Seccure Connection to Outreach

[Daniel Lee]

So many questions and not sure where to start.  We are starting to get pressure from out outreach facilities to get their lab results from our lab into their medical record.  Here’s the questions I have:

– How do I get a secure TCP/IP connection to them?  These facilities have no IT staff so even if I do manage to walk them though setting up a VPN tunnel I still would not feel comfortable setting up a socket to the outside world to our interface engine.  We normally set up VPN tunnels with outside clients but these are clients whom are behind a firewall of some sort themselves and have a little bit of IT competence.  In this case it would be just like setting up a VPN tunnel to some PC at who knows where and having a socket to Cloverleaf over this tunnel.  Can anyone tell me something that would make me feel better about this?

– What do I do if all of a sudden one day the receiving side quits listening and can’t figure out their problem for a week?  Is there a way I can put a thread on hold so it doesn’t take up RAM at all?  I know I can use disk based queuing but this still uses some RAM for pointers to the recovery database.

Any advice would be helpful.

-Daniel

Topic

[Anonymous]

We are doing something similar, sending HL7 messages from our cloverleaf engine lab results to the Physician offices the sysytem they purchased. We are doing this via secure VPN tunnel.

We are only the sending system and we don’t get anything back (except ofcourse the acks back). We are the initiaters. So far we have not got inot any problem.

We have done such a thing with one other system.

I am not exactly the right person to give details as what goes with the VPN tunnel and what may be..

but just to tell you, we are not seeing any issues..

[Nathan Martin]

Instead of a full VPN, you might want to try port forwarding/tunneling.  Some examples:  http://www.openssh.com/” class=”bbcode_url”>http://www.openssh.com/ and http://www.stunnel.org/” class=”bbcode_url”>http://www.stunnel.org/

More info and links on SSH: http://en.wikipedia.org/wiki/SSH” class=”bbcode_url”>http://en.wikipedia.org/wiki/SSH

One of would have to open a port through your firewall so the other could set up the tunnel through it.

[Terry Kellum]

We are looking at something similar to provide lab results to Physician offices that have clinical EMR systems.   We are thinking that we can use Cisco VPN routers.  We have a VPN concentrator that we are connected with ARUP thru that works pretty well.  We also use it to secure a link to a remote lab location where we have a VPN box on the other end as well.  The links tend to be strong and stable.  We have had little problem with them over the 2 years that we’ve been using them.  

On a related issue, Has anyone been approached by an EMR vendor and asked to pay to establish a results interface INTO a physicians office EMR?  We were approached by a vendor, and researched the details, told them “yes, we can do it” and were then asked for a purchase order.

As this is a new EMR install at the physician’s office, it would seem to me that it should be part of the install, or that the office should cover the cost.

[Daniel Lee]

Sometimes the physician’s offices threaten to send their patients to a different lab so we end up eating the cost to keep the business I think.  Right now I’m looking into Cloverleaf’s SSL connection along with a client side app that they have that just takes the data from the SSL connection and writes it to a file.  I think we are going to use this and offer it to the physician

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