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1Fix the driver behind crashes, sound loss and screen glitches2Clear out junk files and repair common Windows errors3Scan for outdated or missing drivers - takes under a minuteYes, you can run OpenEMR on an Ubuntu VPS. The two supported deployment patterns are the official Docker image, which bundles the application with a companion MySQL or MariaDB service, and a native Linux installation using Apache, PHP, and MySQL/MariaDB. Docker is usually the better starting point in 2026 when you want repeatable upgrades and fewer package-integration tasks. Native installation remains useful when you need direct control of the host web server, PHP configuration, and filesystem.
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This guide covers the security baseline, DNS and HTTPS, both installation paths, initial checks, backups, upgrades, and the failure points that most often interrupt a self-hosted deployment. It does not make a compliance or performance guarantee for any VPS; you remain responsible for securing the server, controlling access to patient data, and validating the configuration for your jurisdiction and organization.
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Choose Docker or a native Ubuntu installation
Decide the operating model before creating the server. OpenEMR itself needs a PHP-capable web server and a MySQL-compatible database. Docker packages those moving parts into a documented application image plus a database container. A native install puts Apache, PHP, the database, and OpenEMR files directly on Ubuntu.
| Decision point | Official Docker deployment | Native Apache/PHP/MySQL deployment |
|---|---|---|
| Repeatability | Pin an image tag or digest and reproduce the same application stack. | You control every Ubuntu package and configuration, but must reproduce them yourself. |
| Setup effort | Environment variables and the production compose pattern reduce manual wiring. | More work is required for PHP extensions, Apache settings, database setup, and permissions. |
| HTTPS | The image documents HTTP on port 80, HTTPS on 443, and optional Let’s Encrypt automation. | You configure certificates and renewal in the host web-server stack. |
| Ongoing work | Maintain compose files, secrets, volumes, and image updates. | Maintain OS packages, PHP, Apache, database software, and OpenEMR files. |
| Best fit | Small teams that value a repeatable deployment and simpler application upgrades. | Administrators who require direct control of Apache, PHP, or the Ubuntu filesystem. |
For either route, keep the database on a private host network or container network. Do not publish MySQL or MariaDB to the public internet merely to make the application connect.
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Prerequisites and release-specific requirements
Ubuntu VPS baseline
- Use a currently supported, fully updated Ubuntu release and an administrative account that is not root.
- Allocate enough disk for the operating system, OpenEMR files, database growth, uploaded documents, logs, and local backup staging. The official material does not publish a universal CPU, RAM, or storage size, so size the VPS from your user count, document volume, and retention policy rather than an invented minimum.
- Have a hostname you control, with DNS access to create an A record and, if you use IPv6, an AAAA record.
- Decide where encrypted off-site backups will be stored before loading real data.
Native Linux requirements
The OpenEMR 7.0.4 Linux guide specifies PHP 8.2 or newer, required PHP extensions and settings, Apache (or another PHP-capable server), and MySQL or MariaDB. It uses /var/www/html as the Ubuntu web-root example and calls for an Apache LimitRequestFieldSize value of 32768. Requirements change between releases, so check the guide for the exact OpenEMR version you select before installing packages.
Docker requirements
The official image runs OpenEMR with a companion MySQL/MariaDB service. Its automatic setup requires MYSQL_HOST and MYSQL_ROOT_PASS. Variables for the database name, database user and password, and OpenEMR credentials are optional according to the image documentation. The documented container ports are 80 for HTTP and 443 for HTTPS.
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Provision and harden the Ubuntu server first
- Create a non-root administrator. Log in through the VPS provider’s console or temporary root account, add a named user, grant administrative rights, and test a second SSH session with that account before disabling root access.
- Apply updates. Run the normal Ubuntu package refresh and security upgrade, reboot when the kernel or core services require it, and reconnect before continuing.
- Use SSH keys. Install a key for the administrator, disable password authentication only after key login has been confirmed, and restrict SSH to the addresses or VPN path used by your administrators when practical.
- Configure the firewall. Permit SSH and only the web ports required by your design. A public deployment normally needs TCP 80 and 443; the database port should not be opened to the internet. If Docker is used, verify that container-published ports do not bypass your intended firewall policy.
- Set time and monitoring. Keep Ubuntu time synchronization enabled. Arrange disk-space, memory, certificate-expiry, and service-availability alerts before users depend on the system.
sudo apt update
sudo apt upgrade
sudo ufw allow OpenSSH
sudo ufw allow 80/tcp
sudo ufw allow 443/tcp
sudo ufw enableThe exact firewall tool and SSH policy can differ in your environment. The important boundary is that only administration and web traffic are exposed; application-to-database traffic stays private.
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Point DNS at the VPS and plan HTTPS
- Create an A record such as
emr.example.orgpointing to the VPS IPv4 address. Add an AAAA record only when the server is correctly configured for IPv6. - Wait for the record to resolve from outside your network. Test both the hostname and the final public address before requesting a certificate.
- Choose one TLS design. With the official Docker image, supply
DOMAINand optionallyEMAILso its documented Let’s Encrypt setup can obtain and maintain a certificate. With a native install, configure certificate issuance and renewal in Apache or your chosen reverse-proxy/web-server stack. - Allow certificate validation traffic on port 80 if your selected ACME method requires it, then redirect ordinary HTTP requests to HTTPS after issuance.
Do not place a certificate request in front of a hostname that still resolves to an old server. Confirm the certificate’s hostname, renewal schedule, and what happens when renewal fails.
Deploy with the official Docker image
1. Install Docker and keep the project files together
Install Docker Engine and the Compose plugin using Ubuntu’s supported package method. Create a dedicated directory for the OpenEMR compose project and restrict it to administrators. Keep the compose file, its environment or secret files, and an upgrade log in that directory; do not paste passwords into shell history or commit them to a public repository.
2. Define the application and private database services
Use the official production compose pattern rather than an ad-hoc single container. It should define an OpenEMR service, a MySQL or MariaDB service, persistent volumes for the database and application data, and a private network between the two services. The application service receives MYSQL_HOST and MYSQL_ROOT_PASS; set explicit database and OpenEMR credentials instead of relying on defaults.
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Store values in a root-readable environment file or Docker secret mechanism. At minimum, separate the database root password, the application database user password, and the OpenEMR administrator password. Treat every value as sensitive because the environment can be exposed through diagnostics or backups.
3. Pin the images before starting
Do not deploy an unqualified latest image. At the time of the supplied release information, Docker Hub listed an OpenEMR tag 8.4.1-2026-10-14; that tag is a dated observation, not a permanent recommendation. The production compose example also pins OpenEMR and MariaDB by digest. Check the current official listing immediately before deployment, record the exact tag or digest in your change log, and update it deliberately after testing.
4. Start and verify the stack
- Change into the compose directory and validate the rendered configuration, including volume paths, network names, ports, and secret substitutions.
- Start the services in detached mode using the production compose file.
- Inspect service status and logs. The application should be able to resolve
MYSQL_HOSTon the private network and complete its database initialization. - Browse to the hostname over HTTPS. If the selected image presents a web installer, complete it with the credentials and database values you prepared.
- Sign in with a test account, create a non-production test patient, upload a test document, and verify that the scheduled jobs and mail or external integrations are configured as intended.
Keep HTTP and HTTPS publication limited to the application service. Do not publish the database service port. If you place a separate reverse proxy in front, expose only that proxy publicly and keep the containers on private networks.
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Install OpenEMR natively on Ubuntu
1. Match the release guide before installing packages
Select the OpenEMR release first, then read its Linux instructions. For the 7.0.4 guide, PHP 8.2 or higher is required, along with the listed extensions and settings. Installing an older Ubuntu PHP version and trying to compensate later commonly produces missing-extension errors or incompatible behavior.
2. Install and configure the web and database layers
- Install Apache, PHP at the release-supported version, the required PHP extensions, and MySQL or MariaDB from trusted Ubuntu or vendor repositories appropriate to your release policy.
- Run the database’s hardening procedure, remove anonymous accounts and test databases where applicable, and create a dedicated OpenEMR database account with only the privileges the installer requires.
- Set Apache’s
LimitRequestFieldSizeto32768as specified by the OpenEMR 7.0.4 Linux guide, then validate the Apache configuration before reloading it. - Enable the PHP and Apache modules required by the release guide. Confirm the active PHP version from the command line and from the web server; a CLI version alone does not prove that Apache is using the same PHP runtime.
3. Place the files and run the installer
Download the exact OpenEMR release from the official project channel, verify its integrity using the project’s published method, and place it under the configured web root, using /var/www/html only when that matches your Apache virtual host. Create a dedicated virtual host for the OpenEMR hostname rather than mixing it with unrelated sites.
The native installer may need selected OpenEMR directories to be writable during setup. Grant only the temporary ownership and permissions the installer requests, complete database and administrator configuration, and then return those paths to restrictive ownership and permissions. Never leave the whole web root writable by the web-server account.
4. Configure HTTPS and renewal
Issue a certificate for the OpenEMR hostname, configure Apache to serve it, redirect HTTP to HTTPS, and test renewal before the system is used with real records. Renewal failures should generate an alert; a certificate that expires silently is an outage even when OpenEMR and the database are healthy.
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Complete the first-run security and functionality checks
- Administrator access: Change any temporary credentials, create individual user accounts, and remove accounts that are no longer needed. Avoid shared administrator logins.
- File permissions: Confirm that uploaded documents and configuration files are not world-readable. Verify that only the directories explicitly required for runtime writes are writable by the web-server process.
- HTTPS: Test the hostname from a separate network, confirm the certificate chain and hostname, and check that login and document-upload requests remain on HTTPS.
- Database isolation: From an external scan or firewall review, confirm that MySQL/MariaDB is not reachable publicly. Test application-to-database connectivity from the private network instead.
- Documents: Upload and retrieve a harmless test file, then confirm its permissions and backup inclusion. Do not use real patient documents for the first functional test.
- Scheduled work: Check the jobs OpenEMR relies on in your configuration, including reminders or other scheduled tasks, and verify their logs and execution times.
- Mail and integrations: Configure outbound mail and external integrations only after deciding which credentials, network destinations, and audit records your organization permits. Send a controlled test message.
- Logging: Review Docker or Apache/PHP logs, database logs, and OpenEMR logs for startup errors. Set retention and protect logs because they can contain identifiers or sensitive request data.
Back up OpenEMR before every upgrade
The OpenEMR installation documentation states: “Be sure to back up your OpenEMR installation and database before upgrading.” Treat that as a release gate, not an optional housekeeping task.
What to back up
- The OpenEMR application files, including configuration and uploaded documents.
- The complete MySQL or MariaDB database, with a consistent export or snapshot method appropriate to your database engine.
- The Docker compose file, pinned image references, environment or secret definitions, and any reverse-proxy or Apache configuration needed to rebuild the service.
- Certificate and DNS configuration records, without exposing private keys in an unsecured archive.
How to make the backup useful
- Stop or quiesce writes when your chosen database backup method requires a consistent point in time.
- Export the database and archive the application data separately so each can be inspected and restored independently.
- Encrypt the backup before transferring it off-site. Keep at least one copy outside the VPS account and restrict who can decrypt it.
- Record the OpenEMR version, database engine version, image digest or package versions, and backup timestamp alongside the archive.
- Perform a restore test periodically on an isolated staging VPS. A successful backup job is not proof that the archive can produce a working OpenEMR system.
Upgrade safely
- Read the release notes and the installation instructions for the target OpenEMR version. Pay particular attention to PHP, database, image, and migration requirements.
- Take a fresh backup or VPS snapshot, and verify that the backup is readable before changing production.
- Rehearse the upgrade on staging with a recent sanitized copy when your data-handling policy allows it.
- For Docker, update the pinned OpenEMR and database image references deliberately, preserve the compose configuration, and review the rendered configuration before pulling or recreating services.
- For native installs, update the application and only the supporting packages required by the release guide. Do not perform unrelated operating-system changes in the same maintenance window unless you have tested them.
- Run the web installer or migration step requested by the release, then verify login, patient search, document upload and retrieval, scheduled jobs, mail, integrations, HTTPS, and logs.
- Keep the previous image or package artifacts and the rollback instructions until post-upgrade checks pass and the agreed observation period ends.
Troubleshooting common failures
The browser cannot reach OpenEMR
- Confirm the DNS A/AAAA record resolves to the current VPS.
- Check that the selected service is running and listening on the expected port: Docker documents 80 and 443; native Apache must have an enabled virtual host.
- Review the VPS firewall, provider firewall, and any reverse-proxy rules. A provider-level firewall can block traffic even when Ubuntu allows it.
The application cannot connect to MySQL or MariaDB
- In Docker, verify that
MYSQL_HOSTexactly matches the database service name on the private network and thatMYSQL_ROOT_PASSmatches the database initialization value. - Check database-container logs for initialization errors and persistent-volume permission problems.
- In a native install, test the dedicated database account locally, confirm the database service is running, and check that PHP’s database extension required by the selected release is enabled.
- Do not solve a connection error by publishing the database port publicly.
The native installer reports missing PHP features
Compare the active Apache PHP version and loaded extensions with the exact release guide. A correct CLI version does not guarantee that Apache uses it. Install the missing release-supported extension, reload Apache, and rerun the installer checks. Recheck PHP settings after package upgrades because configuration files can be replaced or new version directories can become active.
Uploads fail or large requests are rejected
Check PHP upload and post limits, Apache request limits, reverse-proxy limits, filesystem free space, and the writable paths required by OpenEMR. For the 7.0.4 native guide, verify Apache LimitRequestFieldSize 32768. Apply the smallest change that meets your document workflow and test both a small and a representative file.
HTTPS works but renewal does not
Confirm that the hostname still resolves to this VPS, that the ACME validation path is reachable, and that the renewal service is running. For Docker’s documented automation, verify the supplied DOMAIN and optional EMAIL values and inspect container logs. For native Apache, inspect the certificate client’s timer or cron configuration and perform a dry-run renewal.
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Operational checklist
- Non-root administration and tested SSH-key access.
- Security updates applied and reboot policy documented.
- Firewall exposes SSH and required web ports only.
- DNS records point to the correct VPS and HTTPS is enforced.
- Database is private and credentials are stored as secrets.
- Docker images are pinned by a dated tag or digest, or native package versions are recorded.
- OpenEMR files and database are included in encrypted off-site backups.
- Restore testing, certificate renewal, disk monitoring, and log review are scheduled.
- Every upgrade is preceded by a verified backup and followed by functional checks.
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