A Custom Electronic Medical Record System for an Ophthalmology Clinic

Running in Production

Content provided by Nick Janetakis and Nick Janetakis - Full stack developer. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Nick Janetakis and Nick Janetakis - Full stack developer or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.

4y ago 1:31:16

MP3•Episode home

In this episode of Running in Production, Jason Swett goes over building an internal medical record system with Ruby on Rails. It’s hosted on AWS using Kubernetes and it’s been up and running since 2019.

Jason talks about replacing a few 3rd party services with 1 custom solution, using custom generators, embracing PORO, transitioning from Ansible and individual servers to Kubernetes, making safe decisions while learning as you deploy new things and much more.

Topics Include

1:14 – The dream is to replace 9 separate systems with 1 custom solution
3:02 – Deploying on day 1 and what exactly is an EMR?
6:20 – Motivation for choosing Ruby on Rails to build a medical system
10:39 – Infrastructure as code is important
13:36 – The app does scheduling and soon emails will be sent to patients
15:29 – Specific things the app does and how Rails helps Jason accomplish them
21:56 – Custom generators are used for different modules
25:11 – Every 5 seconds certain forms are auto-saved and a few gems that are being used
27:56 – Rails can only help you so much, then you’re kind of on your own
34:10 – Making a distinction between imperative and declarative code
36:36 – Server rendered templates with sprinkles of Javascript (StimulusJS)
43:53 – Looking into using Hotwire Turbo in the distant future
45:41 – Migrating to use Elasticsearch and using it over PostgreSQL’s full text search
47:49 – Using AWS for hosting and landing on using Kubernetes with EKS
52:57 – 5% of Jason’s brain is taken up at all times knowing he’s on-call
55:22 – Switching from individual servers with Ansible to Kubernetes
59:37 – Using eksctl and Helm to move towards infrastructure as code
1:06:12 – The deploy process from development to production with Kubernetes
1:09:53 – Using feature flags and code reviews
1:11:35 – Handling database migrations with a load balanced application
1:15:13 – A strategy for writing Jira tickets
1:17:53 – RDS snapshots are handling database backups
1:21:14 – Monitoring, alerting and the idea of “sharpening the saw”
1:25:47 – Best tips? Make safe decisions and improve skills such as reading documentation
1:30:44 – Check out Jason’s site at https://www.codewithjason.com/

Support the Show

This episode does not have a sponsor and this podcast is a labor of love. If you want to support the show, the best way to do it is to purchase one of my courses or suggest one to a friend.

Dive into Docker is a video course that takes you from not knowing what Docker is to being able to confidently use Docker and Docker Compose for your own apps. Long gone are the days of "but it works on my machine!". A bunch of follow along labs are included.

Build a SAAS App with Flask is a video course where we build a real world SAAS app that accepts payments, has a custom admin, includes high test coverage and goes over how to implement and apply 50+ common web app features. There's over 20+ hours of video.

108 episodes