VistA implementations and network technology

[Gregory Woodhouse]

I think I asked this before and didn't get much (any) response. I just want to get a feel for what kinds of network technologies (hardware, protocols, or both) are being employed by VistA adopters. Some possible scenarios include

Hardware (LAN/MAN)

1. No network at all (terminals and serial lines)

2. Conventional Ethernet (10BaseT)

3. Fast Ethernet (100BaseT)

4. Wireless LAN (802.11a/b/g)

5. Wireless MAN links (802.16)

6. FDDI

7. Multiple bridged LANs

8. Multiple LANs interconnected by routers or switches

Hardware (network access)

9. POTS (56K modem)

10. DSL

11. Cable TV

12. Frame Relay

13. Leased lines

Protocols (network)

14. IPv4

15. IPv6

16. IPX / Netware

17. OSI (NSAP)

18. Appletalk

Protocols (LAN, upper layers)

19. NSF

20. DCE

21. ECP (InterSystems)

22. SMB, NetBEUI (Samba)

23. iSCSI

24. HTTP/1.0

25. HTTP/1.1

26. Others?

Gregory Woodhouse

gregory....@sbcglobal.net

I hear and I forget.

I see and I remember.

I do and I understand.

--Attributed to Confucius, 500 BCE

[Mike Schrom]

Mine is a small office, solo MD, 2 receptionists.

LAN uses mixed 10BaseT(older machines with ISA slots) and 100BaseT
through cascaded unmanaged hubs.

No WAN (can't seem to get through my own firewall!), but Cable (without
TV) for internet, shared through a hub/router.

IPv4, mostly peer to peer. I set up Samba, but it doesn't always work.

Mike

> gregory....@sbcglobal.net <mailto:gregory....@sbcglobal.net>

[kdt...@gmail.com]

See below:

Gregory Woodhouse wrote:

> Hardware (LAN/MAN)
>
> 3. Fast Ethernet (100BaseT)
> 4. Wireless LAN (802.11a/b/g) <--- much lesser degree
>
> Hardware (network access)
> 10. DSL
>
> Protocols (network)
> 14. IPv4
>
> Protocols (LAN, upper layers)
> 22. SMB, NetBEUI (Samba) <--- a little.
RPC over TCP/IP
Also, SSH with tightVNC tunnelled

Kevin

[Ismet Kursunoglu]

> I think I asked this before and didn't get much (any) response. I
> just want to get a feel for what kinds of network technologies
> (hardware, protocols, or both) are being employed by VistA adopters.

2300 sq ft clinic with 96 Ethernet drops (about 4-8/room) heading to the server
confluence and into a patch panel.

VOIP system - (Asterisk/CentOS 4.3) with Digium Line card (TDM400) and
two Sipura 3000 units to handle the 4 POTS lines, with VOIP provider for long
distance (Axvoice) connected to Linksys SRW224P 24 port 10/100+2-1000 PoE
managed switch. VOIP phones are Snom 360 models (8 of these - plus one 320
model - tried Grandstream, but the Snoms are much better). BTW, the
Sipura 3000s are amazing products for VOIP.

Internet via DSL(Fixed IP 1MB) -> Ipcop firewall (also setup for DMZ but
not using this segment)-> D-Link DGS-1024D unmanaged 1 GB switch

HTTP for web management interfaces abound - Ipcop, switches, Asterisk,
phones, there is also one for our ECG unit but I don't have the
wireless system added for it yet (Burdick Eclipse Premier system). As an
aside, I don't really pay much attention to devices or diagnostic
tools that don't support Ethernet or TCP-IP. After all what good are they if
they cant' join the network?

SMB/Samba 3.0.14a for the file server for the Windows clients, however
Konqueror/KDE connects quite nicely from the Linux end of things.

CUPS server to handle the main printer - Kyocera FS-3820N which is also setup
as the VistA printer.

SSH via Debian/terminal sessions for VistA and then whatever CPRS uses
from the few Windows clients ($20 Dell GX100 800MHz Celerons with upgraded
Seagate disks seem to work just fine - got them from a local bank)

Debian/Sarge proxy package server - I guess that would come under
TCP/IP - so we can automate updates and security patches.

Dedicated Off-site Debian server with an East-coast hosting service for mail,
web and backup, sitting on a 10MB connection, using again SSH,rsync,
HTTP, IMAP(S), SMTP, TLS

NFS - at times for faster network transfers of large files.

Need to setup more formal local back-up system. Right now just using
rsync remotely for the critical files. Would like to run parallel GT.M
systems.

Anyhow those are the basics.

Thank you for all of your amazing lectures covering networking
technology.
--
Ismet B. Kursunoglu, MD, FCCP

Medical Director
Alaska Clinic, LLC
3750 E. Country Field Circle, STE B
Wasilla, Alaska 99654-6659
i...@alaskaclinic.com
voice (907)357-7240

[Gregory Woodhouse]

On Sep 28, 2006, at 7:38 PM, Ismet Kursunoglu wrote:

Anyhow those are the basics. 

Hey, it sounds like you have quite the setup. Do you mind if I ask whether your devices are unmanaged primarily for cost savings, because you have no need for remote management, or simply haven't implemented it? I ask because one thing I've often considered is implementing SNMP (another UDP based protocol!) in VistA; e.g., to monitor queue length in HL7, the state Broker listeners, and so forth.

Thank you for all of your amazing lectures covering networking

technology.  

Thanks. It's been quite a learning experience. Even when you are familiar with the subject matter, teaching it can bring a whole new perspective. Besides that, it's just been a lot of fun.

Gregory Woodhouse

gregory....@sbcglobal.net

"You can't win if you don't finish the race."

--Richard Petty

[Ismet Kursunoglu]

> Hey, it sounds like you have quite the setup. Do you mind if I ask
> whether your devices are unmanaged primarily for cost savings,
> because you have no need for remote management, or simply haven't
> implemented it? I ask because one thing I've often considered is

I just got the one managed switch for the VOIP portions of the
network. On that I just changed the password, IP address and turned
off the Spanning Tree protocol. We use to have some dropped calls
prior to going over to this setup (i.e. everything was on the one GB
switch) - now that problem is gone.

The other unmanaged switch was for the data side of things. No doubt
as we grow so will the network infrastructure and remote management
will become very important. Right now I am just .4 miles from the
clinic which makes it so much easier.

I was never really in control of any portions of our IT - but now with
this "alpha" project I am the owner and control all aspects of what
we do and how we do it.

SNMP would be very helpful indeed and I look forward to learning more
about it.