IT Support and Hardware for Clinics
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News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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In 20 Years, Most New Cars Won’t Have Steering Wheels or Pedals | Autopia | WIRED

In 20 Years, Most New Cars Won’t Have Steering Wheels or Pedals | Autopia | WIRED | IT Support and Hardware for Clinics | Scoop.it

By 2030, most new cars will be made without rearview mirrors, horns, or emergency brakes. By 2035, they won’t have steering wheels or acceleration and brake pedals. They won’t need any of these things because they will be driving themselves.

That’s the takeaway from a new study by the Institute of Electronics and Engineers (IEEE). It’s based on a survey of more than 200 experts who work in the various industries that are slowly pushing us toward a future where humans are so much worse than robots are at driving, it’s not worth letting us even touch a steering wheel.

Automakers have made huge strides toward producing conventional cars that can drive themselves in select situations. A few of those will likely be on the market by the end of the decade or soon after. It’s not actually a big jump from what we have today to that point. Combine current features like adaptive cruise control, lane keeping assist, pedestrian recognition, and parking assist, and you’ve got a car that controls itself.

We’re not quite there yet. Legislation needs to be passed to govern these cars. Insurance companies must to figure out how their policies will work when you can’t assign the blame for a crash to a human driver. The hardware—the radars, sensors, and cameras that connect the car and the outside world—still needs improvement. In the interim stage, when cars control themselves but humans can still tag in, the stakes won’t be so high.

Shedding the Steering Wheel

The shift to cars without steering wheels and pedals will be revolutionary. It’s one thing to get a driver to let go of the wheel on long highway drives or a boring commute. It’s quite another to put him in a car that he can never drive, even if he wants to.

The change is inevitable, says Alberto Broggi, a professor of computing engineering at the University of Parma and an IEEE fellow. Cars that don’t need human drivers anymore will shed parts made for human control. “There’s nothing you can do about that.” The change will free auto design from the rules that have constrained it for a century. (Only Google has publicly addressed the idea, with a prototype it plans to start testing on public roads this fall.)

Google

Broggi says the 2035 date predictions are realistic, but “you need to be very sure that the car is able to handle any scenario” before you give it full control. That will require a whole lot of testing and validation.

One question the IEEE survey raises but doesn’t answer: What happens to automakers when people don’t drive their cars anymore? Broggi says they can move away from working on the most powerful or best handling cars, and instead strive to deliver the most capable autonomous vehicle. Instead of advertising horsepower, they’ll yammer on about how many crazy situations their four-wheeled robot can handle safely. Marketing departments will trade in gimmicks like hauling around a space shuttle for ways of showing what a driverless car get itself through. We’ve got a few ideas for challenges: Viking attack. Airplane landing on the highway. Sinkhole in your lane. Show us a Ford or Hyundai that can handle those, and we’re in.



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China's Internet adoption sags to levels not seen since in 8 years

China's Internet adoption sags to levels not seen since in 8 years | IT Support and Hardware for Clinics | Scoop.it

China’s rush to the Internet is slowing, with the country adding only 14.4 million new Internet users in the first half of 2014, the lowest half-year growth in eight years.

There were 632 million Internet users in China in June, according to the government-linked China Internet Network Information Center (CNNIC).

Although China has long reigned as the country with the world’s largest Internet population, the services are still struggling to take off in the rural areas, where about 450 million people never go online, said the CNNIC in its bi-annual report.

Total Internet penetration in China is at 46.9 percent. This is far lower than the U.S, which has a penetration rate of 87 percent, according to Internet World Stats.

Many of these non-Internet users in China have low education levels, and have little need to surf the Web, the research group added. To increase adoption, the CNNIC recommended that the country focus on teaching rural elementary students Internet skills.

The slowing growth in Internet usage in China follows a rapid rise in the Internet population there, from just 94 million over a decade ago. Most of the growth has taken place in the country’s urban areas, where the Internet market has begun to mature.

In June, China had 527 million users who went online with mobile phones, which have now overtaken PCs, including both notebooks and desktops, as the most popular way to reach the Internet, the CNNIC said.

Online messaging, search engines, and news are the country’s top Internet services. But social networking sites are facing a decline in popularity, with their user numbers falling by 7.4 percent to 257 million in the last six months. The sites are struggling to innovate, and meet the demands of users, CNNIC said in its report.




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Implementing an EHR in the behavioral health setting | Healthcare IT News

Implementing an EHR in the behavioral health setting | Healthcare IT News | IT Support and Hardware for Clinics | Scoop.it

Behavioral healthcare (BHC) is one of the most varied healthcare settings, encompassing a wide range of services from outpatient substance abuse treatment to full-time, residential psychiatric care. Within these services, the type of care provided also differs. For instance, a single organization may offer group therapy, one-on-one counseling, crisis stabilization and community outreach. Compounding the diversity is the fact that each area has significant sensitivities in terms of both treatment approach and client privacy.

Historically, behavioral health organizations have shied away from implementing an electronic health record (EHR), feeling that the complexity of the care setting precludes technology use. Plus, EHRs have traditionally focused on capturing information about physical medical conditions, and the content for the BHC field has been limited. The expense of an EHR has presented additional roadblocks, as organizations are sometimes hesitant or unable to expend capital for technology. There are, however, challenges for healthcare organizations – providers, facilities and the greater industry – if EHRs are not implemented, especially as behavioral health information becomes a more critical piece of a patient’s longitudinal patient record.

The reality is that selecting and onboarding an EHR that meets the diverse needs of the behavioral health segment can be complicated, but the challenges are not insurmountable. With the right system and a careful, well-considered implementation strategy, BHC organizations can reap the benefits of a tool that efficiently facilitates comprehensive client care and improved outcomes. As Congress once again debates whether to extend Meaningful Use to behavioral health facilities, the time is right for providers to consider implementing an EHR.

Existing Opportunities

There are many advantages to using an EHR in the BHC setting. For instance, a well-designed system can support better information capture, allowing clinicians to fully document care in a format that empowers client and family interactions, enables robust reporting and data aggregation, as well as enhances clinician-clinician communication. For example, if all substance abuse counselors use the system in a similar way, there will be greater care continuity and a more consistent client experience.

An EHR can also help with interoperability. When organizations use a system capable of exchanging information with outside entities, such as hospitals and primary care physicians, they can build a more objective and detailed picture of the client, supporting more informed decisions that take the client’s entire care context into account and limit situations in which a provider is completely dependent on the client and family for health history. As the trend toward integration between primary care and behavioral health becomes more prevalent, it is critical for providers to implement forward-thinking technologies that allow integration and collaboration to support quality care goals.

Key Characteristics of a BHC-Centered EHR

Not all EHRs are ideal for BHC organizations. When vetting potential options, here are some key characteristics to keep in mind:

  • Offers robust BHC content. EHRs have historically focused on capturing data about physical conditions (i.e., the patient has a laceration on the right side, is having trouble breathing or is running a fever). To be effective in the BHC setting, an EHR must have in-depth behavioral health content, such as targeted protocols for psychological diseases and drug treatment. The tool must also accommodate the different types of care found in BHC facilities. For example, a residential program may require an EHR to capture information from client appointments as well as group therapy sessions, offsite field trips and/or general rounds.
  • Captures free text and more. A chief characteristic of BHC treatment is that clinicians often document information about the client in free text, writing down what they observe and what the client and family shares. A BHC-focused EHR should be able to capture discrete data from the content mentioned above and also be able to seamlessly capture free text, integrating it into the clinical record in a useable way. Systems that capture both discrete information and free text allow clinicians to manipulate and examine the information they enter, and use it to add value to the client’s treatment and achieve better outcomes. They also allow the organization to more easily meet the myriad reporting requirements imposed by funding sources, payers and governmental entities. The efficiencies gained in this manner can allow organizations make better use of limited human and capital resources. Some EHRs include a tool that functions like a pen on paper, so that client perceptions of the care experience don’t change once technology is introduced into the environment—the provider appears to be taking notes like usual and is not turning away from the client to use a computer.
  • Delivers interoperability. Sharing information with outside entities is key to creating a comprehensive health record. Organizations should select technology that enables these exchanges in a private and secure fashion.
  • Allows for configuration. Organizations should choose a tool that is configurable to the unique needs of the care site but still fosters consistency to maintain a high standard of care.

Getting Started

To get the most benefit from an EHR, behavioral health organizations should take a concerted approach to implementation. Clinicians need to be directly involved in the process—both in selecting the tool and configuring the system. This is even more important than in other care settings because of the variety of sensitivities and nuances involved in addressing behavioral health.

It is also important to keep an eye on the big picture. Will the technology be used predominantly for data aggregation or to improve treatment planning and enhance communication between providers? Will it drive better reporting or encourage interoperability? Is some combination of these goals appropriate? Taking time to develop an overarching strategy and then framing the technology to support that strategy is a best practice.

Organizations should also have a full appreciation of their workflows, including the steps and people involved as well as the timing. As with other kinds of technology, an EHR will not fix ineffective or inefficient workflows. Organizations should use it to enable well-designed processes to support optimal care. When revising workflows, look for any unintended consequences that may emerge. For example, if the organization streamlines the method for gathering information about substance abuse at registration, how will that affect other areas of care? This is where pulling the clinical staff together and mapping processes becomes most critical.

Moving Forward

While implementing an EHR in a BHC organization may seem daunting, the advantages far outweigh the challenges. Organizations that commit to thoughtful vendor selection and planned system implementation can successfully navigate the effort and reap the benefits.


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Physicians Support EHRs, but Find Implementation Daunting - iHealthBeat

Physicians Support EHRs, but Find Implementation Daunting - iHealthBeat | IT Support and Hardware for Clinics | Scoop.it

While most physicians support the switch from paper to electronic health records, many say the timeline to make the transition is happening too fast and are calling for changes, Politico reports.

Background

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Under the $30 billion program, physicians who meet certain criteria for health IT implementation can earn up to $44,000 annually in incentive payments.

Details of Concerns

Despite providers' support of the program's goal, many say that EHR systems are difficult to use and that savings and care quality improvements have not yet been widely evident, according to Politico.

HHS Director of Innovation Greg Downing said, "Government payment incentives forced people into early adoption of technology that in most of our views is not optimal for what people want to do with it."

Specifically, providers say that many EHR products:

  • Are not easy to use;
  • Are not integrated with other computer systems;
  • Require lengthy data entries;
  • Have severe design flaws; and
  • Require months of training to operate.
Call for Changes

American Medical Association President-Elect Steven Stack said he supports EHRs, but commercial EHR systems are "[i]nfuriating and cumbersome" and slow physicians down while distracting them from patient care. 

Despite the challenges related to implementing EHRs, recent survey show that nearly all physicians have said they are willing to make the transition.

To ease the transition, AMA is requesting that the Obama administration waive meaningful use requirements for older doctors, as well as rural or small practice physicians. Stack said that EHR implementation costs and training requirements are driving older doctors out of practice.

According to Politico, health IT specialists say the only way to handle EHR implementation problems is to work through them. 

National Coordinator for Health IT Karen DeSalvo has said she recognizes that growing pains are part of health IT implementation, adding that there are still "questions about whether it's improving health care. That's an important next chapter" (Allen, Politico, 6/15).



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BYOD advice: Start simple, include clinicians, and be nimble | mHealthNews

BYOD advice: Start simple, include clinicians, and be nimble | mHealthNews | IT Support and Hardware for Clinics | Scoop.it

Crafting a BYOD policy for your hospital or health system? Start simply, include users in your planning committee, and expect problems.

That's the advice of IT security experts who have been through the process: Michael Boyd, chief information security officer for Providence Health & Services, a Seattle-based system with 32 hospital and more than 550 other sites; and Clark Kegley, assistant vice president of information services for the Scripps Health, a San Diego-based four-hospital system.

Speaking at the HIMSS Media Privacy and Security Forum this week in San Diego, Boyd said hospital executives charged with crafting a policy for mobile devices need to approach this not as a security concern, but as a new means of bringing technology into the workplace. In other words, work with the clinicians who are using their own devices, instead of against them.

"It's a behavioral thing," he pointed out. "It's all about people."

More than 60 percent of all industries worldwide embrace BYOD, said Mac McMillan, CEO of the information security company CynergisTek and chairman of the HIMSS Privacy and Security Task Force. In healthcare, he said, that number stands at around 85 percent, with 92 percent of that number saying personal mobile devices are in use multiple times every day.

McMillan offered some sobering numbers as well: 41 percent of users in the healthcare space don't use a password to access their device, 52 percent access unsecured networks, and 52 percent say their devices are Bluetooth-enabled and on all the time.

"Basically they are a walking accident looking for a place to happen," he said.

That's why it's important, McMillan said, to get clinicians to buy into a BYOD policy that sets ground rules and penalties. He offered a five-point plan:

  1. Start with a strategy – accept all devices or certain ones?
  2. Establish an appropriate use agreement – no jailbreaking, no turning off security apps installed by the hospital or preventing remote management in case of an emergency. Make sure the users know what they can and can't do.
  3. Containerization – develop a platform that separates the corporate apps from the personal ones, so that users can continue to store personal data on their devices and not interfere with their work responsibilities.
  4. Monitoring – make sure the users know that the health system has the right to protect its interests on the personal device. That may mean remote-wiping the device of corporate information if it's lost or stolen, or monitoring certain functions while in use.
  5. Expect that this isn't a foolproof policy – be flexible, expect mistakes, and be prepared to fix them.

Boyd pointed out that he's already learned that lesson.

"Four years ago nobody was thinking that doctors were going to show up in the operating room wearing video cameras as eyeglasses," he said, but Google Glass has emerged in the hospital four times.

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How one ACO used mHealth to beat the odds | Government Health IT

An Indiana-based ACO is using mHealth tools to connect providers and home health patients in a new program that keeps them out of the hospital, helps them live healthier lives, and qualifies the health network for extra Medicare incentives.

The 13-hospital Franciscan Alliance Accountable Care Organization, one of the first ACOs in the country to partner with Medicare, is reportedly seeing success on several fronts using Honeywell's Genesis DM and Genesis Touch RPM devices. 

Franciscan VNS, in fact, is partnering with one of the ACO's physician groups in what is called 'The Coaching Program," according to a Honeywell HomMed whitepaper, to target patients with chronic illnesses, typically the most expensive population and one that doesn't traditionally qualify for home health services.

"The Coaching Program was designed to provide the right level of education to patients to empower them to take the management of their healthcare into their own hands and improve the overall health prognosis long-term," the whitepaper states.

Physicians, home health aides and telehealth nurses involved in this program use the Honeywell devices to keep regular tabs on enrolled patients and track long-term health progress with Honeywell's LifeStream Management Suite of analytical software. In all, 70 percent of the program's patients are monitored daily, the whitepaper states, with results compared against general population patients and those using traditional telehealth monitoring tools upon their discharge from the hospital.

According to Franciscan officials, The Coaching Program has resulted in a 5 percent readmission rate (the national average for a Medicare population is 20 percent), medication reconciliation rates above 40 percent, and a patient retention rate of 95 percent. As a result, Franciscan officials report that they've qualified for a higher bonus from the Centers for Medicare and Medicare Services.

"In order to qualify for a piece of this 'shared savings pie,' a hospital or ACO has to know every patient, what services they're getting, what it costs, and how it compared to the" contract that Franciscan has with CMS to treat Medicare patients, the whitepaper points out. "Telehealth solutions are the perfect companion to hospitals and ACOs in the new world order because they have the same overarching goal: Making healthcare delivery more efficient while simultaneously increasing quality of patient care."

The Coaching Program consists of four parts:

1. The creation of a personal health record that connects all members of the care continuum to one patient record;

2. Identifying red flags that key in telehealth nurses and other providers to points of early intervention;

3. A medication reconciliation and self-management process that ensures that the patients understand what medications are prescribed to them; and

4. Preparing patient to be involved in their own health management, including during follow-up visits.

Patients have also reported life changes due to The Coaching Program. They're exercising more often, according to the whitepaper, decreasing their caloric intake and involving themselves in more heart-healthy activities.

The key takeaway is that mHealth programs like The Coaching Program can help providers and ACOs not only reduce hospital readmissions among their most expensive populations, but they can demonstrate an improved quality of life for those patients and optimize new revenue streams.

Those benchmarks will prove vital as the nation's healthcare system transitions from a fee-for-service model to the more inclusive fee-for-value system.



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Hospital IT execs increasingly embrace the cloud

Hospital IT execs increasingly embrace the cloud | IT Support and Hardware for Clinics | Scoop.it

Hospital IT executives increasingly turn to the cloud to lower maintenance costs while trying to meet their growing technology needs, according to a new surveypublished today by HIMSS Analytics.

Of the 150 respondents to the survey--a majority of whom were hospital CIOs--close to 83 percent indicated that they use cloud technology; half of those providers said they use the cloud to host clinical applications. The exchange of patient data and disaster recovery efforts also were among top reasons for both current and future use by providers.

Privacy and security were top of mind for providers both already using cloud technology and those considering adoption. Close to 60 percent of respondents said that physical security of a cloud service provider would factor into their cloud purchasing decisions. The same number said that a vendor's willingness to enter into a business associate agreement was also important. Provider business associates can now be held accountable for data breaches under HIPAA.



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Mobile security: Is antimalware protection necessary?

Mobile security: Is antimalware protection necessary? | IT Support and Hardware for Clinics | Scoop.it


There's been a fair amount of discussion about whether mobile devices needantimalware protection. With my employees using their own devices at work, for work, I want to make sure my company is adequately protected. Is the antimalware investment a necessary one? If not, is there a better product to use?


Over the past decade, mobile device management and mobile security have been two extremely difficult issues for enterprises to address. Whether an investment in antimalware is necessary might be the wrong question to ask. There are many different risks presented by mobile devices, and organizations would be wise to perform a threat assessment to better understand which threats are the highest risks for their specific business and therefore a priority to address.

The potential list of attacks against mobile devices for enterprises is very long, but the list of attacks or security incidents that make the news is relatively short. The most common mobile security threat to enterprises is lost or stolen devices. And the truth of the matter is that antimalware will not help if a device is lost or stolen and doesn't have basic mobile device security controls implemented on it, such as a PIN or remote wipe capabilities. If your organization does not require a PIN or hasn't adopted remote wipe yet, I would say these are higher priorities than antimalware.

Implementing a mobile device management (MDM) tool that includes antimalware along with other security controls (e.g., PIN enforcement, remote wipe, encryption or containerization) might be a good enterprise investment. However, before evaluating MDM tools, enterprises should ask a number of questions:

  • Do we have an inventory of mobile devices to secure?
  • Will the tool be implemented on employee-owned devices?
  • Will our employees allow us to install such a tool on their personally owned devices?

If you cannot answer these questions, deciding to implement a mobile device management tool might not actually provide the protection expected.

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New mHealth Eco-System Will Be Formed by ‘Connected Elite’ of App Publishers, Sensor Vendors, and Enabling Companies

New mHealth Eco-System Will Be Formed by ‘Connected Elite’ of App Publishers, Sensor Vendors, and Enabling Companies | IT Support and Hardware for Clinics | Scoop.it

Three groups of mHealth app market players will form the inner circle of the new mHealth app ecosystem. Vital data like steps, calories burned and glucose readings will constitute the core value of the emerging mHealth app market. Traditional healthcare companies have to find their role not to be left aside.

There is a growing number of mHealth publishers who make use of the third party data in order to enrich the capabilities of their apps. Thanks to opening up their APIs, such publishers may better serve their core value propositions (e.g. weight loss support by incorporating diet plans and high quality food recognition tools) and gain a substantial competitive advantage over rivals. The more such companies, the more competitive the market and better app offering for the users.

In fact, 71% of mHealth of app publishers connect or plan to connect to an API in order to import or export health data. This is one of the results of the mHealth App Developer Economics 2014 study conducted in Q1 2014. A free copy of the 42 pages report on the state of the art mHealth app publishing can be downloaded.

Sensor vendors such as Wahoo and Zephyr as well as a group of companies which enable interconnectedness (“Enabling layer”), support these publishers whose core value propositions rest on open APIs. 

The new layer of “enabling” companies capacitates app-app, app-sensor and app-database connections. In general, such companies can be classified into three main segments:

  1. API aggregators which provide “one stop connecting models” for the health data APIs
  2. App aggregators which serve to collect mHealth apps in one place, and
  3. API Managed Service companies which provide the technical infrastructure to facilitate the connection of apps and sensors and medical databases

All of these, i.e. “open” app publishers, sensor vendors and the enabling companies constitute the three pillars which will form the core of the connected mHealth app economy.

The mHealth app economy is going to be fuelled by the accessibility of the vital (patient) data accessed via APIs. The majority of today’s captured and shared data is fitness and nutrition information like steps and calories. However, with the growing number of app users who regularly track e.g., glucose or blood pressure levels, or consult their apps for the purpose of medical examinations, we are going to witness an explosion in the amount of the aggregated and shared health data.

Strong market pressure e.g. rising healthcare costs and user demand, will facilitate this disruptive market change. The company which is going to be the first to skilfully make meaningful use of this big, aggregated health data might become the Facebook of the healthcare industry. Moreover, this market disruption will presumably take place rather sooner than later.

All healthcare market players must understand the impact of the new mHealth ecosystem on healthcare in general and, in particular, on their own business models. If they do not wish to be left out from the emerging, new healthcare delivery ecosystem, traditional market participants already need to start to reconsider their role in the market landscape.

The free “mHealth App Development Economics 2014” report provides information on the state of the art of the mHealth app market with an overview of its leaders.



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Windows Admin: Understanding and Managing Windows Services

Windows Admin: Understanding and Managing Windows Services | IT Support and Hardware for Clinics | Scoop.it

In today’s Geek School lesson, we’re going to teach you about Windows Services and how to manage them using the built-in utilities.

Over the years, people have spent a lot of time disabling and tweaking the configuration of Windows Services, and entire web sites have been devoted to understanding which services you can disable.

Thankfully modern versions of Windows have greatly streamlined the things that run as services, added the ability to delay them from starting until later, and allowed them to run only when triggered rather than all the time. The overall footprint of Windows has even decreased due to all this work.

But people still are determined to disable services. So today’s lesson is going to teach you about services, how to analyze them, remove them, or disable them. What we’re not going to do is give you an exact list of services to disable, because for the most part, you should leave the built-in services alone.

What Are Services Exactly?

Windows services are a special type of application that is configured to launch and run in the background, in some cases before the user has even logged in. They can be configured to run as the local system account. Services are designed to run continuously in the background and perform system tasks, like backing up your computer or running a server process that listens on a network port.

Back in the Windows XP days, services could be configured to run interactively and run alongside the rest of your applications, but since Vista, all services are forced to run in a special window session that can’t interact with your local desktop. So a service that tries to open a dialog box or show you a message won’t be allowed to do so.

Unlike regular applications, which can be simply launched and run under your user account, a service must be installed and registered with Windows, which requires an administrator account, and usually a User Account Control prompt before that happens. So if you don’t allow an application to run as administrator, it cannot just create a service to run in the background.

The Services Panel

Windows has always used the Services panel as a way to manage the services that are running on your computer. You can easily get there at any point by simply hitting WIN + R on your keyboard to open the Run dialog, and typing in services.msc.

The Services panel is fairly simple: there are a list of services, a status column to show whether it is running or not, and more information like name, description, and the startup type of the service. You’ll notice that not every service is running all the time.

While you can select a service and either right-click it or click the toolbar buttons to start, stop, or restart it, you can also double-click to open up the properties view and get more information.

Disabling the service is as simple as changing the Startup type drop-down to disabled and choosing Apply, although you can also change it to Manual or automatic with a delayed start. From this dialog you can see the full path to the executable as well, which can help in many cases when you want to see what exactly the service is running.

The Log On tab allows you to choose whether the service is logged on as the local system account or under another account. This is mostly useful in a server environment where you might want to run a service account from the domain that has access to resources on other servers.

You might notice the option for “Allow service to interact with desktop”, which we mentioned earlier – by default, services are not allowed to access your desktop unless this box is checked, and this checkbox is really only there for legacy support.

But just checking that box doesn’t immediately give them access – you would also need to make sure that the NoInteractiveServices value in the registry is set to 0, because when it is set to 1, that checkbox is ignored and services can’t interact with the desktop at all. Note: in Windows 8, the value is set to 1, and interactive services are prohibited.

Services aren’t supposed to be interactive because all windows exist in the same user terminal with access to common resources like the clipboard, and if they are running along with other processes there could be an issue where a malicious application running in a normal user process could attempt to gain more access through a service, and considering that services run as the local system account, that probably isn’t a good thing.

The Recovery tab allows you to choose options for what happens when the service fails. You can choose to automatically restart the service, which is generally the default option, or you can run a program or restart the computer.

The Run a program option is probably the most useful, since you could set Windows to automatically send out an email if the service fails more than once – a helpful option in a server environment. It’s definitely much less helpful on a regular desktop.

The dependencies tab shows which services depend on a particular service, and which services depend on the one you are looking at. If you are planning on disabling a service, you should probably consult this section first to make sure nothing else requires that service.

Looking at Services in Task Manager for Windows 8.x

The regular services panel hasn’t changed much in years, but thankfully there is a much better way to look at which services are running, and which of those services are using a lot of resources.

Task manager in Windows 8 has a new Services tab, which allows you to stop and start services, but also comes with a “Search online” option, and even more useful, the “Go to details” option.

Once you’ve selected Go to details from the menu, you’ll be switched over to the Details tab, and the process that is responsible for that service will be highlighted.

As you can see, the process responsible for the Distributed Link Tracking is taking up 28,712 K of memory, which seems like a lot, until you realize that the particular svchost.exe process is actually responsible for a whole bunch of services.

Right-click it again, and then select Go to Services, and you’ll see what we’re talking about. Now many services are selected in the Services window, and you’ll notice they are all in the LocalSystemNetworkRestricted group, and they are all currently running.

So that 28 MB of memory is actually being used for a whole set of services, which makes it more understandable why it is using all that memory.

Using Process Explorer to Look at Services

If you want a much clearer view of what services are running under each process, your best bet is to pull out Process Explorer, find the service in the list, double-click it, and then go to the Services tab. This method works on any version of Windows.

Hint: in Process Explorer all the services should be in the tree underneath services.exe.

Should You Disable Services?

Unfortunately, many crapware applications install Windows Services during their installation process, and use them to keep their nonsense running in the background and re-launching repeatedly. Other applications implement a Windows Service to provide functionality that you might not need. These are the services that you should disable.

Our general rule is that Microsoft’s built-in Windows services should be left alone – Windows 8 or even Windows 7 has done a good job of cutting down the services to just really important functionality, and you won’t gain much in the way of resources by disabling those services.

What you should definitely do, however, is look for any services that are not part of Windows, and try to deal with them instead. If you don’t have any idea what the service is, or it is for an application that you don’t want running all the time, you should do some research and decide whether to disable it.

Don’t Disable, Set to Manual

One of the rules that we like to follow is to avoid disabling services, since that can cause problems and errors. Instead, just try setting the service to Manual start.

If you find that a particular service needs to be running, but maybe doesn’t need to be running immediately, you can also change it to Automatic (Delayed Start) instead, which will delay starting until the system calms down after boot.

Administering Services from the Command Prompt

Some operations just can’t be done through the graphical user interface. If you want to delete a service, for example, you can only do that through the command line.

Note: please do NOT delete services.

You can query the status of a service using the sc command, like this:

sc qc eventlog

There are many other commands and operations that you can perform, including deleting a service, which we would only recommend if you have malware on your system that is running as a service.

sc delete <malwareservicename>

Do not delete services.

You can also do other things, like stopping and restarting services from the command prompt using the sc utility. For example, to stop the distributed link tracking client, use this command:

sc stop TrkWks

To start it again, use sc start <servicename>.

Final Thoughts

If you have services running that are wasting resources and slowing your computer down, you should simply uninstall and remove the applications that put them there. There’s really no reason to delete services, disable them, or anything else.

Because why disable something that needs to be uninstalled?



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More than a Mini? Multiple Surface models tipped for May 20 event | PCWorld

More than a Mini? Multiple Surface models tipped for May 20 event | PCWorld | IT Support and Hardware for Clinics | Scoop.it

While Microsoft's widely expected to reveal a long-rumored 8-inch Surface Mini at its "small" Surface event in New York on May 20, the micro-tablet may not be the only new slate to surface that day.

Bloomberg reports that other models—yes, models, plural—will be announced as well, including some with Intel processors.

Further details aren't specified. If the report is accurate, the Intel-based Surface(s) could be any number of things: A mere refresh of the Surface Pro 2, a new model entirely, or maybe even a "Pro" counterpart to the Surface Mini itself.

Bloomberg, you see, also reports that the Surface Mini—or at least a Surface Mini—will run Windows RT rather than the full-blown version of Windows 8, joining a chorus of similar reports. Microsoft's full-sized Surface slates are available in both ARM and Intel flavors, with the Surface 2 and Surface Pro 2, respectively; it's easy to envision the company doing the same with a line of small-screen tablets. Bloomberg says the Windows RT-flavored Surface Mini will use Qualcomm processors, rather than the Nvidia Tegra chips found in the Surface RT and Surface 2.

The Surface Mini is expected to focus on note-taking capabilities and ship with a digitizer pen similar to the Surface Pro 2's—but it'll take more than a fancy stylus to make a smaller Surface truly shine in a sea of oh-so-similar 8-inch Windows tablets. Be sure to check out the 10 things we want to see in the Surface Mini, then tune in here on May 20 to get the news from the Surface event as it happens.


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Adoption of mHealth Monitoring Tools to Accelerate Through 2019

Adoption of mHealth Monitoring Tools to Accelerate Through 2019 | IT Support and Hardware for Clinics | Scoop.it

A new market reportpublished by Transparency Market Research finds that the global mHealth monitoring and diagnostic medical devices market was valued at 0.65billion in 2012 but is expected to grow at a CAGR of43.3% from 2013 to 2019, to reach an estimated value of 8.03 billion in 2019.

The report authors readily admit, however, that the mHealth monitoring and diagnostic medical devices market “is currently at its nascent stage.” But it is expected to witness a high growth rate during the forecast period owing to increasing demand for remote patient monitoring and rising adoption of wireless technology.

Additionally, mHealth industry is witnessing an exponential growth due to financial crisis across the regions which demanded the need for reduction in healthcare expenditure and deliver healthcare services effectively.

The mHealth monitoring and diagnostic medical devices market is segmented as cardiac monitors, glucose monitors, blood pressure monitors, pulse oximeters, multi-parameter monitors and sleep apnea monitors.

Of all the monitoring devices in 2012, cardiac monitors captured the majority share of this market followed by glucose monitors and blood pressure monitors. However, during the forecast period glucose monitoring devices are expected to foresee highest growth rate followed by multi-parameter monitoring devices during the forecast period reporting a CAGR of over 45%.

“Increasing sports activities and rising awareness about health and fitness are some of the factors anticipated to fuel the growth of this market,” the report summary reads. “Additionally, increasing technological advancements that enable clubbing of several vital parameters into one device is another major factor expected to propel this market growth.”



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Improving Public Health through Health IT - Health IT Buzz

Improving Public Health through Health IT - Health IT Buzz | IT Support and Hardware for Clinics | Scoop.it

About Public Health Reporting

You’ve heard about disease outbreaks of flu, measles, and salmonella on the news. Have you ever wondered how disease outbreaks are detected and tracked? Local and state public health departments rely on information from health care providers. Traditionally, this information was reported by paper, phone, and fax. Health IT tools can provide a faster and more accurate way of moving critical information from providers to health departments where outbreaks are identified, tracked, and managed. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides incentives for providers to adopt electronic health record (EHR) systems and to use those systems in meaningful ways. Some of those meaningful ways include public health reporting components like: lab results, immunizations, and number of cases of certain diseases.

Using health IT tools, electronic reporting of public health data replaces traditional paper-based and fax reporting. This faster, more efficient method allows public health departments to better protect the community’s health . Public health departments use the collected data from providers to understand how much disease is in a community and to develop responses more quickly and efficiently. In 2005, only eight states could accept lab results electronically. Today, 48 states can receive labs electronically. Over 1,800 provider sites nationwide have updated their EHRs to electronically send immunization data to registries. Immunization registries help providers give the right vaccines at the right time. Since the beginning of HITECH, more and more primary care providers are choosing to report public health data like lab results and immunizations electronically (refer to Figure 1). 

Select image to view in full size

Note: public health measures include immunization reporting, syndromic surveillance, and electronic lab reporting
Graphic available online at: http://dashboard.healthit.gov/quickstats/

In conjunction with the Public Health Informatics Conference this week, the ONC is excited to release an issue brief [PDF - 678kb] demonstrating how health IT tools improve public health reporting to build healthier communities.

Looking Forward

Looking ahead, the ONC will continue to serve as the convener and central coordinator for critical health IT advancement and innovation in the nation. HITECH opened the door to align public health with the national health IT strategy. The ONC will continue to promote the use of health IT for the public health community to respond to outbreak challenges more efficiently and protect the health outcomes of Americans. The ONC welcomes and encourages the public health community’s continued engagement in standards work and emerging initiatives for population health. Health IT tools are already helping move public health data faster and more accurately so health departments can plan their responses efficiently. The work being done today will provide more innovative and rapid ways to improve public health in the future.



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Lenovo says it's still committed to small-screen Windows tablets in the U.S.

Lenovo says it's still committed to small-screen Windows tablets in the U.S. | IT Support and Hardware for Clinics | Scoop.it

Lenovo has issued a clarification on its tablet strategy: Refuting an earlier report to the contrary, the world’s largest PC maker will continue to sell Windows tablets with displays smaller than 10 inches in the U.S.

That’s good news for the greater Microsoft story line, but these devices will still face immense pressure from small-display Android-based tablets, which cost much less.

On Thursday, Lenovo said that it has halted U.S. sales for two Windows 8.1 tablets with 8-inch screens—the $400 ThinkPad 8 and the $300 Miix 2

The Lenovo ThinkPad 8.

“In North America, we’re seeing stronger interest in the larger screen sizes for Windows tablets,” Raymond Gorman, a Lenovo spokesman, said in an email. “In other markets, particularly Brazil, China, and Japan, the demand for ThinkPad 8 has been much stronger, so we are adjusting our ThinkPad 8 inventories to meet increasing demand in those markets.”

As for the 8-inch Miix 2, it went off sale without explanation. Lenovo’s U.S. strategy for the ThinkPad 10 and 10.1-inch version of Miix 2 remained unchanged.

Fast forward two days later. In a post on Lenovo.com, the company announced it’s committed to different screen sizes and new 8-inch tablets will be available for the holidays. Said the statement: “Our model mix changes as per customer demand, and although we are no longer selling ThinkPad 8 in the U.S., and we have sold out of Miix 8-inch, we are not getting out of the small-screen Windows tablet business as was reported by the media. In short, we will continue to sell both 8 and 10 inch Windows tablets in both the U.S. and non-U.S markets.”

Translation: Our 8-inch Windows tablet exit is merely temporary. This isn’t a permanent withdrawal, and we’re keeping all options on the table.

That’s certainly wise spin-control, but Lenovo—and all tablet manufacturers—will still have to solve the basic puzzle of making small-display Windows tablets attractive to consumers when cheap, serviceable, 7-inch Android tablets can be had for less than $200.

The 8-inch Lenovo Miix 2.

We gave the ThinkPad 8 a 4-star rating, and raved about its processor speed and 1900x1200 display. But it also retailed at $400. The 8-inch Miix 2 also received 4-star accolades; it’s light and fast, and boasts good battery life. But it was also expensive at $300.

That’s a scary price when the awesome second-generation Nexus 7 costs just $280.




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Why smartphone screens are getting bigger: Specs reveal a surprising story

Why smartphone screens are getting bigger: Specs reveal a surprising story | IT Support and Hardware for Clinics | Scoop.it

Behind the Spec Sheet seeks to draw new insights based on hardware data. Produced by FindtheBest, a company that aggregates specs and features in a centralized database, this weekly guest column will share data-driven discoveries and surprises, and attempt to expose common misconceptions.

Glance at any major smartphone line, and you’ll find a similar pattern: Screen sizes are getting bigger, year after year, model after model.

Let's start with an audit of the world's most famous Android smartphone line—just look at those Samsung phones inch upward in the first chart below. Not to be outdone, HTC has kept pace with Samsung's escalating screen sizes, and Nokia has followed industry trends for its Lumia line as well.

Even Apple—which once described its 4-inch iPhone's screen as a “dazzling display of common sense”—appears poised to follow its rivals. The chart below illustrates a lukewarm interest in larger displays, but rumors are leaning toward the introduction of a 4.7-inch iPhone 6 later this year.

Larger phones: Yep, this is happening

It’s also possible that just the flagship phones are getting bigger. To determine the breadth of the trend, I calculated the correlation between release date and screen size for over a thousand phones. The chart below shows several hundred of the most popular.

As you can see, the trend goes far beyond iPhones and Galaxies. There’s a strong correlation between release date and smartphone screen size.

Before 2011, nearly every phone on the market measured between 2.5 and 4 inches. Since 2013, sub-4-inch phones have nearly disappeared. This graph paints a vivid picture:

So what's going on here? Why are phones turning into tablets? There's certainly more than one possible story behind this trend. I've distilled the data into five different scenarios, ordered from least to most likely.

Scenario #1: We’re witnessing a marketing gimmick, played out over five years

No matter how many flashy software features smartphone developers bake into a new products, nothing grabs attention like new hardware design, particularly if there’s a bigger display in the mix.

The iPhone 5 debuted with LTE support and a new A6 chip, but the updated screen size won every headline. Customers loved the 2013 HTC One’s 4.7-inch screen, but the company couldn’t resist adding another 0.3 inches to the M8. Then there’s Samsung, which followed through on its "Next Big Thing" marketing campaign by steadily increasing screen size on the Galaxy S line, from 4.8 inches (S III) to 4.99 inches (S4) to 5.1 inches (S5).

It’s a tidy little theory, but in the end it’s only a theory. There are too many moving parts to conclude that rising screen sizes are all one big marketing strategy, even if bigger screens seem to be selling more phones. The case against Samsung looks strongest, but it’s still too anecdotal.

Scenario #2: Apple got screen size wrong

When Apple introduced the first iPhone in 2007, the industry scrambled to replicate almost every aspect of Apple’s design—from the app-icon interface and visual voicemail to the keyboard-less hardware and 3.5-inch screen size. For those first few years, it seemed that Apple could do no wrong.

Michael Homnick

Phone screens may have grown to address consumer demand for more display real estate.

It wasn’t until around 2010—with the release of the first Galaxy S and Droid X—that the market had some legitimate iPhone alternatives. Manufacturers seeking to innovate beyond Apple hit on a new insight: iPhone's polish aside, people were desperate for more screen real estate. The rest, then, is history.

There’s probably a kernel of truth to this, but the theory is too neat. Both Google and Apple have copied regularly from one another.

Scenario #3: The changes are largely based on a handful of influential phones

A more nuanced version of Scenario #2 suggests the smartphone’s increasing screen size resulted from a handful of iconic phones, each of which increased screen size and each of which created a mini-revolution.

The Nokia Lumia 1520 made headlines for its size (and its amazing camera).

This makes some sense: There might be more than 1,000 phones in the market, but only about half a dozen per year dominate headlines and sales. With each successful change (examples: the iPhone 4’s sharper display; the better cameras on early DROIDs), other marquee phones have quickly followed. The same is probably true of screen size.

Would something over 4 inches work? The DROID X proved a "big" (for its time) phone could be successful. But what about over 5 inches? The successful, 5.5-inch Galaxy Note II unleashed a whole series of similarly giant phones.

   

For the most popular phones in the industry, the “trendsetter theory” probably explains a few shifts in the market. But it doesn’t fully explain the dramatic, macro-shift we see across the entire industry.

Scenario #4: Manufacturers have always wanted to make bigger phones—technology simply hasn’t allowed it until recently

In 2007, both pixels and battery life came at a hefty premium. Trying to power a 5-inch display with a reasonably high pixel count just wasn’t a possibility. Today, battery and display technology allow manufacturers to make crisp, 6-inch-plus screens that run for well over a day.

Just look at how pixel densities and battery capacities have scaled in Samsung's Galaxy S line across five generations:

It’s the simplest explanation, and perhaps the best one so far. It helps explain why manufacturers wouldn’t touch designs bigger than 4 inches before, but now they churn out 5-inch-plus models routinely.

It does not, however, explain why manufacturers have all but abandoned sub-4-inch phones since 2013...

Scenario #5: The smartphone is turning into our primary computer

Even in 2007, it wasn’t yet clear that the smartphone would become the staple product that it is today—the sort of device that could one day replace most personal computers. Seven years ago, the smartphone was still a combination of three less significant products: a music player, a mobile web browser, and cell phone. Today, the smartphone connects people around the world like nothing before it. Citizens of third-world countries are unlikely to own cars and computers, but they are rapidly buying smartphones.

Michael Homnick

For many people, the smartphone is becoming their primary computer.

So how does this relate to screen size? As smartphones become our primary devices, doing the jobs once held by computers and even televisions, we need a product that can change, like a chameleon, to serve all of these functions.

Before 2010, the extra real estate was unnecessary. After all, we were using phones mostly for making calls, listening to music, or doing a bit of light web-browsing on bad mobile interfaces, making mental notes to do our real work when we got back to our computers.

Michael Homnick

Phablets may not fit into your pocket, but they fit a lot of functionality into what's still a pretty compact device.

Today, the web—from site interfaces to television to native apps—is often designed primarily for the mobile format. The smartphone is no longer just a phone, but a hybrid of devices—and increasingly, the most common way to interact with the world. A bigger screen allows a mobile device to play all of these roles at once.

We’ve ridiculed the so-called phablet (a phone that’s nearly the size of a small tablet), but perhaps we've been headed in that direction all along. Maybe bigger is better.




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Effective IT purchasing L [Health Management Technology]

Effective IT purchasing L [Health Management Technology] | IT Support and Hardware for Clinics | Scoop.it
Effective IT purchasing L [Health Management Technology]

(Health Management Technology Via Acquire Media NewsEdge) What top-of-line issues comprise, challenge effective hardware, software purchasing? When the trade publication Computers In Healthcare debuted in 1980, hospitals and other healthcare facilities already were hip deep in information technology - albeit with closet-sized, clunky mainframes from pioneering companies largely out of the business today.


With the advent of diagnosis-related groups (DRGs), managed care and two healthcare reformations roughly two decades apart, that publication, now known as Health Management Technology, has chronicled business and clinical operations by desktop personal computers, laptops, notebooks, hand-held personal digital assistants and now smartphones and tablet PCs.

During the meteoric rise and global acceptance and adoption of IT in that more than three-decade span of development, healthcare organizations, by and large, had to perform the same, if not similar, due diligence in evaluating, selecting and purchasing IT products.

In fact, in healthcare these days IT is just about as ubiquitous as, say, air.

To keep pace with performance improvement initiatives, provider IT professionals must know what's needed, make fast but detailed decisions and avoid mistakes.

But is there a reliable formula for purchasing IT success? The variables can resemble some of the parameters Supply Chain faces when purchasing products for the entire organization. They include such components and considerations as product price, ongoing maintenance and service, updates and upgrades, interfacing and integration with existing or new systems, overall ease of use and nimbleness to operations and, finally, relevance to the organization's mission, vision, finances and operations.

Yet each facility may stress all of these variables in a different order. As a result, HMT posed to nearly a dozen healthcare IT executives fundamental questions about the basics of purchasing IT effectively.

What do you believe should be the top consideration for effective IT purchasing? Alan Stein, M.D., Ph.D., Vice President, Health care Technology, HP Auto nomy Stein: [What you list] are all important considerations, but their priority may vary by organizations depending on particular circumstances. For example, some providers may be migrating [electronic medical record] systems and are attuned to consolidation of multiple systems. Others that are embarking on a data warehouse strategy will have very data-centric priorities. Others may be sensitive to the availability of professional services that can tailor and maintain their deployments.

Regardless of the relative differences, substantial thought must go into how well the solution addresses organizational needs over time, and how well can it overcome the various barriers to adoption that any new technology must face. Another important consideration will be industry-specific components that can significantly reduce the amount of professional services required to achieve the business objectives.

Bird mitch, CEO, Patientco Blitch: Overall ease of use and nimbleness is certainly a top consideration for effective IT purchasing. Consider this: Budget season is over. The hospital board has asked you, once again, to do more with less. The department needs to produce 20 percent more with 15 percent less resources to do so. Does this sound familiar? With this type of consideration at the top of everyone's minds, it's important to have a non-disruptive solution to help with the workflow. Cloud-based technology platforms oftentimes offer these types of advantages - for example, they can be easily turned on or oft by the simple way the technology stack is built. Healthcare executives should keep overall ease of use at the front of mind so that their teams will be grateful, the board will be satisfied and you can sleep better at night.

Andy Saibrian, Senior Manager, Health care Vertical Marketing. Samsung Enterprise Business Division Saffarian: There are a multitude of considerations to effective IT deployments, from integration into existing systems to identifying the right partner(s) to ensure ongoing maintenance and support. We encourage providers to look carefully at total cost of ownership (TCO) and alignment with their overarching enterprise architecture strategy and direction in selecting any new products and services. TCO encompasses price, integration and maintenance, while extended enterprise architecture ensures compliance with new health IT policies and initiatives within hospitals and clinics in addition to a growing number of merger and acquisitions of practices and clinics with different systems. Given the variable levels of technology expertise among users, ease of use should also be a top criterion in choosing the right products and software selections, but it is often overlooked.

John Glaser, Ph.D., CEO, Health Services, Siemens Glaser: The top priority should be relevance to mission, vision, finances and operations, because that will then drive the other decisionmaking criteria. An HIT system investment is / ' ' just that - an investment in the organizations infrastructure.

Additionally, working with a vendor that is committed to helping your organization achieve its goals and that will work with you as those goals - driven by market demands, environmental dynamics, regulatory and legislative requirements - evolve.

Barry Chaiken, Chief Medical Information Officer, Infor Chaiken: IT purchasing needs to be based upon relevance to mission, vision, finances and operations. Purchasing IT to keep up with current trends does nothing to address the needs of an organization. In addition, it can lead to a poorly implemented IT solution that fails to meet the needs of the organization. A clear vision of organizational goals produces a clear view of what software is required to meet those goals. This allows high-quality vendors to guide an IT implementation that provides value early and throughout the product life cycle. Although pricing may be important in the short term, software costs are just a fraction of the total cost of a product, and therefore must be evaluated on the value provided. Reworking implementations can be very disruptive to operations, and very expensive.

Kent Rowe, Vice President of Sales, ZirMed Rowe: The overall value and return on investI I Price matters, as do ongoing mainteI I and service costs, but you have to view . those in the context of other savings and benQé efits. Interfacing and integrating with existing/ new systems oiten gets overlooked, especially ^b êfor future-proofing. Is the new product you're Kent Rowe, thinking about purchasing vendor-neutral and o ? °f interoperable? What if, a year from now, a vendor sunsets one of your current core systems? Are the services you're purchasing dependent upon that system? Bob Baumgartner, Director, Product Marketing, Mckesson Technology Solutions Baumgartner: Relevance to mission, vision, finances and operations is key. With the increased pressures of both regulatory and financial constraints being placed on healthcare environments, it becomes critical that they ensure that any and all IT expenditures facilitate their efforts to achieve their mission. Facilities that do not focus on this area will continue the siloed and inefficient disparate network of data within their healthcare environment. And with the ongoing consolidation within the market, IT will be tasked more than ever to ensure the future systems are open to support the greater mission of the facility: Reduced costs with higher quality outcomes.

Charlie Lougheed, President and Chief Strategy Officer, Explorys Lougheed: IT departments need to make sure they not only understand the needs of the business units they serve, but also make sure they understand the market trends and the approach that their peers are taking to solve these challenges. It's also important to observe the signals of the venture capital community, particularly in the rapidly evolving healthcare IT space. There is a lot of investment capital flowing into this market. Understanding where and why that money is flowing can help IT leaders see where others are placing their bets.

Mark Byers, CEO, President and Co-Founder, DSS Inc.

Byers: IT departments must ask themselves the following: * How quickly could our infrastructure capacity requirements increase? Decrease? To what extent? And, what are the most likely scenarios? * How rapidly are key technologies changing and evolving? Where in their life cycles are the products we're considering? What's on the horizon? * What are our current and future service level requirements for uptime and availability? * Beyond readily available, online resources, what potential business capabilities will have the greatest positive impact on revenue generation and operational effectiveness? * Who is the end-user and how do they interact with the customer and other IT systems? Mac McMillan, CEO, CynergisTek McMillan: Approaching this from a "privacy and security" perspective, the questions that are important fall into three basic categories: Those related to development, those related to maintenance and administration, and those related to compliance. Some examples for each: Development * What platform is the product developed on? * Does the product require any third-party external resource to be secure? * Was the product coded following security best practices? * Has the product gone through any third-party testing/certification? Maintenance and administration * Can the product be readily patched or upgraded as necessary? * Does the system require backup? * Can access to the system be controlled? Compliance * Does the system have the necessary functionality to meet compliance requirements? * If appropriate, can the system be audited? * Ihe list here is much longer and may also include questions of the vendor and other aspects of their business if the system in question involves ePHI.

While it sounds basic and fundamental, it starts at the top with the organization's strategy. The IT department, as well as other departments, is there to execute the strategy of the senior leadership.

Jamie Helt, Director of Strategy and Business Development, Dell Healthcare and Life Sciences Helt: * Does it impact in a positive way the mission of our organization to improve the continuum of care? * If we procure this technology, what other item may not make the budget cut, and what is the impact to our organization? * Have we assessed the internal skill sets to handle the implementation and rollout, the ongoing support to be handled internally/ externally,the cost associated with support (internal/external) and the future of this offering via upgrades, refresh, etc.? Glaser: No healthcare organization physical structure would be built without a design and blueprint that reflects what care services will be delivered and how the building must function to meet the needs of caregivers and patients alike. The same holds true for building an HIT infrastructure. It begins with the most essential question of what the organization's strategy is and how an HIT system will support this. Fundamentally, the organization must define what it wants to accomplish with an HIT system, such as support and improve existing processes or create new, more efficient processes underpinned by HIT. Then it must define what functional capabilities are required. The key is understanding the functions that the HIT system must support and what the primary users need in a system from the vantage point of understanding the workflow and processes in the various departments. How the accounting office functions is very different from how the maternity department works. And that is very different from the workflow in the oncology department.

Stein: Provider IT departments must take a critical look at new IT products and services to understand: * Where does this technology fit into my organizationspecific technology stack? How will it work with our existing and emerging data sources and formats? * Who are the intended users? How will they transition from their current process to using this product? What level of training is required to achieve the productivity goal within the target time window? * Does this technology fill a current need? How can I demonstrate ROI over time? Is it also forward looking enough to address future needs in the same space? Will we require additional components? Are they available? * Does the technology vendor have the breadth and depth to meet our business and technology needs, even as they evolve? How does the vendor address my data life cycle? * Does this technology satisfy our industry regulatory compliance requirements? Rowe: What's the cost of doing nothing, of maintaining the status quo? Quantify the opportunity cost as much as possible. Nail down prospective vendors on what they can deliver and what improvements their existing customers have seen.

Second, what's the cost of failure? If a product or service doesn't work out, how much time and resources will you have spent implementing it? How immediately will you be able to tell whether it's working as intended, and what's the impact of it potentially not working for that period of time? Baumgartner: First and foremost, the facility must develop a vision for the role of any and all IT within the organization. Without this vision, their decision-making will be limited to a case-by-case solution and not as likely to support the overall mission of the entity. With that in place, it is possible to answer the following essential questions: * How will this new product or service support our vision? * Will this new product improve our operational performance or provide additional detail for the use of quality outcome tracking? * Is this new product simply a departmental solution or is it a solution that meets not only the unique departmental needs, but also support the greater requirement to disseminate the information appropriately across the enterprise? * Is the new product based on standards with an open interface for integration or is it simply proprietary and require extensive one-off interfaces that will be expensive to maintain? * What is the long-term viability of the company? Will they be around for five to 10 years or are they offering such a low price that they will not be around for support and upgrades? * Does the vision of the company support our vision? Chaiken: Organizations that do not communicate a clear strategic objective with related goals are unlikely to achieve IT products and services that deliver value. Once goals are clear, IT departments must thoroughly understand the impact of various IT products and services on the ability of employees using those products and services to meet the organizational goals. In addition, IT departments must understand what each department they serve needs to accomplish and guide them on how IT can help. IT departments that see those throughout the organization as clients will most likely succeed, while others that see themselves as IT purchase and delivery organizations only will not.

Blitch: IT departments should ask themselves three essential questions to determine the optimal IT products and services needed: * How does the product/service integrate with our current platforms? * Is the product/service focused on results that are measurable? * Does the product/service support the vision of our facility? Firstly, integration is a word that tends to scare us all. If you've invested a lot of time and money into an existing platform and your new product doesn't "play nicely" with the existing infrastructure, then it falls on the IT department's shoulders to bridge that gap. Proactively consider this in advance to avoid later complications.

Secondly, what cannot be measured cannot be improved. Though many solutions say they are results oriented, it's up to the vendors to hold themselves accountable as well. Ask third parties these hard questions during the selection process; those who know the answers and can give solid examples will likely be the ones with whom you'll have the most success.

Now more than ever, it is crucial that everyone is driving toward the same outcomes, both clinically and financially. It's important to ensure that the technology vendors you choose each understand and support your short-term and long-term goals. Great vendors are more like partners who not only provide great products that make you better, but also provide great service, support and feedback to help you continually improve.

Saffarian: It is essential that providers begin by developing a shortand long-term EMR strategy, as this must eventually drive compatibility and interoperability with and among various devices and applications inside and outside the walls for care providers, plan providers and patients. Once this is established, conducting a needs assessment for individual users or groups of users is a valuable exercise. Highly portable tablets equipped with a stylus can unlock greater efficiencies for physicians and nurses on the move, for example, while zero-client desktop solutions provide the comfort and ergonomics to enable more stationary employees to be productive. Importantly, virtual desktop infrastructure (VDI) enables both of these employees to access the same information systems with a similar user interface and experience. HMT What are some of the essential questions that must be answered by IT departments to determine the optimal IT products and services they need? (c) 2014 NP Communications, LLC

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IT blamed in Athens EHR debacle | Healthcare IT News

IT blamed in Athens EHR debacle | Healthcare IT News | IT Support and Hardware for Clinics | Scoop.it

Who's to blame when EHR implementations go south? There's often enough fault to go around. But when the fallout is bad enough, sometimes self-interested parties are all too ready to point fingers.

[See also: CEO resigns amid troubled EHR rollout]

In late May, we covered the story of a $31 million Cerner rollout at Athens Regional Health System in Georgia that didn't go as planned.

Thanks to what was described by clinicians as a rushed process, doctors nurses and staff were up in arms about a series of medication mistakes, scheduling snafus and other communication glitches.

[See also: IT and informatics play well together]

"The last three weeks have been very challenging for our physicians, nurses and staff," wrote Athens Regional Foundation Vice President Tammy Gilland, Athens Regional Foundation vice president, in a letter to donors explaining the situation. "Parts of the system are working well while others are not."

The complaints lodged by clinicians were soon followed by the resignation of President and CEO James Thaw and, less than a week later, Senior Vice President and CIO Gretchen Tegethoff.

This past weekend, on June 15, the Athens Banner Herald reported that Athens Regional's chief medical officer – as well as executives from Cerner – were pointing fingers at the health system's IT team, complaining that they made strategic decisions that should have been the bailiwick of clinicians.

"Could there have been more information shared at the administrative level? I suppose you could make that argument," Senior Vice President and CMO James L. Moore told the paper. "The implementation was through the CIO, and so that's where the information was held."

The Banner Herald's Kelsey Cochran also quotes a Cerner vice president, Michael Robin, who noted that while some end-users were involved in the rollout, it seemed primarily to be led by Athens Regional's IT team, which he said was "atypical" of Cerner sites.

Another Cerner VP, Ben Hilmes, told the paper that successful EHR implementations are "clinically driven, not IT-driven." At Athens Regional, he added, "it came out of balance toward the IT side of things."

Moore has since taken the lead on the project. Cerner has pledged to do "whatever we need to do" to help the process get back on track, Hilmes told Cochran.

Whether or not this is a matter of three different parties – IT, clinicians, vendors – circling the wagons around their own and casting blame on others, one thing is certainly true: On big projects like these, the technology side and the clinical side need to be committed and communicative partners from the get-go

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Will Apple's Swift Make mHealth App Development Easier than Ever? | MDDI Medical Device and Diagnostic Industry News Products and Suppliers

Will Apple's Swift Make mHealth App Development Easier than Ever? | MDDI Medical Device and Diagnostic Industry News Products and Suppliers | IT Support and Hardware for Clinics | Scoop.it

Swift, Apple's new programming lanugage, wants to make coding mobile apps easier for everyone-including digital health developers.


 

Swift is designed to lower the barrier to ent anyone looking to creates apps for iOS or Mac OS X [image copyright Apple Inc.]

It's “Objective-C without the baggage of C” according to Apple's senior VP of software engineering Craig Federighi. Apple promises its new programming language, Swift, will make developing apps for OS X and iOS of all kinds, from games to health and fitness, easier and faster than ever. But will Swift live up to its name?

“We don't see a strategic downside from Swift, although as a youthful language, it maintains the risk of global adoption,” says Dr. Chuck Thornbury, CEO and founder of meVisit, an iPhone- and Android-based app that remotely connects patients to their doctors. “Swift is relatively new and maturity is something that has to be considered; it is especially true for those features like mix-and-match and interoperability with old (legacy) code.”
 
The first thing you have to understand is why this is such a big deal from a developer's perspective. Mac and iPhone-based apps are typically created using an older, legacy programming language called Objective-C that first appeared back in 1983 and has carried over through Apple products since the early days. Being an older language however, Objective-C is arguably not best suited for most modern computing applications. After all, it was created in a time when all the computing power of a smartphone would take up an entire desk.
 
“Swift has many excellent features that have been learned from other programming languages. It offers a more similar syntax than other leading languages–especially, those that are script-like, dynamic languages,” Thornbury says. “The mix-and-match between Objective-C and Swift may be expected to attract developers to begin engineering in Swift quickly, as they wouldn't be expected to have concerns regarding the legacy code in Objective-C."
 
Ned Fox, a software engineer with AliveCor, makers of the mobile ECG and accompanying app of the same name, agrees with this assessment. Fox believes that it will be most advantageous for developers to use Objective-C in conjunction with Swift. “In terms of syntax, [Swift has] some pretty big differences that people are using....I'll probably stick with [Objective-C] for a while and use features of Swift,” Fox says. “I don't think it's quite as short a line from Objective-C to Swift.” However he adds that there are new features in Swift that could speed up app development significantly. One such feature is Playground, which allows programmers to test individual snippets of code without having to test the entire app at once.
 
Swift vs. Android
 
However there are conflicting reports on the efficacy of Swift. According to an article from InfoWorld [http://www.infoworld.com/t/development-tools/apples-swift-not-so-swift-after-all-244120?source=footer] Swift performed markedly slower in benchmarks compared to other programming languages, Objective-C included. However Swift has only been released in beta so it is unclear how valuable such benchmarks are at this point, particularly since Swift and Objective-C will have to co-exist for the time being.
 
“We do not believe that Objective-C will diminish from the landscape in the immediate future, as there remain many committed developers that many not see an immediate value in amending their preferred engineering language unless it is absolutely necessary,” Thornbury says. “For new projects, developers may have a passion for using a new language (Swift). Based on the feedback that we've received, engineers may be expected to gradually migrate from Objective-C to Swift as we revisit the old code...The learning curve should be shorter for those with no prior experience in iOS development.”
 
The idea of an easier programming language for Apple platforms has to have raised eyebrows with Android developers. It doesn't take a mastermind to see how clearly advantageous it would be for Apple to lock developers into an exclusive programming language for its platforms. A recent article in Fast Company [http://www.fastcolabs.com/3031491/why-apples-new-swift-language-will-keep-developers-loyal-and-away-from-android] argues that Swift's low barrier to entry and simpler syntax could easily win developers over to Apple's side and keep the ones already there from drifting over into Android-infested waters.
 
However Android is not likely to easily give up its market share and developers who want to reach the broadest audience would still be best served to develop for both platforms. “Swift appears to be most promising; however, the majority market that Android and other platforms command may act as a firm headwind, against which, it would have to pilot,” Thornbury says. “
 
“The iPhone has always been a little bit easier to code for,” Fox says. “But Android has been gaining market share in an important population that I don't believe third-party developers will want to ignore. If Google doesn't come out with something similar to Swift I think someone else will.” The AliveCor ECG is compatible with iPhone and Android phones, though the Android version was released much later.
 
Taking the Next Steps
 
Fox's theory bares some fruit given how widely competitive the digital health app space has gotten this year. Later this month, Google is expected to announce Google Fit [http://www.mddionline.com/blog/devicetalk/google-fit-googles-digital-health-platform-coming-140616], its own digital health platform similar to Apple's HealthKit [http://www.mddionline.com/article/apple-healthkit-will-integrate-all-your-mhealth-apps-140602]. For hardware companies like AliveCor platforms like these can be key ingredients to allow companies to move into the market quickly. “HealthKit is a really great step,” Fox says. “It makes it really easy to collect health data and take data out. If a company is focusing on hardware they can focus on hardware and you can import all of this data.”
 
Apple has already released a free instructional eBook [https://itunes.apple.com/us/book/the-swift-programming-language/id881256329?mt=11] that gives programmers a tour of Swift and its functionality. While the company has certainly taken a step in the right direction in encouraging future app development it will be the developers themselves that ultimately decide where the market goes. Ultimately, coders want the largest audience possible and will use any tool at their disposal to get it. “Large markets, by their very nature, offer incentives for app developers to provide content. Platform-independent development tools might be expected to attract continued innovation and motivate developers,” Thornbury says.
 
 
Apple demonstrates Swift at the 2014 Apple WWDC.



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Big Data, My Data - iHealthBeat

Big Data, My Data - iHealthBeat | IT Support and Hardware for Clinics | Scoop.it

"The routine operation of modern health care systems produces an abundance of electronically stored data on an ongoing basis," Sebastian Schneeweis writes in a recent New England Journal of Medicine Perspective.

Is this abundance of data a treasure trove for improving patient care and growing knowledge about effective treatments? Is that data trove a Pandora's black box that can be mined by obscure third parties to benefit for-profit companies without rewarding those whose data are said to be the new currency of the economy? That is, patients themselves?

In this emerging world of data analytics in health care, there's Big Data and there's My Data ("small data"). Who most benefits from the use of My Data may not actually be the consumer.

Big focus on Big Data. Several reports published in the first half of 2014 talk about the promise and perils of Big Data in health care. The Federal Trade Commission's study, titled "Data Brokers: A Call for Transparency and Accountability," analyzed the business practices of nine "data brokers," companies that buy and sell consumers' personal information from a broad array of sources. Data brokers sell consumers' information to buyers looking to use those data for marketing, managing financial risk or identifying people. There are health implications in all of these activities, and the use of such data generally is not covered by HIPAA. The report discusses the example of a data segment called "Smoker in Household," which a company selling a new air filter for the home could use to target-market to an individual who might seek such a product. On the downside, without the consumers' knowledge, the information could be used by a financial services company to identify the consumer as a bad health insurance risk.

"Big Data and Privacy: A Technological Perspective," a report from the President's Office of Science and Technology Policy, considers the growth of Big Data's role in helping inform new ways to treat diseases and presents two scenarios of the "near future" of health care. The first, on personalized medicine, recognizes that not all patients are alike or respond identically to treatments. Data collected from a large number of similar patients (such as digital images, genomic information and granular responses to clinical trials) can be mined to develop a treatment with an optimal outcome for the patients. In this case, patients may have provided their data based on the promise of anonymity but would like to be informed if a useful treatment has been found. In the second scenario, detecting symptoms via mobile devices, people wishing to detect early signs of Alzheimer's Disease in themselves use a mobile device connecting to a personal couch in the Internet cloud that supports and records activities of daily living: say, gait when walking, notes on conversations and physical navigation instructions. For both of these scenarios, the authors ask, "Can the information about individuals' health be sold, without additional consent, to third parties? What if this is a stated condition of use of the app? Should information go to the individual's personal physicians with their initial consent but not a subsequent confirmation?"

The World Privacy Foundation's report, titled "The Scoring of America: How Secret Consumer Scores Threaten Your Privacy and Your Future," describes the growing market for developing indices on consumer behavior, identifying over a dozen health-related scores. Health scores include the Affordable Care Act Individual Health Risk Score, the FICO Medication Adherence Score, various frailty scores, personal health scores (from WebMD and OneHealth, whose default sharing setting is based on the user's sharing setting with the RunKeeper mobile health app), Medicaid Resource Utilization Group Scores, the SF-36 survey on physical and mental health and complexity scores (such as the Aristotle score for congenital heart surgery). WPF presents a history of consumer scoring beginning with the FICO score for personal creditworthiness and recommends regulatory scrutiny on the new consumer scores for fairness, transparency and accessibility to consumers.

At the same time these three reports went to press, scores of news stories emerged discussing the Big Opportunities Big Data present. The June issue of CFO Magazine published a piece called "Big Data: Where the Money Is." InformationWeek published "Health Care Dives Into Big Data," Motley Fool wrote about "Big Data's Big Future in Health Care" and WIRED called "Cloud Computing, Big Data and Health Care" the "trifecta."

Well-timed on June 5, the Office of the National Coordinator for Health IT's Roadmap for Interoperability was detailed in a white paper, titled "Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure." The document envisions the long view for the U.S. health IT ecosystem enabling people to share and access health information, ensuring quality and safety in care delivery, managing population health, and leveraging Big Data and analytics. Notably, "Building Block #3" in this vision is ensuring privacy and security protections for health information. ONC will "support developers creating health tools for consumers to encourage responsible privacy and security practices and greater transparency about how they use personal health information." Looking forward, ONC notes the need for "scaling trust across communities."

Consumer trust: going, going, gone? In the stakeholder community of U.S. consumers, there is declining trust between people and the companies and government agencies with whom people deal. Only 47% of U.S. adults trust companies with whom they regularly do business to keep their personal information secure, according to a June 6 Gallup poll. Furthermore, 37% of people say this trust has decreased in the past year. Who's most trusted to keep information secure? Banks and credit card companies come in first place, trusted by 39% of people, and health insurance companies come in second, trusted by 26% of people. 

Trust is a basic requirement for health engagement. Health researchers need patients to share personal data to drive insights, knowledge and treatments back to the people who need them. PatientsLikeMe, the online social network, launched the Data for Good project to inspire people to share personal health information imploring people to "Donate your data for You. For Others. For Good." For 10 years, patients have been sharing personal health information on the PatientsLikeMe site, which has developed trusted relationships with more than 250,000 community members.

On the bright side, there is tremendous potential for My Data to join other peoples' data to drive better health for "Me" and for public health. On the darker side, there is also tremendous financial gain to be made by third-party data brokers to sell people's information in an opaque marketplace of which consumers have no knowledge. Individuals have the most to gain from the successful use of Big Data in health. But people also have a great deal to lose if that personal information is used against them unwittingly.

Deven McGraw, a law partner in the health care practice of Manatt, Phelps & Phillips, recently told a bipartisan policy forum on Big Data in health care, "If institutions don't have a way to connect and trust one another with respect to the data that they each have stewardship over, we won't have the environment that we need to improve health and health care." This is also true for individual consumers when it comes to privacy rights over personal health data.



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Enhanced eRx Features Land on iPad EHR

Enhanced eRx Features Land on iPad EHR | IT Support and Hardware for Clinics | Scoop.it


One of the earliest pioneers in mHealth is making headway with electronic prescriptions for iPad EHR.

iPatientCare announced Thursday the enhanced functionality for the ePrescribing / eRx in iPatientCare iPad EHR app.

The app is available on the App Store.
According to a provided statement from the company, hundreds of medical practices already use the iPatientCare iPad EHR app. Now, we’re told, physicians can use the app for advanced electronic prescriptions.

iPatientCare says its fully-integrated EHR system streamlines the prescription process and reduces errors with eRx.

“iPatientCare’s Electronic Health Records software integrates a breakthrough patient care platform with the mobility of the iPad to help medical practice triumph in every setting. With just a few clicks, providers will be transmitting safe and efficient prescriptions through iPatientCare eRx on iPad”, explains Kedar Mehta, CTO of iPatientCare.

“In addition to that,” Mehta adds, “iPatientCare has been awarded with the SureScripts White Coat of Quality for 2013. White Coat program is part of a larger effort to increase e-prescribing quality and accuracy, by recognizing the organizations that excel in those areas.”

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Why the cloud is imperative to image sharing

Why the cloud is imperative to image sharing | IT Support and Hardware for Clinics | Scoop.it

As new payment models increase physician accountability, cloud-based technology for sharing resources such as patient images will become an absolute necessity, according to Keith Hentel, executive vice chairman in the department of radiology at New York-Presbyterian Hospital-Weill Cornell Medical Center.

 

"In today's fee-for-service model, imaging practices don't really benefit financially from the use of cloud technology because we're not doing as many scans," said Hentel (pictured), whose facility embraced the cloud more than four years ago. "But as we move into an accountable care model, things will completely change. Physicians won't have the luxury of being able to perform unnecessary tests."

In an exclusive interview with FierceMedicalImaging, Hentel discusses New York-Presbyterian's adoption of cloud technology, why physicians love it, and how it can improve doctor-patient relationships.

 

FierceMedicalImaging: How is your facility using cloud technology?

Hentel: We use it both to get information out of our practice and to get information into our practice. Getting information into our practice was a no-brainer. We started doing that for trauma patients, patients that needed to be transferred into our institution to one, expedite care; and two, eliminate any repeat imaging that we needed to do, which was just wasteful.

FMI: What was the image-sharing process like prior to the cloud?

Hentel: For patients who were transferred out, we would create CDs and tape them to a patient's chart. For incoming patients, we would have to wait for them to physically show up to evaluate their imaging.

Conversely, when it's in the cloud, the minute they decide to start sharing those images with you, you can start reviewing files and get a sense of what's wrong with a patient. You can get a sense if you're the right institution to transfer the patient to; if you have the expertise to deal with their problem. Having images available in the cloud has really streamlined our processes.



Read more: Why the cloud is imperative to image sharing - FierceMedicalImaging http://www.fiercemedicalimaging.com/story/why-cloud-imperative-image-sharing/2014-05-29#ixzz33YchMDdn 
Subscribe at FierceMedicalImaging


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3-D printing: Healthcare's new edge | Healthcare IT News

3-D printing: Healthcare's new edge | Healthcare IT News | IT Support and Hardware for Clinics | Scoop.it

3D printing is set to become a disruptive technology across many sectors, including healthcare – and a money saver too. Employing 3D printing, one medical wearable startup tallied savings of more than $250,000 in one year.

“A lot of people think [3D printing] is going to be the next industrial revolution," Stuff You Should Know co-host Charles Bryant said in a recent podcast.
“If [3D printing] does take off, and it’s becoming increasingly possible that it [will] as costs come down for materials and the actual printers themselves, …more and more barriers [will come] down and if it becomes widespread,… so long manufacturing and transportation sectors as we know them."

Currently, the price tag associated with 3D printers varies but market researcher Gartner expects worldwide shipments of 3D printers priced less than $100,000 will grow from 56,507 units in 2013 to 98,065 units in 2014.

[See also: Triple aim.]

"The 3D printer market has reached its inflection point," said Pete Basiliere, research director at Gartner, in a press release. "While still a nascent market, with hype outpacing the technical realities, the speed of development and rise in buyer interest are pressing hardware, software and service providers to offer easier-to-use tools and materials that produce consistently high-quality results."
 
The healthcare sector is gearing up to put stock into the burgeoning technology. For example, the Queensland University of Technology in Brisbane, Australia, along with three other research universities in Europe and Australia, have jointly launched a master’s program in bioprinting, the technique of using 3D printers to grow human tissue.

Beyond bioprinting, 3D printing could assist to revolutionize administrative costs for healthcare organizations. In September 2013, Michigan Technology University researchers published their findings in Mechatronics that open source 3D printing technology could save a consumer a range from $300 to $2,000 a year by printing 20 products annually.

Dulcie Madden, CEO and co-founder of Rest Devices, a medical wearable start-up, stated that the Boston-based company saved “well over” $250,000 in a year after purchasing a 3D printer in 2011 for about $2,000.

Beginning as a medical device development company, Rest Devices bought the printer  to assist rapid prototyping for research and development. The company began to develop sensors for an adult shirt that would log an individual’s respiration, temperature and body position and the data to diagnose sleep apnea. However, the company quickly found new use for their technology for infant respiration monitors and shifted prototyping focus for that use. Using 3D printers for more than hundreds of sensor prototypes, Rest Devices was able to save on production costs.

“Instead of having to spend on injection molding for plastic, which can cost thousand of dollars, we can spit out 3D prints in an hour for pennies or dollars,” says Madden.
 
Similarly, Jennifer Mann, lab manager at the Derisi Lab at University of California, San Francisco, has noted that 3D printing allows users from graduate students to post-doctorate students to quickly customize and build designs for a variety of lab equipment.

The lab, which studies infectious diseases such as malaria, employs two printers (they cost about $15,000 each) in which users can use or customize open source designs for equipment as small as a pipette holder or a minifuge rotor to a cutaway model of a malaria parasite showing a new drug target site in a molecular structure.

Mann states that the lab saves approximately $6,000 a year by using the 3D printers to make items that are either customized or more expensive in catalogs.

“We can either order a part or take a few minutes and design it,” says Mann. “For instance, instead of paying $50 for a gel comb, we can make our own for about $1 worth of materials.”

Customization is attractive because not all workspaces are created equal. Thus, one pipette holder to smooth workloads for one lab worker’s work space could need to be changed for another’s.

[See also: Boston Children's Innovation Showcase.]

“In the past, we were limited to either purchasing what vendors offered (with one- to two-day delivery time) or custom machining (one- to four-week delivery time),” says Mann. “Now, if already designed, a part could be ready in one hour to overnight." Having a 3D printer allows the company to save money and time in the long run, he says.

And with the promise of open source customization comes the promise of rapid development and quick exchange of ideas.

“I think 3D printing is going to change the way all product development is done in the future where …. smaller companies can get to market faster is a huge step…mean[ing] there will be more innovation coming into the healthcare space,” says Madden.

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Malware infections tripled in late 2013 thanks to sneaky browser plugin, Microsoft says | PCWorld

Malware infections tripled in late 2013 thanks to sneaky browser plugin, Microsoft says | PCWorld | IT Support and Hardware for Clinics | Scoop.it

A three-fold increase in Microsoft Windows computers infected with malicious software in late 2013 came from an application that was for some time classified as harmless by security companies.

The finding comes as part of Microsoft’s latest biannual Security Intelligence Report (SIR), released on Wednesday, which studies security issues encountered by more than 800 million computers using its security tools.

In the third quarter of 2013, an average of 5.8 Windows computers out of every 1,000 were infected with malware, said Tim Rains, director of Microsoft’s Trustworthy Computing division, which tracks security trends targeting the company’s widely used products. That jumped to about 17 computers per 1,000 for the last quarter of the year.

Rains attributed the rise to malware called “Rotbrow.” The program masquerades as a browser add-on called “Browser Protector” and is supposedly a security product, Rains said by phone Wednesday. Rotbrow was found on about 59 of every 1,000 computers using its security products, he said.

For some time, computer security companies didn’t classify Rotbrow as malicious software. Rotbrow is known as a “dropper,” with capabilities to download other software on a computer. It didn’t initially download malware to computers it was installed on, Rains said.

But then Rotbrow started downloading malicious browser extensions. Microsoft noticed the change and alerted other security companies, which then began blocking it.

The tactic, which had been used by fake antivirus programs in the past, meant that Rotbrow was already installed on a huge number of computers.

“I would characterize it as a low and slow attack,” Rains said. “They were patient and waited a long time before they started to distribute malicious stuff. I think they gained a lot of people’s trust over time.”

Rotbrow often distributes Sefnit, a type of malicious botnet code, which can subsequently download other harmful programs to a computer such as those involved in click fraud. Sefnit has also been linked to “ransomware,” which is malware that encrypts a person’s files and demands payment.

Microsoft added detection for Rotbrow in its Malicious Software Removal Tool (MSRT) last December after it raised suspicion.

Safer overall

Overall, Microsoft’s latest report concluded that security improvements in Windows such as ASLR (Address Space Layout Randomization) and DEP (Data Execution Prevention) have made it much more difficult to exploit known vulnerabilities. The report also said the number of vulnerabilities in Microsoft products that can be remotely exploited has fallen by 70 percent between 2010 and 2013.

“We are really trying to raise the cost of exploitation,” Rains said. “It’s not impossible to exploit, just hard. They have to put in the extra time, extra cost.

As a result, attackers are increasingly trying to just trick people into downloading their malware by bundling it with legitimate programs or music, he said.

The latest report does not include data on the zero-day vulnerability in Internet Explorer that Microsoft released an emergency patch for on Monday. The flaw, which affects IE 6 through IE 11, could allow attackers to execute code remotely on a compromised computer if the user views an infected webpage using the browser.

Rains said “time will tell” if its next report shows a rise in infections due to the bug. But Microsoft believes the quick release of a patch and fact users have to be lured to a malicious website mitigates the risk.

“I don’t think we will see an uptick [in infections] given the quick response and the type of vulnerability that is,” Rains said.




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Why BlackBerry has the potential to drive mHealth apps forward

Why BlackBerry has the potential to drive mHealth apps forward | IT Support and Hardware for Clinics | Scoop.it

There's some exciting news in world of mobile healthcare apps and at the forefront is BlackBerry, planning expand its enterprise footprint into the healthcare market.


Why is this exciting? Because BlackBerry is renowned for its business-focused devices and data security. It once had a knuckle-tight grip as a leader in smartphone technology for the business enterprise and lost that perch partly due to the bring-you-own-device trend that forced enterprises to shift and make room for users' devices. Yet, BlackBerry's security technology is why the White House, most of the stock market and top businesses still use its handsets and communications server for all things work-related.

As we've watched in the past year, data breaches have spiked, specifically within the retail market with top names, including Target, suffering from data break-ins and potential fallout with consumers, and their trust in the brand.

Financial data is valuable, confidential and needs to be protected. But healthcare data is even more valuable and just as confidential, and technology that can boost protection of that data is a welcome sight. Consumers are wary of healthcare devices and providers are nervous about putting such critical data not only on smartphones but in cloud computing environments. BlackBerry understands those concerns and has evidently mapped out a plan for the healthcare segment.

BlackBerry's foray began with its announcement, as FierceMobileHealthcare reported, that it was teaming up with NantHealth on a healthcare platform and smartphone. The players are developing a smartphone that will provide optimization for 3D images and CT scans. And just think that's just the starting point. When it arrives in 2015, I believe the smartphone will very likely be a turning point in mobile healthcare communication devices.

NantHealth has deep healthcare industry roots, with its clinical operating system now in use at 250 hospitals. As NantHealth founder Patric Soon-Shiong noted, BlackBerry's security expertise is incredibly valuable. And as BlackBerry CEO John Chen noted, the venture is a forward-looking collaboration that represents a solid starting point in driving super-secure approaches to mHealth devices and apps.

Shortly after came news that that BlackBerry is embracing healthcare apps, as well. It has now made the Axial Exchange patient engagement app available in its BlackBerry World store. It's clearly the starting point of what BlackBerry hopes to provide to the healthcare user. The Axial app lets users learn about medical conditions, track progress of healthcare efforts and can provide reminders during treatment and recovery times. It can also monitor glucose levels, blood pressure and even weight.           

I see it as just the start of a new secure mHealth frontier and it'll be of little surprise if BlackBerry ends up leading the charge as mHealth tech evolves. -Judy (@JudyMottl and@FierceHealthIT)



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Tips for getting physician buy-in to new IT | Government Health IT

Tips for getting physician buy-in to new IT | Government Health IT | IT Support and Hardware for Clinics | Scoop.it

WASHINGTON – “If you build it,” Edith Dees said of technology and doctors, “they won’t necessarily come.”

Many healthcare organizations learned that while implementing electronic health records systems and those lessons will come in handy when bolting on newer technologies, such as analytics and clinical decision support tools.

Dees, the CIO of Holy Spirit Health System, explained that getting doctors up to speed on new IT products and services takes coordination, diplomacy and empathy. What’s more, doctors don’t like to think they need to be told to do anything, according to Susan Kressly, MD, founding partner at Kressly Pediatrics. 

“It’s like herding cats to get doctors to change, so be careful how you engage doctors and create a partnership with them,” she says. “Pretend it’s an 80-20 partnership in the doctor’s direction and you’ll get where you want to go.”

Richard Schreiber, MD, chief medical informatics officer at Holy Spirit Health System says it’s important to find out what works best for each doctor. “The ‘how’ is the most important part” of motivating the change, he added at the Healthcare Business Intelligence Forum hosted by HIMSS Media and Healthcare IT News.

A good starting point is a low-risk conversation that generates interest rather than making physicians or IT workers feel daunted, suggested Actian Healthcare general manager Lance Speck, particularly when delving into something as seemingly intimidating as predictive analytics.

“Simply ask the question ‘do we use science to analyze our data?’” Speck recommended. Since doctors have health data, and many have the means to analyze it, there is no reason not to be doing so.

Dees said it is best to build in a support plan because doctors generally do better with one-on-one training “at the elbow.” Include an escalation plan to use if decisions about the project cannot be made at lower management levels. Bake it into the project methodology, Rees advised. Also, set up a provider hotline for your doctors, to help them with tasks like resetting passwords that might be necessary but hassle enough to discourage progress. “Anything we can do to support our doctors directly impacts patient care,” Dees added.

Kressly urged attendees to keep in mind how much pressure doctors are under. They are “on” all day worrying about keeping patients safe and don’t want to have any of their attention shift from that main goal, for fear it will compromise care.

Drawing on those lessons learned during EHR implementation, the presenters all called for a tight communication plan that focuses on doctors. Rather than selling an EHR for its potential to improve billing, for instance, focus on what a particular technology can help doctors do their jobs. “You’ll grab a doctor’s attention if you advocate for their patient,” Kressly said.

She also suggested eagerly listening to the rank and file, establishing a physician IT champion, applying continuous incremental change, and demonstrate how the technology, be it an EHR, clinical decision support, or predictive analytics can help them better treat patients. “Allow the doctors to see the power of the data,” Kressly said.

Checking back with physicians after the initial training is key, Schreiber advised, because “you have to learn how the learner learns.”

Then, you can identify quick wins and apply those to advocate for new technologies.

“After that success, get a full check-up at your organization. Where are the areas you could improve care and lower costs?” Speck said. “Get a full diagnosis. Prioritize and build a path. See what kind of outcomes you can improve.”

See also:



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