Hardware, servers, software - group knowledge

[Guest guest]

I think part of the reason we end up paying so much for information

technology in our practices is a fundamental lack of

knowledge. I had no idea that a server is merely a computer

with some extra software, much that could be obtained free. I'm a

hostage to vendors who tell me that I " must " have certain

hardware and software. I'm given lists like this:

Office Location Server

Specifications

When using the Alteer Central Server data

model, Alteer Office v4.8 will require the following hardware and

software for the Office Location Server:

• Processor:

1.2GHz or faster (Intel P4 1.8GHz or

faster recommended)

• Memory:

1GB RAM or more.

• Storage:

Minimum 50GB available hard drive space,

formatted NTFS

• Operating System:

Microsoft Windows 2000/2003 Server,

Windows 2000 Small Business Server, or

Windows 2003 Small Business Server Premium

• Database Software:

Microsoft SQL Server 2000 Standard w/ SP3

and applicable CALs

• Video:

Minimum resolution of 1024 X 768 16 Bit

color

• Fax Card:

Brooktrout TruFax 200 PCI Fax Card (Mfg.

Part # 904-030-50)

• UPS:

700 VA (Auto shut down capable)

• Remote Support:

pcAnywhere v11.01 Host & Remote

• Antivirus Software:

Symantec Antivirus Small Business Edition

v8.1

• Additional Software:

Adobe Reader v6.01

The implication of such a specific and forceful request/suggestion

is that most will blindly follow (myself included). Dell quotes

$7000-$9000 for this setup. The specifics of this particular

recommendation are not the point, but rather how can we share the

knowledge we each have in different aspects for the greater good of

all?

Would a bulletin board be more helpful for this type of exchange?

Gordon

At 08:53 PM 12/28/2006, you wrote:

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]

ok, any decent current computer will already contain the processor, memory and storage, and far exceed the listed minimums, figure approx 1500$. the server software can be purchased oem, eg sbs 2003 is <500$SQL is available for free on the internet (see alex's posts). all decent monitors are at least 1024x768 resolution, approx $150 for 17" lcd (get two, increases efficiency). good fax card can purchased for <100$, or why not use internet fax service, or udox, or apractis? ups approx 125$. remote access either free through the operating system (remote desktop), or gotomypc, 100$/yr. antivirus, approx 200$? adobe standard comes with fujitsu snapscan, approx 350$. IT to build and install hardware and software, approx 1000$. total cost significantly <7-9K$. it's like buying and maintaining a car-- the

more you know what's under the hood, how it works, and if you are willing to invest some sweat equity, if not in build and setup, only in product and service information, you can still lower your costs significantly. LL "L. Gordon " wrote: I think part of the reason we end up paying so much for information technology in our practices is a fundamental lack of knowledge. I had no idea that a server is merely a computer with some extra software, much

that could be obtained free. I'm a hostage to vendors who tell me that I "must" have certain hardware and software. I'm given lists like this:Office Location Server SpecificationsWhen using the Alteer Central Server data model, Alteer Office v4.8 will require the following hardware andsoftware for the Office Location Server:• Processor: 1.2GHz or faster (Intel P4 1.8GHz or faster recommended)• Memory: 1GB RAM or more.• Storage: Minimum 50GB available hard drive space, formatted NTFS• Operating System: Microsoft Windows 2000/2003 Server, Windows 2000 Small Business Server, orWindows 2003

Small Business Server Premium• Database Software: Microsoft SQL Server 2000 Standard w/ SP3 and applicable CALs• Video: Minimum resolution of 1024 X 768 16 Bit color• Fax Card: Brooktrout TruFax 200 PCI Fax Card (Mfg. Part # 904-030-50)• UPS: 700 VA (Auto shut down capable)• Remote Support: pcAnywhere v11.01 Host & Remote• Antivirus Software: Symantec Antivirus Small Business Edition v8.1• Additional Software: Adobe Reader v6.01The implication of such a

specific and forceful request/suggestion is that most will blindly follow (myself included). Dell quotes $7000-$9000 for this setup. The specifics of this particular recommendation are not the point, but rather how can we share the knowledge we each have in different aspects for the greater good of all?Would a bulletin board be more helpful for this type of exchange?GordonAt 08:53 PM 12/28/2006, you wrote: I agree. But a "server", from a software standpoint, is nothing morethan a program that runs on a computer on your network and isconnected or "listening" to what is called in "TCP/IP" (i.e. Internetlingo), a "socket" or "port" on the network. It's actually not reallythat hard to program it at all, and it can all be done with nowadayswith completely free open source programming tools. OK, so it doesrequire that it "authenticate" the request, like with a username

andpassword, and maybe restrict requests to only certain trusted IPaddresses, and possibly encrypt the data, but that's not that hardeither, and also can be done with free software. So why are wepaying so much money for that kind of feature in our EMRs? It's mainlybecause they know that you will likely have more users on yournetwork, the "seats", as they like to term it in the licensingagreements, and they want to be sure to capture all the revenuepossible from your installation. In other words, as Larry says, itappears in some cases, they want to "MD" off of you. Caldwell, M.D.> __________________________________________________

[Guest guest]

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]

From Drain, Oregon Gordon, my small computer company built this list of things for my server, plus the extended front desk computer, with two flat screen monitors, plus a tape system backup, plus installing......for about $3000.00. We run our micropractices solo, giving better service and better function for less money because we trade on our knowledge and are willing to change the way practice happens. Other small business people are doing that in their areas of expertese. Why not look beyond Dell for a well recommended, work-oriented private computer geek company run locally? Joanne Holland DVM/MD"L. Gordon " wrote: I think part of the reason we end up paying so much for information technology in our practices is a fundamental lack of knowledge. I had no idea that a server is merely a computer with some extra software, much that could be obtained free. I'm a hostage to vendors who tell me that I "must" have certain hardware and software. I'm given lists like this:Office Location Server SpecificationsWhen using the Alteer Central Server data model, Alteer Office v4.8 will

require the following hardware andsoftware for the Office Location Server:• Processor: 1.2GHz or faster (Intel P4 1.8GHz or faster recommended)• Memory: 1GB RAM or more.• Storage: Minimum 50GB available hard drive space, formatted NTFS• Operating System: Microsoft Windows 2000/2003 Server, Windows 2000 Small Business Server, orWindows 2003 Small Business Server Premium• Database Software: Microsoft SQL Server 2000 Standard w/ SP3 and applicable CALs• Video: Minimum resolution of 1024 X 768 16 Bit color• Fax Card: Brooktrout TruFax 200 PCI Fax Card (Mfg. Part # 904-030-50)• UPS: 700 VA (Auto shut down capable)• Remote Support: pcAnywhere v11.01 Host & Remote• Antivirus Software: Symantec Antivirus Small Business Edition v8.1• Additional Software: Adobe Reader v6.01The implication of such a specific and forceful request/suggestion is that most will blindly follow (myself included). Dell quotes $7000-$9000 for this setup. The specifics of this particular recommendation are not the point, but rather how can we share the knowledge we each have in different aspects for the greater good of all?Would a bulletin

board be more helpful for this type of exchange?GordonAt 08:53 PM 12/28/2006, you wrote: I agree. But a "server", from a software standpoint, is nothing morethan a program that runs on a computer on your network and isconnected or "listening" to what is called in "TCP/IP" (i.e. Internetlingo), a "socket" or "port" on the network. It's actually not reallythat hard to program it at all, and it can all be done with nowadayswith completely free open source programming tools. OK, so it doesrequire that it "authenticate" the request, like with a username andpassword, and maybe restrict requests to only certain trusted IPaddresses, and possibly encrypt the data, but that's not that hardeither, and also can be done with free software. So why are wepaying so much money for that kind of feature in our EMRs? It's mainlybecause they know that you will likely have more users on

yournetwork, the "seats", as they like to term it in the licensingagreements, and they want to be sure to capture all the revenuepossible from your installation. In other words, as Larry says, itappears in some cases, they want to "MD" off of you. Caldwell, M.D.> __________________________________________________

[Guest guest]

You can frequently buy a used server from a local computer installer

for pennies on the dollar. May last one was 500 with software. It

ran 6 doctors without a problem , duel raid etc. If you use the

local expertise you can save bunches, just like them using you can

save dollars in the long run.

Brent

>

> 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]

" Do, or do not-there is no try " -- Yoda

Wishing everyone a happy new year. It's time to put my money where

my mouth is. I think hardware and workflow is an excellent place to

start podcasts and anyone interested can e-mail me. Caldwell is

already on board and I hope to speak with him sometime this week.

The ideal way to proceed is for anyone interested to download the

software-www.gizmoproject.com and we can use both computers to

communicate. However, that is not absolutely necessary as I can call

out from my computer to a landline and it should work. I would like

to do the first few conversations with just two people and then

transition to conference calls. (With two or three people online).

Actually, today would be fine as I am just hanging around reading,

watching football etc. This coming Wednesday or Friday would also be

fine. Evenings would probably work. The second week of January I

will be in Kansas City-but this should work adequately with my laptop.

I should be able to fairly easily mix the conversations down into MP3

files and there are places on the web where I can upload it for

everyone to access.

Let me know-I'm ready to go-just have patience with me trying

something new.

Lou Spikol

Louis Spikol M.D.

Senior Healthcare Information Technology Consultant

Center for Health Information Technology

American Academy of Family Physicians

lspikol@...

lspikol@...

mobile:

>

> 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.

>

>

>

> .

>

>

> <http://geo.yahoo.com/serv?

s=97359714/grpId=9360914/grpspId=1705061327/msgId

> =10734/stime=1167589561/nc1=3836825/nc2=3848489/nc3=3848602>

>

[Guest guest]

This is pretty cool stuff. I am glad you are helping being on the

cutting and bleeding edge on this list serve. I often wonder if some

of the big wigs higher up in some of the large medical academies

really get what has to change at the grass root level.

Brent

> >

> > 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.

> >

> >

> >

> > .

> >

> >

> > <http://geo.yahoo.com/serv?

> s=97359714/grpId=9360914/grpspId=1705061327/msgId

> > =10734/stime=1167589561/nc1=3836825/nc2=3848489/nc3=3848602>

> >

>