IT Support and Hardware for Clinics
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News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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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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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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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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The dangers of autocomplete passwords

The dangers of autocomplete passwords | IT Support and Hardware for Clinics | Scoop.it

Hackers have found a new way to track you online. Aside from using advertisements and suggestions, they can now use autocomplete passwords to track you down. Feeling insecure? Here are some ways to keep you out of harm’s way.

Why auto-fill passwords are so dangerous

As of December 2018, there are 4.1 billion internet users in the world. This means users have to create dozens of passwords, either to protect their account or simply to meet the password-creation requirements of the platform they’re using. Unfortunately, only 20% of US internet users have different passwords for their multiple online accounts. 


Certain web browsers have integrated a mechanism that enables usernames and passwords to be automatically entered into a web form. On the other hand, password manager applications have made it easy to access login credentials. But these aren’t completely safe.


Tricking a browser or password manager into giving up this saved information is incredibly simple. All a hacker needs to do is place an invisible form on a compromised webpage to collect users’ login information.

Using auto-fill to track users

For over a decade, there’s been a password security tug-of-war between hackers and cybersecurity professionals. Little do many people know that shrewd digital marketers also use password auto-fill to track user activity.

 

Digital marketing groups AdThink and OnAudience have been placing these invisible login forms on websites to track the sites that users visit. They’ve made no attempts to steal passwords, but security professionals said it wouldn’t have been hard for them to do. AdThink and OnAudience simply tracked people based on the usernames in hidden auto-fill forms and sold the information they gathered to advertisers.

One simple security tip for today

A quick and effective way to improve your account security is to turn off auto-fill in your web browser. Here’s how to do it:

  • If you’re using Chrome – Open the Settings window, click Advanced, and select the appropriate settings under Manage Passwords.
  • If you’re using Firefox – Open the Options window, click Privacy, and under the History heading, select “Firefox will: Use custom settings for history.” In the new window, disable “Remember search and form history.”
  • If you’re using Safari – Open the Preferences window, select the Auto-fill tab, and turn off all the features related to usernames and passwords.

This is just one small thing you can do to keep your accounts and the information they contain safe. 

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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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Cloud Computing Supports Telemedicine Growth

Cloud Computing Supports Telemedicine Growth | IT Support and Hardware for Clinics | Scoop.it

Today’s healthcare professionals enjoy convenient access to a multitude of tools that would have amazed previous generations. Unfortunately, lack of awareness or access to technical experts means that many practices are unable or unwilling to take advantage of the latest technological advances, advances that increase efficiency, security and productivity. Others are intimidated by the technical jargon often associated with eHealth. All that is needed to eliminate all these issues is a partnership with a provider that specialises in the health industry, rather than deal with IT companies that are themselves unwilling to recommend healthcare-specific solutions that they are unfamiliar with.

 

Providers of healthcare solutions are familiar with the inner workings of practices and clinics and can easily review existing processes and recommend solutions that will integrate technology in the best possible manner. They will also support any new technological solutions, leaving medical professionals more time for patient care, which will ultimately provide substantial benefits that aid early diagnosis and prolong lives.

 

Providers without healthcare knowledge will recommend solutions that they are familiar with, ones that are normally selected by traditional commercial enterprises. Such solutions are generally unsuitable for healthcare clinics and practices and often require expensive customisation, assuming that they can even be customised sufficiently to meet existing regulations.
Smaller clinics and practices do not have an on-site IT team and often eliminate IT requirements by automating server maintenance, data backups and archiving using a cloud solution. In such a scenario, it is the provider that is responsible for all of these activities.

 

Telemedicine allows easier collaboration and involves the use of mobile or other internet-enabled devices. Advantages include instant videoconferencing, remote consults, immediate access to electronic health records and the elimination of geographical issues, where patients are unable to visit the practice or clinic in person. These collaborative features are used between medical teams in multiple locations, between mobile clinics and their headquarters and of course can be used by any medical professional on the move.

 

When cloud services are used, connectivity is possible from anywhere a broadband signal is present, whether to a PC or portable device. This is ideal for patients in remote are rural areas and eliminates the time and expense necessary to consult with a specialist in the traditional manner. With videoconferencing, for example, no travel is required yet an excellent service is provided by the healthcare professional involved. Even follow-ups are possible online. Security concerns are also eliminated as a travelling professional accesses data remotely and never stores it on their own personal devices.

 

There are additional cloud benefits for healthcare professionals and these include:


• Scalability – you pay for the amount of space you use and it can be increased on demand


• Automatic updates – the provider’s IT team install security patches promptly


• Disaster recovery – automated regular backups take place and are restored when active data is lost


• Redundancy – multiple broadband connections are available. When one fails, another takes over


• Flexibility – if additional bandwidth is needed, it is readily available. This is not possible with traditional networks


• Works from anywhere – an internet-ready device, a 3G or broadband connection and you are good to go


• Collaboration – depending on requirements, there are specific software applications available to aid collaboration between team members and patients


• Document management – a single document repository allows secure and controlled access to confidential information


• Security – the use of the cloud ensures data is never stored in portable devices, given that thousands are lost or stolen every year

 

• Green-tech – the carbon footprint for each practice or clinic is substantially reduced, with cloud servers using less power per client due to virtualisation technology


• Cost savings – every clinic and practice uses the latest in hardware and software technology but without the initial investment. Ongoing IT maintenance costs are also dramatically reduced

 

When it comes to telemedicine, in addition to data management and document control features, there are software applications available that maximise patient turnover per clinic, improve patient care and even improve follow-up treatment and remote monitoring processes.

 

With benefits of this magnitude and with evolving regulations to embrace technological advances in eHealth, clinics need to install a telemedicine solution sooner rather than later or give competitive advantage to those that adopt now. This is especially true if patients and colleagues are in other geographical areas. In fact, government services are already active for eligible aged-care homes and to patients of Aboriginal Medical Services throughout Australia.

 

 

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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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Why Firms Of All Sizes Need To Outsource? 

Why Firms Of All Sizes Need To Outsource?  | IT Support and Hardware for Clinics | Scoop.it

I was working as a product development engineer at AcroMed (a spinal implants manufacturer that was acquired by DePuy in 1998), when I noticed a gap in the medical device industry. There were plenty of companies coming up with great ideas for devices, but there were holes in the product development cycle thanks to a lack of resources or expertise.

 

That’s when I decided to grab a shovel and start filling some of those holes. First came Empirical Testing Corp. (ETC), which focused on testing devices. It was all we did, so we got good at it over the course of 20 years. Through ETC, we heard from clients who needed small-batch manufacturing and prototyping, so we launched Empirical Machine. Clients came to us for regulatory support through both of those specialty companies, so we added Empirical Consulting to our group of companies. Each branch of our corporate family tree developed as an answer for companies or individual developers lacking a critical in-house resource.

 

For companies large and small, outsourcing specific aspects of device development builds forward momentum and supports the entire industry.

 

Andy Fauth is an engineer by training. For 13 years, he’s worked in a private-equity, privately owned business he says owes its growth to finding the right vendors. He’s now chief technology officer for SMV Scientific, a company that specializes in the bone-implant interface and designs, develops, and manufactures orthopedic devices. The company began as a two-person research and development venture four years ago and has grown into a 17-person business with three devices on the market and six 510(k)s completed.

 

“As an emerging company, we don’t have the capital to have the equipment internally or hire everybody we’d like to hire for the right way to handle this stuff,” he said. “The only way we could incubate this company and grow was to outsource.”

 

Even for larger companies, it often makes sense to outsource specific parts of device development, he said.

 

“There’s always a bottle neck somewhere—that’s why there is an outsource market,” Fauth said. “Some of that stuff is specialty. When you’re going to do it once every couple of years, you don’t want to do that internally. There’s always specialty equipment, whether it’s a test frame or test fixture or experience with a certain protocol you don’t have in-house, or don’t want to invest in having that in-house long-term. You just need to use it once and check the box.”

 

Raymond Cloutier, vice president, Engineering & Development, Advanced Technologies at Exactech, said despite significant resources and commitment to Exactech’s in-house resources, he also turns to outside vendors for specialized support. Sometimes it’s an issue of capacity, but he also appreciates the benefits of outside expertise.

 

“[Outside vendors] are in a somewhat privileged position,” he said. “They’re also doing work for other companies, which helps them know the benchmark or industry standard. Sometimes when we’re in our own world as a company, we don’t have as much understanding of how requirements should be interpreted. An outside consultant may better understand what expectations, for example, the FDA may have. Suppliers generally have seen how multiple companies prepare submissions.”

 

He said bigger companies may, at times, err on the side of being overly cautious.

 

“Oftentimes large companies take very conservative positions because they have a lot at stake,” Cloutier said. “The question is, are they being ‘overly compliant’? Are they doing things more rigidly than what the external regulatory bodies require? Sometimes an outside perspective helps you better know the answer to that.”

 

David Poirier is founder and owner of spinal implant company Presidio Surgical, which has a staff of eight. He keeps quality control, marketing, sales, distribution, and accounting in-house, but the bulk of his device development work depends on outside vendors.

 

“Everything we do, we pay for through sales and distribution of our products,” Poirier said. “They have to be right. There’s really no room for error. We’ve made errors. They hurt.”

 

At first glance, it may appear outsourcing is more expensive than keeping things under your roof. But those numbers can be misleading. You may pay $200 per hour to a single vendor—which is often more than an employee’s hourly wage—but you’re not paying benefits or down time when the employee is not actively engaged on the project, Poirier said. There’s also a matter of prioritizing in-house expertise to make the best use of time and money, he said.

 

“If I take someone in quality engineering and say, ‘I need you to work on this gauge design,’ my project may have a mid-level priority, but I’ve taken them from a much higher-level project; there’s an opportunity cost,” Poirier said. “There’s the cost of the benefits and true cost of employees, then the opportunity cost. It’s a general management issue you have to think about. With consultants, you’re only paying them for what they deliver instead of the full cost (of an employee).”

 

Paying for support a la carte is less expensive than developing that service for your business, Poirier said.

 

“I only pay them for the work they do,” he said. “When you’re outsourcing, it can be a benefit if you have really good experts. You’re paying them for what you want and get what you need. You’re paying for specific service rather than a staff member. It’s hard to find good people.”

 

Working with consultants who are well-known in the industry has its advantages, Fauth said.

 

“Just to get the expertise for third-party validity for our customers, we’d outsource,” he said. “We actually had to challenge and re-invent new standards. We worked with the FDA to develop protocols and standards that didn’t exist at the time. When you have an outsource company that’s done all of that already and has a reputation of being a good firm, it lends a lot of credibility and merit to what you’re trying to do.”

 

Word-of-mouth referrals and networking are solid first steps toward finding the partner.

 

“Reputable is the key,” Cloutier said. “One test that gives me an indication is how careful they are at protecting other companies’ knowledge. If they share confidential information from other companies with you, then they’re probably sharing your confidential information with others. Observing this helps me judge who is a trustworthy supplier to work with and who isn’t.”

 

And even as you consider outsource options for aspects of your project, never forget the big picture, Fauth said.

 

“I look at anybody we interact with as a potential partnership, not just a customer/supplier relationship,” he said. “If something goes bump in the night, I want everyone equally committed to fixing it.
I also want it to be a win for both parties. That’s the right way to do business long-term. It’s not always about price or lead time. Those are factors. It’s also about quality, it’s about trust, it’s about faith they’re going to make it right if something goes wrong and everybody’s going to work for everybody else’s best interest.”

 

Dawn Lissy is a biomedical engineer, entrepreneur, and innovator. Since 1998, the Empirical family of companies (Empirical Testing Corp., Empirical Consulting LLC, and Empirical Machine LLC) has operated under Lissy’s direction. Empirical offers the full range of regulatory and quality systems consulting, testing, small batch and prototype manufacturing, and validations services to bring a medical device to market. Empirical is very active within standards development organization ASTM International and has one of the widest scopes of test methods of any accredited independent lab in the United States. Because Lissy was a member of the U.S. Food and Drug Administration’s Entrepreneur-in-Residence program, she has first-hand, in-depth knowledge of the regulatory landscape. Lissy holds an inventor patent for the Stackable Cage System for corpectomy and vertebrectomy. Her M.S. in biomedical engineering is from The University of Akron, Ohio.

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EMPOWR Porous And Complex Primary Knee Systems

EMPOWR Porous And Complex Primary Knee Systems | IT Support and Hardware for Clinics | Scoop.it

DJO, a provider of medical technologies designed to get and keep people moving, introduced the EMPOWR Porous Knee System and EMPOWR Complex Primary Knee System at the 2018 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS). These new additions to the EMPOWR Knee Platform expand one of the industry’s most modern total knee replacement systems, which now offers primary, cementless primary, complex primary, and tibial revision solutions for surgeons and patients.

EMPOWR Porous Knee System is based on two decades of clinical experience and highly porous materials designed to enhance early implant fixation, while creating an ideal environment for both immediate and long-term biologic fixation.1 DJO’s surface coating technologies, including DJO’s proprietary, highly porous coating, P2 aids in bone apposition for superior in-growth performance.1 EMPOWR Porous’ bladed keel has a bone sparing geometry optimized for cementless application.2 The bladed keel of the asymmetric baseplate was developed to provide robust fixation, while the cruciform pegs provide initial component fixation and durable rotational stability.2

EMPOWR Complex Primary Knee System, with the EMPOWR Universal Tibial Baseplate and EMPOWR Varus Valgus Constraint (VVC) Tibial Insert expand the utility of the EMPOWR Knee Platform and provide a wider range of solutions for complex primary and revision knee arthroplasty. These new implant technologies are designed to provide an efficient and seamless transition from standard primary to revision knee procedures, with a minimal number of additional instruments and trays. The EMPOWR Universal Tibial baseplate maintains the EMPOWR System’s characteristic asymmetric footprint which maximizes cortical coverage and prevents component overhang to ensure long-term fixation without tissue irritation4. This baseplate also provides the ability to stem and augment when more supplementary fixation is required. The VVC insert is offered in e+ polyethene, formulated to reduce long-term wear3, while the insert is designed to provide the necessary support and stability in knees with supportive soft tissue deficiencies.

“DJO has a proven record of bringing high-quality products to market with incredible cadence—faster than any other implant company today,” said Dr. Eugene S. Krauss, an orthopedic surgeon with Northwell Health. “In 2018 alone, the EMPOWR Porous Knee and EMPOWR Complex Primary Knee launches have significantly expanded our ability to treat a wide variety of patients in our practices.”

“The efficiency of DJO’s instrument trays and the streamlined instrumentation enables my surgical team and I to perform up to 12 knee replacements in a single day, making the system well-suited for both hospital and ambulatory surgery center environments,” said Dr. Krauss.

Over the past decade, the science of highly porous metals, including DJO’s P2, has significantly advanced, helping to improve implant longevity and ultimately patient outcomes. These scientific advancements coupled with a younger, healthier patient population, have resulted in a resurgence of cementless knee arthroplasty. Therefore, the contemporary design of the EMPOWR Porous Knee, is certain to have a meaningful impact on the market.

“DJO Surgical’s strong growth over the past few years is a reflection of our commitment to developing products and solutions that help improve clinical outcomes and enhance patient experience,” said Jeffery A. McCaulley, Global President of DJO Surgical. “Our continued expansion of the EMPOWR Platform reflects the overwhelmingly positive reaction we’ve received from surgeons and patients since the first EMPOWR Knee System was launched here at AAHKS in 2015.”

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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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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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3 Common Technology Problems and How to Solve Them

3 Common Technology Problems and How to Solve Them | IT Support and Hardware for Clinics | Scoop.it

We know that businesses struggle to keep their IT in optimal working condition. While some problems take the skilled hand of an expert to fix properly, many other issues are easier to deal with internally, but still, go chronically unaddressed. Here are some of those problems, and tips for how to deal with them.

Problem 1 – Inconsistent or Lackluster Email Security

Did you know that 92.4% of all malware is delivered via email? That’s from Verizon’s 2018 Data Breach Investigations Report. Not only is email an effective means for hackers to send you malware, but it’s a successful one too. The same Verizon report found that people in the U.S open 30% of all phishing emails, with 12% of people even clicking on the link inside the email.

 

These statistics point to a two-sided problem. Hackers know that email is a great way to get into your company, and employees are still not being cautious enough about their email usage. So, what’s the best way to help secure your email system against compromise?

 

  • Enable Two-Factor Authentication (2FA)
    This is the easiest measure to take. Two-factor authentication provides an extra layer of security that goes beyond just simple username and passwords. It requires that users verify their identity with a code sent to an authorized device (usually a cell phone), which can go a long way to keeping unauthorized users out of business email accounts. Unfortunately, 2FA adoption remains stubbornly low at businesses, despite the greatly increased security that it provides. One of the reasons holding 2FA back is that there are several different versions available, including SMS/mobile based solutions, physical keys, app-based models, and others.

 

There are advantages and disadvantages to each of these methods, so pick a 2FA model that meets the specific security and compliance needs of your organization.

 

  • Teach Employees Email Best Practices
    According to recent data from Wombat Security, 30% of employees in the U.S. don’t even know what phishing is. That’s a big problem, as your team is the first line of defense against email-delivered cyber threats.

 

Teach your employees how to defend themselves. Go over the basics, such as poor grammar, incorrect spelling, suspicious email addresses, and other phishing red flags. Company policies against bad habits, like leaving email accounts open when you’re away from your desks, can also be very helpful. You may even want to give your staff the occasional quiz to ensure that they’re aware of the most important threats, and to educate them in a fun and memorable way.

 

Have you implemented email encryption or malware scanning for your email attachments yet? If not, those are two technical measures you can take to improve email security quickly. You may also want to think about enforcing an email retention policy. Regularly deleting emails is a best practice that’s often a vital part of maintaining regulatory compliance.

Problem 2 – Poor IT Vendor Management

According to this survey from the Tech Republic, 57% of companies say that they’re spending more time managing their IT vendors than just two years ago, driven by the growing interest in cloud computing, SaaS, and cybersecurity services. IT vendor management is crucial to helping you deliver positive IT outcomes and control the cost of these services.

 

Engage company stakeholders and subject matter experts to form a workgroup to manage your vendors. While each vendor management process will differ, you’ll want to centralize all the related information, including contracts and related documents into one data repository. This body of information will help you evaluate your IT vendors to ensure they’re still a good fit for your needs, as well as negotiate future contracts.

 

From a cybersecurity point of view, you’ll also want to create a security risk profile for each vendor. As the number of vendors your company uses grows, so does the difficulty of maintaining strong security. According to PwC, 74% of companies do not have a complete inventory of the third parties that handle personal employee or customer data, a glaring oversight that your vendor management team should seek to rectify.

 

Proper IT vendor management is critical to any compliance efforts, meaning that this work must be handled with great care in regulated industries like finance and healthcare. In these cases, you’ll likely need the help of a trusted technology partner.

Problem 3 — Poorly Secured Workstations

Cybersecurity is a big, very important topic, which we’ve written a white paper on. One area of security where we’ve noticed many businesses fall short is in securing their workstations.

 

On any given day, a workstation may get used by several different employees or teams. Because they often hold valuable data that’s directly related to your productivity, these computers must be held to a higher standard of security than your average PC or mobile device.

 

  • Employ Stronger Passwords
    81% of hacking-related data breaches involve a compromised Because passwords are all that separate your workstation data from a malicious outsider (or insider), you’ll want to make sure that all your passwords adhere to the current best practices — which are constantly evolving. Did you know, for example, that mixing upper-case and lower-case letters are no longer seen as the best way to create a strong password? In fact, the man who came up with that idea in the first place now regrets ever saying it. Instead, combine 3 or 4 unrelated English words and sprinkle a number or two in for good measure. This provides a much stronger foundation for a secure workstation.

 

  • Secure Administrator Accounts and Privileges
    Administrator accounts have the ability to move data around your computer network in ways that standard user accounts can’t. This makes them attractive to interlopers, who will do whatever they can do to gain administrator access, like social engineering. Start by making sure that all default passwords have been changed and are different on each of your workstations. Using the same passwords on any two workstations could cause problems, by encouraging a successful hacker to move laterally through your network. While you’re at it, make sure that your admins aren’t using their administrator accounts for their daily work. This is another easy fix, but we see it all the time. Having your administrators use a separate account for non-administrative duties will help ensure that if their regular account gets compromised, the account with the privileged access remains secure.
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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.

Technical Dr. Inc.'s insight:
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3 Common Technology Problems and How to Solve Them

3 Common Technology Problems and How to Solve Them | IT Support and Hardware for Clinics | Scoop.it

We know that businesses struggle to keep their IT in optimal working condition. While some problems take the skilled hand of an expert to fix properly, many other issues are easier to deal with internally, but still, go chronically unaddressed. Here are some of those problems, and tips for how to deal with them.

 

Problem 1 – Inconsistent or Lackluster Email Security

Did you know that 92.4% of all malware is delivered via email? That’s from Verizon’s 2018 Data Breach Investigations Report. Not only is email an effective means for hackers to send you malware, but it’s a successful one too. The same Verizon report found that people in the U.S open 30% of all phishing emails, with 12% of people even clicking on the link inside the email.

 

These statistics point to a two-sided problem. Hackers know that email is a great way to get into your company, and employees are still not being cautious enough about their email usage. So, what’s the best way to help secure your email system against compromise?

  • Enable Two-Factor Authentication (2FA)
    This is the easiest measure to take. Two-factor authentication provides an extra layer of security that goes beyond just simple username and passwords. It requires that users verify their identity with a code sent to an authorized device (usually a cell phone), which can go a long way to keeping unauthorized users out of business email accounts.Unfortunately, 2FA adoption remains stubbornly low at businesses, despite the greatly increased security that it provides. One of the reasons holding 2FA back is that there are several different versions available, including SMS/mobile based solutions, physical keys, app-based models, and others. There are advantages and disadvantages to each of these methods, so pick a 2FA model that meets the specific security and compliance needs of your organization.
  • Teach Employees Email Best Practices
    According to recent data from Wombat Security, 30% of employees in the U.S. don’t even know what phishing is. That’s a big problem, as your team is the first line of defense against email-delivered cyber threats.

Teach your employees how to defend themselves. Go over the basics, such as poor grammar, incorrect spelling, suspicious email addresses, and other phishing red flags. Company policies against bad habits, like leaving email accounts open when you’re away from your desks, can also be very helpful. You may even want to give your staff the occasional quiz to ensure that they’re aware of the most important threats, and to educate them in a fun and memorable way.

 

Have you implemented email encryption or malware scanning for your email attachments yet? If not, those are two technical measures you can take to improve email security quickly. You may also want to think about enforcing an email retention policy. Regularly deleting emails is a best practice that’s often a vital part of maintaining regulatory compliance.

Problem 2 – Poor IT Vendor Management

According to this survey from the Tech Republic, 57% of companies say that they’re spending more time managing their IT vendors than just two years ago, driven by growing interest in cloud computing, SaaS, and cybersecurity services. IT vendor management is crucial to helping you deliver positive IT outcomes and control the cost of these services.

 

Engage company stakeholders and subject matter experts to form a workgroup to manage your vendors. While each vendor management process will differ, you’ll want to centralize all the related information, including contracts and related documents into one data repository. This body of information will help you evaluate your IT vendors to ensure they’re still a good fit for your needs, as well as negotiate future contracts.

 

From a cybersecurity point of view, you’ll also want to create a security risk profile for each vendor. As the number of vendors your company uses grows, so does the difficulty of maintaining strong security. According to PwC, 74% of companies do not have a complete inventory of the third parties that handle personal employee or customer data, a glaring oversight that your vendor management team should seek to rectify.

Proper IT vendor management is critical to any compliance efforts, meaning that this work must be handled with great care in regulated industries like finance and healthcare. In these cases, you’ll likely need the help of a trusted technology partner.

Problem 3 — Poorly Secured Workstations

Cybersecurity is a big, very important topic, which we’ve written a white paper on. One area of security where we’ve noticed many businesses fall short is in securing their workstations.

On any given day, a workstation may get used by several different employees or teams. Because they often hold valuable data that’s directly related to your productivity, these computers must be held to a higher standard of security than your average PC or mobile device.

  • Employ Stronger Passwords
    81% of hacking-related data breaches involve a compromisedBecause passwords are all that separate your workstation data from a malicious outsider (or insider), you’ll want to make sure that all your passwords adhere to the current best practices — which are constantly evolving.Did you know, for example, that mixing upper-case and lower-case letters are no longer seen as the best way to create a strong password? In fact, the man who came up with that idea in the first place now regrets ever saying it. Instead, combine 3 or 4 unrelated English words and sprinkle a number or two in for good measure. This provides a much stronger foundation for a secure workstation.
  • Secure Administrator Accounts and Privileges
    Administrator accounts have the ability to move data around your computer network in ways that standard user accounts can’t. This makes them attractive to interlopers, who will do whatever they can do to gain administrator access, like social engineering.Start by making sure that all default passwords have been changed and are different on each of your workstations. Using the same passwords on any two workstations could cause problems, by encouraging a successful hacker to move laterally through your network.While you’re at it, make sure that your admins aren’t using their administrator accounts for their daily work. This is another easy fix, but we see it all the time. Having your administrators use a separate account for non-administrative duties will help ensure that if their regular account gets compromised, the account with the privileged access remains secure.

 

 

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

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

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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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Tips To Help Ensure A Successful Surgeon Design Team

Tips To Help Ensure A Successful Surgeon Design Team | IT Support and Hardware for Clinics | Scoop.it

Design surgeons and surgeon design times have been at the core of the significant advances that have occurred in the medical device market in the last few decades. Working with surgeon design teams is inspirational, mentally demanding, and exciting.

 

Let’s assume a new opportunity has been identified that will improve your organization’s financial position. The marketing team has studied the market space—that is, classified at least three types of current and potentially new innovative strategies this opportunity should incorporate (as was described in the March/April 2018 issue of ODT, “Innovation and the Development Engineer”).

 

Once a complete financial plan, which includes cost to develop/introduce, and a sales/marketing plan have both been vetted and approved by the organization’s senior staff, it is time to move ahead to develop the surgeon design team.

 

I have had experience with two different types of surgeon design teams. The first—a “Hub and Spoke” model—was utilized in situations where aligning with a given group of surgeons or an institution would alienate others from using the product once it was released. The second is the more traditional surgeon design team with a group of surgeons selected to work on a project from beginning to end.

 

The Hub and Spoke model concept relies on one or two core key opinion leading (KOL) surgeons to serve as the hub of the wheel. Different surgeons or groups of surgeons meet independently with the KOL surgeon and the development engineering lead at a series of low-key meetings held at various time points to obtain feedback on different aspects of the design. There is a significant amount of reliance placed upon the KOL surgeon as the amount of involvement of the non-KOL surgeons is substantially less than in a traditional surgeon design team model. In this model, the non-KOL surgeons are assisting with validating the market assessments and need requirements, as well as providing market acceptance feedback of the new product later in the process. It is the responsibility of the KOL surgeon and the development staff to turn that information into a viable product.

 

With the more common traditional surgeon design team, assembling a good design team is critical to the success of the endeavor. The product development team needs to work closely with the marketing department in the selection and assembly of the surgeon design team. The selection process is very much like picking players for a team sport. The desire is to pick the most talented team, with personalities that mesh with each other while becoming aligned to win in the same way.

 

The training and clinical experience of the surgeons, the number of surgeons on the team, and their geographic locations are just a few of the important factors to be considered. The surgeon’s CV is a great reference as are their publications to discover where and by whom they were trained, as well as if they have any won any awards or honors. This process helps an organizer begin to understand a surgeon’s philosophy so as to determine if it matches with the objectives of the project. If these elements do not seem to align, it is best to move on. Further, there are other important considerations—is this the first design team the surgeon has been a part of or is it just the most recent? Has he or she been a part of prior design projects, and if so, what has been the success of those products? You need to fully understand the motivation of a surgeon to be a member of a design team.

 

It is critical the surgeons understand the commitment they will need to make to be part of the design team, as there will be meetings and other activities that will take them away from their clinical practice and surgery. Provide an understanding of the duration of the project and the time periods where their involvement will be greater than other periods as the project progresses. For example, one design project required great commitment from the surgeons as it met approximately every two to three weeks and for full weekends. As a result of the commitment from the surgeons and support of the company, a very large implant/instrument project was conceived and introduced in 18 months. Conversely, projects without full commitment from all surgeons has resulted in the opposite effect, significantly delaying the project, and doubling the anticipated time to market. Therefore, if the surgeon is not willing to commit the time, they are not a good candidate.

 

I have had the opportunity to work with a wide group of surgeons from around the world on numerous design teams. All were excellent surgeons, but their interests and how they assisted the design teams varied greatly. There were some true innovators and designers who would design or create their own drawings of new and innovative products. When the product was introduced, they were willing to stand behind the new concept until it was clinically proven, even in the face of being questioned by traditionalists. Others were known for performing clinical studies or understanding the issues surgeons were facing. Still others offered their strengths in addressing the surgical technique. It is crucial to understand the strengths and weaknesses of the members of the design team.

 

Regarding the project itself, it is vital to have the project well-scoped. The scope needs to be flexible in nature but, at the same time, there need to be boundaries in place to avoid creep and to ensure the end results fulfill the original unmet market requirement. What is the new product or service expected to perform and what is it not going to address? What shouldn’t be addressed is, many times, more important than determining what needs to be. Ensure everyone understands the project’s clinical scope, the financial objectives, and the other innovative aspects desired. In order to keep the team focused and grounded as time progresses, it is often necessary to reflect back upon the scope to avoid derailing and delaying the project.

 

Having the development engineer/staff gain the respect of the surgeon design team is also important. The engineer must have a wide base of knowledge to keep multiple elements of the development project within his or her view. As the process progresses, certain elements of the product are being locked down that impact the long-term commercial success, design attributes, manufacturability, inventory costs, marketing/sales, user experience, and clinical outcomes. Throughout the project, subject matter experts (e.g., the surgeons, manufacturing engineers, etc.) will provide input and support, but the development engineer is ultimately the one who must sift through all the information and recommendations to decide which to accept, modify, or reject. As such, the development engineer must be a jack-of-all-trades. Leading a development program should not be handled as if it is a democracy, but rather, as a benevolent dictatorship. The leader must listen, assess the situation, make a decision, and move on. Attempting to satisfy all parties will only cause delays.

 

There are techniques that can be used to help sort through the issues to attempt to make the best decisions. One technique is to note how many times the same concern is raised. If the issue is repeated by numerous surgeons and/or other advisors, it likely requires further exploration. If it is rarely stated or only by one surgeon, it may be safe to consider it a much lower priority. If the factor significantly impacts cost, however, determine how significantly it could impact the marketability of the product.

 

If a new, creative solution is conceived by a surgeon that seems to have originated from out of left field, it should not be automatically dismissed. Instead, challenge the surgeon to “sell” the idea to the rest of the design team. If he or she cannot earn their acceptance, it may be best to move on. This does not mean the concept was not worthy, but perhaps it needs to be sidelined from the current program and examined independently on its own merits at a later time or for a future generation of the product. Some creative solutions may seem like an idea that makes sense, but ultimately, must be considered within the scope definition for the project.

 

When having a design meeting, it is important to know the outcome ahead of time. Since design meetings can sometimes become confrontational, first addressing key topics individually with surgeons to understand their concerns and issues will provide a means to be better prepared for the full meeting and make it more productive. If there are controversial issues to be addressed, have one of the surgeon designers present them, which can also assist in making the meeting more productive.

 

After the concept for the product design has been finalized, enroll a second group of surgeons not part of the original design team to objectively review the new product concept. This can help ensure market acceptance and help identify issues that may have been overlooked. All members of the design team are too close to the project to objectively review the new product. While this review occurs late in the design process, it is still early enough to allow for modifications to be made relativity inexpensively.

 

Surgeon design teams have been and will continue to be a critical element for the advancement of healthcare in the development of new and innovative medical devices. Leading surgeon design teams is a skill a development engineer needs to hone and refine. It involves technical knowledge, psychology, business acumen, and most importantly, strong leadership attributes.

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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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