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GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.

Global Technology Solutions Institute


eHealth System Integration Hands-on Labs Training Manual

Step-By-Step Install Guide openEMR on Debian 5 Server


Kefa Rabah
GTS Institute, Vancouver Canada
krabah@gtechsi.org
www.gtechsi.org

Table of Contents Page No.

STEP-BY-STEP INSTALL GUIDE OPENEMR ON DEBIAN 5 SERVER 1

1.0 Introduction 1

Part 1: Install & Configure Debian 5 Server 2


Step 1: Install Linux Debian 5 Lenny 2
Step 2: Update Debian 5 Operating Systems 2

Part 2: Install & Configure Pre-requisites 2


Step 1: Installing Apache5 and PHP5 2
Step 2: Installing MySQL Database Server 3
2.1 Manually Creating users to use MySQL and Changing Root Password 4
Step 3: Install OpenSSH Package 5
Step 4: Install Webmin 5

Part 3: Install & Configure open EMR 6

Part 4: Moving around openEMR Admin Console 10


Step 1: openEMR Calendar 10
Step 2: openEMR Patient/Client 10
Step 3: openEMR Fees Link 12
Step 4: openEMR Administration Link 13

Part 5: Need More Training on Linux: 21


eHealth openEMR Server Administration Training 21

Part 6: Hands-on Labs Assignments 21


Debian Server Administration Training 21

A GTSI Open Access Technical Academic Publications


Delivering Cutting-edge Technology at your Fingertips the 21st Century

1
April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Global Technology Solutions Institute


eHealth Systems Integration Hands-on Labs Training Manual

Step-By-Step Install Guide openEMR on Debian 5 Server


By Kefa Rabah, krabah@gtechsi.org Dec 14, 2010 GTS Institute

1.0 Introduction
OpenEMR is a free Open source, Practice management, Electronic Medical Records, prescription writing
and medical billing application. These programs are also referred to as electronic health records.
OpenEMR is licensed under the General Gnu Public License (General GPL). It is a free open source
replacement for medical applications such as Medical Manager, Health Pro, and Misys. It features support
for EDI billing to clearing houses such as Availity, MD-Online, MedAvant and ZirMED using ANSI X12.

OpenEMR was originally developed by Synitech and version 1.0 was released in June 2001 as MP Pro
(MedicalPractice Professional). Much of the code was then reworked for HIPAA compliance and improved
security, and the product was reintroduced as OpenEMR version 1.3 a year later, in July 2002. You can
install openEMR on Unix-like systems (Linux, UNIX, and BSD systems), Microsoft systems, Mac OS X
and other platforms. In this you’ll learn how to install openEMR on Linux distros that are open source.

Debian 5 or Lenny is based on the 2.6.25 Linux kernel. For the desktop, Lenny supports both KDE 3.5.9
and GNOME 2.20.1.1. It also includes the most recent versions of many popular end-user software
applications. These include: Firefox 3.01, OpenOffice 2.4.1, and Evolution 2.22.3.1. Lenny is also
excellent for developer. It all includes the best developer and server programs. For example, Lenny
comes with glibc 2.7 and Samba 3.2.

For networking, Lenny will include full support for the IPv6 networking protocol and NFSv4 (Network File
System). On the server side, Lenny is also expected to have LFS (Large File Support). With this,
applications will have access to the largest files supported by the operating system and file system rather
than an application-bound arbitrary file size limits. In general, Debian 5 is an outstanding Linux
distribution. Since Debian is, in turn, the foundation of many other distributions, such as Ubuntu and its
family of Linux distributions; MEPIS; and Xandros, this bodes well for all of Linux.

Hands-on Lab Solution:


In this Hands-on Lab session, you’ll learn how to setup virtual network on VMware (you may also use any
other virtual machines like MS VirtualPC, Linux Xen, or VirtualBox from Oracle, or Citrix XenServer). In
this lab session, we’ll concentrate on installing Linux Debian 5 Lenny server which we then use to install
and configure eHealth openEMR application. After completing the initial installation I’ll show you how to
install LAMP server and openSSH as pre-requisites for openEMR application. You will also learn how to
setup secure MySQL database server. Webmin, although not required, is a useful admin tool that I’ll show
you how to install. You’ll also have opportunity to carryout some lab assignments at the end of the lab
session. After completion of this lab session, you should have gained enough skills to install and setup
openEMR on Debian 5.

1
April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Part 1: Install & Configure Debian 5 Server

Step 1: Install Linux Debian 5 Lenny


In this hands-on lab it’s assumed that you have a good knowledge of Linux Debian 5 distro. It’s also
assumed that you already have a Debian 5 in place or know how to install setup and configure one. If not
then you can check this out or excellent hands-on manual entitled: “Step-By-Step Install Guide Debian 5
Lenny Server v1.1”:

It’s here assumed that your target computer is connected to the internet as we’re going to make use of
packages download and system upgrade.

Step 2: Update Debian 5 Operating Systems


It is useful to update your system with the latest components and system patches. The first command
below asks Debian 5 to update its database of available packages, and the second command installs the
latest packages based on your current configuration. We run the upgrade command twice to ensure that
any packages that may have post-upgrade dependencies also have an opportunity to be upgraded.

After installing the operating system, login to your machine and ensure you perform software updates to
bring your systems up-to-date.

1. From the command line, enter the following commands, one at a time.

# apt-get update
# apt-get -u upgrade

2. We’re done with this section

3. You’re now ready to begin installing openEMR pre-requisite packages.

Part 2: Install & Configure Pre-requisites

Step 1: Installing Apache5 and PHP5


Apache is one of the most famous web server, which runs on most Linux based servers. With just few
commands you can configure apache to run PHP 5. If didn’t pre-install them during initial installation then
no worries, I’ll show you how to do so.

1. To install Apache2 with PHP5, run:

apt-get install apache2 php5 libapache2-mod-php5

2. Apache configuration file is located at: /etc/apache2/apache2.conf and your web folder is
/var/www.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

3. To check whether PHP is installed and running properly, just create a testinfo.php in your
/var/www folder with phpinfo() function exactly as shown below.

vi /var/www/testinfo.php

<?php
/* testinfo.php */
phpinfo();
?>

4. Fire-up your favorite browser and point it to http://ip.address/testinfo.php or http://domain/testinfo.php


and this should show you all your PHP configuration and default settings.

5. You’re done with this section.

Step 2: Installing MySQL Database Server


Installing MySQL database server is always necessary if you are running a database driven ecommerce
site. Remember running mysql server to a fair extend requires at least 256MB of RAM in your server. So
unless you are running database driven sites you don’t absolutely need MySQL.

1. Again if you didn’t pre-install the MySQL database server, then no worries - the following commands
will install mysql 5 server and mysql 5 client.

# apt-get install mysql-server mysql-client php5-mysql

Note: the configuration file of mysql is located at: /etc/mysql/my.cnf

Security Warning! By default there is no root password set for MySQL after initial installation, and
therefore, it is important that you set the password for the ROOT account.

Fig. 1
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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Note: Confirm the password if prompted

2.1 Manually Creating users to use MySQL and Changing Root Password
2. By default mysql creates user as root and runs with no passport. You might need to setup the root
password.

3. To setup MySQL password, run:

# /usr/bin/mysqladmin -u root password 'new-password'

Note: you must never use root password, so you might need to create a user to connect to mysql
database for a PHP script. Alternatively you can add users to mysql database by using a control panel
like Webmin or phpMyAdmin to easily create or assign database permission to users. We will install
Webmin and phpmyadmin during later once we complete basic installation.

4. You can also try remote localhost login as "root" user, as follows:

# mysql -h localhost -u root -p

1. Now let’s test the login for "netadmin" user , as follows:

netadmin@debian5:~$ mysql -u netadmin -p


Enter password:

mysql> SHOW DATABASES;


+--------------------+
| Database |
+--------------------+
| information_schema |
| datactrbk |
+--------------------+
2 rows in set (0.07 sec)

mysql>exit
BYE
netadmin@debian5:~$

5. You’re done with this section.

6. That's it! MySQL and phpMyAdmin are ready. Log in with your mysql root password and create users
to connect to database from your PHP script.

4
April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Step 3: Install OpenSSH Package


In order to support secure remote connections to your server, you will need to install the OpenSSH
package. This package will come in handy in the future to support administrative tasks on the system. By
default this package is already installed in the Ubuntu server option.

1. To install OpenSSH, issue the following command:

$ sudo apt-get install openssh-server -y

2. To log into a remote computer that is running OpenSSH, you use the ssh username@hostname
command, replacing username with a valid user name on the computer you are trying to log into, and
replacing hostname with either the fully qualified host name (e.g. example.com) of your server, or
it’s IP address (e.g. 192.168.83.180), as show in Fig. 2.

Fig. 2

3. We’re done with this section

Step 4: Install Webmin


Although Webmin is not one of the pre-requisite packages for install openEMR, but is a very handy tool
that all Linux admin should have in place. Webmin is a web-based interface for system administration for
Linux/Unix. Using any modern web browser, you can setup user accounts, Apache, DNS, file sharing and
much more. Webmin removes the need to manually edit Unix configuration files like "/etc/passwd",
and lets you manage a system from the console or remotely. Currently there is no Webmin package in
the Debian repositories. This tutorial will explain how to install Webmin in Debian Intrepid Ibex

You can install Webmin for your server web interface to configure Apache2, MySQL, FTP, DNS servers
and many more. Now we will see how to install Webmin in Debian 5 Lenny
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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Preparing your system


4. First you need to install the following packages

# apt-get install perl libnet-ssleay-perl openssl libauthen-pam-perl


libpam-runtime libio-pty-perl

5. Now download the latest Webmin using the following command or from here

wget http://prdownloads.sourceforge.net/webadmin/webmin_1.530_all.deb

6. Now we have webmin_1.530_all.deb package install this package using the following
command

# dpkg -i webmin_1.530_all.deb

Note: incase you encounter any difficulties in installing dependency; then issue the command:

# apt-get –f install

Fig. 3

7. We’re done with this section

8. We’re also done with installing all the necessary pre-requite packages.

Part 3: Install & Configure open EMR


This package is basically a one-click installation/configuration package for Ubuntu and Debian OS that
also configures Apache and PHP. It is extremely simple to install, and we plan to support automated
OpenEMR upgrading in the future. It has been tested in the desktop and server versions of Ubuntu 10.04
Lucid Lynx and 10.10 Maverick Meerkat, and Debian 5 Lenny. In this hands-on lab session, we’re going to
install openEMR on Debian 5.

In Ubuntu distro installation can either be done in desktop or command line. However, for Debian, a
command-line install is recommended.

To install openEMR on Debian 5 server, perform the following procedure:

1. Download the openEMR. At the time of writing, version: openemr_3.2.0-1_all.deb

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

2. Change to the download directory and as root user, issue the following command (Note: you’ll be
required to respond to some query, like MySQL password):

# dpkg -i openemr_3.2.0-1_all.deb

Note: incase you encounter and any with this initial command, the run:

# apt-get install -f
.....
......
Creating config file /etc/php5/cli/php.ini with new version
Setting up imagemagick (7:6.3.7.9.dfsg2-1~lenny4) ...
Setting up openemr (3.2.0-1) ...
Configuring OpenEMR
Configuring Apache for OpenEMR
Added entries to apache configuration to secure directories with patient
information.
Placed backup of your original apache configuration file to
/etc/apache2/httpd.conf.BAK
Configuring PHP for OpenEMR
We changed the following setting(s) in your php configuration file at
/etc/php5/apache2/php.ini :
(We have placed a backup of your php configuration at
/etc/php5/apache2/php.ini.BAK)
Successfully set max_execution_time = 60
Successfully set max_input_time = 90
Successfully set display_errors = Off
Successfully set log_errors = On
Successfully set post_max_size = 30M
Successfully set upload_max_filesize = 30M
Restarting Apache service
--------------------------------------------------

You can now use OpenEMR by browsing to:


http://localhost/openemr
user is 'admin' and password is 'pass'

3. As can be observed from the above installation process, you can access to OpenEMR by browsing to
http://localhost/openemr, as shown in Fig. 4.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 4

4. Now login with username 'admin' and password 'pass', as shown in Fig. 5. You now take time to
get familiarized with the openEMR layout and functionality. As you can observe I am logged in as an
Administrator.

Note: on the left pane, you have links which allows you to access other openEMR admin
functionalities while on the right-pane; you have access to the current month Calendar, date and
schedule times. From here you can also do some system Search.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 4

5. Other cool stuff: to access the man page run:

$ man openemr

6. You’re done with this section.

9
April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Part 4: Moving around openEMR Admin Console

Step 1: openEMR Calendar


1. Login to openEMR web admin console with admin user credentials.

2. Click on the Calendar link to access the default current Calendar, as shown in Fig. 5. From here you
can search and schedule patients’ for checkup or admission.

Fig. 5

7. You’re done with this section.

Step 2: openEMR Patient/Client


1. Login to openEMR web admin console with admin user credentials.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

2. Click on the Patient/Client link Æ Management to access the default current “Search or Add
Patient” pane on the right-pane, as shown in Fig. 6. From here you can search or add patient to the
system.

• Under Management link, you also have access to other links like Current and Summary,
which are currently grayed-out.

Fig. 6

3. Click on the Patient/Client link Æ Visits link, as shown in Fig. 7. From here you can search or
add patient to the system.

• Under Visits link, you also have access to other links like: New Visit, Current, List,
Transact and Chart Tracker. Except, Chart Tracker, all the other links here are
currently grayed-out.

• Click on the Chart Tracker link to access and external “Chart Tracker” window, as shown
in Fig. 7. Fm here you can perform new patient lookup using their ID.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 7

4. Click on the Patient/Client link Æ Visit Forms link.

• Under Visit Forms link, you also have access to other links which all are currently grayed-
out.

5. Click on the Patient/Client link Æ Medical Records link. From here you also have access to
other links which all are currently grayed-out.

8. You’re done with this section.

Step 3: openEMR Fees Link


1. Login to openEMR web admin console with admin user credentials.

2. Click on the Fees link, as shown in Fig. 8.

• Under Fees link, you also have access to other links like: Fee Sheet, Checkout, and
Billing. Except, Billing, all the other links here are currently grayed-out.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

• Now click on the Billing link to access “Billing Report” form. From here can perform all
billing related functionalities.

Fig. 8

3. You’re done with this section.

Step 4: openEMR Administration Link


4. Login to openEMR web admin console with admin user credentials.

5. Click on the Administration link, as shown in Fig. 9 with Facilities link clicked.

• Under Administration link, you also have access to other links like: Facilities, Users,
Practice, Services, Layout, Lists, and ACL.

• From Facilities link Æ Facilities Administrations form, complete all the required fields
under the “New Facility Information”. When done click on the Add button to apply the
changes.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 9

6. Click on the Administration link Æ Users link, as shown in Fig. 10. From here you can add new
users to the system.

• From Users link Æ User Administrations form, complete all the required fields under the
“New User”, select the user type from the under the Access Control. When done click on the
Add button to apply the changes.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 10

7. Click on the Administration link Æ Practices link, as shown in Fig. 11. From here you can add
new other Practices to the system.

1. These are: Add a Pharmacy, Insurance Companies, Insurance Numbers, X12,


Partners, Documents, Edit Categories and HL7 Viewer.

• Click Add a Pharmacy link and complete all the required fields. When done click on the
Update button to apply the changes.

• Repeat same for all the other links.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 11

8. Click on the Administration link Æ Services link, as shown in Fig. 12. Enter all the required
fields and then either click on the [update] or the [Add as New] link.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 12

9. Click on the Administration link Æ Layouts link, as shown in Fig. 13. From Layouts link Æ
Edit Layout drop down menu, select the desired option.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 13

1. Click on the Administration link Æ Lists link, as shown in Fig. 14. From Lists link Æ Edit
List drop down menu, select the desired option. When done click on the Save button to apply the
changes.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 14

2. Click on the Administration link Æ ACL link, as shown in Fig. 15. From ACL link Æ Access
Control List Administration, select the desired option.

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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

Fig. 15

3. Click on the Administration link Æ backuup link, as shown in Fig. 16. From here you can click
on the “Create Backup: button to “create and download a full backup”.

Fig. 16
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April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

4. Click on the Administration link Æ Others link, from here you can perform other functionalities
like: Language, Forms, Logs and Database related activities.

5. Take your time and continue with the same sequence of getting yourself acquainted with the
openEMR layout and functionalities.

6. You’re done with this hands-on lab session.

Part 5: Need More Training on Linux:


Are you having trouble understanding or comprehending the working of Linux OS, if so, then check out
some of our introductory courses on Linux at: GTS Institute, Vancouver Canada.

eHealth openEMR Server Administration Training


You can now register and take our superb eHealth openEMR Server Training course, covering installing
setup and configuring Linux Debian 5 and Ubuntu 10.04 LTS. Next you’ll how to install & maintain
openEMR on Debian5 and Ubuntu 10.04 servers.

• ETC101- Debian Server Administration Training

Call us today:
Email: info@gtechsi.org. URL: www.gtechsi.org

Part 6: Hands-on Labs Assignments


1. Install and configure update Debian 5 Lenny server or Desktop
2. Install and configure a LAMP, openSSH and Webmin on Linux Debian 5
3. Install and configure a openEMR on Linux Debian 5
4. Install Postfix mail server and Evolution mail client. Lockdown your server by installing and
configuring; Clamd, ClamAV and MailScanner.
5. Deploy Astaro GS Router to secure your private network.

Debian Server Administration Training


You can now register and take our superb Debian Server Training course, covering Debian/Ubuntu
servers, EHCP and ISPConfig ISP hosting solutions, RESTORE backup, EJBCA PKI and DTC GPLHost
Control Panel solutions and many more…

• ETC101- Debian Server Administration Training

21
April 2007, Kefa Rabah, Global Technology Solutions Institute, Vancouver Canada

www.gtechsi.org EIH21 – eHealth Server Administration Training


GTS Institute eHealth Labs Install Guide openEMR on Linux Debian 5 Server v1.1

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11. Install & Setup Astaro Security Gateway to Protect Corporate Network v1.1

-----------------------------------------------
Kefa Rabah is the Founder of Global Technology Solutions Institute. Kefa is knowledgeable in several
fields of Science & Technology, Information Security Compliance and Project Management, and
Renewable Energy Systems. He is also the founder of Global Open Versity, a place to enhance your
educating and career goals using the latest innovations and technologies.

Fellow us on Twitter: GTS Institute and Kefa Rabah

A GTSI Open Access Technical Academic Publications


Delivering Cutting-edge Technology at your Fingertips in the 21st Century
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