberg wrote:
  Why do you need support?  I have Windows XP on my
  notebook.  I never expect anything from Windows
  (except for the occasional updates that consistently
  remove functionality from my OS).
 
  Kevin
 

 Really.  You've never run a PC lab with 25 laptops then.  Windows are
 very high maintenance and the device drivers that manufactures use are
 awful.  They freeze, the file systems become corrupted, they are virus
 plagued, they malfunction with new PCI cards, they have lousy
 interoperability, they are infested with spyware and so on.  They fall
 on and off the network.  I have to even be reminded of all the gut
 wrenching frustration just to get the routing tables to work correctly.


 Ruben



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Thies, Karl Mr LND]

I am working at Landstuhl Regional Medical Center in Germany at the
moment, and we have just brought up CHCS II at Landstuhl Regional
Medical Center and most of our associated clinics and hospitals across
Europe. CHCS II is now being run at DoD hospitals and clinics across
Europe.  By the end of the summer it is projected to be operational from
Iceland to Turkey.  Now granted CHCS II is running alongside CHCS I,
provides relatively little functionality compared to the current CHCS I,
and in no way replaces CHCS I, but it appears that there is some
political/financial impetus behind CHCS II which indicates to me that
the project is still alive and not a failure.  Your tax dollars and
my tax dollars are being spent to deploy CHCS II around the world (DoD
bases in Asia are next).  Could Chris please elaborate on his statement
that CHCS II is/has been a failure?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 10:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when
the
vendors came to Hawaii).  Their code was supposed to work and it didn't.
In
four months they could generate a patient list in twenty five minutes
when
they could go over to the CHCS I terminal and get that same atient list
in
30 seconds.  It was embarassing for these guys, but failure is not
defeat,
just justification to expend even more government money.  After about
two
years this batch of vendors was kicked out and another set was brought
in
under a new management vendor.  The result was equally disapointing and
even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away
from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution.  I
explained to them the reasons why their results were so bad.  It isn't
that
the solution has to be all MUMPS, not at all.  Let's think about using
these
tools for what they are good at.

  This was not the only task that the engineers helped make the
interfaces
work.  There was a management interface where they wanted all of the
data
elements from the CHCS I system downloaded to their database (it
happened to
be a Relational Database).  The process was tested out at Landstuhl,
Germany, a CHCS site.  They hooked their database engine up to the CHCS
system and CHCS I downloaded to them for 6 and a half days until they
ran
out of disk space.  CHCS I still had lots of data to send them.  This
was
tried at Walter Reed as well and the add-on system was so slow that CHCS
I
was dumping the data to them faster than they could add it into their
database and so it went to tape.  Their system became an off-board
tape-drive.

   Keep in mind that the winning of CHCS I by SAIC was part of a
compute-off
run by the military.  The TRIMIS spec was the requirements, (20 years of
specification without implementation).  Four vendors, Baxter-Travenol,
Technicon, Mc Donnel-Douglas, and SAIC doing the VA set-aside (suggested
by
Congressman Sonny Montgomery).  Each participant was given $25 million
dollars to provide a solution tot he compute-off.  Baxter and Technicon
spent their money and no-bid the contract.  The contract was written so
there would be a follow-on contractor as part of the process (an 85:15%
split).  OK, so Mac Donnel Douglas run their model and got a 67%
functionality score and their bid was $2.6 Billion to do the military
hospitals around the world.  Not too bad.  SAIC's entry into the
compute-off
was the CHCS model derived from the VA DHCP.  Their entry scored 98%
functionality and the bid was $1.01 Billion, 40% of the competing bid
with
more functionality.  Mac Donnel Douglas could have had 15% of the
contract
by just standing there.  They walked away.  SAIC won 100% of the
contract.
These economies of scale are not unusual for MUMPS solutions.  This was
the
1986-7 time frame.  CHCS I is still runnning the DoD hospitals.

   I don't mind having MUMPS replaced with something that works as well
and
as cheaply, but lets have a level playing field for once.  Let MUMPS
compete
head to head with these other technologies and may the best system
succeed.
Of course, there are very few absolutes in life, but to throw away a big
hunk of your tools just out of predjudice and politics is just wrong.
One
tool is not going to fit all applications, great.  Lets find out what is
going to be the easiest to support

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Karl, haven't heard from you in a long time.  This is news to me that CHCS
II is still being deployed.  You are on the front line, so you have better
sources than mine, perhaps.  I am late for work and can't connect again
until after work. Will write more this evening.  Tell us more about the
history of CHCS II if you know it.  I was working on the third cycle
(attempt) of CHCS II back in 1998.

   Best wishes;  Chris

- Original Message -
From: Thies, Karl Mr LND [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 3:18 AM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


I am working at Landstuhl Regional Medical Center in Germany at the
moment, and we have just brought up CHCS II at Landstuhl Regional
Medical Center and most of our associated clinics and hospitals across
Europe. CHCS II is now being run at DoD hospitals and clinics across
Europe.  By the end of the summer it is projected to be operational from
Iceland to Turkey.  Now granted CHCS II is running alongside CHCS I,
provides relatively little functionality compared to the current CHCS I,
and in no way replaces CHCS I, but it appears that there is some
political/financial impetus behind CHCS II which indicates to me that
the project is still alive and not a failure.  Your tax dollars and
my tax dollars are being spent to deploy CHCS II around the world (DoD
bases in Asia are next).  Could Chris please elaborate on his statement
that CHCS II is/has been a failure?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 10:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when
the
vendors came to Hawaii).  Their code was supposed to work and it didn't.
In
four months they could generate a patient list in twenty five minutes
when
they could go over to the CHCS I terminal and get that same atient list
in
30 seconds.  It was embarassing for these guys, but failure is not
defeat,
just justification to expend even more government money.  After about
two
years this batch of vendors was kicked out and another set was brought
in
under a new management vendor.  The result was equally disapointing and
even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away
from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution.  I
explained to them the reasons why their results were so bad.  It isn't
that
the solution has to be all MUMPS, not at all.  Let's think about using
these
tools for what they are good at.

  This was not the only task that the engineers helped make the
interfaces
work.  There was a management interface where they wanted all of the
data
elements from the CHCS I system downloaded to their database (it
happened to
be a Relational Database).  The process was tested out at Landstuhl,
Germany, a CHCS site.  They hooked their database engine up to the CHCS
system and CHCS I downloaded to them for 6 and a half days until they
ran
out of disk space.  CHCS I still had lots of data to send them.  This
was
tried at Walter Reed as well and the add-on system was so slow that CHCS
I
was dumping the data to them faster than they could add it into their
database and so it went to tape.  Their system became an off-board
tape-drive.

   Keep in mind that the winning of CHCS I by SAIC was part of a
compute-off
run by the military.  The TRIMIS spec was the requirements, (20 years of
specification without implementation).  Four vendors, Baxter-Travenol,
Technicon, Mc Donnel-Douglas, and SAIC doing the VA set-aside (suggested
by
Congressman Sonny Montgomery).  Each participant was given $25 million
dollars to provide a solution tot he compute-off.  Baxter and Technicon
spent their money and no-bid the contract.  The contract was written so
there would be a follow-on contractor as part of the process (an 85:15%
split).  OK, so Mac Donnel Douglas run their model and got a 67%
functionality score and their bid was $2.6 Billion to do the military
hospitals around the world.  Not too bad.  SAIC's entry into the
compute-off
was the CHCS model derived from the VA DHCP.  Their entry scored 98%
functionality and the bid was $1.01 Billion, 40% of the competing bid
with
more functionality.  Mac Donnel Douglas could have had 15% of the
contract
by just standing there.  They walked away.  SAIC won 100

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

Ah, my cue to mention MDO and VistAWeb Services.  MDO is designed to savvy
different kinds of data sources, M, SQL, HL7, XML, and present to the client
objects like ProgressNote, Allergy, etc., regardless of where the data came
from.  We're putting this inside web services which results in an XML-SOAP
interface to VistA, the HDR, the Oracle registry database.  What's more, MDO
knows how to visit VistA sites, ie, get (or put) data without having A/V
codes.  So it has access to all VHA sites.  A few VA projects are currently
using these services and we're about to make them available to a vendor.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of David
Sommers
Sent: Sunday, June 12, 2005 5:09 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

I think we agreed on most of it.  It's hard to compare M to SQL or Mac
to Windows (although getting easier now that Macs will be Intel based).

On point #4 (change platforms when your current platform restricts your
architecture options.) is not targeted at the processor architecture
but the application architecture.

Here's a fine example: Interoperability between VistA/M and other
systems.  M, Cobol, Fortran - these are considered legacy and most
college students know them simply as mainframes.  Microsoft, Sun, IBM,
Oracle (etc) currently provide Web Services and the SOA model to
communicate between systems.

Web Services != Broker RPC.  New vendors that have an application to
offer on the VistA desktop have a high cost of entry into that desktop
for many reasons, and number 1 is accessing the M system.

I'm not against VistA/M for use in hospital systems.  I honestly believe
it's a great system and I think re-hosting is a waste of resources
unless you attack the project as something to start over.  I mean, why
start over if you do the exact same thing?  Utilize OOP, SOA, re-usable
code, interfaces, etc.

I just saw an email that says the new system works with MySQL.  That's
utterly stupid.  Not because it's MySQL (I have it running right now),
it's because MS SQL Server and Oracle allow parameterized store
procedures.  NOT using stored procs in an enterprise system is utterly
crazy.  Of course your return is slow, you're using interpreted ad-hoc
query text and the system can't optimize the query against the data set.

Will the new system be worse than VistA/M?  Sounds like it...  but not
because it's simply relational.

/David.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 4:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when
the
vendors came to Hawaii).  Their code was supposed to work and it didn't.
In
four months they could generate a patient list in twenty five minutes
when
they could go over to the CHCS I terminal and get that same atient list
in
30 seconds.  It was embarassing for these guys, but failure is not
defeat,
just justification to expend even more government money.  After about
two
years this batch of vendors was kicked out and another set was brought
in
under a new management vendor.  The result was equally disapointing and
even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away
from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution.  I
explained to them the reasons why their results were so bad.  It isn't
that
the solution has to be all MUMPS, not at all.  Let's think about using
these
tools for what they are good at.

  This was not the only task that the engineers helped make the
interfaces
work.  There was a management interface where they wanted all of the
data
elements from the CHCS I system downloaded to their database (it
happened to
be a Relational Database).  The process was tested out at Landstuhl,
Germany, a CHCS site.  They hooked their database engine up to the CHCS
system and CHCS I downloaded to them for 6 and a half days until they
ran
out of disk space.  CHCS I still had lots of data to send them.  This
was
tried at Walter Reed as well and the add-on system was so slow that CHCS
I
was dumping the data to them faster than they could add it into their
database and so it went to tape.  Their system became an off-board
tape-drive.

   Keep in mind that the winning of CHCS I by SAIC was part of a
compute-off
run

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

This is the second time this morning that I find myself profoundly not 
in agreement with what you are saying.


There is an implication in your posting that freebies, as in open 
source free software, is unsupported. As the vendor of a product that is 
open source free software, but for which we offer 24x7 support on a 
commercial basis, and as the user of such products, I must assert that 
the issue of paying for a software license and support are two 
completely orthogonal issues.


I would argue that a vendor that provides paid support for open source 
free software has an incentive to provide better, more cost effective, 
support in order to get paid than a software vendor that charges for 
licenses and then effectively has its customers arms held behind their 
backs (or pick your other favorite analogy) to charge what it will for 
support, and deliver whatever quality of support it chooses to deliver. 
 (I didn't mention any names.  You did.)


Take a look at http://www.fsf.org/licensing/essays/free-sw.html when you 
have a moment.


-- Bhaskar

Gillon, Joseph wrote:

Well, I tend to shy away from freebies because of the support issues.
Dammit, stop laughing!  I know, I know, like I can get support from
Microsoft.  Still, there's the hope or illusion of support.



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

Hey, I've been wrong before, back in 1956 I think it was.  Could even happen
again.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of K.S.
Bhaskar
Sent: Monday, June 13, 2005 10:37 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

This is the second time this morning that I find myself profoundly not 
in agreement with what you are saying.

There is an implication in your posting that freebies, as in open 
source free software, is unsupported. As the vendor of a product that is 
open source free software, but for which we offer 24x7 support on a 
commercial basis, and as the user of such products, I must assert that 
the issue of paying for a software license and support are two 
completely orthogonal issues.

I would argue that a vendor that provides paid support for open source 
free software has an incentive to provide better, more cost effective, 
support in order to get paid than a software vendor that charges for 
licenses and then effectively has its customers arms held behind their 
backs (or pick your other favorite analogy) to charge what it will for 
support, and deliver whatever quality of support it chooses to deliver. 
  (I didn't mention any names.  You did.)

Take a look at http://www.fsf.org/licensing/essays/free-sw.html when you 
have a moment.

-- Bhaskar

Gillon, Joseph wrote:
 Well, I tend to shy away from freebies because of the support issues.
 Dammit, stop laughing!  I know, I know, like I can get support from
 Microsoft.  Still, there's the hope or illusion of support.


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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

Chris --

We make our money from selling GT.M support to VistA users in addition 
to making money from banking and elsewhere.  Think of GT.M as a profit 
center (a business within a business) and we sell our services 
internally as well as externally.


To Greg's point, what is, to the best of my knowledge, the largest 
single real time core processing system (this is the system of record 
for bank balances) in a commercial bank that is operational anywhere in 
the world is running on GT.M.


-- Bhaskar

Chris Richardson wrote:

Greg;
   How do you think Fidelity (Sanchez and GT.m) makes their money?

- Original Message -
From: Gregory Woodhouse [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Sunday, June 12, 2005 7:30 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==




I was initially surprised to learn that MUMPS was being used for
financial/banking applications, but when you think about it, it makes
sense. The patterns of use and data organization have a lot in common
with health information systems.

===
Gregory Woodhouse
[EMAIL PROTECTED]

And the end of all our exploring
will be to arrive where we started
And know the place for the first time -- T.S. Eliot



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Greg Woodhouse]

I know that one reason I have tended to shy away from Linux is that I
have been unable to find a vendor that sells and/or supports Linux on a
notebook. It's not that I don't have the technical competence to
install Linux, or even that I am averse to downloading and installing
new drivers, etc. It's ironic, too, because I have a longstanding
interest in operating systems. (In fact, I think it was reading
Tanenbaum's Minix book, a book I could hardly put down, BTW, that
finally led to my making the shift from mathematics to computing.) Some
people enjoy building their own systems (or working on their own cars),
and I guess I'm just not one of them.

--- K.S. Bhaskar [EMAIL PROTECTED] wrote:

 This is the second time this morning that I find myself profoundly
 not 
 in agreement with what you are saying.
 
 There is an implication in your posting that freebies, as in open 
 source free software, is unsupported. As the vendor of a product that
 is 
 open source free software, but for which we offer 24x7 support on a 
 commercial basis, and as the user of such products, I must assert
 that 
 the issue of paying for a software license and support are two 
 completely orthogonal issues.
 
 I would argue that a vendor that provides paid support for open
 source 
 free software has an incentive to provide better, more cost
 effective, 
 support in order to get paid than a software vendor that charges for 
 licenses and then effectively has its customers arms held behind
 their 
 backs (or pick your other favorite analogy) to charge what it will
 for 
 support, and deliver whatever quality of support it chooses to
 deliver. 
   (I didn't mention any names.  You did.)
 
 Take a look at http://www.fsf.org/licensing/essays/free-sw.html when
 you 
 have a moment.
 
 -- Bhaskar
 
 Gillon, Joseph wrote:
  Well, I tend to shy away from freebies because of the support
 issues.
  Dammit, stop laughing!  I know, I know, like I can get support from
  Microsoft.  Still, there's the hope or illusion of support.
 
 
 ---
 This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
 shotput
 a projector? How fast can you ride your desk chair down the office
 luge track?
 If you want to score the big prize, get to know the little guy.  
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The most profound technologies are those that disappear.
--Mark Weiser


Greg Woodhouse 
[EMAIL PROTECTED] 
[EMAIL PROTECTED] 






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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

It's always nice to have a member join the group with a sense of humor. 
 Welcome!


-- Bhaskar

[EMAIL PROTECTED] wrote:

Hey, I've been wrong before, back in 1956 I think it was.  Could even happen
again.



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
 I know that one reason I have tended to shy away from Linux is that I
 have been unable to find a vendor that sells and/or supports Linux on a
 notebook.

You mean besides Emperor Linux, HP, IBM and Dell?  For what it is worth,
the correct term is GNU/Linux.


Ruben



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 10:45, [EMAIL PROTECTED] wrote:
 Hey, I've been wrong before, back in 1956 I think it was.  Could even happen
 again.
 

If your implying that free Software shouldn't be used because of support
issues, then you've been wrong, as a fact, at least since 1991, if not
1981.

There is no relationship between price, licenser and support other than
the software with the better licenses, just as the GPL, have continually
had the best support.
  
Ruben
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of K.S.
 Bhaskar
 Sent: Monday, June 13, 2005 10:37 AM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 This is the second time this morning that I find myself profoundly not 
 in agreement with what you are saying.
 
 There is an implication in your posting that freebies, as in open 
 source free software, is unsupported. As the vendor of a product that is 
 open source free software, but for which we offer 24x7 support on a 
 commercial basis, and as the user of such products, I must assert that 
 the issue of paying for a software license and support are two 
 completely orthogonal issues.
 
 I would argue that a vendor that provides paid support for open source 
 free software has an incentive to provide better, more cost effective, 
 support in order to get paid than a software vendor that charges for 
 licenses and then effectively has its customers arms held behind their 
 backs (or pick your other favorite analogy) to charge what it will for 
 support, and deliver whatever quality of support it chooses to deliver. 
   (I didn't mention any names.  You did.)
 
 Take a look at http://www.fsf.org/licensing/essays/free-sw.html when you 
 have a moment.
 
 -- Bhaskar
 
 Gillon, Joseph wrote:
  Well, I tend to shy away from freebies because of the support issues.
  Dammit, stop laughing!  I know, I know, like I can get support from
  Microsoft.  Still, there's the hope or illusion of support.
 
 
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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Thies, Karl Mr LND]

Chris -
I cannot really comment on the history of CHCS II as I have only been
re-associated with DoD software again for the last year and a half, and
I don't really know much about the development and deployment of this
product.  I can tell you that the current developer is a company called
Integic, that the database to which all CHCS II sites around the world
are connected is Oracle (located at one site in the US), and the first
phase of the product has in fact been deployed at DoD sites across the
US and Europe.  I am not saying at *all* DoD sites, but I know for a
fact that it is currently deployed at many major DoD hospitals in the US
and Europe.  The goal is to replace CHCS I, but the target date is
several years away, minimum.  Right now there the product is layered
on top of CHCS I and has relatively little functionality of its own, at
least at our site.  All appointments, patient administration, and
ancillary processing is still currently being done by the CHCS I
backend, but CHCS II is providing the front end to order entry via a
nice GUI frontend.  I don't know if other there are beta sites in the
US who have more capable CHCS II software, but I would presume so.

And you read that right...currently all clinical and patient information
associated with every encounter at CHCS II sites around the world is
being sent to one Oracle database.  That database in turn populates the
user's CHCS II encounter screen at any CHCS II site at which the patient
presents himself, so that if a patient has been seen at any facility
which uses CHCS II, any and all encounters which have been entered into
CHCS II from any site will be displayed.  The physician will have access
to the historical HER regardless of where the patient was seen

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Monday, June 13, 2005 1:37 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

Karl, haven't heard from you in a long time.  This is news to me that
CHCS
II is still being deployed.  You are on the front line, so you have
better
sources than mine, perhaps.  I am late for work and can't connect again
until after work. Will write more this evening.  Tell us more about the
history of CHCS II if you know it.  I was working on the third cycle
(attempt) of CHCS II back in 1998.

   Best wishes;  Chris

- Original Message -
From: Thies, Karl Mr LND [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 3:18 AM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


I am working at Landstuhl Regional Medical Center in Germany at the
moment, and we have just brought up CHCS II at Landstuhl Regional
Medical Center and most of our associated clinics and hospitals across
Europe. CHCS II is now being run at DoD hospitals and clinics across
Europe.  By the end of the summer it is projected to be operational from
Iceland to Turkey.  Now granted CHCS II is running alongside CHCS I,
provides relatively little functionality compared to the current CHCS I,
and in no way replaces CHCS I, but it appears that there is some
political/financial impetus behind CHCS II which indicates to me that
the project is still alive and not a failure.  Your tax dollars and
my tax dollars are being spent to deploy CHCS II around the world (DoD
bases in Asia are next).  Could Chris please elaborate on his statement
that CHCS II is/has been a failure?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 10:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when
the
vendors came to Hawaii).  Their code was supposed to work and it didn't.
In
four months they could generate a patient list in twenty five minutes
when
they could go over to the CHCS I terminal and get that same atient list
in
30 seconds.  It was embarassing for these guys, but failure is not
defeat,
just justification to expend even more government money.  After about
two
years this batch of vendors was kicked out and another set was brought
in
under a new management vendor.  The result was equally disapointing and
even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away
from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Greg Woodhouse]

I've never heard of emperor Linux. I called Dell (and HP, and IBM).
Dell, for example, told me that they support Linux, but not on a
notebook.

--- Ruben Safir [EMAIL PROTECTED] wrote:

 On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
  I know that one reason I have tended to shy away from Linux is that
 I
  have been unable to find a vendor that sells and/or supports Linux
 on a
  notebook.
 
 You mean besides Emperor Linux, HP, IBM and Dell?  For what it is
 worth,
 the correct term is GNU/Linux.
 
 
 Ruben
 
 
 
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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

If you want certified and supported hardware with Linux, see 
http://h10018.www1.hp.com/wwsolutions/linux/products/clients/clientscert-suse.html 
for HP notebooks certified on Linux.  If you want a laptop with Linux 
pre-loaded, you will probably need to order off the web or by phone. 
Walmart offers (or offered) a laptop pre-loaded with Linux, but the 
reviews were less than glowing.


As a practical matter, Linux runs on many if not most laptops (see 
http://www.linux-laptop.net/).  To check out how compatible a laptop is 
with Linux without touching the contents of the hard drive, download the 
latest copy of Knoppix (http://knoppix.org - the default language is 
German; click on the hybrid Union Jack / Stars and Stripes icon for 
English) or try the latest OpenVistA VivA FOIA Gold live CD.


As a practical matter, I have only seen two laptops on which I had 
trouble with Linux I couldn't solve.  One was an old Compaq Armada.  The 
other was a brand new Dell model and the owner came to me for help 
because the Windows XP display driver that came with it didn't work, and 
tech support (I don't know whether Dell/Microsoft) had him re-install 
Windows XP (which took him a long time in itself, but that's another 
story).  In desperation, he tried Linux, and when it didn't work either, 
he returned the laptop.


-- Bhaskar

Greg Woodhouse wrote:

I've never heard of emperor Linux. I called Dell (and HP, and IBM).
Dell, for example, told me that they support Linux, but not on a
notebook.



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

I buy everything preinstalled, including recently from Dell and HPP,
although my favorite laptop is the Sony Picture Book I brought from
Emperor Linux.

Those guys are miracle workers.

Ruben

On Mon, 2005-06-13 at 11:41, K.S. Bhaskar wrote:
 If you want certified and supported hardware with Linux, see 
 http://h10018.www1.hp.com/wwsolutions/linux/products/clients/clientscert-suse.html
 for HP notebooks certified on Linux.  If you want a laptop with Linux 
 pre-loaded, you will probably need to order off the web or by phone. 
 Walmart offers (or offered) a laptop pre-loaded with Linux, but the 
 reviews were less than glowing.
 
 As a practical matter, Linux runs on many if not most laptops (see 
 http://www.linux-laptop.net/).  To check out how compatible a laptop is 
 with Linux without touching the contents of the hard drive, download the 
 latest copy of Knoppix (http://knoppix.org - the default language is 
 German; click on the hybrid Union Jack / Stars and Stripes icon for 
 English) or try the latest OpenVistA VivA FOIA Gold live CD.
 
 As a practical matter, I have only seen two laptops on which I had 
 trouble with Linux I couldn't solve.  One was an old Compaq Armada.  The 
 other was a brand new Dell model and the owner came to me for help 
 because the Windows XP display driver that came with it didn't work, and 
 tech support (I don't know whether Dell/Microsoft) had him re-install 
 Windows XP (which took him a long time in itself, but that's another 
 story).  In desperation, he tried Linux, and when it didn't work either, 
 he returned the laptop.
 
 -- Bhaskar
 
 Greg Woodhouse wrote:
  I've never heard of emperor Linux. I called Dell (and HP, and IBM).
  Dell, for example, told me that they support Linux, but not on a
  notebook.
 
 
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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Greg Woodhouse]

So, basically SUSE is it...but that's sure an improvement over what I
found last time I looked -- which was nothing.

I don't know a think about SUSE, the only distribution I've worked with
is Red Hat. But I appreciate this link. I'll look into it.

--- K.S. Bhaskar [EMAIL PROTECTED] wrote:

 If you want certified and supported hardware with Linux, see 

http://h10018.www1.hp.com/wwsolutions/linux/products/clients/clientscert-suse.html
 
 for HP notebooks certified on Linux.  If you want a laptop with Linux
 
 pre-loaded, you will probably need to order off the web or by phone. 
 Walmart offers (or offered) a laptop pre-loaded with Linux, but the 
 reviews were less than glowing.
 
 As a practical matter, Linux runs on many if not most laptops (see 
 http://www.linux-laptop.net/).  To check out how compatible a laptop
 is 
 with Linux without touching the contents of the hard drive, download
 the 
 latest copy of Knoppix (http://knoppix.org - the default language is 
 German; click on the hybrid Union Jack / Stars and Stripes icon for 
 English) or try the latest OpenVistA VivA FOIA Gold live CD.
 
 As a practical matter, I have only seen two laptops on which I had 
 trouble with Linux I couldn't solve.  One was an old Compaq Armada. 
 The 
 other was a brand new Dell model and the owner came to me for help 
 because the Windows XP display driver that came with it didn't work,
 and 
 tech support (I don't know whether Dell/Microsoft) had him re-install
 
 Windows XP (which took him a long time in itself, but that's another 
 story).  In desperation, he tried Linux, and when it didn't work
 either, 
 he returned the laptop.
 
 -- Bhaskar
 
 Greg Woodhouse wrote:
  I've never heard of emperor Linux. I called Dell (and HP, and IBM).
  Dell, for example, told me that they support Linux, but not on a
  notebook.
 
 
 ---
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[EMAIL PROTECTED] 






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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 11:16, Greg Woodhouse wrote:
 I've never heard of emperor Linux. I called Dell (and HP, and IBM).
 Dell, for example, told me that they support Linux, but not on a
 notebook.
 

Talk to a different sales rep.  It's not in their main line.  Also, if
you have a cooperate account, take to them about that.  I ondered a year
ago 12 laptops preinstalled with SuSE from Dell for a business.

Ruben

PS - Emperor Linux has the best support, although NYLXS does this all
the time for free for anyone with a laptop.


  
 --- Ruben Safir [EMAIL PROTECTED] wrote:
 
  On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
   I know that one reason I have tended to shy away from Linux is that
  I
   have been unable to find a vendor that sells and/or supports Linux
  on a
   notebook.
  
  You mean besides Emperor Linux, HP, IBM and Dell?  For what it is
  worth,
  the correct term is GNU/Linux.
  
  
  Ruben
  
  
  
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 [EMAIL PROTECTED] 
 [EMAIL PROTECTED] 
 
 
 
 
 
 
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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[A. Forrey]

On Fri, 10 Jun 2005, Richard G. DAVIS wrote:


I understand the dichotomy Gregory mentions, and I agree with the views he
has expressed.


I quite agree with the basic thread of what Richrd has said in this 
exchange. In fact we have put that exzct situation to both a website on 
the EHR here at UW (http://www.ehrweb.org) and in the description of the 
VistA architecture that is intended for health informatics education in 
both a documnt and a website form. The ideas are also part of draft 
document for A Guide to the Health Informatics Body of Knowledge that 
identifies that these two pespectives are really mutually supportive 
rather than in conflict and need to be part of an integrated educational 
approach that has Enterprise view, Life Cycle Principles that draw on 
your 1999 expostulation of the Zachman Principles. As you rightly note the 
focus on the technical plaform is a distraction from yje key issues. 
First, their must be attention to the Conceptual Content that Kolodner, 
Christensen etc in their recent 2005 Book tout for HealthePeople. The 
hardhats and the WV Community must continue to emphasize how the VistA 
conceptual content is going to evolve and draw on the contribution of the 
various health professional specialty disciplines; with that emphasis the 
statements regarding the primacy of the technology will begin to fade. 
Technology will always be a factor but not the prime focus.




However, I believe the fundamental issue is less a technical matter and more
an natural 'tension' between concerns for operational
effectiveness--delivery of quality health care, and the interest in
administrative IT that arises from management.  These two groups in most any
enterprise you may choose to study are chronically in a state of 'conflict'
due their different priorities and requirements for IT, and information
management architecture.
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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Kevin Toppenberg]

Why do you need support?  I have Windows XP on my
notebook.  I never expect anything from Windows
(except for the occasional updates that consistently
remove functionality from my OS).

Kevin


--- Greg Woodhouse [EMAIL PROTECTED]
wrote:

 I've never heard of emperor Linux. I called Dell
 (and HP, and IBM).
 Dell, for example, told me that they support Linux,
 but not on a
 notebook.
 
 --- Ruben Safir [EMAIL PROTECTED] wrote:
 
  On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
   I know that one reason I have tended to shy away
 from Linux is that
  I
   have been unable to find a vendor that sells
 and/or supports Linux
  on a
   notebook.
  
  You mean besides Emperor Linux, HP, IBM and Dell? 
 For what it is
  worth,
  the correct term is GNU/Linux.
  
  
  Ruben
  
  
  
 

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 Games.  How far can you
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 The most profound technologies are those that
 disappear.
 --Mark Weiser
 
 
 Greg Woodhouse 
 [EMAIL PROTECTED] 
 [EMAIL PROTECTED] 
 
 
 
 
 
 

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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

Yes, but if your or the the vendor are paying an M$tax for software that 
you don't use (which can happen if your vendor buys from another vendor 
with XP pre-installed and then installs Linux over it), that is more 
dollars that can be used to generate  spread FUD  innuendo.


-- Bhaskar

Ruben Safir wrote:

I buy everything preinstalled, including recently from Dell and HPP,
although my favorite laptop is the Sony Picture Book I brought from
Emperor Linux.

Those guys are miracle workers.



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Greg Woodhouse]

Now, that's whst I call a web site! 

--- A. Forrey [EMAIL PROTECTED] wrote:

 
 On Fri, 10 Jun 2005, Richard G. DAVIS wrote:
 
  I understand the dichotomy Gregory mentions, and I agree with the
 views he
  has expressed.
 
 I quite agree with the basic thread of what Richrd has said in this 
 exchange. In fact we have put that exzct situation to both a website
 on 
 the EHR here at UW (http://www.ehrweb.org) and in the description of
 the 
 VistA architecture that is intended for health informatics education
 in 
 both a documnt and a website form. The ideas are also part of draft 
 document for A Guide to the Health Informatics Body of Knowledge
 that 
 identifies that these two pespectives are really mutually supportive 
 rather than in conflict and need to be part of an integrated
 educational 
 approach that has Enterprise view, Life Cycle Principles that draw
 on 
 your 1999 expostulation of the Zachman Principles. As you rightly
 note the 
 focus on the technical plaform is a distraction from yje key issues. 
 First, their must be attention to the Conceptual Content that
 Kolodner, 
 Christensen etc in their recent 2005 Book tout for HealthePeople.
 The 
 hardhats and the WV Community must continue to emphasize how the
 VistA 
 conceptual content is going to evolve and draw on the contribution of
 the 
 various health professional specialty disciplines; with that emphasis
 the 
 statements regarding the primacy of the technology will begin to
 fade. 
 Technology will always be a factor but not the prime focus.
 


The most profound technologies are those that disappear.
--Mark Weiser


Greg Woodhouse 
[EMAIL PROTECTED] 
[EMAIL PROTECTED] 






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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Maybe it's not support so much as knowing which doll to stick pins in.  When
MS products don't work (yes, hard to believe), I know to append my new hate
to the hate I've already heaped on Bill Gates.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Kevin
Toppenberg
Sent: Monday, June 13, 2005 12:20 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

Why do you need support?  I have Windows XP on my
notebook.  I never expect anything from Windows
(except for the occasional updates that consistently
remove functionality from my OS).

Kevin


--- Greg Woodhouse [EMAIL PROTECTED]
wrote:

 I've never heard of emperor Linux. I called Dell
 (and HP, and IBM).
 Dell, for example, told me that they support Linux,
 but not on a
 notebook.
 
 --- Ruben Safir [EMAIL PROTECTED] wrote:
 
  On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
   I know that one reason I have tended to shy away
 from Linux is that
  I
   have been unable to find a vendor that sells
 and/or supports Linux
  on a
   notebook.
  
  You mean besides Emperor Linux, HP, IBM and Dell? 
 For what it is
  worth,
  the correct term is GNU/Linux.
  
  
  Ruben
  
  
  
 

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 The most profound technologies are those that
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 --Mark Weiser
 
 
 Greg Woodhouse 
 [EMAIL PROTECTED] 
 [EMAIL PROTECTED] 
 
 
 
 
 
 

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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 12:35, Gillon, Joseph wrote:
  I know to append my new hate
 to the hate I've already heaped on Bill Gates.
 

ROFL

I so try not to do that.  The guys who right SAMBA always say never to
attribute to mallous what is easily seen as incompetency.

Ruben
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Kevin
 Toppenberg
 Sent: Monday, June 13, 2005 12:20 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 Why do you need support?  I have Windows XP on my
 notebook.  I never expect anything from Windows
 (except for the occasional updates that consistently
 remove functionality from my OS).
 
 Kevin
 
 
 --- Greg Woodhouse [EMAIL PROTECTED]
 wrote:
 
  I've never heard of emperor Linux. I called Dell
  (and HP, and IBM).
  Dell, for example, told me that they support Linux,
  but not on a
  notebook.
  
  --- Ruben Safir [EMAIL PROTECTED] wrote:
  
   On Mon, 2005-06-13 at 10:59, Greg Woodhouse wrote:
I know that one reason I have tended to shy away
  from Linux is that
   I
have been unable to find a vendor that sells
  and/or supports Linux
   on a
notebook.
   
   You mean besides Emperor Linux, HP, IBM and Dell? 
  For what it is
   worth,
   the correct term is GNU/Linux.
   
   
   Ruben
   
   
   
  
 
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  The most profound technologies are those that
  disappear.
  --Mark Weiser
  
  
  Greg Woodhouse 
  [EMAIL PROTECTED] 
  [EMAIL PROTECTED] 
  
  
  
  
  
  
 
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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 12:56, Kevin Toppenberg wrote:
 LOL.
 
 My kids are 5 and 7.  Already I am teaching them that
 the reason their computers (windows based) don't work
 the way they want them to is Because Bill Gates is
 Evil.  LOL

Hmmm

http://www.linuxdevcenter.com/pub/a/linux/2002/03/14/household.html

 
 Kevin
 
 
 --- Gillon, Joseph [EMAIL PROTECTED] wrote:
 
  Maybe it's not support so much as knowing which doll
  to stick pins in.  When
  MS products don't work (yes, hard to believe), I
  know to append my new hate
  to the hate I've already heaped on Bill Gates.
  
  -Original Message-
  From: [EMAIL PROTECTED]
 
 [mailto:[EMAIL PROTECTED]
  On Behalf Of Kevin
  Toppenberg
  Sent: Monday, June 13, 2005 12:20 PM
  To: hardhats-members@lists.sourceforge.net
  Subject: Re: [Hardhats-members] == VistaWeb Missing
  Apps ==
  
  Why do you need support?  I have Windows XP on my
  notebook.  I never expect anything from Windows
  (except for the occasional updates that consistently
  remove functionality from my OS).
  
  Kevin
  
  
  --- Greg Woodhouse [EMAIL PROTECTED]
  wrote:
  
   I've never heard of emperor Linux. I called Dell
   (and HP, and IBM).
   Dell, for example, told me that they support
  Linux,
   but not on a
   notebook.
   
   --- Ruben Safir [EMAIL PROTECTED] wrote:
   
On Mon, 2005-06-13 at 10:59, Greg Woodhouse
  wrote:
 I know that one reason I have tended to shy
  away
   from Linux is that
I
 have been unable to find a vendor that sells
   and/or supports Linux
on a
 notebook.

You mean besides Emperor Linux, HP, IBM and
  Dell? 
   For what it is
worth,
the correct term is GNU/Linux.


Ruben



   
  
 
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   The most profound technologies are those that
   disappear.
   --Mark Weiser
   
   
   Greg Woodhouse 
   [EMAIL PROTECTED] 
   [EMAIL PROTECTED] 
   
   
   
   
   
   
  
 
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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 12:56, Kevin Toppenberg wrote:
 LOL.
 
 My kids are 5 and 7.  Already I am teaching them that
 the reason their computers (windows based) don't work
 the way they want them to is Because Bill Gates is
 Evil.  LOL
 

I never teach my kids to hate ;)

http://www.linuxdevcenter.com/pub/a/linux/2002/03/14/household.html




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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Lloyd Milligan]

What does this discussion have to do with VistA or with the specific 
subject of this post VistaWeb Missing Apps?


Lloyd

- Original Message - 
From: Kevin Toppenberg [EMAIL PROTECTED]

To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 12:56 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==



LOL.

My kids are 5 and 7.  Already I am teaching them that
the reason their computers (windows based) don't work
the way they want them to is Because Bill Gates is
Evil.  LOL

Kevin


--- Gillon, Joseph [EMAIL PROTECTED] wrote:


Maybe it's not support so much as knowing which doll
to stick pins in.  When
MS products don't work (yes, hard to believe), I
know to append my new hate
to the hate I've already heaped on Bill Gates.

-Original Message-
From: [EMAIL PROTECTED]


[mailto:[EMAIL PROTECTED]

On Behalf Of Kevin
Toppenberg
Sent: Monday, June 13, 2005 12:20 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing
Apps ==

Why do you need support?  I have Windows XP on my
notebook.  I never expect anything from Windows
(except for the occasional updates that consistently
remove functionality from my OS).

Kevin


--- Greg Woodhouse [EMAIL PROTECTED]
wrote:

 I've never heard of emperor Linux. I called Dell
 (and HP, and IBM).
 Dell, for example, told me that they support
Linux,
 but not on a
 notebook.

 --- Ruben Safir [EMAIL PROTECTED] wrote:

  On Mon, 2005-06-13 at 10:59, Greg Woodhouse
wrote:
   I know that one reason I have tended to shy
away
 from Linux is that
  I
   have been unable to find a vendor that sells
 and/or supports Linux
  on a
   notebook.
 
  You mean besides Emperor Linux, HP, IBM and
Dell?
 For what it is
  worth,
  the correct term is GNU/Linux.
 
 
  Ruben
 
 
 
 



---

  This SF.Net email is sponsored by: NEC IT Guy
 Games.  How far can you
  shotput
  a projector? How fast can you ride your desk
chair
 down the office
  luge track?
  If you want to score the big prize, get to know
 the little guy.
  Play to win an NEC 61 plasma display:
 http://www.necitguy.com/?r=20
  ___
  Hardhats-members mailing list
  Hardhats-members@lists.sourceforge.net
 



https://lists.sourceforge.net/lists/listinfo/hardhats-members

 


 The most profound technologies are those that
 disappear.
 --Mark Weiser

 
 Greg Woodhouse
 [EMAIL PROTECTED]
 [EMAIL PROTECTED]









---

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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

You have to be told?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lloyd
Milligan
Sent: Monday, June 13, 2005 1:11 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

What does this discussion have to do with VistA or with the specific 
subject of this post VistaWeb Missing Apps?

Lloyd

- Original Message - 
From: Kevin Toppenberg [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 12:56 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 LOL.

 My kids are 5 and 7.  Already I am teaching them that
 the reason their computers (windows based) don't work
 the way they want them to is Because Bill Gates is
 Evil.  LOL

 Kevin


 --- Gillon, Joseph [EMAIL PROTECTED] wrote:

 Maybe it's not support so much as knowing which doll
 to stick pins in.  When
 MS products don't work (yes, hard to believe), I
 know to append my new hate
 to the hate I've already heaped on Bill Gates.

 -Original Message-
 From: [EMAIL PROTECTED]

 [mailto:[EMAIL PROTECTED]
 On Behalf Of Kevin
 Toppenberg
 Sent: Monday, June 13, 2005 12:20 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing
 Apps ==

 Why do you need support?  I have Windows XP on my
 notebook.  I never expect anything from Windows
 (except for the occasional updates that consistently
 remove functionality from my OS).

 Kevin


 --- Greg Woodhouse [EMAIL PROTECTED]
 wrote:

  I've never heard of emperor Linux. I called Dell
  (and HP, and IBM).
  Dell, for example, told me that they support
 Linux,
  but not on a
  notebook.
 
  --- Ruben Safir [EMAIL PROTECTED] wrote:
 
   On Mon, 2005-06-13 at 10:59, Greg Woodhouse
 wrote:
I know that one reason I have tended to shy
 away
  from Linux is that
   I
have been unable to find a vendor that sells
  and/or supports Linux
   on a
notebook.
  
   You mean besides Emperor Linux, HP, IBM and
 Dell?
  For what it is
   worth,
   the correct term is GNU/Linux.
  
  
   Ruben
  
  
  
  
 

 ---
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  Games.  How far can you
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 chair
  down the office
   luge track?
   If you want to score the big prize, get to know
  the little guy.
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   Hardhats-members@lists.sourceforge.net
  
 

 https://lists.sourceforge.net/lists/listinfo/hardhats-members
  
 
 
  The most profound technologies are those that
  disappear.
  --Mark Weiser
 
  
  Greg Woodhouse
  [EMAIL PROTECTED]
  [EMAIL PROTECTED]
 
 
 
 
 
 
 

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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Richard G. DAVIS]

Lloyd,

Nothing!  Absolutely nothing to do with the subject heading.

Isn't language wonderful?!  Semantic drift in action.  Now 'missing apps'
has a much broader meaning.  (sic)

And, judging by the volume of posts to this subject, 'missing apps' is a
really interesting topic.  ..

I am amused that the comments I made earlier in this thread are directly
reflected in the discussion that has followed.  Recursion in action.

Regards,

Richard.

 From: Lloyd Milligan [EMAIL PROTECTED]
 Organization: Sea Island Systems, Inc.
 Reply-To: hardhats-members@lists.sourceforge.net
 Date: Mon, 13 Jun 2005 13:11:18 -0400
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 What does this discussion have to do with VistA or with the specific
 subject of this post VistaWeb Missing Apps?
 
 Lloyd
 

...

.



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Jim Self]

Joseph.Gillon wrote:
Getting more and more interesting.  So what's the state of the art these
days in hierarchical/M databases?  Is anyone trying to fix the problems like
them being difficult to query?

I am working to develop general web based query capabilities for MUMPS that can 
take
advantage of features in MUMPS and Fileman not easily reflected in SQL. You can 
already
get virtually all VistA data via M2Web.

---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)


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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

People that express strong anti-Microsoft or anti-Bill always strike a
nerve with me.

I can understand that, as a user, a product may not work as advertised
or as you intended but this is the exact FUD you knock MS for.

Fear Uncertainty and Doubt.  The Microsoft today isn't the same
Microsoft 5 years ago or 10 years ago.  I think Windows 95 was ok and
Windows XP is much better and I'm hoping Longhorn is better than that.
I don't run Linux 2.4 anymore and I doubt many of you have a 1.x flavor
sitting around either.  Live and learn.

Do you FUD a MS product before ever installing it?  A great example is a
recent posting on Slashdot about Microsoft's latest product (in beta),
Acrylic.
http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
185

The poster immediately bashes Microsoft and says: Microsoft should be
prepared to eat another few million in lost development funds.  If,
however, you start to read the comments - the unbiased users immediately
point out that the user never really understood the product to begin
with.

Hey - I have a FC3 laptop to my left and my Powerbook to my right but
I'm writing to you on my XP box.  They all work.

I find that Apple and Linux users normally utilize FUD more than any
marketing engine out there. 

And I don't mean to start a war because you don't have to correct me
on my own personal views and opinions.

Couple great blog posts by one of those evil worker bees in the shrine
of Bill.
http://neopoleon.com/blog/posts/13591.aspx
Quote: Some of us come in peace, damn it.
http://neopoleon.com/blog/posts/13551.aspx
Quote: I also agree about IE and standards. I'd love to see us
put out a kick-ass browser that conforms to standards.

(And no - I don't hold stock in MS.)

Be fair - be calm - be nice.

/David.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Greg
Woodhouse
Sent: Monday, June 13, 2005 1:56 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

The way things are going, I'm beginning to wish every message
containint the word Microsoft (or any of its variations) was sent on
to the moderator for approval. I know Microsoft isn't terribly popular
around here, but do we need to be so shrill?

--- Richard G. DAVIS [EMAIL PROTECTED] wrote:

 Lloyd,
 
 Nothing!  Absolutely nothing to do with the subject heading.
 
 Isn't language wonderful?!  Semantic drift in action.  Now 'missing
 apps'
 has a much broader meaning.  (sic)
 
 And, judging by the volume of posts to this subject, 'missing apps'
 is a
 really interesting topic.  ..
 
 I am amused that the comments I made earlier in this thread are
 directly
 reflected in the discussion that has followed.  Recursion in action.
 
 Regards,
 
 Richard.
 
  From: Lloyd Milligan [EMAIL PROTECTED]
  Organization: Sea Island Systems, Inc.
  Reply-To: hardhats-members@lists.sourceforge.net
  Date: Mon, 13 Jun 2005 13:11:18 -0400
  To: hardhats-members@lists.sourceforge.net
  Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
  
  What does this discussion have to do with VistA or with the
 specific
  subject of this post VistaWeb Missing Apps?
  
  Lloyd
  
 
 ...
 
 .
 
 
 
 ---
 This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
 shotput
 a projector? How fast can you ride your desk chair down the office
 luge track?
 If you want to score the big prize, get to know the little guy.  
 Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
 ___
 Hardhats-members mailing list
 Hardhats-members@lists.sourceforge.net
 https://lists.sourceforge.net/lists/listinfo/hardhats-members
 


The most profound technologies are those that disappear.
--Mark Weiser


Greg Woodhouse 
[EMAIL PROTECTED] 
[EMAIL PROTECTED] 






---
This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
shotput
a projector? How fast can you ride your desk chair down the office luge
track?
If you want to score the big prize, get to know the little guy.  
Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
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https://lists.sourceforge.net/lists/listinfo/hardhats-members


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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, Jun 13, 2005 at 05:48:43PM -0400, David Sommers wrote:
 People that express strong anti-Microsoft or anti-Bill always strike a
 nerve with me.
 
 I can understand that, as a user, a product may not work as advertised
 or as you intended but this is the exact FUD you knock MS for.


No

That's not true.  It's, frankly, an ignorant statement, and it's narrow
minded.  

MS is a convicted monopolists, and their software, but not eclussively
there's, is trusted on the public without any market choice, and backed
billions of dollars of marketing lies.

They lie under oath.  How much more obvious can it get.

And their software genuinely is without any merit.  It is insecure, 
it is poorly designed as a fact from a human interface perspective,
and it is expensive.

There is little I hate more than someone just making excuses for MS and
then is anyone complains about what is fameously obvious, that they then
point like the deserved critism of MS is somehow undeserved and is FUD.

Let me understand you, complaining about MS products is FUD, despite the
fact that it is supported by real science, but MS's billion dollar marketing
and illegal activities is an excuse to defend them?

Please.  Save it for the ignorant.

Your arguements have no grounds to stand on.

Ruben

 
 Fear Uncertainty and Doubt.  The Microsoft today isn't the same
 Microsoft 5 years ago or 10 years ago.  I think Windows 95 was ok and
 Windows XP is much better and I'm hoping Longhorn is better than that.
 I don't run Linux 2.4 anymore and I doubt many of you have a 1.x flavor
 sitting around either.  Live and learn.
 
 Do you FUD a MS product before ever installing it?  A great example is a
 recent posting on Slashdot about Microsoft's latest product (in beta),
 Acrylic.
 http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
 185
 
 The poster immediately bashes Microsoft and says: Microsoft should be
 prepared to eat another few million in lost development funds.  If,
 however, you start to read the comments - the unbiased users immediately
 point out that the user never really understood the product to begin
 with.
 
 Hey - I have a FC3 laptop to my left and my Powerbook to my right but
 I'm writing to you on my XP box.  They all work.
 
 I find that Apple and Linux users normally utilize FUD more than any
 marketing engine out there. 
 
 And I don't mean to start a war because you don't have to correct me
 on my own personal views and opinions.
 
 Couple great blog posts by one of those evil worker bees in the shrine
 of Bill.
 http://neopoleon.com/blog/posts/13591.aspx
   Quote: Some of us come in peace, damn it.
 http://neopoleon.com/blog/posts/13551.aspx
   Quote: I also agree about IE and standards. I'd love to see us
 put out a kick-ass browser that conforms to standards.
 
 (And no - I don't hold stock in MS.)
 
 Be fair - be calm - be nice.
 
 /David.
 
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Greg
 Woodhouse
 Sent: Monday, June 13, 2005 1:56 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 The way things are going, I'm beginning to wish every message
 containint the word Microsoft (or any of its variations) was sent on
 to the moderator for approval. I know Microsoft isn't terribly popular
 around here, but do we need to be so shrill?
 
 --- Richard G. DAVIS [EMAIL PROTECTED] wrote:
 
  Lloyd,
  
  Nothing!  Absolutely nothing to do with the subject heading.
  
  Isn't language wonderful?!  Semantic drift in action.  Now 'missing
  apps'
  has a much broader meaning.  (sic)
  
  And, judging by the volume of posts to this subject, 'missing apps'
  is a
  really interesting topic.  ..
  
  I am amused that the comments I made earlier in this thread are
  directly
  reflected in the discussion that has followed.  Recursion in action.
  
  Regards,
  
  Richard.
  
   From: Lloyd Milligan [EMAIL PROTECTED]
   Organization: Sea Island Systems, Inc.
   Reply-To: hardhats-members@lists.sourceforge.net
   Date: Mon, 13 Jun 2005 13:11:18 -0400
   To: hardhats-members@lists.sourceforge.net
   Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
   
   What does this discussion have to do with VistA or with the
  specific
   subject of this post VistaWeb Missing Apps?
   
   Lloyd
   
  
  ...
  
  .
  
  
  
  ---
  This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
  shotput
  a projector? How fast can you ride your desk chair down the office
  luge track?
  If you want to score the big prize, get to know the little guy.  
  Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
  ___
  Hardhats-members mailing list
  Hardhats-members@lists.sourceforge.net
  https://lists.sourceforge.net/lists/listinfo/hardhats-members
  
 
 
 The most profound

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

Actually, I just did a google search on you, and I see no expereince on
your part with anything outside of MS Corporate work.

Please, don't fein any expertise in these issues without also stating either
your expertise in unbias computer sciences or disclosing your connections
with Microsoft.



Ruben


On Mon, Jun 13, 2005 at 05:48:43PM -0400, David Sommers wrote:
 People that express strong anti-Microsoft or anti-Bill always strike a
 nerve with me.
 
 I can understand that, as a user, a product may not work as advertised
 or as you intended but this is the exact FUD you knock MS for.
 
 Fear Uncertainty and Doubt.  The Microsoft today isn't the same
 Microsoft 5 years ago or 10 years ago.  I think Windows 95 was ok and
 Windows XP is much better and I'm hoping Longhorn is better than that.
 I don't run Linux 2.4 anymore and I doubt many of you have a 1.x flavor
 sitting around either.  Live and learn.
 
 Do you FUD a MS product before ever installing it?  A great example is a
 recent posting on Slashdot about Microsoft's latest product (in beta),
 Acrylic.
 http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
 185
 
 The poster immediately bashes Microsoft and says: Microsoft should be
 prepared to eat another few million in lost development funds.  If,
 however, you start to read the comments - the unbiased users immediately
 point out that the user never really understood the product to begin
 with.
 
 Hey - I have a FC3 laptop to my left and my Powerbook to my right but
 I'm writing to you on my XP box.  They all work.
 
 I find that Apple and Linux users normally utilize FUD more than any
 marketing engine out there. 
 
 And I don't mean to start a war because you don't have to correct me
 on my own personal views and opinions.
 
 Couple great blog posts by one of those evil worker bees in the shrine
 of Bill.
 http://neopoleon.com/blog/posts/13591.aspx
   Quote: Some of us come in peace, damn it.
 http://neopoleon.com/blog/posts/13551.aspx
   Quote: I also agree about IE and standards. I'd love to see us
 put out a kick-ass browser that conforms to standards.
 
 (And no - I don't hold stock in MS.)
 
 Be fair - be calm - be nice.
 
 /David.
 
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Greg
 Woodhouse
 Sent: Monday, June 13, 2005 1:56 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 The way things are going, I'm beginning to wish every message
 containint the word Microsoft (or any of its variations) was sent on
 to the moderator for approval. I know Microsoft isn't terribly popular
 around here, but do we need to be so shrill?
 
 --- Richard G. DAVIS [EMAIL PROTECTED] wrote:
 
  Lloyd,
  
  Nothing!  Absolutely nothing to do with the subject heading.
  
  Isn't language wonderful?!  Semantic drift in action.  Now 'missing
  apps'
  has a much broader meaning.  (sic)
  
  And, judging by the volume of posts to this subject, 'missing apps'
  is a
  really interesting topic.  ..
  
  I am amused that the comments I made earlier in this thread are
  directly
  reflected in the discussion that has followed.  Recursion in action.
  
  Regards,
  
  Richard.
  
   From: Lloyd Milligan [EMAIL PROTECTED]
   Organization: Sea Island Systems, Inc.
   Reply-To: hardhats-members@lists.sourceforge.net
   Date: Mon, 13 Jun 2005 13:11:18 -0400
   To: hardhats-members@lists.sourceforge.net
   Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
   
   What does this discussion have to do with VistA or with the
  specific
   subject of this post VistaWeb Missing Apps?
   
   Lloyd
   
  
  ...
  
  .
  
  
  
  ---
  This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
  shotput
  a projector? How fast can you ride your desk chair down the office
  luge track?
  If you want to score the big prize, get to know the little guy.  
  Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
  ___
  Hardhats-members mailing list
  Hardhats-members@lists.sourceforge.net
  https://lists.sourceforge.net/lists/listinfo/hardhats-members
  
 
 
 The most profound technologies are those that disappear.
 --Mark Weiser
 
 
 Greg Woodhouse 
 [EMAIL PROTECTED] 
 [EMAIL PROTECTED] 
 
 
 
 
 
 
 ---
 This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
 shotput
 a projector? How fast can you ride your desk chair down the office luge
 track?
 If you want to score the big prize, get to know the little guy.  
 Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
 ___
 Hardhats-members mailing list
 Hardhats-members@lists.sourceforge.net
 https://lists.sourceforge.net/lists/listinfo/hardhats-members

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[James Gray]

And their software genuinely is without any merit.


How can you possibly say that?  What is your definition of merit?

Jim

- Original Message - 
From: Ruben Safir [EMAIL PROTECTED]

To: hardhats-members@lists.sourceforge.net
Cc: [EMAIL PROTECTED]
Sent: Monday, June 13, 2005 4:09 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==



On Mon, Jun 13, 2005 at 05:48:43PM -0400, David Sommers wrote:

People that express strong anti-Microsoft or anti-Bill always strike a
nerve with me.

I can understand that, as a user, a product may not work as advertised
or as you intended but this is the exact FUD you knock MS for.



No

That's not true.  It's, frankly, an ignorant statement, and it's narrow
minded.

MS is a convicted monopolists, and their software, but not eclussively
there's, is trusted on the public without any market choice, and backed
billions of dollars of marketing lies.

They lie under oath.  How much more obvious can it get.

And their software genuinely is without any merit.  It is insecure,
it is poorly designed as a fact from a human interface perspective,
and it is expensive.

There is little I hate more than someone just making excuses for MS and
then is anyone complains about what is fameously obvious, that they then
point like the deserved critism of MS is somehow undeserved and is FUD.

Let me understand you, complaining about MS products is FUD, despite the
fact that it is supported by real science, but MS's billion dollar 
marketing

and illegal activities is an excuse to defend them?

Please.  Save it for the ignorant.

Your arguements have no grounds to stand on.

Ruben



Fear Uncertainty and Doubt.  The Microsoft today isn't the same
Microsoft 5 years ago or 10 years ago.  I think Windows 95 was ok and
Windows XP is much better and I'm hoping Longhorn is better than that.
I don't run Linux 2.4 anymore and I doubt many of you have a 1.x flavor
sitting around either.  Live and learn.

Do you FUD a MS product before ever installing it?  A great example is a
recent posting on Slashdot about Microsoft's latest product (in beta),
Acrylic.
http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
185

The poster immediately bashes Microsoft and says: Microsoft should be
prepared to eat another few million in lost development funds.  If,
however, you start to read the comments - the unbiased users immediately
point out that the user never really understood the product to begin
with.

Hey - I have a FC3 laptop to my left and my Powerbook to my right but
I'm writing to you on my XP box.  They all work.

I find that Apple and Linux users normally utilize FUD more than any
marketing engine out there.

And I don't mean to start a war because you don't have to correct me
on my own personal views and opinions.

Couple great blog posts by one of those evil worker bees in the shrine
of Bill.
http://neopoleon.com/blog/posts/13591.aspx
Quote: Some of us come in peace, damn it.
http://neopoleon.com/blog/posts/13551.aspx
Quote: I also agree about IE and standards. I'd love to see us
put out a kick-ass browser that conforms to standards.

(And no - I don't hold stock in MS.)

Be fair - be calm - be nice.

/David.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Greg
Woodhouse
Sent: Monday, June 13, 2005 1:56 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

The way things are going, I'm beginning to wish every message
containint the word Microsoft (or any of its variations) was sent on
to the moderator for approval. I know Microsoft isn't terribly popular
around here, but do we need to be so shrill?

--- Richard G. DAVIS [EMAIL PROTECTED] wrote:

 Lloyd,

 Nothing!  Absolutely nothing to do with the subject heading.

 Isn't language wonderful?!  Semantic drift in action.  Now 'missing
 apps'
 has a much broader meaning.  (sic)

 And, judging by the volume of posts to this subject, 'missing apps'
 is a
 really interesting topic.  ..

 I am amused that the comments I made earlier in this thread are
 directly
 reflected in the discussion that has followed.  Recursion in action.

 Regards,

 Richard.

  From: Lloyd Milligan [EMAIL PROTECTED]
  Organization: Sea Island Systems, Inc.
  Reply-To: hardhats-members@lists.sourceforge.net
  Date: Mon, 13 Jun 2005 13:11:18 -0400
  To: hardhats-members@lists.sourceforge.net
  Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
  What does this discussion have to do with VistA or with the
 specific
  subject of this post VistaWeb Missing Apps?
 
  Lloyd
 

 ...
 
 .



 ---
 This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
 shotput
 a projector? How fast can you ride your desk chair down the office
 luge track?
 If you want to score the big prize, get to know the little guy.
 Play to win an NEC 61 plasma display: http://www.necitguy.com/?r

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[K.S. Bhaskar]

I realize that individuals among us have strong feelings for and against 
different software vendors, products, business models and philosphies. 
But one of the things this community has avoided in the past is a flame 
war.  I hope I speak for many who would like to keep it that way.  Let 
us feel free to voice our opinions, but let us keep the dialog civil 
when we agree to disagree.  Thank you very much.


-- Bhaskar


---
This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you shotput
a projector? How fast can you ride your desk chair down the office luge track?
If you want to score the big prize, get to know the little guy.  
Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20

___
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 I think Windows 95 was ok and
 Windows XP is much better and I'm hoping Longhorn is better than that.
 I don't run Linux 2.4 anymore 

This is also ridicules.  I have 5 systems running 2.4 kernels and 3
running 2.3 kernels.  And why are you comparing a Kernal to an Operating
System?  bin utilities hasn't changed since Richard wrote them in 1984.

In fact, I'm posting this from a Slackware 3.1 box, build from god knows
when and constantly upgraded by me as I felt I needed to or to patch
sendmail for security reasons.  This is running on a Pentium 133mghtzz
machine driving 4 20 gig scsi's

Show me a W95 box that is going to do that, and handle 200 remote users
a day like this does, while still running Gnome (which by the way has
security and networking features XP never dreamed of).  

It's one thing to get off the path and discuss software implementation
and design, but if this is going to melt down to a pointless (and
ANCIENT) flame fest defending Microsoft, there is no point and VISTA
will just suffer all the stupidity that exists.

If someone is going to make an assertion about the usability of a
proprietary software product, they better at least be able to back it
the need for such a product with some serious, unbiased, hard evidence. 
At least something better than the slashdot claptrap.

For god's sake, MS, IBM and Sun have whole offices dedicated to just
controlling the spin on slashdot.

Ruben


 and I doubt many of you have a 1.x flavor
 sitting around either.  Live and learn.
 
 Do you FUD a MS product before ever installing it?  A great example is a
 recent posting on Slashdot about Microsoft's latest product (in beta),
 Acrylic.
 http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
 185
 
 The poster immediately bashes Microsoft and says: Microsoft should be
 prepared to eat another few million in lost development funds.  If,
 however, you start to read the comments - the unbiased users immediately
 point out that the user never really understood the product to begin
 with.
 
 Hey - I have a FC3 laptop to my left and my Powerbook to my right but
 I'm writing to you on my XP box.  They all work.
 
 I find that Apple and Linux users normally utilize FUD more than any
 marketing engine out there. 
 
 And I don't mean to start a war because you don't have to correct me
 on my own personal views and opinions.
 
 Couple great blog posts by one of those evil worker bees in the shrine
 of Bill.
 http://neopoleon.com/blog/posts/13591.aspx
   Quote: Some of us come in peace, damn it.
 http://neopoleon.com/blog/posts/13551.aspx
   Quote: I also agree about IE and standards. I'd love to see us
 put out a kick-ass browser that conforms to standards.
 
 (And no - I don't hold stock in MS.)
 
 Be fair - be calm - be nice.
 
 /David.
 
 
 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Greg
 Woodhouse
 Sent: Monday, June 13, 2005 1:56 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 The way things are going, I'm beginning to wish every message
 containint the word Microsoft (or any of its variations) was sent on
 to the moderator for approval. I know Microsoft isn't terribly popular
 around here, but do we need to be so shrill?
 
 --- Richard G. DAVIS [EMAIL PROTECTED] wrote:
 
  Lloyd,
  
  Nothing!  Absolutely nothing to do with the subject heading.
  
  Isn't language wonderful?!  Semantic drift in action.  Now 'missing
  apps'
  has a much broader meaning.  (sic)
  
  And, judging by the volume of posts to this subject, 'missing apps'
  is a
  really interesting topic.  ..
  
  I am amused that the comments I made earlier in this thread are
  directly
  reflected in the discussion that has followed.  Recursion in action.
  
  Regards,
  
  Richard.
  
   From: Lloyd Milligan [EMAIL PROTECTED]
   Organization: Sea Island Systems, Inc.
   Reply-To: hardhats-members@lists.sourceforge.net
   Date: Mon, 13 Jun 2005 13:11:18 -0400
   To: hardhats-members@lists.sourceforge.net
   Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
   
   What does this discussion have to do with VistA or with the
  specific
   subject of this post VistaWeb Missing Apps?
   
   Lloyd
   
  
  ...
  
  .
  
  
  
  ---
  This SF.Net email is sponsored by: NEC IT Guy Games.  How far can you
  shotput
  a projector? How fast can you ride your desk chair down the office
  luge track?
  If you want to score the big prize, get to know the little guy.  
  Play to win an NEC 61 plasma display: http://www.necitguy.com/?r=20
  ___
  Hardhats-members mailing list
  Hardhats-members@lists.sourceforge.net
  https://lists.sourceforge.net/lists/listinfo/hardhats-members
  
 
 
 The most profound technologies are those that disappear.
 --Mark Weiser
 
 
 Greg Woodhouse 
 [EMAIL PROTECTED

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Mon, 2005-06-13 at 18:32, James Gray wrote:
  And their software genuinely is without any merit.
 
 How can you possibly say that?  What is your definition of merit?
 

Last post on this topic by me (consider it self moderation).  Software
has merit when it is usable by the end user without causing the system
to fail or to be hacked when used in the way it was designed and how a
user can be expected to behave.  In addition, it needs to fill a need
not currently filled better by existing software, or solve an existing
problem in a more user friendly way and with more efficiency.

That eliminates a lot of software, not just MS's.

Ruben
  
 Jim
 
 - Original Message - 
 From: Ruben Safir [EMAIL PROTECTED]
 To: hardhats-members@lists.sourceforge.net
 Cc: [EMAIL PROTECTED]
 Sent: Monday, June 13, 2005 4:09 PM
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 
  On Mon, Jun 13, 2005 at 05:48:43PM -0400, David Sommers wrote:
  People that express strong anti-Microsoft or anti-Bill always strike a
  nerve with me.
 
  I can understand that, as a user, a product may not work as advertised
  or as you intended but this is the exact FUD you knock MS for.
 
 
  No
 
  That's not true.  It's, frankly, an ignorant statement, and it's narrow
  minded.
 
  MS is a convicted monopolists, and their software, but not eclussively
  there's, is trusted on the public without any market choice, and backed
  billions of dollars of marketing lies.
 
  They lie under oath.  How much more obvious can it get.
 
  And their software genuinely is without any merit.  It is insecure,
  it is poorly designed as a fact from a human interface perspective,
  and it is expensive.
 
  There is little I hate more than someone just making excuses for MS and
  then is anyone complains about what is fameously obvious, that they then
  point like the deserved critism of MS is somehow undeserved and is FUD.
 
  Let me understand you, complaining about MS products is FUD, despite the
  fact that it is supported by real science, but MS's billion dollar 
  marketing
  and illegal activities is an excuse to defend them?
 
  Please.  Save it for the ignorant.
 
  Your arguements have no grounds to stand on.
 
  Ruben
 
 
  Fear Uncertainty and Doubt.  The Microsoft today isn't the same
  Microsoft 5 years ago or 10 years ago.  I think Windows 95 was ok and
  Windows XP is much better and I'm hoping Longhorn is better than that.
  I don't run Linux 2.4 anymore and I doubt many of you have a 1.x flavor
  sitting around either.  Live and learn.
 
  Do you FUD a MS product before ever installing it?  A great example is a
  recent posting on Slashdot about Microsoft's latest product (in beta),
  Acrylic.
  http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
  185
 
  The poster immediately bashes Microsoft and says: Microsoft should be
  prepared to eat another few million in lost development funds.  If,
  however, you start to read the comments - the unbiased users immediately
  point out that the user never really understood the product to begin
  with.
 
  Hey - I have a FC3 laptop to my left and my Powerbook to my right but
  I'm writing to you on my XP box.  They all work.
 
  I find that Apple and Linux users normally utilize FUD more than any
  marketing engine out there.
 
  And I don't mean to start a war because you don't have to correct me
  on my own personal views and opinions.
 
  Couple great blog posts by one of those evil worker bees in the shrine
  of Bill.
  http://neopoleon.com/blog/posts/13591.aspx
  Quote: Some of us come in peace, damn it.
  http://neopoleon.com/blog/posts/13551.aspx
  Quote: I also agree about IE and standards. I'd love to see us
  put out a kick-ass browser that conforms to standards.
 
  (And no - I don't hold stock in MS.)
 
  Be fair - be calm - be nice.
 
  /David.
 
 
  -Original Message-
  From: [EMAIL PROTECTED]
  [mailto:[EMAIL PROTECTED] On Behalf Of Greg
  Woodhouse
  Sent: Monday, June 13, 2005 1:56 PM
  To: hardhats-members@lists.sourceforge.net
  Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
  The way things are going, I'm beginning to wish every message
  containint the word Microsoft (or any of its variations) was sent on
  to the moderator for approval. I know Microsoft isn't terribly popular
  around here, but do we need to be so shrill?
 
  --- Richard G. DAVIS [EMAIL PROTECTED] wrote:
 
   Lloyd,
  
   Nothing!  Absolutely nothing to do with the subject heading.
  
   Isn't language wonderful?!  Semantic drift in action.  Now 'missing
   apps'
   has a much broader meaning.  (sic)
  
   And, judging by the volume of posts to this subject, 'missing apps'
   is a
   really interesting topic.  ..
  
   I am amused that the comments I made earlier in this thread are
   directly
   reflected in the discussion that has followed.  Recursion in action.
  
   Regards,
  
   Richard.
  
From: Lloyd Milligan [EMAIL PROTECTED

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

So, Karl, it sounds like they have implemented the MPI (Master Patient
Index) in Oracle.  It would be interesting to see how these systems are
running and the cost.   I had heard that Integic had been a player in CHCS
II and had made some progress.  Cool.  It does seem as though CHCS I is
still rather key to keeping the hospitals going.  It would be interesting to
see what the CHCS II interface does provide.  If it works, it works.  But
one of the real strengths of CHCS was that it provided synergistic data
between the different departments.   I have things I need to do tonight.
Thanks for taking the time.

Chris


- Original Message -
From: Thies, Karl Mr LND [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 8:10 AM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


Chris -
I cannot really comment on the history of CHCS II as I have only been
re-associated with DoD software again for the last year and a half, and
I don't really know much about the development and deployment of this
product.  I can tell you that the current developer is a company called
Integic, that the database to which all CHCS II sites around the world
are connected is Oracle (located at one site in the US), and the first
phase of the product has in fact been deployed at DoD sites across the
US and Europe.  I am not saying at *all* DoD sites, but I know for a
fact that it is currently deployed at many major DoD hospitals in the US
and Europe.  The goal is to replace CHCS I, but the target date is
several years away, minimum.  Right now there the product is layered
on top of CHCS I and has relatively little functionality of its own, at
least at our site.  All appointments, patient administration, and
ancillary processing is still currently being done by the CHCS I
backend, but CHCS II is providing the front end to order entry via a
nice GUI frontend.  I don't know if other there are beta sites in the
US who have more capable CHCS II software, but I would presume so.

And you read that right...currently all clinical and patient information
associated with every encounter at CHCS II sites around the world is
being sent to one Oracle database.  That database in turn populates the
user's CHCS II encounter screen at any CHCS II site at which the patient
presents himself, so that if a patient has been seen at any facility
which uses CHCS II, any and all encounters which have been entered into
CHCS II from any site will be displayed.  The physician will have access
to the historical HER regardless of where the patient was seen

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Monday, June 13, 2005 1:37 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

Karl, haven't heard from you in a long time.  This is news to me that
CHCS
II is still being deployed.  You are on the front line, so you have
better
sources than mine, perhaps.  I am late for work and can't connect again
until after work. Will write more this evening.  Tell us more about the
history of CHCS II if you know it.  I was working on the third cycle
(attempt) of CHCS II back in 1998.

   Best wishes;  Chris

- Original Message -
From: Thies, Karl Mr LND [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 3:18 AM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


I am working at Landstuhl Regional Medical Center in Germany at the
moment, and we have just brought up CHCS II at Landstuhl Regional
Medical Center and most of our associated clinics and hospitals across
Europe. CHCS II is now being run at DoD hospitals and clinics across
Europe.  By the end of the summer it is projected to be operational from
Iceland to Turkey.  Now granted CHCS II is running alongside CHCS I,
provides relatively little functionality compared to the current CHCS I,
and in no way replaces CHCS I, but it appears that there is some
political/financial impetus behind CHCS II which indicates to me that
the project is still alive and not a failure.  Your tax dollars and
my tax dollars are being spent to deploy CHCS II around the world (DoD
bases in Asia are next).  Could Chris please elaborate on his statement
that CHCS II is/has been a failure?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 10:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Greg;

   You also have (or had) Debian to play with, and I can provide you with
version 9.2 or 9.3 SuSe, if you wish.

- Original Message -
From: Greg Woodhouse [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Monday, June 13, 2005 9:00 AM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 So, basically SUSE is it...but that's sure an improvement over what I
 found last time I looked -- which was nothing.

 I don't know a think about SUSE, the only distribution I've worked with
 is Red Hat. But I appreciate this link. I'll look into it.

 --- K.S. Bhaskar [EMAIL PROTECTED] wrote:

  If you want certified and supported hardware with Linux, see
 

http://h10018.www1.hp.com/wwsolutions/linux/products/clients/clientscert-sus
e.html
 
  for HP notebooks certified on Linux.  If you want a laptop with Linux
 
  pre-loaded, you will probably need to order off the web or by phone.
  Walmart offers (or offered) a laptop pre-loaded with Linux, but the
  reviews were less than glowing.
 
  As a practical matter, Linux runs on many if not most laptops (see
  http://www.linux-laptop.net/).  To check out how compatible a laptop
  is
  with Linux without touching the contents of the hard drive, download
  the
  latest copy of Knoppix (http://knoppix.org - the default language is
  German; click on the hybrid Union Jack / Stars and Stripes icon for
  English) or try the latest OpenVistA VivA FOIA Gold live CD.
 
  As a practical matter, I have only seen two laptops on which I had
  trouble with Linux I couldn't solve.  One was an old Compaq Armada.
  The
  other was a brand new Dell model and the owner came to me for help
  because the Windows XP display driver that came with it didn't work,
  and
  tech support (I don't know whether Dell/Microsoft) had him re-install
 
  Windows XP (which took him a long time in itself, but that's another
  story).  In desperation, he tried Linux, and when it didn't work
  either,
  he returned the laptop.
 
  -- Bhaskar
 
  Greg Woodhouse wrote:
   I've never heard of emperor Linux. I called Dell (and HP, and IBM).
   Dell, for example, told me that they support Linux, but not on a
   notebook.
 
 
  ---
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 The most profound technologies are those that disappear.
 --Mark Weiser

 
 Greg Woodhouse
 [EMAIL PROTECTED]
 [EMAIL PROTECTED]






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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Kevin Toppenberg]

I actually think that Microsoft makes fairly good
software.  After all, if you get that many people
working together, with that kind of funding, you have
to have something to show for it.

What rubs me wrong about Microsoft is that I get a
very strong feeling that I exist to serve the
software, not the other way around.  With Linux, I
never feel like the software is out to trick me, or
secretly sabatoge other software packages installed on
my system.

I think that Microsoft is pretty clear that they are
out to dominate in their markets, and that they think
it is perfectly fine to compete agressively.

Kevin


--- David Sommers [EMAIL PROTECTED] wrote:

 People that express strong anti-Microsoft or
 anti-Bill always strike a
 nerve with me.
 
 I can understand that, as a user, a product may not
 work as advertised
 or as you intended but this is the exact FUD you
 knock MS for.
 
 Fear Uncertainty and Doubt.  The Microsoft today
 isn't the same
 Microsoft 5 years ago or 10 years ago.  I think
 Windows 95 was ok and
 Windows XP is much better and I'm hoping Longhorn is
 better than that.
 I don't run Linux 2.4 anymore and I doubt many of
 you have a 1.x flavor
 sitting around either.  Live and learn.
 
 Do you FUD a MS product before ever installing it? 
 A great example is a
 recent posting on Slashdot about Microsoft's latest
 product (in beta),
 Acrylic.

http://slashdot.org/article.pl?sid=05/06/11/1851231tid=152tid=109tid=
 185
 
 The poster immediately bashes Microsoft and says:
 Microsoft should be
 prepared to eat another few million in lost
 development funds.  If,
 however, you start to read the comments - the
 unbiased users immediately
 point out that the user never really understood the
 product to begin
 with.
 
 Hey - I have a FC3 laptop to my left and my
 Powerbook to my right but
 I'm writing to you on my XP box.  They all work.
 
 I find that Apple and Linux users normally utilize
 FUD more than any
 marketing engine out there. 
 
 And I don't mean to start a war because you don't
 have to correct me
 on my own personal views and opinions.
 
 Couple great blog posts by one of those evil worker
 bees in the shrine
 of Bill.
 http://neopoleon.com/blog/posts/13591.aspx
   Quote: Some of us come in peace, damn it.
 http://neopoleon.com/blog/posts/13551.aspx
   Quote: I also agree about IE and standards. I'd
 love to see us
 put out a kick-ass browser that conforms to
 standards.
 
 (And no - I don't hold stock in MS.)
 
 Be fair - be calm - be nice.
 
 /David.
 
 
 -Original Message-
 From: [EMAIL PROTECTED]

[mailto:[EMAIL PROTECTED]
 On Behalf Of Greg
 Woodhouse
 Sent: Monday, June 13, 2005 1:56 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing
 Apps ==
 
 The way things are going, I'm beginning to wish
 every message
 containint the word Microsoft (or any of its
 variations) was sent on
 to the moderator for approval. I know Microsoft
 isn't terribly popular
 around here, but do we need to be so shrill?
 
 --- Richard G. DAVIS [EMAIL PROTECTED] wrote:
 
  Lloyd,
  
  Nothing!  Absolutely nothing to do with the
 subject heading.
  
  Isn't language wonderful?!  Semantic drift in
 action.  Now 'missing
  apps'
  has a much broader meaning.  (sic)
  
  And, judging by the volume of posts to this
 subject, 'missing apps'
  is a
  really interesting topic.  ..
  
  I am amused that the comments I made earlier in
 this thread are
  directly
  reflected in the discussion that has followed. 
 Recursion in action.
  
  Regards,
  
  Richard.
  
   From: Lloyd Milligan [EMAIL PROTECTED]
   Organization: Sea Island Systems, Inc.
   Reply-To: hardhats-members@lists.sourceforge.net
   Date: Mon, 13 Jun 2005 13:11:18 -0400
   To: hardhats-members@lists.sourceforge.net
   Subject: Re: [Hardhats-members] == VistaWeb
 Missing Apps ==
   
   What does this discussion have to do with
 VistA or with the
  specific
   subject of this post VistaWeb Missing Apps?
   
   Lloyd
   
  
  ...
  
  .
  
  
  
 

---
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 Games.  How far can you
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 down the office
  luge track?
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 http://www.necitguy.com/?r=20
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https://lists.sourceforge.net/lists/listinfo/hardhats-members
  
 
 
 The most profound technologies are those that
 disappear.
 --Mark Weiser
 
 
 Greg Woodhouse 
 [EMAIL PROTECTED] 
 [EMAIL PROTECTED] 
 
 
 
 
 
 

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 shotput
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 If you want

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[GARY MONGER]

Sure you need to store, preserve and validate the data, but we were
discussing querying the database.  My contention is that design,
implementation, and complexity of the data relationships have as much to do
with how easy it is to get at the data as the tool used to get it.  Systems
like VistA are sufficiently complex as to require professionals to get what
is needed from the data, no matter the DBMS and no matter the tool used to
query.  SQL doesn't solve that problem, people do.
So for Joe's patient screen, I'll take his word that it is hard to do. And
I'll hope he'll take mine that there are plenty of tasks that are made easy
in VistA that would be hard under another implementation.  My suggestion
would be to learn a little MUMPS and a little Fileman and write your own
RPC, its probably not as hard as you think.  Alternatively post your problem
to this group, someone may have already solved it.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Ruben
Safir
Sent: Sunday, June 12, 2005 7:26 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

On Sun, Jun 12, 2005 at 07:15:38PM -0400, GARY MONGER wrote:
 Your friends on Wall Street employ quite a few programmers, which they
keep
 very busy, some even with M.  SQL does not mean you get your data any
easier
 or faster,
   
That is not the purpsoe of a database.  A database needs to store, preserve
and
validate data.

   or that you have less need of professional programmers.
 
 If you are using a conventional RDBMS, realistically what is your
 alternative to SQL?  

:)

Every database has a built in API which is faster. It's just not universal
and
usually needs compulation.

SQL is just better because it is desinged on sould database theory and honed
by 3 decades of real world expereince.

 I guess there are some object tools now, but
 historically that toolbox only holds hammers.

Definetely not.  In fact, when I programmered Oracle apps I used no SQL.

Ruben

-- 
__
Brooklyn Linux Solutions

So many immigrant groups have swept through our town 
that Brooklyn, like Atlantis, reaches mythological 
proportions in the mind of the world  - RI Safir 1998

DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://fairuse.nylxs.com

Yeah - I write Free Software...so SUE ME

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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

 Comments about failed projects based on differing technologies.

 Comments on speed of that vs speed of this.

 Comments saying this thing bites and this other thing is...


Whoa - slow down...

I don't hold a PHD in database design but I do know:

1) A project fails for many more reasons than the database it was built
upon.

If CHCS II failed, VistA failed/fails, or This new thang fails - it
has many factors involved.  CHCS II could be slow because the
developers queried the database wrong, designed the database wrong,
forgot a crucial clustered index on 2 level join and returned unused
columns thru an uncached web service.  Whatever the reasoning -
computers do what they are told and they're usually told wrong.

2) An effective system is more than the benchmark.

If you have a bug turn-around time of 2 days instead of 2 weeks because
the system is better but takes 20% longer to return your report - is
it worth it?  What if you could build a new feature in 1/4 the time
because the system is modular, etc?  What if your bug count was much
lower because you utilized test-driven development, unit testing, etc?
Where's the line between productivity and speed?  I could write an ISAPI
filter for IIS that'll return pages REALLY FAST because it was written
in C but it won't be easily maintained or flexible. 

3) Any project directly ported to another technology will not benefit
from the advances in that new technology.

If I had, say the Windows or Linux Kernel written in C.  Porting it to
some new technology like E (D actually exists) - will it simply work
faster?  Probably not.  Not because E is a bad language, the kernels
simply take advantage of C as it was implemented. 

The same thing applies to databases.  My current SQL Server and OLAP
(Analysis) Server are not the same.  Two technologies used for different
purposes.  M is different, no doubt about that.  But if you were to
build a business application that once read lines out of a text file,
would you have a relational database consisting of a single table and
one column that holds each line of the text file?  Nope.  You'd probably
normalize that thing out and make the most use of your technology.

Maybe mapping VistA straight from M - SQL isn't the best approach?  If
it is or isn't, I don't think one organization's implementation of an
EMR sets the pace for comparison.  Epic uses SQL - not all banks use M -
many CRMs use relational system - etc.  Going back to #1 - it's not just
the database's fault.

4) Dropping VistA for the sake of changing technologies.

I have a saying (well, I never actually say it out loud) - change
platforms when your current platform restricts your architecture
options.

If SOA (web services) is something you want and you can't do it in ASM -
then you should check your options.  There are many languages out there
and they're all good at something - but not everything.

Could VistA be re-written in .NET, Java, or Python?  Yes.
Can it be just as successful as VistA-M?  Possible.  Depends on the
interface between the chair and keyboard.

And may I recommend this:

http://www.amazon.com/exec/obidos/tg/detail/-/0596100124/ref=wl_it_dp/00
2-5699553-5527248

Database in Depth
by C.J. Date

Remember: You can't optimally use the targeted system until you know how
it works under the hood.  If you're using .NET or Java, question those
easy-to-use syntax commands.  So why is the StringBuilder better than
looping thru a string?  Why is a string immutable?

Why does a patient's meds take longer to load on the new system than the
old?  Check those queries, your data model, your middle/business tier,
etc.  And if it's truly new technology - are you using fetch-ahead,
background/multi-threading, caching, etc.

Out.


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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

 your current platform restricts your architectuyre
options.  What do you mean by that?  The MUMPS model is exceptionally
flexible and strangely very platform independant.  CHCS I was implemented on
PDPs (running DSM-11), then Vaxes (VMS, then Open VMS), then Dell Servers
(SCO Unix), and then the Alpha (also OpenVMS, and NT).  CHCS I interfaced
with every other technology I ever heard them ask for.  Some of those
interfaces were too slow to be fed by DSM.  Some of the interfaces would
generate a NAK for every other record to slow the CHCS I system down (CHCS
was responsible for recording the communication errors, the other system was
not).  The CHCS I system was supporting a hospital and a number of these
add-on dedicated interfaces (probably more than a dozen different
interfaces) and CHCS I still had time to handle even more.  The Open VistA
model runs on PCs under the whole line of Microsoft OSs, haven't seen a
Linux yet that won't work, now I believe that Apple has been added to the
list.  I have seen the VistA model run on IBM, Tandem, and a bunch of
others.   The MUMPS technology is breaking out of it's boundaries with more
and more new interfaces, PHP, HTML, XML, Apachea and CGI, RPC, you name it.
Somebody has found a way to get it to work.  Once the technicals are worked
out, these interfaces find their way into the applications.

I have to close this off for now and get some sleep.  Hey, proper tool for
the proper job.  Just let's have some level playing fields and open
publication of benchmarks, compute-offs, and the like.


- Original Message -
From: David Sommers [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Saturday, June 11, 2005 11:07 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 Comments about failed projects based on differing technologies.

 Comments on speed of that vs speed of this.

 Comments saying this thing bites and this other thing is...


Whoa - slow down...

I don't hold a PHD in database design but I do know:

1) A project fails for many more reasons than the database it was built
upon.

If CHCS II failed, VistA failed/fails, or This new thang fails - it
has many factors involved.  CHCS II could be slow because the
developers queried the database wrong, designed the database wrong,
forgot a crucial clustered index on 2 level join and returned unused
columns thru an uncached web service.  Whatever the reasoning -
computers do what they are told and they're usually told wrong.

2) An effective system is more than the benchmark.

If you have a bug turn-around time of 2 days instead of 2 weeks because
the system is better but takes 20% longer to return your report - is
it worth it?  What if you could build a new feature in 1/4 the time
because the system is modular, etc?  What if your bug count was much
lower because you utilized test-driven development, unit testing, etc?
Where's the line between productivity and speed?  I could write an ISAPI
filter for IIS that'll return pages REALLY FAST because it was written
in C but it won't be easily maintained or flexible.

3) Any project directly ported to another technology will not benefit
from the advances in that new technology.

If I had, say the Windows or Linux Kernel written in C.  Porting it to
some new technology like E (D actually exists) - will it simply work
faster?  Probably not.  Not because E is a bad language, the kernels
simply take advantage of C as it was implemented.

The same thing applies to databases.  My current SQL Server and OLAP
(Analysis) Server are not the same.  Two technologies used for different
purposes.  M is different, no doubt about that.  But if you were to
build a business application that once read lines out of a text file,
would you have a relational database consisting of a single table and
one column that holds each line of the text file?  Nope.  You'd probably
normalize that thing out and make the most use of your technology.

Maybe mapping VistA straight from M - SQL isn't the best approach?  If
it is or isn't, I don't think one organization's implementation of an
EMR sets the pace for comparison.  Epic uses SQL - not all banks use M -
many CRMs use relational system - etc.  Going back to #1 - it's not just
the database's fault.

4) Dropping VistA for the sake of changing technologies.

I have a saying (well, I never actually say it out loud) - change
platforms when your current platform restricts your architecture
options.

If SOA (web services) is something you want and you can't do it in ASM -
then you should check your options.  There are many languages out there
and they're all good at something - but not everything.

Could VistA be re-written in .NET, Java, or Python?  Yes.
Can it be just as successful as VistA-M?  Possible.  Depends on the
interface between the chair and keyboard.

And may I recommend this:

http://www.amazon.com/exec/obidos/tg/detail/-/0596100124/ref=wl_it_dp/00
2-5699553-5527248

Database in Depth
by C.J. Date

Remember: You

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Now that is VERY interesting.  It's going to make the next several months
even more interesting than they were already going to be.  I'm also
interested in the CHCS remarks because I am working with DoD people to get
data flowing back and forth.  However, CHCS II is not permanently shelved.
The colonel/doc I was working with has been transferred to DC to help with
that project.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Saturday, June 11, 2005 10:52 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

Joseph;

   One reason you haven't seen benchmark comparisions between the different
relational databases (Oracle, Sybase, DBase (you pick the release),
Informix), the vendors contractually inhibits their users from publishing
the results.  Why would they do that?  Because they know the outcome.  It
ain't good for them.  The Koreans did publish the results of one benchmark
they did in one of the Last MUG Quarterlies.  The results were astounding.
Same hardware, same load, same task took the relationals 6 hours or more to
complete.  MUMPS took something less than one hour to complete.

   Oracle used to be a true relational database and their performance really
sucked.  They hired Irene Chen from SAIC and the CHCS project.  They learned
some of why MUMPS is faster.  Soon after Oracle became a relational database
that mapped to a heirachical database internally.  This gave them a big
boost in performance and some improvement in scalability.  They just didn't
learn the rest of the lesson, how to make it scalable or learn how to build
effective memory cacheing.

  The result is that MUMPS allows for some very important performance
enhancement that other databases haven't learned yet.  One such enhancement
is that most read requests are satisfied in memory cache and these requests
don't have to go out to disk.  So only about 15% of the reads on a loaded
system actually result in a physical read.   This is a phenomenal increase
in performance.  A MUMPS system will speed up with more people on the system
(to a max determined by the available memory and the CPU performance), but
these limits are much higher numbers of users than Oracle or Sybase could
support on the same hardware.

  The bottom line is that there have been attempts to replace MUMPS systems
in the past and the CHCS project for the DoD has been no exception.  They
have been trying to bring up CHCS II to replace the CHCS I system which was
patterned after DHCP, the direct predicessor to VistA.  After 15 years and
many millions of dollars, CHCS II has finally been withdrawn for the last
time and CHCS I still runs the hospitals.  If Oracle or Sybase, or Informix
could do the job, they would be doing it.  Where are they??

  Want an idea of the complexity of the VistA model?  Look up the Entity
Relationship Diagrams.  Then show one of the nearly 100 pdf files to your
favorite Relational Database Guru and watch him blanch at the numbers of
data elements and relationships represented there.  On CHCS there were over
22,000 different data elements in the data dictionary.  In Northern
California, nearly 500,000 patient records are stored in less than 120
gigabytes of disk space.  It would be interesting to see how much space the
same information would take up in the relational model, then pack a lunch,
cause it will take a good long time to traverse that data as a relational
database.

- Original Message -
From: [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Saturday, June 11, 2005 5:22 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 Yes, it will be interesting to see what can be done with Cache.  We're
 looking into the patient screening issue I mentioned previously, for
 example.

 It's interesting, I never heard of this M/VistA being faster than SQL
 relational until I started reading these messages.  I'm keen to see if
 that's true.  I just got done writing an HL7 data access object to talk to
 the HDR which is Oracle.  (Don't ask why I'm talking HL7 to an Oracle
 database, I'm not sure I know myself.)  I will certainly be looking at the
 speed.

 Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
 in town, I wonder?  Surely there's something between SQL Server and
Oracle?

 And yes, speed is essential.  It's what makes VistAWeb so popular with
 providers, along with its simple interface.  I'm not gonna be happy if the
 HDR slows it down.

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Nancy
 Anthracite
 Sent: Saturday, June 11, 2005 3:00 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

 It seem to me that you do want is an M database that is reengineered for
 VistA
 because of its speed, easier mantainance and reliability and additionally,
 the ability to do

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Well, I tend to shy away from freebies because of the support issues.
Dammit, stop laughing!  I know, I know, like I can get support from
Microsoft.  Still, there's the hope or illusion of support.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Ruben
Safir
Sent: Sunday, June 12, 2005 12:23 AM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
 in town, I wonder?  Surely there's something between SQL Server and
Oracle?
 

You mean aside from Postgres, Mysql and others?

Ruben




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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph Dal Molin]

There is very good commercial support for both Postgres and MySql...they 
just don't advertise on million dollar America Cup racing yachts or F1 
cars :-). Just ask the big trading houses and financial management firms 
on Wall st. they were some of the first commercial adopters of these 
tools. I understand that the VA is actually using MySql along with 
several other SQL databases in the redevelopment of VistAImaging to 
ensure that the solution is database independent.


Joseph

Gillon, Joseph wrote:

Well, I tend to shy away from freebies because of the support issues.
Dammit, stop laughing!  I know, I know, like I can get support from
Microsoft.  Still, there's the hope or illusion of support.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Ruben
Safir
Sent: Sunday, June 12, 2005 12:23 AM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==




Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
in town, I wonder?  Surely there's something between SQL Server and


Oracle?


You mean aside from Postgres, Mysql and others?

Ruben




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.




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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

Getting more and more interesting.  So what's the state of the art these
days in hierarchical/M databases?  Is anyone trying to fix the problems like
them being difficult to query?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 4:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly 10
successive failures where the only criterion was that the solution could not
be MUMPS.  I lived it.  I was there for the first three or four failures.
The four month integration trials out at Tripler where the vendors where on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when the
vendors came to Hawaii).  Their code was supposed to work and it didn't.  In
four months they could generate a patient list in twenty five minutes when
they could go over to the CHCS I terminal and get that same atient list in
30 seconds.  It was embarassing for these guys, but failure is not defeat,
just justification to expend even more government money.  After about two
years this batch of vendors was kicked out and another set was brought in
under a new management vendor.  The result was equally disapointing and even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution.  I
explained to them the reasons why their results were so bad.  It isn't that
the solution has to be all MUMPS, not at all.  Let's think about using these
tools for what they are good at.

  This was not the only task that the engineers helped make the interfaces
work.  There was a management interface where they wanted all of the data
elements from the CHCS I system downloaded to their database (it happened to
be a Relational Database).  The process was tested out at Landstuhl,
Germany, a CHCS site.  They hooked their database engine up to the CHCS
system and CHCS I downloaded to them for 6 and a half days until they ran
out of disk space.  CHCS I still had lots of data to send them.  This was
tried at Walter Reed as well and the add-on system was so slow that CHCS I
was dumping the data to them faster than they could add it into their
database and so it went to tape.  Their system became an off-board
tape-drive.

   Keep in mind that the winning of CHCS I by SAIC was part of a compute-off
run by the military.  The TRIMIS spec was the requirements, (20 years of
specification without implementation).  Four vendors, Baxter-Travenol,
Technicon, Mc Donnel-Douglas, and SAIC doing the VA set-aside (suggested by
Congressman Sonny Montgomery).  Each participant was given $25 million
dollars to provide a solution tot he compute-off.  Baxter and Technicon
spent their money and no-bid the contract.  The contract was written so
there would be a follow-on contractor as part of the process (an 85:15%
split).  OK, so Mac Donnel Douglas run their model and got a 67%
functionality score and their bid was $2.6 Billion to do the military
hospitals around the world.  Not too bad.  SAIC's entry into the compute-off
was the CHCS model derived from the VA DHCP.  Their entry scored 98%
functionality and the bid was $1.01 Billion, 40% of the competing bid with
more functionality.  Mac Donnel Douglas could have had 15% of the contract
by just standing there.  They walked away.  SAIC won 100% of the contract.
These economies of scale are not unusual for MUMPS solutions.  This was the
1986-7 time frame.  CHCS I is still runnning the DoD hospitals.

   I don't mind having MUMPS replaced with something that works as well and
as cheaply, but lets have a level playing field for once.  Let MUMPS compete
head to head with these other technologies and may the best system succeed.
Of course, there are very few absolutes in life, but to throw away a big
hunk of your tools just out of predjudice and politics is just wrong.  One
tool is not going to fit all applications, great.  Lets find out what is
going to be the easiest to support, to expand, and to adapt to the needs of
the tasks ahead.

#1  Projects fail for a lot of reasons, [politics and vendor pressure can be
a couple of reasons.  Non-technical management making technical decisions
and predjudicing the outcome is another reason.]

#2 An effective system is more than the benchmark.  [Hey, true enough, but
the proof is in the puting.  Remember that Legacy also means that the
current system does work and the new system should do at least what the
current system does.  Ain't seen it yet.]

#3 Any project directly ported to another technology will not benefit from
the advances in that new technology

[Directly ported, I could agree with you

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Greg;

  What I was saying is that the type of study you are talking about can
probably never be done because;
1) The study you are asking for costs money, (the money has to come from
somewhere),
2) Vendors won't spend the money because they know the outcome,
3) Legally running such a suite of test puts you at risk for breach of
contract with the vendor's code if you try to publish the outcome..  Others
have done these benchmarks, but they are constrained from publishing the
results by their user contracts.

Perhaps there is a user community out there who will fund such a benchmark
or construct a compute-off competition??

So we are stuck with anecdotal evidence and personal experience and actual
satisfaction of the end customer (after all, isn't this last item what we
are all working towards?).  Let me tell you, if I am on the table of an
Emergency Room, I don't want the excuses I hear complaints about a slow
system.  I want the best decision possible based of the most complete
medical record my doctor can get.  Thus far MUMPS-based systems continue to
perform with up-time, reliability, speed, adaptability, over-all cost, and
just getting the job done.  If a fraction of the money thrown at other
solutions could be spent of new MUMPS development, imagine what could be
done.


- Original Message -
From: Gregory Woodhouse [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Sunday, June 12, 2005 6:04 AM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 I agree. Most vendors don't pay much attention to the existence of
 MUMPS in their marketing literature. But that's a different issue: my
 point was that it's necessary to go beyond anecdotal evidence if you
 want to make rigorous claims about which type of system is faster.
  From a practical point of view, anecdotal evidence (It worked for
 me), may be just fine, but it doesn't really answer the kinds of
 questions a scientific analysis would need to address.

 ===
 Gregory Woodhouse
 [EMAIL PROTECTED]

 The whole of science is nothing more than a refinement
   of everyday thinking.  -- Albert Einstein


 On Jun 11, 2005, at 8:43 PM, Chris Richardson wrote:

  Greg;
 
 I am pointing out that the vendors do not publish such figures
  because
  the outcomes are attocious for comparisions with other technologies
  they
  hope to supress.  The paper was published over 5 years ago and I am
  a bit
  hazy on the specific figures, but those figures and the testing
  constraints
  were published.  These results are correct in the magnetudes, but I
  am a bit
  hazy on the details.  But if someone else might have that article,
  we might
  put it up on hardhats for review.
 
 Also remember that the MUG Quarterly was a user group
  publication and not
  the IEEE.  I think that it is a sad state when the vendors can't put
  together a reasonable set of benchmarks to let the truth be known.
  Also
  remember that Kaiser in Northern California just stopped a ten year
  project
  to install Oracle in favor of another MUMPS solution.  Southern
  California
  Kaiser never changed off of MUMPS technology.   Hard to beat the
  ecconomies
  of scale.
 



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Yes, the proof is in the pudding, regardless of how it was made.  VA
providers are used to a certain responsiveness and if that suffers there'll
be hell to pay.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 10:56 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

Greg;

  What I was saying is that the type of study you are talking about can
probably never be done because;
1) The study you are asking for costs money, (the money has to come from
somewhere),
2) Vendors won't spend the money because they know the outcome,
3) Legally running such a suite of test puts you at risk for breach of
contract with the vendor's code if you try to publish the outcome..  Others
have done these benchmarks, but they are constrained from publishing the
results by their user contracts.

Perhaps there is a user community out there who will fund such a benchmark
or construct a compute-off competition??

So we are stuck with anecdotal evidence and personal experience and actual
satisfaction of the end customer (after all, isn't this last item what we
are all working towards?).  Let me tell you, if I am on the table of an
Emergency Room, I don't want the excuses I hear complaints about a slow
system.  I want the best decision possible based of the most complete
medical record my doctor can get.  Thus far MUMPS-based systems continue to
perform with up-time, reliability, speed, adaptability, over-all cost, and
just getting the job done.  If a fraction of the money thrown at other
solutions could be spent of new MUMPS development, imagine what could be
done.


- Original Message -
From: Gregory Woodhouse [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Sunday, June 12, 2005 6:04 AM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 I agree. Most vendors don't pay much attention to the existence of
 MUMPS in their marketing literature. But that's a different issue: my
 point was that it's necessary to go beyond anecdotal evidence if you
 want to make rigorous claims about which type of system is faster.
  From a practical point of view, anecdotal evidence (It worked for
 me), may be just fine, but it doesn't really answer the kinds of
 questions a scientific analysis would need to address.

 ===
 Gregory Woodhouse
 [EMAIL PROTECTED]

 The whole of science is nothing more than a refinement
   of everyday thinking.  -- Albert Einstein


 On Jun 11, 2005, at 8:43 PM, Chris Richardson wrote:

  Greg;
 
 I am pointing out that the vendors do not publish such figures
  because
  the outcomes are attocious for comparisions with other technologies
  they
  hope to supress.  The paper was published over 5 years ago and I am
  a bit
  hazy on the specific figures, but those figures and the testing
  constraints
  were published.  These results are correct in the magnetudes, but I
  am a bit
  hazy on the details.  But if someone else might have that article,
  we might
  put it up on hardhats for review.
 
 Also remember that the MUG Quarterly was a user group
  publication and not
  the IEEE.  I think that it is a sad state when the vendors can't put
  together a reasonable set of benchmarks to let the truth be known.
  Also
  remember that Kaiser in Northern California just stopped a ten year
  project
  to install Oracle in favor of another MUMPS solution.  Southern
  California
  Kaiser never changed off of MUMPS technology.   Hard to beat the
  ecconomies
  of scale.
 



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Kevin Toppenberg]

Couldn't such a test be done with one of the
opensource relational databases?  No contracts
there...

Kevin


--- Chris Richardson [EMAIL PROTECTED] wrote:

 Greg;
 
   What I was saying is that the type of study you
 are talking about can
 probably never be done because;
 1) The study you are asking for costs money, (the
 money has to come from
 somewhere),
 2) Vendors won't spend the money because they know
 the outcome,
 3) Legally running such a suite of test puts you at
 risk for breach of
 contract with the vendor's code if you try to
 publish the outcome..  Others
 have done these benchmarks, but they are constrained
 from publishing the
 results by their user contracts.
 
 Perhaps there is a user community out there who will
 fund such a benchmark
 or construct a compute-off competition??
 
 So we are stuck with anecdotal evidence and personal
 experience and actual
 satisfaction of the end customer (after all, isn't
 this last item what we
 are all working towards?).  Let me tell you, if I am
 on the table of an
 Emergency Room, I don't want the excuses I hear
 complaints about a slow
 system.  I want the best decision possible based of
 the most complete
 medical record my doctor can get.  Thus far
 MUMPS-based systems continue to
 perform with up-time, reliability, speed,
 adaptability, over-all cost, and
 just getting the job done.  If a fraction of the
 money thrown at other
 solutions could be spent of new MUMPS development,
 imagine what could be
 done.
 
 
 - Original Message -
 From: Gregory Woodhouse
 [EMAIL PROTECTED]
 To: hardhats-members@lists.sourceforge.net
 Sent: Sunday, June 12, 2005 6:04 AM
 Subject: Re: [Hardhats-members] == VistaWeb Missing
 Apps ==
 
 
  I agree. Most vendors don't pay much attention to
 the existence of
  MUMPS in their marketing literature. But that's a
 different issue: my
  point was that it's necessary to go beyond
 anecdotal evidence if you
  want to make rigorous claims about which type of
 system is faster.
   From a practical point of view, anecdotal
 evidence (It worked for
  me), may be just fine, but it doesn't really
 answer the kinds of
  questions a scientific analysis would need to
 address.
 
  ===
  Gregory Woodhouse
  [EMAIL PROTECTED]
 
  The whole of science is nothing more than a
 refinement
of everyday thinking.  -- Albert Einstein
 
 
  On Jun 11, 2005, at 8:43 PM, Chris Richardson
 wrote:
 
   Greg;
  
  I am pointing out that the vendors do not
 publish such figures
   because
   the outcomes are attocious for comparisions with
 other technologies
   they
   hope to supress.  The paper was published over 5
 years ago and I am
   a bit
   hazy on the specific figures, but those figures
 and the testing
   constraints
   were published.  These results are correct in
 the magnetudes, but I
   am a bit
   hazy on the details.  But if someone else might
 have that article,
   we might
   put it up on hardhats for review.
  
  Also remember that the MUG Quarterly was a
 user group
   publication and not
   the IEEE.  I think that it is a sad state when
 the vendors can't put
   together a reasonable set of benchmarks to let
 the truth be known.
   Also
   remember that Kaiser in Northern California just
 stopped a ten year
   project
   to install Oracle in favor of another MUMPS
 solution.  Southern
   California
   Kaiser never changed off of MUMPS technology.  
 Hard to beat the
   ecconomies
   of scale.
  
 
 
 
 

---
  This SF.Net email is sponsored by: NEC IT Guy
 Games.  How far can you
 shotput
  a projector? How fast can you ride your desk chair
 down the office luge
 track?
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 the little guy.
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 http://www.necitguy.com/?r=20
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https://lists.sourceforge.net/lists/listinfo/hardhats-members
 
 
 
 
 
 

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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

It would be interesting to see a well designed study of the  
performance characteristics of GTM (say) and MySQL (but let's be sure  
it isn't an exercise in comparing apples and oranges).


I would expect GTM to fare quite well in such a study. I would also  
expect to see some surprises.


Oh, and by the way M and Fileman are NOT hierarchical.
===
Gregory Woodhouse
[EMAIL PROTECTED]

The most incomprehensible thing about the world is that it
is at all comprehensible. --Albert Einstein (1879-1955)


On Jun 12, 2005, at 9:03 AM, Kevin Toppenberg wrote:


Couldn't such a test be done with one of the
opensource relational databases?  No contracts
there...

Kevin






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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[James Gray]

Perhaps I should wait and read all of the responses before responding, but 
Ruben, I am sure you have missed the point that Richard Davis was making. 
The conflict he refers to is not between IT professionals and the end users, 
but a conflict between two classes of users: managers of the organization 
and employees who provide the services to the customers of the organization.


Jim Gray

- Original Message - 
From: Ruben Safir [EMAIL PROTECTED]

To: hardhats-members@lists.sourceforge.net
Cc: [EMAIL PROTECTED]
Sent: Friday, June 10, 2005 10:49 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


However, I believe the fundamental issue is less a technical matter and 
more

an natural 'tension' between concerns for operational
effectiveness--delivery of quality health care, and the interest in
administrative IT that arises from management.  These two groups in most 
any
enterprise you may choose to study are chronically in a state of 
'conflict'

due their different priorities and requirements for IT, and information
management architecture.




If I may interject

This is a fundemental error that I've seen pertetrated for years now.

There is no conflict between IT and archetectural concerns and usability.
Human usability is simply part of the scientific theory and technology of 
every
other scientific part of computer system design.  As clearly that you 
wouldn't let
a patient perform surgury on themselves, it is equally just as certain 
that
implimentation should never be in the hands of non-computer science 
engineers.


It is simply irresponsible.

There is no tension between the IT professionals and the users.  There is 
just
ignorance of the users to think they know what they need better than the 
Ph.D's and
Masters of Comp Sci, and the bigotry of the IT professionals who refuse to 
learn
anything about human interface design.  Such IT professionals, BTW, are 
almost always
not Comp Sci majors (or those old enough to have gotten in on the ground 
floor prior

to it being wildly available as a schooling option).

I've been a proponent of serious non-bias Comp Sci education in high 
school education and
within the university setting.  Unfortanelty, this is almost as hard as 
getting non-bias
drug information today.  However, it's ridicules for people without an IT 
background to
make serious assertions about product design without a clue about the 
serious implications

to design and implementation.

Tell us what your symptoms are, and we can help you.  Dictate the cure and 
you'll be on the

fast tract to an early and painful grave.

Ruben



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Sun, Jun 12, 2005 at 12:50:31PM -0600, James Gray wrote:
 Perhaps I should wait and read all of the responses before responding, but 
 Ruben, I am sure you have missed the point that Richard Davis was making. 
 The conflict he refers to is not between IT professionals and the end 
 users, but a conflict between two classes of users: managers of the 
 organization and employees who provide the services to the customers of the 
 organization.


I might have miss understand a little, but there is no reason, at least 
technicaly, between these two users either when developing.

I see no reason why they both can not be satisfied.  In fact, they have to be.

Ruben


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Re: [Hardhats-members] == VistaWeb Missing Apps == 1998 Oracle vs M

[JohnLeo Zimmer]

Chris Richardson wrote:

 ... The Koreans did publish the results of one benchmark
 they did in one of the Last MUG Quarterlies.  The results were astounding.
 Same hardware, same load, same task took the relationals 6 hours or more to
 complete.  MUMPS took something less than one hour to complete.
 
I found one M Computing Article (Title Only)
Volume 5, Number 3, August 1997
The Superiority of M-Technology for a Hospital Information System, part
II, Comparison of System Performance between Ingres and Open M

Can't find Part I, but there turns out to be a part III with a very
interesting abstract:

The Superiority of M-Technology for the Hospital Information System:
III. comparison of system performance between Relational Database
Management System and M-Technology (Superiority of M in HIS).

Jeon JH, Kwak YS, Cho H, Kim HS
J Korean Soc Med Inform. 1998 Dec;4(Dec):43-48. Korean.

In 1994, Ajou University Medical Center implemented a hospital
information system with a relational database management system(Ingres)
and underwent migration using newly improved M technology in 1996. In
this paper, a comparison study of database performance between M and
RDBMS is presented.  Three different types of comparative studies were
carried out on the performances of Ingres, Oracle 7.1 (Oracle) and
M-Technology(Mumps). Two types of M are adopted to compare with Ingres:
Standard M and Open M. The open M was used for DBMS and Standard M was
used for writing applications. The system response time was compared by
a simple bulk test in a simulated HIS environment. It was found that the
performance of Open M was about 100 times faster than that of Ingres. In
the live HIS environment, the performance of Open M was found to be 2-8
times faster than Ingres depending on the number of globals involved in
the processing of transactions. The performance of Standard M and
MSM-SQL was compared with that of Oracle by a simple bulk test in a
simulated HIS environment and found that Standard M was more than 100
times faster than Oracle and MSM-SQL was on an average. 1.7 times faster
than Oracle. The M was faster than Ingres and Oracle. Despite the cons
of RDBMS already discussed, we have found very few pros of RDBMS if M is
applied. We have found that conventional RDBMS requires redundant
hardware resources which result in slow processing time which HIS
manifests in a serious bottleneck during the course of our development
and implementation. The performance of M strongly implies that M is most
appropriate DB in a HIS environment.

http://www.koreamed.org/SearchBasic.php?RID=99408DT=1QY=%22J+Korean+Soc+Med++Inform%22+%5BJTI%5D+AND+1998+%5BDPY%5D

(beware the wrapped URL)


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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

Actually you do - I was once at a site that had a large Exchange setup
and something went wrong.  It was hard to believe that Microsoft was on
the phone and put things back to normal within 4 hours (because of our
company's stupid mistake).  Cache, Oracle, MySQL, etc - they all have
support contracts in one form or another.  IBM is a service company  :)

/David.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
Gillon, Joseph
Sent: Sunday, June 12, 2005 10:52 AM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

Well, I tend to shy away from freebies because of the support issues.
Dammit, stop laughing!  I know, I know, like I can get support from
Microsoft.  Still, there's the hope or illusion of support.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Ruben
Safir
Sent: Sunday, June 12, 2005 12:23 AM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only
game
 in town, I wonder?  Surely there's something between SQL Server and
Oracle?
 

You mean aside from Postgres, Mysql and others?

Ruben




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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

I think we agreed on most of it.  It's hard to compare M to SQL or Mac
to Windows (although getting easier now that Macs will be Intel based).

On point #4 (change platforms when your current platform restricts your
architecture options.) is not targeted at the processor architecture
but the application architecture.

Here's a fine example: Interoperability between VistA/M and other
systems.  M, Cobol, Fortran - these are considered legacy and most
college students know them simply as mainframes.  Microsoft, Sun, IBM,
Oracle (etc) currently provide Web Services and the SOA model to
communicate between systems.

Web Services != Broker RPC.  New vendors that have an application to
offer on the VistA desktop have a high cost of entry into that desktop
for many reasons, and number 1 is accessing the M system.

I'm not against VistA/M for use in hospital systems.  I honestly believe
it's a great system and I think re-hosting is a waste of resources
unless you attack the project as something to start over.  I mean, why
start over if you do the exact same thing?  Utilize OOP, SOA, re-usable
code, interfaces, etc.

I just saw an email that says the new system works with MySQL.  That's
utterly stupid.  Not because it's MySQL (I have it running right now),
it's because MS SQL Server and Oracle allow parameterized store
procedures.  NOT using stored procs in an enterprise system is utterly
crazy.  Of course your return is slow, you're using interpreted ad-hoc
query text and the system can't optimize the query against the data set.

Will the new system be worse than VistA/M?  Sounds like it...  but not
because it's simply relational.

/David.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 4:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly
10
successive failures where the only criterion was that the solution could
not
be MUMPS.  I lived it.  I was there for the first three or four
failures.
The four month integration trials out at Tripler where the vendors where
on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when
the
vendors came to Hawaii).  Their code was supposed to work and it didn't.
In
four months they could generate a patient list in twenty five minutes
when
they could go over to the CHCS I terminal and get that same atient list
in
30 seconds.  It was embarassing for these guys, but failure is not
defeat,
just justification to expend even more government money.  After about
two
years this batch of vendors was kicked out and another set was brought
in
under a new management vendor.  The result was equally disapointing and
even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away
from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy Solution.  I
explained to them the reasons why their results were so bad.  It isn't
that
the solution has to be all MUMPS, not at all.  Let's think about using
these
tools for what they are good at.

  This was not the only task that the engineers helped make the
interfaces
work.  There was a management interface where they wanted all of the
data
elements from the CHCS I system downloaded to their database (it
happened to
be a Relational Database).  The process was tested out at Landstuhl,
Germany, a CHCS site.  They hooked their database engine up to the CHCS
system and CHCS I downloaded to them for 6 and a half days until they
ran
out of disk space.  CHCS I still had lots of data to send them.  This
was
tried at Walter Reed as well and the add-on system was so slow that CHCS
I
was dumping the data to them faster than they could add it into their
database and so it went to tape.  Their system became an off-board
tape-drive.

   Keep in mind that the winning of CHCS I by SAIC was part of a
compute-off
run by the military.  The TRIMIS spec was the requirements, (20 years of
specification without implementation).  Four vendors, Baxter-Travenol,
Technicon, Mc Donnel-Douglas, and SAIC doing the VA set-aside (suggested
by
Congressman Sonny Montgomery).  Each participant was given $25 million
dollars to provide a solution tot he compute-off.  Baxter and Technicon
spent their money and no-bid the contract.  The contract was written so
there would be a follow-on contractor as part of the process (an 85:15%
split).  OK, so Mac Donnel Douglas run their model and got a 67%
functionality score and their bid was $2.6 Billion to do the military
hospitals around the world.  Not too bad.  SAIC's entry into the
compute-off
was the CHCS model derived from the VA DHCP.  Their entry scored 98%
functionality and the bid was $1.01 Billion, 40

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

I guess it depends on the application that you're implementing.

Microsoft, IBM, and Oracle all have implementations of the IBuySpy
portal.  The fictional web site allows users to purchase products, use a
shopping cart, update a profile, etc.  Each implemented the same
functional requirements but implemented it in their own technology.
It's a very good comparison model and there's a lot to learn from the
process of comparison.  How some vendors/technologies provide best
practices, etc.

If you could pick a fair application model to build on each platform,
then a comparison could take place.  But there's one small problem.  MS
SQL Server, MySQL, and Oracle make up the back-end.  Each requires
something in front of it to interface with the user.

Do you compare the designed function or pure benchmarking?  What's
important, filling a Global/Table with 100,000 bits of data and sorting
it?  Or pulling up a 200 page catalog of products for 1,000 users?  One
seems more practical than the other.

/David.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
Gregory Woodhouse
Sent: Sunday, June 12, 2005 12:46 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

It would be interesting to see a well designed study of the  
performance characteristics of GTM (say) and MySQL (but let's be sure  
it isn't an exercise in comparing apples and oranges).

I would expect GTM to fare quite well in such a study. I would also  
expect to see some surprises.

Oh, and by the way M and Fileman are NOT hierarchical.
===
Gregory Woodhouse
[EMAIL PROTECTED]

The most incomprehensible thing about the world is that it
is at all comprehensible. --Albert Einstein (1879-1955)


On Jun 12, 2005, at 9:03 AM, Kevin Toppenberg wrote:

 Couldn't such a test be done with one of the
 opensource relational databases?  No contracts
 there...

 Kevin





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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 Well, I tend to shy away from freebies because of the support issues.

This has no place in a serious discussion of issues.  Support?  From
Microsoft?  When Seimans know they have have you by the gonads and
you've signed an exclusive contract with them for a healthcare system,
when do you expect to get support.

In fact, all the companies and moving to the Free Software model of
support (as opposed to the no support they used to have) which is an
open technological discussion group with their engineers and advanced
users.

But why would I want to spend my time and energy becoming an expert in a
closed single sourced products with no guarantees, when you just know in
a year or two down the road, the whole thing will be a complete waste
when big Monopoly Company: Insert your favorite one here like Sun will
intentionally obstruct development and support within a few short months
in order to push their next wonderful slaveware solution of the week.

I can write a ***books*** on Foxpro 2.5, Paradox, Borland Pascal, a
dozen other useless dead end technologies.  I'm getting too old and have
no more time to waste learning any product which won't cooperate by
giving me full possession of the code base.  Support be damn.  When I
was in the army, I learned that support was one soldier with a loaded
M16.  Your the first and last line of defense for support.  You must
understand what your working with, and you must be prepared to roll up
your sleeves in order to get the job done when things go wrong.  Every
Eula I've read says in plain English,  Company XYZ is not responsible
for the results of using their software  

If your big enough and sitting near a seat of government power, you can
often squeeze more, but that is not going to help the thousands health
care facilities which which are our target audiences, nor will it help
us in development of a sane product,

Ruben  






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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 Do you compare the designed function or pure benchmarking?  What's
 important, filling a Global/Table with 100,000 bits of data and sorting
 it?  Or pulling up a 200 page catalog of products for 1,000 users?  One
 seems more practical than the other.
 

David

Hello :)

this is a mistake.  They are not either or, they are both. You must be
able to store 100,000 bites of data (which is nothing BTW) in order to
work with a 1000 users.

In fact, this is a bad analogy anyway.  I do that on my TSR80 and it's
pik chip ;)

Do you realize that the common cheap $300 PC can do over 2,000,000,000
calculations per second.  That is a lot of patient information when one
stops swallowing marketing clap trap and focuses on the scientific
facts.


Ruben




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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[GARY MONGER]

If you look at Cache and some of the 3rd party tools supporting objects and
SQL, I think you'll find as many ways to query a MUMPS database as you could
want.  The difficulty you describe in getting at some VistA data has more to
do with design than the technology.
Old systems on any platform have a tendency to look like VistA.  Part of
that is just the nature of adapting to a changing environment and affects
all systems that that grow.  Part of that is that we've learned a few things
about building systems in the past 20 years.  And part is that some poor
design and implementation choices were made.  When schedule is dictated by
Congress or the President, sometimes quality is compromised.

There are many jobs out there where the primary task is building SQL queries
to run reports.  The tools to support this get better and better, but there
are still lots of people required to do this work.  Without nitpicking the
details of which is easier or faster, I don't see a big difference between
such a person doing that work, and a MUMPS programmer writing a custom
report.  SQL may shine for a simple query, but you let the relationships get
a little more sophisticated and the SQL statement will need to be as well.
A lot of real world problems result in complex solutions, with complex data
representations, relational or otherwise.  It sometimes takes a skilled,
experienced person to get what is needed from the data.

I would counter your example of the patient screen with the power of the new
Clinical Reminders indexes.  Some very complex queries are available and
lightning fast.  Of course indexes can be implemented in relational systems
too, and that brings us back to the importance of good system design and
implementation.


As far as benchmarks, a search of the Intersystems site for benchmark
yields 35 hits.  If anybody has benchmarks, it would be them.  Of course I
would not anticipate lots white papers about when Cache is slower than
Oracle.

The MUMPS abstraction, sans indexes is essentially an inverted index.  That
is one heck of a place to start.  You also start with a sparse array, so for
many real world situations, you automatically get more out of every disk hit
and more in every memory page.  Its no surprise MUMPS is fast.

I think as a general rule, if the solution lends itself to the relational
model, relational systems will work well.  For problems that don't lend
themselves to relational implementation, a transformation is necessary to
use a relational store.  A further transformation is necessary because the
physical storage is also radically not relational.  With MUMPS the three
things are much closer in nature.  They all look like trees.  Of course,
Fileman negates much of that advantage by flattening the forest.

Speed ain't what it used to be though.  Hardware is cheap and programmers
aren't.  I'd like to see World VistA looking at how VistA can take advantage
of the power of Cache, ESI Objects, M2Web, etc.  How can we hang on to the
old, stay in synch with current VA development, and make the most of the new
tools available?


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
[EMAIL PROTECTED]
Sent: Sunday, June 12, 2005 11:01 AM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

Getting more and more interesting.  So what's the state of the art these
days in hierarchical/M databases?  Is anyone trying to fix the problems like
them being difficult to query?

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Chris
Richardson
Sent: Sunday, June 12, 2005 4:11 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

David;

  The failure of CHCS II was not just one failure but a series of nearly 10
successive failures where the only criterion was that the solution could not
be MUMPS.  I lived it.  I was there for the first three or four failures.
The four month integration trials out at Tripler where the vendors where on
site living DLL hell on a daily basis.  In four months of integration
testing (this was supposed to work the first time out of the bag when the
vendors came to Hawaii).  Their code was supposed to work and it didn't.  In
four months they could generate a patient list in twenty five minutes when
they could go over to the CHCS I terminal and get that same atient list in
30 seconds.  It was embarassing for these guys, but failure is not defeat,
just justification to expend even more government money.  After about two
years this batch of vendors was kicked out and another set was brought in
under a new management vendor.  The result was equally disapointing and even
more government money sunk down the hole.

  I was brought in to help the vendors figure out how to migrate away from
MUMPS and VistA.  I was happy to have some real world comparison of the
capabilities of this New technology with the Legacy

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 Here's a fine example: Interoperability between VistA/M and other
 systems. 

There is never any reason to have an interoperability problem other than
when a company decides it is in their best interests to obscure
something.  The most basic principle of Computer Sciences, as proven by
the Turing Machine, is that ALL COMPUTER SYSTEMS are equivalent. 

  M, Cobol, Fortran - these are considered legacy and most
 college students know them simply as mainframes. 

But they are not mainframes, they are programming languages which have
compilers which product bitcode that is understood by a specific CPU.

  Microsoft, Sun, IBM,
 Oracle (etc) currently provide Web Services

Um, no.  Web Services is meaningless.  They use the httpd protocols to
move information, hopefully with security, through the Internet via
TCP/IP.  Companies do not provide this.  IBM uses mostly the Apache Web
Server, as does Sun.  Oracle, I'm not sure what httpd server they are
using.
 
  and the SOA model to
 communicate between systems.

SOA is just a marketing term for a watered down SGML document model for
communication between systems.  It's no different than what has been
happening since the days before Gophernet, and HTML.  This is not any
new ground.  BTW, XML can be very inefficient although it can be
useful.  Remember when WAP was all the crazy.  Open Office uses xml
based word processing documents and Sordopi uses XML for it's vector
based graphics.  And PS is just an older based system as well which is
theoretically the same thing.

You do not want your databases, whose main job is for the security and
validation  of information, to run on some XML system.  They'd never be
secure or get anything done.  The place for this is strictly in
middleware, SOAP etc.

 
 Web Services != Broker RPC.  New vendors that have an application to
 offer on the VistA desktop have a high cost of entry into that desktop
 for many reasons, and number 1 is accessing the M system.
 

Just build the middleware and put the published standard out.  LEt any
vendor who wants to build the client side interpreter.  There is no
reason for anyone to be locked into anything just because your trying to
communicate with the database.


 I just saw an email that says the new system works with MySQL.  That's
 utterly stupid.  Not because it's MySQL (I have it running right now),
 it's because MS SQL Server and Oracle allow parameterized store
 procedures.  

And that locks everything into a proprietary code base, which you
CERTAINLY can't give ***any*** guarantee is going to still exist by the
end of the decade.

And BTW, MYSQL has UDM modules which are exactly what stored procedures
are, except more powerful and faster.  In fact, I had dinner with Monty
and we were talking about this just about 3 months ago because I was
writing another application to leverage this.


 
 NOT using stored procs in an enterprise system is utterly
 crazy.  

Prove that please with unbiased research.  The thing seems to work just
fine for Google.

And for what it is worth, nobody has better support than Monty.  Monty
has reached right into my machines and fixed problems on the spot from
across the world.

Ruben



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

SQL may shine for a simple query, but you let the relationships get
a little more sophisticated and the SQL statement will need to be as
well. A lot of real world problems result in complex solutions, with
complex data representations, relational or otherwise.  It sometimes
takes a skilled, experienced person to get what is needed from the
data.



All my friends on Wall Street handle this problem everyday and they do
it with supposedly slow and awkward tools - SQL, Perl, Sybase and MYSQL,
Oracle.

And nobody is churning out more information, and faster than they are. 
There is a reason why we keep hitting ourselves with SQL.  Because it
just works.  If your DBA's and your programmers are brain dead, then
Garbage in; Garbage out  We're all familiar with the expression, When
your a hammer, everything looks like a nail

shoulder shrug 



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[GARY MONGER]

Your friends on Wall Street employ quite a few programmers, which they keep
very busy, some even with M.  SQL does not mean you get your data any easier
or faster, or that you have less need of professional programmers.

If you are using a conventional RDBMS, realistically what is your
alternative to SQL?  I guess there are some object tools now, but
historically that toolbox only holds hammers.


-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Ruben
Safir
Sent: Sunday, June 12, 2005 6:12 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

SQL may shine for a simple query, but you let the relationships get
a little more sophisticated and the SQL statement will need to be as
well. A lot of real world problems result in complex solutions, with
complex data representations, relational or otherwise.  It sometimes
takes a skilled, experienced person to get what is needed from the
data.



All my friends on Wall Street handle this problem everyday and they do
it with supposedly slow and awkward tools - SQL, Perl, Sybase and MYSQL,
Oracle.

And nobody is churning out more information, and faster than they are. 
There is a reason why we keep hitting ourselves with SQL.  Because it
just works.  If your DBA's and your programmers are brain dead, then
Garbage in; Garbage out  We're all familiar with the expression, When
your a hammer, everything looks like a nail

shoulder shrug 



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

On Sun, Jun 12, 2005 at 07:15:38PM -0400, GARY MONGER wrote:
 Your friends on Wall Street employ quite a few programmers, which they keep
 very busy, some even with M.  SQL does not mean you get your data any easier
 or faster,
   
That is not the purpsoe of a database.  A database needs to store, preserve and
validate data.

   or that you have less need of professional programmers.
 
 If you are using a conventional RDBMS, realistically what is your
 alternative to SQL?  

:)

Every database has a built in API which is faster. It's just not universal and
usually needs compulation.

SQL is just better because it is desinged on sould database theory and honed
by 3 decades of real world expereince.

 I guess there are some object tools now, but
 historically that toolbox only holds hammers.

Definetely not.  In fact, when I programmered Oracle apps I used no SQL.

Ruben

-- 
__
Brooklyn Linux Solutions

So many immigrant groups have swept through our town 
that Brooklyn, like Atlantis, reaches mythological 
proportions in the mind of the world  - RI Safir 1998

DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://fairuse.nylxs.com

Yeah - I write Free Software...so SUE ME

http://www.mrbrklyn.com - Consulting
http://www.inns.net -- Happy Clients
http://www.nylxs.com - Leadership Development in Free Software
http://www2.mrbrklyn.com/resources - Unpublished Archive or stories and 
articles from around the net
http://www2.mrbrklyn.com/downtown.html - See the New Downtown Brooklyn



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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Ruben;

  I have to mention at this point that the British Stock Exchange is
actually being run on MUMPS.  Earlier someone said that not all banks run
MUMPS.  This is a correct statement, but they can also spend a lot more
money for less service than if they were using MUMPS technology.  Back in
1977, when I worked for Shared Medical Systems out of King of Prussia, PA,
we had an average of 15 minutes from report of a database or application
problem to its successful resolution on the M systems at remote sites.  On
our Cobol systems, 3 day turnaround was the norm.   Obviously the
traditional support has gotten better, but it would be interesting to see
what the up-times are like as well as the mean times to repair.  A database
which is not available does not help care for patients.

As for the purpose of a database is not just to storage, preserve, and
validate data.  A database also needs to be able to preserve the
relationships of data to other data, and to explolit those relationships to
gain insight into the meaning of that data.  Often those insights are not
originally built into the design of the data structures.  The database needs
to allows for the ad hoc representation to extract that meaning.

   Best wishes;   Chris

- Original Message -
From: Ruben Safir [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Sunday, June 12, 2005 4:26 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 On Sun, Jun 12, 2005 at 07:15:38PM -0400, GARY MONGER wrote:
  Your friends on Wall Street employ quite a few programmers, which they
keep
  very busy, some even with M.  SQL does not mean you get your data any
easier
  or faster,

 That is not the purpsoe of a database.  A database needs to store,
preserve and
 validate data.

  or that you have less need of professional programmers.
 
  If you are using a conventional RDBMS, realistically what is your
  alternative to SQL?

 :)

 Every database has a built in API which is faster. It's just not universal
and
 usually needs compulation.

 SQL is just better because it is desinged on sould database theory and
honed
 by 3 decades of real world expereince.

  I guess there are some object tools now, but
  historically that toolbox only holds hammers.

 Definetely not.  In fact, when I programmered Oracle apps I used no SQL.

 Ruben
 __
 Brooklyn Linux Solutions

 So many immigrant groups have swept through our town
 that Brooklyn, like Atlantis, reaches mythological
 proportions in the mind of the world  - RI Safir 1998

 DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
 http://fairuse.nylxs.com

 Yeah - I write Free Software...so SUE ME

 http://www.mrbrklyn.com - Consulting
 http://www.inns.net -- Happy Clients
 http://www.nylxs.com - Leadership Development in Free Software
 http://www2.mrbrklyn.com/resources - Unpublished Archive or stories and
articles from around the net
 http://www2.mrbrklyn.com/downtown.html - See the New Downtown Brooklyn






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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

I was initially surprised to learn that MUMPS was being used for  
financial/banking applications, but when you think about it, it makes  
sense. The patterns of use and data organization have a lot in common  
with health information systems.


===
Gregory Woodhouse
[EMAIL PROTECTED]

And the end of all our exploring
will be to arrive where we started
And know the place for the first time -- T.S. Eliot



On Jun 12, 2005, at 6:54 PM, Chris Richardson wrote:


Ruben;

  I have to mention at this point that the British Stock Exchange is
actually being run on MUMPS.  Earlier someone said that not all  
banks run
MUMPS.  This is a correct statement, but they can also spend a lot  
more
money for less service than if they were using MUMPS technology.   
Back in
1977, when I worked for Shared Medical Systems out of King of  
Prussia, PA,
we had an average of 15 minutes from report of a database or  
application
problem to its successful resolution on the M systems at remote  
sites.  On

our Cobol systems, 3 day turnaround was the norm.   Obviously the
traditional support has gotten better, but it would be interesting  
to see
what the up-times are like as well as the mean times to repair.  A  
database

which is not available does not help care for patients.

As for the purpose of a database is not just to storage, preserve, and
validate data.  A database also needs to be able to preserve the
relationships of data to other data, and to explolit those  
relationships to
gain insight into the meaning of that data.  Often those insights  
are not
originally built into the design of the data structures.  The  
database needs

to allows for the ad hoc representation to extract that meaning.

   Best wishes;   Chris





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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Greg;
   How do you think Fidelity (Sanchez and GT.m) makes their money?

- Original Message -
From: Gregory Woodhouse [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Sunday, June 12, 2005 7:30 PM
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==


 I was initially surprised to learn that MUMPS was being used for
 financial/banking applications, but when you think about it, it makes
 sense. The patterns of use and data organization have a lot in common
 with health information systems.

 ===
 Gregory Woodhouse
 [EMAIL PROTECTED]

 And the end of all our exploring
 will be to arrive where we started
 And know the place for the first time -- T.S. Eliot



 On Jun 12, 2005, at 6:54 PM, Chris Richardson wrote:

  Ruben;
 
I have to mention at this point that the British Stock Exchange is
  actually being run on MUMPS.  Earlier someone said that not all
  banks run
  MUMPS.  This is a correct statement, but they can also spend a lot
  more
  money for less service than if they were using MUMPS technology.
  Back in
  1977, when I worked for Shared Medical Systems out of King of
  Prussia, PA,
  we had an average of 15 minutes from report of a database or
  application
  problem to its successful resolution on the M systems at remote
  sites.  On
  our Cobol systems, 3 day turnaround was the norm.   Obviously the
  traditional support has gotten better, but it would be interesting
  to see
  what the up-times are like as well as the mean times to repair.  A
  database
  which is not available does not help care for patients.
 
  As for the purpose of a database is not just to storage, preserve, and
  validate data.  A database also needs to be able to preserve the
  relationships of data to other data, and to explolit those
  relationships to
  gain insight into the meaning of that data.  Often those insights
  are not
  originally built into the design of the data structures.  The
  database needs
  to allows for the ad hoc representation to extract that meaning.
 
 Best wishes;   Chris
 



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Listen, I'm not sure what this says, but I somehow feel the need to make it
clear I have nothing but respect for VistA and its developers.  It was
great, in fact, still is, but the old gray mare ain't what she used to be
and is aging by the day.  All systems that are worth a damn someday reach
obsolescence.  Which ain't to say VistA's going away any time soon.  It's
not hard to imagine a few years from now when several non-VA systems will be
using it and the VA won't be.  But the stuff the VA produces to replace it
will be public domain too...

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Richard
G. DAVIS
Sent: Saturday, June 11, 2005 12:18 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

I understand the dichotomy Gregory mentions, and I agree with the views he
has expressed.

However, I believe the fundamental issue is less a technical matter and more
an natural 'tension' between concerns for operational
effectiveness--delivery of quality health care, and the interest in
administrative IT that arises from management.  These two groups in most any
enterprise you may choose to study are chronically in a state of 'conflict'
due their different priorities and requirements for IT, and information
management architecture.

Where these competing forces arrive at a state of least tension, you usually
find that the two groups have separated their IT, both software and hardware
into two largely independent systems.

For those who have been in university/college settings, you may remember
that those institutions tend to have academic computer centers and
associated resources under the governance of some faculty body, and separate
administrative computer systems used to run the university controlled the
the 'CEO' of the institution.

DHCP has also been chronically plagued with an interesting form of this
problem, that waxes and wanes over time.

At present within the VA we see the administrative folks throwing their
territorial imperatives around and not giving due consideration to the
operational requirements of the enterprise.  These 'conflicts' are often
deflected into debates about hardware issues, and software system issues,
all of which are usually not at all relevant to the bed-rock forces at work
here.  The person who says MUMPS is a dead language, get rid of VistA
simply doesn¹t understand the problem.  It is easier to indict a technology
that can't defend itself, that to tackle the real core problem(s).

Thus, the matter is not really about decentralized or centralized IT
resources.  It is all about meeting the needs of health care delivery staff
and at the same time satisfying the needs of management.

I am frequently convinced that the best outcomes are achieved with
organizational structures, and IT systems that permit two relatively
independent systems to coexist, one optimized for health care delivery, and
one optimized for organizational administration.  (The obvious need for
effective interaction between these two systems is a subordinate or
collateral matter to the core issue.)

At the outset, DHCP was essentially free of intrusion of administrative
demands.  We built what seemed best for patient care.  Only as Congress has
insisted that the DVA generate some revenue to supplement appropriated funds
has the 'administrative' fist come down in a heavy handed way on top of the
health care interests.  (Yes, there are other forces in play here as well.)
This trend has promoted increased 'tension' between the operational and
administrative sides of the house.

The process needs to be focused on the organizational behavior issues where
the natural conflicts between the two sides of the house can be resolved
appropriately.  These processes are not technology based or driven.
Instead, they are very much about organization and management.  (It is in
the spirit of the best of breed bureaucrats who prefer diffusion of
responsibility and scape-goating of technology that we so often see the cry
to throw out the 'old' stuff.)

Clearly, the VAH health care delivery process is mission critical and
focused on the patient.  The IT system need there is for a highly
'decentralized' framework that is centered on the patient/caregiver
partnership.

On the other hand, the DVA administration process must be able to
effectively manage the resources of the DVA to maintain its two main lines
of business--entitlements and sick veterans.  That requires a highly
'centralized' IT framework that is centered on the problem of enterprise
management.

Whether these two groups are served by a single monolithic hardware system
buried in a Colorado mountain, or by two slightly smaller computer systems
situated at opposite ends of the Continental US, or by a massive number of
desktop computers is really not too important once the balance between these
two competing groups has been achieved.  After that, all us 'techno-nerds'
can go off

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Nancy Anthracite]

It seem to me that you do want is an M database that is reengineered for VistA 
because of its speed, easier mantainance and reliability and additionally, 
the ability to do SQL queries on that database.  Seems like Cache delivers 
that and with the right additional software, GT.M can do that as well.  

The Intersystems folks knew what they were doing when they bought up all of 
those flavors of M.  The Epic folks know what they are doing as well.  

Relational databases are slower and that has long been recognized, and they 
require a lot more work to maintain and design.  Oracle is probably the 
gorilla in that field and is very expensive and slow.  Yea, maybe you get 
some pretty reports from it, but not likely in real time.  

Tell all of the busy healh care worker why they have to wait when they should 
be taking care of patients so that you can get reports easily.  The patients 
and those who care for them are not likely to be very understanding.  

On Saturday 11 June 2005 01:39 pm, Gillon, Joseph wrote:
 Listen, I'm not sure what this says, but I somehow feel the need to make it
 clear I have nothing but respect for VistA and its developers.  It was
 great, in fact, still is, but the old gray mare ain't what she used to be
 and is aging by the day.  All systems that are worth a damn someday reach
 obsolescence.  Which ain't to say VistA's going away any time soon.  It's
 not hard to imagine a few years from now when several non-VA systems will
 be using it and the VA won't be.  But the stuff the VA produces to replace
 it will be public domain too...

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Richard
 G. DAVIS
 Sent: Saturday, June 11, 2005 12:18 AM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

 I understand the dichotomy Gregory mentions, and I agree with the views
 he has expressed.

 However, I believe the fundamental issue is less a technical matter and
 more an natural 'tension' between concerns for operational
 effectiveness--delivery of quality health care, and the interest in
 administrative IT that arises from management.  These two groups in most
 any enterprise you may choose to study are chronically in a state of
 'conflict' due their different priorities and requirements for IT, and
 information management architecture.

 Where these competing forces arrive at a state of least tension, you
 usually find that the two groups have separated their IT, both software and
 hardware into two largely independent systems.

 For those who have been in university/college settings, you may remember
 that those institutions tend to have academic computer centers and
 associated resources under the governance of some faculty body, and
 separate administrative computer systems used to run the university
 controlled the the 'CEO' of the institution.

 DHCP has also been chronically plagued with an interesting form of this
 problem, that waxes and wanes over time.

 At present within the VA we see the administrative folks throwing their
 territorial imperatives around and not giving due consideration to the
 operational requirements of the enterprise.  These 'conflicts' are often
 deflected into debates about hardware issues, and software system issues,
 all of which are usually not at all relevant to the bed-rock forces at work
 here.  The person who says MUMPS is a dead language, get rid of VistA
 simply doesn¹t understand the problem.  It is easier to indict a technology
 that can't defend itself, that to tackle the real core problem(s).

 Thus, the matter is not really about decentralized or centralized IT
 resources.  It is all about meeting the needs of health care delivery staff
 and at the same time satisfying the needs of management.

 I am frequently convinced that the best outcomes are achieved with
 organizational structures, and IT systems that permit two relatively
 independent systems to coexist, one optimized for health care delivery, and
 one optimized for organizational administration.  (The obvious need for
 effective interaction between these two systems is a subordinate or
 collateral matter to the core issue.)

 At the outset, DHCP was essentially free of intrusion of administrative
 demands.  We built what seemed best for patient care.  Only as Congress has
 insisted that the DVA generate some revenue to supplement appropriated
 funds has the 'administrative' fist come down in a heavy handed way on top
 of the health care interests.  (Yes, there are other forces in play here as
 well.) This trend has promoted increased 'tension' between the operational
 and administrative sides of the house.

 The process needs to be focused on the organizational behavior issues where
 the natural conflicts between the two sides of the house can be resolved
 appropriately.  These processes are not technology based or driven.
 Instead, they are very much about organization and management

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

Actually, I think VistA's growing pains (or death throes, depending  
on your point of view), really has much less to do with the  
underlying language and DBMS than many suppose. The trouble is that  
it is such an obvious difference between VistA and some other systems  
that we tend to focus on it far too much, thinking this is where we  
can find the reason for its success or failure.


===
Gregory Woodhouse
[EMAIL PROTECTED]

Before one gets the right answer, one must ask the right question.  
-- S. Barry Cooper



On Jun 11, 2005, at 12:00 PM, Nancy Anthracite wrote:

It seem to me that you do want is an M database that is  
reengineered for VistA
because of its speed, easier mantainance and reliability and  
additionally,
the ability to do SQL queries on that database.  Seems like Cache  
delivers

that and with the right additional software, GT.M can do that as well.

The Intersystems folks knew what they were doing when they bought  
up all of

those flavors of M.  The Epic folks know what they are doing as well.

Relational databases are slower and that has long been recognized,  
and they
require a lot more work to maintain and design.  Oracle is probably  
the
gorilla in that field and is very expensive and slow.  Yea, maybe  
you get

some pretty reports from it, but not likely in real time.

Tell all of the busy healh care worker why they have to wait when  
they should
be taking care of patients so that you can get reports easily.  The  
patients

and those who care for them are not likely to be very understanding.





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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

I'm just on my way out the door right now, but while I think the relational model sometimes gets a raw deal around here, I also agree that it is not the be and end all of database technology. If you try and sit down and work through the mathematics, you'll quickly find that object models have their problem (not insurmountable, IMO), too. I do think we're seeing the beginnings of a paradigm shift (and only recently forwarded the message from ACM Queue on "post-relational" technology). UML is maturing, metadata is really picking up steam, and I believe ODMG is a much more solid specification than Date and others give it credit for. On a theoretical level, there are a lot of areas of work (such as ontologies and computational applications of modal logic) that I believe are very promising. At the time of Dr. Codd's seminal work, many of these ideas were only beginning to take shape. ===Gregory Woodhouse[EMAIL PROTECTED]"Perfection is achieved, not when there is nothing moreto add, but when there is nothing left to take away."-- Antoine de Saint-Exupery On Jun 11, 2005, at 1:48 PM, GARY MONGER wrote:From my perspective relational SQL databases have served well in a one size fits all sort of way, but they are hardly the summit of 21st century system design. I dont hold that 21st century necessarily holds a better solution either. Ive seen some very well done raw MUMPS systems, even some with SQL mappings for those that like verbose queries. SQL mapping of VistA data has been available for some time. The HDR historical project will result in a SQL mapping of the bulk of VistA clinical data.A database, well designed and implemented, be it SQL, Fileman, MUMPS, filing cabinet, shoebox, or whatever can solve some problems well, others not so well. No matter what the technology, no matter what the architecture, no matter what the design, any system that replaces VistA will have significant shortcomings. The task is so massive, and so varied that no choice will serve every aspect well. The real issue at hand is how to get it implemented well. I think the VHA has and will continue to struggle with this. Its a tough problem, especially for a government agency.Managing implementation is also a tough problem for World VistA. I can see that there is some good work going on, but Im curious about how major efforts will be handled. This data standardization issue is not an easy one to solve, its the nature of the clinical world. Will that be tackled by World VistA? What about name and number spaces? How about mods to Kernel, HL7, and Broker? I buy the open source model for development, at least theoretically, but were not talking about a Linux Kernel here. In addition to the scale, VistA has very real ties to VHA development, which is likely to continue for quite some time, and now there is VistA-Office as well.As for shooting VistA in the head ASAP, maybe we should get the new horse saddled up before shooting the one were riding.

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

Yes, it will be interesting to see what can be done with Cache.  We're
looking into the patient screening issue I mentioned previously, for
example.

It's interesting, I never heard of this M/VistA being faster than SQL
relational until I started reading these messages.  I'm keen to see if
that's true.  I just got done writing an HL7 data access object to talk to
the HDR which is Oracle.  (Don't ask why I'm talking HL7 to an Oracle
database, I'm not sure I know myself.)  I will certainly be looking at the
speed.

Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
in town, I wonder?  Surely there's something between SQL Server and Oracle?

And yes, speed is essential.  It's what makes VistAWeb so popular with
providers, along with its simple interface.  I'm not gonna be happy if the
HDR slows it down.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Nancy
Anthracite
Sent: Saturday, June 11, 2005 3:00 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

It seem to me that you do want is an M database that is reengineered for
VistA 
because of its speed, easier mantainance and reliability and additionally, 
the ability to do SQL queries on that database.  Seems like Cache delivers 
that and with the right additional software, GT.M can do that as well.  

The Intersystems folks knew what they were doing when they bought up all of 
those flavors of M.  The Epic folks know what they are doing as well.  

Relational databases are slower and that has long been recognized, and they 
require a lot more work to maintain and design.  Oracle is probably the 
gorilla in that field and is very expensive and slow.  Yea, maybe you get 
some pretty reports from it, but not likely in real time.  

Tell all of the busy healh care worker why they have to wait when they
should 
be taking care of patients so that you can get reports easily.  The patients

and those who care for them are not likely to be very understanding.  

On Saturday 11 June 2005 01:39 pm, Gillon, Joseph wrote:
 Listen, I'm not sure what this says, but I somehow feel the need to make
it
 clear I have nothing but respect for VistA and its developers.  It was
 great, in fact, still is, but the old gray mare ain't what she used to be
 and is aging by the day.  All systems that are worth a damn someday reach
 obsolescence.  Which ain't to say VistA's going away any time soon.  It's
 not hard to imagine a few years from now when several non-VA systems will
 be using it and the VA won't be.  But the stuff the VA produces to replace
 it will be public domain too...

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Richard
 G. DAVIS
 Sent: Saturday, June 11, 2005 12:18 AM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

 I understand the dichotomy Gregory mentions, and I agree with the views
 he has expressed.

 However, I believe the fundamental issue is less a technical matter and
 more an natural 'tension' between concerns for operational
 effectiveness--delivery of quality health care, and the interest in
 administrative IT that arises from management.  These two groups in most
 any enterprise you may choose to study are chronically in a state of
 'conflict' due their different priorities and requirements for IT, and
 information management architecture.

 Where these competing forces arrive at a state of least tension, you
 usually find that the two groups have separated their IT, both software
and
 hardware into two largely independent systems.

 For those who have been in university/college settings, you may remember
 that those institutions tend to have academic computer centers and
 associated resources under the governance of some faculty body, and
 separate administrative computer systems used to run the university
 controlled the the 'CEO' of the institution.

 DHCP has also been chronically plagued with an interesting form of this
 problem, that waxes and wanes over time.

 At present within the VA we see the administrative folks throwing their
 territorial imperatives around and not giving due consideration to the
 operational requirements of the enterprise.  These 'conflicts' are often
 deflected into debates about hardware issues, and software system issues,
 all of which are usually not at all relevant to the bed-rock forces at
work
 here.  The person who says MUMPS is a dead language, get rid of VistA
 simply doesn¹t understand the problem.  It is easier to indict a
technology
 that can't defend itself, that to tackle the real core problem(s).

 Thus, the matter is not really about decentralized or centralized IT
 resources.  It is all about meeting the needs of health care delivery
staff
 and at the same time satisfying the needs of management.

 I am frequently convinced that the best outcomes are achieved with
 organizational

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Chris Richardson]

Joseph;

   One reason you haven't seen benchmark comparisions between the different
relational databases (Oracle, Sybase, DBase (you pick the release),
Informix), the vendors contractually inhibits their users from publishing
the results.  Why would they do that?  Because they know the outcome.  It
ain't good for them.  The Koreans did publish the results of one benchmark
they did in one of the Last MUG Quarterlies.  The results were astounding.
Same hardware, same load, same task took the relationals 6 hours or more to
complete.  MUMPS took something less than one hour to complete.

   Oracle used to be a true relational database and their performance really
sucked.  They hired Irene Chen from SAIC and the CHCS project.  They learned
some of why MUMPS is faster.  Soon after Oracle became a relational database
that mapped to a heirachical database internally.  This gave them a big
boost in performance and some improvement in scalability.  They just didn't
learn the rest of the lesson, how to make it scalable or learn how to build
effective memory cacheing.

  The result is that MUMPS allows for some very important performance
enhancement that other databases haven't learned yet.  One such enhancement
is that most read requests are satisfied in memory cache and these requests
don't have to go out to disk.  So only about 15% of the reads on a loaded
system actually result in a physical read.   This is a phenomenal increase
in performance.  A MUMPS system will speed up with more people on the system
(to a max determined by the available memory and the CPU performance), but
these limits are much higher numbers of users than Oracle or Sybase could
support on the same hardware.

  The bottom line is that there have been attempts to replace MUMPS systems
in the past and the CHCS project for the DoD has been no exception.  They
have been trying to bring up CHCS II to replace the CHCS I system which was
patterned after DHCP, the direct predicessor to VistA.  After 15 years and
many millions of dollars, CHCS II has finally been withdrawn for the last
time and CHCS I still runs the hospitals.  If Oracle or Sybase, or Informix
could do the job, they would be doing it.  Where are they??

  Want an idea of the complexity of the VistA model?  Look up the Entity
Relationship Diagrams.  Then show one of the nearly 100 pdf files to your
favorite Relational Database Guru and watch him blanch at the numbers of
data elements and relationships represented there.  On CHCS there were over
22,000 different data elements in the data dictionary.  In Northern
California, nearly 500,000 patient records are stored in less than 120
gigabytes of disk space.  It would be interesting to see how much space the
same information would take up in the relational model, then pack a lunch,
cause it will take a good long time to traverse that data as a relational
database.

- Original Message -
From: [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Saturday, June 11, 2005 5:22 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


 Yes, it will be interesting to see what can be done with Cache.  We're
 looking into the patient screening issue I mentioned previously, for
 example.

 It's interesting, I never heard of this M/VistA being faster than SQL
 relational until I started reading these messages.  I'm keen to see if
 that's true.  I just got done writing an HL7 data access object to talk to
 the HDR which is Oracle.  (Don't ask why I'm talking HL7 to an Oracle
 database, I'm not sure I know myself.)  I will certainly be looking at the
 speed.

 Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
 in town, I wonder?  Surely there's something between SQL Server and
Oracle?

 And yes, speed is essential.  It's what makes VistAWeb so popular with
 providers, along with its simple interface.  I'm not gonna be happy if the
 HDR slows it down.

 -Original Message-
 From: [EMAIL PROTECTED]
 [mailto:[EMAIL PROTECTED] On Behalf Of Nancy
 Anthracite
 Sent: Saturday, June 11, 2005 3:00 PM
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

 It seem to me that you do want is an M database that is reengineered for
 VistA
 because of its speed, easier mantainance and reliability and additionally,
 the ability to do SQL queries on that database.  Seems like Cache delivers
 that and with the right additional software, GT.M can do that as well.

 The Intersystems folks knew what they were doing when they bought up all
of
 those flavors of M.  The Epic folks know what they are doing as well.

 Relational databases are slower and that has long been recognized, and
they
 require a lot more work to maintain and design.  Oracle is probably the
 gorilla in that field and is very expensive and slow.  Yea, maybe you get
 some pretty reports from it, but not likely in real time.

 Tell all of the busy healh care worker why they have to wait when

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

Are you saying that a paper didn't make it through the peer review  
process? If I were a reviewer for a paper of this type, I'd be  
looking for clear definitions of terms like faster, and I'd also  
want to see some theoretical basis for the comparisons being made. My  
personal opinion is that M based systems would fare very well in a  
study such as this, but I would not expect papers relying largely on  
anecdotal evidence or measures such as transactions per second  
(without further qualification) to be rejected.

===
Gregory Woodhouse
[EMAIL PROTECTED]

The whole of science is nothing more than a refinement
 of everyday thinking.  -- Albert Einstein


On Jun 11, 2005, at 7:51 PM, Chris Richardson wrote:


Joseph;

   One reason you haven't seen benchmark comparisions between the  
different

relational databases (Oracle, Sybase, DBase (you pick the release),
Informix), the vendors contractually inhibits their users from  
publishing
the results.  Why would they do that?  Because they know the  
outcome.  It
ain't good for them.  The Koreans did publish the results of one  
benchmark
they did in one of the Last MUG Quarterlies.  The results were  
astounding.
Same hardware, same load, same task took the relationals 6 hours or  
more to

complete.  MUMPS took something less than one hour to complete.

   Oracle used to be a true relational database and their  
performance really
sucked.  They hired Irene Chen from SAIC and the CHCS project.   
They learned
some of why MUMPS is faster.  Soon after Oracle became a relational  
database
that mapped to a heirachical database internally.  This gave them a  
big
boost in performance and some improvement in scalability.  They  
just didn't
learn the rest of the lesson, how to make it scalable or learn how  
to build

effective memory cacheing.

  The result is that MUMPS allows for some very important performance
enhancement that other databases haven't learned yet.  One such  
enhancement
is that most read requests are satisfied in memory cache and these  
requests
don't have to go out to disk.  So only about 15% of the reads on a  
loaded
system actually result in a physical read.   This is a phenomenal  
increase
in performance.  A MUMPS system will speed up with more people on  
the system
(to a max determined by the available memory and the CPU  
performance), but
these limits are much higher numbers of users than Oracle or Sybase  
could

support on the same hardware.

  The bottom line is that there have been attempts to replace MUMPS  
systems
in the past and the CHCS project for the DoD has been no  
exception.  They
have been trying to bring up CHCS II to replace the CHCS I system  
which was
patterned after DHCP, the direct predicessor to VistA.  After 15  
years and
many millions of dollars, CHCS II has finally been withdrawn for  
the last
time and CHCS I still runs the hospitals.  If Oracle or Sybase, or  
Informix

could do the job, they would be doing it.  Where are they??

  Want an idea of the complexity of the VistA model?  Look up the  
Entity
Relationship Diagrams.  Then show one of the nearly 100 pdf files  
to your
favorite Relational Database Guru and watch him blanch at the  
numbers of
data elements and relationships represented there.  On CHCS there  
were over

22,000 different data elements in the data dictionary.  In Northern
California, nearly 500,000 patient records are stored in less than 120
gigabytes of disk space.  It would be interesting to see how much  
space the
same information would take up in the relational model, then pack a  
lunch,
cause it will take a good long time to traverse that data as a  
relational

database.

- Original Message -
From: [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Saturday, June 11, 2005 5:22 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==



Yes, it will be interesting to see what can be done with Cache.   
We're

looking into the patient screening issue I mentioned previously, for
example.

It's interesting, I never heard of this M/VistA being faster than SQL
relational until I started reading these messages.  I'm keen to  
see if
that's true.  I just got done writing an HL7 data access object to  
talk to

the HDR which is Oracle.  (Don't ask why I'm talking HL7 to an Oracle
database, I'm not sure I know myself.)  I will certainly be  
looking at the

speed.

Yes, Oracle is expensive, perhaps prohibitively so.  Is that the  
only game

in town, I wonder?  Surely there's something between SQL Server and


Oracle?



And yes, speed is essential.  It's what makes VistAWeb so popular  
with
providers, along with its simple interface.  I'm not gonna be  
happy if the

HDR slows it down.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of  
Nancy

Anthracite
Sent: Saturday, June 11, 2005 3:00 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

It seem

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

Which is faster? An Indy car or a Formula One car? In the  
Indianapolis 500, the leaders speeds will be between 220 and 230 mph.  
Speeds in the Grand Prix del Monaco will not be as high. What  
conclusions can you draw from this?


===
Gregory Woodhouse
[EMAIL PROTECTED]

A practical man is a man who practices the errors of his  
forefathers. -- Benjamin Disraeli




On Jun 11, 2005, at 7:51 PM, Chris Richardson wrote:


Joseph;

   One reason you haven't seen benchmark comparisions between the  
different

relational databases (Oracle, Sybase, DBase (you pick the release),
Informix), the vendors contractually inhibits their users from  
publishing
the results.  Why would they do that?  Because they know the  
outcome.  It
ain't good for them.  The Koreans did publish the results of one  
benchmark
they did in one of the Last MUG Quarterlies.  The results were  
astounding.
Same hardware, same load, same task took the relationals 6 hours or  
more to

complete.  MUMPS took something less than one hour to complete.

   Oracle used to be a true relational database and their  
performance really
sucked.  They hired Irene Chen from SAIC and the CHCS project.   
They learned
some of why MUMPS is faster.  Soon after Oracle became a relational  
database
that mapped to a heirachical database internally.  This gave them a  
big
boost in performance and some improvement in scalability.  They  
just didn't
learn the rest of the lesson, how to make it scalable or learn how  
to build

effective memory cacheing.

  The result is that MUMPS allows for some very important performance
enhancement that other databases haven't learned yet.  One such  
enhancement
is that most read requests are satisfied in memory cache and these  
requests
don't have to go out to disk.  So only about 15% of the reads on a  
loaded
system actually result in a physical read.   This is a phenomenal  
increase
in performance.  A MUMPS system will speed up with more people on  
the system
(to a max determined by the available memory and the CPU  
performance), but
these limits are much higher numbers of users than Oracle or Sybase  
could

support on the same hardware.

  The bottom line is that there have been attempts to replace MUMPS  
systems
in the past and the CHCS project for the DoD has been no  
exception.  They
have been trying to bring up CHCS II to replace the CHCS I system  
which was
patterned after DHCP, the direct predicessor to VistA.  After 15  
years and
many millions of dollars, CHCS II has finally been withdrawn for  
the last
time and CHCS I still runs the hospitals.  If Oracle or Sybase, or  
Informix

could do the job, they would be doing it.  Where are they??

  Want an idea of the complexity of the VistA model?  Look up the  
Entity
Relationship Diagrams.  Then show one of the nearly 100 pdf files  
to your
favorite Relational Database Guru and watch him blanch at the  
numbers of
data elements and relationships represented there.  On CHCS there  
were over

22,000 different data elements in the data dictionary.  In Northern
California, nearly 500,000 patient records are stored in less than 120
gigabytes of disk space.  It would be interesting to see how much  
space the
same information would take up in the relational model, then pack a  
lunch,
cause it will take a good long time to traverse that data as a  
relational

database.

- Original Message -
From: [EMAIL PROTECTED]
To: hardhats-members@lists.sourceforge.net
Sent: Saturday, June 11, 2005 5:22 PM
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==



Yes, it will be interesting to see what can be done with Cache.   
We're

looking into the patient screening issue I mentioned previously, for
example.

It's interesting, I never heard of this M/VistA being faster than SQL
relational until I started reading these messages.  I'm keen to  
see if
that's true.  I just got done writing an HL7 data access object to  
talk to

the HDR which is Oracle.  (Don't ask why I'm talking HL7 to an Oracle
database, I'm not sure I know myself.)  I will certainly be  
looking at the

speed.

Yes, Oracle is expensive, perhaps prohibitively so.  Is that the  
only game

in town, I wonder?  Surely there's something between SQL Server and


Oracle?



And yes, speed is essential.  It's what makes VistAWeb so popular  
with
providers, along with its simple interface.  I'm not gonna be  
happy if the

HDR slows it down.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of  
Nancy

Anthracite
Sent: Saturday, June 11, 2005 3:00 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==

It seem to me that you do want is an M database that is  
reengineered for

VistA
because of its speed, easier mantainance and reliability and  
additionally,
the ability to do SQL queries on that database.  Seems like Cache  
delivers
that and with the right additional software, GT.M can do

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 Relational databases are slower and that has long been recognized, and they 
 require a lot more work to maintain and design.  Oracle is probably the 
 gorilla in that field and is very expensive and slow.  Yea, maybe you get 
 some pretty reports from it, but not likely in real time.  
 


Not all of them.  Certainly Oracle and MS SQL are slower.

Ruben



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only game
 in town, I wonder?  Surely there's something between SQL Server and Oracle?
 

You mean aside from Postgres, Mysql and others?

Ruben




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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Nancy Anthracite]

Actually I think the VA has plans to be able to use any number of SQL 
databases when they are done with this rehosting, but I doubt that any SQL 
database will beat the speed of M.  After all, it was specifically designed 
for use in this setting.  Relational databases are going to be better for 
some things, but I don't think this setting is one of them.

On Sunday 12 June 2005 12:23 am, Ruben Safir wrote:
  Yes, Oracle is expensive, perhaps prohibitively so.  Is that the only
  game in town, I wonder?  Surely there's something between SQL Server and
  Oracle?

 You mean aside from Postgres, Mysql and others?

 Ruben




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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

I use MySQL and am pretty happy with it.

===
Gregory Woodhouse
[EMAIL PROTECTED]

A practical man is a man who practices the errors of his  
forefathers. -- Benjamin Disraeli




On Jun 11, 2005, at 9:23 PM, Ruben Safir wrote:




Yes, Oracle is expensive, perhaps prohibitively so.  Is that the  
only game
in town, I wonder?  Surely there's something between SQL Server  
and Oracle?





You mean aside from Postgres, Mysql and others?

Ruben




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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Sowinski, Richard J.]

Joe, 
your note title example can be explained inthis way. For years Vista was 
used in a standalone manner. Each site, wasessentially an island, that 
could create it's own note titles, lab test names, etc.

Then,software like RDV's and Vistaweb came along, and exposed 
(everyday) the fact that people used different terms at different sites, for 
essentially the same data.

This 
is not a software problem, it's a data problem. It's an artifact of making what 
was essentially a standalone system, into a networked 
system.

It's 
cure, is standardization work. Unfortunately that work can be tedious and not as 
glorious as other work, which is why it has been a slow starter. But sooner or 
later that work will get done, and Vista will be around for 
awhile.

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of 
  Cameron SchlehuberSent: Thursday, June 09, 2005 10:45 
  PMTo: hardhats-members@lists.sourceforge.netSubject: RE: 
  [Hardhats-members] == VistaWeb Missing Apps ==
  
  Actually, the 
  standardization work is being done VistA M-side.
  
  -Original 
  Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of David SommersSent: Thursday, June 09, 2005 7:49 
  PMTo: 
  hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  And I doubt the 
  underlying technology in the current VistA is restricting the ability to make 
  this happen now. It just happens to occur where the VA is doing "new 
  work" (unless it's being back-ported to VistA).
  
  
  
  
  
  From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Gordon MoresheadSent: Thursday, June 09, 2005 8:50 
  PMTo: 
  hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  Oh!? That is a 
  data/terminology standardization issue and not particularly relevant to 
  "replacing Vista". This can be an issue in any system implemented in 
  multiple sites.
  
  
  
  
  
  From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Gillon, JosephSent: Thursday, June 09, 2005 6:24 
  PMTo: 
  'hardhats-members@lists.sourceforge.net'Subject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  Yep. One of the 
  many, very valid reasons the VA is replacing VistA, and one not mentioned, I 
  believe, in the St. Pete Times article.
  
  
  
  
  
  From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Cameron 
  SchlehuberSent: Thursday, 
  June 09, 2005 5:53 PMTo: 
  hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  Regarding the 
  nonstandard note titles and the difficulties that poses ... there have 
  actually been some significant peer-reviewed journal articles by some VA folks 
  on that very issue. In fact, standardization of note titles is one of 
  the things currently in the queue to be accomplished in VistA (I'm not sure 
  but I believe it's also part of the CPRS-R work coming out very soon). A 
  fair amount of automated matching to standard titles will be performed (no 
  doubt with some manual intervention and checking). Once in place, new 
  note titles would be quickly built up from a compound set of expressions from 
  the Enterprise Reference Terminology which would cover virtually all of the 
  useful note titles (excepting the odd and uninformative ones such as "Dr 
  Soandso's notes"). That means that both old and new titles can be sorted 
  and searched in computationally meaningful ways for quick and easy 
  use.
  
  -Original 
  Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Gillon, JosephSent: Thursday, June 09, 2005 1:06 
  PMTo: 
  hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  That's an interesting 
  problem you pose. Did you ever see Euclid? It had a 
  problem-centric UI that apparently providers loved. I guess you would 
  click on, say, diabetes, and it would tell you what you should know about 
  diabetes for patients of a certain age, gender, ethnicity, whatever. It 
  would offer recommendations for meds and also check prescriptions for possible 
  problems. It was written by a doc who's now in Reno. He just sent 
  me the latest which is now web-based and uses MDO, the middleware techonology 
  that VW uses. 
  
  A sort of related but 
  not quite the same feature is something VW will use soon, and that's 
  Up-to-Date and medical dictionary searches. User highlights text, right 
  clicks, picks the search engine and gets info.
  
  I'm saying all this 
  just to indicate there are efforts to get some AI into our EMRs. In 
  fact, the CPRS-R folks are going to use a lot of the old Euclid 
  functionality. Oh, it has a thing called Assist that helps write 
  notes. Sorry I don't know exactly how...
  
  
  
  
  
  From: 

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Gregory Woodhouse]

This is why I've never been very enamored of the original name of VistA, Decentralized Hospital Computer System (DHCP). It wasn't decentralized at all, but rather each DHCP system was one of a number of independent, facility level systems. An ant colony is an example of a decentralized system: there is no centralized control, yet the colony is able to work together to accomplish a common task.Unfortunately, this false dichotomy has continued to plague VistA and the continued development of VistA. Far too often, centralized solutions (either data or control, or both) are thought to be the only alternative to completely independent application instances having no ability to work together effectively. There is, of course, another option, one that has been explored in a limited way, but not yet fully realized, that is to build loosely coupled systems that are, at once, decentralized an integrated (at the functional level). ===Gregory Woodhouse[EMAIL PROTECTED]"The whole of science is nothing more than a refinement of everyday thinking."  -- Albert Einstein On Jun 10, 2005, at 2:30 PM, Sowinski, Richard J. wrote:oe, your note title example can be explained in this way. For years Vista was used in a standalone manner. Each site, was essentially an island, that could create it's own note titles, lab test names, etc. Then, software like RDV's and Vistaweb came along, and exposed (everyday) the fact that people used different terms at different sites, for essentially the same data. This is not a software problem, it's a data problem. It's an artifact of making what was essentially a standalone system, into a networked system. It's cure, is standardization work. Unfortunately that work can be tedious and not as glorious as other work, which is why it has been a slow starter. But sooner or later that work will get done, and Vista will be around for awhile.

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph Dal Molin]

The significant opportunity we have outside of the VA is to avoid 
repeating the data problem. How can that best be done? I think Greg's 
option is on targetnot sure if this would be called a federated 
model...


Joseph

 There is, of course, another option, one that
 has been explored in a limited way, but not yet fully realized, that is
 to build loosely coupled systems that are, at once, decentralized an
 integrated (at the functional level).

Gregory Woodhouse wrote:
This is why I've never been very enamored of the original name of VistA, 
Decentralized Hospital Computer System (DHCP). It wasn't decentralized 
at all, but rather each DHCP system was one of a number of independent, 
facility level systems. An ant colony is an example of a decentralized 
system: there is no centralized control, yet the colony is able to work 
together to accomplish a common task.


Unfortunately, this false dichotomy has continued to plague VistA and 
the continued development of VistA. Far too often, centralized solutions 
(either data or control, or both) are thought to be the only alternative 
to completely independent application instances having no ability to 
work together effectively. There is, of course, another option, one that 
has been explored in a limited way, but not yet fully realized, that is 
to build loosely coupled systems that are, at once, decentralized an 
integrated (at the functional level).


===
Gregory Woodhouse
[EMAIL PROTECTED] mailto:[EMAIL PROTECTED]

The whole of science is nothing more than a refinement

 of everyday thinking.  -- Albert Einstein



On Jun 10, 2005, at 2:30 PM, Sowinski, Richard J. wrote:

oe, your note title example can be explained in this way. For years 
Vista was used in a standalone manner. Each site, was essentially an 
island, that could create it's own note titles, lab test names, etc.
 
Then, software like RDV's and Vistaweb came along, and exposed 
(everyday) the fact that people used different terms at different 
sites, for essentially the same data.
 
This is not a software problem, it's a data problem. It's an artifact 
of making what was essentially a standalone system, into a networked 
system.
 
It's cure, is standardization work. Unfortunately that work can be 
tedious and not as glorious as other work, which is why it has been a 
slow starter. But sooner or later that work will get done, and Vista 
will be around for awhile.






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Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Richard G. DAVIS]

I understand the dichotomy Gregory mentions, and I agree with the views he
has expressed.

However, I believe the fundamental issue is less a technical matter and more
an natural 'tension' between concerns for operational
effectiveness--delivery of quality health care, and the interest in
administrative IT that arises from management.  These two groups in most any
enterprise you may choose to study are chronically in a state of 'conflict'
due their different priorities and requirements for IT, and information
management architecture.

Where these competing forces arrive at a state of least tension, you usually
find that the two groups have separated their IT, both software and hardware
into two largely independent systems.

For those who have been in university/college settings, you may remember
that those institutions tend to have academic computer centers and
associated resources under the governance of some faculty body, and separate
administrative computer systems used to run the university controlled the
the 'CEO' of the institution.

DHCP has also been chronically plagued with an interesting form of this
problem, that waxes and wanes over time.

At present within the VA we see the administrative folks throwing their
territorial imperatives around and not giving due consideration to the
operational requirements of the enterprise.  These 'conflicts' are often
deflected into debates about hardware issues, and software system issues,
all of which are usually not at all relevant to the bed-rock forces at work
here.  The person who says MUMPS is a dead language, get rid of VistA
simply doesn¹t understand the problem.  It is easier to indict a technology
that can't defend itself, that to tackle the real core problem(s).

Thus, the matter is not really about decentralized or centralized IT
resources.  It is all about meeting the needs of health care delivery staff
and at the same time satisfying the needs of management.

I am frequently convinced that the best outcomes are achieved with
organizational structures, and IT systems that permit two relatively
independent systems to coexist, one optimized for health care delivery, and
one optimized for organizational administration.  (The obvious need for
effective interaction between these two systems is a subordinate or
collateral matter to the core issue.)

At the outset, DHCP was essentially free of intrusion of administrative
demands.  We built what seemed best for patient care.  Only as Congress has
insisted that the DVA generate some revenue to supplement appropriated funds
has the 'administrative' fist come down in a heavy handed way on top of the
health care interests.  (Yes, there are other forces in play here as well.)
This trend has promoted increased 'tension' between the operational and
administrative sides of the house.

The process needs to be focused on the organizational behavior issues where
the natural conflicts between the two sides of the house can be resolved
appropriately.  These processes are not technology based or driven.
Instead, they are very much about organization and management.  (It is in
the spirit of the best of breed bureaucrats who prefer diffusion of
responsibility and scape-goating of technology that we so often see the cry
to throw out the 'old' stuff.)

Clearly, the VAH health care delivery process is mission critical and
focused on the patient.  The IT system need there is for a highly
'decentralized' framework that is centered on the patient/caregiver
partnership.

On the other hand, the DVA administration process must be able to
effectively manage the resources of the DVA to maintain its two main lines
of business--entitlements and sick veterans.  That requires a highly
'centralized' IT framework that is centered on the problem of enterprise
management.

Whether these two groups are served by a single monolithic hardware system
buried in a Colorado mountain, or by two slightly smaller computer systems
situated at opposite ends of the Continental US, or by a massive number of
desktop computers is really not too important once the balance between these
two competing groups has been achieved.  After that, all us 'techno-nerds'
can go off and play with our cool software and hardware.  :-)

Regards,

Richard.


 From: Joseph Dal Molin [EMAIL PROTECTED]
 Reply-To: hardhats-members@lists.sourceforge.net
 Date: Fri, 10 Jun 2005 19:36:54 -0400
 To: hardhats-members@lists.sourceforge.net
 Subject: Re: [Hardhats-members] == VistaWeb Missing Apps ==
 
 The significant opportunity we have outside of the VA is to avoid
 repeating the data problem. How can that best be done? I think Greg's
 option is on targetnot sure if this would be called a federated
 model...
 
 Joseph
 
 There is, of course, another option, one that
 has been explored in a limited way, but not yet fully realized, that is
 to build loosely coupled systems that are, at once, decentralized an
 integrated (at the functional level).
 
 Gregory Woodhouse wrote

Re: [Hardhats-members] == VistaWeb Missing Apps ==

[Ruben Safir]

 However, I believe the fundamental issue is less a technical matter and more
 an natural 'tension' between concerns for operational
 effectiveness--delivery of quality health care, and the interest in
 administrative IT that arises from management.  These two groups in most any
 enterprise you may choose to study are chronically in a state of 'conflict'
 due their different priorities and requirements for IT, and information
 management architecture.
 


If I may interject

This is a fundemental error that I've seen pertetrated for years now.

There is no conflict between IT and archetectural concerns and usability.
Human usability is simply part of the scientific theory and technology of every
other scientific part of computer system design.  As clearly that you wouldn't 
let
a patient perform surgury on themselves, it is equally just as certain that
implimentation should never be in the hands of non-computer science engineers.

It is simply irresponsible.

There is no tension between the IT professionals and the users.  There is just
ignorance of the users to think they know what they need better than the Ph.D's 
and
Masters of Comp Sci, and the bigotry of the IT professionals who refuse to learn
anything about human interface design.  Such IT professionals, BTW, are almost 
always
not Comp Sci majors (or those old enough to have gotten in on the ground floor 
prior
to it being wildly available as a schooling option).

I've been a proponent of serious non-bias Comp Sci education in high school 
education and 
within the university setting.  Unfortanelty, this is almost as hard as getting 
non-bias
drug information today.  However, it's ridicules for people without an IT 
background to
make serious assertions about product design without a clue about the serious 
implications
to design and implementation.

Tell us what your symptoms are, and we can help you.  Dictate the cure and 
you'll be on the
fast tract to an early and painful grave.

Ruben



-- 
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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Richard . Sowinski]

When I speak of the complexities of the infrastructure I am speaking of
the MPI, 
the updating of data across sites, etc. Initializing all patients with ICN's
etc.

Actually, I think that particular infrastructure could be simplified, and
probably should be
simplified, if one wanted to implement remote data viewing capability
outside of
VHA.

When you think about it, you really only need a list of sites a patient has
been
registered at, and a good identifying scheme, to assemble a patient's
record
from multiple sites.

But actually, the model I prefer is a centralized repository or
repositories.

The problem with apps like Remote Data Views and VistaWeb is, the physician
has
to hunt an peck for data. Physicians are expected to do 20-minute
appointments,
write their computerized notes and orders, and maintain 2000-patient panels.
Many Docs
simply do not have the time to look through this remote data.

Other issues are, you cannot run research-type queries across sites, to
identify cohorts
of patients meeting certain research criteria. Data is not standardized.
Your lab test name, 
or lab test panel, may be different from mine.

With a data repository: reminders, alerts, etc can be run against a
standardized database,
and and data from many sites can be viewed via a common interface. A Doctor
can even be 
paged automatically, if a patient's test data is outside normal ranges. Or
for any other
reason, specified.

But apps like RDV's and VistaWeb certainly fill a niche, for some Docs who
have smaller panels
or, who take the extra time, for now.

- Rich



-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Jim
Self
Sent: Wednesday, June 08, 2005 5:55 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


Richard Sowinski wrote:
The reason I have asked people on this list if they have VistaWeb up and
running, is because I suspect
they underestimate the infrastructure required under the hood, to make
it,
or RDV run.

I also suspect, some have misconstrued what VistaWeb is. I think some of
them think it is a Web-based front-end
to Vista, instead of a remote view-only application, used to view patient
data at other sites.

I haven't tried to get VistaWeb running because of a lack of free time for
playing with
things dependent on M$ proprietary technology, but I have thought that the
source files in
VistaWeb might be helpful in defining some aspects of what a Web-based
front-end to VistA
should include.

From reviewing the VistaWeb documentation a while back, it seemed to me that
it would be
quite easy using M2Web to improve upon the views of VistA data provided by
VistaWeb if
someone could take a little time just to specify what views are needed and
what data
fields should be included. I had the same impression from a health-e-vet
demo earlier, but
I haven't had the free time to pursue either very much so far. I have a good
understanding
of the underlying technology (MUMPS, Fileman, Web, etc.) but not of the
VistA EMR, so
someone with that knowledge and/or the time to gather it could help greatly
to move such a
project along.

---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)


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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Nohlgren]

- Forwarded by Steve Nohlgren/News/Sptimes on 06/09/2005 01:43 PM -




[EMAIL PROTECTED]
Sent by: [EMAIL PROTECTED]
06/09/2005 10:18 AM
Please respond to hardhats-members


To:hardhats-members@lists.sourceforge.net
cc:
Subject:RE: [Hardhats-members] == VistaWeb Missing Apps ==

Mr. Sowinski's comments about the value of a central data repository or repositories speaks to an issue we are wondering about at the St. Petersburg Times--whether or not HealtheVet plans inject some unnecessary complexities while upgrading VistA. As I understand it, the national HDR will be an Oracle database that will merge clinical data real time and avoid this hunting and pecking for remote info. It will also to allow for report writing and queries to get a better handle on trends. Kaiser Permanente is splitting those two functions in their Epic System. The clinical data is stored in a Cache warehouse so everything pops up automatically no matter where the patient goes for treatment, but that data also become input to an Oracle warehouse for report writing and analysis. As I understand it, they figured that keeping both functions in a relational database would require more CPU and slow down the clinical side. Would such a divided s
 ystem make more sense for the VA's centralized database. If anyone feels like responding to me directly, you can use your home e-mail.

Thanks, Steve Nohlgren

When I speak of the complexities of the infrastructure I am speaking of
the MPI, 
the updating of data across sites, etc. Initializing all patients with ICN's
etc.

Actually, I think that particular infrastructure could be simplified, and
probably should be
simplified, if one wanted to implement remote data viewing capability
outside of
VHA.

When you think about it, you really only need a list of sites a patient has
been
registered at, and a good identifying scheme, to assemble a patient's
record
from multiple sites.

But actually, the model I prefer is a centralized repository or
repositories.

The problem with apps like Remote Data Views and VistaWeb is, the physician
has
to hunt an peck for data. Physicians are expected to do 20-minute
appointments,
write their computerized notes and orders, and maintain 2000-patient panels.
Many Docs
simply do not have the time to look through this remote data.

Other issues are, you cannot run research-type queries across sites, to
identify cohorts
of patients meeting certain research criteria. Data is not standardized.
Your lab test name, 
or lab test panel, may be different from mine.

With a data repository: reminders, alerts, etc can be run against a
standardized database,
and and data from many sites can be viewed via a common interface. A Doctor
can even be 
paged automatically, if a patient's test data is outside normal ranges. Or
for any other
reason, specified.

But apps like RDV's and VistaWeb certainly fill a niche, for some Docs who
have smaller panels
or, who take the extra time, for now.

- Rich



-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Jim
Self
Sent: Wednesday, June 08, 2005 5:55 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==


Richard Sowinski wrote:
The reason I have asked people on this list if they have VistaWeb up and
running, is because I suspect
they underestimate the infrastructure required under the hood, to make
it,
or RDV run.

I also suspect, some have misconstrued what VistaWeb is. I think some of
them think it is a Web-based front-end
to Vista, instead of a remote view-only application, used to view patient
data at other sites.

I haven't tried to get VistaWeb running because of a lack of free time for
playing with
things dependent on M$ proprietary technology, but I have thought that the
source files in
VistaWeb might be helpful in defining some aspects of what a Web-based
front-end to VistA
should include.

>From reviewing the VistaWeb documentation a while back, it seemed to me that
it would be
quite easy using M2Web to improve upon the views of VistA data provided by
VistaWeb if
someone could take a little time just to specify what views are needed and
what data
fields should be included. I had the same impression from a health-e-vet
demo earlier, but
I haven't had the free time to pursue either very much so far. I have a good
understanding
of the underlying technology (MUMPS, Fileman, Web, etc.) but not of the
VistA EMR, so
someone with that knowledge and/or the time to gather it could help greatly
to move such a
project along.

---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)


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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Sowinski, Richard J.]

Joe, 


It's 
good to see you on Hardhats. What took you so long ?

Sorry 
about "hunt and peck" analogy it's just the most apt description of what I see 
users doing when they use these products.

It's 
just my bias, I think remote data viewers fillan interimniche. But I 
have had busy docs tell me that they don't have the time to sift through this 
data on most patients, unless they are really, really curious about something. I 
think the same thing can be said for Docs sifting through reams of CPRS data 
from their own site! Just no time to do that: they see their patient, 
writetheir note, writetheir prescription and any other orders, and 
get on to the next patient.

This 
is no reflection on your VistaWeb product. I think it's a great tool, faster 
than RDV's, and an accomplishment on your part. It certainly helps alot 
whenDocs really want to see that data.

I also 
think it is good that there is suchgreat interest outside of VA in some of 
the things VA has developed over the past few years, including 
VistaWeb.

It's all good.

Joe, 
you are on the right track, I think your VistaWeb product could be separated 
pretty simply from some of the "complexities" underneath. 

We can 
talk off-line if you want. I don't want to burn anymore Hardhats bandwidth on 
this topic, especially considering who is listening.

I have 
all the respect in the world for the St Peterburg Times and their affiliation 
with the Poynter Institute, one of the most respected journalism schools in the 
country, but I wish we could "talk tech" here without worrying about being 
monitored or quoted.

After 
all, that'sreally whatthis forum is for.

- Rich

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of 
  Gillon, JosephSent: Thursday, June 09, 2005 1:06 
  PMTo: hardhats-members@lists.sourceforge.netSubject: RE: 
  [Hardhats-members] == VistaWeb Missing Apps ==
  
  First, I should 
  mention that if you are a VA employee be careful what you say to this 
  guy. He's a biased, sensationalist reporter looking to make copy and 
  not, IMHO, particulary interested in veracity. More interested in 
  uncovering another CoreFLS than anything else.
  
  On to Rich. And 
  hi BTW, been a while. Thinking just of implementing VW or RDV outside 
  the VA, you hit on one extremely important item, namely standardization of 
  data. I disagree with the "hunt and peck" label you're sticking VW with 
  since it shows all the data, collated, in seconds. However, due to the 
  non-standard note titles and stuff of that ilk, when you sort the titles you 
  don't necessarily get, say, all the cariology notes, in one place. Were 
  I starting a new multi-site VistA system I 
  would really, really, really give some time and effort to implementing 
  standard note/report titles, lab panel titles, team names, etc. All this 
  stuff is a totally squirrelly mess in the VA after years of each site doing 
  whatever it pleased.
  
  And I think Rich hits 
  another nail on the head with the MPI thing. If you are going to have 
  distributed databases you definitely need something central to figure out what 
  sites to query. Well, maybe if you only had half a dozen sites... 
  Still. Rich, I know that VistA kicks 
  out an HL7 message on inpatient events (admit, discharge, transfer). 
  Does it do anything on outpatient visits? If it did you could just set 
  up an HL7 listener to catch these messages and put the relevant data into an 
  SQL database. Then, since VW can talk to SQL databases as well as 
  VistA databases, you could just replace the 
  MPI RPC with a select statement.
  
  
  
  
  
  From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of 
  [EMAIL PROTECTED]Sent: Thursday, June 09, 2005 1:45 
  PMTo: hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  - 
  Forwarded by Steve Nohlgren/News/Sptimes on 06/09/2005 01:43 PM 
  - 
  


  

  
[EMAIL PROTECTED] 
Sent by: 
[EMAIL PROTECTED] 

06/09/2005 10:18 
AM Please respond to 
hardhats-members 
  

   
 To:hardhats-members@lists.sourceforge.net 
   
         cc:    
     Subject:RE: [Hardhats-members] == 
VistaWeb Missing Apps 
==
  Mr. Sowinski's comments about 
  the value of a central data repository or repositories speaks to an issue we 
  are wondering about at the St. Petersburg Times--whether or not HealtheVet 
  plans inject some unnecessary complexities while upgrading VistA. As I understand it, the national HDR will be an 
  Oracle database that will merge clinical data real time and avoid this hunting 
  and pecking for remote info. It will also to allow for report writing 
  and queries to get a better handle on trends. Kaiser Permanente is splitting 
  those two functions

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Thats an interesting problem you
pose. Did you ever see Euclid?
It had a problem-centric UI that apparently providers loved. I guess you
would click on, say, diabetes, and it would tell you what you should know about
diabetes for patients of a certain age, gender, ethnicity, whatever. It
would offer recommendations for meds and also check prescriptions for possible
problems. It was written by a doc whos now in Reno. He just sent me the latest which
is now web-based and uses MDO, the middleware techonology that VW uses. 



A sort of related but not quite the same
feature is something VW will use soon, and thats Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



Im saying all this just to indicate
there are efforts to get some AI into our EMRs. In fact, the CPRS-R folks
are going to use a lot of the old Euclid
functionality. Oh, it has a thing called Assist that helps write
notes. Sorry I dont know exactly how











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is
suchgreat interest outside of VA in some of the things VA has developed
over the past few years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the
complexities underneath. 











We can talk off-line if you want. I don't
want to burn anymore Hardhats bandwidth on this topic, especially considering
who is listening.











I have all the respect in the world for
the St Peterburg Times and their affiliation with the Poynter Institute, one of
the most respected journalism schools in the country, but I wish we could
talk tech here without worrying about being monitored or quoted.











After all, that'sreally
whatthis forum is for.











- Rich





-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==

First, I should mention that if you are a
VA employee be careful what you say to this guy. He's a biased,
sensationalist reporter looking to make copy and not, IMHO, particulary
interested in veracity. More interested in uncovering another CoreFLS
than anything else.



On to Rich. And hi BTW, been a
while. Thinking just of implementing VW or RDV outside the VA, you hit on
one extremely important item, namely standardization of data. I disagree
with the hunt and peck label you're sticking VW with since it shows
all the data, collated, in seconds. However, due to the non-standard note
titles and stuff of that ilk, when you sort the titles you don't necessarily
get, say, all the cariology notes, in one place. Were I starting a new
multi-site VistA system I would really,
really, really give some time and effort to implementing standard note/report
titles, lab panel titles, team names, etc. All this stuff is a totally
squirrelly mess in the VA after years of each site doing whatever it pleased.



And I think Rich hits another nail on the
head with the MPI thing. If you are going to have distributed databases
you definitely need something central to figure out what sites to query.
Well, maybe if you only had half a dozen sites... Still. Rich, I
know that VistA kicks out an HL7 message on
inpatient events (admit, discharge, transfer). Does it do anything on
outpatient visits? If it did you could just set up an HL7 listener to
catch these messages and put the relevant data into an SQL database.
Then, since VW can talk to SQL databases as well as VistA
databases, you could just replace the MPI RPC with a select statement.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]
Sent: Thursday, June 09

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Cameron Schlehuber]

Regarding the nonstandard note titles and
the difficulties that poses  there have actually been some significant
peer-reviewed journal articles by some VA folks on that very issue. In fact,
standardization of note titles is one of the things currently in the queue to be
accomplished in VistA (Im not sure but I believe its also part of the
CPRS-R work coming out very soon). A fair amount of automated matching to
standard titles will be performed (no doubt with some manual intervention and
checking). Once in place, new note titles would be quickly built up from a
compound set of expressions from the Enterprise Reference Terminology which would
cover virtually all of the useful note titles (excepting the odd and
uninformative ones such as Dr Soandsos notes). That means
that both old and new titles can be sorted and searched in computationally meaningful
ways for quick and easy use.



-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



Thats an interesting problem you
pose. Did you ever see Euclid? It had a problem-centric UI that
apparently providers loved. I guess you would click on, say, diabetes,
and it would tell you what you should know about diabetes for patients of a
certain age, gender, ethnicity, whatever. It would offer recommendations
for meds and also check prescriptions for possible problems. It was
written by a doc whos now in Reno. He just sent me the latest
which is now web-based and uses MDO, the middleware techonology that VW
uses. 



A sort of related but not quite the same
feature is something VW will use soon, and thats Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



Im saying all this just to indicate
there are efforts to get some AI into our EMRs. In fact, the CPRS-R folks
are going to use a lot of the old Euclid functionality. Oh, it has a
thing called Assist that helps write notes. Sorry I dont know
exactly how











From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To:
'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is
suchgreat interest outside of VA in some of the things VA has developed
over the past few years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the
complexities underneath. 











We can talk off-line if you want. I don't
want to burn anymore Hardhats bandwidth on this topic, especially considering
who is listening.











I have all the respect in the world for
the St Peterburg Times and their affiliation with the Poynter Institute, one of
the most respected journalism schools in the country, but I wish we could
talk tech here without worrying about being monitored or quoted.











After all, that'sreally
whatthis forum is for.











- Rich





-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==

First, I should mention that if you are a
VA employee be careful what you say to this guy. He's a biased,
sensationalist reporter looking to make copy and not, IMHO, particulary
interested in veracity. More interested in uncovering another CoreFLS
than anything else.



On to Rich. And hi BTW, been a
while. Thinking just of implementing VW or RDV outside the VA, you hit on
one extremely important item, namely standardization of data. I disagree
with the hunt and peck label you're sticking VW with since it shows
all the data, collated, in seconds. However, due to the non-standard note
titles and stuff

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Cameron Schlehuber]

That was the original expectation.
That had to change a bit due to demand and practical considerations.



-Original Message-
From: Greg Woodhouse [mailto:[EMAIL PROTECTED] 
Sent: Thursday, June 09, 2005 3:33 PM
To: [EMAIL PROTECTED]
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==



Isn't that just rehosting from Delphi to Java (with no
re-engineering

work)?



-Original Message-
From: Cameron Schlehuber
[mailto:[EMAIL PROTECTED] 
Sent: Thursday, June
 09, 2005 2:53 PM
To:
'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



Regarding the nonstandard note titles and
the difficulties that poses  there have actually been some significant
peer-reviewed journal articles by some VA folks on that very issue. In
fact, standardization of note titles is one of the things currently in the
queue to be accomplished in VistA (Im not sure but I believe its
also part of the CPRS-R work coming out very soon). A fair amount of
automated matching to standard titles will be performed (no doubt with some
manual intervention and checking). Once in place, new note titles would
be quickly built up from a compound set of expressions from the Enterprise
Reference Terminology which would cover virtually all of the useful note titles
(excepting the odd and uninformative ones such as Dr Soandsos
notes). That means that both old and new titles can be sorted and
searched in computationally meaningful ways for quick and easy use.



-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



Thats an interesting problem you
pose. Did you ever see Euclid? It had a problem-centric UI that
apparently providers loved. I guess you would click on, say, diabetes,
and it would tell you what you should know about diabetes for patients of a
certain age, gender, ethnicity, whatever. It would offer recommendations
for meds and also check prescriptions for possible problems. It was
written by a doc whos now in Reno. He just sent me the latest
which is now web-based and uses MDO, the middleware techonology that VW
uses. 



A sort of related but not quite the same
feature is something VW will use soon, and thats Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



Im saying all this just to indicate
there are efforts to get some AI into our EMRs. In fact, the CPRS-R folks
are going to use a lot of the old Euclid functionality. Oh, it has a
thing called Assist that helps write notes. Sorry I dont know
exactly how











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is
suchgreat interest outside of VA in some of the things VA has developed
over the past few years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the
complexities underneath. 











We can talk off-line if you want. I don't
want to burn anymore Hardhats bandwidth on this topic, especially considering
who is listening.











I have all the respect in the world for
the St Peterburg Times and their affiliation with the Poynter Institute, one of
the most respected journalism schools in the country, but I wish we could
talk tech here without worrying about being monitored or quoted.











After all, that'sreally
whatthis forum is for.











- Rich





-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==

First

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Yep. One of the many, very valid reasons
the VA is replacing VistA, and one not mentioned, I believe, in the St. Pete
Times article.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Cameron Schlehuber
Sent: Thursday, June 09, 2005 5:53
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Regarding the nonstandard note titles and
the difficulties that poses ... there have actually been some significant
peer-reviewed journal articles by some VA folks on that very issue. In
fact, standardization of note titles is one of the things currently in the
queue to be accomplished in VistA (I'm
not sure but I believe it's also part of the CPRS-R work coming out very
soon). A fair amount of automated matching to standard titles will be
performed (no doubt with some manual intervention and checking). Once in
place, new note titles would be quickly built up from a compound set of
expressions from the Enterprise Reference Terminology which would cover
virtually all of the useful note titles (excepting the odd and uninformative
ones such as "Dr Soandso's notes"). That means that
both old and new titles can be sorted and searched in computationally
meaningful ways for quick and easy use.



-Original Message-
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



That's an interesting problem you
pose. Did you ever see Euclid?
It had a problem-centric UI that apparently providers loved. I guess you
would click on, say, diabetes, and it would tell you what you should know about
diabetes for patients of a certain age, gender, ethnicity, whatever. It
would offer recommendations for meds and also check prescriptions for possible
problems. It was written by a doc who's now in Reno. He just sent me the latest which
is now web-based and uses MDO, the middleware techonology that VW uses. 



A sort of related but not quite the same
feature is something VW will use soon, and that's Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



I'm saying all this just to indicate
there are efforts to get some AI into our EMRs. In fact, the CPRS-R folks
are going to use a lot of the old Euclid
functionality. Oh, it has a thing called Assist that helps write
notes. Sorry I don't know exactly how...











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To:
'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is
suchgreat interest outside of VA in some of the things VA has developed
over the past few years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the
complexities underneath. 











We can talk off-line if you want. I don't want
to burn anymore Hardhats bandwidth on this topic, especially considering who is
listening.











I have all the respect in the world for
the St Peterburg Times and their affiliation with the Poynter Institute, one of
the most respected journalism schools in the country, but I wish we could
talk tech here without worrying about being monitored or quoted.











After all, that'sreally
whatthis forum is for.











- Rich





-Original Message-
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==

First, I should mention that if you are a
VA employee be careful what you say to this guy. He's a biased,
sensationalist reporter looking to make copy and not, IMHO, particulary
interested in veracity. More 

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gordon Moreshead]

Oh!? That is a data/terminology
standardization issue and not particularly relevant to replacing Vista. This can be an issue in any system
implemented in multiple sites.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 6:24
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Yep. One of the many, very valid
reasons the VA is replacing VistA, and one not mentioned, I believe, in the St.
Pete Times article.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Cameron Schlehuber
Sent: Thursday, June 09, 2005 5:53
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Regarding the nonstandard note titles and
the difficulties that poses ... there have actually been some significant
peer-reviewed journal articles by some VA folks on that very issue. In
fact, standardization of note titles is one of the things currently in the
queue to be accomplished in VistA (I'm not
sure but I believe it's also part of the CPRS-R work coming out very
soon). A fair amount of automated matching to standard titles will be
performed (no doubt with some manual intervention and checking). Once in
place, new note titles would be quickly built up from a compound set of expressions
from the Enterprise Reference Terminology which would cover virtually all of
the useful note titles (excepting the odd and uninformative ones such as
Dr Soandso's notes). That means that both old and new titles
can be sorted and searched in computationally meaningful ways for quick and
easy use.



-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



That's an interesting problem you
pose. Did you ever see Euclid?
It had a problem-centric UI that apparently providers loved. I guess you
would click on, say, diabetes, and it would tell you what you should know about
diabetes for patients of a certain age, gender, ethnicity, whatever. It
would offer recommendations for meds and also check prescriptions for possible
problems. It was written by a doc who's now in Reno. He just sent me the latest which
is now web-based and uses MDO, the middleware techonology that VW uses. 



A sort of related but not quite the same
feature is something VW will use soon, and that's Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



I'm saying all this just to indicate there
are efforts to get some AI into our EMRs. In fact, the CPRS-R folks are
going to use a lot of the old Euclid
functionality. Oh, it has a thing called Assist that helps write
notes. Sorry I don't know exactly how...











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is suchgreat
interest outside of VA in some of the things VA has developed over the past few
years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the complexities
underneath. 











We can talk off-line if you want. I don't
want to burn anymore Hardhats bandwidth on this topic, especially considering
who is listening.











I have all the respect in the world for
the St Peterburg Times and their affiliation with the Poynter Institute, one of
the most respected journalism schools in the country, but I wish we could
talk tech here without worrying about being monitored or quoted.











After all, that'sreally
whatthis forum is for.











- Rich





-Original Message-
From:
[EMAIL PROTECTED]
[mailto:[EMAIL

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[David Sommers]

And I doubt the underlying technology in
the current VistA is restricting the ability to make this happen now. It just
happens to occur where the VA is doing new work (unless its
being back-ported to VistA).











From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Gordon Moreshead
Sent: Thursday, June 09, 2005 8:50
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Oh!? That is a data/terminology
standardization issue and not particularly relevant to replacing Vista. This can be an issue in any system implemented in multiple sites.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 6:24
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Yep. One of the many, very valid
reasons the VA is replacing VistA, and one not mentioned, I believe, in the St.
Pete Times article.











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Cameron Schlehuber
Sent: Thursday, June 09, 2005 5:53
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==





Regarding the nonstandard note titles and
the difficulties that poses ... there have actually been some significant
peer-reviewed journal articles by some VA folks on that very issue. In
fact, standardization of note titles is one of the things currently in the
queue to be accomplished in VistA (I'm not sure but I believe it's also part of
the CPRS-R work coming out very soon). A fair amount of automated
matching to standard titles will be performed (no doubt with some manual
intervention and checking). Once in place, new note titles would be
quickly built up from a compound set of expressions from the Enterprise
Reference Terminology which would cover virtually all of the useful note titles
(excepting the odd and uninformative ones such as Dr Soandso's
notes). That means that both old and new titles can be sorted and
searched in computationally meaningful ways for quick and easy use.



-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Gillon, Joseph
Sent: Thursday, June 09, 2005 1:06
PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==



That's an interesting problem you
pose. Did you ever see Euclid? It had a problem-centric UI that
apparently providers loved. I guess you would click on, say, diabetes,
and it would tell you what you should know about diabetes for patients of a
certain age, gender, ethnicity, whatever. It would offer recommendations
for meds and also check prescriptions for possible problems. It was
written by a doc who's now in Reno. He just sent me the latest which is
now web-based and uses MDO, the middleware techonology that VW uses. 



A sort of related but not quite the same
feature is something VW will use soon, and that's Up-to-Date and medical
dictionary searches. User highlights text, right clicks, picks the search
engine and gets info.



I'm saying all this just to indicate there
are efforts to get some AI into our EMRs. In fact, the CPRS-R folks are
going to use a lot of the old Euclid functionality. Oh, it has a thing
called Assist that helps write notes. Sorry I don't know exactly how...











From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard J.
Sent: Thursday, June 09, 2005 3:51
PM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







Joe, 











It's good to see you on Hardhats. What
took you so long ?











Sorry about hunt and peck
analogy it's just the most apt description of what I see users doing when they
use these products.











It's just my bias, I think remote data
viewers fillan interimniche. But I have had busy docs tell me that
they don't have the time to sift through this data on most patients, unless
they are really, really curious about something. I think the same thing can be
said for Docs sifting through reams of CPRS data from their own site! Just no
time to do that: they see their patient, writetheir note,
writetheir prescription and any other orders, and get on to the next
patient.











This is no reflection on your VistaWeb
product. I think it's a great tool, faster than RDV's, and an accomplishment on
your part. It certainly helps alot whenDocs really want to see that data.











I also think it is good that there is
suchgreat interest outside of VA in some of the things VA has developed
over the past few years, including VistaWeb.











It's all good.











Joe, you are on the right track, I think
your VistaWeb product could be separated pretty simply from some of the
complexities underneath. 











We can talk off-line if you want. I don't want
to burn anymore Hardhats bandwidth on this topic, especially

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Gillon, Joseph]

Re MPI, Subscription Control file, etc.:



VistAWeb makes
exactly the same use of the MPI as RDV. So if you have RDV working you
should have not problem with VW, and conversely.



I have no idea what
the Subscription Contol file is, and I wrote VW, from which I conclude you dont
need it. At least per se VW. Maybe this is required for a site to
be kept upto-date on the current MPI. In which case you would need
it. But youd also need it for RDV.



VW does not use the patient
ICN since none of the RPCs it uses does. It uses the DFN at each patient
site, so that should be no problem.



Basically, you need
a working MPI, and if you can make RDV work, you must have a working MPI, and
that means VW will also work.

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Alberto Odor Morales]

Thanks for the clarification Joe.

I have VistA (Cache) installed in a server and I'm accessing it from my 
network. I would like to prove VistaWeb in this setting, just to be able to 
show diferent GUIs to people who could decide to addopt Vista for the Ministry 
of Health in Mexico.

Is this possible?

The LoginFrameset.htm pages comes up OK, but if I try to access my cache 
istallation (I modified one of the sites in the aspx page to reflect my 
settings) I gat:
ConnectionError: Java.net NoRouteToHostExeption () Host 200.38.167.26, Port 
9300 (my server's external IP) or Host 192.168.20.11 Port 9300 (my server's 
internal IP.

Alberto Odor
Mexico City




Re MPI, Subscription Control file, etc.:

VistAWeb makes exactly the same use of the MPI as RDV.  So if you have RDV 
working you should have not problem with VW, and conversely.

I have no idea what the Subscription Contol file is, and I wrote VW, from which 
I conclude you don’t need it.  At least per se VW.  Maybe this is required for 
a site to be kept up–to-date on the current MPI.  In which case you would need 
it.  But you’d also need it for RDV.

VW does not use the patient ICN since none of the RPCs it uses does.  It uses 
the DFN at each patient site, so that should be no problem.

Basically, you need a working MPI, and if you can make RDV work, you must have 
a working MPI, and that means VW will also work.


==
Dr. Alberto Odor Morales
[EMAIL PROTECTED]



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

Well, if you have a functioning MPI it should be possible.  If not you'll
have to alter the code in patient selection to fake it.  NoRouteToHost
really doesn't have anything to do with VW.  That's just telling you the
host you specified can be gotten to.  You shouldn't mess with the code in
the aspx pages to add/edit sites.  VW reads its site info from the vhaSites
XML file in resources/xml.  Put your sites in there.  Be sure you can ping
them and tracert to them.  Until then VW will not see them.  I'm going to
give you the name and email of a guy who's done what you want to do and is
probably willing to help.  Joe Tastrom, [EMAIL PROTECTED]

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Alberto
Odor Morales
Sent: Wednesday, June 08, 2005 11:48 AM
To: hardhats-members@lists.sourceforge.net
Cc: [EMAIL PROTECTED]
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

Thanks for the clarification Joe.

I have VistA (Cache) installed in a server and I'm accessing it from my
network. I would like to prove VistaWeb in this setting, just to be able to
show diferent GUIs to people who could decide to addopt Vista for the
Ministry of Health in Mexico.

Is this possible?

The LoginFrameset.htm pages comes up OK, but if I try to access my cache
istallation (I modified one of the sites in the aspx page to reflect my
settings) I gat:
ConnectionError: Java.net NoRouteToHostExeption () Host 200.38.167.26, Port
9300 (my server's external IP) or Host 192.168.20.11 Port 9300 (my server's
internal IP.

Alberto Odor
Mexico City




Re MPI, Subscription Control file, etc.:

VistAWeb makes exactly the same use of the MPI as RDV.  So if you have RDV
working you should have not problem with VW, and conversely.

I have no idea what the Subscription Contol file is, and I wrote VW, from
which I conclude you don't need it.  At least per se VW.  Maybe this is
required for a site to be kept up-to-date on the current MPI.  In which case
you would need it.  But you'd also need it for RDV.

VW does not use the patient ICN since none of the RPCs it uses does.  It
uses the DFN at each patient site, so that should be no problem.

Basically, you need a working MPI, and if you can make RDV work, you must
have a working MPI, and that means VW will also work.


==
Dr. Alberto Odor Morales
[EMAIL PROTECTED]



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Joseph . Gillon]

So the subscription control file is the
file that is updated by the MPI? Is it the file I read from with the RPC
ORWCIRN FACLIST? Because thats the RPC both CPRS and VW use.



Yes, I do exchange the ICN for the DFN at
each site. Nothing invisible about it. Some patients dont
have ICNs, and then VW will exchange SSN for DFN.



VW is not just remote view only. It
also shows data from the local VistA.
What it doesnt do is write any data to VistA.



And yes, much more difficult than just
getting CPRS to talk to a single M system. 











From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Sowinski, Richard J.
Sent: Wednesday, June 08, 2005
12:11 PM
To:
'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==







The subscription control file contains the
list of sites the patient has been treated at. I suspect you access it





via an RPC to get a list of sites a
patient has been treated at, either that, or you're accessing the MPI directly.





It's the only two places that data could
live. In either case, it's obviouslybeen encapsulated well, by the RDV
developers.





I suspect your applicationmay also
be usingthe ICN, to resolve DFN's, at a lower level than is visible to
you.











The reason I have asked people on this
list if they have VistaWeb up and running, is because I suspect





they underestimate the infrastructure
required under the hood, to makeit, or RDVrun.











I also suspect, some have misconstrued
what VistaWeb is. I think some of them think it is a Web-based front-end





to Vista,
instead of a remote view-only application, used to view patient data at other
sites.











Nobody has responded that they have
VistaWeb, or RDV up and running outside of VHA.











I'm not saying it can't be done. It most
certainly can. But it'sgoing to be a littlemore difficult
thansetting upCPRS to connect to an M implementation





running Vista
on one's laptop. I think.











- Rich





-Original Message-
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Gillon, Joseph
Sent: Wednesday, June 08, 2005
10:14 AM
To:
hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] ==
VistaWeb Missing Apps ==

Re MPI, Subscription Control file, etc.:



VistAWeb makes
exactly the same use of the MPI as RDV. So if you have RDV working you
should have not problem with VW, and conversely.



I have no idea what
the Subscription Contol file is, and I wrote VW, from which I conclude you
don't need it. At least per se VW. Maybe this is required for a
site to be kept up-to-date on the current MPI. In which case you would
need it. But you'd also need it for RDV.



VW does not use the
patient ICN since none of the RPCs it uses does. It uses the DFN at each
patient site, so that should be no problem.



Basically, you need
a working MPI, and if you can make RDV work, you must have a working MPI, and
that means VW will also work.

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Richard . Sowinski]

Actually it looks like the file that holds the data about where each 
patient has been seen, is file 391.91, the Treating Facility 
file.
Now 
that I know which RPC you used, it waspretty easy to figure that out. 


- 
Rich

  -Original Message-From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED]On Behalf Of 
  [EMAIL PROTECTED]Sent: Wednesday, June 08, 2005 1:06 
  PMTo: hardhats-members@lists.sourceforge.netSubject: RE: 
  [Hardhats-members] == VistaWeb Missing Apps ==
  
  So the subscription 
  control file is the file that is updated by the MPI? Is it the file I 
  read from with the RPC ORWCIRN FACLIST? Because that's the RPC both CPRS 
  and VW use.
  
  Yes, I do exchange 
  the ICN for the DFN at each site. Nothing invisible about it. Some 
  patients don't have ICNs, and then VW will exchange SSN for 
  DFN.
  
  VW is not just remote 
  view only. It also shows data from the local VistA. What it doesn't do is write any data to 
  VistA.
  
  And yes, much more 
  difficult than just getting CPRS to talk to a single M system. 
  
  
  
  
  
  
  From: 
  [EMAIL PROTECTED] 
  [mailto:[EMAIL PROTECTED] On Behalf Of Sowinski, Richard 
  J.Sent: Wednesday, June 08, 
  2005 12:11 PMTo: 
  'hardhats-members@lists.sourceforge.net'Subject: RE: [Hardhats-members] == 
  VistaWeb Missing Apps ==
  
  
  The subscription 
  control file contains the list of sites the patient has been treated at. I 
  suspect you access it
  
  via an RPC to get a 
  list of sites a patient has been treated at, either that, or you're accessing 
  the MPI directly.
  
  It's the only two 
  places that data could live. In either case, it's obviouslybeen 
  encapsulated well, by the RDV developers.
  
  I suspect your 
  applicationmay also be usingthe ICN, to resolve DFN's, at a lower 
  level than is visible to you.
  
  
  
  The reason I have 
  asked people on this list if they have VistaWeb up and running, is because I 
  suspect
  
  they underestimate 
  the infrastructure required "under the hood", to makeit, or 
  RDVrun.
  
  
  
  I also suspect, some 
  have misconstrued what VistaWeb is. I think some of them think it is a 
  Web-based front-end
  
  to Vista, instead of a remote view-only application, used 
  to view patient data at other sites.
  
  
  
  Nobody has responded 
  that they have VistaWeb, or RDV up and running outside of 
  VHA.
  
  
  
  I'm not saying it 
  can't be done. It most certainly can. But it'sgoing to be a 
  littlemore difficult thansetting upCPRS to connect to an M 
  implementation
  
  running Vista on one's laptop. I 
  think.
  
  
  
  - 
  Rich
  
-Original 
Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]On Behalf Of Gillon, JosephSent: Wednesday, June 08, 2005 10:14 
AMTo: 
hardhats-members@lists.sourceforge.netSubject: RE: [Hardhats-members] == 
    VistaWeb Missing Apps ==
Re MPI, Subscription 
Control file, etc.:

VistAWeb makes 
exactly the same use of the MPI as RDV. So if you have RDV working you 
should have not problem with VW, and 
conversely.

I have no idea 
what the Subscription Contol file is, and I wrote VW, from which I conclude 
you don't need it. At least per se VW. Maybe this is required 
for a site to be kept up-to-date on the current MPI. In which case you 
would need it. But you'd also need it for 
RDV.

VW does not 
use the patient ICN since none of the RPCs it uses does. It uses the 
DFN at each patient site, so that should be no 
problem.

Basically, you 
need a working MPI, and if you can make RDV work, you must have a working 
MPI, and that means VW will also work.

RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Jim Self]

Richard Sowinski wrote:
The reason I have asked people on this list if they have VistaWeb up and
running, is because I suspect
they underestimate the infrastructure required under the hood, to make it,
or RDV run.

I also suspect, some have misconstrued what VistaWeb is. I think some of
them think it is a Web-based front-end
to Vista, instead of a remote view-only application, used to view patient
data at other sites.

I haven't tried to get VistaWeb running because of a lack of free time for 
playing with
things dependent on M$ proprietary technology, but I have thought that the 
source files in
VistaWeb might be helpful in defining some aspects of what a Web-based 
front-end to VistA
should include.

From reviewing the VistaWeb documentation a while back, it seemed to me that 
it would be
quite easy using M2Web to improve upon the views of VistA data provided by 
VistaWeb if
someone could take a little time just to specify what views are needed and what 
data
fields should be included. I had the same impression from a health-e-vet demo 
earlier, but
I haven't had the free time to pursue either very much so far. I have a good 
understanding
of the underlying technology (MUMPS, Fileman, Web, etc.) but not of the VistA 
EMR, so
someone with that knowledge and/or the time to gather it could help greatly to 
move such a
project along.

---
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)


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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Sowinski, Richard J.]

Has anyone gotten VistaWeb to function outside of VA ?

I haven't looked really closely at the code, but I thought it had some
pretty tight dependencies on things like the Master Patient Index, and the
Subscription Control file, in order to resolve where (what sites) to fetch
patient data from.

That is not to say it can't work outside of VA (especially in a demo mode)
but I thought certain data elements like INTEGRATION CONTROL NUMBER, and
SUBSCRIPTION CONTROL #, have to be populated with valid data, in order for
VistaWeb to know which sites to get the data from.

- Rich S.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of
Alberto Odor Morales
Sent: Wednesday, June 01, 2005 6:35 PM
To: hardhats-members@lists.sourceforge.net
Cc: [EMAIL PROTECTED]
Subject: [Hardhats-members] == VistaWeb Missing Apps ==


The installation manual for VistaWeb says that two apps:
1. VistaWebDocs
2. VistaWebUserMgt
should be in the EMR.zip file from ftp.va.gov

Well, they are not, and they are needed for VistaWeb to function properly. 

Anybody knows where can I find them?

Alberto

==
Dr. Alberto Odor Morales
[EMAIL PROTECTED]



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RE: [Hardhats-members] == VistaWeb Missing Apps ==

[Cameron Schlehuber]

I expect there would be a fair amount of code changes to get it to work
outside the VA environment.

The missing items Alberto asked about are now posted in two zip files (with
the names of the apps) at
ftp://ftp.va.gov/vista/software/packages/vistaweb/.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Sowinski,
Richard J.
Sent: Thursday, June 02, 2005 7:35 AM
To: 'hardhats-members@lists.sourceforge.net'
Subject: RE: [Hardhats-members] == VistaWeb Missing Apps ==

Has anyone gotten VistaWeb to function outside of VA ?

I haven't looked really closely at the code, but I thought it had some
pretty tight dependencies on things like the Master Patient Index, and the
Subscription Control file, in order to resolve where (what sites) to fetch
patient data from.

That is not to say it can't work outside of VA (especially in a demo mode)
but I thought certain data elements like INTEGRATION CONTROL NUMBER, and
SUBSCRIPTION CONTROL #, have to be populated with valid data, in order for
VistaWeb to know which sites to get the data from.

- Rich S.

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of
Alberto Odor Morales
Sent: Wednesday, June 01, 2005 6:35 PM
To: hardhats-members@lists.sourceforge.net
Cc: [EMAIL PROTECTED]
Subject: [Hardhats-members] == VistaWeb Missing Apps ==


The installation manual for VistaWeb says that two apps:
1. VistaWebDocs
2. VistaWebUserMgt
should be in the EMR.zip file from ftp.va.gov

Well, they are not, and they are needed for VistaWeb to function properly. 

Anybody knows where can I find them?

Alberto

==
Dr. Alberto Odor Morales
[EMAIL PROTECTED]



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