RE: Re: Hardware, servers, software - group knowledge

[Guest guest]

FYI – the list Gordon posted is for

the old version of Alteer (3 years old) – current specs for version 5.1

are heftier. I’ll try to find them and post.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of l_spikol

Sent: Friday, December 29, 2006

9:05 AM

To:

Subject:

Re: Hardware, servers, software - group knowledge

Ha--- the hardware specifications are actually

minimal-I can build a

computer like this in 30 minutes from $600 worth of parts.

(Of course the software, configuration and other " value added " stuff

specially configured for doctors could make up the rest of the 4-

$5,000 worth. Maybe I'm in the wrong business.)

As we say in Philly-how much does this cost?-how much ya got?

Lou

>

> >I agree. But a " server " , from a software standpoint, is

nothing

more

> >than a program that runs on a computer on your network and is

> >connected or " listening " to what is called in

" TCP/IP " (i.e.

Internet

> >lingo), a " socket " or " port " on the network. It's

actually not

really

> >that hard to program it at all, and it can all be done with

nowadays

> >with completely free open source programming tools. OK, so it does

> >require that it " authenticate " the request, like with a

username

and

> >password, and maybe restrict requests to only certain trusted IP

> >addresses, and possibly encrypt the data, but that's not that hard

> >either, and also can be done with free software. So why are we

> >paying so much money for that kind of feature in our EMRs? It's

mainly

> >because they know that you will likely have more users on your

> >network, the " seats " , as they like to term it in the

licensing

> >agreements, and they want to be sure to capture all the revenue

> >possible from your installation. In other words, as Larry says, it

> >appears in some cases, they want to " MD " off of you.

> >

> > Caldwell, M.D.

> >

> > >

>

[Guest guest]

But isn’t

that Gordon’s point. Like Larry says, it pays to know what’s under

the hood, but for most docs, the challenge of 1) deciding to set up a low

overhead office and settling on practice type (LLC, S-corp, etc), 2) finding an

appropriate EMR, 3) finding an appropriate affordable location, 4) signing up

with insurance companies (or opting out of insurances), 5)deciding on and hiring

staff, 6) figuring out marketing, 7) etc, etc is so overwhelming that there is

little time for a general course in computer networking. Like 3rd year

of medical school and internship, there is so much to learn with IMPing. Much

of it may be stimulating, but it is voluminous. Unfortunately, if you only have

a few months, you have to rely on others expert opinions to fill in all the

gaps.

After I decided on my ehr, I too was given

a list of hardware to go with my system and was given the phone number to a guy

who could put it all together. My system works and works well. Total bill for

hardware and networking was around $14,000. Although I only have 2 desktops and

a server, I am told with the power of the server and the way it is configured,

I could add another 30 desktops. In other words, lots of wasted money and overkill

because I relied on expert opinions. But, the system works and I would not know

any better if it were not for this forum.

That is why we need to narrow down what

the true needs are for the software that is out there, so those without the understanding

of what’s under the hood of a computer can quickly get another opinion as

to what exactly they need to run a highly efficient IMP office.

Re: Hardware, servers, software - group knowledge

Ha--- the hardware specifications are actually minimal-I can build a

computer like this in 30 minutes from $600 worth of parts.

(Of course the software, configuration and other " value added " stuff

specially configured for doctors could make up the rest of the 4-

$5,000 worth. Maybe I'm in the wrong business.)

As we say in Philly-how much does this cost?-how much ya got?

Lou

>

> >I agree. But a " server " , from a software standpoint, is

nothing

more

> >than a program that runs on a computer on your network and is

> >connected or " listening " to what is called in

" TCP/IP " (i.e.

Internet

> >lingo), a " socket " or " port " on the network. It's

actually not

really

> >that hard to program it at all, and it can all be done with

nowadays

> >with completely free open source programming tools. OK, so it does

> >require that it " authenticate " the request, like with a

username

and

> >password, and maybe restrict requests to only certain trusted IP

> >addresses, and possibly encrypt the data, but that's not that hard

> >either, and also can be done with free software. So why are we

> >paying so much money for that kind of feature in our EMRs? It's

mainly

> >because they know that you will likely have more users on your

> >network, the " seats " , as they like to term it in the

licensing

> >agreements, and they want to be sure to capture all the revenue

> >possible from your installation. In other words, as Larry says, it

> >appears in some cases, they want to " MD " off of you.

> >

> > Caldwell, M.D.

> >

> > >

>

[Guest guest]

I have spent about $8000 over the last 2 years to build up to 5  workstations (3 imacs and 2 Ibooks) and 1 windows server, 1 Hp 3380 multifunction and 1 stand alone scanner, and wireless networking. When I started we had just 2 work stations. I have spent 0 dollars on IT support  in the last 2 years. To set up our network I took the computers out of their box and plugged them in, connected our internet cable to our airport base station and our network was working. I then set up a name and a password on each computer and our base station  to have a secure and encrypted wireless network.   Our network has been down for a total of 15 minutes in 2 years and that was because our wireless router got unplugged. Apple might be a bit more expensive but it is so simple I think that it makes much more sense for a small office for people who don't want to have to fiddle with their computers all the time. With an inexpensive emr such as Spring Charts available for macs I think that people need to consider Apple. It sounds that the people with amazing charts spend a lot of time fiddling with their systems. I currently use Powermed which I love but might be a little more emr than most people with an IMP might need. Larry Lindeman MDBut isn’t that Gordon’s point. Like Larry says, it pays to know what’s under the hood, but for most docs, the challenge of 1) deciding to set up a low overhead office and settling on practice type (LLC, S-corp, etc), 2) finding an appropriate EMR, 3) finding an appropriate affordable location, 4) signing up with insurance companies (or opting out of insurances), 5)deciding on and hiring staff, 6) figuring out marketing, 7) etc, etc is so overwhelming that there is little time for a general course in computer networking. Like 3rd year of medical school and internship, there is so much to learn with IMPing. Much of it may be stimulating, but it is voluminous. Unfortunately, if you only have a few months, you have to rely on others expert opinions to fill in all the gaps.After I decided on my ehr, I too was given a list of hardware to go with my system and was given the phone number to a guy who could put it all together. My system works and works well. Total bill for hardware and networking was around $14,000. Although I only have 2 desktops and a server, I am told with the power of the server and the way it is configured, I could add another 30 desktops. In other words, lots of wasted money and overkill because I relied on expert opinions. But, the system works and I would not know any better if it were not for this forum.That is why we need to narrow down what the true needs are for the software that is out there, so those without the understanding of what’s under the hood of a computer can quickly get another opinion as to what exactly they need to run a highly efficient IMP office. -----Original Message-----From: [mailto: ] On Behalf Of l_spikolSent: Friday, December 29, 2006 11:05 AMTo: Subject: Re: Hardware, servers, software - group knowledge Ha--- the hardware specifications are actually minimal-I can build a computer like this in 30 minutes from $600 worth of parts.(Of course the software, configuration and other "value added" stuff specially configured for doctors could make up the rest of the 4-$5,000 worth. Maybe I'm in the wrong business.)As we say in Philly-how much does this cost?-how much ya got?Lou> > >I agree. But a "server", from a software standpoint, is nothing more> >than a program that runs on a computer on your network and is> >connected or "listening" to what is called in "TCP/IP" (i.e. Internet> >lingo), a "socket" or "port" on the network. It's actually not really> >that hard to program it at all, and it can all be done with nowadays> >with completely free open source programming tools. OK, so it does> >require that it "authenticate" the request, like with a username and> >password, and maybe restrict requests to only certain trusted IP> >addresses, and possibly encrypt the data, but that's not that hard> >either, and also can be done with free software. So why are we> >paying so much money for that kind of feature in our EMRs? It's mainly> >because they know that you will likely have more users on your> >network, the "seats", as they like to term it in the licensing> >agreements, and they want to be sure to capture all the revenue> >possible from your installation. In other words, as Larry says, it> >appears in some cases, they want to "MD" off of you.> >> > Caldwell, M.D.> >> > >>

[Guest guest]

How true….

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ]

On Behalf Of s_clemen

Sent: Sunday, December 31, 2006

11:21 AM

To:

Subject:

Re: Hardware, servers, software - group knowledge

I think one of the biggest problems of starting an IMP

is that nobody

is out there designing the ultimate low overhead system. Due to lack

of knowhow, time, interest, a lot of us end up with systems with far

more infrastructure than is needed. It is like spending a fortune on

a Ferrari when the speedlimit is 45mph.

..