Successful build of RPMS

[Christian Caldwell]

Greetings HardHats Community -

I am looking for some guidance on getting a POC environment of RPMS up and running. I've tried using the WorldVista Docker Images but I ran into issues using various apps like Scheduling, Behavioral Health and others. Just trying to register a new patient errors out and completely closes the terminal give a ton of MUMPS errors on the way out. I've even tried to build an environment out in IRIS Community Edition on Windows and Linux using the guide included in the FIOA download here. Still no luck here as I get an error trying it initialize the site file as was, I can't start the CIA listener. Is there a working RPMS docker image or a good guide on how to successfully build an RPMS environment? I am looking to do a POC with some mental health orgs I help provide IT for and are looking for a EHR solution. When looking around the RPMS BHA App as well as the Third-Party billing and Registration Apps seemed to fit their needs well plus they are really feature rich compared to OpenEMR. Any advice or guidance that could be provided would be greatly appreciated. Hope to talk with the group soon. 

Christian Caldwell

[Sam Habiel]

I will respond in more detail in a couple of days. However, to start with, did you try this docker image?

https://hub.docker.com/r/worldvista/rpms/

--Sam

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[Christian Caldwell]

Hi Sam - 

Thank you for getting back to me. I've just discovered your website and am reviewing it to see if it can help. Yes, I have the WorldVista/rpms image as well as I've built in an image out using the Docker image tool here GitHub - WorldVistA/docker-vista: Dockerfile for VistA instances, but still no luck on getting these working in a functional state.  Here are a few examples of the errors I get with the Docker Images. 

Using the Clinical Scheduling GUI 

Scheduling App Terminal 

Patient Registration

Behavior Health on various screens/reports

[Sam Habiel]

Christian,

I will preface my response with a couple of recommendations:

1. Today, at this point in time all the people who used RPMS outside of IHS have stopped using it (Clinics in West Virginia, Hospitals in Hawaii); and IHS plans to move off RPMS, and per my history of RPMS where they moved systems before, I think they will succeed. I know they will lose a lot of functionality in the process, but RPMS is becoming hard to maintain for a small organization. People on the outside never appreciate how hard it is to maintain a massive software suite. For you, investing all of this money/effort in RPMS is in my opinion not worth it, since you have to try to support this for at least the next 10 years. At least, you should be able to tell that we don't have much activity on this mailing list anymore, unlike the older days. If you are considering an open-source system, perhaps try using VistA. I anticipate you being able to get support for it in the next decade.

2. RPMS is today a Cache/IRIS based system, and they used some newer features which expect use of that software.

To answer your questions:

1. Clinical Scheduling GUI: That's a configuration issue. But I won't help you fix it; part of learning to support VistA and RPMS is learning that you will spend your life on these issues.

2. Scheduling App Terminal: Check my Kernel-GTM project. I thought I fixed the issue; but if not, it should be simple if you know M.

3. Patient Registration: I think there is some configuration thing going on here. It requires looking at the error trap. It shouldn't be using the HLO package I think.

3. Behavioral Health: That's easy to fix, but if you are on Cache, it will work out of the box.

--Sam

To view this discussion visit https://groups.google.com/d/msgid/hardhats/67bcda60-ce01-4a72-adc5-9c3c991a0e63n%40googlegroups.com.

[PeterBodtke]

Hi Sam,

It has been over a decade since I posted a note to Hardhats. Over the years, on occasion, I have opened a HH group email to check in on the community. Obvisously I did not read the group messages frequently enough to know West Virginia clinics and hospitals in Hawaii stopped using RMPS, and now IHS will be sunsetting the system. Sad news indeed. In 2010, I was working for a VistA implementor and organized a visit to clinics in West Virginia for a customer/surgeon and the company's IT lead. Back then,  RMPS was working well for the clinics. In honesty, I didn't take a deep dive with the clinics to understand their costs and any perceived shortcomings.
I am curious why IHS and West Virginia have or are discontinuing to use RPMS. What do you sense put the nail in the RPMS's coffin? Is RPMS simply lagging behind the big electronic health records systems? Is the cost of support perceived as being too high? 

Peter Bodtke

[Nancy Anthracite]

Dr. Howard Hays, IHS CMIO, will be talking about what is going on with the IHS and RPMS at the Virtual VistA Community Meeting, Feb 20.  Keep and eye here for the time.  There are also prior presentations where he explains their decision process and decisions, at past meetings.

https://worldvista.org/Conferences/43rd_VistA_Community_Meeting

--

Nancy Anthracite

On Thursday, January 15, 2026 10:57:31 PM EST PeterBodtke wrote:

> Hi Sam,

>

> It has been over a decade since I posted a note to Hardhats. Over the

> years, on occasion, I have opened a HH group email to check in on the

> community. Obvisously I did not read the group messages frequently enough

> to know West Virginia clinics and hospitals in Hawaii stopped using RMPS,

> and now IHS will be sunsetting the system. Sad news indeed. In 2010, I was

> working for a VistA implementor and organized a visit to clinics in West

> Virginia for a customer/surgeon and the company's IT lead. Back then,  RMPS

> was working well for the clinics. In honesty, I didn't take a deep dive

> with the clinics to understand their costs and any perceived shortcomings.

> I am curious why IHS and West Virginia have or are discontinuing to use

> RPMS. What do you sense put the nail in the RPMS's coffin? Is RPMS simply

> lagging behind the big electronic health records systems? Is the cost of

> support perceived as being too high?

>

> Peter Bodtke

>

> On Tuesday, January 13, 2026 at 1:31:00 PM UTC-5 Sam Habiel wrote:

>

> > Christian,

> >

> > I will preface my response with a couple of recommendations:

> >

> > 1. Today, at this point in time all the people who used RPMS outside of

> > IHS have stopped using it (Clinics in West Virginia, Hospitals in Hawaii);

> > and IHS plans to move off RPMS, and per my history of RPMS

> > <https://smh101.com/articles/Hx_RPMS_final.html> where they moved systems

> > before, I think they will succeed. I know they will lose a lot of

> > functionality in the process, but RPMS is becoming hard to maintain for a

> > small organization. People on the outside never appreciate how hard it is

> > to maintain a massive software suite. For you, investing all of this

> > money/effort in RPMS is in my opinion not worth it, since you have to try

> > to support this for at least the next 10 years. At least, you should be

> > able to tell that we don't have much activity on this mailing list anymore,

> > unlike the older days. If you are considering an open-source system,

> > perhaps try using VistA. I anticipate you being able to get support for it

> > in the next decade.

> >

> > 2. RPMS is today a Cache/IRIS based system, and they used some newer

> > features which expect use of that software.

> >

> > To answer your questions:

> >

> > 1. Clinical Scheduling GUI: That's a configuration issue. But I won't help

> > you fix it; part of learning to support VistA and RPMS is learning that you

> > will spend your life on these issues.

> > 2. Scheduling App Terminal: Check my Kernel-GTM

> > <http://github.com/shabiel/Kernel-GTM> project. I thought I fixed the

> > issue; but if not, it should be simple if you know M.

> > 3. Patient Registration: I think there is some configuration thing going

> > on here. It requires looking at the error trap. It shouldn't be using the

> > HLO package I think.

> > 3. Behavioral Health: That's easy to fix, but if you are on Cache, it will

> > work out of the box.

> >

> > --Sam

> >

> > On Sat, Jan 10, 2026 at 12:22 AM Christian Caldwell <

> > christian...@mbskco.org> wrote:

> >

> >> [image: Screenshot 2026-01-09 221054.png]Hi Sam -

> >> Thank you for getting back to me. I've just discovered your website and

> >> am reviewing it to see if it can help. Yes, I have the WorldVista/rpms

> >> image as well as I've built in an image out using the Docker image tool

> >> here GitHub - WorldVistA/docker-vista: Dockerfile for VistA instances

> >> <https://github.com/WorldVistA/docker-vista>, but still no luck on

> >> getting these working in a functional state.  Here are a few examples of

> >> the errors I get with the Docker Images.

> >>

> >> Using the Clinical Scheduling GUI

> >>

> >> [image: Screenshot 2026-01-09 215959.png]

> >>

> >> Scheduling App Terminal

> >> [image: Screenshot 2026-01-09 220507.png]

> >> Patient Registration

> >> [image: Screenshot 2026-01-09 221054.png]

> >> Behavior Health on various screens/reports

> >> [image: Screenshot 2026-01-09 221505.png]

> >> On Friday, January 9, 2026 at 9:52:31 PM UTC-7 Sam Habiel wrote:

> >>

> >>> I will respond in more detail in a couple of days. However, to start

> >>> with, did you try this docker image?

> >>>

> >>> https://hub.docker.com/r/worldvista/rpms/

> >>>

> >>> --Sam

> >>>

> >>> On Fri, Jan 9, 2026 at 11:48 PM Christian Caldwell <

> >>> christian...@mbskco.org> wrote:

> >>>

> >>>> Greetings HardHats Community -

> >>>>

> >>>> I am looking for some guidance on getting a POC environment of RPMS up

> >>>> and running. I've tried using the WorldVista Docker Images

> >>>> <https://github.com/WorldVistA/docker-vista> but I ran into issues

> >>>> using various apps like Scheduling, Behavioral Health and others. Just

> >>>> trying to register a new patient errors out and completely closes the

> >>>> terminal give a ton of MUMPS errors on the way out. I've even tried to

> >>>> build an environment out in IRIS Community Edition on Windows and Linux

> >>>> using the guide included in the FIOA download here

> >>>> <https://rpms.worldvista.org/>. Still no luck here as I get an error

> >>>> trying it initialize the site file as was, I can't start the CIA listener.

> >>>> Is there a working RPMS docker image or a good guide on how to successfully

> >>>> build an RPMS environment? I am looking to do a POC with some mental health

> >>>> orgs I help provide IT for and are looking for a EHR solution. When looking

> >>>> around the RPMS BHA App as well as the Third-Party billing and Registration

> >>>> Apps seemed to fit their needs well plus they are really feature rich

> >>>> compared to OpenEMR. Any advice or guidance that could be provided would be

> >>>> greatly appreciated. Hope to talk with the group soon.

> >>>>

> >>>> Christian Caldwell

> >>>>

> >>>>

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> >>>> Groups "Hardhats" group.

> >>>> To unsubscribe from this group and stop receiving emails from it, send

> >>>> an email to hardhats+u...@googlegroups.com.

> >>>> To view this discussion visit

> >>>> https://groups.google.com/d/msgid/hardhats/5d8dfa5f-eba8-47af-89ed-92343544f8ban%40googlegroups.com

> >>>> <https://groups.google.com/d/msgid/hardhats/5d8dfa5f-eba8-47af-89ed-92343544f8ban%40googlegroups.com?utm_medium=email&utm_source=footer>

> >>>> .

> >>>>

> >>

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> >> https://groups.google.com/d/msgid/hardhats/67bcda60-ce01-4a72-adc5-9c3c991a0e63n%40googlegroups.com

> >> <https://groups.google.com/d/msgid/hardhats/67bcda60-ce01-4a72-adc5-9c3c991a0e63n%40googlegroups.com?utm_medium=email&utm_source=footer>

> >> .

> >>

> >

>

>

[Christian Caldwell]

Hey Sam - 

Thanks for the response. I appreciate your feedback and advice on this. I will spend a little more time playing around with the Docker image of Vista. The mental health app in Vista just seems a little lacking compared to the RPMS Behavioral App. I know the schedule, patient registration, and third-party billing apps in Vista are similar to RPMs, as far as I can see. From what I can research and work, I'm pretty sure I could get the behavioral health app over to Vista. It's a bummer that IHS and Vista are moving away from these apps over to Cerner. They have so much potential with just a little investment. I know MUMPS is an older language, but it's still widely used, especially since Meditech and Epic are still based on it. WelI look forward to joining the group and conversations. Thanks again for the advice. 

Christian Caldwell

[Christian Caldwell]

Quick question: Can Vista/RPMS work on the community version of IRIS, or does the Resource usage limit of 20 cores and 8 connections prevent this?

Christian Caldwell  

[Christian Caldwell]

This is the error I get when trying to build on IRIS by the way 

[David Whitten]

The %RCR program is a recursive global copy command for FileMan. 

Could you print the copy you have for DIRCR to see which M operating system you copy is localized for ?

Did you run DO ^ZTMGRSET before you ran DO ^DINIT ?

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[Sam Habiel]

Almost by and large nobody knows about the people who left VistA/RPMS; whereas we always hear about the adoption; creating a bias in the remaining people around here that things are going great, when in reality they are not. For reference, the big success story Midland Memorial Hospital (c. 2006-8) switched from VistA to Cerner in 2015.

Chris E told me that the West Virginia clinics no longer use RPMS; from Chris U, I got a contact in Hawaii and I got to ask them how has their experience with RPMS been. I don't remember much of what he told me, but I remember that they were no longer using RPMS. American Samoa Hospital ended up purchasing a Medsphere system (which was VistA with parts of RPMS ported over), but Medsphere just went under and had to sell itself. 

I don't know why outside people left RPMS, but I think it's the 2 things I hear over and over again: lack of support (You can't run a medical system and say we will update the CPT codes whenever!), and lack of billing integration.

As to why IHS left RPMS: I have a strong insight into that, as I was part of the working group assembled to decide a "future" for RPMS. My task was to describe the current architecture, but I got to see the final report, which is public and was posted here. There are mainly 3 reasons:

- VA is moving away from VistA, and that's in parts of RPMS an existential risk.

- Even in the best of times, RPMS was difficult to support at the end user level due to lack of staffing, both at the local and national level. A lot of tribes left RPMS already, many due to this issue.

- Development of RPMS in the last decade was becoming quite difficult (Meaningful Use, the ever expanding suite of software requiring lots of experts, the Clinger-Cohen act requiring outsourcing which ironically decimated local talent, so new developers could not learn the system as all development is outsourced).

I know that IHS has had a very difficult decision to make, but luckily for them, ANMC in Alaska moved from RPMS 20 years ago, who showed that it's possible to do so.

Hope that helps,

--Sam

To view this discussion visit https://groups.google.com/d/msgid/hardhats/597c6617-e7f2-4931-a3c8-bc7389f80d5an%40googlegroups.com.

[Sam Habiel]

The community version is intended for experimentation and development; I don't think the license allows you to run a production system on it, even if it is small.

--Sam

To view this discussion visit https://groups.google.com/d/msgid/hardhats/906ae779-49c2-46ec-8c17-44d3512b1b02n%40googlegroups.com.

[Sam Habiel]

I remember in the back of my head from EONS ago that RPMS has MSM syntax in %RCR. Cache has had MSM compatibility; but I guess they finally killed it. The best thing for you to do is get a copy of DIRCR.m from VistA and get it over to your RPMS instance, and run ^ZTMGRSET again.

--Sam

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[Benjamin Irwin]

https://edu2.opensourcevista.net/vista/wbrtn.php?fn=rtn&rtn=DIRCR

[Christian Caldwell]

Hmm for some odd reason it won't let me import the dircr routine in. I'll keep playing with it. 

[Benjamin Irwin]

Christian,

This routine came from the FOIA release on GT.m.  A simple copy and paste of the routine from file into a IRIS routine would work.

Ben