Saint to Speak at HLUG

If you’d like to hear a live talk in front of a preponderantly male audience and check out my scruffy beard in person, Ignacio Valdes (that’s me) will be speaking about ‘How Linux Will Unify Medical Education and Practice’ at the Houston Linux User’s Group (HLUG) meeting Saturday September 2, 2000 at 2:00 pm. It will be held at Houston Area League of PC Users (HAL-PC) headquarters 4543 South Post Oak, Suite 200. Just follow the steady stream of geeks to the second floor. If you want to relax afterwards there’s a froofy day spa in close proximity to HAL-PC on the 1st floor. Go figure.

Review: Win4Lin Puts Windows on Linux Desktop

Updated 9/1/00: Let’s face it, on the desktop it is still a Microsoft world. Windows and the myriad useful programs such as Quickbooks, Lotus Notes and Photoshop, that are unique to it are not going to go away soon. While StarOffice 5.2 is VERY compatible with MS Office, a 100% clone of MS Office on Linux will not be available for some time, if ever. While many believe Linux on the desktop is inevitable, the coming years will be a time of transition. One of the best and least expensive ways to let the two operating systems co-exist and avoid annoying dual-booting is an excellent product from Trelos called Win4Lin which lets you run Windows 9x on your Linux Desktop.

While not perfect, it has many benefits: 1) Run Windows and MS Office from within Linux without having to dual-boot. 2) A crashed Windows session can simply be re-started from Linux and won’t bring the entire system down. 3) Runs as fast as native Windows. 4) Provides a smooth migration path between Windows and Linux. 5) Costs much less than its competitor VMware.

Most Linux systems have a dual-boot prompt in which you can choose which operating system to start at boot time. This allows both to co-exist on the same computer. If you’ve used the feature for any length of time it quickly gets tiresome having to reboot, bring up Windows, do what is needed in Windows, then reboot again to Linux. Win4Lin changes all of that by treating Windows as simply another program. A product overview on the Trelos site gives the technical details: ‘…tight integration with both the Linux filesystem and network stack,…[results in] no need to create separate partitions or configure additional networking services. This results in lower system overhead, higher performance, and ease of use.’

Problems with Win4Lin: you have to own a copy of the real deal Microsoft Windows. The 100% open source Microsoft free alternative, WINE, is not near completion and may never be since it has to clone Windows bugs as well as Windows functions. The other open source project Plex86 takes a virtual machine approach like Win4Lin’s competitor, VMware however, Plex86 is only capable of running DOS 6.22 at this stage. VMware has better application compatibility and supports more hardware at this time, but it is resource hungry and does not perform as well as Win4Lin. Installation of Windows 98 was extremely slow. VMware takes a virtual machine (VM) approach in which it emulates an entire PC. The installation interface and documentation is better than Win4Lin, but VMware costs much more at $299 or $99 for a student edition. Win4Lin costs $35. I’m told that adding RAM makes Windows performance with VMware comparable to native. VMware’s site recommends 128Mb minimum. Win4Lin’s performance was superior to VMware’s and comparable to native Windows. Update: The discussion below pointed out one final competitor is Bochswhich is a x86 software emulator.

Win4Lin installation guide needs improvement, and the installation user interface is somewhat clumsy. While not difficult to install, the instructions can be fragmented and sketchy, sometimes leaving you guessing as to whether you should be installing as root or as a regular user. But after the installation hurdle is passed, it is remarkable how well it works. It was eerie to see MS Internet Explorer running happily on Linux.

There are limitations with version 1.0 The biggest are no sound, com or serial port support (but there are patches available, see below) as well as only being able to run in either a fixed-sized window or full screen, but can’t be switched on the fly. Right now that means that it will only work on a 1024×726 or higher resolution screen for a window. Printing is supported and is simple to setup provided that a default Linux printer has been setup previously. Version 2.0 is currently in beta.

While limited, the product is very useful. In the reality of a Windows and Office dominated desktop, this is a very necessary bridge betwen the two that relieves the dual-booting chore. At $35 with a free upgrade to version 2.0 when available, it is well worth the price and is an example of a hybrid closed/open source system that will likely be the norm for the future.

The Software Gap

No where can the shortage of engineering resources be more acute than in clinical computing. A moderately useful system can consume tremendous man-hours. The NY Times on the web article Can ‘Open Source’ Bridge the Software Gap? writes about a report to the president on the ‘Software gap’ the article states: ‘…programmers simply could not
keep pace with exploding
demand for high-quality software…To bridge the gap, the
group said, the nation must not
only train more skilled
programmers but also explore
fresh, even radical, approaches to
developing and maintaining
software…the group, will recommend that
the federal government back
“open source software as an
alternate path for software
Score another one for open source software.

First HIPAA Final Rule Published; The Countdown to Mandatory Compliance Begins

On August 17th , the US Department of Health and Human Services published the National Standards for Electronic Transactions final transaction rule, which will have a significant impact on health care organizations conducting business via electronic transactions (such as claims clearinghouses). Available via the Administrative Simplification web, affected organizations have two years to comply with the first Final Rule directive, which will affect workflows, business processes as well as supporting technologies. Stiff fines and jail time await those who do not comply, according to William Braithwaite, senior advisor on healthcare information policy, DHHS.

IST Funds Many Health Related Projects

It seems as though the Europeans continue to be out in front of the US in adopting open source in healthcare: Information Society Technology (IST) is an executive organization consisting of 15 European countries that among other things funds healthcare technology projects, part of which are required to be in the public domain. Many of these projects sound ambitious. Support for open source can be found in their vision statement: “Start creating…seamless delivery of services and applications in Europe relying…upon testbeds and open source software…develop and converge the networking infrastructure in Europe to world-class” With more speeches here.

What Do You Think?

Shaun Grannis, MD writes:

1) I’m giving strong consideration to a fellowship in Medical Informatics to strengthen and refine my skills — currently looking in Boston and Minneapolis. What are your thoughts on this?

2) With all of the various open-source software projects going on, where do you see programming/design efforts best being spent at this time? I appreciate all of the hard work everyone is putting into the various projects, but I’ve not been too impressed with them to date (of course, they are alpha software!)

3) Do you see a viable career in open source medical software design/implementation/etc? I don’t need to be rich, but I do need to feed my
family. I haven’t reached a good answer to how I can devote my livelihood to doing open source work.

How about it LMN readers?