In order to use the Virtual Machine (VM) image, you will need a VM framework such as VMWare Fusion or VirtualBox. These instructions are based on installing the VM framework locally, but for suggestions of a cloud-based approach, for example, see https://aws.amazon.com/ec2/vm-import/.
The tranSMART VM image (.ova file) can be downloaded from the transMART Foundation's library, the VM Section. The VM images all contains all of the components of tranSMART as well as a set of sample data, pre-loaded. The file is approximately 6 GB in size so may take some time to download depending on your connection speed.
Simple as (1) start Virtual Box, (2) File-> import application (follow instructions on wizard) (3) start VM. Similar instructions apply for VMWare. And AWS EC2.