Yet Another Java Based FOSS PMS application

Just read on freshmeat about a new java based Practice Management System that is being developed under the GPL. Has anyone ever heard of openPMS? Most interesting is that they are claiming to support X12 and HCFA-1500 billing! One wonders why they did not simply join an existing project I wonder if they know about FreeB? It would be nice to have another free and open source X12 implmentation to study!

Some basic principles of Care2x

After observing some discussion threads in several lists lately, I believe we need to remind ourselves that Care2x:

a) does not and will not discriminate any nation, continent, language, race, religion, culture and socio-political-economic systems.

b) is not a religion and will stay neutral to religious beliefs.

c) is not a political platform and should not be abused as such.

d) is not a political tool and should not be abused as such.

e) is not a weapon and should not be abused as such.

f) has the PATIENT as its center of activities.

g) will respect other “standards” even if Care2x may or may not propose its own standard soon or in the future.

h) will try to integrate other “standards” (e.g. HL7) inside an abstraction layer (similar to ADODB in principle).

i) will not enter into a competitive race against similar projects but instead try to create a channel to communicate with their applications.

Also, Care2x’s mailing lists:

a) are democratic and every subscriber can post his own opinion

b) are not censored

c) subscribers should be responsible for their statements

d) subcribers are free to rebutt or counter any posted statement

d) subscribers’/members’ statements DO NOT automatically constitute the project’s principles.

A little known fact:
There are people from North America, USA and Autralia who are interested in implementing Care2x in their health institutions and are hoping to have it accepted widely in their countries. Interestingly, these people are modest, humble and chose to keep low profile.

Elpidio Latorilla

FreeB Bounty Program Announced

The Free Medical Billing Project (FreeB) has announced a bounty program for building interface bridges between FreeB and popular free as well as proprietary medical applications: ‘…In order to encourage developers to takle this challenge I am allowing users to donate to a bounty fund for various practice management systems. The first developer to submit working implementation of FreeB for a particular Practice Management System gets all the money. Further, I am also setting bounties for work on different formats and features. If you are a developer and would like to work on a bounty, or if you would like a bounty placed on a feature that is not here, please subscribe to the freeb mailing list and drop a line…’

Knoppix Offer to all Medical/Health Open Source related projects

Wilfried G�dert has put together a Knoppix CD of the Care2x project and is offering to include other medical open source screenshots, presentations and articles on the CD. Per G�dert, the creator of Knoppix is personally involved in this so the quality should be good. Please contact him at the above e-mail if you are interested. The full text of his announcement is within. This is different from the Debian-med project which seeks to create a specifically medical distribution of Linux.

(please forward this info to other Open Source projects) I spoke with Elpidio, that we have some place or make it possible for the Care2x CD

I wrote also to IValdes about it.

So i think if someone like to send me some papers or presentations from his Health/Medical related Open Source project. It is possible to add it at the CD. Prefered format is pdf or an Open Office format. Open Office will be includet to the CD.

I includet also Minaltas Gallery so that Screenshots send to me can be integrated in a folder. Pictures/Flash films of Developers or Developement Departements are wellcome. Please in a good resolution whats interesting for press. The Content and pictures must be free for distribution. Creative Commons will help you.

At every start of the CD a Browser pops up and give the information about this additional content with a link to the right folder. I need help for translations to other languages!!!
A pre design of the CD Startpage you will find here:

The Content of additional Information about health related stuff is inside the talk folder.

The Final version of the CD remastering is in a few days.
Please mail me your articles or at minimum some infos about your project to



AMA steps in as WebMD drops the ball

There is an article at Information Week regarding a letter that the AMA has sent to WebMD. From the article: ‘…The American Medical Association has sent a letter to WebMD Corp.,likely the medical industry’s most powerful player in electronic insurance-claims processing, complaining that it has mishandled claims submitted by doctors resulting in “hundreds of thousands of dollars” in delayed and denied payments, InformationWeek has learned. WebMD acknowledges there have been problems, but attributes them to implementing a new process…
Hmm, sounds like vendor lock in to me…
I wonder if this will drive people towards
better solutions

Knoppix Linux Kernel Bug

A lot of people are astonished that, after remastering a Knoppix CD, the result blows up a lot. The reason is that there is a Kernel bug what is not fixed. Normaly it makes no difference. But during the remastering process it has some sideeffects. It resets a lot of hardlinks that before were softlinks.

I tested a lot of different Knoppix versions that are remastered. I saw none that keep attention to the remastered Linux and what happened with it as result.

If you remaster a Knoppix CD you have to look at a lot of things. The same for linux and medical applications. Its the same effect that you see with Aspirin versus a Generic Drug. Its not the same result.

Today I personaly phoned Klaus Knopper who is personally involved in the remastered Care2x Knoppix CD. I also informed Elpidio (main developer of Care2x) and tested a pre-release Version of the CD. He likes the result very much.

Future planning for the ISO and the Care2x Knoppix CD will be at the Flensburg developer meeting. We plan a special team of experts there to for working on additional projects. These will be useful for other projects than the Care2x Project in the future.

Discussion are underway for improvements of Linux and Care2x for handicapped people. We will discuss these new projects in Flensburg. Klaus Knoppix is personally interested in supporting it. We are also looking for developers interesting in writing code and with special expertise.

Klaus needs a sponsor for braille. That’s realy important. There is a Knoppix version available for blind people. But if you realy test it the result nearly useless. Under real working conditions Knoppix and Linux needs a lot of improvement.

Please be careful about mailing Klaus personaly. He is answering but is very busy. There are more than 13000 e-mails with support requests for Knoppix at the moment. He likes to have a little time time to work on the projects.

The Care2x CD comes with the new Kernel and some improvements. It is tested. The Quality Control is being done by Klaus himself.



Linux used in Ortho Surgery System

“This article”: from the Globe and Mail states that Linux has been certified for use in medical equipment. *”The new Navitrack Station equipped with the IBM IntelliStation has already proved to be faster than the previous configurations, in the Operating Room. The Navitrack Station also has the IEC 601 certification international medical equipment standard.”*

VistA VivA 0.1 Introduced

*Updated 1/26/04: That’s version 0.1 not 1.0, folks.* Recipient of the 2002 Linux Medical News Award, K.S. Bhaskar has announced that VistA VivA 0.1 is now available. It is a bootable CD which runs VistA. *’…A klunky first release of OpenVistA VivA, the OpenVistA Linux live CD is
available for download from the WorldVistA project at Source Forge
( This live CD is based on
remastering Morphix ( and is a combination of Morphix
and OpenVistA SemiVivA…* Read on for the full text of the announcement.

“Release early, release often,” is a mantra of the open source movement,
I believe attributed to Eric S. Raymond.

A klunky first release of OpenVistA VivA, the OpenVistA Linux live CD is
available for download from the WorldVistA project at Source Forge
( This live CD is based on
remastering Morphix ( and is a combination of Morphix
and OpenVistA SemiVivA.

To use it, download and burn the ISO CD image from Source Forge, and
boot an x86 PC (probably at least 128MB RAM and a Pentium processor — I
don’t know what the minimum requirements really are, but I have tried it
on a 256MB 700MHz Athlon PC and a 1GB 1.8GHz Pentium IV PC) from it.
This will put you in a Linux desktop. Caveat: a PC running off a CD-ROM
based compressed file system will run more slowly than a PC running off
uncompressed files on a hard disk.

To run VistA, the operating system (if any!) on the hard drive will not
be touched. However, since I haven’t yet figured out how to operate a
database on a CD-ROM (and don’t expect to any time soon!), the database
will need to be installed on the hard drive. Open a terminal window by
clicking on the terminal icon at the bottom of the screen.

Morphix does not mount hard drive partitions by default, so you will
need to mount the partition on which you wish the database to reside,
e.g. “sudo mount -o rw /mnt/hda1” (if you are not sure what partitions
you have, type “cat /etc/fstab” and look for names that look like
/mnt/xdy or /mnt/xdy# where x is one of the letters h or s, and # is a

To install the database and run it, to run a previously installed
database, or to erase a previously installed database, run “sudo
/usr/local/OpenVistA/vista” (UNIX/Linux users note: there is no
ampersand at the end of that command!). You will be prompted for
required input (and taken to a GT.M shell prompt for the initial
install, from where you will be able to type D ^XUP, D P^DI, etc.). On
an install, the dialog box telling you the database is being copied may
go away before the copy is complete. You should wait for the GT.M

When completed, logout of Morphix. You will be taken to a shell prompt
from where you can type “halt” or “reboot”. Since the CD-ROM drive
won’t open at that point (since the CD is still mounted), I find that I
need to type reboot, and then eject the CD as the PC reboots, and then
power it down. Awkward, but it works. If you type halt, you will be
able to open the CD-ROM drive only on the next boot, as the BIOS does
comes to life.

This first release is klunky and primarily aimed at friendly users. If
you are uncomfortable with a GTM> command mode prompt from where you
have a roll and scroll VistA interface, this is not for you. Remember
that from “GTM>” you can type “Halt” to exit to a Linux shell.

I have created a forum (
for discussion of any issues at the WorldVistA project at Source Forge.
You can also submit Bugs
( and Patches
( and ask for
Support ( at
the WorldVistA project at Source Forge.

Networking is supported by Morphix. So you should be able to configure
your network interfaces and run a CPRS GUI on a Windows machine against
OpenVistA VivA.


If your PC can’t boot from a CD-ROM, you can make a bootable floppy
( is
a 1.4M floppy; I believe there is a 2.8M floppy image on the CD). Use
the Linux dd command or the DOS/Windows RAWRITE.EXE (available on the CD
if you just mount it) to write the floppy images.


Only hard drives with FAT16/32 (Windows 95/98/ME and some Windows NT
PCs) and common Linux partitions are supported. Hard drives with NTFS
partitions (some Windows NT, and most Windows XP and Windows 2000) are
known to be not supported. I don’t know about partitions with Linux
file systems such as jfs and xfs, since I don’t have access to PCs with

The GT.M database is not configured here with journaling turned on. So,
if you power down the PC without shutting down GT.M cleanly (Halt from
the command prompt — unlike other M implementations GT.M doesn’t use a
daemon), you will get database errors (likely to be benign, but you
should repair them). Refer to the Administration and Operations manual,
available at Source Forge
( You will need to enable
and turn on journaling if you want more operational robustness.

OpenVistA VivA is set up as a demo. It comes with no warranty express
or implied. Use it at your own risk.

OpenVistA VivA was done by me as a personal project and Sanchez was not
involved in any way.

Never trust technical work done by a manager.

OpenVistA VivA is untested by anyone except me, and my testing too has
been cursory.

D ^XUP from the GT.M prompt results in a VistA application complaint
about a terminal device not being configured in the database. I have no
idea what to do about it.

The time reported by Morphix seems to be one hour behind the actual
time. I have no idea why.

— Bhaskar

Much Activity on AMIA OS-WG List

The recently established American Medical Informatics Association (AMIA) Open Source Working Group e-mail list is showing a lot of activity. Currently this is a member-only benefit, but may become open to the public in the future. A request for short biographies of list members by myself yielded an impressive membership. It also yielded several previously unknown to Linux Medical News Free/Open Source projects and companies worth knowing about. Read more for full descriptions: OpenRCT, EvalSuite, Epimetrics group, Openkaart,
Prot�g�, caCORE. Apologies to those I’ve missed.

The Open Remote Collaboration Tool (OpenRCT) is a multidisciplinary effort to enhance collaboration – between students working together, between students and instructional staff, and between researchers who are not co-located in time and space. OpenRCT is an Open Source platform-independent, multimedia tool that supports synchronous and/or asynchronous communication. It can be used for group discussions, collaborative assignments, collaborative research, and distance communication.