Help on Debian install

physmed wrote on Wednesday, September 05, 2007:

I would like to start out by congratulating Ron Leemhuis and his daughter Dorothy on a very good set of instructions on setting up openemr under Debian.  However I have made up 4 seperate virtual machines using their directions and while technically everything "WORKS" when I am done I am still having some issues with the set up.

Debian 4.0 Etch
Apache 2
Mysql 5.0
Postgresql 8.1
Sql-ledger 2.6.22

I enter a new patient in openemr and I can see the patient in sql-ledger, so far so good, but when I put in a visit for that patient and save it the transaction does not go over to sql-ledger!  Now the instructions do bogg down when it comes to setting up the sql-ledger part of the installation and I have had to do a patchwork using part of the instructions from the Mandriva installation.

Any thoughts or instructions would be greatly appreciated.

Thanks
Rick

rpl122 wrote on Thursday, September 06, 2007:

Hmm…

I’ve set this up successfully 2-3 times from scratch (and many times unsuccessfully before that!).  I try to follow my written instructions and not go from habit or memory because I want the instructions to be right.

Believe me, in my successful installations the transactions DO go over into SQL-Ledger accounts receivable.  If you don’t get this running smoothly, I’ll have to try meticulously following my own instructions again just to be sure there isn’t a type somewhere.

If everything else weems OK, you may want to try this, however:

For every user you have set up in OpenEMR, “edit” that user demographics.  You don’t actually have to change anything, but you DO have to save the demographics for that user while connected to SQL ledger.  If that user was added before being connected to SQL ledger, then the two programs don’t seem to talk right.

Also, it appears necessary to do the same thing for each patient demographics to make them talk together right.

I’m eager to know whether that is the problem.

Ronald Leemhuis MD

rpl122 wrote on Thursday, September 06, 2007:

Another thought –

It is possible that the transaction code “MS” was not properly set up in SQL-Ledger.  I know that at times I didn’t actually activate the “save” button properly.

Also, there is a place in one of the configuration files – see the instructions – where you have to specify "MS" as the proper transaction code for charges put out by OpenEMR.

Ronald Leemhuis MD

physmed wrote on Friday, September 07, 2007:

Thanks Ron

I tried the tips and suggestions that you listed but it didn’t seem to work.  I am wondering if you enter a transaction in openemr and it is not linked properly with sql-ledger for whatever reason does that then make it impossible to get any further transactions to post to sql-ledger?

Anyway I was looking over the instructions for setting up sql-ledger again and I was wondering if (when you get the time) you could take a look at the instructions for creating the dataset for openemr in sql-ledger.  The instructions that I have are dated August 24th but I know that you updated them a couple of days after that.  It starts out with specify:

login openemr

password put password sql-ledger password here

Be sure Pg driver radio button is marked

host localhost

port 5432

user sql-ledger

password put your postgresql password here

connect to template1

The problem I had with those instructions is that there are more instructions than there are places to put that much information on the create dataset screen.

Help

rpl122 wrote on Friday, September 07, 2007:

When I used browser to go to http://localhost/sql-ledger/admin.pl it asked me for the administrator password and I then arrived at a screen labeled "SQL-Ledger Accounting/Database Administration."

Here it had boxes to enter five values:

Host
Port
User
Password
Connect to

in the Host box I put "localhost"
in the Port box I put "5432"
in the User box I put "sql-ledger"
in the Password box I put the password I chose
in the "Connect to" box I put "template1"

(For some reason I could not connect by leaving host and port blank to use defaults.)

Then one comes to a screen labeled "SQL=Ledger Accounting Database Administration/Create Dataset"

At the top it displays "Existing datasets."
It shows a box labeled "Create Dataset."  It is there that I entered "openemr."  I left everything else blank and clicked the default radio button and then went from there.

Maybe you can come up with some specific, clear, wording that I could cut and paste into my WIKI instructions.

Ronald Leemhuis MD

physmed wrote on Friday, September 07, 2007:

Thanks Ron

I think the confusion is because on your instructions we are already logged into sql-ledger administration to change the administrative password so you wouldn’t think that you had to log out and back in again just to create the dataset.  But I could be wrong because when it comes to Linux it is not that hard to throw me off.  I won’t have time to get to my install until this weekend so I will have to get back to you on possible clarification of the instructions for those of us that have the “Dufus” factor operating.

Rick

physmed wrote on Monday, September 10, 2007:

OK I would like to appologize to Ron for taking up his time because when I went into my install yesterday I got it to post to sql-ledger by performing the one step on the billing screen that I had overlooked.  That was to mark the billings as cleared so that they would post to sql-ledger.  I felt like a real moron but in my own defense none of the previous medical accounting packages that I have used required that extra step because it was included both when you saved the transaction and when you printed the day sheet and automatically closed it for the day.  But I would still like to put up my recommendations for the Debian install instructions so here goes.

Starting with the line:

Next, click on the "Pg Database Administration" tab. You will create the dataset for openemr.

Host=localhost
Port=5432
User=sql-ledger
Password=Your sql-ledger user password
Connect to=template1

Then click "Create Dataset"

Create Dataset=openemr
Leave Multibyte Encoding blank
Create Chart of Accounts leave Default checked

Then click "Continue"

Then click "Continue" again when it says Dataset openemr succesfully created.

Next, click on "Add User."

Login=openemr
Password=enter your password that you wish to use to log in to sql-ledger here
Name=openemr

Leave everything else as is on the Add User screen and go down to the Database screen.

Driver=click Pg button
Dataset=openemr
User=sql-ledger
Host=localhost
Port=5432
Password=enter your sql-ledger user password again here

Scroll down to the bottom of the page and click save

The only other thing that I did differently was in modifying the sql-ledger.conf file I used “double” quotes instead of single for 2 reasons-1st reason was because all of the other variable listings were in double quotes and 2nd was when I tried to enter a new patient in openemr when I had only used the single quotes I got an error message stating that openemr couldn’t log on to sql-ledger to transfer the information that had just been saved in openemr.

Thanks for all of your help

Rick

physmed wrote on Friday, September 14, 2007:

Hi it’s me again I wanted to post one more message to let everyone know of a command that I found in the book “Linux for Dummies” that made it a lot easier to set FreeB up as a self starting server at boot time.

Log in as root in a terminal window and instead of typing in the 4 command lines to get it to be in the runlevels 2,3,4, and 5 type the following command.

update-rc.d freeb defaults and hit enter

That one line will set it up so that the next time you boot the system the freeb server will automatically start up.

Then just keep following Dr. Leemhuis’s instructions to finish the install and you will be all set for freeb to run in the billing window.

Thanks

Rick

rpl122 wrote on Saturday, September 15, 2007:

Over the last few days I have been cleaning up typos and other errors on the Debian installation wiki.

http://www.oemr.org/modules/wiwimod/index.php?page=DebianInstall&back=OpenEmrInstallHowtos

At this point, the detailed instructions seem to work reproducibly.  I’m getting OpenEMR to talk to SQL-Ledger properly.  SSL works, and phpgacl controls access properly.  While freeb seems to pass most of the diagnostic tests, I’m getting BLANK pdf output of HCFA forms.  I know it’s fixable, because one of my installations actually produced proper output.  However, I don’t know how I got that to work.

I’m going to look at Rick’s method above and probably put it in the wiki.

I’m eager to get feedback on getting the Debian installation wiki correcvt and clear.  Thanks, Rick, for your input.

Ron Leemhuis MD

rpl122 wrote on Saturday, September 15, 2007:

Rick –

I updated the Debian installation instructions on the wiki to include your contributions. 

First, I cut and pasted your instructions for the SQL-Ledger postgresql database and user creation.

Second, I entered your slick method for putting freeb in the rcX.d directories automatically.

Finally, I commented that double quotes may help in the sql-ledger.conf file.  I have not yet tried that out.

Please look at my changes and feel free to make necessary corrections and give yourself acknowledgement on the site for your contributions.

I still don’t know why my pdf HCFA files are blank.  Could it be the single vs double quotes?  All else seems to work well.

Ronald Leemhuis MD

physmed wrote on Sunday, September 16, 2007:

Ron

I took a look at your corrected instructions and I think they are pretty nearly perfect for those of us out there that are Linux challenged!  I am glad that I was able to help a little.  Now as far as the blank PDF files are those the freeb created batch files that have the date as the file name that are listed after the que processing on the billing screen for that transaction or transactions?  I only ask because all of my installs have had those generated by freeb irrespective of the link to sql-ledger.  Do you have freeb’s printer listed as a PDF printer?  That’s what I had to do because my virtual machines always seem to have trouble printing to the host computer’s printer so I just log on using the host computer’s browser and click on those files in the billing window and the text that would normally go into the CMS 1500 claim form is all there!

Rick

physmed wrote on Sunday, September 16, 2007:

Ron

I was able to reproduce the blank PDF’s under the following set of circumstances!

I entered 2 seperate CPT codes for the encounter and then justified 2 different ICD9 codes for the CPT codes.  Such as 99213 846.0  and a procedure code with 729.1 justified to it = blank PDF claim.  But put in 1 CPT code and a justified ICD9 code and presto there is your PDF file with all the proper information in there.  I have no clue why that would happen!

Rick

sunsetsystems wrote on Sunday, September 16, 2007:

It should work fine with multiple procedures, as long as they are justified.  So something else must be going on.

FreeB is hard to install and hard to troubleshoot.  We need to rewrite the logic for paper claims in the same way as has been already done for electronic claims, and then we can be done with FreeB completely.  Indeed the hard part is already done with the creation of Claim.class.php, and the task only needs about another 3 days of work.

In the meantime, see http://www.oemr.org/modules/wiwimod/index.php?page=FreebInstall&back=FreebInstallHowtos for some important troubleshooting tips.  There are too many things that can cause blank PDFs, and anything else is just stabbing in the dark.

Rod
www.sunsetsystems.com

rpl122 wrote on Monday, September 17, 2007:

It all works now!

I had to put a file called process_bills.log into the /usr/share/freeb/public/ directory and set its ownership to www-data.www-data.

As of 9:25 PM on Sunday September 16, 2007 the debianinstall section of the http://www.oemr.org wiki works to set up OpenEMR, SQL-Ledger, SSL, phpgacl and freeb.  It creates electronic claims and pdf paper claims just fine.

Ronald Leemhuis MD

rpl122 wrote on Thursday, October 04, 2007:

I’ve been proofreading and making small corrections to the Debian/Ubuntu installation instructions on the http://www.oemr.org/modules/wiwimod/index.php?page=DebianInstall&back=OpenEmrInstallHowtos site.

At this point the instructions lead to reliable and reporducible results in installing the cvs version of OpenEMR with SSL, SQLLedger, phpgacl.  Everything seems to work right to that point.

However, there is some sort of apparently minor glitch in the instructions for adding freeB for paper claims.  Sometimes pdf files are generated properly, and other times they come out blank.  I’ve checked error files for postgresql and apache2 without any real clues.  I’ve tried it with and without SSL and phpgacl.  I’ve tried disabling ssl in the postgresql.conf configuration file.

I’ve played around with the postgresql.conf and pg_hba.conf files to no avail. I’ve tried the same versions of OpenEMR and SQLLedger and postgresql that do work properly on Brady Miller’s Mandriva virtual machine.  They have the same problem in my Debian/Ubuntu environment.

Seems to me that it could be an authentication issue, a problem with the RPC features or maybe lack of some required supportive software package.

If somebody can figure how to fix the instructions to make freeB communicate properly with OpenEMR in the Debian/Ubuntu environment, it would be a great contribution to the reputation of OpenEMR.  As for me, I’m stumped.

sunsetsystems wrote on Thursday, October 04, 2007:

If the PDFs are only sometimes blank, then it seems likely to be something wrong with individual claims.  Note especially that procedure codes must be "justified" by linking them with at least one diagnosis.

It’s unfortunate that FreeB problems are so difficult to troubleshoot.  The good news is we’ve gotten rid of it for electronic claims.

Rod
www.sunsetsystems.com

rpl122 wrote on Thursday, October 04, 2007:

I have meticulously “justified” charges by linking them to diagnosis codes.  I have been entering charges using Rod’s fee list form.