OSEHRA Conference 2015: EWD.js - The Future Starts Here

Copyright © 2015 M/Gateway Developments Ltd
EWD.js
The Future Starts Here
Rob Tweed
Twitter: @rtweed
rob.tweed@gmail.com
http://www.mgateway.com

What if…
• EWD.js was adopted at the VA?
• What's the view like from up there?

EWD.js: the bigger picture
• What does it make possible?
• A glimpse of the vision behind EWD.js

What is EWD.js
• Development framework
• Run-time platform
http://ewdjs.com

What is EWD.js
– Client-server applications in the browser
– Web Services
– Legacy Mumps application modernisation

What is EWD.js
– Node.js-based application server
– Web Server
– Integrated JSON database
• Caché, GT.M, GlobalsDB, MongoDB

EWD.js key features
• 100% JavaScript
– Browser
– Back-end (business logic): Node.js
• 100% JSON-based data
– Browser
– Back-end
– Database
• Legacy Mumps code can be accessed from Node.js
• High performance
– Node.js
– In-process interface to database
• Highly scalable
– stateless

Current VistA
VistA
Caché
VistA Server
Roll & Scroll
RPC BrokerCPRS
RPCsFileMan
Stateful

EWD.js-enabled VistA
EWD.js
VistA
Caché
Node.js
VistA Server
cache.node
Roll & Scroll
RPC BrokerCPRS
RPCsFileMan
Interface functions
Web
Service
Clients
HTTPS +
HMAC
SHA256
Stateful
JavaScript /Node.js
business logic
Stateless

VistA
Caché
EWD.js
Application
Server
Caché
nginx
EWD.js
Application
Server
Caché
EWD.js
Application
Server
Caché
ECP
Networking
Mapped globals
for shared EWD Sessions
& VistA data
Mapped VistA
routines
Incoming
WebService
Traffic
Scaling Out

Federated access across the VA?

ewd-federator
Cache / GlobalsDB / GT.M
persistent JSON cacheing, storage
Node.jsREST
Clients
REST
Requests
EWD.js
system
HTTP-based
Web Service
REST-based
Service
Back-end
Servers
HTTP
REST
HM
AC-SHA256
Signed
HTTP
https://github.com/robtweed/ewd-federator

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
VistA
VistA
VistA
VistA

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
Aggregate
responses
VistA
VistA
VistA
VistA

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
Intercept
Incoming
request
VistA
VistA
VistA
VistA

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
re-directIntercept
Incoming
request
VistA
VistA
VistA
VistA

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
Intercept
Incoming
response
VistA
VistA
VistA
VistA

ewd-federator
Node.jsREST
Clients
REST
Requests
EWD.js
system
Back-end
Servers
EWD.js
system
EWD.js
system
EWD.js
system
Intercept
Incoming
response
re-direct
VistA
VistA
VistA
VistA

So that's REST…
What about browser-based apps?

ewd-federator
EWD.js
Application
Server
EWD.js
VistA
EWD.js
VistA
Site 1
Site 2
EWD.js
VistA
Site 3
REST
Browser
WebSockets
HTTP
Web
Services

All good stuff, but
It's the narrow, technical perspective on why EWD.js
Can be considered to be just one potential option

Benefits to the VA
• Single language skill
– JavaScript

Benefits to the VA
– JavaScript
• Controlled migration:
– from rare Mumps development resources
– To readily-available JavaScript developers

Benefits to the VA
– JavaScript
• Controlled migration:
– from rare Mumps development resources
– To readily-available JavaScript developers
– One-off interfacing of core VistA functionality
via JavaScript functions

Browsers
JavaScript
Node.js
React Native

Browsers
JavaScript
Node.js
React Native
There's never been a more exciting time to be in IT
And all the big innovations and developments are focused
In these 4 areas

JavaScript:
Now the world's most popular language
Already huge, and only getting bigger

Node.js:
JavaScript on the server
There's a module for everything!
Tap into a huge and growing pool
of innovations

Browsers:
The ubiquitous desktop client
The target UI for all new applications

So, browser-based VistA Apps
The right way to go?

• Myth #1: Browser UIs just aren't good enough for clinical/medical apps
• Myth #2: Browsers and web technologies aren't fast enough / too much latency
• Myth #3: Browsers and web technologies aren't secure enough

•Myth #1: Browser UIs just aren't good enough for clinical/medical apps
It seems they're good enough for everyone else
There's nothing a browser can't do these days
The days of being limited to simple pages were decades ago

Do you use:
• Google Docs
• Microsoft Office 365
• Do you bank, shop, watch videos, etc on your browser at home?

• Sophisticated graphics:
• 2-d - charts, graphs – updated in real-time
• 3-d eg http://data-arts.appspot.com/globe/

See the work of Astute Semantics
VistA modernisation using EWD.js

•Myth #2: Browsers and web technologies aren't fast enough / too much latency
Are the following hopelessly slow for you?
• Amazon
• EBay
• Google
• Do you watch Netflix or YouTube in your browser?

Demonstrations showing federated access to multiple
VistA systems using ewd-federator and EWD.js:
Sub-second response
Asynchronous pre-emptive data fetching based on usage statistics

•Myth #3: Browsers and web technologies aren't secure enough
It seems they're good enough for online banking….

•Myth #3: Browsers and web technologies aren't secure enough

The future is browser-shaped
• Web-sockets – used by EWD.js applications
– Redefines the way you can think about browser apps
– Server can send messages to the browser at any
time:
• Alerts, message of the day
– Real-time graphing of clinical results on tablet
browser by the bed-side
– Real-time bed state display
– Cross-browser inter-communication between provider
and patient
– Legacy green screen terminal in browser
• https://robtweed.wordpress.com/2014/03/04/vista-the-hackable-open-source-ehr-hackable-platform/

• WebRTC
– Real time communications
– Skype-like behaviour in a browser, without
plug-ins
• Video
• Audio
• File transfer
– Key to browser-based telemedicine

Asm.js
• Subset of JavaScript that can be compiled and
run at near native C++ speed in asm.js-enabled
browsers
• Emscripten compiler
• Being driven by the games industry
– Unreal Engine ported to run in browser, without plug-
ins
– Try this:
• http://www.flohofwoe.net/demos/dsomapviewer_asmjs.html

Chromecast
• $35 Device from Google
• Marketed as a video streaming
device for your TV
• It actually has a lot more potential,
particularly in healthcare

Chromecast Schematic
Chrome
Browser
Chrome OS
HDMIOutput
TV
Monitor
Projector
WirelessNetwork
Interface

Chromecast
• Turns an HDMI-
interfaced monitor or TV
into a sophisticated,
controllable display
https://robtweed.wordpress.com/2014/04/05/chromecast-understanding-its-potential/

VistA Chromecast Applications
Chromecast
PC or Mac
Chrome
Chromecast
JavaScript APIs
Sender
Application
WirelessNetwork
Chrome
HTML Page
Chromecast
JavaScript APIs
EWD.js
Application
EWD.js Application
JavaScript
EWD.js / Node.js
Server
EWD.js JavaScript
WebSocket
messaging
VistA

The future is JavaScript-based
Costs $80

What does it do?
Detects hand movements
and gestures in 3D area
above and around the device

How do you use it?
• USB Device
• Move one or more hands
above it
• Software can detect:
– Palms
– Fingers & thumbs
• Including joints
– Position
– Rotation in 3D
• Samples at whatever
frequency you wish
• Sub-millimeter accuracy
• Program in JavaScript
http://osehra.org/sites/default/files/QuantitativeHandTremorTweed.pdf

The future is JavaScript-shaped
The Internet of Things will be powered by JavaScript and Node.js

React Native:
Facebook's Open Source solution
to the mobile app dilemma

React Native:
• How to effectively develop apps for:
• desktop browsers
• iOS mobile devices
• Android devices

React Native:
• Android devices
• without 3 different skill-sets
• JavaScript, HTML, CSS
• Objective C, Swift
• Java

React Native:
• Android devices
• without 3 different skill-sets
• JavaScript, HTML, CSS
• Objective C, Swift
• Java
• or avoiding the compromises of
• mobile browser apps
• hybrid apps

React
State Change
Re-render
Virtual DOM
iOS
UIKit
Components
Standard React.js
JavaScriptCore

• Creates truly Native Mobile Applications
• Currently iOS only, but Android port due to
be released to Open Source any day
• Mobile apps can be built by JavaScript
developers
– Who can also create browser app equivalents
in the same way
• Note:
– NOT write once, run everywhere
– Learn Once, Write Anywhere

React Native:
This is HUGE!
Provides the mobile solution
that the VA have been
searching for
EWD.js makes it possible for the VA
to use React Native TODAY!
https://www.youtube.com/watch?v=zOIwTU6oPuo

Further benefits to the VA
EWD.js
VistA
Caché
Node.js
VistA Server
cache.node
Roll & Scroll
RPC BrokerCPRS
RPCsFileMan
Interface functions
Web
Service
Clients
HTTPS +
HMAC
SHA256
Stateful
JavaScript /Node.js
business logic
Stateless
Free up server
resources

Further benefits to the VA
• all EWD.js apps would work
• highly secure
• insignificant cost per device
• significantly simplify and reduce
costs of security procedures

Consequences for the VA
• ewd-federator:
– Code distribution
– Software update management
– Synchronising configurations
– Federated control over user privileges
– Centralised performance monitoring /
dashboards

Consequences for the VA
• ewd-federator:
– Code distribution
– Software update management
– Synchronising configurations
– Federated control over user privileges
– Centralised performance monitoring /
dashboards
• These are things the VA has been struggling to
find solutions for, for years

What about the Open-Source VistA
Community?
• Everything I've described applies to them
also
– All these capabilities and features are
available for GT.M-based versions of VistA
• Fully supports the original aims of
OSEHRA

So imagine if…
EWD.js was adopted at the VA..

You really need to see the view
from up here!

OSEHRA Conference 2015: EWD.js - The Future Starts Here

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OSEHRA Conference 2015: EWD.js - The Future Starts Here