IT Support and Hardware for Clinics
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IT Support and Hardware for Clinics
News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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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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How Serious is the Cybersecurity Talent Shortage? 

How Serious is the Cybersecurity Talent Shortage?  | IT Support and Hardware for Clinics | Scoop.it

Across all industries worldwide, cybersecurity has become a top priority. Hackers keep pumping out new types of malware, and data breaches keep occurring. As of April 8, there were already 281 breaches exposing nearly 6 million records in 2019 so far, according to the Identity Theft Resource Center. Businesses can’t afford to sit back and wait until they’re attacked to defend themselves against cybercriminals.

 

With the average cost of a data breach globally totaling $3.86 million according to IBM and the Ponemon Institute, the wisest course of action is to proactively protect your organization with a comprehensive cybersecurity strategy.

 

However, everyone looking to effectively combat IT security threats faces a significant obstacle: a cybersecurity talent shortage. If you’re a business leader seeking to minimize your data breach risk, consider the following information on the extent of this issue and what you can do to overcome it.

 

The Cybersecurity Workforce Gap by the Numbers (ISC)² – an international, nonprofit association for information security professionals – released a report on the cybersecurity workforce gap in 2018. The report draws on a survey of nearly 1,500 cybersecurity pros and IT pros who spend at least 25 percent of their time on cybersecurity tasks.

 

Here are a few key statistics from the report that illustrate the extent of the talent shortage: The global shortage of cybersecurity professionals is approximately 2.93 million. 63 percent of survey respondents said their organizations have a shortage of IT staff focused on cybersecurity. 59 percent also say their organizations have a moderate or extreme cyberattack risk level because they lack sufficient cybersecurity talent. “Awareness of the cybersecurity skills shortage has been growing worldwide,” the report’s introduction states.

 

“Nevertheless, that workforce gap continues to grow, putting organizations at risk. Despite increases in tech spending, this imbalance between supply and demand of skilled professionals continues to leave companies vulnerable.” What’s Behind the Cybersecurity Talent Gap?

 

The increasing popularity of e-commerce and the rise of new technologies like mobile devices and the Internet of Things has created more opportunities for cybercrime. In the past few years, in particular, the demand for cybersecurity talent has surged, according to Verizon. Basically, the supply hasn’t had time to catch up to the skyrocketing demand. Universities and training programs need time to develop the right courses so that job candidates have the cybersecurity skills companies are searching for, Verizon explains.

 

However, it will take a while for college students to complete the new coursework and find their way into the workforce. Another, faster answer to the talent shortage is for workers to learn through on-the-job training.

 

What Can Businesses that Need IT Security Expertise Do to Overcome the Talent Gap? There are several ideas out there already concerning how to remedy the growing and highly concerning cybersecurity skills shortage.

 

Here are a few notable proposals: Form an industry-wide alliance: If large enterprises in the IT world (e.g., Dell, Cisco, Microsoft, Google and so on) join forces, they could put cybersecurity training programs in motion to address the talent shortage, according to the CSO opinion piece “The cybersecurity skills shortage is getting worse” by Jon Oltsik, a principal analyst at Enterprise Strategy Group. Broaden the job search to include candidates with the potential to learn.

 

Companies shouldn’t necessarily rule out professionals who don’t have the ideal qualifications in terms of degrees, certifications, and experience, Arctic Wolf Networks CEO Brian NeSmith advises in the Forbes article “The Cybersecurity Talent Gap Is An Industry Crisis.” Be open-minded and consider that intelligent candidates with great problem-solving skills might do well in the role, even if they don’t have all the prerequisites.

 

Turn to a third-party provider for assistance. A managed security services provider like Stratosphere Networks can help you gain access to high-level cybersecurity expertise while still containing costs. Services such as virtual CISO and CSO can give you all the benefits of having a security pro on staff without drawbacks like the price of training and hiring an in-house executive.

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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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The Time to Stop Relying on Spreadsheets Has Arrived

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

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

Spreadsheets are Highly Error-Prone

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

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

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

Spreadsheets Waste Time

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

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

Spreadsheets Can Lead to Catastrophe

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

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

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Custom Business Software Addresses All the Shortcomings of Spreadsheets

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

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

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

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

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

NYC’s Custom Software Development Partner

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

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

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3 Smart Ways To Prevent A Cyber Attack

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

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

 

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

 

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

 

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

 

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

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Important Factors To Consider While Buying Clinic Management Software 

Important Factors To Consider While Buying Clinic Management Software  | IT Support and Hardware for Clinics | Scoop.it

Choosing the right Clinic Management Software is anything but easy. However, it is one of the best decisions you will ever make that will help you enhance patient care and maximize revenues.

Considering the enormity of the decision and the impact it will have on your clinic’s operational performance, there are critical factors that you may want to consider before the actual buy.

Read through this guide to know the 7 most important factors to consider while buying a Clinic Management Software:

1. How Much Automation Are You Looking At?

There are a lot of options available as far as automating your clinic is concerned. There are exclusive billing or patient records or OPD scheduling software’s available; there are also complete clinic automation softwareavailable which include all the modules like billing, patient records, OPD scheduling, stores, pharmacy and much more. Depending on your budget, the ability to embrace change by your staff and your confidence on automating your processes, choose the right combination for you.

2. How Much Customization Will Be Needed?

No software will come custom made for your clinic because you will have some of your unique processes, which will need customization in your Clinic Management Software. After deciding how much automation you need, next logical step is to decide how much customization would you need and how confident is your vendor of delivering those. Be sure to choose a software that can accommodate all your mandatory requirements.

3. How Integration Friendly Is The Software?

A critical point for consideration while buying a software is how easy will be the transition from your old system to your new system. It is important not to lose any data and choose a software that allows a hiccup free integration. Be sure to consider this factor and also ensure the time it will take to integrate, the downtime involved and the additional investment involved, both in terms of time and money.

4. How Much Time Will Implementation Take?

Timeline for automation goes well beyond buying the product or the hardware and software installation; it is the total implementation including training of the staff and getting them to use all the features of the software. Timelines with target dates for each level of implementation and the cross checking of each level needs to be considered and discussed with complete clarity before the purchase decision is made.

5. How Much Post-Sales Technical Support Will Be Available?

Bought. Installed. Trained. Implemented. What about an unforeseen hiccup after implementation? Each staff member would have understood the technicalities in a different way and there could be a hiccup owing to wrong use or there could be a situation that was not a market reality while implementing the software? It is crucial that technical and training support should be available at a cost, post-sales. Be sure to negotiate a profitable association for the clinic while considering technical support post-sales.

6. Get Clarity

Be clear on how and at what cost will the software and hardware upgrades be implemented, what will be the downtime while the upgrade/s are happening and what will be the training routine post the upgrade/s? These are some critical questions to ensure long-term effective performance of the software and the answer needs to be clear before the buy decision is made.

7. Check Credentials and Certifications

Once you are satisfied with these performance points of the software, do a background check of the company you are finalizing to buy the software from. Check how long they have been in the business, check their clients list and see if they have serviced a clinic of your capacity in terms of specialties and turnover, do they have an experienced team to support you in your automation journey etc. This is to ensure that you have all the information to make the right decision for you.

Given that there are hundreds of points that can be considered while buying a Clinic Management Software, these are the most critical 7 points that cannot be ignored. Ensure these are on your checklist when you initiate your clinic’s automation journey.

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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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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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Health Care Providers Face More Direct Billing, More and Tougher Collections

Health Care Providers Face More Direct Billing, More and Tougher Collections | IT Support and Hardware for Clinics | Scoop.it

Opponents figure that they pretty much killed the Affordable Care Act in December when they ended the individual mandate. They may be right. The mandate – the part of the ACA that required Americans to buy health insurance or face a minor penalty – was a key to trying to broaden and deepen the insurance pool, mitigate payers’ risk and, not least, keep premiums at least remotely tethered to people’s ability to pay.

 

Another part of the ACA is also under threat. The law allowed states to agree to an expansion of Medicaid that was meant to help people who couldn’t afford to meet the mandate on their own.  Still another: it also offered subsidies to help payers meet the expenses of covering all the previously untreated people they’d have to insure and of covering everyone’s pre-existing conditions. 

Premiums in fact did not grow as fast in states that accepted the Medicaid expansion during the past three years and as an estimated 40 million more people gained some form of health insurance.

The end of the individual mandate, the junking of one of the subsidies for health insurers and last year’s drastically truncated open enrollment period for the remaining Exchange plans, however, have again started to reduce the number of Americans with health insurance.

 

These changes affect more than practice volume. They impact operations for practices that retain patients, too.

For without increased attention to “revenue cycle,” all health care providers can expect to be doing more direct billing of patients, doing more collections work and assuming more bad debt from people with higher, tougher-to-pay deductibles in the coming months and years.

 

Here’s why: No one yet knows how many people who bought insurance only because they were required to. There’s reason to believe the end of the individual mandate will start making them drop out of all kinds of plans during the next open enrollment period.

A federally truncated open enrollment period October-December, 2017 has already reduced the number of insured people in the nation.  A number of forces are leading fewer people – and fewer younger, healthy people – to buy plans, and some predictions have premiums rising an extra 10 percent this coming year.

 

More shrinkage is coming. Newly permitted work requirements for Medicaid coverage promise to push still more people into the ranks of the uninsured. Kentucky’s new rules, for example, will drive an estimated 40,000 people out of Medicaid coverage during the next five years. As of this writing, nine other states are considering imposing new restrictions on who can qualify for Medicaid coverage.

 

The increase in the numbers of the uninsured obviously has disturbing implications for the nation’s health as a whole. It will also force payers to raise premiums to make up for the rising costs of being able to spread their risk across smaller, riskier customer pools.

 

The uninsured aren’t the only ones threatening practice finances.

Rising premiums, in turn, are leading employers to offer employees more high-deductible health plans. These HDHPs have lower premiums but higher risk for patients, who in addition to their premiums must pay an average of the first $2,400 of their families’ medical bills out of their own pockets. Some plans have deductibles as high as $10,000.

 

The lower premium costs, however, are attracting more and more people.

 

They are also higher risks for physician practices, which have a harder time collecting from patients with HDHPs. Thirty-seven percent of the people working for employers who offered plans in 2017 chose high-deductible plans. That’s up from 28 percent in 2016. The same year, that accounted for 39.3 percent of all Americans on employer-based health plans. All told, up to 37 percent of insured Americans, regardless of where they bought it, were using HDHPs.

 

But there have been dire unintended consequences. With the costs of care so high, 64 percent of those with high-deductible plans say they’ve put off care because they didn’t want to or couldn’t pay the deductible. And 62 percent said that, despite the lower premiums, they end up spending more on health care than under their previous plan.

 

People with the high-deductible plans thus tend to be bigger financial risks for providers.

Of HDHP customers, 15.5 percent reported having trouble paying medical bills in 2016 (versus 10.3 percent of those with “traditional” plans).

 

In sum, this means everyone in health care – providers, hospitals, practices – are going to chance offending more patients by billing them directly and, at minimum, going to have to devote more resources to revenue cycle and collecting what patients owe them.

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4 Advantages of Maintenance Support

4 Advantages of Maintenance Support | IT Support and Hardware for Clinics | Scoop.it

Managing your hardware and software maintenance contracts can be overwhelming. Most IT assets are under contract and need ongoing support, and with every contract comes a tremendous amount of administrative work to keep those assets covered. As your assets grow in numbers, so does the total across your entire IT infrastructure, making it difficult to track properly.

 

Whether you are managing the contracts on your own, overseeing asset turnover, handling aging assets, or monitoring service levels compliance, it requires continuous effort. This is true for both hardware and software components. As more and more products move from hardware-based to software-based, it creates even more tracking challenges simply because there is no longer a physical asset. Tracking all of these assets with so many moving pieces and multiple manufacturers—from individual asset stop dates to maintenance coverage—can get confusing, convoluted, and leaves a margin for error.

 

Mistakes made could lead to a lapse in contract coverage, costing more money to renew in the long run. When you work with a maintenance support services partner, your assets are effectively managed so you can use them to drive more business.

 

Four Benefits of Having Your Maintenance Handled for You

 

1. Better analysis

With many individual assets to manage, it can be difficult to find the time to identify what needs to be done to remain compliant and run most effectively. With maintenance support, you no longer have to worry whether the information looks right or wrong. Instead, you will receive a thorough analysis of all of your information so you can make the best decisions for your business based on that analysis.

 

2. Cost savings

Not only does a proper analysis provide more accurate data management, it is also a friend to your bottom line. Ongoing asset analysis tackles the complexity of maintenance contracts, including multiple manufacturers, so you can prioritize what’s most important for your business. Not only is someone monitoring your assets for you, but they are also determining if the information is up to date and, in turn, identifying areas that can be reallocated, ultimately cutting costs.

 

3. Time savings

With cost savings, comes time savings. You can remove hours of time from your day, while getting a clearer depiction of your assets. When a maintenance support services partner is tasked with analyzing your assets, you’ll receive more efficient reporting, allowing you to make better and faster decisions for your business.

 

4. Lifecycle management

Get the help you need with lifecycle management and streamline your current support to be as efficient as possible based on your specific assets. With a coverage methodology, you can rest easy knowing that your assets and devices are subject to a thorough analysis, which ensures that everything is functioning optimally. By understanding your inventory and how everything is working together (including aging devices) you will be positioned well for future budgeting and remove any roadblocks if there are specific support issues.

 

Get the Support You Need to Focus on Business Priorities

Having the support you need can help you focus on your business, instead of dealing with the logistics and tracking associated with complicated maintenance contracts. Take advantage of better, more efficient analysis so you can make more informed decisions about your hardware and software devices, save on time and costs, and improve your lifecycle management capabilities.

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Cloud performance tests reveal the impact of location

Cloud performance tests reveal the impact of location | IT Support and Hardware for Clinics | Scoop.it

If a cloud-based EHR isn’t fast enough to meet the needs of hospitals and other medical facilities, quality of care will suffer, clinicians and support staff will become frustrated, and provider organizations operating on thin margins will have wasted valuable IT dollars on inadequate technology.

 

Several industry trends make it clear that providers are increasingly confident cloud-based EHRs can deliver data and applications at sufficient speeds because vendors have dramatically reduced latency. Epic Systems, the largest EHR vendor in the U.S., began offering cloud services in 2014 to medical groups and small hospitals. The company said in 2016 that it has seen a big shift among its customers toward cloud-based systems. One of those customers is University of California San Diego Health, which announced in August 2017 that it is migrating its Epic EHR to the cloud.

 

Cerner has also revealed that a number of healthcare systems are moving onto its hosted cloud environment. Inspira Health Network, a nonprofit healthcare organization that serves communities across New Jersey, and Bay State, an integrated health system in western Massachusetts health system, have both moved to Cerner’s cloud hosting model.

 

Another EHR vendor, Athenahealth, offers only cloud-based EHR services to its network of 56 hospitals and 106,000 providers that serves more than 100 million patients. Ellenville Regional Hospital in upstate New York, reports that running its EHR on a single network gives staff in all departments real-time access to patient records.

 

For health systems that will select their own cloud host, after considering the cost of strategic planning and security, the success of a migration ultimately rests on performance. Can EHR data, applications and services be delivered fast enough to support the needs of clinicians? Cloud performance is generally measured by average latency which represents the delay between the time when a client computer requests data and the cloud platform responds.

 

Tests have shown that distance between the cloud provider and the enterprise can have a significant impact on latency with delays of as much as 50 percent when the cloud is at a great distance.

 

Cedexis tested services and found distance was a leading indicator of performance

 

Monitoring company Cedexis performed tests throughout the United States that quantify this. Tests were performed on all of the major cloud platform vendors. The determining factor in latency performance was distance from the test client system to the servers at the cloud data center, with a deterioration of as much as 50 percent seen over longer distances within the same region.

 

For example, tests performed in the northwest region recorded latency was as low as 63 ms. when the cloud was near; a latency of 92 ms. was recorded on a cloud system at a greater distance from the test location. A test on cloud platforms in the northeast found 66 ms. latency on the low end and 78 ms. on the high end.

 

A number of vendors offer cloud performance tests that are free to be used during an evaluation process. One example is

 

CloudHarmony who offers a free service that will test performance for many of the leading vendors at a variety of their geographic locations. The test, at Cloud Harmony Speed Test will provide results for DNS query, downlink and latency.

Integration challenges


Migrating an EHR system to the cloud rarely is an all-or-nothing process. Rather, many healthcare IT managers are moving incrementally, evaluating the success of each application migration, learning from mistakes, and carefully preparing the next move based on need and experience. For example, some may decide to first migrate back-office or HR applications, and eventually, migrate clinical apps and billing data at a later date. Providers certainly can choose a one-shot migration to the cloud, but they run the risk of network and system disruptions, loss of productivity, and bandwidth limitations.

 

After cloud migration goals are set, computing models are chosen, and a migration plan established, healthcare providers can begin choosing a CSP (or more than one). For providers with concerns about potential latency issues, selecting a CSP with a hosted location close to the provider’s facilities makes sense. The provider’s IT staff and the CSP can then begin the cloud migration. This process involves addressing several integration challenges.

 

Perhaps the primary challenge is to prevent disruptions to systems or services during or as a result of the migration that would impact clinical care, staff productivity, or IT processes. Other challenges include protecting and backing up migrated data and connecting to and integrating disparate systems.

 

Integration may involve linking cloud-based apps and data with non-cloud apps in legacy systems. “An illustrative scenario could involve a multi-hospital operation which chooses to retain on-premises EHR for inpatient operations but wants to leverage public cloud services for geographically distributed outpatient clinics,” according to the Cloud Standards Customer Council (CSCC).

 

The CSCC argues that a successful cloud EHR migration depends on security and network connectivity.

 

“Whether you are ensuring insurance coverage for the public, developing the next generation of cancer drugs, or providing critical care/tier I trauma services, the new emphasis is being put on providing network availability, performance and security,” CSCC writes. “Although creating a highly available network might be expensive, those costs can be offset by the capabilities provided to the organization.”

 

The vast majority of healthcare providers today have moved or are moving applications, infrastructure, or development platforms to the cloud because they recognize the performance benefits and cost savings. For a cloud migration to pay off, providers must develop a realistic migration strategy and goals, choose the appropriate cloud computing and services models, find one or more CSPs whose services, support, and pricing match their needs and ensure that their networks have the bandwidth capacity to handle cloud-based workloads.

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8 Health IT Trends to Watch

8 Health IT Trends to Watch | IT Support and Hardware for Clinics | Scoop.it

“We’re in the middle of an incredible moment in the healthcare industry, where expectations and standards are shifting.”

 

That statement was part of the opening remarks from Cerner’s Senior Vice President of Population Health John Glaser at the 2017 Cerner Health Conference. His position was a strong one: The industry, he says, is shifting from reactive sick care to proactive health management, from fragmented niche care to a cross-continuum care system and from reward for volume to reward for quality, efficiency, and safety.

 

Today, we’re watching as the physician, long considered to be at the center of the healthcare universe, is moving aside in favor of the consumer.

 

These shifts aren’t happening in a vacuum: They’re touching in every area of the industry, and they are reshaping the way the business of healthcare is done. Here’s a look at some of the top trends that will push the industry forward in 2018.

 

Consumer-centered health care


We talked a lot about the rise of consumerism in health care over the last year, and that train is not going to slow down in 2018. Increasingly, we're seeing people wanting to have a more active role in managing their own health and care (this is particularly clear when we consider the rise of mobile health apps and wearables). They expect the same level of information, detail, and options that they have in other industries when it comes to making purchase decisions, and there is a rising call for data transparency and access.

 

While there have been some great strides toward empowering the individual with healthcare organizations working to improve the patient experience, we're still waiting for the healthcare industry to wholly adapt to the needs of the consumer.

 

At Cerner, we recognize this as a new era, where the consumer will, at last, join their own health care team. That's why, at this year's CHC, Cerner President Zane Burke announced that we’re making a free consumer-directed health record available within our clients’ enterprise portals, providing individuals more control over how their data is used and shared. Each patient will have his or her information compiled on their behalf and can direct the use of that information to create their own experience.

 

The era of the consumer is here – and it’s time for the healthcare industry to embrace that.

 

IoT


From controlling the thermostat on your phone to monitoring your health with technology, the Internet of Things (IoT) is transforming the way we work, live and interact with the world around us. IoT has been a popular phrase in health care for the past few years, but today, the conversation is shifting. The primary issue now is understanding how we can take the plethora of big data available from connected systems and tailor it to provide person-centric care.

 

Moving forward, we need to harness the potential of IoT to drive better efficiencies. From a data collection perspective, the advantages of connected medical devices are vast. When we can provide data bridges from disparate health care systems within a single organization, we’re making critical patient information more accessible to clinicians and care teams and ultimately impacting patient outcomes.

 

Through the use of IoT devices, we have the opportunity to deliver true virtual care for chronic condition management, virtual visits, and other care coordination activities to streamline and benefit the patient. Connected devices enable more real-time insights and health status for a person.

 

“IoT is tied to consumer enablement, which ranges from remote patient monitoring to mobile applications,” Hamilton says, “and it certainly includes the ever-increasing trend of telehealth, which isn’t going to go away.”

 

Artificial Intelligence


“Intelligence isn't a new idea,” Glaser said at CHC. Our cars tell us when the oil is low, and they’ve been doing that for years. But we’re about to take a significant leap in the intelligence of our devices. We’re already seeing this with products from companies like AWS, Azure, and Google.

 

We're in the early stages of seeing how artificial intelligence will play out in the healthcare industry. One example is in precision medicine, an approach for disease treatment and prevention that accounts for individual variability in genes, environment, and lifestyle for each person. This approach relies heavily on big data analytics, where machine learning algorithms and precision molecular tools make it possible to understand the mechanisms of disease and match up individual problems with personalized treatments. The implications for genomics and precision oncology are significant.

 

We’re also beginning to see AI algorithms affect and enhance medical imaging. These algorithms find patterns in images, identifying specific anatomical markers and scoping details that the human eye can’t – while simultaneously combing through a patient’s history, helping clinicians make efficient and quick diagnoses. The future of AI in health care won’t see clinicians being replaced by machines but rather empowered by them.

 

Big Data


“Data is the new oil,” Andreas Weigend, Amazon's former Chief Scientist, said recently. It’s a bold statement, but he has a point: Big data and cloud technology are changing how we interact with data, and previously untapped data sources are now attainable.

 

One of the greatest examples of big data’s implications for the healthcare industry is in predictive analytics, where data is used to identify behavior patterns in a patient or population and forecast outcomes. For example, when EHR data is organized into meaningful groups, such as social determinant factors, it can help predict hospital readmissions and can shed some insight on strategies to improve readmission rates.

 

This power to affect additional value and efficiencies within a hospital setting is no small thing. Perhaps most critically, these newfound big data insights are pushed to those that can make a difference: clinicians and care team members. Acute and ambulatory decision support, for example, can be enhanced by creating an empowered care team with a clear picture of the patient, thanks to increased access to patient data that's built directly into the existing daily workflows. And big data has exciting implications for precision medicine.

 

Whatever route organizations hoping to take with big data, it's clear that it will be a catalyst for change for the better good and health of society.

 

Data governance


As organizations begin to share data across departments and with other health systems, there can be a few questions: Who owns this data? Have the appropriate parties consented to its release? What are the rules, conditions, and terms of data sharing?

 

“Data governance is a huge thing that organizations are struggling with right now, even as they try to solve for it,” says Hamilton. In a recent survey, only 44 percent of hospital leaders said they had data governance capability across their entire organization, while 56 percent said they had inefficient governance standards.

 

What organizations really need is a governance strategy that everyone understands and can abide by, Hamilton says. In the future, we’ll see more and more healthcare organizations looking for help from external experts to create and refine their data governance protocol and practices.

 

Open platform development and API usage expansion


Open data access and increased interoperability are continuing to clear the road for development in health IT (HIT) – particularly when it comes to academic medical centers and rural health care systems. This trend will only continue to grow as open standards, like SMART Health IT and the HL7 FHIR standard, encourage a new level of collaboration and innovation.

 

As the FHIR standard matures, we’re going to see an explosion of new apps that can integrate with EHRs to help improve workflow efficiencies and achieve better outcomes. Application programming interfaces (APIs) offer direct programming access to the underlying health IT system and enable 'app' developers to create tools that can ingest EHR data and provide new services to consumers.

 

In a previous blog post, Cerner's Dr. David McCallie discussed how, through projects like SMART® on FHIR®, providers are becoming familiar with APIs that support customization of the EHR experience. However, API access is not limited to providers. A new class of APIs will give consumers the ability to access their health information on demand via apps of their choice. These APIs are emerging thanks to consumer demand, and they are also driven by major regulations coming into effect – particularly Meaningful Use Stage 3.

 

Consumer-directed access will place control of personal health information in the consumers' hands. APIs that allow the transfer of discrete data will help drive the advancement of interoperability by delivering more specific data where it makes sense within the workflow, in a way that positively impacts outcomes.

 

UX and health IT


On the coattails of the rise of consumerism in health care is a growing emphasis on integrating user-centered design into healthcare products and solutions. To optimize any solution, user experience (UX) must be engineered in at every step of the solution design process. This way, the experience for the HIT user – be they a clinician or a patient – should meet or exceed their expectations.

 

Cerner's Vice President of User Experience, Paul Weaver, discusses the integration of UX design thinking and health IT through the example of mobile health apps. "When you think about consumer apps today, there is a huge amount of competition to get people's attention," Weaver says. "If you search for a notes app on the Apple store, for example, there's probably a few hundred for you to choose from. So, if I'm an app developer, how do I design the app of choice?"

 

The answer, Weaver says, is by providing a quality user experience.

 

"In the health space, historically, this has been a little bit of a walled garden," he adds. "You go to a health provider, and they give you a link to the app they want you to use, and there's no choice in the matter." It's the responsibility of the UX team to think about that application in the context of all their other solutions available so that whatever they're designing sits alongside its contemporaries in an equal level of quality.

 

UX is about more than just creating user-friendly applications. It’s a state of mind – a perspective that favors taking a human-centered approach to creating solutions. "That's what we're starting to achieve here," Weaver says, "and we're on the cusp of it becoming real for our end users, which is fantastic. How there be anything more exciting than an application that actually helps your health?"

 

Payer-provider convergence


One of the most significant trends in today’s market is the blurring of roles between providers and payers. As the industry shifts toward value-based care, it should become increasingly easy for payers and providers to collaborate at the point of care. A person’s relevant medical history, including medications and treatment plan, should be available to both the healthcare provider and payer – that way the patient’s insurance benefits are included in the provider network and are in sync. Shared access to this data means that clinicians are empowered to provide the right care at the right time to the right patient.

 

That’s payer-provider convergence in theory – but the reality is that there are two dynamics happening in tandem.

 

“You've got providers trying to take on characteristics of a payer because they’re doing at-risk relationships, and you’re seeing the payers making a direct play into the provider market,” says Ryan Hamilton, Cerner’s Senior Vice President of Population Health. Recent moves, such as UnitedHealth’s Optum purchasing DaVita Medical Group and Amazon’s push into pharmaceutical distribution, suggest that the trend of payers and providers merging together will continue to rise.

 

Along the same lines, there’s a lot of interest right now around provider network management – and that focus is only expected to grow. “How you actually recruit, manage and maintain a high-quality network of providers is and will continue to be a huge focus for our client base,” Hamilton says.

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Breathe new life into your old PC

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

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

 

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

 

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

 

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

Make a NAS server

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

 

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

 

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

 

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

Secure your online privacy

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

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

Kick your media up a notch

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

 

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

 

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

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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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5 tips to lower your printing costs

5 tips to lower your printing costs | IT Support and Hardware for Clinics | Scoop.it

Your growing printing expenditures may be the result of over-dependence on hard copies, the lack of effective printing workflow, and obsolete printers. With some fresh ideas, clever problem-solving, and the following tips, you could significantly cut down your printing budget.

 

Replace outdated printers

Outdated and cheap printers may be functional, but they are putting a huge dent in your IT budget.

Any piece of equipment that is seven years old (or older) requires frequent repairs and causes more trouble than it’s worth. Because old printers are no longer under warranty, fixing them is more costly and challenging. It’s also difficult to replace parts for old printers because manufacturers have stopped carrying them for models that have been phased out.

When you replace outdated equipment with newer, multi-functional printers, you’re investing in hardware that will pay for itself with increases in productivity and efficiency.

 

Avoid purchasing unnecessary supplies

A poorly managed printer environment could result in a stockpile of cartridges, toners, and reams of paper. This happens when, for example, an employee uses a printer that’s about to run out of ink and makes an unnecessary request for new ink or toner. This is more common than you may think and definitely more expensive.

In the absence of a dedicated printer manager, you can avoid this situation by automating supply replacement. Assign a point person to proactively place orders when supplies are about to run out, so your company can avoid needless purchases.

 

Impose strict process workflows

Submitting expense reports, filing reimbursements, and other administrative tasks require a proper document workflow. Without a guideline, employees and administrative staff tend to print an unnecessary amount of documents.

Automate your company’s document-driven processes to reduce or prevent redundant print jobs that result in stacks of abandoned documents. Not only are these printouts wasteful, but they’re also a security and privacy concern.

 

Go paperless

Designing a document management solution that reduces paper consumption is the best way to save money. It may not be possible in every department, but those who can do their jobs without printing should be encouraged to do so by management. Printing lengthy email chains that can be discussed in a meeting is just one example of a wasteful practice that should be avoided.

 

Reduce IT support calls for printing issues

Calling your company’s IT guys to assist with problems like paper jams, printer Wi-Fi issues, and other concerns reduce employee frustration. You and your IT personnel could avoid dealing with these productivity killers by identifying the problem areas of your print environment. Then, you can work on solutions specific to your office, such as drafting a printing workflow or getting help from document management experts who can recommend time- and budget-saving solutions.

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Make sure your VoIP phones survive a disaster

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

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

Invest in VoIP monitoring services

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

Choose your VoIP provider wisely

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

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

Have a backup broadband line

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

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

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

Route calls to mobile devices

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

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

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

Test your plan

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

 

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

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Medical billing for dummies

Medical billing for dummies | IT Support and Hardware for Clinics | Scoop.it

Here are some frequently asked questions about medical billing and their answers that will serve as your first lesson on the field of medical billing.

What is medical billing?

Medical billing is the process of submitting and following up on health insurance claims with the insurance company. This process is undertaken by a medical billing specialist with the support of the insurance desk team of the hospital or healthcare provider.

 

It is the responsibility of the medical biller to ensure that the service provided to the patient (who is insured with the insurance company) receives reimbursement. As part of this process, the medical biller sends an invoice detailing the treatment and the health services provided to the health insurance company on behalf of the healthcare provider. Therefore, when done efficiently, medical billing can optimise revenue performance for the healthcare provider. Today, most medical billers make use of specialised software which help in automating and improving the speed and efficiency of the process.

How is medical billing different from medical coding?

Both medical coding and medical billing are processes that are largely responsible for the smooth progress of the healthcare provider’s revenue cycle. Medical coding, carried out by a medical coder, is the process of assigning specific codes to the different health services rendered to the patient.

 

Medical billing, carried out by a medical biller, utilises the diagnosis and procedure codes derived from the medical record documentation to assemble all data concerning the medical bill or claim accurately and efficiently. Therefore, medical billing is a process that is dependent on medical coding.

What are the steps involved in medical billing?

The basic steps involved in medical billing are:

  1. Charge Entry
    • The medical biller, in this step, enters the charges for services provided to the patient. The charge entry also includes the appropriate linking of medical codes to services and procedures rendered during the patient’s visit.
  2. Claims Transmission
    • Once the claim has been properly completed, it must be submitted to the insurance company for payment. This step is called claims transmission or claims submission and is done electronically in formats specifically required by the insurance companies. Sometimes, clearing houses are used to reformat the claims in the format that matches the need of the insurance company.
  3. Monitoring of Adjudication
    • Once a claim is submitted to the insurance company, it undergoes a process called claims adjudication wherein the insurance company evaluates the claim and decides whether or not the claim is eligible for reimbursement based on factors including validity and compliance.
    • At the end of the adjudication, the insurance company sends a report to the healthcare provider. It is the medical biller’s responsibility to review this report and ensure that all procedures listed on the claim are accounted for. If there are any discrepancies, the biller will enter into an appeal process with the insurance company.
  4. Payment Posting
    • This step marks the end of the billing cycle and involves posting and deposit functions. Payment or settlement is received from the insurance company at this point, and the payment records of every patient are recorded in the billing management software.
  5. Patient follow-up
    • Medical billers follow up with patients whose bills are delinquent, rejected or partially paid to make sure that the payment due for the healthcare service, which has not been settled by the health insurance company, is received. This may involve contacting the patient directly, sending follow-up bills, or, enlisting a collection agency.

 

In conclusion, it can be said that the medical biller is the bridge between the healthcare provider and the health insurance company. Additionally, the medical biller may also be involved in supporting the insurance desk, communicating with the physician for clarifications and many such tasks that are related to the claims process.

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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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Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective

Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective | IT Support and Hardware for Clinics | Scoop.it

Neuroprosthetics—implants containing multi-contact electrodes that can substitute certain nerve functionalities—have the potential to work wonders. They may be able to restore amputees' sense of touch, help the paralyzed walk again by stimulating their spinal cords and silence the nerve activity of people suffering from chronic pain. Stimulating nerves at the right place and the right time is essential for implementing effective treatments, but still a challenge due to implants' inability to record neural activity precisely. "Our brain sends and receives millions of nerve impulses, but we typically implant only about a dozen electrodes in patients. This type of interface often doesn't have the resolution necessary to match the complex patterns of information exchange in a patient's nervous system," said Sandra Gribi, a Ph.D. student at the Bertarelli Foundation Chair in Neuroprosthetic Technology.

Replicating—and Improving—How Neuroprosthetics Work
Scientists at the lab run by Dr. Stéphanie Lacour, a professor at EPFL's School of Engineering, have developed a nerve-on-a-chip platform that can stimulate and record from explanted nerve fibers, just as an implanted neuroprosthetic would. Their platform contains microchannels embedded with electrodes and explanted nerve fibers faithfully replicate the architecture, maturity, and functioning of in vivo tissue.

The scientists tested their platform on explanted nerve fibers from rats' spinal cords, trying out various strategies for stimulating and inhibiting neural activity. "In vitro tests are usually carried out on neuron cultures in dishes. But these cultures don't replicate the diversity of neurons, like their different types and diameters, that you would find in vivo. Resulting nerve cells' properties are changed. What's more, the extracellular microelectrode arrays that some scientists use generally can't record all the activity of a single nerve cell in a culture," said Gribi.

The nerve-on-a-chip platform developed at EPFL can be manufactured in a clean room in two days and is able to rapidly record hundreds of nerve responses with a high signal-to-noise ratio. However, what really sets it apart is that it can record the activity of individual nerve cells. The research has just been published in Nature Communications.

Inhibiting the Activity of Specific Neurons
The scientists used their platform to test a photothermic method for inhibiting neural activity. "Neural inhibition could be a way to treat chronic pain like the phantom limb pain that appears after an arm or leg has been amputated, or neuropathic pain," said Lacour.

The scientists deposited a photothermic semiconducting polymer, called P3HT:PCBM, on some of the chip's electrodes. "The polymer heats up when subject to light. Thanks to the sensitivity of our electrodes, we were able to measure a difference in activity between the various explanted nerve fibers. More specifically, the activity of the thinnest fibers was dominantly blocked," said Gribi. And it's precisely those thin fibers that are nociceptors—the sensory neurons that cause pain. The next step will be to use the polymer in an implant placed around a nerve to study the inhibiting effect in vivo.

Distinguishing Between Sensory and Motor Nerve Fibers
The scientists also used their platform to improve the geometry and position of recording electrodes, in order to develop an implant that can regenerate peripheral nerves. By running the measured neural data through a robust algorithm, they will be able to calculate the speed and direction of nerve impulse propagation—and therefore determine whether a given impulse comes from a sensory or motor nerve. "That will enable engineers to develop bidirectional, selective implants allowing for more natural control of artificial limbs such as prosthetic hands," said Lacour.

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Information Technology in Today’s Veterinary Practice -

Information Technology in Today’s Veterinary Practice - | IT Support and Hardware for Clinics | Scoop.it

5 Common challenges of the traditional veterinary practice

  • Paper record keeping, appointment scheduling, service reminder distribution
  • Increased labor cost due to inefficiency
  • Difficulty in accurately managing inventory and accounting
  • Lack of advertisement avenues and initiatives
  • No connection with necessary modern medical equipment, associated practices, or specialty practices

We will now discuss the advantages of moving to a cloud based practice management system.

Why should a practice utilize cloud based technology?

Accuracy of records, reporting, and scheduling

In a paper record practice, patient files can be difficult to locate, reference, and store. Staff may be frequently disorganized, and it may slow the process of patient care. Your staff will likely spend more time shuffling paperwork than providing medical attention.

With a cloud based practice, patient files are easily accessible, updated real-time, and require no physical space for storage. The ability to schedule appointments is streamlined and accurate, reducing client wait-time and cancelled visits.

Increasing client compliance

In a paper record practice, staff is responsible for tracking services due which may lead to missing service reminders or sending redundant communications. But with a cloud based practice, the system does the work for you.  It allows you to send reminders in a variety of ways; postcards, emails, and text messages.

Reducing costs of operation

In a paper record practice, the cost is obvious. The physical storage demands are large and those costs will only continue to grow over time.  The inefficiencies in finding records, tracking service due dates, and communicating with the client is large and are frequently error prone. And in an installed system, you have to worry about the cost of purchasing equipment and updating that equipment.

 

With a cloud based practice, no servers or backups are required which frees up the staff and resources to allow them to provide better patient care. Cloud based systems usually have a low upfront cost with a reasonable monthly subscription price. The monthly price includes the system, automatic updates, support, and training.

Staff productivity and satisfaction

Let’s be honest, most veterinary clinic staff members joined this industry to spend time with animals and to help provide quality care. Managing paper records or an installed system isn’t something they bought into. However, they can leverage their system to help with the quality of care.

 

With a cloud based practice, staff can become more efficient giving them more time to do what they love which is being with the patient and providing that care. A happier staff normally translates to higher revenue.

Client interaction and communication

For a paper record practice, client interaction is limited to office visits, phone calls, and direct mailings. But with a cloud based practice, you get all those plus the ability to email, text message, client portal (pet portal), and social media.

Business growth and expansion

The record keeping process with which you run your practice shouldn’t prevent growth. Using paper records will take a toll on resources and will stifle growth.  An installed system will require more upkeep as hardware becomes outdated.  It is also very common to start with a hardware setup to support your clinic, but then grow out of that hardware setup. This would require new hardware and servers.

With a cloud based practice, servers are managed by the software vendor and are set up to grow with the business.

Medical technology and cross practice connectivity

For a paper record practice, there is no option to seamlessly pull in lab results, radiographs, or specialists’ reports – they must all be stored separately.  Coordinating this with a multi-location practice is near impossible.

With an install system, you can at least connect your software to external devices like lab analyzers and x-ray equipment. However, you can’t easily connect multi-location practices.

With a cloud based system, you can do both and do both well. In a multi-location practice, you can easily access one or more clinics from the same computer or device. You can also share clients and patients across locations reducing double entry. In most cases, you can run reports that show a group practice view which is near impossible with paper or installed systems.

Eddie Heinz is the CEO of eVetPractice.com, a leading provider of veterinary practice management software. Founded in 2011, the company’s clientele spans more than 40 states within the United States, as well as Canada and Australia.

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4 Industries That Find Blockchain Technology Useful

4 Industries That Find Blockchain Technology Useful | IT Support and Hardware for Clinics | Scoop.it

 

By 2024, the global blockchain market is expected to be worth $20 billion, and according to a recent study by IBM, one-third of C-level executives are considering adopting these technologies. Does that surprise you? Is your organization exploring blockchain or distributed ledger solutions?

 

Recent reports indicate that blockchain has the potential to reduce certain industries’ infrastructure costs by 30 percent. Additionally, there’s a $8-12 billion annual savings for certain industries that use blockchain technology. Let that sink in.

 

Companies of all industry types are using blockchain technology to help them improve transparency, traceability and trust; but here are four industry-specific benefits.

 

  1. Healthcare: Hospitals are now able to seamlessly access patient data shared between member hospitals and participating hospitals.
  2. Banking: Financial institutions are able to simplify and speed up the transfer of funds, while ensuring the identity of the user.
  3. Supply chain: Manufacturers can ensure the authenticity of goods and products with better transparency and accountability.
  4. Insurance: Companies can eliminate common sources of fraud, and use smart contracts to improve efficiency and improve customer experience.

 

With all of these sample use cases, blockchain helps companies increase efficiency and reduce friction. Sirius offers various services to help organizations define and develop their blockchain solution.

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5 advantages of cloud computing and how they can benefit your practice

5 advantages of cloud computing and how they can benefit your practice | IT Support and Hardware for Clinics | Scoop.it

While the specialty may vary, practices of all sizes across Australia are turning to the cloud to run their business. With the launch of Clinic to Cloud (C2C) in early 2015, over 1200+ healthcare professionals, operating from hundreds of different practices are now computing with our cloud-based platform. With new clinicians joining C2C daily, benefits of the cloud services are now being widely recognized and accepted as the norm.

 

So if you’re looking to open a new practice for the first time or hoping to migrate your existing practice to the cloud, let’s look at 5 advantages of cloud computing and how your practice can benefit:

 1. Staying in touch

Cloud computing is storing and securely interacting with data over the internet, rather than your computer or local server. That puts connectivity and real-time data as the clearest advantage of working on the cloud. Yes, someone changed the WIFI password without telling you or the careless construction worker nearby didn’t check before drilling. However, one can argue that servers fail and files get lost. The internet is truly an essential resource, which is why it has become so readily accessible and available from multiple sources, smartphone, portable WIFI device, personal connection, net hubs at cafes, offices and even some commercial planes will essentially keep you connected.

 

What does this mean for the clinician? Not only that your data is stored in state of the art datacentres, as long as you are connected, but you can also run your practice.  Control you practice on-site, from home, hospital, on break at your favorite café or even on the flight to your next medical conference from a desktop or mobile device. Full connectivity anytime, anywhere – this is the cloud.

 

  1. Tools of the Trade

Smartphones, tablets, and ultrabooks are essential tools for any busy working professional. With top cloud services offering dedicated mobile apps, working on the go also means working with your indispensable devices. Like the stethoscope to the physician or the scalpel to the surgeon – The Clinic to Cloud App gives you the tools to stay conveniently connected with your practice whilst on the go. For time-poor clinicians, buying time during your super busy schedule comes from having your entire practice visible from your smartphone.

 

  1. That new software smell

Top cloud providers are regularly updating and improving their software. The moment updates are released, they are made available for the benefit of all customers. You would have noticed those design changes and new features on your social media account without you manually needing to install or upgrade anything. Simply log in and updates are there. Clinic to Cloud follows suit, we typically update every 3 to 4 weeks to better user outcomes and reduce practice costs. On release date, all our subscribers then benefit with the best part being at no extra cost. For the clinician - you are not wasting time having to update your practice software or pay for often expensive IT support to run updates. It’s cloud and it’s simple.

 

  1. Soft on the Wallet

Moving to the cloud can save you large capital expenditure, as you do not have to purchase expensive servers and other I.T hardware to host your data or run your software. Accessing your cloud application, in many cases, simply requires an internet capable device (smartphone, tablet, or computer) and an internet connection. Not to mention, local servers also have expensive on-going maintenance and repair costs and backup requirements as well. Clinic to Cloud does not require complex IT infrastructure and server equipment with messy cabling disrupting the feng shui of your practice. A modern desktop or laptop computer and you are on your way to the clouds.

 

  1. Security and Data

One of the concerns with Cloud is typically security and many are concerned about the safety of Cloud hosted software applications. Although we understand the feelings behind the concern, studies have shown that the cloud is safer than on-premise servers that are susceptible to virus and hardware failure and data loss daily. Cloud solutions can be compared to Airline travel; they remain the safest way to do business.  At Clinic to Cloud, we have taken additional security measures such as to Factor Authentication and high levels of encryption.

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