D R™ clinician x INSTRUCTOR MANUAL
STUDENT USER MANUAL
TECHNICAL APPENDIX Contents
Browser Requirements...... 3 System Requirements (Client side)...... 3 Windows...... 3 Macintosh...... 3 Screen Size and Monitor Resolution...... 4 Sound...... 4 Uploading Your Media Files to the Server...... 4 Acceptable File Types ...... 4 Server-side System Requirements & Installation Instructions...... 5 Overview...... 5 System Requirements...... 5 Installing MySQL™...... 6 Installing ActivePerl ...... 6 Installing Necessary Perl Modules ...... 6 Web Server Configuration Unix/Apache...... 7 Installing DxR Clinician under Apache,Option1...... 7 Installing DxR Clinician under Apache,Option2...... 8 Securing DxR Management...... 11 Web Server Configuration NT/IIS...... 13 1.Creating the Directory Structure...... 13 2.Setting NTFS Permissions for the Install Process...... 13 3.Creating and Configuring the IIS Website...... 14-16 4.Unpacking the product .TAR file...... 16 5.Placing the DxRSetup directory into the cgi-bin folder...... 16 6.Running the dxrSetup.pl file to install the product...... 16 7. Securing your DxRManag Directory...... 17 8.Securing the DxRSetup.pl file:...... 17 Review of IIS Permissions by Directory:...... 17 Review of Directory Security Settings for IIS...... 18 Review of Windows NT Permissions set through NT Explorer...... 18
DxRCTechv2.5.1SQL112006
1 Copyright Information
© 2006 DxR Development Group, Inc., 148 East Pleasant Hill Road, Carbondale, Illinois 62903-9919, for software template and icons. All rights reserved.
No part of this software program, including artwork and text, may be utilized, repro- duced, stored, or transmitted in any form by any means, electronic or mechanical, or by any information storage or retrieval system, without permission in writing from the copyright holder.
Address inquiries to: DxR Development Group, Inc. 148 East Pleasant Hill Road Carbondale, Illinois 62903-9919
Licensee of the software does have permission to duplicate the printed manuals, and to print and duplicate manuals from the PDF files contained on the CD-ROM. Macintosh is a registered mark of Apple Computer, Inc. Windows is a registered mark of Microsoft Corporation. QuickTime is a trademark of Apple Computer, Inc. DxR Development Group, Inc., is a licensed distributor of QuickTime. QuickTime and the QuickTime logo are trademarks used under license. Portable Document Format (PDF) and Acrobat are trademarks of Adobe, Inc. ActiveState Perl/Active Perl is a product of ActiveState Tool Corp. MySQL is a trademark of MySQL AB in the United States and other countries. Brands and product references noted are the trademarks of their respective compa- nies.
2 Browser Requirements
Cookies and Javascript must be enabled.Your browser must also have Apple Computer’s QuickTime® 5.0.2 or greater plug-in installed. Make sure you select a full install of QuickTime. Also make sure your browser preferences are set to allow the page to specify the colors and fonts.The following browsers are compatible with this program. Using a browser and/or browser version other than one of the following may cause browser crashes and other unpredictable results when using this program.
Windows® Macintosh® Microsoft® Internet Explorer Microsoft® Internet Explorer version 5.0 or higher version 5.0 (Do not use Microsoft Internet Explorer version 5.1 with DxR Clinician.) Netscape® version 4 browsers Netscape® version 4 browsers Netscape 6.2 or newer browsers Netscape 6.2 or newer browsers (Previous Netscape Version 6 series (Previous Netscape Version 6 series browsers are not recommended.) browsers are not recommended.) Firefox® version 1.5 or later Firefox® version 1.5 or later
System Requirements (Client System Requirements)
Windows® • System: Windows 95, 98, NT4, 2000, XP • Processor: 166 Mhz Intel® Pentium® processor or greater • RAM: 32 MB of available RAM
Macintosh® • System: Mac OS 8.1 to OS X • Processor: 120 Mhz Power PC or greater • RAM: 32 MB or more of available RAM
3 Screen Size and Monitor Resolution
DxR Clinician requires a minimum monitor resolution of 800 x 600 pixels. If your mon- itor is not set for 800 x 600 pixels or higher resolution, portions of your screen may be cut off and a warning message will appear when you try to log in to the case. Your monitor must also be set display at least 16 bit color (thousands of colors). If your monitor is not set to display 16 bit or higher color, images and movies may appear distorted, chunky, or washed out on your screen.
Sound
Heart and breath sounds will sound best when heard through headphones.
Uploading Your Media Files to the Server
Acceptable File Types Instructors may want to attach their own media files to a case or cases.These files must first be uploaded to a server. File types that are acceptable for upload include: Graphics: Audio files: Formats: .jpg (.jpeg), .gif, .mov, .png Format: .mp3 File Size|KB: less than 100KB(kilobytes) File Size: less than 100 KB File Resolution: 72ppi (pixels per inch) File Dimensions: Lab section: 564 pixels (w) by 320 pixels (h) Exam section: 310 pixels (w) by 380 pixel (h) Interview section: not recommended Uploading and Adding Media Files
Open the Management Utility, select a directory and the case that you want to edit, and then enter the Edit Case Data function. Navigate to the portion of the case and to the specific item to which you want to add a media file. Scroll down to the Media section of the edit screen. To upload a media file from your computer to the server: 1. Click Add New Media. 2. Make sure your media file meets the specifications listed above. 3. Click Browse and then navigate to the file that you wish to upload. 4. Click Upload File. Once the file is uploaded, it will appear in the Available Media List. Note: Once a file is successfully uploaded, it can’t be removed by anyone but your system administrator.
To add a media file once it’s been added to the Available Media List: 1. From the Edit screen, click Available Media List. 2. Select the media file that you want to add to this item. If you aren’t sure if you’ve selected the correct item, click Preview Media. 3. When you have selected the media file that you wish to insert, click Add. 4. Close the window and return to the Edit screen.
4 Server-side System Requirements & Installation Instructions
This is intended for the System Administrator/Web Master/IT person who will be over- seeing the installation of the program on your server. Overview The CD contains digital versions of the program’s documentation, the source files for the program and for the cases that your school ordered, and dxrSetup.pl, an exe- cutable that will install the program’s common files and will create waiting rooms and install cases into those waiting rooms. You start by decompressing and copying the Diagnostic_Reasoning directory from the CD to a part of your hard drive where the setup program will be able to find it.
System Requirements Server Side Windows Based Systems: • Windows NT/2000 or Windows 2003 Internet Information Server • ActivePerl 5.6.1 Build 638 MSI (www.activestate.com) **PERL MODULES** • dbi perl package • dbd::mysql perl package • MySQL 4.026 win32.zip production release (www.mysql.com)
Linux/Unix Based Systems: • Apache Web Server (www.apache.org) • Perl 5.8 series (www.perl.org) **PERL MODULES** • dbi perl package • dbd::mysql perl package • MySQL 4 production release (www.mysql.com)
NOTE: Most distributions include the required applications, check your distributor’s documentation for details.
DxR Clinician has been successfully installed on many Unix-type servers running Apache, and on Windows NT/2000 and Windows 2003 server running IIS. It should install and run on any Unix-type machine that has Apache and Perl.While we support the use of Windows NT/2000/2003 and IIS, we recommend a Unix-type sys- tem running Apache for maximum performance, stability, reliability, and sercurity. If your operating system of choice is not one of those mentioned here, we offer several options, including hosting your site on our servers. Contact DxR Development Group at (800) 453-8040 for pricing.
475 Megabytes of hard drive space on the server. Size is based on a single installation of all cases. It may vary depending on the number of cases and number of copies installed. 5 Installing MySQL™
To run DxR Clinician, you must have MySQL installed and running properly on your server. MySQL is available at the following Internet address: www.mysql.com 1. Follow the links to the downloads page and select MySQL version 4 (production release only). 2. Windows Users: • Launch and run the Setup.exe to install the application. Unix Users: • If you downloaded a binary package, use your package manager to install it. • If you downloaded source, follow the directions included with the distribution for compiling on your operating system. 3. Read and follow all installation instructions for starting the database on your type of server configuration. 4. Once MySQL is successfully installed on your server, you must assign a password to the root user. At the command line, change directories into the mysql -> bin directory and type in the following: mysqladmin -u root password ‘my password’ (In place of ‘my password’ type in your chosen password inside single quotes.) 5. Press return. Remember to keep your password in a safe place.You will not be prompted to confirm your password at this time.You will be prompted for your password if you reenter this function in order to change the root password at a later time.
Installing ActivePerl (Windows Users Only) Locate ActivePerl at the following Web site and follow the steps below. www.activestate.com. 1. Follow the links to the download page. Download ActivePerl 5.6.1, not 5.8.0. 2. When you begin the installation process, you will encounter an Install shield. Answer “yes” to all the questions in order to keep the ActivePerl default settings.
Installing the Necessary Perl Modules
For Windows Users: 1. Open the command prompt. 2. Type in the command below in order to install modules. C:\Perl\bin\ppm 3. Install the DBI module by typing in the following command. install dbi 4. Install the module called DBD::mysql by typing in the following command. install DBM-MYSQL 5. Type Exit to leave this application. For Unix Users: 1.Type the following into a shell prompt: perl -MCPAN -e shell 2. Install the DBI module by typing in the following command. install dbi 3. Install the module called DBD::mysql by typing in the following command. install dbd::mysql 4. Type Exit to leave this application. 6 Web Server Configuration Unix/Apache Installing DxR Clinician under Apache, Option 1 The Apache web server provides two ways to host multiple web sites on a single serv- er and to keep each site and their many parts separated from each other.These are VirtualHost and NameVirtualHost.With a VirtualHost, each site on the server has both a unique name, such as: http://dxr.your_school.your_university.edu as well as a unique IP number.The VirtualHost entry for such a site in the Apache configuration file would look something like this:
7 6. If your server already has a domain name, and a DNS entry on your institution’s DNS server, you can proceed to Securing DxR Management. After installing your first waiting room, the directory structure will look like this: home/html/ dxr/ Diagnostic_Reasoning cgi-bin/ DxRSetup/ (this directory should be password-protected) DxR/ DxR/ DxRManag/ (this directory should be password-protected) dxrPatnt/ dxrElem/ index.html cgi-bin/ icons/ etc/httpd/ logs conf
Installing DxR Clinician under Apache, Option 2 The actual location of the Apache web server, its configuration file, log files, cgi-bin and HTML documents will vary from system to system. Using Linux as an example, the log and configuration files will likely be under /etc/httpd. Using the default Apache directory structure, you will be installing the DxR Clinician Program in the directory Apache identifies as the DocumentRoot.To continue with Linux as our example, the document root is called “html”, and you will be looking at a directory structure like this: /home/httpd/ cgi-bin/ html/ /etc/httpd/ logs/ conf/ In this scenario, we address a server that may or may not already have other web pages and sites, but which is still using the default Apache configuration file and directory structure, and is not using Virtual Hosting. Insert and mount the DxR Clinician CD. 1. Untar the compressed Diagnostic_Reasoning.tar file into the “html”directory (or your server’s equiva- lent). 2. Copy the DxRSetup directory and all its contents (found in the Diagnostic_Reasoning directory) into the cgi-bin directory. Password protect this directory.
8 3. Using the Linux example above, your Apache directory structure should look like this: /home/httpd/ cgi-bin/ DxRSetup/ (this directory should be password-protected) html/ Diagnostic_Reasoning/ icons/ /etc/httpd/ conf/ logs/ 4. DxR Clinician expects the cgi-bin to be in a particular place in relationship to the rest of the program’s files, and in this scenario, the cgi-bin is in the “wrong” place. To correct this, without disabling existing sites or reconfiguring Apache, you will need to create a symbolic link to your server’s real cgi-bin and a symlink at the same level as the real cgi-bin that points back to the DxR directory at the roof of the site. Continuing with the Linux example, navigate into the html directory and enter a command like the following: ln -s /home/httpd/cgi-bin cgi-bin where ln -s makes a symlink, /home/httpd/cgi-bin is the target, i.e. your real cgi- bin, and cgi-bin is the name of your link to the cgi-bin.You will have to make sure that the path to the target cgi-bin matches your system. 5. If your server already has a domain name, and a DNS entry on your institution’s DNS server, or if you are using an IP number instead of a domain name, you can proceed to Securing DxR Management. Prior to installing your first waiting room and cases, your directory structure will look something like this: /home/httpd/ cgi-bin/ DxRSetup/ (this directory should be password-protected) html/ Diagnostic_Reasoning/ cgi-bin (the link to the real cgi-bin) icons/ /etc/httpd/ conf/ logs/ After installing your first waiting room and cases, navigate to the same level as the cgi-bin and enter the following: ln -s /home/httpd/html/DxR DxR
9 This second symlink is vital.Without it, the program will appear to function nor- mally until you try to convert student records for download, causing a failure. The directory structure will look like this: /home/httpd/ cgi-bin/ DxRSetup/ DxR (link to the real DxR) html/ Diagnostic_Reasoning/ cgi-bin (the link to the real cgi-bin) DxR/ dxrPatnt/ dxrElem/ index.html (this will be called dxr.html if there is a pre-existing index.html page) icons/ /etc/httpd/ conf/ logs/
10 Securing DxR Management Your site includes the DxR Management tool, which allows instructors to rebuild the patient databases, allow or deny access to the cases, download student records and edit case data.We strongly recommend restricting access to this part of the site, using the htpasswd utility of Apache.The first time you run the dxrSetup.pl program it will create the DxR Management section of your site, which will be located at: yoursite/DxR/DxRManag.Therefore the Apache configuration file entry to restrict access to this portion of the site will be something like:
Maintaining Patient Data Files Your DxR Clinician web site and the waiting rooms within it should have been created using the dxrSetup.pl program.The patient data is shipped in a very generic form which can be used by a wide variety of servers.To be accessed quickly while students are investigating a patient, it must be converted to the database software running on your particular server. As a part of the installation process these files are automatically converted to databases. Occasionally it may be necessary to manipulate these files manually.This section explains how patient databases are created and restored or saved. The Patient Data Files section of DxR Management allows you to build, or rebuild, the patient database files. If your site, or a waiting room of your site, was set up by copying individual files, rather than using the setup program, you will need to convert the patient data files to database files. Click Make Database Files, enter the path to the case or waiting room you want in the box marked “Enter Path”, then click Make Database Files. To build the database files for a single case in a waiting room called HST_410, your path would be: ../DxR/HST_410/Dombkoski/ To do the same for all the cases in that waiting room, your path would be: ../DxR/HST_410/
If you modify a case, you may wish to preserve your changes independent of the database.This function is useful in creating a back-up copy that includes your changes.To do this, you must convert your database files back to text files. 1. In the Export Database files field, enter the path to the case. 2. Click Export Database Files.Your new files will be named dataPat.cpy and con- sults.cpy and will be stored in the source case’s caseData directory inside the cgi-bin. 11 You can use these exported text files for installing the case with your changes into another waiting room.To do this, you must convert the exported text files back to database files, following these steps. 1. Install the case in its new waiting room and copy the two .cpy files to the new installation’s caseData directory. 2. Change the file extension to .txt, replacing the original data files. 3. Now enter the path to the new installation and click Make Database Files.
If you want every installation of a particular case to use edited data, you must first export the data as described above. Then follow these steps. 1. Change the file extension on the files you just exported from .cpy to .txt 2. Follow the file path shown below and replace the Case’s dataPat.txt and consults.txt files in the Case_Folders_and_Media directory with the files you just exported and renamed. Diagnostic_Reasoning Case_Folders_and_Media 00_Case for_cgi-bin_DxR Case caseData Doing this successfully requires a fair degree of familiarity with both your server’s operating system, and with the structure of the DxR Clinician site.You must also have administrative access to the server. Consult your system administrator. The patient data files will be found at: ../cgi-bin/DxR/unit_name/case_name/caseData/ where unit_name is the name of your waiting room, and case_name is the name of the particular case.
12 Web Server Configuration NT/IIS 1. Creating the Directory Structure (Optional) Use this option only if you don’t want to use your default IIS Website. At right is a diagram of the required structure: Full Path Equivalent: X:\FOO\DXRROOT\cgi-bin\ X is the drive you’re installing the product to. FOO is a ‘buffer’ folder. It is needed to enable the setup script to select the website’s root directory properly. You can name it whatever you wish. DXRROOT will be the root directory of the Figure 1. Directory Structure. website.This is the folder that will be listed as the Home Directory in IIS. cgi-bin will be the CGI folder for the Web site. Do not link this folder to the original cgi-bin in WWWROOT. 2. Setting NTFS Permissions for the Install Process For the install process, you will need to enable Full Control of the DXRROOT folder and its subfolders for the Everyone account.This can be done by right-clicking the DXRROOT folder, selecting Properties, and clicking the Security tab. Select Everyone and change the Type of Access to Full Control.
Figure 2. Directory Permissions and type of access.
13 3. Creating and Configuring the IIS Website Start up the IIS Management Console, and if you are not using the default Web site, use the Action Menu to create a new web site.The wizard will allow you to choose a name, home directory, port, initial permissions, and the IP address to use. You can name the site whatever you wish. If you created a new directory in Step 1, the Home Directory will be X:\FOO\DXRROOT.The default port is 80. Unless you absolutely must change it, leave it at 80.The initial permissions will be Read.The IP address will most likely be the IP address of the machine. Next, highlight and right-click on the desired Website to bring up its context menu, then select Properties. Click the Home Directory tab.You will see a screen simi- lar to what you see below.
Figure 3. Home Directory information.
If you created a new directory in Step 1, confirm that the Local Path box still has X:\FOO\DXRROOT entered. Make sure that Read is checked. Under Execute Permissions, make sure that you select Scripts and Executables. Now, click the Configuration button, and then go to the App Mappings tab. Make sure there is an entry for the perlis.dll file that is associated to the .pl extension. If not, click ADD and then fill in the following fields.
Executable: X:\Perl\bin\perlis.dll Extension: .pl
14 Make sure the Script Engine checkbox is CHECKED.The end result should look like this:
Figure 4. Application Mappings settings in IIS.
Once you’ve set up the App Mappings, click OK and go to the Directory Security tab. You’ll want to make sure that Allow Anonymous Access and Windows NT Challenge/Response are checked. Next, choose the HTTP Headers tab. Under the MIME Types section, add the following file extension: .rec Figure 5. Adding the .rec extension
15 Once you have confirmed the MIME type settings, click OK to get out of the Authentication Methods screen, and then click OK again to get back to IIS proper. Right click the Web site and select Start, which will allow you to continue to the next step. Lastly, click on the Web Server Extension at the bottom of the tree and allow Perl CGI Extensions.
Figure 6. Web Server Extensions
4. Unpacking the product .TAR file On the CD, you will find a large .TAR file. For our DxR Clinician product, it will be named Diagnostic_Reasoning.tar.This file contains the core product files.You must extract the contents of the file to your DXRROOT folder.WinZip (shareware, http://www.winzip.com) is the most common utility used for this purpose, and the following instructions are written with it in mind. a. Double-click on the .tar file to open it into WinZip. b. Click the Extract button located in the top tool bar. c. Make sure that All Files is selected. d. Make certain that Use Folder Names is checked. e. Find and highlight the X:\FOO\DXRROOT\ folder in the folder list. f. Click the Extract button. Once the files have finished extracting (as indicated by the green light in the lower right corner of the WinZip window), you may close WinZip. 5. Placing the DxRSetup directory into the cgi-bin folder. The DxRSetup directory contains scripts that will set up all of the cases included with this product. After you have unpacked the .tar file in the previous step, you will have a Diagnostic_Reasoning directory.Within that directory is a DxRSetup directory. Copy the DxRSetup directory into your cgi-bin directory. 6. Running the dxrSetup.pl file to install the product. To run the setup script, you will need to type the following address into a web browser: http://
Review of IIS Permissions by Directory: • Allow for Read • Allow for Read: DxRManag • Allow for Read: all other directories for the DxR software (Review continued on next page)
17 Review of Directory Security Settings for IIS: • cgi-bin/SECURE: No anonymous access • DxRManag: No anonymous access (Please note that there will be a /records folder created in /DxRManag. This folder must have anonymous write-access so that student records can be writ- ten.) • all other DxR-associated directories: Allow anonymous access
Review of Windows NT Permissions set through NT Explorer: • User account created for setup and admin tools: Full Control of cgi-bin/SECURE and DxRManag
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