IT Support and Hardware for Clinics
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IT Support and Hardware for Clinics
News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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Malware in the Cloud: What You Need to Know

Malware in the Cloud: What You Need to Know | IT Support and Hardware for Clinics | Scoop.it

Cloud security is not as simple as it may seem. Businesses have a shared security responsibility with cloud service providers, but some lack the knowledge to keep up their share of the bargain. Poor configuration and data leaks are common problems that many businesses encounter in the cloud. These issues can lead to malware infecting your cloud computing environment.

Here are a few of the different types of malware that can disrupt your cloud services.

DDoS Attacks

Botnets are becoming more and more common, with malware-as-a-service being offered by more malicious actors at an increasingly cheap price. Self-service cloud offerings allow these attackers to easily gain access and notoriety by launching large-scale DDoS attacks, which have been measured at speeds of up to 30 Gbps. Since cloud computing hosts multiple customers in a single cloud, these attacks can affect your cloud environment, as well.

Hypercall Attacks

An attacker uses a Virtual Machine (VM) to intrude the victim’s VM by exploiting the Virtual Machine Manager (VMM) hypercall handler. This gives the attacker the ability to access VMM privileges and possibly even execute malicious code.

Hypervisor DoS

This attack uses a high percentage of your hypervisor’s resources in order to leverage flaws in design or setup. Researchers found that this malware accounted for 70 percent of malware attacks targeting cloud providers’ hypervisor, which manages customers’ virtual environments. One study found that 71.2 percent of all Xen and 65.8 percent of all KVM vulnerabilities could be exploited by a guest VM. For the sake of context, AWS uses Xen for its hypervisor, and Google uses a proprietary version of KVM.

Co-Location

An attacker tries to find the target VM’s host in order to place their own VM on the same host. This is used to gain leverage in cross-VM side-channel attacks, such as Flush/Reload or Prime and Probe.

Hyperjacking

This is where an attacker tries to take control of the hypervisor, sometimes using a virtual machine-based rootkit. If the attacker is successful, they will have access to the entire machine. This could be used to change the behavior of the VM, causing it to be partially or fully compromised.

Man in the middle (MITM)

MITM is when an attacker can intercept and/or change messages exchanged between users. Ghostwriter is a common precursor to a MitM attack. This allows the attacker access to a misconfigured cloud configuration with public write access.

Exploiting Live Migration

During migration from one cloud service provider to another, the cloud management system is tricked into creating multiple migrations, which turns into a denial-of-service attack. This can also be used to potentially craft a VM Escape.

VM Escape

This accounts for 13.1 percent of all malware attacks on virtual machines in cloud environments. VM Escape involves running in a VM and escaping to infect the hypervisor. The goal in this attack is to obtain root privileges, host OS control and maybe even full access across the environment.

Flush/Reload

This attack utilizes a memory optimization technique known as memory deduplication. By enacting a sophisticated cross side-channel technique, a malicious actor can detect a full AES encryption key.

Prime and Probe

This is a VM cross side-channel attack that utilizes cache instead of memory. The attacker fills the cache with some of their own information. Once the victim uses the VM, the attacker uses this information to see which cache lines were accessed by the victim. This method has been used to recover an AWS encryption key.

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Medical Device Security Risks: What Healthcare institutions can do

Medical Device Security Risks: What Healthcare institutions can do | IT Support and Hardware for Clinics | Scoop.it

Medical devices, just like any other Internet of Things (IoT) object, are prone to hackers. These hacks can get dangerous quickly— security risks with medical devices become patient safety issues, as while medical devices carry patient data that needs to be protected according to HIPAA laws, these instruments also perform critical functions that save lives.

 

Weaknesses that augment the risk of a potential breach include the fact that medical devices tend to be five to six years old by the time they are even put in use at hospitals, after which they are operating for another fifteen years. These devices are the most prone to security breaches, as they are not built with future tech advancements in mind.

 

On top of this, many hospitals have not updated or patched their software or medical devices until something has already gone wrong. After the WannaCry ransomwareattack in May of 2017, Windows released patches for operating systems as old as Windows XP, yet many hospitals are slow to download the patch, and some did not download it at all. Hospitals, along with medical device manufacturers, are testing and deploying the patches across the millions of medical devices.

 

Due to the increasing connectivity of medical devices, cyberattacks have been steadily increasing over the past few years.

Here are some examples of alarming events that have occurred with medical devices:

  • In 2014, researchers alerted the Department of Homeland Security that certain models of the Hospira infusion pump could be digitally manipulated. A year later, the FDA issued an advisory discouraging hospitals from using the pump; however, it is still in use in many medical settings. Even if a security risk is detected, the device is still needed for patient health.

 

  • Years later, in September 2017, eight security vulnerabilities were found in the Medfusion 4000 Wireless Syringe Infusion Pump, the worst of which had a Common Vulnerability Scoring System (CVSS) score of a 9.8 out of 10.

 

  • In 2016, researchers from the University of Leuven in Belgium and the University of Birmingham in England evaluated ten types of implantable cardioverter defibrillators (ICDs) and gained the ability to turn off the devices, deliver fatal shocks, and access protected health information (PHI). Not only could they drain the battery and change the device’s operation, if the researchers had used slightly more advanced or sophisticated equipment, they would have been able to interfere with the devices from hundreds of meters away.

 

  • In late 2016, over 100,000 users of insulin pumps were notified of a security vulnerability where an unauthorized third party could alter a patient’s insulin dosage.

 

  • In May 2017, NSA hacking tools believed to have been stolen by North Korea were used to infect MRI systems in US hospitals. Although this hack did not directly threaten patient safety, the machines ceased functionality for an extended period of time, increasing the need for hospital resources and causing critical delays.

 

  • In August of 2017, the FDA recalled 465,000 implanted cardiac pacemakers due to a vulnerability where unauthorized users could modify the pacemaker’s programming.

 

After all of these life-threatening hacks, the FDA has provided updated recommendations with a revision of NIST’s 2014 Framework for Improving Critical Infrastructure Cybersecurity.

 

Cybersecurity risk assessments can facilitate calculating the vulnerability of these medical devices. One form of this is penetration testing, where security engineers target identified or unidentified vulnerabilities in code and report the product response. Other types of risk assessments can include malware testing, binary/byte code analysis, static code analysis, fuzz testing, and security controls testing.

There are four key steps that a healthcare organization using these medical IoT devices can take to protect patient data and the devices themselves:

  1. Hospitals should use proactive approaches to hacking threats rather than waiting for something to go wrong; always change default passwords and factory settings.
  2. Healthcare companies should also assess their legacy systems and any outdated hardware; systems that are outdated are not only prone to hackers but do not integrate with newer devices perfectly. This lack of interoperability leads to more security gaps, which creates a cycle of weakness.
  3. Hospitals should isolate the medical devices that cannot be patched on a separate network so that hackers do not have access to the medical devices, in a process known as network segmentation.
  4. To discard hardware, the disposal should be done domestically, include complete data destruction, and be coordinated so that data cannot be recreated from abandoned devices.

 

Medical devices are not removed from the realm of hackable devices and should be treated as such. In fact, they should be treated with even more caution and care. If these devices are infected by hackers, both safety and privacy are at risk. Hospitals have an obligation to ensure the highest degree of security controls within medical devices they use. While the FDA may issue guidelines or recommendations with caution, as they put patient well-being above all, government agencies should still do everything in their power to make cybersecurity recommendations for medical devices enforceable and part of the law.

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Design Of A Mobile Health Clinic

Design Of A Mobile Health Clinic | IT Support and Hardware for Clinics | Scoop.it

A mobile clinic allows the health provider or health business to deliver its services from multiple locations. Simply put, you go to the patient, they don’t come to you.


The concept of mobile and virtual health clinics has grown rapidly and both are now key business models for health businesses in Australia.

 

Mobile health clinics have certainly grown in both numbers and services offered, as you now have clinicians and health practitioners flying into towns to hold a clinic or even doing a roadshow-like journey through rural and remote areas.

 

Mobile health clinics are also increasing in metropolitan areas where health practitioners or health businesses are going into the corporate, government and educational sectors to offer their services to the staff of those organizations.

 

Simply put, doctors, allied health professionals, and community workers are now becoming more mobile and as such, are having a bigger reach.

 

Most health practitioners agree that the biggest challenge in a mobile health clinic is to be mobile. In order words, the ability to access all the necessary clinical and business tools and offer the same service as an in-house health clinic is the greatest challenge.

Below are some tips on how to design a mobile health clinic (from an IT perspective).

 

Know what tools you need to complete your tasks in a mobile environment, this includes:

  • The clinical software applications you currently use (MD, BP, Genie, Pathology)
  • The billing applications you currently use (BP Management, eClaims)
  • The communication/messaging applications you currently use (Argus, Healthlink)
  • The administrative tools you currently use (Outlook, calendar)

Ask your current eHealth IT consultant to perform some research on

  • Cloud solutions specific to the health industry
  • Remote desktop solutions
  • Remote access solutions

 

At REND Tech, our Cloud for Health solution allows mobile, virtual and FIFO businesses to access their complete clinical IT environment from anywhere (home, office, mobile office), at any time and using their preferred device (iPads, tablets, laptops).

Before agreeing on a solution/vendor, ensure that

  • You have thoroughly tested the solution and it meets your requirements
  • Your data and applications are hosted in Australia
  • Your data, applications and complete IT environment are backed up daily
  • You are happy with the security levels provided
  • There is ongoing IT support and maintenance to ensure that your solution is always available.
  • You have tested the solution using wireless, networked and 3G/4G connections

 

By following the steps above, you should be well and truly on your way to having an excellent IT foundation for your mobile health clinic.

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Track And Maintain Your New And Existing Patients Records Effectively

Track And Maintain Your New And Existing Patients Records Effectively | IT Support and Hardware for Clinics | Scoop.it

Cracking the code to access and save the heart of medical care

Medical records are undoubtedly the lifelines of medical care today. You don’t just need them to treat the patient correctly and follow-up well but also to ensure that you have documented it and have a record.

 

These are not just some paperwork requirement of the process; they are also legal documents and have come a long way,from being mere bundles of files to an important requirement in the medico-legal environment.

 

The change in the stature of patient records in the entire system has led to many strategies being developed to ascertain tracking and maintaining of patient records of both new and old patients effectively.

 

Here we list for you some foolproof and effective ways of doing the same at your clinic.

1. Unique Clinic Identity Document (UCID)

UCID is a unique alphanumeric or numeric code generated by the Clinic Management software for each new patient at the clinic. The software can be customized to generate such an ID ensuring every record of the patient going forward is stored under this ID. Being a unique code this will not be assigned to any other patient ever and this code becomes equivalent to a personal locker of the patient in the software. To access the records of any patient at any time irrespective of how old or new the patient is, all you need is the UCID and login rights to access it, and lo and behold, all relevant information will be displayed on your screen.

2. Integrate Accurately and Completely

While the Clinic Management software can be customized to generate a UCID for every new patient, old patient records need to be integrated into the system while implementing the software. This is precisely the reason why integration is an important factor to be considered while buying Clinic Management software because you cannot, in any way, afford to lose the medical records of your old patients. They need to be manually or otherwise digitized and saved on the server, to be accessed in exactly the same manner as the new ones.

3. Record Only Through EMR

Discontinue the option of the physical recording of patient records at your clinic. Recording in the software puts into use the EMR module of the software and with only one format of patient records available, tracking and maintaining patient records is easy. If both manual medical record-keeping and EMR are running parallel to each other at your clinic, patient records can never be maintained effectively and the tracking or access will never be easy or complete.

4. Patient Records On Cloud Is Better

In the battle between in-house servers vs. cloud-based server as far as patient records and their access is concerned, the cloud-based server will win hands down. The in-house server may be down for maintenance or due to some technical glitch and in that down-time no patient records can be accessed or recorded; while on cloud-based servers, continuity in tracking and maintaining the patient records is a key feature. Using a cloud-based server is a better option to effectively track and maintain patient records.

While there are many more ways to effectively maintain and track the patient records of both old and new patients at your clinic, these 4 strategies address the most pertinent issues – maintenance and access to patient records easily.

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Breathe new life into your old PC

Breathe new life into your old PC | IT Support and Hardware for Clinics | Scoop.it

Don’t be so quick to dump that old computer! Despite being slow, clunky, and prone to crashes, your old desktop or laptop might just be perfectly usable — after a few light upgrades that will breathe new life into it and enable you to use it for other computing needs.

 

As mentioned, you have to make a few upgrades on your old PC. You may want to try a lighter OS, for example. Keep in mind that the latest version of Windows or MacOS won’t work optimally without a fast processor, so a Linux-based OS, which comes in a variety of options called “distros,” would be a better option. It will make your computer feel brand new without exhausting its hardware.

 

Popular distros options such as Ubuntu, elementary OS, and PinguyOS can be easily installed. Plus, they have similar interfaces to Windows and come with a boatload of software packages. The best part is they require a minimum of 4GB of RAM, so you won’t have to invest much at all.

 

Once you’ve upgraded your old PC, you can start using it as a NAS server, a dedicated privacy computer, or a digital media hosting platform.

Make a NAS server

Network-attached storage (NAS) is a server for your home or small business network that lets you store files that need to be shared with all the computers on the network. If your old PC has at least 8GB of RAM, you can use it as your own NAS.

 

Simply download FreeNAS, a software accessible on Windows, MacOS, or Linux, that enables you to create a shared backup of your computers. FreeNAS has access permissions and allows you to stream media to a mobile OS, like iOS and Android.

 

But if you’d rather convert your PC into a private cloud for remote access and data backup, Tonido is a great alternative. Compatible with Mac, Windows, and Linux, this free private cloud server turns your computer into a storage website, letting you access files from anywhere on any device.

 

Tonido offers up to 2GB of file syncing across computers, and there are even Tonido apps for iOS and Android.

Secure your online privacy

Install The Amnesic Incognito Live System (TAILS) on your old computer and enjoy your very own dedicated privacy PC.

TAILS routes all your internet traffic and requests through TOR Project, a software that makes it difficult for anyone to track you online. All of this Linux-based software’s integrated applications like a web browser, Office suite, and email software are pre-configured for robust security and privacy protection.

Kick your media up a notch

Looking for a way to listen to music and podcasts or watch videos on other PCs or mobile devices? Server software like Kodi can help.

 

Kodi brings all your digital media together into one user-friendly package so you can use your old PC as an audio and video hosting platform. From there, you can play files on other devices via the internet. There are remote control apps for both iOS and Android, and even an app for Kodi playback on Amazon Fire TV.

 

Kodi works on any Windows, MacOS, and Linux computer, and even on even rooted Android and jailbroken iOS devices.

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3 Cisco Cloud Security Products to Check Out 

3 Cisco Cloud Security Products to Check Out  | IT Support and Hardware for Clinics | Scoop.it

Cisco continues to evolve its cloud security profile with new developments from Meraki, Umbrella and Duo products. These three products are made to seamlessly integrate with your systems to better protect your business. Learn more about each below.

Cisco Meraki

Cisco Meraki combines security cameras, cloud-management, and analytics with the MV lineup. The MV22 and MV72 cameras provide reliable security. They are easy to set up and manage through the Meraki dashboard. This tool eliminates the single point of failure, so you don’t have to worry about one camera failing and taking down the whole system. Both models have 256GB of solid states storage and up to 1080 pixels of high definition resolution. The Meraki dashboard allows for monitoring and management of all cameras from anywhere in one or multiple locations with no extra software required. The dashboard uses analytics to provide valuable insights to protect your business. An example is performing a motion search, which can detect people using pixels at certain periods of time during the day. Additionally, under the Meraki brand, the Meraki SD-WAN is 100% centralized cloud management for security, networking and application control. The dashboard enables network admins to view networked clients, bandwidth consumption, and application usage across all sites. Some of its features include no external modem, high availability, and advanced security license/firewire.

Cisco Umbrella

Cisco Umbrella Solution is a cloud-based secure internet gateway and provides the first line of defense from threats on the internet – even if the end-user is working remotely from a company device or their own computer. The Umbrella boasts an easy deployment and an even easier system to operate. It integrates directly with Meraki products and the rest of the Cisco security profile. With Umbrella, users are protected anywhere they access the internet with or without a VPN. The DNS is the biggest threat to security and most of the time isn’t monitored. The Umbrella Cloud Solution solves this gap as the first line of defense. It not only solves requests, but it also looks at comparisons in the data to better detect similar threats from cyber fingerprints used by attackers.

Duo

The duo is the most recent addition to the Cisco family. This tool offers a streamlined way to improve the user experience during the multi-factor authorization while also protecting your business. The duo takes it a step further by checking devices managed and unmanaged to ensure it meets security standards before granting access. 


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Make sure your VoIP phones survive a disaster

Make sure your VoIP phones survive a disaster | IT Support and Hardware for Clinics | Scoop.it

Voice over Internet Protocol (VoIP) telephony systems are great for today’s businesses. They’re more mobile with greater functionality and better cost efficiency versus traditional landline phones. But as with any technology, VoIP is vulnerable to disruptions due to equipment failure, disasters, and cyberattacks. Plan ahead and make sure your VoIP can weather any breakdown.

Invest in VoIP monitoring services

Before implementing any disaster recovery solutions, install a third-party VoIP monitoring service to keep tabs on the status of your phone system. This will identify all network issues disrupting your phone system, so you can resolve them quickly.

Choose your VoIP provider wisely

When evaluating VoIP systems, you must verify your provider’s service-level agreements. Ask them about their security and availability guarantees, and how they’re able to achieve them.

Whomever you partner with, be sure they host your VoIP systems in facilities that are safe from local disasters. Your provider should also use advanced network security services to protect your calls.

Have a backup broadband line

Because VoIP solutions are dependent on internet connections, you should have a backup or alternate internet service in case one network goes down.

Ideally, one internet service provider (ISP) will be dedicated to your VoIP service, while another supports your main computer network. Once you’ve installed both networks, you can then program them to automatically transfer services to the other should one network fail. Thus, if your main phone network goes down, your VoIP solution switches to the other network so you can keep working.

Of course, subscribing to two separate ISPs will increase your internet expenses, but the cost to maintain both is far less than the cost of significant downtime.

Route calls to mobile devices

With a cloud-based VoIP solution, you can choose where to receive your calls with call forwarding — a feature that automatically reroutes incoming calls to other company-registered devices. If your main office is hit by a local disaster or network outage, your employees can continue working from their mobile devices as if nothing happened.

To benefit from this feature, make sure to register all employee mobile devices to your VoIP system and configure such devices to receive rerouted calls.

And don’t forget to set policies for remote working. You should have rules that forbid staff from connecting to public WiFi networks, as this can put them at risk of VoIP eavesdropping.

Test your plan

There’s little value in a VoIP continuity plan if it isn’t tested on a regular basis. Test your VoIP service and check whether contact details are up to date, call forwarding features are routing calls to the right devices, and your backup internet service works. Ultimately, your goal is to find flaws in your VoIP recovery strategy and make necessary adjustments to avoid them from occurring in the future.

 

If managing VoIP is too time-consuming and complex, call our professionals today. We design, implement, and test a powerful, disaster-proof VoIP phone system to ensure your communications are always online.

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Achieving Seamless Interoperability in Healthcare from Concept to Reality 

Achieving Seamless Interoperability in Healthcare from Concept to Reality  | IT Support and Hardware for Clinics | Scoop.it

What can we achieve with seamless interoperability in healthcare?

The era of digital healthcare is indeed revolutionizing the care landscape. Data- and technology-driven solutions are enabling every member of the care network to deliver a patient-centric experience. However, despite this tremendous leap, the care landscape is still facing challenges in simplifying care for both the patient and the provider.

 

Innumerable tools and solutions are facilitating multiple aspects of the care process – right from access to care and diagnostics to continued treatment. But these brilliant innovations often remain in silos, with almost zero scope for exchange of data across the various healthcare systems. This lack of interaction nullifies all the potential of these innovations.


This ability to communicate between systems, exchange precious data, and interpret them accurately is an essential enabler to complete the transition into digital healthcare, and is called interoperability.

What can we achieve with seamless interoperability in healthcare?
When devices, systems, and tools effortlessly share information across an interoperable interface, every care partner – from the patient, care and provider to the lab technician and pharmacist – receives the same version of the shared data regardless of the disparate technological environment of each stakeholder.

This capability delivers immense advantages:

1. Easy, secure, and real-time access to in-depth patient data

A critical enabler of delivering timely and efficient care across the healthcare system, interoperability eliminates duplication of work.

2. Supporting patient safety

Many reports have indicated that more than 50% of medication errors arise during care transition; hence, effective interoperability between all the care points ensures continuity of care and zero scope for error.

3. Effortless collaboration

Interoperability facilitates delivering a well-coordinated care, with increased clinical and business collaboration across the entire care network.

4. Efficient adoption of best practices across the landscape

extensive data insights from a well-connected and interoperable ecosystem help care partners to assess the process and derive optimal strategies and best practices.

5. Cost efficiency and high quality

With interoperability removing many administrative and data validation burdens, providers and other care partners can focus on delivering technology-enabled values to patients at a lower cost and high quality.

Thus, interoperability between every element of the healthcare ecosystem brings together three core pillars of the landscape – people, process, and technology. It enables seamless information capture, exchange, interpretation, and application of data across the landscape.

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Benefits Of Wearable Technology In The Health Sector

Benefits Of Wearable Technology In The Health Sector | IT Support and Hardware for Clinics | Scoop.it

When most of us consider wearables, we include devices such as Bluetooth headsets. However, in the medical industry, we expect more from our wearables and only include devices that not only provide a specific function but will also store sensor data for later retrieval by healthcare professionals. This data is then analysed to aid medical diagnosis.

 

In a growing telehealth market, it is these sensor-based devices that will improve healthcare services for millions of patients worldwide. Existing forecasts indicate that the global telehealth spend will increase tenfold within five years, rising to $4.5 billion by 2018.

 

Like any new technology, early adoption figures are quite weak but luckily, in Australia, we are always eager to experiment with new innovations. In fact, a 2014 Kronos survey demonstrates that no less than 30 per cent of Australians already use wearable technology, twice that of our U.S. counterparts. In addition, more than 40 per cent use them for work-related tasks. This high adoption rate is encouraging for future increased use of wearables in the health and fitness areas.

 

For this adoption rate to continue, I believe we need our healthcare providers to embrace the use of wearables, as they are best positioned to encourage their patients of wearable benefits, with the most important being improved care monitoring and increased efficiency for early diagnosis of common ailments. When a medical professional recommends a product, people listen. There are several reasons for this but primarily these include:

 

A company with a commercial interest in the product is unlikely to achieve the same positive response level.


Patients trust their doctors to act in their best interest.
By using these technologies themselves, patients are encouraged to take a more proactive approach to their personal health.
Fitness plans were perhaps the first wearable that provided useful data for medical professionals and were primarily used by those in cardiovascular activities such as running and cycling. Like any product type, the features available vary by model and manufacturer but most are capable of acting as a pedometer and can also record pulse and heart rates. The data gathered by the device sensors is then transmitted to your smartphone using Bluetooth or possibly ANT+ for cycling enthusiasts with bicycle computers. This data is often useful to doctors as it can aid diagnostics, surpassing the original plans for the device as a general fitness monitor.

 

Wearables that are specifically designed for the healthcare industry work in an identical manner. Senses are used to gather data, which is then transferred to another device for later analysis. Smartphones are most commonly used, with apps available for several platforms including Apple’s iOS and Google’s Android, but residential users can also use Wi-Fi to transfer data to the cloud or to another monitoring device.

 

In my opinion, as this technology grows, I believe real-time reporting will be possible, where data is displayed on the health professional’s monitor as soon as new data is uploaded. The exact direction this technology will take requires valuable input from knowledgeable medical professionals. That is not to say that the existing range of devices for the medical industry is limited as this is far from the situation. There are several preventative care devices already on the market and these include:

 

Glucose meters that notify clinics of an emergency situation, ideal for remote monitoring of elderly diabetics
Remote monitoring devices that store information such as blood pressure, temperature, ECG data and more. These can save a vast amount of clinic time, allowing healthcare professionals to prioritize according to patient ailment and creating an environment where early diagnosis is certain for many common ailments.
There are several dedicated devices and applications for monitoring diets, all of which act as a virtual personal trainer who recommends a specific diet according to age and cardiovascular status.
The examples listed above are probably the most common but there are many other devices available that monitor specific conditions. All share the same properties, to gather information and to monitor patients in real-time, thereby improving doctor-patient interaction and the healthcare service provided.

 

The use of wearable technology is a win-win for both healthcare professionals and patients and can reduce individual patient costs while also eliminating unnecessary clinic visits for the patient. For example, if you have high blood pressure and are prescribed specific medication to alleviate the condition, you will no doubt have to make several trips to the clinic to verify that the prescribed treatment is actually working. However, with the use of wearable technology, this is no longer necessary, as the data gathered from the device is simply analysed without travelling to the clinic.

 

Australian healthcare professionals need to adopt wearable technology as soon as possible, given that the benefits surpass any possible costs or training headaches. It is a fact but careful selection of wearable devices and software apps can increase the efficiency of any medical practice, whether it is immediate access to patient data from anywhere, guided surgery, health monitoring tasks and more. Early adopters have already discovered that these solutions can reduce the frequency of clinic visits and related clinic hours per patients.

 

Individual patient costs are reduced substantially but this does not mean that clinics will lose revenue, it merely means that available clinic time is spent treating the seriously ill or patients that require emergency care.

 

Mobile devices, remote data access and analysis with the resulting ability to increase early patient diagnosis are the way of the future. It may take some effort to define the correct processes, workflows and procedures but it is clearly worth it. Can you really afford to ignore the benefits of wearable technology?

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The Promising Future For AI In Orthopedics

The Promising Future For AI In Orthopedics | IT Support and Hardware for Clinics | Scoop.it

In their most simple form, AI applications in healthcare consist of a collection of technologies that will enable machines to sense, comprehend, predict, act, and learn. The first application for AI-based machines, as discussed at the World Medical Innovation Forum (held in April 2018), is to execute healthcare administrator and clinical healthcare functions. Current technologies are limited because they are algorithm based. The future of AI will make the leap past algorithm-only tools to become indispensable instruments for patients, providers, physicians, and payers. AI has the potential to truly augment human activity.

 

Why This Is Important
The potential to drive improvements in quality, cost, and access has made AI a notable buzzword in healthcare. The AI health market is growing rapidly and is forecasted to reach $6.6 billion by 20211 (Table 1).

 

AI Applications in Orthopedics
AI has demonstrated high utility in classifying non-medical images. A study2 looked at the feasibility of using AI for skeletal radiographs. The study authors compared an AI program against the radiography gold standard for fractures. They also compared the performance of the AI program with two orthopedic surgeons who reviewed the same images. They found the AI program had an accuracy of at least 90 percent when identifying laterality, body part, and exam view. AI also performed comparably to the senior orthopedic surgeons’ image reviews. The study outcomes support the use of AI in orthopedic radiographs. While the current AI technology does not provide important features surgeons need, such as advanced measurements, classifications, and the ability to combine multiple exam views, these are technical details that can be worked out in future iterations for the orthopedic surgeon community.

 

AI in Computer-Assisted Navigation3
Orthopedic surgeons have had access to robotic technology to help them position screws, prostheses, or tunnels for some time, but AI enhanced applications are in development (Table 2). For example, one device utilizes infrared light to locate bones intraoperatively. Another technology uses a form of AI to mill the canal for a prosthesis based on CT scans. In total hip surgery, computer assistance in placing the cup of the prosthesis is reported to have the same accuracy as with traditional methods. In the realm of knee replacement surgery, AI-supplemented robotics technology assists to align prostheses. In spine surgery, AI-enhanced computer-assisted navigation helps surgeons avoid neurovascular structures, and place thoracic and lumbar pedicle screws accurately. It is reported that the incidence of poorly placed screws has reached 42 percent with conventional surgical techniques, according to some studies, but is as low as 10 percent with AI-based computer assistance.

 

We Have Needed a Tool Like AI for a Long Time
AI will change the way healthcare work is performed. AI will fill the gaps we all know are coming in the future, such as the labor shortage in healthcare (Table 3). Through AI, we will empower clinicians and give workers tools to increase their productivity. Healthcare institutions will need an AI-trained workforce and culture. Think of the value your products will bring with AI and the ability to gain clinician face-time and recognition as they use AI to enhance efficiency, quality, and outcomes.

 

The Medi-Vantage Perspective
In almost every strategy research project we manage, when we look at adjacent technologies in consumer markets, we see AI being utilized again and again. Our strategy research helps clients understand the opportunity to integrate AI technology into their product strategies. Someday, even the most common medical devices will have an AI component.

 

Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in both small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical where she boosted the company valuation prior to its acquisition by Covidien/Medtronic, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy as well as innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses and is a member of the Aligo Medtech Investment Committee (www.msbiv.com). She can be reached at 855-343-3100, ext. 102, or at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.

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Physicians are not Experts, they rely on their Health IT Vendors for Support and Security Guidance 

Physicians are not Experts, they rely on their Health IT Vendors for Support and Security Guidance  | IT Support and Hardware for Clinics | Scoop.it

Medicine has its own version of a digital divide. In terms of cybersecurity accountability, the buck stops with the physician. The problem is that security expertise lies with information technology (IT) vendors who provide software, equipment, training and other services to physician practices. These vendors often speak a different language than the physician, who is well versed in clinical matters but whose tech savvy may end with the cable TV remote.

 

“Physicians are not security experts. It’s not what they went to school for,” said Laura G. Hoffman, assistant director of the AMA’s department of federal affairs, and presenter on two recent AMA cybersecurity training webinars. Because physicians are not experts, they “rely on their health IT vendors for support and security guidance.”

 

A recent AMA-Accenture survey of 1,300 physicians found that more than a quarter of physicians already outsource their security management and an almost equal number are interested in doing so. Many physician practices go it alone—about half of the practices surveyed have an in-house security official—juggling the requirements of various systems and equipment, and relying largely on trust that the products and services they pay for are secure, reliable and work seamlessly together.

 

“Physicians really trust their vendors and that can be good and bad,” Hoffman said. Under the Health Insurance Portability and Accountability Act (HIPAA), she noted, it’s physicians who “are the ones on the hook if anything goes wrong.”

 

Bridging medicine’s cybersecurity digital divide can be an intimidating prospect, especially for smaller practices. How products from various vendors fit together may be unclear. The scope of a physician’s discussion with a vendor will vary greatly by not only by practice size, but by technology choices. For example, a practice with cloud-based records storage will have different concerns to address than one with its own server. Here is what to consider for having a more effective conversations with vendors.

 

Think ePHI and beyond, not just EHR. A medical practice’s starting point for getting a handle on vendors might be the electronic health record (EHR), but cybersecurity preparedness and accountability requires a broader view. In terms of cybersecurity, HIPAA covers any and all electronic protected health information (ePHI). An EHR is sure to contain ePHI, but ePHI is likely to be found throughout the practice. HIPAA requires a security risk analysis and whether done in-house or by a vendor, it is a great starting point for getting an inventory of all the relevant technology and understanding the interactions of the devices involved.

 

The AMA offers a free, one-hour webinar to familiarize physicians and practice managers about how to conduct it. Beyond obvious HIPAA concerns, there is other technology—for example, non-EHR office software and computers—that can play a role in the safe and smooth functioning of the practice. “Identifying the actual technology in your environment is a first step in making sure everyone is at the table when you have these conversations,” said AMA Senior Health IT Consultant Matt Reid, co-presenter with Hoffman in a separate AMA webinar on cybersecurity and patient safety.

 

Practices need to be more assertive. Technology from different vendors may not always smoothly mesh. For example, a larger practice with cloud-based records storage requires an Internet service provider to supply sufficient Internet bandwidth to reliably store and retrieve data.

 

What’s required is a practice cybersecurity and technology “champion,” said Reid. It is that individual—who may well be a practice staff member as opposed to a physician—who can get vendors together, face to face or in a conference call, to have all the practice’s technology work together. According to Reid, the he champion’s message should be: “This is an issue where we all want to row in the same direction, so how are we all going to work together cohesively?”

 

Vendors need to be more forthcoming. When that practice champion gets the conversation going, a top priority is collecting and sharing a complete set of technical information from all of the practice’s health IT vendors. The objective is to find out fully what the practice needs to know about and, critically, what the vendors need to know about each other’s hardware, software and services requirements.

 

Testing is essential. A practice should periodically test the technology it relies on—Hoffman noted one example of an EHR that, unbeknownst to the practice, ran out of storage space—and be aware that technology problems can arise whenever anything new is added to the mix.

 

Looking ahead, the AMA is exploring how practices can be incentivized to work closer with vendors on cybersecurity. Nearly three-quarters of the doctors in the AMA-Accenture survey said they would be willing to pay a vendor to implement a cybersecurity framework if adoption meant that practices would not be subject to random HIPAA audits.

 

Also on the AMA’s advocacy list: safe-harbor exemptions from the Stark Law and Anti-Kickback Statute expanded to allow donation of cybersecurity-related hardware or software to small medical practices from other provider groups. The AMA recently sent a letter to the U.S. Department of Health and Human Services’ Office of Inspector General on the matter.

 

In the letter, the AMA expressed its deep concern that the country’s health care providers have been insufficiently prepared to meet the cybersecurity challenges of an increasingly digital health system. The AMA firmly believes that this is a national priority and that physicians and other health care providers need tools to secure sensitive patient information in the digital sphere.

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Advanced Software Offers Metal Artifact Reduction For Extremities

Advanced Software Offers Metal Artifact Reduction For Extremities | IT Support and Hardware for Clinics | Scoop.it

Carestream Health will demonstrate new optional advanced metal artifact reduction software for its Carestream OnSight 3D Extremity System at the Radiological Society of North America tradeshow (Booth #6713). Carestream’s OnSight 3D Extremity system captures high-quality, low-dose 3D extremity exams. The company’s new metal artifact reduction software is pending FDA 510(k) Clearance.

“Carestream’s second generation of software takes our state-of-the-art original metal reduction software to a new level. It provides enhanced flexibility depending on the metal content present and reduces the visual distortion caused by screws, implants, rods and other metal objects to create improved visibility and diagnostic confidence,” said Helen Titus, Carestream’s worldwide marketing director for ultrasound & CT.

The optional software makes it easier for radiologists and orthopedic surgeons to accurately diagnose a patient’s condition and develop treatment plans. Image processing can be adjusted and optimized according to the amount of metal present.

The software uses information from the original scan to eliminate the need for additional imaging studies, which reduces costs and lowers radiation exposure for patients.

An intuitive touch screen interface allows technologists to adjust for either moderate or complex metal content. The metal artifact reduction software can be activated prior to the scan or it can be applied after the original reconstruction is complete. Both the original and corrected images are always available to view and compare.

The OnSight 3D Extremity System also assists surgeons in detecting occult and non-union bone fractures. Unlike traditional CT systems, this cone beam CT system has a large-area detector that captures a 3D image of the extremity in a single rotation, which takes only 25 seconds. A patient simply places the injured extremity into a donut-shaped opening in the system. Since the patient’s head and body are not confined, patients do not experience the claustrophobia that often occurs with traditional CT systems. Dose is significantly reduced because only the affected body part is imaged.

The compact extremity system can be installed in an exam room and plugs into a standard wall outlet.

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FDA Clears IlluminOss Medical's Bone Stabilization System

FDA Clears IlluminOss Medical's Bone Stabilization System | IT Support and Hardware for Clinics | Scoop.it

IlluminOss Medical, a privately held, commercial-stage medical device company focused on minimally invasive orthopedic fracture repair, announced that it has received U.S. Food and Drug Administration (FDA) de novo clearance for the IlluminOss Bone Stabilization System for treatment of impending and actual pathological fractures of the humerus, radius and ulna from metastatic bone disease.

The IlluminOss System incorporates the use of a thin-walled PET balloon that is infused with a liquid monomer and delivered in a minimally invasive fashion into the intramedullary canal of the bone through a small incision.

Once the balloon is infused with monomer, it conforms to the shape of the patient’s specific bone. The surgeon then activates a light source which delivers visible light to the PET balloon, polymerizing the monomer. The cured, hardened implant provides longitudinal strength and rotational stability over the length of the implant, stabilizing the fracture.

The IlluminOss System, which has been commercially available in international markets and been in clinical use since 2010, will now be available to patients in the U.S. for the treatment of pathological fractures of the humerus, radius and ulna.

“The FDA marketing clearance marks a significant milestone for IlluminOss Medical, allowing us to bring our products to the U.S. market,” said Robert Rabiner, chief technology officer, IlluminOss. “The IlluminOss System was developed with an aim to provide improved patient experiences and outcomes when treating pathologic fractures. There is a critical need to make less invasive orthopedic fracture repair options available to an aging and underserved market segment.”

Surgeons’ experiences with the product in the international markets have reported smaller incisions, shorter procedural times, faster return to patient’s daily living activities, with reduced hospital stays and lower complication rates for patients.

“The IlluminOss System has significantly changed the way we are able to approach the treatment of certain impending and actual pathological fractures resulting from metastatic bone disease,” said Dr. Richard McGough, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center. “We were able to offer patients a quick, reliable surgical option that minimized pain and hospitalization. We were also able to consolidate their treatments; in some cases, we moved from two-day admissions to outpatient surgery, and we were ultimately able to complete radiation much more quickly.”

“I am delighted that we now have an improved option to help patients with metastatic bone disease of the humerus,” said John Healey, Chief of Orthopaedic Surgery, Memorial Sloan Kettering Cancer Center. “Since this device doesn’t violate the rotator cuff and can be inserted with reduced operative time and blood loss, it relieves pain and restores function more effectively than alternative treatments, in my experience. Furthermore, this new technology is versatile, and I anticipate that new applications will follow.”

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Do the Cyber Risks of the IoT in Healthcare Outweigh the Benefits?

Do the Cyber Risks of the IoT in Healthcare Outweigh the Benefits? | IT Support and Hardware for Clinics | Scoop.it

The Internet of Things, or IoT, is a system of internet-connected objects that collect, analyze and monitor data over a wireless network. The IoT is used by organizations in dozens of industries, including healthcare. In fact, the IoT is revolutionizing the healthcare sector as devices today have the capability to gather, measure, evaluate and report patient healthcare data.  

 

Unfortunately, IoT connected devices also exponentially increase the amount of access points available to cyber criminals, potentially exposing sensitive and confidential patient information.  In order to take advantage of this valuable new technology, healthcare firms need to ensure that they are aware of the risks and address them ahead of implementation.

How are healthcare organizations using the IoT?

Businesses in the healthcare sector are taking advantage of the IoT to provide better care, streamline tracking and reporting, automate tasks, and often decrease costs. Here are a few examples of how healthcare organizations are using IoT:

  • Medicine dispensers are now integrated with systems that automatically update a patient’s healthcare provider when they skip a dose of medication.
  • Smart beds are equipped with sensors that indicate when it is occupied, alerting the nursing staff if the patient is trying to get up.
  • Caregivers are taking advantage of ingestion monitoring systems whereby swallowed pills transmit data to a device, tracking whether a patient is taking medication on schedule or not.
  • Smart inhalers can now track when asthma and Chronic Obstructive Pulmonary Disease (COPD) sufferers require their medicine. Some of these devices are even equipped with allergen detectors.

 

Connectivity of healthcare solutions through cloud computing gives providers the ability to make informed decisions and provide timely treatment. With the IoT connected technology, patient monitoring can be done in real-time, cutting down on doctor visit expenses and home care requirements.

 

However, as healthcare organizations begin to integrate IoT technology into devices more frequently, cybersecurity risks increase significantly.

Cyber risks of healthcare IoT tech

Cyber risks have become sophisticated and there has been an enormous increase in the quantity and severity of attacks against healthcare providers. In fact, since 2009 the number of healthcare industry data breaches has increased every year, progressing from only 18 in that year to 365 incidences in 2018.  Significant financial costs to a healthcare organization are a consequence of these breaches due to fines, settlements, ransoms, and of course the costs to repair the breach itself.  

 

Businesses are becoming progressively vulnerable to cybersecurity threats due to rapid advancement and increasing dependence on technology. Unsecured IoT devices pose a higher risk by providing an easily accessible gateway for attackers looking to get inside a system and deploy ransomware. Everything from fitness bands to pacemaker devices can be connected to the internet, making them vulnerable to hacking. Most of the information transmitted isn't sufficiently secured, which presents cybercriminals with an opportunity to obtain valuable data.

Managing IoT cybersecurity risks

No organization, including healthcare firms, can block all attackers. However, there are ways in which they can prepare themselves. Use these tips to help protect your healthcare organization from IoT-related cybersecurity risks:

  • Encrypt data to prevent unauthorized access

  • Leverage multi-factor authentication

  • Execute ongoing scanning and testing of web applications and devices

  • Meet HIPAA compliance requirements

  • Ensure vendors meet HIPAA compliance requirements

  • Protect endpoints like laptops and tablets

  • Healthcare staff should be educated to look for signs of phishing emails like typos and grammatical errors

IoT device-specific protection tips:

  • Acquire unique logins and device names. Avoid using the default configurations
  • Ensure the latest version of the software is installed
  • Take an inventory of all apps and devices that documents where it resides, where it originated, when it moves, and its transmission capabilities

Smart devices connected through the IoT increase access points for cyberattacks, significantly increasing risk and organizations need to be prepared in advance to prevent damage from such threats.  The healthcare industry is one of the most sensitive and frequently targeted sectors as well as one of the most costly in which to address a breach. Therefore, it is prudent for organizations to include IoT devices in a thorough cybersecurity risk assessment and ensure that they take all the necessary precautions to minimize vulnerabilities from implementing these IoT devices.

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Is Cloud Storage Right For Your Business? 

Is Cloud Storage Right For Your Business?  | IT Support and Hardware for Clinics | Scoop.it

Is Cloud Storage Right For Your Business? Some Pros and Cons to Consider

 

Due to the rising bandwidth requirements and shift toward wireless systems, the enterprise network equipment market is projected to hit $30.6 billion by 2020. Cloud equipment is becoming an increasingly popular investment for many small and mid-sized companies. Before you determine whether or not cloud equipment is the right investment for your business, it’s important to know the facts. Here are just a few basic pros and cons of cloud storage options.

PRO: Accessibility

First, cloud storage comes in many different platforms, one popular option being Meraki equipment. Professional Meraki support is also available to ensure adequate storage and data protection. Furthermore, cloud storage offers optimal accessibility — users can seamlessly view and upload data from anywhere with an Internet connection. This also means that time zones won’t be an issue.

CON: Potential Privacy Risks

Redundant data centers provide almost complete (99.99%) reliability, including local network functions still working if the Meraki dashboard went down. While the majority of cloud providers offer nothing but virtually 100% reliable service, there are some providers that may take improper measures and leave your data vulnerable. Our Meraki specialists offer expert Meraki support, ensuring your data is as protected as possible at all times, so this should never be an issue with our services.

PRO: Reduced Operating Costs

About 82% of companies surveyed said that they saved money by moving to the cloud, and it’s likely that yours will too. This is a direct result of the nature of cloud technology.

“Cloud storage for your business will come at little or no cost for a small or medium-sized organization. This will reduce your annual operating costs and even more savings because it does not depend on internal power to store information remotely,” writes Amy Pritchett on CompareTheCloud.

CON: Potential for Complexity

Finally, it may be challenging to get all employees properly trained on new cloud services and technology for your business. But with some time, anyone can learn and use it effectively.

When all is said and done, 80% of cloud adopters saw improvements within six months of moving to the cloud. Being able to weigh the pros and cons of this innovative technology can help you make the best decisions for your business.

 

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6 Reasons Why NOT Having Your Server In-house is a Good Idea

6 Reasons Why NOT Having Your Server In-house is a Good Idea | IT Support and Hardware for Clinics | Scoop.it

Benefits of having cloud based laboratory information system.

The myths surrounding data storage on Cloud are many. Most of us have preconceived notions regarding data safety and security, data vulnerability, storage, data retrieval& transfer, etc. However, what we fail to remember is that data storage on Cloud is extremely reliable and robust with most banks and financial institutions using it seamlessly. Therefore, it is about time that the healthcare fraternity embraces Cloud wholeheartedly to explore and take complete advantage of this cutting edge technology solution.

 

Today, we take a peek into the most evident advantages of having your Laboratory Information System on Cloud and what makes it one of the smartest business choices you will ever make:

1. No Hassle in data Accessibility

In this age of evidence-based medicine, data accessibility is of paramount importance as far as effective patient care is concerned. Cloud-based LIS makes data accessibility much easier as compared to the LIS, which is located in on-site servers. Since the data is stored on the Cloud, information from multiple centers can be accessed from anywhere, anytime. Cloud-based LIS makes it easy for data to be accessed from any location or any device through secure logins thereby speeding up the whole process of pathological deductions and decisions leading to faster report turn around.

2. Your Data Remains Ultra Safe

One of the major concerns in a laboratory information system is the security of the patient data that is generated on a daily basis and stored on the servers. Cloud-based LIS takes care of this perfectly. The data in the Cloud-based LIS is stored in encrypted form that has high security levels and cannot be accessed in usable form by anyone other than authorized personnel with access rights. With practically no server downtime as compared to the on-site servers, Cloud-based LIS relieves the user of any operational problems and data security issues that result from server downtime.

3. Reduced IT Requirements

A Cloud-based LIS means that the servers are off-site and all the costs associated with the hardware installation and the associated maintenance is nullified. The easy accessibility associated with Cloud based LIS also makes it simple to add users, centers, sections, services etc. to the master log. This means you don’t have to go hunting for the in-house IT team; and anyone who has the login with administrator rights can do it easily. You effectively save additional manpower cost spent on maintaining a big IT team to maintain the server, add/ edit the master logs and related activities.

4. Staggered Investments

Cloud-based LIS gives the laboratory owner the option of not buying a large server at the onset and thereby blocking up money. It takes away the risk of projecting the growth of the lab correctly and buying a server that will be able to scale and handle the data and operations load of that projected growth. Cloud-based LIS means the server space can be hired as and when the growth happens. There is no prior commitment and no blocked investment. Investment on server space only needs to happen when the need arises and that too, only as an added amount in the form of simple monthly utility fees.

5. Cost Effective

The most obvious reason why Cloud-based Laboratory Information System is a smart business choice is due to its cost effectiveness. As the servers are off-site, it requires no hardware installation and the resultant licensing fees, maintenance costs and the software updates that will keep happening life-long for the software can be cut out immediately. There is no cost of hardware either and only monthly utility fees is what you need to pay.

6. Practically Zero Maintenance

With no server within your premises you don’t need to worry about the safety of the server room, temperature maintenance, pest control, server downtime, software updates and other such factors. Fixed amounts as monthly utility fee will take care of all this for you.

Having a Cloud based LIS can smoothen your operations to a large extent. It makes automation a cost effective option and also leaves you with more time to focus on the core operations, and taking care of your patients.

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Things to consider when upgrading your computers

Things to consider when upgrading your computers | IT Support and Hardware for Clinics | Scoop.it

The health industry is continuing to grow with massive investments in technology and related processes to meet today’s industry needs for increased collaboration, cross-entity, and platform integration as well as the need to achieve more by doing less. Those factors highlighted above have prompted the need for health businesses to invest in implementing IT solutions, which for the health industry fall under the eHealth banner.

 

Through our experience in implementing IT platforms for different size health businesses, we would like to share the top ten tips to save you time, money and potential headaches.

 

Technology makes your life easy: This is the main reason why we have the technology and invest in IT solutions. You need to know why you need to implement a new IT solution and appreciate that change is coming. Whether it’s changing from a paper-based system to a paperless system or complying with new industry standards, IT solutions will allow you to continue your clinical work and help minimize the administration cost. Make sure you know why you are implementing a new IT solution and set the expectations straight away.

 

Ask for a solution design proposal: As a specialist eHealth/IMIT firm we design new solutions for health businesses every day. No business is the same and no IT solution is the same. eHealth professionals know the industry requirements, they know the technology lifecycle and will know what works for your business. Ask an expert to design and scope an IT solution tailored for your business. Call different IT providers and ask them to provide their own solution/design. This way you will have options to choose from.

 

Don’t cut corners with the server: Simply the most important aspect of a clinical IT environment. The server will host your business, clinical and billing data. The server ensures that you and your staff have access to all the relevant tools and data to keep on working. Ensure that your server is a brand name (NOT PUT TOGETHER USING DIFFERENT BITS AND PIECES), ensure the server comes with at least a three-year warranty (or purchase an extension)and, most importantly, ensure that the server can handle business and data growth. You are thereby futureproofing your IT environment.

 

Technicalities of the server: Again, no business is the same. However, there is a common denominator when looking for a small/medium size server. Ask for:

  • Quad core CPU (Xeon processor) for future application/data load
  • 16GB RAM to handle more users, data, and load
  • RAID 1 configuration using SAS drives to ensure that should the hard drive fail, there is a second one to take over
  • Dual power supply to ensure the server keeps working should the primary power supply fail (it happens)
  • UPS to protect your server and data should a power outage occur
  • Windows server operating system to run your applications, store your data and ensure a secure platform

 

Backup and disaster recovery: Backup solutions ensure that your business/clinical data is safe and can be recovered should there be any data loss. Having said that, the ability to recover the data quickly and efficiently is just as important. The correct disaster recovery solution will save you a lot of time and money. Below is a quick solution guide that you can use:

 

  • Buy an imaging software like Shadow Protector Backup Assist. Ask for a daily image of your server to be implemented
  • Use USB 3.0 hard drives to back up your image (from above) and clinical data. Rotate the hard drive on a daily basis
  • Use USB thumb drives to back up the clinical data only and rotate daily

 

What about the workstations?: Easy. If the server solution is: Terminal server: Ask for thin client terminals also known as dummy terminals. Those are devices without any hard drives and connect directly to the server. Standard server/workstation environment: We recommend i5 dual-core processors with 8GB RAM and Windows 7 64-bit (do not purchase anything older than Windows 7)

 

The implementation: Ensure hiring of an IT firm that specializes in the health industry. They will liaise with the different software vendors, pathologies and ensure that your new IT environment meets the RACGP standards so you can get accredited. Remember to also ask the IT firm to ensure that your practice meets the new e-PIP requirements. Most importantly, ask the IT firm to provide a project plan and an implementation plan with deadlines on when you will obtain the hardware, the time to implementation and handover dates.

 

Security tips: This is quite simple. Ask for a top brand antivirus program to be installed and configured on all devices. I tend to recommend ESET NOD32. Ask for the network to be set up as a domain and not a workgroup. Ask for different user groups (staff, management, administrators) where the staff isn’t allowed to install any software, management can install on the workstations and administrator group has full access. Set up each user with their own password and ask them to change it every three months. Avoid Wi-Fi and use standard LAN.

 

Remote login: Do you work from different locations (aged care visits, home visits) and would like to access your clinical IT environment? There are a number of options that we recommend, one being implementing a VPN (Virtual Private Network) or an RDP (Remote Desktop Protocol configuration). Your IT provider will advise on the best solution. However, you must be sure to tell them that you wish to log in remotely before committing to any hardware/solution.

 

All businesses are different and as such, IT solutions will differ per business requirements, size and budget. The most important thing is to ensure that the server has at least a three-year lifecycle and have the selected solution implemented by professionals. This will save you time and money in the future.

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Tech Talks: 8×8 Delivers Secure Cloud Communication Solutions

Tech Talks: 8×8 Delivers Secure Cloud Communication Solutions | IT Support and Hardware for Clinics | Scoop.it

Would you like to enhance your customer experience (CX) with reliable and secure cloud-based solutions? If so, you might want to consider 8×8, a leading provider of communication-related products for businesses of all sizes looking to enhance their customer experience and increase staff engagement.

 

Our consultants recently attended a presentation and “sales blitz” by this cloud solution provider and got a detailed look at their key offerings. Here’s some of what we know about 8×8 that we’d like to share with you if you’re a business leader looking to improve your communication capabilities. Provider Overview Founded in 1987 and based in San Jose, Calif., 8×8 focuses on delivering cloud solutions that help companies transform both their team members’ and customers’ experiences.

 

This vendor’s solutions give businesses the ability to communicate and collaborate effectively and quickly with a single system of engagement for contact center, voice, video, and collaboration. 8×8 has earned recognition as a leading cloud-based communication solutions provider: For instance, the vendor has been named a leader in the Gartner Magic Quadrant for Unified Communications as a Service, Worldwide for seven years in a row. Unique Differentiator 8×8 has its own platform and native cloud contact center, rather than running on BroadSoft or another third-party cloud contact center like many of its competitors.

 

This gives them a considerable edge, as their clients realize the benefits of an all-in-one platform and provider. Featured Offerings 8×8 provides a wide range of communication solutions, such as VoIP business phone service, web conferencing, hosted PBX, virtual contact center, UC and more. Here are just a couple of their notable offerings. Business Phone Systems: An X Series Business Phone System solution from 8×8 gives you a single cloud platform for meetings, voice, call center, collaboration and more. Select elements of the different plans (starting with X2) to meet your company’s specific needs. This solution is available for small businesses as well as larger enterprises.

 

Cloud Contact Center: Enhance your customer experience with a cost-effective X Series Cloud Contact Center. Choose the model that best fits your communication needs, from the X5 (voice contact center with predictive dialer) up to the X8 (multi-channel contact center with predictive dialer and advanced analytics). Security and Compliance Guaranteed Additionally, for clients that must comply with industry regulations, this vendor’s Virtual Office and Virtual Contact Center solutions are certified as compliant with the following standards: HIPAA FISMA CPNI ISO 27001 ISO 9001 UK Government ATO Privacy Shield Framework Cyber Essentials

 

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The Time to Stop Relying on Spreadsheets Has Arrived

The Time to Stop Relying on Spreadsheets Has Arrived | IT Support and Hardware for Clinics | Scoop.it

Microsoft Excel is used for a wide variety of tasks, from visualizing business data, to tracking work expenses and managing books. But in the age of cloud-empowered productivity and pervasive mobile devices, is the humble spreadsheet keeping pace? While many accountants still seem to enjoy using them, there’s a huge number of tasks that spreadsheets are ill-suited for, like business reporting and project management. Let’s take a closer look at how spreadsheets may be hurting your business, and why custom software that’s powered by a robust database is usually the better solution.

Spreadsheets are Highly Error-Prone

Have you heard of “dueling spreadsheets”? It’s a term that describes when two different versions of the same spreadsheet contain conflicting data. This is an unfortunately common scenario that can arise in a few different ways.

The most common is when spreadsheets aren’t being stored in a centralized location. If one employee downloads a spreadsheet that contains today’s data, but the next day another employee downloads a copy with tomorrow’s data, then a conflict between these two datasets is likely. The problem of dueling spreadsheets is also common when people add or delete information to a single spreadsheet then share it with others via email or cloud file-sharing systems. Which version is which? It’s hard to know.

Because spreadsheets were not built with the security or integrity of data in mind, and offer no reliable way to audit changes, the problem of errors is extremely common. According to MarketWatch, as many as 88% of spreadsheets contain an error, a problem that’s grown so severe; it’s even led to the formation of an organization specifically to address the issue of spreadsheet mistakes.

Spreadsheets Waste Time

According to a report by research and advisory firm Ventata, 44% of businesses struggle with managing their spreadsheets. Their research found that the average employee spends 12 hours a month looking for and correcting errors in spreadsheets. You can read more about that in their blog post here.

In some situations, that 12 hours a month might even be low. Microsoft Excel is not just spreadsheet software, it is, in fact, a Turing complete programming language. If your employees are not experienced Excel users, then the time required to check Excel files for problems could be even greater. Compare these wasted staff-hours with the return of customized software, which provides increased benefits as your company scales, and the problem of spreadsheet error only intensifies.

Spreadsheets Can Lead to Catastrophe

Big businesses have lost enormous amounts of money because of mishandled spreadsheets. Take for example the 6 billion-dollar loss that JP Morgan Chase incurred during the “London Whale” incident, which experts attribute in part to the improper use of spreadsheets. There are many examples of poor Excel usage leading directly to financial losses, such as this 24-million dollar cut and paste error at Canadian power company TransAlta, as well as others.

According to the white paper, Capitalism’s Dirty Little Secret, by global financial modeling and forecasting company F1F9, 1 in 5 businesses have lost money because of spreadsheets. Any loss due to spreadsheet errors, even the relatively small ones that occur at SMBs, should be considered unnecessary and could easily have been avoided with custom software.

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Custom Business Software Addresses All the Shortcomings of Spreadsheets

There’s evidence that shows as a business grows, it becomes more susceptible to financial losses due to spreadsheet errors. Instead of relying on spreadsheets, with all their inefficiencies and pitfalls, growing businesses must look to custom software and database solutions to provide the reliability and efficiency they need to scale. Let’s look at some of the most important benefits custom software can provide.

1 – Purpose-Built for the Future of Your Business
Software that’s specifically designed to improve the operations at your company does so much better than any off-the-shelf product can. Custom software not only responds to the workflows and business rules of your team, it also simplifies your employee training programs by reducing the number of applications your employees need to learn. These are key points that Excel lacks. Don’t adjust your company workflows or personal habits to suit your software — it should be the other way around.

2 – Empowered Data Discovery
The future of productivity points toward deeper integration between data from mobile, IoT, and cloud applications. Unlike Excel, which requires a great deal of skill to use, and doesn’t provide the power most businesses need, custom software sitting atop a database that’s tailored to your requirements can help tie all those sources together and provide a strong foundation for artificial intelligence and analytics.

3 – Security and Compliance Controls
Excel spreadsheets lack stringent access controls, so once your data is exported to Excel, it’s much harder to ensure proper security. The security weaknesses in spreadsheets can have important compliance ramifications for companies in regulated industries, such as finance or healthcare. In comparison, custom software can be built to meet even the strictest security requirement, ensuring seamless integration with your existing network and compliance controls.

4 – Custom Software is Cost Effective
Mentioning customized software makes people instantly think of expensive enterprise solutions that are available to only the largest businesses, but this is far from reality. Today, custom software solutions are readily available to SMBs and often provide cost savings over per-license commercial software. The software development division of Manhattan Tech Support, Exceed Digital, has developed an innovative payment model that allows companies to purchase software on a monthly subscription basis. Would you like to know more?

NYC’s Custom Software Development Partner

Manhattan Tech Support doesn’t just manage the IT and network infrastructure of businesses throughout greater NYC, we also provide world-class software and database development servicesto businesses throughout the United States.

If you want to streamline the flow of data through your company and empower your team with better, more intuitive software, we encourage you to call us at 646-439-3767. We’re always available to help businesses better understand the software development process, and provide them with the expertise they need to make the transition to custom software a success. We look forward to speaking with you!

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3 Smart Ways To Prevent A Cyber Attack

3 Smart Ways To Prevent A Cyber Attack | IT Support and Hardware for Clinics | Scoop.it

Over half (55%) of small to medium sized businesses were victims of cyber attacks within the last 12 months. That being said, it’s more important than ever for small businesses to stay vigilant and avoid a cyber attack at all costs. Here are just a few expert tips to help your business prevent a cyber attack or security breach.

 

Create And Enforce Internal Security Policies
It may sound surprising, but a great number of business security breaches actually occur within the business itself as opposed to originating from an external threat. Usually, this will occur when an employee clicks on a link in an email that contains phishing software. Other times, employees simply use poor passwords that are easily guessed. That’s why educating your employees and forming clear security policies is the first step to gaining control of your IT security. Keep all employees on the same page regarding password protections and provide quarterly training sessions to keep employees updated with the latest security information.

 

Don’t Ignore Update Requests
Your employees have probably done this before — instead of letting their computers update as usual, they’ll keep delaying the process because it’s just not a convenient time for an update. This can weaken your business’s security and prevents your business from achieving true IT optimization and efficiency. Make sure all your employees are paying attention to their update notifications and are installing and implementing updates as soon as possible after they become available.

 

Consider A Managed Services Provider
In addition to taking the previous two preventative measures, your business should also highly consider investing in reliable IT management such as a managed services model to optimize computer network maintenance and greatly reduce or even effectively eliminate the possibility of a cyber attack. In fact, for 38% of companies of all sizes, enhanced security and compliance was the reason for using a managed services provider. Yes, hiring an IT service provider does require an additional investment, but for many businesses, the peace of mind that accompanies is absolutely priceless — not to mention the money and frustration you may be saving if a cyberattack were to occur.

 

Ultimately, knowing how to keep your business’s IT infrastructure as secure as possible is the key to preventing a cyber attack. For more information about IT service providers, contact Manhattan Tech Support.

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6 Outstanding Applications of AI in Today's Care Ecosystem

6 Outstanding Applications of AI in Today's Care Ecosystem | IT Support and Hardware for Clinics | Scoop.it

Behold the Magic of Intelligent Care Healthcare with Artificial Intelligence

Artificial intelligence (AI) – the smart, cognitive devices of today’s era – has penetrated extensively across all possible verticals – from financial services to manufacturing – and healthcare is no exception. With interest in AI booming exponentially, its scope of application in care-based applications has widened beyond imagination.

 

Reports indicate that the AI-driven healthcare market will see a tremendous growth of almost 40% by the end of this decade. From delivering advanced care-related information to physicians to make informed decisions to personalized real-time treatment, advanced applications of AI in healthcare are indeed revolutionizing care.

 

Let’s check out some of the outstanding applications of AI in today’s care ecosystem.

1. Diagnosis

One of the most advanced applications of AI in healthcare is in disease diagnosis. With AI, machines are supercharged with the ability to analyze voluminous data from medical images, prompting early diagnosis of many disorders. AI provides an easy solution through intelligent diagnostic imaging. This approach has multiple applications in proactive diagnosis of the possibility of stroke, tumor growth, and certain types of cancer, giving the physician the chance to derive a comprehensive treatment plans for patients well ahead of time.

2. Biomarkers

Biomarkers automatically provide accurate visual and audio data of patients’ vital health parameters that indicate the presence of specific medical conditions, help choose the ideal medications, or assess treatment sensitivity. Biomarkers accurately capture symptoms, as against the guesswork of symptoms perceived by patients. The accuracy and speed of biomarkers have made them the preferred tools of diagnosis, promptly highlighting possibilities of any disorders.

3. Virtual nursing assistance

AI -based applications and chat bots support care providers in delivering nursing assistance after discharge from hospital. This feature helps simplify provision of outpatient services and increases the accuracy of monitoring patient compliance post discharge. Available even as simple wearable’s and on smart phones, these AI-enabled devices also act as virtual health assistants that remind patients about their medications, encourage them to follow their exercise routines, answer simple medical clarifications sought by patients, and warn care providers about any untoward incidents such as sudden increase in blood pressure or a fall.

4. Remote monitoring of patients

This involves round-the-clock remote monitoring of patients, constant evaluation of their vital signs, and real-time alerts to caretakers and care providers. This remote assessment of vital health parameters helps physicians identify core symptoms of diseases and disorders in patients and respond accordingly. This approach clearly prevents unnecessary visits to the physician to a great extent.

5. AI and drug discovery

AI-driven computing can accurately and promptly study structures of multiple drug molecules and predict their pharmacological activity, potency, and adverse effects. This possibility opens up a rapid and cost-efficient route of drug discovery. It also has the chance of drastically reducing the cost of medications. Used across pharmaceutical companies, AI-based drug discovery has contributed to supporting the treatment of cancer and neurodegenerative disorders.

6. AI-enabled hospital care

AI simplifies care delivery in hospitals through a wide range of solutions including smart monitoring of IV solutions, patient medication tracking, patient alert systems, nursing staff performance assessment systems, and patient movement tracking within hospitals. Robot-assisted surgeries and AI applications in routine phlebotomy procedures are other potentially useful applications. AI has been found to considerably decrease dosage errors and increase nursing staff productivity in hospitals.

 

Conclusion – the era of AI has arrived in style
With voluminous investments pouring in for AI applications in healthcare, this technology still has a long way to go, despite its presence in healthcare for quite many years now. The main reasons for its slow adoption are the cost of research, the security concerns involved in opening up extensive databases, and misconceptions or errors in coming to quick conclusions. But the quest for ideal AI solutions looks quite promising indeed, with AI supplementing healthcare and improving the quality of care from diagnosis to prognosis.
So, where are you in your journey towards an AI-driven care ecosystem?

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Servers In Medical Centres

Servers In Medical Centres | IT Support and Hardware for Clinics | Scoop.it

Servers in medical centres are a common aspect if IT support & maintenance. Here’s a tip for Healthcare IT Support.

 

Some use a PC which is configured to act as a server, other healthcare organisations would have implemented a professional business grade server to store their medical applications and finally, some use cloud based server which are essentially virtual servers.

 

At some stage in the business’s lifecycle, the network or IT environment begins to slow down, become slightly unreliable and you hear more and more frustrations from the staff.

 

The typical knee jerk reaction will always be to reinvest into a new server and replace the old one. This can be an expensive, complex and frustrating exercise if its not completed by a dedicated healthcare IT professional.

 

In this blog we wanted to share something a little different; some strategies which will make your network more reliable, increase the lifecycle of your server and finally, help you save your money.

 

Our hot tips are:

 

Monthly Server Maintenance
By far the easiest and most important task. The monthly server maintenance can be implemented by your IT provider (or if you are interested, email us and we will give you the steps on how to do it).

The monthly maintenance includes installing all the new server operating system updates, the clinical software updates, updating your antivirus and third party software.

Other tasks include checking your disk space and removing any temporary files, rebooting the server and finally, deleting any unnecessary files in the downloads or documents folder.

This activity will ensure that your server is up to date and the reboot will run all the required servers correctly.

 

Upgrade Your Firmware Every 6 Months
We highly recommend you engage an IT professional for this activity. According to the world’s leading technology vendors, over 90% of hardware reliability issues are due to the lack of updating the machine’s firmware.

 

Firmware is a software product which managed the hardware of your server and it effects the way it behaves. By upgrading the firmware of your server, you are installing the latest updates, fixes and patches which directly relate to your server.

 

Some benefits of firmware updates include a faster server, less over heating, less server lockups and most importantly, a longer lifecycle.

 

Add More RAM & Hard Disk Space
When you purchased your server it would’ve had little load on it. Your staff numbers were limited and back then it didn’t have to support new updates.

 

As your clinic grows and the network requirements become more, your server will begin to feel the load. Its memory is now at full capacity and its working as hard as possible.

 

By upgrading the RAM and hard disk space (if you are not sure how to do it, contact your IT provider OR US), you are essentially giving your server more resources to handle the extra load.

 

This upgrade usually costs about 15% the price of a new server and in turn, saving you more money and giving your network more firepower.

 

Manage Your Backups Correctly
Running a backup is one of the most memory heavy tasks a server can do. A backup can take up all the memory and CPU power. Our strategy is to always ensure that the backup of your server and clinical data is running outside business hours. This way you won’t feel the network on the server.

 

Implement The Right Configurations
A very open term I know however configuring the server in the right way does play a big part on how it behaves when processing data and ensuring that your clinic staff can access their medical applications.

 

A simple example would be implementing an Active Directory role (technical I know however this is important). If your server is setup as an active directory then it can manage and facilitate how the users access the data in a more efficient way.

 

Another recommendation would be to setup your server as DHCP and DNS. This way when you access your clinical applications (Medical Director, Genie, Best Practice etc..) then the network computers can quickly find the server and locate the clinical database.

 

Check The Firewall Settings
Most of the connection issues (speed, reliability) relate to 3 core aspects, the quality of the connection between the computer and the server, the way the server is configured and finally, the way the firewall is configured.

 

Depending on which firewall solution you have in place, it needs to be configured correctly so that it allows undisturbed access to the clinical applications from the clinic’s computer.

 

If the firewall is not configured correctly then you will notice that the network will be slow, so will the server and finally, so will the clinical applications.

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Medical Device Quality: Why Software Is More Challenging Than Hardware

Medical Device Quality: Why Software Is More Challenging Than Hardware | IT Support and Hardware for Clinics | Scoop.it

The U.S. Food and Drug Administration’s (FDA) Quality System Regulation 21 CFR Part 820.30(g) states, “Design validation shall include software validation and risk analysis, where appropriate.” The words, “where appropriate,” indicate that further guidance is necessary to successfully comply with the regulation. FDA’s guidance document, “General Principles of Software Validation,” is an important first read in that regard, but many medical device manufacturers are not sufficiently familiar with it.

 

It is impossible to imagine the medical device industry today without the software revolution. From defibrillators to infusion pumps and robotic surgical systems, a broad range of devices relies on software to function safely and effectively. At the same time, medical device software has introduced a level of complexity that dwarfs anything seen before in the field. This column addresses some basic facts about medical device software and how quality professionals, together with executive management, can work together to ensure that FDA’s rigorous requirements are satisfied.

 

Note that FDA has separate requirements for medical device software and quality system software. This column addresses only the software that is part of a medical device, such as software that triggers an alarm when a product fails. Other software, such as that used by a medical device manufacturer to manage complaints in its quality system, is outside of the scope of this discussion.

 

In October 2017, FDA released two new final guidance documents on the same day: “Deciding When to Submit a 510(k) for a Change to an Existing Device” and “Deciding When to Submit a 510(k) for a Software Change to an Existing Device.” In other words, medical device software changes have so many unique challenges and risks that they earn a guidance document of their own, separate from all other device changes.


The Problem: Software Is Different from Hardware
Validation is at the heart of device design, and the validation of software design is especially challenging. Even though FDA’s guidance document, “General Principles of Software Validation,” was last updated in January 2002, that guidance is still highly relevant and useful. When a medical device incorporates software, FDA expects the manufacturer to be well-read in the guidance document.

 

Furthermore, FDA does not intend the guidance document on software validation to be read only by software developers or quality engineers, as it states, “Software engineering needs an even greater level of managerial scrutiny and control than hardware engineering.” The guidance is written in laymen’s terms, so executive management is not excused from this responsibility, even when they have limited experience in software development.

To get to the heart of the problem, the guidance document on software validation includes the deceptively simple statement: “Software is different from hardware.” Actually, there are many complex differences between software and hardware, and understanding those differences is key to ensuring that software validation will pass FDA muster. The comparison chart (above and on the previous page) is adapted from, and expands on, the FDA guidance.

 

The Solution: Software Validation Driven by Rigorous Requirements


Both of the last two differences in the chart use the phrase, “a clear set of detailed requirements.” This is the most crucial element for proper software validation, and one that is frequently neglected. The flow chart figure on page 20 illustrates how requirements play an early and crucial role in software development.

 

During the phases that developers are coding and testing the software, the requirements enter a tunnel that is closed to non-developers, and the software emerges from the other side as a complete design. The resulting software can support a safe and effective device only if executive management and other stakeholders have reviewed a detailed and unambiguous set of requirements. Quality and regulatory teams can expedite this crucial phase by ensuring smooth communications between engineering and the rest of the organization.

 

At the far end of the tunnel, quality and regulatory conduct the final stages of user site testing with faithful attention to the original requirements. As noted in the list of differences between software and hardware, “user expectations are often unexpected,” and any expectations that were not properly specified as requirements are likely to emerge as errors during testing.

 

Clearly, the future of medical device development is bound up with new advances in software—wearable devices, remote medicine, algorithmic diagnostics, and robotics. FDA expects that manufacturers’ quality systems and design controls will ensure safety and efficacy, even as the software code at the heart of the device remains opaque to executive management. Software design might be more challenging than hardware, but software validation will keep the differences manageable and the quality undiminished.

 

Dan Goldstein is a manager for Quality Assurance at Musculoskeletal Clinical Regulatory Advisors (MCRA), primarily focusing on quality system requirements for bringing new devices to market and keeping experienced manufacturers in compliance with FDA and Notified Bodies. He provides MCRA clients with gap assessments, mock FDA inspections, Form 483 remediations, Design History Files, Technical Files, Summary Technical Documents, and Clinical Evaluation Reports. A graduate of the University of Maryland University College, Dan has worked since 2002 in quality assurance for medical devices, including autologous blood products for wound healing and computer-aided-detection software for lung diseases. Musculoskeletal Clinical Regulatory Advisers LLC has broad experience in the area of software validation. MCRA’s staff is especially adept at promoting and maintaining the lines of communication that keep executive management, the “voice of the customer,” and software developers on the same page with regard to the detailed requirements that drive the development process. The organization believes in requirements that follow the “four Cs”—clear, concise, correct, and complete.

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EHR Hardware Basics in Health IT Guides

EHR Hardware Basics in Health IT Guides | IT Support and Hardware for Clinics | Scoop.it

Hardware Basics for Electronic Health Records

 

Basic Terms


Workstation - This refers to the hardware that holds everything a physician or office staff worker needs to perform their jobs: word processing, practice management software, EHR software, fax software, etc.


Desktop - One of three basic types of workstations. This describes a fixed, hard-wired computer that does not move around. The computer can actually sit on the top of the desk (desktop) or on the floor (tower).


Laptop - One of three basic types of workstations. This is a portable computer that has a keyboard and either a touchpad, stick, or mouse for moving the cursor around the screen. It is a fully functioning computer that can be carried or placed on a cart and moved around the office.


Tablet PC - One of three basic types of workstations. Tablet PCs contain built-in handwriting recognitions software that allows the user to "write" on the screen using a stylus, much as they would write on paper attached to a clipboard. Tablet PCs can have add-on keyboards for instances when typing is preferred.


Desktops


The basics:

 

  • A desktop computer usually has a standard configuration consisting of a CPU, monitor, keyboard, and mouse.
  • It is stationary; it resides in one location and cannot be moved from room to room.
  • It can stand alone or work with any of a variety of network arrangements

 

Advantages:

  • Desktops are low-cost and available from a wide variety of vendors.
  • Because desktop PCs are standardized, it is relatively easy and inexpensive to find spare parts and support, or to replace a machine.
  • Desktops will run just about any software you need.
  • Additional devices such as microphones, speakers, and headsets are readily available at low cost.

 

Disadvantages:

  • Because it's stationary, you need to buy a desktop PC for each room in which you need access to your EHR software.
  • Desktops typically take up more space than a laptop or tablet PC. While flat screen monitors and tower units save actual desktop space, the standard desktop computer requires more room than either a laptop or tablet PC.
  • You must purchase additional equipment to take full advantage of voice recognition and/or handwriting recognition programs.

 

What your peers have to say:
"Have had wired computers [desktops] in the exam room since 1998 and think it is the best way. I find it less hassle than carrying a computer around all day, worrying about batteries running out or losing wireless connectivity or dropping the computers. The computers are much cheaper both to buy initially and fix if something does happen. Tried a tablet but did not like it all. Never had a problem with children or adults interfering with the computer in the examining room and if you log out when you leave, HIPAA is not an issue."
-- Keith Stafford, MD, Greenville, South Carolina


Laptops


The basics:


A laptop is a fully functioning computer that is small enough to be portable. Laptops can take advantage of wireless as well as traditional networks. A laptop can easily serve as a desktop machine and can connect via a docking station to a larger monitor and a standard keyboard.

 

Advantages:

  • A laptop has a smaller footprint and can easily be turned to allow patients to view information on the screen.
  • A laptop is less obtrusive during patient interviews.
    Most have fairly long battery life and/or an A/C adaptor.
    Laptops use standard PC inputs such as keyboard and mouse and/or touchpad.

 

Disadvantages:

  • Although laptops are portable, they can be heavy to carry, typically weighing five to eight pounds.
  • Repairs and maintenance tend to be more expensive because laptops use non-standard or proprietary parts. You may have to send a laptop off-site for diagnosis and repair.

 

What your peers have to say:
"

  • We work wirelessly with laptops. All [prescriptions] print from one central printer right outside the exam rooms. Benefits of laptop:
  • Can open the note and chart before entering the room and bring up appropriate templates. Can enter the room already knowing what HM is late and what the purpose of the visit is.
  • Can close the note right outside the room if you want to go ahead and have the patient leave before finishing a note.
    Can see with bifocals; no neck strain.
  • Can have all my personal settings and programs handy all the time - PDR, links, hospital links, etc.
  • Can look at patient easily over the top of the laptop and can easily show patients what I'm doing.
  • Touchpad is always in the same place in relation to keys; easy to switch from it to typing or tabbing without looking. I like having a full size keyboard.

 

"I'm hooked on my laptop and am so accustomed to carrying it around that I don't even notice even though it is Dell's heaviest one."
-- Sue Andrews, MD, Murfreesboro, Tennessee

 

Tablet PCs


The basics:
There are two main types of tablet PCs: a slate tablet PC, which is a tablet with no attached keyboard (although one can be added), and a convertible tablet PC, which is basically a laptop computer with a screen that can swivel and fold onto the keyboard to create the tablet.

 

Advantages:

  • Tablets are truly portable and lightweight, typically weighing three to four pounds.
  • It is as powerful as a PC, but it doesn't require a keyboard. Instead, you add information by writing on the screen with a digital pen or stylus, much like you do in a paper chart.
  • Handwriting recognition software developed for tablet PCs is excellent, even for very poor handwriting.
  • Tablet PCs have integrated dictation capability with voice recognition software that transcribes directly into the patient record.


Disadvantages:

  • Writing with a stylus takes getting used to; there is a longer learning curve in adapting to a new way of using a computer.
  • Handwriting recognition dictionaries have not yet fully integrated medical terminology and acronyms, requiring more correction.
  • There is not as much standardized software yet available for tablets.
  • Screens are easily scratched and can become unusable without screen protectors purchased at additional cost.

 

What your peers have to say:
"I have been using a Gateway tablet in the room with my OB patients for the past two years. We use an ASP prenatal record called eNatal. I wouldn't trade for it. It has three methods of entering data on the screen, all vastly improved with the SP2 for Windows XP for Tablet.

 

"The first method is through tapping on a screen-based keyboard with the stylus (slow but very accurate). The second is through straight handwriting recognition. I have relatively poor handwriting, but it is amazing how accurate and fast this is! The only thing that seems to trip it up is some abbreviations, acronyms, or words that it can not find in the dictionary. The third option is a letter-by-letter handwriting recognition panel that is slower but extremely accurate.

 

"We've had no downtime. The wireless connection works well. The battery life is good (I plug it into the docking cradle between OB patients). We have used laptops and desktops for eNatal in the rooms and the tablet works best by far. As we look to add a full EMR, we hope to use a tablet-based system, probably the Motion Computing tablets with the biometric (fingerprint) access."
-- G. Jeffrey Young, MD, FAAFP, Levelland, Texas


Using EHR technology require a certain adjustment in the way you're used to interacting with your patiens and their charts. Deciding how to do this in the way that makes you the most comfortable will help guide your choice of hardware -- e.g. using a desktop, laptop, or tablet PC.

 

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In Situ Cured Silicone Could Enable Personalized Implants

In Situ Cured Silicone Could Enable Personalized Implants | IT Support and Hardware for Clinics | Scoop.it

Medical-grade silicone is a highly valued, versatile biomaterial widely used for medical implants. Often associated with applications such as cardiovascular pacemakers, cochlear implants, hydrocephalus shunts, implantable infusion pumps, and even intraocular lenses, silicones began to be used for a broad range of orthopedic medical applications beginning in the 1960s. The idea of replacing the small joints of the hand with silicone implants was first introduced by Swanson about 50 years ago.1 Since then, medical-grade silicone elastomer implants have become common in the replacement of diseased small joints. Typically, silicone elastomers are used to fabricate components of devices or entire devices, which are then assembled, packaged, and sterilized prior to implantation via surgery. Now, new dispensing technology serves as a means to provide an alternate method of surgical implantation, where uncured pre-sterilized silicone can be provided as a part of the surgical kit and cured in situ during the orthopedic procedure.

 

Benefits and Innovation
Silicone provides a diverse range of characteristics that make it useful, with properties ranging from very sticky to very slippery, and from soft and pliable to stiff or rigid. Consequently, it is very attractive for different medical uses, such as molded parts or lubricious coatings for medical devices; soft silicone adhesives for wound care; soft tissue implants; and even high-modulus tubing.

 

Device manufacturers often choose silicone for its established pedigree of biocompatibility, unique physical properties, and its ability to be altered at the polymer level. This ability to let manufacturers custom-modify material properties to satisfy specific medical device requirements has given silicone a reputation as a high-technology biomaterial that invites innovation.

 

Innovation in silicones, however, is expanding beyond the properties of the biomaterial itself. A new development in sterilizable dispensing systems allows sterile, uncured silicone elastomers to be considered for therapeutic use in orthopedic and other applications where pre-formed silicone implants are traditionally used. By enabling the silicone to be cured to its final form in situ within the specific area in the body receiving the implant, new approaches to orthopedic device design, fabrication, and implantation have the potential to be developed.

 

Medical-Grade Silicones: Value for Implantable Devices
To explore the value of in situ cured silicone elastomers in orthopedic applications, it’s helpful to examine some key traits and performance considerations that make silicone particularly appealing for implants.

 

Biocompatibility: Medical-grade silicones have been proven to be chemically stable for use in long-term implantable devices, with results demonstrating that biocompatible silicones are not harmful to living tissue.

 

The biomaterials supply crisis of the early 1990s presented a significant testing and documentation challenge for medical device manufacturers. There was a need to provide exhaustive safety data to obtain the regulatory approval required to market their products. Silicone especially, as the primary material from which breast implants are made, received intense evaluation. As a result, more than two decades of laboratory and clinical research and experience with silicone-containing medical devices of all types has produced thousands of peer-reviewed articles, as well as carefully considered regulatory decisions. These findings validate the safety and biocompatibility of implantable devices manufactured with silicone.

 

Customization: Silicone-based implanted orthopedic devices have multiple therapeutic applications, whether for finger joints or even spinal repair. Depending upon how it is used, each device has unique physical property requirements, such as firmness, cushioning ability, or flexibility. The advantage of silicone is its ability to be highly customized, so the desired properties such as elasticity, fatigue resistance, and durometer can be formulated for the appropriate functionality in a device.

 

Durability: Cured silicone retains its properties over long periods of time. This is especially useful in applications such as finger joint replacement, where the elasticity of the moving joint is a key characteristic. In long-term implantable applications, whatever balance of elasticity or firmness the device manufacturer specifies needs to be sustained over the life of the implant.

 

Curability: To fully leverage the properties of silicone, the material must be cured to activate these properties and make the material chemically stable. A widely used method for curing silicone is platinum-catalyzed addition cure. With this method, a platinum-based catalyst is included in the silicone formulation to activate crosslinking. Depending upon the final application, the silicone can cure to be relatively flexible or very hard. Platinum-catalyzed, addition cure chemistry is frequently chosen for implanted medical devices because there are no catalyzation byproducts; all formulation components are chemically bonded in the polymer matrix. Another benefit is the platinum catalyzation allows for flexibility in controlling the cure rate over a wide range of time and temperature.

 

Benefits of In Situ Cured Silicones in Orthopedics
The distinctive features of silicone offer tremendous potential value for therapeutic orthopedic applications. For example, they can create a seal, fill a void, provide cushioning, or enable flexibility. These types of applications can perform best when they fit the anatomy of a patient.

 

Until recently, silicone orthopedic devices were typically produced, cured, and sterilized prior to surgical implantation. However, the advent of silicone that can be cured in situ at the site of the implant is appealing for several reasons. In situ curing of medical-grade silicones in the body, rather than fabricating the device outside the body and implanting it, increases the ability to customize the fit of implanted orthopedic devices, since it is more of a “real-time” implant. In fact, research has already been conducted on the use of in situ-cured silicones in spinal applications. In vertebral repair, for example, it is conceivable that in situ-cured silicone could enable a custom-fit device. Using in situ-cured silicone implants also opens possibilities for less invasive implantation procedures. In addition, customization of in situ-cured silicone enables the material properties to be “tuned” in accordance with specific therapeutic requirements. For example, viscosity can be defined to make in situ implantation and curing easier to accomplish. The cure time can be tuned, so that the silicone cures in situ at body temperature. Moreover, the final physical properties of the material can be precisely defined to provide the desired performance, such as a specific level of hardness, if the orthopedic application is to support; or softness, if the orthopedic device is meant to cushion.

 

Sterilizing Silicone for Implants
As the industry reviews the potential for versatility and usefulness of in situ-cured silicone materials for orthopedic implants, another key factor to consider is sterilization. In order to be implanted, devices pre-fabricated with medical-grade silicones must be sterilized—so an efficient and fully verifiable sterilization solution is necessary.

 

The traditional method for producing silicone orthopedic devices uses a multi-step process. Although methods vary between manufacturers, most implants are molded from liquid silicone, which is then cured. This cured, molded part is typically placed along with other devices used for a specific therapeutic application into a single package or tray, which is then sealed and sterilized before it is delivered for use with a patient.

 

A number of processes can be used to sterilize uncured silicone. However, these processes have had challenges in the past with sterilization of platinum-catalyzed, addition cure silicones in their uncured state.

 

  • Gamma and electron-beam irradiation: May cause premature cure
  • Dry heat and autoclave: May be detrimental for heat- or moisture-sensitive formulation ingredients and packaging components

 

Exposing the silicone to ethylene oxide (EtO) gas is a widely used and effective sterilization method when used with compatible packaging to allow for ingress and egress of the sterilant gas. The implant is typically packaged along with the other components in the orthopedic surgical kit and sterilized as a single unit.

This process works for implants that are fabricated and cured prior to implantation. However, a technical challenge often faced by silicone manufacturers is how to package uncured silicones, so they can be sterilized then later used for in situ-cured therapeutic treatments.

 

New Packaging Enables Sterilization
Designed specifically to allow sterilization of uncured medical grade silicones, a new innovation in silicone dispensing systems makes in situ-cured silicone implants for orthopedics possible.

This novel, patented system2 features a dual-cartridge prefilled dispensing system. One cartridge contains the uncured silicone while the other contains the catalyzing agent. Each cartridge has a gas-permeable plunger seal that allows EtO sterilant gas to permeate through the plunger seal to sterilize the contents of the cartridge.


Key features of the packaging system include:

  • Disposable syringes that are available in a variety of sizes—5.0, 10, 25, 50, and 75 mL—which offers choices to help match the needs for the specific quantity of material required
  • One-step sterilization of both the material in the cartridge and the packaging
  • Easily adaptable to a variety of injection technologies
  • Engineered for use in complete surgical kits

 

Testing of this two-part dispensing system demonstrated that, after sterilization, the uncured silicones were fully sterilized, and there was no residual EtO remaining in the material. Equally important, there was minimal change to key silicone physical properties, such as rheology, durometer, modulus, work time, and cure rate.

 

Thus, the highly valued material properties of silicone—and the increased versatility and custom-fit capabilities offered by in situ curing of silicone—are now more viable through a dispensing system that can be efficiently and effectively sterilized prior to the orthopedic procedure.

 

The development of a new patented dual-cartridge prefilled silicone dispensing system makes in situ silicone curing a practical reality, offering the orthopedic community the potential to explore new therapeutic approaches that provide better outcomes to meet the implant needs of patients.

 

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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