Category: General

General Musings…

Categories
General Linux Open Source & Programming Pediatric Orthopedics

Making Media rich Medical Presentations using Emacs, Org-mode and Reveal.js – Part 1


Scenario

As a practicing Paediatric Orthopaedic Surgeon, I am called to meeting to present my work. This involves presenting to peers, co-workers, patients and parents of children I care for. Each of these presentations will be with a different focus on a particular topic. 

While this is not an uncommon scenario, the solution to create a reusable presentation slides using #OpenSourceSoftware tailored to individual audience is. Most doctors are not familiar with programming environment  and shy away from anything that is not WYSIWYG. They rely on good old #PowerPoint / #Keynote to save them. At the most some of them may try and use the clunkly #LibreOffice or #OpenOffice if they want to stick to OpenSource. Recently with advent of tools like Prezi, media heavy interactive presentations have become popular. The popular presentation softwares of KeyNote, PowerPoint have also spruced up their animations and transitions to enable them to look more attractive. Still the WYSIWYG nature of these and point-and-click makes them very slow. We could achieve better, faster and more attractive results with using #FOSS tools. 

 

What I use now

For the past few years I’ve been using a combo of 

  1. #LaTeX via #beamer class 
  2. #RevealJS ,
  3. #Emacs, Org-Mode, org-reveal
  4. #HTML5 and #CSS3
  5. FOSS Image and Video editing softwares as required to arrange the media. I mainly use GIMP, InkScape, KdenLive, OpenShot, HandBrake to arrange my media and encode them. 

My choice depends on the demands of the presentation. 

For media heavy, especially video heavy presentations I use RevealJS. For presentations that are more of less static with few videos I tend to use Beamer / LaTeX. What I note below are my experiences as I tried to create a smooth workflow that could replace PowerPoint ( or KeyNote / LibreOffice ) as a tool to create #Medical Presentations. 

Overtime I have refined my workflow and now I find that I am far more productive and my slides can pack much more information than a power point slide. While the more advanced interactions would require some knowledge of JavaScript, and therefore would turn off most doctors, most of what follows require minimal programming use. 

I will detail my workflow to create simple fast layout using Emacs and RevealJS without handcoding of JS and HTML. We will be relying on the RevealJS, Emacs, Org-Mode and ox-reveal package to do the lifting. 

 

Disclaimer : Even though it doesn’t need programming knowledge, ability to use Emacs is a must for this workflow. It is preferable that one is on a Linux OS as the attempt is to go all #FOSS here. 

 

so, here goes ….

 

Aim

To create an visually impressive medical presentation using non Power Point open source (FOSS) softwares.

Tools

  1. Emacs (24.3 or greater)
  2. org-mode
  3. org-reveal
  4. Reveal.js
  5. Chrome Browser
  6. Open source video codecs on the system

Why this and not PowerPoint ?

Over the years Medical Conference presentations have got mature and old tools have got boring. Varied audiences, topics, media content , interactivity required, transitions and animations to keep audiences interested have all changed.

PowerPoint with it’s traditional set of tools is boring to say the least. The point and click interface is slow by comparison to plain text typing. This seems counter intuitive to PowerPoint pandits but I’ve found that once the media is arranged and readied, once can create more far more attractive presentations with the tools mentioned above. 

As far as medical presentations go, the video presentations embedded PowerPoint / LibreOffice have a habit of breaking on stage. I have seen numerous instances of this happening.

And, of course PowerPoint costs 💰💰

It is also Closed Source making it difficult to edit and reproduce when you are with a system where it is not installed.

 

Okay, but why Emacs, why indeed ?

Emacs is Open Source

Emacs is stable

Emacs is good

Emacs is better than #Vim

Emacs has un-paralleled number of extensions and programming support

Emacs has Org-mode… 

 

Okay, So why org-mode, what has that got to do with presentations ?

org-mode is cool

org-mode is simple text

org-mode can be manipulated anywhere with text-editor

Its FOSS

It can be extended with other tools like org-reveal

 

Hm, Okay, but why Reveal.js ?

An actively developed FOSS Tool with a community

Allows 2D stacking of slides permitting nesting

Plugins and all the JS/CSS/HTML5 goodies can be integrated

Very good slider-presenter notes

PDF export option for handouts

Very nice transitions and animations

Good builtin themes and literally infinite customisation options as per CSS

Works very well with slide-projectors and remote tools to advance slides

 

Okay, but why use org-mode / org-reveal with Reveal.js ?

Org-mode is cool, easy, transparent text typing

org-mode is structured and nested just like a regular presentations would be

One can easily do a text-only sketch of a presentations by typing out a few lines of text in org–mode formatting and out put a neatly animated stacked presentation in Reveal.js

If one were to code HTML and JS with Reveal.js, it would be considerably opaque, with HTML markup and JS obscuring the structural details of the presentation.

By integrating org-mode, org-reveal and reveal.js we are integrating all that is good in respective tools while sticking to what the non-programmer user ( an average medical professional ) would like to do – type text and structure the presentation.

 

So, How to go about making one ?

Part 1 : Preparing the ground

Step 1 :

Install GNU-Emacs > 24.3

 

Step 2 :

Update package-archives and use Melpa archive.

Update org-mode.

 

Step 3 :

Install ox-reveal package

 

Step 4 :

‘require(ox-reveal) in your .emacs file

 

Step 5 :

Download and keep the Reveal.js file in a folder.

Note down the path to the folder relative to the folder where the presentation will live.

If you have Bower installed you can just do bower install revealjs

 

Step 6 :

Create a folder where your presentation will live. 

Inside the folder create subfolders for Images, Videos, Scripts, CSS styles and other documents which may be needed for the presentation. 

Now we can create the main file of the presentation – the Org-mode file using Emacs.  Org-mode file is a simple text file which can be opened using any other text-editor. It has the extension of  “.org”. 

While using Emacs and Org-Mode, however, it provides lot of goodies. Org-Mode in Emacs has lot of extensions one can install that extends it functionality. One can for example use the same org-mode file to output HTML, LaTeX, and PDF. 

So let us create the main presentation file. I title my presentations the following way, giving it context, separated by underscores : <topic>_<audience>_<date>_<venue> . For example if I am giving a public talk on Cerebral Palsy at my home town of Palakkad, on July 30th,2019 , I would title my presentation like this : “CerebralPalsy_PublicTalk_Palakkad_30072019.org”

This allows me to keep separate org-mode files for different audience and keep using the same images, videos etc.. Therefore I am fully portable and self-contained when I have to whip up a presentation tailored to any particular audience – technical or non-technical. 

C-x C-f  in Emacs  to the file you want to create with .org extension.

C-C C-# to insert Template for a Reveal.JS presentation.

If you have ‘ox-reveal loaded it should be available as a choice.

Once chosen it will list some options at the top of the org-mode file.

We will need to provide the path to the REVEAL_ROOT directory to the place we have stored the reveal.js library. This path is relative to the folder where the file for presentation lives. 

Once these are done, It is important to get the images, videos ready. They have to be edited using FOSS tools for editing photos and videos. Once edited they’ve to be named properly so that we can reference them in our presentations. 

 

This completes the ground work required to start writing the presentation. While this may seem a lot of work, one must remember this is one time effort.

We will deal with the actual creation of  org-mode file, the options while using Reveal.JS in the next part ….

Advertisement
Categories
General

Sanskritam at IIT


IITs has been asked to teach Samskritam … read all about it !

…..screamed our electronic media. The reaction has been mostly negative. Occasional person voicing some positive comments. Twitter has been abuzz, specifically with people and blogs quoting Deputy CM of Delhi, Mr. Manish Sisodia to the effect that whether the nex-gen JS version is really worth the upgrade over Samskritam. What better could one expect from a party whose leader is a self-confessed anarchist.

Armed with my usual salt ( a pinch is too small a dose. I take spoonfuls ) considering the state of our media I searched for the full press release of Ministry of HRD to find out what it actually said. Unfortunately there is no press release so far in public domain from Ministry of HRD on this. What was projected and decided without a debate was from her statements in Loksabha.

The most acceptable version seems to be …

Accordingly, IITs have been requested to teach Sanskrit language especially with reference to study of works which contain scientific knowledge,” Irani said

This is based on the report submitted by N. Gopalaswami, who headed a committee formed by Ministry of HRD in Nov. 2015 for promotion of Sanskritam as a language. This was set up to look into and recommend measures to integrate its  study with disciplines such as mathematics, physics, chemistry, medical science and law. It will suggest changes in Sanskrit education in schools and universities and modern ways to impart Sanskrit education.
Eventhough Ms. Smriti Irani has clarified that it would be an elective, the media is still abuzz with people commenting on this, each looking at it with their lenses.

I cannot understand…

How a language which has given birth to most of the Indian Languages we speak today in many states or influenced the rest heavily could be such a politically fought tool.
How Sanskrit the language cannot be decoupled from opression, cateism, exclusivity, hindutva, brahminism and aryan-dravidian politics. If it is because it brings back bad memories to some, why dosent the language English bring back memories of British Oppression, Elitism, Exclusivity, Divide and rule politics and Missionary work ? Why dosent Arabic/Persian raise questions about Islamic suppression and atrocities ?
You hate the oppressor, not the language that he/she speaks.

What’s in a name ?

The language is a language. The time when Sanskrit was widely used – nobody seems to know when this was – but lets assume a safe year of 1000 BC, there still seems to have other languages that drew from it and thrived. It was a pan-indic-religious languages. Lets face it.  Hinduism, Buddhism, Jainism have large volumes of works written in it. Its not this only-Brahmin heritage.
The so called Dravidian ( which itself is a Sanskrit word ) languages are all heavily drawing from Sanskrit. Being a native speaker of both Malayalam and Tamil and student of Sanskritam I can say that both these languages draw heavily from it. Its a myth that Tamil just grew alone and is untouched by Sanskrit. The poster boy of Tamil Literature, Thiruvalluvar and his Thirukkural itself has many Samskritam words in it.All the Thevarams praise the Vedic Gods and include plentiful Samskritam to convey  untranslatable concepts.
It is my regular question set to my tamilian friend when it comes to opposing anything Hindi/Samskritam:
If Thiruvalluvar himself did not want to cleanse non-Tamil words from Thirukkural, why do the tamil politicians bother to clean tamil of sanskrit/ north-indian influence ? Do the modern tamilians claim to be better tamil lovers than Thiruvalluvar ?
If tamil is really an independent language, how come tamil legends talk about Agasthiyar ( a vedic Rishi) as the one who created Tamil ?
How a vedic God Shiva become the first Tamil Sangam Leader ? 

 

Why .. Why … Why do people love to hate it ?

The answer is that Sanskritam hatred is convenient and beneficial.
Let see how many birds one can kill with one stone – just by opposing Sanskritam.
  • 1  : Hindutva lovers / Sanghis / BJP
  • 2 : Hail Dravidian Identity and Tamil nationalism
  • 3 : Project modernity and upwardly mobile culture
  • 4 : Hey, its not as if I dont get a job if i dont study it.
  • 5 : Brahmin:  you oppressor, take that

In short ..

It’s a soft target. It has ‘X’ marked on it for any passer-by’s convenience. A quick punch. The vent. The pleasure. Un matched for the number of political/philosophical schools it pleases at the same time – commies, aaptards, congis,dravidians, upwardly mobile…


So do we need to protect, revive and reinstate Samskritam ?

If India has to go back to the glory days when it attracted people from distant lands to come and learn at its Universities at Takshashila and Nalanda,  when its riches were stuff of lore told in other lands, when we were living in a different century than the rest of the planet, we need to first find out what worked for us. We need then to find out what went wrong. Then we can understand whether we can go back. If we already have it there is no need to reinvent the wheel, but to look at ourselves we need the lingua-franca of the golden ages to understand its literature.

I am not talking of searching for lost technology for building airplanes, of doing genetic works, but I am sure all those wise men who trooped to our famous universities did so for a very good reason. We’d be fools to not look into our own culture and history to get us back where we were, for that’d be the most natural step to take. We have already been there, done that. We can do it again.
Lets hope good sense dawns, once the dust settles and India can get back to where it was.

A gentle yet clear brushing off of the cobwebs of the so-called Aryan theory and all its vicious corollaries is therefore absolutely necessary, especially for the South, and a proper self-respect created by a knowledge of the past grandeur of one of the great ancestors of the Aryan race — the great Tamilians.

We stick, in spite of Western theories, to that definition of the word “Arya” which we find in our sacred books, and which includes only the multitude we now call Hindus. This Aryan race, itself a mixture of two great races, Sanskrit-speaking and Tamil-speaking, applies to all Hindus alike.

-Swami Vivekananda, Aryans and Tamilians
Categories
General Others

Would you wear a garment without a blouse?


At a politically tumultuous time when you’re not even sure what secularism, nationalism, sedition, freedom of speech in particular and freedom in general (aazaadi) is, we have here a  peice on what constitutes ….for want of better words , shall we say and in the process provoke a redefinition of the word ‘decently dressed’. Thought provoking for the impartial inquirer, revolting to the convent educated elite, too much for even the liberalism chanting neavueau-upworldly mobile, slap in the face for ultra-conservatives. All at the same time. Are we staring at the truth here – for isn’t not truth said to be unpleasant/uncomfortable ?

This piece was a reaction to seeing a room full of amazing black and white photos by Sunil Janah of women who were topless. Like the below photo of a Hill Maria Woman from Bastar.  Courtesy of the …

Source: Would you wear a garment without a blouse?

Categories
General Others Spine & Scoliosis Surgery

Interventional Pain management and Palliative Pain Care – a write up on Cancer Pain


Coimbatore Pain Clinic

 

Commemorative day for Cancer passed us by, mostly un-noticed amidst the din of modern self centered life. Here is an article by my dear friend and senior colleague Dr. Sekar Michael who runs a Coimbatore Pain Clinic at Coimbatore, Tamil Nadu, India and is actively involved in treating under priviliged cancer patients.

This was published in Times Of India, an Indian News Paper.

Categories
Deformity Correction and Limb lengthening General Orthopedics Pediatric Orthopedics

India’s battle againt Polio…

Categories
General

Is Medical Administration a wasteful expenditure ?


In continuation of my previous blog article: How many Administrators does it take to run a Hospital ?, the brevity and conclusion of which interested me so much that I went deeper into this subject.

A link from that article drew me to an article by Kevin MD on the subject of health care spending.

In India, as in the USA where health care spending is something worrisome, this should make very interesting reading.

It is no secret that there is no love lost between Administrators and Doctors in most institutions.

Usually the Administration claims that the doctors don’t justify the amount being spent on them by the Hospital in terms of salary and other facilities provided. This data seems to point otherwise.

As the final word on this is yet to be spoken, still every bit of more reading I do on this topic seems to affirm the feeling I always had : That I was right

See the link below for an interesting article on what the author thinks about this.

Claims are backed up with some data from US Presidents advisors…

Administration comprises one of the biggest factors for health care waste.

But does health reform do enough to streamline it? It’s doubtful.

Consider the following chart presented by David Cutler, a President Obama advisor:

Health care administration is a source of medical waste

In other words, for every one doctor there are 5 more are employed to do administrative tasks.

And, frankly, it’s ridiculous. As Dr. Cutler says, “There is a lot of money spent doing things that in no other industry do we tolerate.”

Health reformers are hopeful that the money spent for electronic health records and claims processing will cut down on the bureaucracy. But it’s doubtful. Because universal standards for health IT are fragmented and difficult to implement, it’s unlikely that digital systems are a viable answer. If anything, I can see electronic records creating more positions, such as IT support, that will further bloat the administrative side of health care.

This is compounded by the impending transition to ICD-10 — with a 10-fold increase in coding complexity.

Read More Here:

http://www.kevinmd.com/blog/2010/04/health-care-administration-source-medical-waste.html#more-43828

Categories
General

How Many Administrators Does It Take to Run A Hospital?


Dr. Wes: How Many Administrators Does It Take to Run A Hospital?.

I always asked myself this question…

How many administrators does it take to run a hospital smoothly.

They are apparently employed to make doctors life smooth which leads to better working environment and better patient care. .. well, at least in theory. In practice, things are a lot different.

So, I started searching. I was sure I was not the only one who was having these thoughts.

This is an interesting blog article on that subject. A very short one, but serves the purpose.

How Many Administrators Does It Take to Run A Hospital?

From KevinMD:

… for every one doctor there are 5 more are employed to do administrative tasks.

And, frankly, it’s ridiculous. As Dr. Cutler says, “There is a lot of money spent doing things that in no other industry do we tolerate.”

If you want to find out how many administrators it takes to run a hospital, ask yourself how many work on the weekend.

That number should be just about right.

-Wes

 

Once you have finished that,  please see this article for more data on this and wasteful hospital expenditure

Categories
General

The 20 most-watched TED Talks to date


The 20 most-watched TED Talks to date.

Categories
General Linux Open Source & Programming Python

Plone based Open Source Intranet Solution for Hospitals


As discussed in my previous post I have implemented an Open Source Intranet Solution in my Hospital, Ortho One Orthopaedic Speciality Centre, Coimbatore, India.

This is based on Plone. Customisation have been done to suit and hospital work flow. Necessary add-ons have been added to achieve the desired functionality along with custom scripts. Basic styling has been done to keep it simple and presentable.

Plone is served from an Ubuntu Server 12.04, 4GB Ram and 500 GB HDD. The processor is Core2Duo. This is a staging server. We may be shifting out once we have fitted the gaps and are ready to go live. That said the existing hardware serves well.

Here are a few screenshots:

Intranet Wall
Intranet wall for file dumping, discussions, chats, announcements.. even secret meetings !

Chat on Intranet.. Too lazy to create events, pages ? Chat away…

Staff Leave Calendar
Staff Leave Calendar

Intranet Login Page
The Login page…

Intranet Discussion Board
Discussion Board for the Intranet.

 

Categories
General Linux Open Source & Programming Python

Kaniyam August issue released


Kaniyam August issue released.

Categories
General

Guide to Successful Open Source Software Implementation in Hospitals – Some Difficulties That Needs to be Crossed..


      Its the age of Great Leap Forward..

People are happy, work goes on.. life is kind of strange with no BSOD but people are still carrying on.

One thing they are unhappy about.. They have to work. Gone or the days when their trusted OS used to giveway under then leaving them staring at a BSOD so that they could make a quick call to the IT in charge and go out for a coffee.

Excuses for work delay have come down.

So how did we get ourselves in this mess ?

We had to struggle.

What follows is a first hand account and a general guide for all Doctors who wish to implement Open Source Solutions / Software or Linux based systems at their workplace but are afraid to take the plunge.

For the technically minded Mr. Kumaran (http://kums.in) is preparing a more technically heavy note full of implementation details. Please watch that space.

 

Essential Reading

1) How we moved to Open Source at our hospital

2) Intranet &PACS

3) My Open Source EMR

4) EMR Implementation

Planning ::
==========

– Sit down and think what we want our computers to do for us and define a budget.

– This will dictate what software & hardware you need to get that
job done.

– Make the right Hardware and Software Investments. It is very easy to
get convinced by the vendor to invest more in features you may never
use / need.

– You need to choose you FOSS projects carefully.

http://www.ohloh.net/

http://www.sourceforge.net

gives you indices that help you decide the popularity of the software.

– Look Before you Buy: Always check the Linux Compatibility of the
hardware you are going to purchase after you have installed Linux.
While many will work out of the box, some will work after tweaking,
some may not work.

– Get the right persons for the job. There will be an element of luck
here. If you are, then you will find somebody passionate abt this. Consult them.FOSS enthusiasts and ready to help.

– Do your Homework: I worked for 5 years trying out one solution after another before settling on the ones I wanted. Since I know the work flow of my hospital, I naturally know what suits it the best.

– Keep it cheap. It can be done. Cost is important, even if you are willing to pay
more. Bargain hard. Buy only what you want. Dont by what you are
sold.

– Interoperability within and without your office. This is important.
When going down the not-so-beaten-before track. Detractors are many.
Complaints will be raised. It will be irritating. Don’t expect users
to share your idealistic vision. Every complaint needs to be
listened to and most of them can be safely ignored. Some of them
will give an idea of the gap that needs to be bridged.

– After-installation-service – accessibility, response time, ?365X24X7.
This needs support. If you have an in house reponse team that knows
FOSS solutions, then thats good, otherwise you may need to buy
support. My Open Source friends tell me that Red Hat support is good
and is value for the money paid. Decide on support. Lord Murphy is
always watching. Depending on the level of in house support there may be some investment here.

– Staff training had to be spot on so that there is no excuses
to put up your hand and say `open office is too tough`. This is the
most important. Implementation will fail otherwise. Management will
be inundated by complaints of `non-working’ computers. In our
Hospital. Mr. Kumaran cleverly themed Cent-OS to look list Win7.
Most users tech-savviness ends are very `iconic`, so thats all that
will require.

What did we do ::
=================

– Even when we had the WinSystems I stood firm and never let the management invest in MS office. It was unnecessary. Complaints were many ranging from inability to open external files to difficult UI.

Some of the complaints, especially UI related were somewhat relevent, but I decided not to pay heed. These have settled down.

– Avoiding repeated investments to tide over a initial improper investment: The Pros kept telling us to invest in Teminal Server License but we stood firm. I kept telling the management that that takes away the advantage of cost and that I could run it better without any further investment by installing Linux. There needs to be a strong FOSS enthusiast in whom the management has trust. Otherwise the Corporate win.

– Kept to a budget: When we cut off all the frills like antivirus, firewall, terminal license we cut off all the recurring expenses.

Know what you want and buy only that. They will try to sell you more; thats their job. Let them do theirs, and you do yours.

– Choose your FOSS projects you wnt to implement: Now that you have got the courage to implement, use only well maintained and mature FOSS projects. We have Cent OS , Ubuntu, Zope & Plone, mysql, postgresql, dcm4che,JBoss – all mature and well maintained. For EMR you can use Open EMR, Open MRS, GnuMed, GNU-Health. There are several DICOM viewers you can use depending on the data you want : Oviyam, Mayam, Osirix(Mac), Aeskulap, GingkoCADx, inVesalius and many more. ImageJ is useful with its Java plugins for image analysis.

-Use the LTS version of the OS if possible. Install it on the staging system first. Train all the staff, get them to use it everyday and stress the system. This will give you an idea as to what kind of server you need now and when you expand in future.

– Training. It is important to train the staff. This is paramount. Our Admin Officer (AO) who also looks after IT complaints goes around doing all the minor trouble shooting and doubts. Once the staff realise work has to be done with this, they keep quiet and try to learn. We do Plone/Zope training many times a week. The software vendor and our AO do the Hospital Software training. The basic use of a Linux thin client interface has been taught. The theming is very handy for bridging the gap.

– Firewall. Set up a linux firewall and set up basic access rights to prevent unauthorised access to internet. Setup a secure Wireless. This will help access to Intranet, PACS, EMR over mobile and touch devices and also allow remote access.

Accept the Sore Areas:

===============

Medical Presentations: Right now its only MS office. Even Mac guys have trouble presenting many times; atleast in India. This will need users to use their personal MS office products to prepare their presentations. Sadly Libreoffice Presenter leaves much to be desired. It can do the basic .ppt export, but cannot be relied upon

Printer Support: This will need you to look before you buy. If you have expensive existing systems please evaluate. We could not use two network printers (Sharp)after switching over. They are both aged, so replacement is an alternative.

External DICOM applications: Many patients come with CDs with bundled DICOM viewer software. This may not work in Linux ; even under wine. Depending on the type of practice this may be a problem. In our current practice most patients come with printed films so it is ok. Some of the DICOM viewers open / the CDs can be opened with Aeskulap, but GE PACS cd usually dont.

.docx files: People send you MS Office files of all kinds. You cannot expect them to save it in a legacy format. Ubiquity of MS Office and Win make them expect a reply when the files are received. MS office 2007 – 2010 files are an issue. Simple ones open. Extensive use of animation, graphics causes improper rendering. Usually Office communications are bland letters which open without an issue. For academic presentation use, we suggest you rely on a personal copy of MS Office in you laptop.

Hopefully these basic guidelines will help people to switch. This is first hand account. That should be encouragement enough.

We have made it happen at our Hospital. It is comfortable. Transition has been very smooth with most users not even knowing the OS has changed. They only feel the computer is faster.

Please feel free to leave comments in case of any implementation queries.
As I said before watch http://kums.in for technical updates.

Categories
EMR General

Document , Image Annotation & Drawing App for my EMR


This is a screenshot of Document, Image annotation & Drawing app with HTML and Javascript.
This will be integrated into the EMR.

Annotation for EMR
Annotation app for EMR

Categories
EMR General

My Hospital runs Linux (OR) How we closed the Windows & Opened the Doors


The Great Dream …

This post is my dream .. or has been for about 4 years.

A day that my hospital runs on full Open Source Software.

First a little about me. I am a practicing Paediatric Orthopaedic and Spine Surgeon. I am a Open Source enthusiast. I started using Linux 6 years ago and for past 4 year I am using it almost exclusively at work and home. The only time I use Windows is for the odd gaming. I do Python programming – web & desktop.

When we moved into our new hospital premises, set up 2 years ago, to start on a good note and to save start up cost I set up an Open Source Intranet (Plone) and Open Source PACS for my use at the Hospital. I also started developing my own EMR project that I speak abt in this blog.

I dreamed that the hospital will implement an all Open Source Solution. I advised them likewise.

They seemed to listen. Then FUD (Fear -Uncertainty-Doubt) took over them:

How can we follow the advise of this Non-Professional ?

What happens if we have a trouble in future and then he cant help us ?

Where do you find the Linux certified guys to help you ?

What happens if Linux is sold off to come company and it becomes a paid?

(Yes, they did actually say that ).

So they sell themselves to the “Professionals” . Our Management was no different.

It was advised that our Hospital will need the best server, a professional firewall, latest antivirus, and all windows machines. Individual desktops were advised, even for Reception area ! . This along with the latest MS Office and all the great accompaniments. … It was not cheap – It was not meant to be. The offer looked really good. The guileless management was tempted to say ‘yes’.

Then they thought they’d double check with me, just in case.

The Great Deliberation followed.

One looked at the order, I chopped off half of it. Why do you need a comp with Core2Duo, 320 GB drive, 4GB RAM and Win7Prof  for Reception, Cash ?. All that they ever use to is to login to our Hospital Software.

I suggested all Thin Clients, Open Office, Linux on Server. Firewall with Linux. No antivirus software. Intranet with Open Source and Open Source PACS system. Desktops only for Doctor chambers and Media editing.

After mustering courage and ample dosage of FUD from the Professionals, Management decided on Windows Server & Win Thin Clients. They were whining all the while saying that my idea is ill advised. I suppose he would considering that I trimmed the budget at least 5 -6 lakhs of Rupees.

So it was going to be a huge server we may never use with features and specs that many small IT companies may not have or want or need or use : Sonic wall firewall, MacAfee antivirus, MS Office on all Desktops the list went on and on… There were ThinClients at all stations and Desktop at Doctors rooms and other important admin areas only. IT was Windows everywhere.

The Professionals offered to set up the Server with domains all the security stuff. It was bundled with the purchase.

Things had barely gotten off the ground after a year of struggling to set it up. Then a 2 year jinx started.

The Great Depression followed.

The Thin Clients which needed to work with only our Hospital Software (written in Java) needs Firefox. Most stations needed this software for the daily work. Even though we had purchased the ThinClients after testing with Firefox and our Software, after implementation it was horridly slow. CPU was clocking   100 % the moment we use the software on Firefox.

The ‘Pros’ blamed it on Thin Clients. They told Mangement we told you so. You needed Desktops. Buy it and it will run things smoothly. Blame game between the ‘Pros’ and the software vendor started.

They could not sort it out for over two years. Work at the hospital suffered. We needed to replace the Thin Clients at the high workflow areas with old desktops to that we could serve.

All the while I kept telling them you move to Linux it will be all right, but they needed a ‘Pro’ to tell them that. Of course, they would not. They tried to sell us more. After `considerable study` at their HQ and evaluation of the software, they said it will be all right if the server did all the processing and asked us to shell out more for the Terminal  License for Windows.

I put my foot down and said no. I said I could make it run smoothly under Linux if they wanted, so they had better come up with a better option.

Things dragged on with no news from them even after 1 year. The Management was frustrated. Then Windows cracked and light came through. The Management decided to Open the Doors.

The Great Revival followed.

Enter Mr. Kumaran (http://www.kums.in)

Cent-OS it was then for the main server with customised `really thin` clients. One week of testing with VirtualBox and couple of flashed thin clients and the Managements saw the light of what I was saying all the while. All processing at the server. Hospital Software is fast. Staff are happy. Work gets done. Management is happy. Work get done with no money spent.

Now we have fully converted. Printing is an issue because of the WinPrinters we had purchased. Luckily most of the are aging and needs to be replaced.

The Great Leap Forward …..

Open Source Intranet Platform

  • Intranet has been customised and installed.
  • Used everyday at our Hospital now.
  • It runs Plone with add-ons and custom scripts.
  • Currently we are `fitting the gaps`
  • Scheduled implementation is due next month.
  • Staff seem to like the concept and are getting the hang of it.

Open Source PACS

  • Set up and running at full tilt
  • Currently in testing.
  • Scheduled implementation in a months time.

Our setup now contains

  • A main Cent-OS Server serving the Thin Clients
  • A Desktop with Ubuntu 12.04 PACS Server (Staging)
  • A Desktop Ubuntu 12.04 Intranet Server (Staging)
  • A Desktop Ubuntu 9.04 Server for the Hospital Management Software Maintained by Software Vendor. We need to migrate this as it is aging.

So, what are we leaping to ?

  • Open Source EMR
  • Open Source ERP
  • and more…..
Categories
General

Let us start at the beginning…..


In the beginning, I did not exist….

there was this great void on the web….

… then on one lazy Friday after noon.. after an enriching cup of hot Milo, the Spider decided enough was enough and in a great maniacal flurry of creative hurry, decided to leave marks of its existence on the web of life.

This Blog is a product of  that afternoon. Now i exist on Orkut, Facebook, LinkedIn, WordPress and Twitter..

Enough about Me…. Now on to something completely different………….

Me…( Ya.. i like Monty Python)

I am an Orthopaedic Surgeon,, that is to say i try to mend Broken bones.. and fix worn out Joints for a living.

I grew up in a small town called Palakkad; a dry and windy town of Kerala State in South of India.

After training and doing Fellowships in various subspecialities that has now come up to split up the once broad speciality of Orthopaedics.. i have come to subspecialize in Paediatric Orthopaedics, Deformity Correction and Spine Surgery.

When i get bored, i tweak my Linux and i code my Python, PHP.. I have a great project of building my own EMR.. ( that is an electronic medial record)

Jokes aside fellows,

Great to be here..  Just feeling my way around here..

Hope to fill the blog in coming days with Orthopaedic notes, Patient education write ups. Also plan to start a Python code snippet collection.. someday..

Thanks for peeping in..

Comeback sometime . Hope to have the contents ready.

..