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J.D. KeithvxVistA Network Architect

vxVistA Systems Architecture with Intersystems Cache on Microsoft

WindowsApril 2, 2010

Sponsored by

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Operating Systems and vxVistA Currently vxVistA is commercially supported by only DSS, Inc. and their direct Partners on Windows Server 2003 and Windows Server 2008

Linux is a viable option for those companies that have in-house expertise with Linux and wish to utilize existing infrastructure and resources – though at this time there is no commercial support available for vxVistA on Linux.

We will be discussing Windows-based solutions today.

vxVistA may be adapted and supported for Linux and other platforms by community members in the future.

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vxVistA – Why Windows Server? Microsoft Windows Server 2003 and Windows Server 2008 are stable platforms with mature, structured support. Both versions of the Microsoft Server Operating System offer plentiful availability of technical resources in both core information technology and in healthcare globally. Costs of operating systems are offset by abundance of resources and existing knowledge and support infrastructure in most areas and operating environments. Currently the vxVistA Graphical User Interface Applications require Windows client operating systems – making for easy interoperability between client and server without mixed operating system environments and costly support complexities. Again - future versions of vxVistA may be commercially supported on other operating system platforms.

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Database Platforms for vxVistA Currently vxVistA is commercially supported by DSS, Inc. and their direct Partners on Intersystems Cache

The vxVistA Open Source installation and setup files are available for download at www.vxVistA.org and the community is encouraged to participate in future phases of development.

Individuals or companies participating in the community eco-system may contribute additional resources for operating vxVistA with other database platforms.

GT.M is another database option for vxVistA, though currently no commercial support is available for the EHR on GT.M.

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vxVistA – Why Intersystems Cache? The Intersystems Cache Database platform is a mature platform with global presence and a well-organized support infrastructure.

Familiar GUI-style interfaces and web technology driven management architecture make Cache simple to adopt and manage.

The commercial expense of the database platform is offset by a feature-rich operating platform supporting extensive redundancy and high-availability measures, as well as data integrity protection .

Ease of installation, integration, and extensive support resources make this a suitable platform for organizations that require vendor support to maintain their patient care model and preserve the integrity of the patient health record.

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VxVistA Hardware: Processor Architecture

VxVistA is supported only on the basis of the Operating System and the Database Platform. Processor and motherboard architectures affect primarily performance of the systems.

Currently vxVistA is supported on Intel x86-32 and 64-bit as well as AMD 32 and 64-bit processor architectures (K8/K10) by DSS, Inc. and its direct Partners.

The vxVistA Open Source installation and setup files are available for download at www.vxVistA.org and the community is encouraged to participate in future phases of development, including the expansion of support into other processor architectures.

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VxVistA: Processors – Speed vs. Cores To reiterate: currently vxVistA is supported on Intel x86-32 and 64-bit as well as AMD 32 and 64-bit processor architectures (K8/K10) by DSS, Inc. and its direct partners.

Generally adding cores is a better response to increasing user counts.

Clock speeds beyond 1.8 Ghz generally provided diminishing returns when compared to the performance improvements seen when adding cores to the system .

50 to 100 users per core can be a reasonable estimate for maintaining high performance and low system response times – transactional load may affect this estimation.

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VxVistA: RAM, Cache, Buffers RAM is key to performance for databases. 12 GB of RAM is a common recommendation for systems supporting 20 or more concurrent users. High user counts and high transactional volume may indicate the need

to increase RAM – Database statistics (such as GLOSTAT for Cache) are a good tool for discovering shortages.

Reporting and querying performance – as well as multi-tasking – can suffer from RAM shortages. Processor cache can have significant effects on throughput at the database - especially if massive data queries, reporting requirements, or analysis (math, stats, finance, complex billing, etc) are necessities. Buffering – configuration, but needs must be met by hardware All Intersystems Cache Buffers (Globals and Routines) should fit

within the available RAM resources . More information is available at

www.intersystems.com/cache/documentation

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vxVistA Architecture modeling

Scalability

High Availability and DR

Other Architectures

vxVistA Hardware Configurations

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vxVistA Scalability vxVistA is a very scalable solution Both Up and Down

From Single Providers to Multi-location Ambulatory and Inpatient service groups and more

Functional requirements discovery and flow documentation discovery make it possible to adapt the modules of vxVistA to each scenario.

Load-balancing at Application Layer

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High Availability and Disaster Recovery Planning

Within Intersystems Cache – Online Journaling

Shadow Journaling Next Steps

Mirroring OS-based HA and Disaster Recovery Network Load Balancing Server Clustering Asynchronus Replication

SAN-Based or Block-level Replication

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Other ArchitecturesApplication Service Provider (ASP) or Cloud Virtual environments are still suspicious to many, but as the technology matures and interest grows this is very likely to see deployment.

Additionally as cost of ownership decreases this becomes more attractive.

OpenVMSNative VistA operating environment but no vxVistA operations currently use this.

LinuxUntested to date with vxVistA

GT.MUntested to date with vxVistA

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VxVistA Open Source VxVistA Open Source 2010.1 is available with version 2010.2 expected to be released later this year by DSS, Inc.

The vxVistA Open Source installation and setup files are available for download at www.vxVistA.org and the community is encouraged to participate in future phases of development.

Individuals or companies participating in the community eco-system may contribute additional resources for operating vxVistA on other operating system platforms.

Future versions of vxVistA may be commercially supported on other operating system platforms.

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Open Source Commitment

vxVistA is currently available as an Open Source core release with commercial support available and commercial modules for purchase.

DSS, Inc. Is committed to the Open Health Tools model of Open Sourcing the core tools and maintaining a viable model of commercial support for vxVistA.

vxVistA is the only VistA derivative currently fully aligned with the FOIA VistA patch stream and currently mandated to remain within that patch stream.

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Questions?

Thanks!