Public vs Private Cloud Computing and Companies

I found these articles insightful regarding the decisions that companies face regarding cloud computing.  It seems that “Private” cloud computing is an option that companies are considering when security, privacy and control cannot be ceded to a “public” cloud. Yet the cost savings and flexibility of outsourcing your infrastructure is very appealing to those that make decisions. 

“An organization with a large internal IT estate may wish to repurpose some of this to create a private infrastructure cloud--a sound way to increase utilization of existing assets and consider the internal economics of providing IT as a service.”Owen Garrett, “Keeping Cloud Costs Grounded”, 2010, <>(accessed June 04, 2010).

“As cloud computing shows its strengths in flexibility and economical operations, corporate computing operations are taking notice--even at companies that are too conservative to place much trust in the cloud services on the Internet. So now we hear a lot of talk about "private clouds," which usually mean server clusters behind the corporate firewall that mimic the operation of the public clouds.”David F. Carr, “What Cloud Computing Means”, <>(accessed June 04, 2010).

Can medical organizations go with IaaS (Infrastructure as a Service) and still meet HIPPA compliance?  Will relying on the vendor’s best practices on securing patient data be sufficient to avoid government fines in the event of a breach?  These are questions that have not been answered and unfortunately may not have an answer until the first breach occurs.  I would expand on David F. Carr statement that not only “companies that are too conservative”, but industries that are too conservative like banking, medical will need to be slow to move towards public cloud computing. Any company that deals intimately with user privacy will need to experiment with the private cloud computing option before they ever considering the public aspect of cloud computing.


Check you settings

This site made fixing my setting for my privacy reeeeally easy.  I think FB has been really useful for connecting with friends but let’s face it they are pimping out our info to make money which isn’t cool.  So check your setting and close the door to protect your info and your family and friends.


Progress AI Roll forward Issue

I had an issue with restoring my Progress database and the AI roll forward process that has me a little stumped.  I restored the backup from 5/27 12:30AM without incident.  During the evening I went and copied over the AI files for that day as seen at the very bottom.  Below I copied the command prompt for the session I was using during the roll forward operation.

C:\Intergy\DB>rfutil medman -C roll forward -a D:\int_bkp\CopyAI\medman.a4

OpenEdge Release 10.1B0347  as of Tue Feb  3 10:20:44 EST 2009

** The database was last changed Thu May 27 21:13:10 2010. (831)

** The after-image file expected Tue May 25 21:00:04 2010. (832)

** Those dates don't match, so you have the wrong copy of one of them. (833)

roll forward open D:\int_bkp\CopyAI\medman.a4 error: -1. (11014)

I got a response from Donald Church that explained what’s going on:

“Glad to hear that the training is proving useful – and I think I know what is happening with your AI roll. According to your screenshots, you restored a backup that was made at 12:30 AM on 27 May. This would mean that at that time an AI switch would have occurred, the previous AIs copied to the backup folder and all copied AIs would have been remarked as empty. (This is assuming you had used the backup script and not a manual backup)


What the message in the Roll Forward of .a4 is telling you is that at some point after the restore, around 9:13 PM, the database was started and records began to be written. So if you imagine for a moment that the database was on record 10,000 at the time of backup, the AI file immediately started would have recorded record 10,001. But by starting the database at 9:13, a new record 10,001 was written along with whatever data followed thereafter. Now fast forward to 10:20 PM when you attempt the Roll Forward – you are asking the database to accept the original record 10,000 from the AI file when it is now on record 10,012 or something due to the database running since the restore. In a nutshell, by using the database after the restore, you invalidated all those AI records since they are sequential for only the original data.


This is similar to the issue in the movie ‘Back to the Future, Part II’ – Doc and Marty couldn’t fix what Biff did with the sports almanac in the future because if they traveled to the future, it would be the alternate future where Biff was powerful. The solution to your problem is the same as what they did in the movie – go to the past and fix it there. Restore the database from the backup again and Roll Forward the AIs without starting the database this time. That will make the numbers be in sequence and work.


The only caveat to all this is whether or not AI was turned on after you did the original restore – if so, you might have AI data based off all the records that the database added after the restore at 9:13 PM. Luckily, RFUTIL is pretty smart and will notice those records don’t match on time stamps and have wrong sequence numbers.”

Intergy Backup Restore Checklist

I’ve been restoring our Intergy database on Progress and I developed this checklist below to help define the process. I read the Checklist Manifesto and found the overall message really applicable to IT tasks. 


Intergy Backup Restore Checklist

r1. Is the medman.odbk file from the previous date on the Intergy Backup Server (INTBKPSRV)

o    If NO find it on \\\share\int_bkp and move to INTBKPSRV.

r2. Copy AI files from Production server to AI drive on INTBKPSRV

r3. Confirm that drive structure matches production environment

o    D = AI

o    E = BI

o    F = DB

r4. Before Installing run (install.exe user \) prior to running the setup.exe for Intergy.

r5. Install Intergy Server (Point DB to drive F)

o    EHR

o    Storage Server

o    Patient Portal

o    > 50 Users


r6. AI & BI file locations: During installation you must point Intergy toward the appropriate drives for where this data will reside. (See step 2)

r7. After Server Restart Launch Database Administration

r8. Choose Enterprise 80 GB

r9. Redirect the AI, BI and DB to the correct drive paths

r10. Navigate in Command Prompt to c:\intergy\db to run all commands

r11. Intergy large File Support: To add support for larger than 2GB storage area files, run the following command:

o    PROUTIL medman –C enablelargefiles

r12. Consult the medman.lg file for detailed information concerning the database.

r13. Shutdown Database: promon medman Option 8 then Option 2

r14. VERIFY DATABASE: prorest medman D:\IntergyBackup\medman.odbk –vp

r15. DELETE DATABASE FILES: prodel medman

r16. RESTORE DATABASE: prorest medman D:\IntergyBackup\medman.odbk

r17. Launch “Database Administration” and Start the database.

r18. Run Intergy, Intergy EHR and Test



r19. RESTORE FILES FROM LAST BACKUP: rfutil medman –C roll forward –a <afile#>

r20. ENABLE AI: rfutil medman –C aimage begin



r21. Verify Cluster size: proutil medman –C truncate bi 16384

r22. Verify AI is enabled: rfutil medman –C aimage extent list

r23. RESTART SERVER (After restart review the medman.lg file to ensure proper database start up.


Restore database without loading Intergy

rRepeat Steps 12 through 18


Intergy Testing

rLogin to 10 random Data Sets

rCheck patient demographic data in Intergy PM and Intergy EHR.

rCheck patient billing data in Intergy PM

rView EOB image from DOM

rPrint Encounter form

rPrint Schedule Summary for the day

rChange patient demographic and billing data

rMake a backup of new changed database. (45 min)

rRestore original database and have Operations validate that data is gone. (45 min)

rRestore changed database and have Operations validate that data is restored. (45 min)


Can you draw me a picture?

The very first thing I do when I have some data in my hot little hands, is dump it in a graph as quickly as possible.  Honestly any graphical tool will do.  By seeing the data in a visual format, I can more easily recognize trends and special cause variation.  Both items will spur thought and conversation with the appropriate folks in your operations because the data is your evidence (or effect) of things (or events) that are occuring in your real life business.  This is why you do analysis, so you can understand what is happening and react accordingly.

Whether it is a simple trend line over time or a bar chart by some variable or a fancy control chart, any visual display will instantly tell you about your operations.  Trend lines are easy to do and to interpret.  They will tell you that some thing is out there lurking in your business environment and it is affecting you.  Control charts will help you find any odd or weird thing happening out there (another word for it is special cause variation).  Regardless of the chart, you will learn something about your operations the second you draw a picture with the data, so take out the crayons and start drawing.