Step-by-step Install Guide Oscar Mcmaster Ehealth Cms On Ubuntu 10.04 Lts V1.5 6n5l1j

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and then hit Enter key. 7 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada

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CCT301 - OSCAR EMR CMS eHealth Solutions

Global Open Versity eHealth Labs

Install Guide OSCAR McMaster CMS on Linux Ubuntu 10.04 LTS v1.5

3. Next, Read the license and then select the and then hit the Enter key to accept the license and install the jdk6. 4. Finally, issue the ldconfig command $ sudo ldconfig Note: ldconfig creates the necessary links and cache to the most recent shared libraries found in the directories specified on the command line. 5. We’re done with this section.

Step 3: Install Ant Package The source code compilation process for OSCAR is managed by the Ant package. 1. To install Ant package, issue the following command: $ sudo apt-get install ant-optional 2. We’re done with this section

Step 4: Install MySQL Database Server Package Your specific OSCAR CMS data, profiles, and information will all be stored in the MySQL database. This installation sequence for MySQL will ask you for a secure for the database server – this as you will need it again later in the installation. 1. To install MySQL database server, issue the following command: $ sudo apt-get install mysql-server libmysql-java 2. When prompted, enter a new root , as shown in Fig. 2. Hit the Tab key to select , and then hit the Enter key. Repeat the when prompted.

8 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Fig. 2

Warning!: Do not forget the entered here, as it’ll be required later to to the MySQL database server. 3. Finally, issue the ldconfig command $ sudo ldconfig 4. We’re done with this section.

Step 5: Install Apache Tomcat 6 Package To OSCAR’s web based interface, the system leverages the extensive resources of the Apache Tomcat web application framework. 1. To install Apache Tomcat 6 web application framework, issue the following command: sudo apt-get install tomcat6 tomcat6- sudo ln -s /usr/share/tomcat6 /usr/local/tomcat 1. Test that Apache Tomcat is successfully installed, start your browser and enter the URL: http://localhost:8080. Try port 8180 if 8080 doesn’t work. (Note: If you’re using Ubuntu 8.04.4 LTS, you browser might render a blank page, its ok don’t worry, so long as it didn’t return an error, you’re good to go!) 2. We’re done with this section

Step 6: Install Pretty Good Privacy (PGP) Package At times you may be interested in encrypting your data if you’re worried of data falling into the wrong hands. Luckily OSCAR backup can be configured to use the Pretty Good Privacy subsystem. 1. To install PGP package, issue the following command: 9 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





$ sudo apt-get install pgpgpg 2. We’re done with section.

Step 7: Install CVS Concurrent Versions System (CVS) is used for source code control on the OSCAR Project. You will need this package to grab the OSCAR source code. 1. To install CVS, issue the following command: $ sudo apt-get install cvs 2. We’re done with this section

Step 8: Install PostgreSQL database server OSCAR’s prescription drug & allergy database, DrugRef, requires the PostgreSQL database. Note: If already installed, the packages will be upgraded. 1. To install PostgreSQL database server, issue the following commands: $ export LC_ALL=C $ sudo apt-get install postgresql python-pgsql $ unset LC_ALL Note: Please note that the sudo command is not required for the following export and unset commands. Note: for this hands-on lab session we have used entirely MySQL database! 2. We’re done with this section

Step 9: Install UNZIP Package If you are installing OSCAR on the Ubuntu 10.04 LTS Server Edition, then the default package will not include unzip. (Note: if you installed GNOME desktop on top of Ubuntu server, then you can skip this step.) It’s by default installed on the Desktop option. 1. To install UNZIP package, issue the following command: $ sudo apt-get install unzip 2. We’re done with this section. 10 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Step 10: Install Network Time Protocol (NTP) Service To keep OSCAR’s clock synchronized with the world, we recommend you install the Network Time Protocol (NTP) service. This will require that your OSCAR maintains a link to the Internet to work. 1. To install NTP service, issue the following command: $ sudo apt-get install ntp

2. These are all of the base packages that need to be installed. 3. We’re done with this part

Step 11: Reboot the server Now need to reboot the machine to effect some of the changes that we have made. 1. To reboot the server, issue the following command: $ sudo shutdown -r now 2. After the server restarts, once again, and proceed to the next section.

Step 12: Configuring the Base Packages A few environment variables need to be set to OSCAR server. 1. To set environment variables for some of our packages, use your favorite Text editor to edit the /etc/profile file, as follows: $ sudo vi /etc/profile

Which Text Editor to use?

A note about the following command – 'vi' (for visual editor) is a classic Unix editor (classic, in the sense of, you have to know it to really love it). Alternative editors exist. Examples of other Ubuntu editors include 'nano', if you are running in a terminal environment, and 'gedit', if you are running with a GUI. 'emacs' lovers need to install the emacs package via apt-get before you can use it as it is not part of the base distro. If you elect to use an alternative editor, replace 'vi' in the commands that follow with your editor of choice Note: If you are configuring OSCAR on a freshly installed Ubuntu desktop machine, then you should be safe to add these lines at the beginning of the /etc/profile file.






JAVA_HOME="/usr/lib/jvm/java-6-sun" CATALINA_HOME="/usr/share/tomcat6" CATALINA_BASE="/var/lib/tomcat6" ANT_HOME="/usr/share/ant" export JAVA_HOME CATALINA_HOME CATALINA_BASE ANT_HOME 2. To load the new environment variables into your existing terminal, run the following command. Please note that the sudo command is not required in this case. $ source /etc/profile 3. The infrastructure is now in place and it is time to get the OSCAR source code. 4. Test that Apache Tomcat is successfully installed, start your browser and enter URL: http://localhost:8080, and should the browser rendered as shown in Fig. 3.

Fig. 3: Apache Tomcat home page

5. We’re done with this section

Step 13: Configuring Tomcat6 We will now configure Tomcat6. 1. First, adjust the configuration file to allocate more resources to OSCAR. sudo vi /etc/default/tomcat6 12 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





2. Find the following sections and configure the variables to match what is below. Once again, we’re assuming that you have at least 4GB RAM. # Arguments to to the Java virtual machine (JVM). JAVA_OPTS="-Xmx2048m -Xms1024m -XX:MaxPermSize=512m" # Use the Java security manager? (yes/no) TOMCAT5_SECURITY=no 3. Save the configuration file and when you are back to the shell, then we next need create the SSL certificate to secure our Internet connection.

Step 14: Secure Apache Tomcat6 using SSL 4. To create the SSL certificate (localize the specific values noted in this command for your particular situation and change the default of "changeit" to something specific for your installation) by issuing the following command: sudo $JAVA_HOME/bin/keytool -genkey -alias tomcat -validity 3650 -keyalg RSA -keystore /etc/tomcat6/.keystore -key changeit -store changeit Note: below are the series of questions you will be prompted to answer (change as desired!): What is your first and last name? [Unknown]: Kefa Rabah What is the name of your organizational unit? [Unknown]: GOV Labs What is the name of your organization? [Unknown]: Global Open Versity What is the name of your City or Locality? [Unknown]: Vancouver What is the name of your State or Province? [Unknown]: BC What is the two-letter country code for this unit? [Unknown]: ca Is CN=Kefa Rabah, OU=GOV Labs, O=Global Open Versity, L=Vancouver, ST=BC, C=ca correct? [no]: y 5. Now, modify Tomcat’s server config file to secure encrypted connections via SSL. sudo vi $CATALINA_BASE/conf/server.xml 6. In the server.xml file, look for the SSL SSL HTTP/1.1 Connector entry and enable that block of configuration code by removing the comment tags (). 13 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Then modify the section to look like the following section. 7. With these changes now configured, we need to restart the Tomcat application server. sudo /etc/init.d/tomcat6 restart 1. Now you need to open your web browser and enter the following https://your-server-ip:8443/ Note: on the This Connection is Untrusted page, click I Understand the Risk link, and then click Add Exception… button. Final click Confirm Security Exception button.

2. Figure 4 shows that we can now access our server via secure SSL connection (i.e., https)

Fig. 4: SSL Secured connection (https)






Note: Those who are interested in learning more about configuring SSL/TLS on Tomcat can check these articles: Secure Connection Tomcat Webserver on Windows and HowTo Generate & Setup Secure Connection on Tomcat AS on Linux. 3. We are done with this section

Part 5: Install OSCAR CMS Server Step 1: & Install OSCAR 1. The first cvs command below will ask you for a – please respond by hitting the Enter key, without adding a (i.e., a null ). 2. By specifying a specific date/time on the checkout command, you ensure that you get a specific, dated version that you can track from. The command, run without the datestamp verb "-D "201005-05 23:59:59" will retrieve the most recent version that works for both BC and ON. 3. By specifying a particular release, you will get the code from that branch of the code. The command, run without the release flags, will get you the code from the development branch. If the development stream code is what you want, run the command without -r and also without "-r RELEASE_9_12". 4. It’s important to note that this tutorial is specific to the commands in the following section. mkdir -p $HOME/src/oscar_source cd $HOME/src/oscar_source

cvs d:pserver: [email protected]:/cvsroot/oscarmcmaster cvs -z3 -r d:pserver: [email protected]:/cvsroot/oscarmcmaster co -r RELEASE_9_12 -D "2010-05-05 23:59:59" oscar_mcmaster cvs d:pserver: [email protected]:/cvsroot/oscarmcmaster Note: It will take a few minutes for the source code to . 5. Next, to compile OSCAR, change its Build directory and run the ant command. cd $HOME/src/oscar_source/oscar_mcmaster/build ant 6. You may ignore the warnings from the compiler, however you should expect to receive the message: BUILD SUCCESSFUL, as shown in Fig. 5. 15 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Fig. 5

7. Next, copy the resulting WAR files to the web server. sudo $HOME/src/oscar_source/oscar_mcmaster/build/tmp/*.war $CATALINA_BASE/webapps 8. We’re done with this section

Step 2: Create OSCAR Database on MySQL OSCAR includes scripts to populate the MySQL database. 1. Change to the OSCAR MySQL Database cd $HOME/src/oscar_source/oscar_mcmaster/database/mysql Note: For the following set of commands, you need to replace ****** with a secure . this as it will be required to ister the database. Note: Only run one of the following two database creation commands! ƒ

Option 1: s that wish to use Ontario’s billing subsystem should run the following command (Note: we have used Ontario’s billing system): ./createdatabase_on.sh root ****** oscar_mcmaster

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Option 2: Whereas s who wish to use British Columbia’s billing subsystem should run this command ./createdatabase_bc.sh root ****** oscar_mcmaster Note: OSCAR s that are from neither Ontario nor BC can run either of the above commands (you must run one of them), then you will need to adjust the billing system according to your own location.

2. Next, we will need to move the "oscar_*.properties" files to $CATALINA_HOME as describe below. sudo $HOME/src/oscar_source/oscar_mcmaster/install/oscar_mcmaster.properties $CATALINA_HOME






sudo ln -s $CATALINA_HOME/oscar_mcmaster.properties $CATALINA_HOME/oscar.properties

3. Next, the oscar.properties file needs to be localized for your specific configuration. sudo vi $CATALINA_HOME/oscar.properties Note: Specific configuration variables to consider for modification may include the following (but please review all properties for your own situation): i)

First make these general changes, as follows:

db_ = oscar2003 ### change to your mysql database project_home = oscar

## replace with "oscar_master"

backup_path = /usr/local/backups/ ### change to a place for your backup files SHOW_APPT_REASON=yes ### uncomment by removing the ‘#’ ENABLE_EDIT_APPT_STATUS=yes ### uncomment by removing the ‘#’ #ticklerplus=on ### disable by adding the ‘#’ #clientdropbox=off ### disable by adding the ‘#’ CASEMANAGEMENT=all ### turn on the new echart CMESort=UP ### add this to make make the echart sort nicely TESTING=yes ### enables the Invoice Report feature FILTER_ON_FACILITY=false And also that the "drugref_URL" reads as follows: drugref_url = http://localhost:8080/drugref2/DrugrefService ## points locally ii)

Now make one of this special changes according to your region, either Ontario or BC, as follows:

•

Ontario s will probably want to adjust the following (Warning do not put any blank spaces at the end of any line!). In our case we have used Ontario.

db_ = ******* isNewONbilling=true billregion=ON billcenter = R phoneprefix = 705•

### change to your mysql database

### change to your local OHIP office code

BC s will probably want to adjust the following to match their environment

db_ = ******* visitlocation = P1|PEMBERTON dataCenterId = 00000 msp_error_codes =

### change to your mysql database

# supply the file location of msp error codes 17

April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





billregion=BC NEW_BC_TELEPLAN=yes CDM_ALERTS=250,428,4280 COUNSELING_CODES=18220,18120,17220,17120,16220,16120,13220,12220,12120,00120 phoneprefix = 613pathnet_url= # supply the Location of Pathnet DLL pathnet_name= # supply to access the system pathnet_= # supply ?s 4. If you didn’t change the default location for the documentation directories in the properties file, you will need to create the appropriate directories. sudo mkdir -p /usr/local/tomcat/webapps/OscarDocument/oscar_mcmaster/form/record

and in one line: sudo chown tomcat6:nogroup -R /usr/local/tomcat/webapps/OscarDocument/oscar_mcmaster/form


Part 6: Enabling New eCharts

Step 1: Enable eChart Now we’ll need to enable the new eChart interface. 1. To do this, issue the following command: cd $HOME/src/oscar_source/oscar_mcmaster/database/mysql java - .:$CATALINA_BASE/webapps/oscar/WEB-INF/lib/mysql-connector-java3.0.11-stable-bin.jar importCasemgmt $CATALINA_HOME/oscar.properties and adjust some tables mysql -uroot -p****** oscar_mcmaster

### will bring you to the mysql database prompt

mysql> insert into issue (code,description,role,update_date) select icd9.icd9, icd9.description, "doctor", now() from icd9; mysql> quit;

### gets you out of mysql







Part 7: Drugref2/3 In this section, I’ll show how to and install Drugref2 from Google code site. To do this, perform the following procedure:

Step: 1: Install Required Packages 1. Here, we are going to install the necessary tools to help us with ing and installing Drugref. These are Mercurial and Maven packages. i)

First, we’re going to install Mercurial package: http://mercurial.selenic.com/. Mercurial is a free, distributed source control management tool. It efficiently handles projects of any size and offers ease of use. Mercurial package is required to drugref2. To install it issues the following command: $ sudo apt-get install mercurial -y

ii)

Next, we need to install and learn Maven which for Ubuntu or Debian is a simple: $ sudo apt-get install maven2 -y

2. We’re done with this section.

Step: 2: Create Drugref Database Here, we are going to make this real simple, and just use MySQL database instead of PostgreSQL to hold our drugref database. To do this, perform the following procedure: 1. Now using your own name and for mysql, create drugref database as follows: mysql -uname -p mysql>create database drugref; mysql>quit;

2. Next, change or adjust memory settings for Java to allow for the increased load, if you haven’t done so. Not so surprising if you follow this howto and install on the same machine that is serving Oscar your JVM will be sucking back 800 MB of memory, 500 of it Heap. JAVA_OPTS="-Xmx2048m -Xms1024m -XX:MaxPermSize=512m" which could be a line in /etc/default/tomcat6 file but this is variable






3. Next, create a unencrypted http connector in Tomcat if you don't already have one typically port 8080 or 8180 4. We’re done with this section.

Step: 3: and install Drugref2 Here, you have two options to Drugref file, these are as follows: 5. the Drugref2 code from a separate repository: http://code.google.com/p/drugref2/source/checkout Alternatively, you can get a local copy of the drugref2 repository with this command: hg clone https://drugref2.googlecode.com/hg/ drugref2 this is the option we have used. 6. To build Drugref2: navigate to the drugref2 directory that you just ed and issue the command: $ cd drugref2 $ mvn clean install when down you should see a result as follows: [INFO] [install:install {execution: default-install}] [INFO] Installing /home/krabah/drugref2/target/drugref2.war to /home/krabah/.m2/repository/org/drugref/drugref2/1.0-SNAPSHOT/drugref2-1.0SNAPSHOT.war [INFO] -------------------------------------------------------------------[INFO] BUILD SUCCESSFUL [INFO] -------------------------------------------------------------------[INFO] Total time: 3 minutes 18 seconds [INFO] Finished at: Sun May 16 15:45:26 PDT 2010 [INFO] Final Memory: 12M/47M [INFO] -------------------------------------------------------------------7. Now navigate to $HOME/drugref2/target/ directory and copy the "drugref2.war" to where Tomcat will find it (i.e., in the webapps folder) and it auto decompresses the war, i.e., cd $HOME/drugref2/target/ sudo drugref.war $CATALINA_BASE/webapps 8. Now that Tomcat has extracted it navigate to 20 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





cd $CATALINA_BASE/webapps/drugref2/WEB-INF/classes/ and use your favorite Text editor: vi or nano , as follows: vi drugref.properties and then adjust the "db_" and "db_" to match what you used in Part 6 above to create the drugref schema for MySQL, as follows: db_=root db_=****** db_url=jdbc:mysql://127.0.0.1:3306/drugref db_driver=com.mysql.jdbc.Driver 9. Restart Tomcat6 for the changes to take effect: sudo /etc/init.d/tomcat6 restart 10. Next, vi or nano your "oscar.properties" i.e., sudo vi $CATALINA_HOME/oscar.properties and comment out your current "drugref_url" by placing a # mark ahead of the line; #drugref_url = http://localhost:8001 And add these two lines: RX3=yes drugref_url = http://yourtomcatip:port/drugref2/DrugrefService it should look something like: drugref_url = http://localhost:8080/drugref2/DrugrefService 11. Restart tomcat6 sudo /etc/init.d/tomcat6 restart 12. To populate the database with the drug data, open your browser and navigate to the server. If you installed on a local desktop version of Ubuntu it is as follows: •

Launch your browser and open http(s)://yourtomcatip:port/drugref2 to check that the JSP loads, as shown in Fig. 6.






Fig. 6

•

Next, open http(s)://yourtomcatip:port/drugref2/Update.jsp to allow the schema to populate with tables and data. (If you installed via a SSH tunnel open firewall access for port 8080 on the server and change localhost to its URL) Note: It will take awfully long time to render the data to the browser!

13. If you get tired you can check the progress from MySQL server: mysql -uname -p drugref mysql>show tables; Note: if you get 15 rows of table names you are still on the right track. Note: Time to head for that overdue coffee break NOTHING will seem to happen (except for the page loading symbol) for almost an hour so get a coffee. When you get back you should get the results rendered to the browser as shown in Fig. 7.






Table 1: Update Drugref Database!

Fig. 7

14. We’re done with this section.

Part 8: Time to try OSCAR We are now ready to to OSCAR for the first time. 1. To test the connection, open your favorite web browser and go to the web address of your server as shown below. You should see the OSCAR page, see Fig. 8. http://localhost:8080/oscar or using secure connection: https://localhost:8443/oscar or https://192.168.83.231:8443/oscar






Fig. 8: Oscar CMS Home page

Note: Your connection to the OSCAR server is encrypted. Note: Your browser may complain about your unofficial or uncertified certificate self-signed certificate. You can ignore these warnings and avoid them in the future by accepting and installing the certificate on your workstation. The instruction for doing this is browser specific and beyond the scope of this document, however, for Firefox 3, below is a simple howto: Note: on the This Connection is Untrusted page, click I Understand the Risk link, and then click Add Exception… button. Final click Get Certificate button, followed by Confirm Security Exception button 2. The default parameters for OSCAR is as follows: Name: oscardoc : mac2002 2nd Level code: 1117 Note: If you can , as shown in Fig. 9, then you have successfully installed a plain OSCAR and you can start playing with it.






Fig. 9: OSCAR McMaster CMS home page: Doctor Appointment Access

Warning! The first thing you will need to do once you is to change your primary s from the defaults, i.e. "mac2002". This expires exactly one month from the installation date.

3.

To change your primary , click Pref -> Change Your , see Fig. 10.

Fig. 10






Note: you need to enter a good complexity for your , see Fig. 11.

Fig. 11

4. Next, we need to activate Rx3, when logged into Oscar. Again from Fig. 10, click Set To Use Rx3 link and then click the check box "Use Rx3" and hit the Submit button, see Fig. 12.

Fig. 12

Note: When done, click the get back to Fig. 10

icon to close the window, and then click the Update button when you

5. For added security for your production environment you will need to secure your installation further and apply proper firewall/router configuration. For securing your network, please check our Firewall/Router article using IPCop: Install Guide IPCop Firewall/Router for Network Security with Spam and Virus Protection 6. We’re done with this section.






Part 9: Configure OSCAR Backup Step 1: Create OSCAR Backup Directory There are a number of ways to automate your backup of your data on the OSCAR server. A few areas will need to be considered are as follows: ƒ ƒ ƒ ƒ

the database the properties file the document directory the eforms directory

1. Our recommendation is to automatically backup the database nightly, then use rsync to move all the files, including the database dump to a remote machine for the sake of safety and risk management. 2. First, create a database backup directory, and change the permissions so that only the root can read the contents. sudo mkdir /usr/local/backups sudo chown tomcat6:nogroup /usr/local/backups sudo chmod 755 /usr/local/backups 3. Now we will create a script that we can use to backup the database and create an archive of all the dynamic files on the system. As the archive file of the ed files will become quite large over time, we’ll only keep two copies on hand at any given time. You can, of course, configure your system to keep more if you like. 4. First, we will create the file: sudo vi /usr/local/backups/backupOSCAR.sh 5. In this file, put the following lines (replacing the ****** with your actual MySQL database ): #!/bin/sh -e # /usr/bin/mysqldump –add-drop-table -uroot -p****** oscar_mcmaster > /usr/local/backups/backupOSCAR-`date +%F`.sql /bin/gzip -f /usr/local/backups/backupOSCAR-`date +%F`.sql /bin/mv /usr/local/backups/backupOscarFiles.tar.gz /usr/local/backups/backupOscarFiles.older.tar.gz /bin/tar cfz /usr/local/backups/backupOscarFiles.tar.gz /usr/local/tomcat/webapps/OscarDocument/oscar_mcmaster /usr/local/tomcat/oscar_mcmaster.properties 6. Make this file executable.






sudo chmod 700 /usr/local/backups/backupOSCAR.sh 7. We’ll configure Ubuntu to run the command every day. This is done by creating a cron job for the script we just made. Run the following command: sudo crontab –e 8. And add to the existing file an entry so that the command looks like below: # m h dom mon dow command 05 04 * * * /usr/local/backups/backupOSCAR.sh Note: You’ve now configured a daily backup of the MySQL OSCAR database. This backup will run at 5 minutes after 4 am, each morning. Each backup file will be created in the /usr/local/backups directory and will be time stamped based on the day it was created. 9. You will be able to see the contents of the backup directory with the command: sudo ls /usr/local/backups The complete sequence of configuring OSCAR backup is shown in Fig. 13.

Fig. 13

10. These backup files are also viewable/able via the Æistrative page as shown in Fig. 14. 28 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Fig. 14

Scroll down and under the oscarBackup heading click oscarDatabase/Document link, to access the page shown in Fig. 15.

Fig. 15






Step 2: Restoring OSCAR from a Backup 11. To restore OSCAR from a backup file, you run this command (once again, inserting your own in lieu of the asterisks, and also adjusting the timestamp for the appropriate backup file from your own directory): sudo zcat /usr/local/backups/backupOSCAR-2010-04-16.sql | mysql -uroot p****** oscar_mcmaster 12. Finally, for safety and disaster recovery sake; let’s move the backup files, and the backup database to a remote machine. This is accomplished by running the following command, and replacing name with a valid name for the remote machine, and replacing domainname with the FQDN or IP of the remote host: sudo rsync -azvv -e ssh /usr/local/backups name@domainname:backups 13. We’re done with configuring OSCAR backup and restore tasks.

Part 10: Getting Started With OSCAR CMS Now that OSCAR is installed, there are a number of activities that you will need to perform to get the most out of your new CMS. Some of these tasks may include: • • • • • • •

add s and configure their security and optionally their schedules configure your clinic information import your patient demographic records localize your billing templates and update the system to the latest fees schedule configure electronic access to your labs configure your prescription pad add some forms and eforms

Many of these activities are intuitive to configure and most are described in the guide which is available on the OSCAR Canada web site. In the next two sections, we will go through a couple simple tasks to get you started.

Step 1: Configuring Forms 1. to the OSCAR server as oscardoc. 2. Select from the menu Æ Select Forms., under oscarEncounter heading. This will open a window which allows you to add and remove the forms that are available via the patient’s Encounter window, as shown in Fig. 16.






Fig. 16

3. Highlight Discharge Summary from the Selected Forms list, and click <
Annual Annual V2 CHF Growth 0-36m Growth Charts ImmunAllergies Lab Req 2007 Mental Health MMSE PeriMenopausal Risk Assessment Rourke Rourke2006 Self Efficacy T2Diabetes Vascular Tracker

Note: to make your task easier, hold down the Ctrl key and click each selection desired and then finally, click the Add>> button. 4. When done with your selection(s), click the Close button to exit the Select Forms window. 5. These forms will now be viewable via the Encounter page of each patient.






Step 2: Enabling Flowsheets OSCAR s a number of flowsheets, including: • • • •

INR Hypertension HIV Diabetes

These flowsheets are enabled by configuring the disease registry. To do this, perform the following procedure: 1. First, to OSCAR if you haven’t done so, and then select Æ then under oscarEncounter heading click Customize Disease Registry Quick List, see Fig. 17.

Fig. 17

Next, click Edit Quick List Æ default, and then click the Continue button, see Fig. 18.

Fig. 18






2. Now enter each of the icd9 codes for the following items and select Add (select Close when you are finished), see Fig. 19: • • • • • •

Atrial Fibrillation (code: 42731) Diabetes Mellitus (code: 250) Essential Hypertension (code: 401) Human Immuno Virus Dis (code: 042) HX-VEN Thrombosis/Embols (code: V1251) Long-Term Use Anticoagul (code: V5861)

Fig. 19

Note: when done click the Close button twice to exit the oscarDXResaerch window. 3. And now, to enable a flowsheet for a specific patient, you will select from the patient’s Encounter Æ Dx Registry Æ Quick List window the appropriate condition. Note: The appropriate flowsheet will now be enabled on the Encounter page (you will need to refresh/reload the Encounter page to see the Flowsheet under the Measurements heading. 4. We’re done with this section 5. We’re done with this lab session for time being – however, do come around to check updates on this install guide. Note: This is a work in progress; please do come back and check on the status of the lab manual.






14. You have now completed the lab session on installation of OSCAR CMS on Ubuntu 10.04 LST Desktop. 15. Stay tuned and, keep checking this site and article for more updates as we’ll be updating this lab manual with more goodies. 16. Search the web with Google search and keep reading for hints on what to do next.

Part 11: Migrating OSCAR to a Latest Version In this section we’ll assume you have installed new server Ubuntu 10.04 LTS running OCAR 9.12, and would like to migrate your old that migrating from OSCAR 9.06 data. For those in the process of moving OSCAR EMR to the latest version – perform the following procedure:

Step 1: Backup your old OSCAR EMR Data 1. to your old machine via terminal server as 2. Change to you’re your backup folder, e.g.,: cd /usr/local/backups 3. Now, let’s create a backup script to backup our entire OSCAR installation. Using your favorite Text editor, create a new "fullBackupOSCAR.sh" file vi extendedBackupOSCAR.sh 4. Copy and paste the following text #!/bin/sh -e #set the backup directory name installation=oscar backup=/usr/local/backups mysql_root_=******* oscarname=extended.$installation.backup backupdir=$backup/$oscarname-`date +%F` #create the backup directory mkdir $backupdir #dump the mysql data into the backup sqlname=$oscarname.sqldump.`date +%F` 34 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





/usr/bin/mysqldump --add-drop-table -uroot -p$mysql_root_ oscar_mcmaster > $backupdir/$sqlname.sql gzip $backupdir/$sqlname.sql #tar the oscar server tarname=$oscarname.webapps.`date +%F` tar -cf $backupdir/$tarname.tar /usr/share/tomcat5.5/webapps gzip $backupdir/$tarname.tar 5. Run the backup script: sudo ./extendedBackupOSCAR.sh Warning! if the update goes horribly wrong, it is essential that you can roll back your server to what you had before. http://tech.oscarpei.net/2010/05/how-to-switch-oscar-to-new-server.html http://tech.oscarpei.net/2009/06/how-to-upgrade-oscar-to-latest-version.html 6. You’re done with this section.

Part 12: Adding a New Provider to OSCAR EMR It’s important to note that each provider’s ID must be unique because of the database relationship it builds. It is, therefore, necessary to check first to see what is your last number assigned to a provider before asg a number to a new provider. Therefore, before you can add a new provider, you must look through the existing providers to see what your last provider ID number was.

Step 1: Add a New Provider To do this, perform the following procedures: 1. to your OSCAR EMR web console with credentials. 2. Next, click on the tab and then from the following ISTRATIVE PAGE, under Provider heading, 3. Click the ‘Search / Edit / Delete Provider Records’ link to access a” Search a Provider” window 4. Now, click on the "Search" button without typing any name in the box, to get the full list of providers in the database, as shown in Fig. 20. As can be observed, we have two providers listed. 35 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Fig. 20

5. From Fig. 20, click on the ‘ID’ heading to put the ID numbers in numerical order – if you not yet done so (each heading allows you to sort the database by each of the heading titles when clicked) 6. After noting your last provider ID number, decide what the ID number will be for the new provider and write it down, in this case let use '000001' 7. Click on the Back link 8. Click on Add a Provider Record link, to access Add a Provider page shown in Fig. 21. Complete all the required fields and then click on the Add Provider Record button. name: szulu : mac2002#1 Pin: 1001






Fig. 21






9. When done, and no error encountered, you should be presented with “Successful Addition of a Provider Record”. Click on the Back link. 10. Now, click again on the ‘Search / Edit / Delete Provider Records’ link to access a “Search a Provider” window. Click on the Search button again to that our newly added provider record is indeed added, and as can be observed, it is, see Fig. 22.

Fig. 22

11. Click on the Back arrow. 12. You’re done with this section.

Step 2: Asg Security Role to a New Provider To do this, perform the following procedures: 13. to your OSCAR EMR web console with credentials, if you haven’t done so. 14. Next, click on the tab and then from the following ISTRATIVE PAGE, under Security heading, 15. Click the ‘Search / Edit / Delete Security Records’ link to access a “SEARCH SECURITY RECORDS” window






16. Now, click on the "Search" button without typing any name in the box, to get the full list of Security in the database, and verity that the has not been added to the Security. Click on the Back arrow when done. 17. Still under the Security heading, click on the Add a Record link, to access Add a page shown in Fig. 23. From under Provider No.:, click on the drop-down menu and select Shaka Zulu, and the complete all the required fields and then click on the Add Record button. name: szulu : mac2002#1 Pin: 1001

Fig. 23

Note: you should see a confirmation “Successful Addition of a Record”. 18. Click on the Back arrow. 19. Still under the Security heading, click on the Assign a Role to Provider link, to access ProviderRole List page shown in Fig. 24. From the row containing provider Shaka Zulu, under the Role column, click on the drop-down menu and select "doctor". Click on the Add button to assign this role to Dr. Zulu.






Fig. 24

Note: you should see a confirmation “Role doctor is added. (000001)”. 20. Click on the

icon to close the window.

21. You’re done with this section.

Step 3: Unlocking the New Provider 22. St times you may nee to unlock a provider . 23. For example, o unlock the new provider szulu’s to allow him to to Oscar EMR console: http://ip-address:8080/oscar/ 24. From under the Security heading, click on the Unlock link, to access Unlock screen shown in Fig. 23. From under Role name, click on the drop-down menu and select Dr. Zulue’s, ID number, and then click on the Unlock button.

Fig. 25






25. Now and as provider Dr. Shaka Zulu with following credentials: name: szulu : mac2002#1 Pin: 1001 •

If all is OK, you should be logged in as Dr. Zulu as shown in Fig. 26.

Fig. 26

26. To complete this section add the following providers: Receptionist, and a Nurse, and repeat all the steps to allow them to to the OSCAR EMR web console 27. You may add as many providers as desired. 28. You’re done with this section.

Part 13: Adding a New Demographic Record to OSCAR EMR Occasionally one may need to a new patient to OSCAR EMR.

Step 1: Add a New Demographic Record To do this, perform the following procedure: 1. to your OSCAR EMR web console with credentials. 41 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





2. Next click on the Search tab at the top, as shown in Fig. 27.

Fig. 27

3. From the Fig. 28, you have the option to search for the patient from the system or create one; however, it’s always a good idea to search the patient record first. Once done with search and confirming that the patient is not on the list, then you can go ahead him/her. 4. To create a new patient record, click on the “Create a new Demographic” link.

Fig. 28






5. From Fig. 29, ADD A DEMOGRAPHIC RECORD page, you have the option to search for the patient or add record by completing the required fields. When done click on the Add Record button.

Fig. 29

6. If all is OK and you have no error, you’ll be taken to the page shown in Fig. 30, which shows a “Successfully Addition of a Demographic Record”. You have the option to click Go To record link, Close this Window or Back to Demographic Search Page. Note: You may add as many Demographic records as desired for this lab session. Click Go To record link.






Fig. 30

7. When you click Go To record link, you’ll be taken to the record you just created as shown in Fig. 31. Here, you have option produce PDF files of the new patient.

Fig. 31

8. Now from Fig. 31, click on the Back button to be taken to the “Successfully Addition of a Demographic Record”. From there click on the Close this Window link to close the window. 44 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada






Step 2: Booking Appointment In this lab session, we created have created receptionist provider with the following credentials: Provider: Office Assistant Name: Emily Jones name: ejones : mac2002#2 Pin: 1002 1. to your OSCAR EMR web console as Emily Jones (ejones), with above credentials, as shown in Fig. 32.

Fig. 32

To book appointment for a patient, perform the following procedure:

2. Click on the appropriate date using the CALENDAR button on the upper left corner





• •


OR click the month tab and select the date OR advance a day at a time with the arrow on either side of the date in the upper left corner of the screen

3. Clicking on the desired time will open a window to enter appointment details as shown on Fig. 33. •

In the Last Name box, type part of the patients last name and click on the Search button or hit the enter key

•

From the list generated, click on the grey demographic number for the desired patient

•

Change the length of the appointment in the Duration box, if needed, from the default of 15 min to 30, 45, 60 min etc.

•

Finally, fill in the reason for the appointment and click Add Appointment button.

Fig. 33


Step 3: Viewing Patient’s Billing History 5. In the Appointment screen, click the Search tab 6. Type in the patients name and click Search 7. Click on the Demographic ID for the correct patient to access the ‘Patient’s Detail Record” 46 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





Alternatively, 8. If the patient has an appointment, click on the M beside the patient’s name on the Appointment screen 9. Clicking "BILLING HISTORY" shows a list of the encounters that have been billed with date, bill type, provider and comment column 10. Clicking on the date will allow you to view what was billed for each encounter 11. Only billed encounters that have NOT been submitted to OHIP can be unbilled and re-billed 12. You’re done with this section.

Part 14: Need More Training on Linux Are you having trouble understanding or comprehending the working of Linux OS, if so, then check out some of our introductory courses on Linux at: Global Open Versity, Vancouver Canada.

OSCAR EMR CMS e-Health Information Mgmt Solution Training This course is meant for owners and IT professionals who are responsible for deploying e-Health systems in medical clinics and hospitals. Students will learn how to install OSCAR v9.12 on Ubuntu 10.04 LTS. You’ll also learn how to update Ubuntu server, install and configure required packages and applications needed to run OSCAR e-Health, e.g., Sun JDK6, Apache Tomcat application server, MySQL database server, and OpenSSH server. You’ll learn how to secure your OSCAR server using SSL connection; how to setup OSCAR backups using Cron command on your local machine or on a remote off-site server, and how to restore your backups. Finally, you will learn how to perform some simple configuration tasks on your as-installed OSCAR server. Upon completion of this course, you should have acquired a capability and skills that will allow you to plan, design implement and deploy OSCAR e-Health information management system on a Linux Ubuntu machine •

OSCAR EMR CMS e-Health Information Mgmt Solution - CCT301

Call us today: Email: [email protected]. URL: www.globalopenversity.org

Part 15: Hands-on Labs Assignments 1. Install and configure Ubuntu 10.04 LS Server and then install OSCAR 9.12 on it. 2. Install and configure DNS server for your LAN 3. Install configure a messaging server using Sendmail for your network infrastructure Other Related Articles & Hands-on Lab Manuals: 1. Step-By-Step Install Guide eHealth OpenEMR on Debian 5 Server 2. Using Webmin and Bind9 to Setup DNS Server on Linux 47 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada





3. 4. 5. 6. 7. 8. 9.

Step-By-Step Install Guide Debian 5 Lenny Server v1.0 Step-By-Step Install Guide Mandriva Enterprise Server 5 Install Guide Secure Postfix Messaging Server with Dovecot and ClamAV on Linux v1.2 Deploy Secure Messaging Solutions using Sendmail & Dovecot Servers with ClamAV on Linux Build your own ISP Hosting using EH on Ubuntu 10.04 LTS Server Step-By-Step Install Guide DTC on Linux CentOS5 Server v1.0 Build your Own Private Data Center Backup Solutions using Ubuntu Powered RESTORE Backup Server v1.0 10. Install & Setup Astaro Security Gateway to Protect Corporate Network v1.1

References This document has been modified and adapted for our internal lab use from the original instructions by David Daley by Peter Hutten-Czapski and is freely licensed under the Creative Commons AttributionShare Alike 3.0 Unported License.

Troubleshooting 1. Configuring Oscar on Ubuntu — Family Medicine I_T_ group (MySQL Database Connector) http://it.oscarmcmaster.org/howto-s/configuring-oscar-on-ubuntu 2. 6_1 Basic Oscar 9_12 install (oscarmanual): http://sites.google.com/site/oscarmanual/-oscar-emr/6-0-installing-oscar/installing-oscar-onubuntu-10-4ltc-lucid 3. Troubleshooting OSCAR 9.12 Drugref installation and setup on Ubuntu 10.04 LTS: http://wiki.gnumed.de/bin/view/Gnumed/DrugRef

eHealth Server istration Training You can now and take our superb eHealth openEMR Server Training course, covering installing setup and configuring Linux Debian 5 and Ubuntu 10.04 LTS. Next you’ll learn how to install & maintain openEMR on Debian 5 and Ubuntu 10.04 servers. •

EIH21 – eHealth Server istration Training

----------------------------------------------Kefa Rabah is the Founder of Global Technology Solutions Institute. Kefa is knowledgeable in several fields of Science & Technology, Information Security Compliance and Project Management, and Renewable Energy Systems. He is also the founder of Global Open Versity, a place to enhance your educating and career goals using the latest innovations and technologies.

http://creativecommons.org/licenses/by-nc-sa/3.0/

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Kefa Rabah

A GOV Open Access Technical Academic Publications Delivering Cutting-edge Technology at your Fingertips in the 21st Century 48 April 2007, Kefa Rabah, Global Open Versity, Vancouver Canada



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