I am implementing automated HL7v2.7 reporting of observations on a point of care device. The way this works is by sending an "ORU^R30 Unsolicited Point-Of-Care Observation Message without Existing Order - Place an Order" message to what I'm assuming will be a laboratory information system or an associated channel in an integration engine. I'm currently going to have the device ask for IP/port numbers to the LIS and MPI/their associated connections on first set-up - our device is going to communicate over TCP/LLP.
Is this the smart way to do all this? I've never worked with HL7 or any kind of HIS before.
I appreciate any possible insight. This isn't the stuff you can learn about in the standard, and I don't think I can just email Epic and ask them how they design EHR/HIS systems.
Thanks!
Message Content: ORU^R30 is not a commonly used message type, but the structure is close enough to R01 that most systems will be able to receive it. Focus on making sure you collect as much patient demographics and the visit number, or better yet scan both from the patient's wristband barcode. You must have patient and visit to file the observations.
Transmission: It's safest to just do MLLP over TCP, it will speed up your installs because that's what everybody else does. The alternative is having the health system write something custom to receive the data, usually via the interface engine.
Network: It sounds like you're thinking of putting the connection info on the device. This probably is a bad idea, I would build some kind of aggregator service that actually sends data to the EHR, that way you don't have to deal with multiple devices trying to get through firewalls, etc.
Related
I recently purchased an HP Deskjet wifi-enabled printer (model no. 3515). Set it up successfully as good as that both me (in the same network as the printer) as well as another person few miles apart from me (having different isp than mine) could print wirelessly successfully.
The printing across network (printing from a network other than that to which the printer is connected) has been set-up and tested successfully both through Google Cloud Print and HP ePrint Software.
However, when it comes to scanning across network, or cloud scan as we may call it, none of these two support, or even say anything about, it. Talking to an HP customer care executive about it was fruitless as i expectedly got no better answer than 'it is not possible'. Also, unfortunately, I have not found anything worthwhile on internet regarding this either.
What my understand is - if printing could be done wirelessly across network, so could be scanning. After all, in both we do roughly the same thing but in opposite direction. That is, in layman's terms, if i am not wrong, in printing we convert digital information into hardcopy document, and in scanning it is just the other way round.
Please correct me if am assuming too many things too wrong.
HP ePrint is email based, i.e. the printer acts as an email client that polls a mailbox for print jobs. When you print to the cloud, your printjob goes to your printer's mailbox and the printer fetches the job from there. It is pretty much one-way, in the sense that you just send off the print job and hope it gets printed and there can be many different clients submitting print jobs to the same printer.
Scanning is much more complex and actually requires a fully working two-way communication, i.e. the computer is interacting with the scanner to tell it do to do a preview scan, selecting scannable areas/size, setting resolutions, etc. while getting instantaneous responses and data from the scanner. So it is not really feasible to do via a mailbox, and at least not via the printer's mailbox as you cannot read results from its mailbox.
You would think it would be possible for the scanner to send scanned pages to your mailbox, but I guess the implementation is just not there yet. There are some security implications, such as it would be a bad idea to start a scan job from a remote location, because then any bad guy could try to scan whatever secret document you happen to have placed in the scanner. But if you were to initiate the scan from the scanner and there select the email address to send the results to, it should be secure enough. I guess the developers at HP are saving some features for the next generation of multi-purpose devices so they can sell you a new device next year.. :)
I don't know if it sounds crazy, but here's the scenario -
I need to print a document over the internet. My pc ClientX initiates the process using the web browser to access a ServerY on the internet and the printer is connected to a ClientZ (may be yours).
1. The document is stored on ServerY.
2. ClientZ is purely a cliet; no IIS, no print server etc.
3. I have the specific details of ClientZ, IP, Port, etc.
4. It'll be completely a server side application (and no client-side on ClientZ) with ASP.NET & C#
- so, is it possible? If yes, please give some clue. Thanks advanced.
This is kind of to big of a question for SO but basically what you need to do is
upload files to the server -- trivial
do some stuff to figure out if they are allowed to print the document -- trivial to hard depending on scope
add items to a queue for printing and associate them with a user/session -- easy
render and print the document -- trivial to hard depending on scope
notify the user that the document has been printed
handling errors
the big unknowns here are scope, if this is for a school project you probably don't have to worry about billing or queue priority in step two. If its for a commercial product billing can be a significant subsystem in its self.
the difficulty in step 4 depends directly on what formats you are going to support as many formats are going to require document specific libraries or applications. There are also security considerations here if this is a commercial product since it isn't safe to try to render all types of files.
Notifications can be easy or hard depending on how you want to do it. You can post back to the html page, but depending on how long its going to take for a job to complete it might be nice to have an email option as well.
You also need to think about errors. What is going to happen when paper or toner runs out or when someone tries to print something on A4 paper? Someone has to be notified so that jobs don't just build up.
On the server I would run just the user interaction piece on the web and have a "print daemon" running as a service to manage getting the documents printed and monitoring their status. I would use WCF to do IPC between the two.
Within the print daemon you are going to need a set of components to print different kinds of documents. I would make one assembly per type (or cluster of types) and load them into your service as plugins using MEF.
sorry this is so general, but you are asking a pretty general and difficult to answer question.
We intend to design a system with three "tiers".
HQ, with a single server
lots of "nodes" on a regional basis
users, with iPads.
HQ communicates 2-way with the nodes which communciate 2-way with the users. Users never communicate with HQ nor vice-versa.
The powers that be decree a Windows app from HQ (using Delphi) and a native desktop app for the users' iPads. They have no opinion on the nodes.
If there are compelling technical arguments, I might be able to beat them down from "decree" to "prefer" on the Windows program (and, for isntance, make it browser based). The nodes have no GUI, they just sit there playing middle-man.
What's the best way for these things to communicate (SOAP/HTTP/AJAX/jQuery/home-brewed-protocol-on-top-of-TCP/something-else?) Is it best to use the same protocol end to end, or different protocols for hq<-->node and node<-->iPad?
Both ends of each of those two interfaces might wish to initiate a transaction (which I can easily do if I roll my own protocol), so should I use push/pull/long-poll or what?
I hope that this description makes sense. Please ask questions if it does not. Thanks.
Update:
File size is typcially below 1MB with nothing likely to be above 10MB or even 5MB. No second file will be sent before a first file is acknowledged.
Files flow "downhill" from HQ to node to iPad. Files will never flow "uphill", but there will be some small packets of data (in addition to acks) which are initiated by user action on the iPad. These will go to the local node and then to the HQ. We are probably talking <128 bytes.
I suppose there will also be general control & maintenance traffic at a low rate, in all directions.
For push / pull (publish / subscribe or peer to peer communication), cross-platform message brokers could be used. I am not sure if there are (iOS) client libraries for Microsoft Message Queue (MSMQ), but I would also evaluate open source solutions like HornetQ, Apache ActiveMQ, Apollo, OpenMQ, Apache QPid or RabbitMQ.
All these solutions provide a reliable foundation for distributed messaging, like failover, clustering, persistence, with high performance and many clients attached. On this infrastructure message with any content type (JSON, binary, plain text) can be exchanged, and on top messages can contain routing and priority information. They also support transacted messaging.
There are Delphi and Free Pascal client libraries available for many enterprise quality open source messaging products. (I am am the author of some of them, supporting ActiveMQ, Apollo, HornetQ, OpenMQ and RabbitMQ)
Check out MessagePack: http://msgpack.org/
Also, here's more RPC discussion on SO:
RPC frameworks available?
MessagePack: fast cross-platform serializer and RPC - please share experience
ICE might be of interest to you: http://zeroc.com/index.html
They have an iOS layer: http://zeroc.com/icetouch/index.html
IMHO there are too little requisites to decide what technology to use. What data are exchanged, how often, what size? Are there request/response time constraints? etc. etc. Never start selecting a technology before you understand your needs deeply.
I'm in the planning phase of our new site - it's an extension of some mobile apps we've built. We want to provide our users with a central point for communication and also provide features for users who don't want to/can't use the mobile apps. One of the features we're looking at adding is a reputation system similar in nature to the SO badge system. We're designing the system to use SOA.
I don't want to have to code all of this logic into the main app as discreet chunks. I'm thinking of creating a means to accomplish this which will allow us to define new thresholds and rules for gaining reputation and have them injected into some service. The two ways I've thought of doing this so far are:
To look for certain traits in a users actions and respond, this would mean having a service running that can run through the 'plugged in' award definitions and check for thresholds that have been met and respond appropriately.
To fire events when the user performs actions - listen out for those events and respond appropriately. Because the services which will be carrying out these actions are running in separate app domains potentially on separate servers the only way I can see having a central message bus to listen and respond to these events is by using something like MassTransit, nServiceBus or Rhino.Esb.
I know that using a service bus can very easily be inappropriately designed into an application that simply doesn't need it and most times - unless you're integrating disparate, heterogenous systems - you most likely won't need one when designing a new system but I'm a bit lost for options as to the best way to do this. I don't like the idea of having a service hammer the Db all the time in the background. But it does sound like it might be a lot simpler early on - later on - I dread to think!
Has anyone here designed a system like this? How did you accomplish this? We're designing for high throughput as we expect there will be times when the system will need to be able to cope with bursts of users.
I've designed a system that had similar requirements. To achieve this the key elements were:
Plugins
Event messaging - using Emesary
The basic concept is that the core is not aware of exactly which module will perform any given task.
The messages are defined and at points within the system they are dispatched. The sender is not aware if the message is required. This effectively decouples vast chunks of the system.
So to perform a job some code is plugged in, that registers with the event messaging bus and will receive messages. When it receives a message that it needs to process it will process it.
The Emesary code is extremely small and efficient in the first instance I've called it (Emesary and you're free to use it; or from Emesary CodePlex
As the system becomes more complex it is possible that there are lots of events flying about, if you get more than 20k a second it was always in my design to add filtering and routing (implemented by the recipient interface being extended to allow a recipient to specify messages it wants to receive during registration). I've never needed to add this filtering because Emesary is sufficiently efficient that it is the processing of the messages that takes the time.
I've build a version of Emesary which bridges two Notifiers across disparate systems using WCF, Corba and TCP/IP. I investigated using RabbitMQ and decided it was possible to use this underneath Emesary if needed.
Base Class Diagram
Scalable server.
This is a fairly complex example however it shows where Emesary fits in. In this diagram anything with a drop shadow can have multiple instances and this is managed outside of what I'm trying to explain here.
I am implementing some networking stuff in our project. It has been decided that the communication is very important and we want to do it synchronously. So the client sends something the server acknowledges.
Are there some general best practices for the interaction between the client and the server. For instance if there isn't an answer from the server should the client automatically retry? Should there be a timeout period before it retries? What happens if the acknowledgement fails? At what point do we break the connection and reconnect? Is there some material? I have done searches but nothing is really coming up.
I am looking for best practices in general. I am implementing this in c# (probably with sockets) so if there is anything .Net specific then please let me know too.
First rule of networking - you are sending messages, you are not calling functions.
If you approach networking that way, and don't pretend that you can call functions remotely or have "remote objects", you'll be fine. You never have an actual "thing" on the other side of the network connection - what you have is basically a picture of that thing.
Everything you get from the network is old data. You are never up to date. Because of this, you need to make sure that your messages carry the correct semantics - for instance, you may increment or decrement something by a value, you should not set its value to the current value plus or minus another (as the current value may change by the time your message gets there).
If both the client and the server are written in .NET/C# I would recommend WCF insted of raw sockets as it saves you a from a lot of plumbing code with serialization and deserialization, synchronization of messages etc.
That maybe doesn't really answer your question about best practices though ;-)
The first thing to do is to characterize your specific network in terms of speed, probability of lost messages, nominal and peak traffic, bottlenecks, client and server MTBF, ...
Then and only then you decide what you need for your protocol. In many cases you don't need sophisticated error-handling mechanisms and can reliably implement a service with plain UDP.
In few cases, you will need to build something much more robust in order to maintain a consistent global state among several machines connected through a network that you cannot trust.
The most important thing I found is that messages always should be stateless (read up on REST if this means nothing to you)
For example if your application monitors the number of shipments over a network do not send incremental updates (+x) but always the new total.
In a common think about network programming, I think you should learn about :
1. Socket (of course).
2. Fork and Threading.
3. Locking process (use mutex or semaphore or others).
Hope this help..