It’s been almost two months since I’ve contributed to this blog. A lot has been going on including the completion of our billing module for iRIS and enterprise upgrade to Snow Leopard, the building of a pool at home and adoption of a 8-month old Wheaten Terrier (dog), Kira.

In the Apple PACS world Osirix was upgraded to 3.6 which is a rather sizeable upgrade. Some of our SecureRAD customers are using it and we’ve had very little pushback. It’s solid.

Two new customers came online with SecureRAD this quarter including University of South Florida and a small but busy radilology shop in NC. Were having a lot of fun helping them solve some interesting problems.

Shipping DICOM data between two or many WAN-connected PACS archives is often a burden on infrastructure resources (bandwidth, switches, routers, etc).  A customer requested we install three separate PACS and have each system write data to the other creating a multi-site mesh-configured archival solution.  While at the surface this makes sense, the resources required to execute this solution are in excess of what is necessary.  An additional challenge on top of this is working with the DICOM c-store communication method which is inherently inefficient over WAN connected archives.  With DICOM, each individual medical image that is archived and stored is individually transmitted from the origin to the destination.  Erroneous TCP data encapsulates each communication compounding the amount of bandwidth needed for each communication to occur.

A solution we are now implementing to intelligently archive the medical imaging data produced during a given day is to package it and distribute it to the remote sites using SFTP at the end of business.  Efficiency is increased by a immeasureable magnitude by transporting a single data stream vs. many thousand streams (each individual image).  Once the package arrives at the destination a script extracts that data, parses it and uses DICOM’s c-store method to submit it to the local archive.  As well, an E-mail is sent to the PACS administrator notifying him/her of the success or failure of the transmission.

sudo /System/Library/CoreServices/RemoteManagement/ARDAgent.app/
Contents/Resources/kickstart -activate -configure -access -on -users
admin -privs -all -restart -agent -menu

This command saved my butt when it came time to install two Xserve’s (headless) as I had no access to a Mini Display Port adapter and Server Assistant “shit the bed.”

It’s worth mentioning you should be ssh’d in as Admin/Administrator.  I speculate this won’t work as root, but I don’t know.

Our son, “Topher”, was born on February 4th 2009.  Apparently blogging dropped off my priority list (see date of last post).  I’m dusting off the WordPress “dashboard” hyperlink and putting the pen to the paper, once again.

The birth of our son meant changing how business is done so I could be home to help.  Change is a good thing and in retrospect, has made SecureRAD a more succesful company.  Much of SecureRAD’s business is now direct-ship to the customer.  We’ve built and shipped a number of PACS systems from February 4th – June 13th.  Two of those “installations” are in Trinidad (I wanted to jump in the box and go, myself) and others are around the continental US.  Whether this is the right answer or not, I’m on the road again.  This time in Cleveland, Ohio installing at St. Vincent’s Charity Hospital.

(A note to Apple: Why not include the Mini Display Port adapter in the Xserve box?)  Seriously, this was a more frustrating moment of the installation which otherwise went off without hitch.  To get the headless servers setup with IP’s and ARD-available, I used Server Assistant.  This worked well until it came time to “Apply” the settings and the button remained greyed out.  I ended up SSH’ing into the boxes, used ‘networksetup’ to configure the “Ethernet 1″ interface and used Kickstart (ARD) to start the ARD processes.

People are friendly in the midwest but man, there is nothing to do here.

Minicolo.net, a Mac Mini co-location and hosting provider, is giving away 5 free MacMini’s to the first five co-location customers. Check it out at http://www.minicolo.net/.

Here’s a quick how-to for crontab:

nano /etc/crontab
crontab /etc/crontab
crontab -l
/etc/init.d/crond restart

So, the Unix date command is pretty cool.  We often use it in things like shell scripts which need variables that are based on the date.  This is a great link that helped me avoid using the Unix ‘awk’ command to only specify certain components of the date (Year, Month and Day).

Link

Today I begin a five day installation at Veterans Affairs Palo Alto in Palo Alto, CA. We’re upgrading a Pilot solution we installed in early 2008 to extend medical visualization to departments other than radiology. This new installation includes two redundant Apple Xsan’s with over 35TB of aggregate storage for medical imaging (DICOM) data. The entire solution is fundamentally driven by open source software.

Some of our clients requested an online video “stream” of our data center in Annapolis, Maryland.  Here it is!

UPDATE: We’ll need to turn the lights on!

Today I was cruising around Red Hat’s website and came across a video profile of a Dr. John D. Halamka, Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician. I get a warm-and-fuzzy feeling inside when I discover other healthcare IT professionals realizing the power of open source software. His blog, Life as a Healthcare CIO, can be found here.