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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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On January 20th, 2020 Windows 7 and Windows Server 2008 will no longer be HIPAA Compliant

On January 20th, 2020 Windows 7 and Windows Server 2008 will no longer be HIPAA Compliant | IT Support and Hardware for Clinics | Scoop.it

On January 20th, 2020 Windows 7 and Windows Server 2008 will no longer be HIPAA Compliant

 

Microsoft has announced that on January 20th, 2020 Windows 7 and Windows Server 2008 (Server 2008R2) will reach their EOL (End of Life) Product Life-cycle; meaning Microsoft will no longer provide routine security updates making these systems considerably more vulnerable to cyber attacks and therefore no longer HIPAA compliant. Even the presence of a single non-compliant device (computer, router, switch, etc.) can deem your entire site to be non-compliant so this should be taken seriously to avoid potential data loss and/or fines.

 

As you are reviewing your IT budget for 2019 take into account that some or all of your hardware may need to be replaced. If you still have Windows 7 32-bit operating system computers in your environment you should consider replacement.

 

Any facility that has Windows 7 64-bit operating system computers deployed may have hardware deployed that
can easily be upgraded to Windows 10 Pro or may need only minor upgrades such as memory.

 

Windows Server 2008 and Windows Server 2008 R2 is a software operating system that does not have upgrade options. You will definitely need a new server platform to address a migration to Windows 2016 Server or Windows Server 2019 operating system.

 

Because of the number of systems/sites still running these older operating systems scheduling PC and server upgrades is several months out. Considering supply issues from the Far East (trade sanctions, etc.) hardware vendors are experiencing supply shortages and price pressures.

 

Aside from the hardware supply line, scheduling downtime for your migration to the new operating system/hardware and possible application compatibility issues for the new operating systems should be considered. A gradual roll-out of new PCs will reduce the budgetary impact and allow staff members to familiarize themselves with the new operating system.

 

Having a plan to deploy a new server for your facility well in advance of the deadline of January 20th, 2020 will make a smooth transition a lot more likely. January 2020 will be here in no time.

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Cloud Computing Supports Telemedicine Growth

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

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

 

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

 

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

 

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

 

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

 

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


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


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


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


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


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


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


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


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


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

 

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


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

 

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

 

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

 

 

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Medical Software On The Cloud

Medical Software On The Cloud | IT Support and Hardware for Clinics | Scoop.it

As more and more traditional companies leverage the benefits of the cloud, it’s no real surprise that the healthcare industry has embraced technology, with electronic health records now commonplace. We have provided a cloud-based solution for clinical and practice management software since 2012 and the adoption rate among Australian healthcare practices and clinics grows each year.

 

Cloud for Health allows users of popular clinical software packages (such as Medical Director and Best Practice) to access data from anywhere by simply using their web browsers on any internet-ready device. It allows users to concentrate on core activities without worry about servers, backup maintenance or essential security updates as we take care of all that under our service level agreement(SLA).

 

Other advantages include guaranteed data storage on Australian servers (also a legal requirement) and immediate access to an ideal solution for rural GPs that often need to travel long distances between clinics, allowing the easy use of mobile clinics, taking the practice on tour, so to speak.

 

Doctors located in the middle of the desert can access their clinic records remotely, simply by using a laptop and phone, tethering the laptop to a 3G or 4G connection if available. Alternatively, you can simply use a smartphone , netbook or other portable device with a browser. In times past, you would have needed to log in directly to your practice, with low speed often the result. Not so with the cloud, as maximum performance is always available.

 

As the whole process is browser-based, it’s no longer necessary to have a high-performance laptop for productive tasks. Even older laptops will work perfectly as long as an internet connection is available.

 

Not all healthcare professionals require mobility but cloud hosting has other advantages:

 

  • You no longer need a server and can eliminate associated hardware costs and maintenance issues.
  • Data backups are automated using redundant hard drives, preventing unexpected data loss
  • 24/7 maintenance and support is offered by reputable service providers
  • Software patches and security updates are handled by the service provider


Our aim as a service provide is to remove IT as a consideration for healthcare professionals and let them focus on patient care. Even in extreme situations where all hardware in the practice has failed (due to power loss, fire or water damage, for example) vital clinical data can still be accessed using a mobile phone. The benefit to business continuity is obvious.

 

The majority of clinical software is designed for use with Microsoft Windows, with Mac users often experiencing problems. However, by use of a Citrix Desktop Viewer, the platform does not matter as everything is viewed in a standard browser, regardless of whether the user is on Windows, Android, iOS or MacOS.

 

Coming from a family of doctors, I originally considered offering a free service to make the lives of healthcare professionals easier by allowing them to focus on patient care. However, I decided to implement a licence fee structure, given the variety of experts, hardware and hosting requirements necessary to provide a reliable service. It is true that ‘you get what you pay for’ and a free service would have compromised features and defeated my original goals.

 

The licence fee structure works well and is cost-effective, regardless of the size of the practice, given the backup protection and risk managements solutions that are immediately solved. In addition, we perform a full IT and business process audit to maximise the investment, ensuring that all systems are configured correctly.

 

While some are still reluctant to move to the cloud, due to perceive security issues, I believe these concerns to be ill-founded, especially when you consider that cloud service providers are held to a higher standard than traditional networks. We are subject to regular third party audits that we cannot avoid if we are to retain our IT and industry certification status. By achieving these standards, we publicly confirm that we exercise due diligence in security, data storage and internal disaster recover processes.

 

Therefore, we can offer a complete IT solution with confidence, whether it’s on the cloud, onsite or a combination of both. Eliminate your IT concerns and focus on your business. Contact us for further details.

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Medical Device Quality: Why Software Is More Challenging Than Hardware

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

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

 

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

 

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

 

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


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

 

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

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

 

The Solution: Software Validation Driven by Rigorous Requirements


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

 

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

 

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

 

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

 

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

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EHR Hardware Basics in Health IT Guides

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

Hardware Basics for Electronic Health Records

 

Basic Terms


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


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


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


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


Desktops


The basics:

 

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

 

Advantages:

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

 

Disadvantages:

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

 

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


Laptops


The basics:


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

 

Advantages:

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

 

Disadvantages:

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

 

What your peers have to say:
"

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

 

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

 

Tablet PCs


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

 

Advantages:

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


Disadvantages:

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

 

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

 

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

 

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


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

 

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Tips To Help Ensure A Successful Surgeon Design Team

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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Why Firms Of All Sizes Need To Outsource? 

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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EMPOWR Porous And Complex Primary Knee Systems

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

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

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

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

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

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

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

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

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Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients 

Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients  | IT Support and Hardware for Clinics | Scoop.it

The Hong Kong Polytechnic University (PolyU) recently developed a robotic arm to facilitate self-help and upper-limb mobile rehabilitation for stroke patients. The lightweight device enables the patients to engage in intensive and effective self-help rehabilitation exercise anywhere, anytime after they are discharged from the hospital. The robotic arm, called “mobile exo-neuro-musculo-skeleton,” is the first-of-its-kind integration of exoskeleton, soft robot, and exo-nerve stimulation technologies.

Stroke is the third leading cause of disability worldwide1. In Hong Kong, there are about 25,000 new incidences of stroke annually in recent years2. Research studies have proven that intensive, repeated and long-term rehabilitation training are critical for enhancing the physical mobility of stroke patients, thus helping to alleviate post-stroke symptoms such as disability. However, access to the outpatient rehabilitation service for stroke patients has been difficult. Due to the overwhelming demand for rehabilitation services, patients have to queue up for a long time to get a slot for rehabilitation training. As such, they can’t get timely support and routine rehabilitation exercises. Stroke patients also find it challenging to travel from home to outpatient clinics.

The “mobile exo-neuro-musculo-skeleton,” developed by Dr. Hu Xiao-ling and her research team in the Department of Biomedical Engineering (BME) of PolyU, features lightweight design (up to 300g for wearable upper limb components, which are fit for different functional training needs), low power demand (12V rechargeable battery supply for 4-hour continuous use), and sportswear features. The robotic arm thus provides a flexible, self-help, easy-to-use, mobile tool for patients to supplement their rehabilitation sessions at the clinic. The innovative training option can effectively enhance the rehabilitation progress.

 

Dr. Hu Xiaoling said development of the novel device was inspired by the feedback of many stroke patients who were discharged from the hospital. They faced problems in having regular and intensive rehabilitation training crucial for limb recovery. “We are confident that with our mobile exo-neuro-musculo-skeleton, stroke patients can conduct rehabilitation training anytime and anywhere, turning the training into part of their daily activities. We hope such flexible self-help training can well supplement traditional outpatient rehabilitation services, helping stroke patients achieve a much better rehabilitation progress.” Her team anticipated that the robotic arm could be commercialized in two years.

The BME innovation integrates exoskeleton and soft robot structural designs—the two technologies commonly adopted in existing upper-limb rehabilitation training devices for stroke patients as well as the PolyU-patented exo-nerve stimulation technology.

Integration of Exoskeleton, Soft Robot, and Exo-Nerve Stimulation Technologies
The working principle of both exoskeleton and soft robot designs is to provide external mechanical forces driven by voluntary muscle signals to assist the patient’s desired joint movement. Conventional exoskeleton structure is mainly constructed by orthotic materials such as metal and plastic, simulating external bones of the patient. Although it is compact, it is heavy and uncomfortable to wear. The soft robot, made of air-filled or liquid-filled pipes to simulate one’s external muscles, is light in weight but very bulky in size. Both types of structures demand high electrical power for driving motors or pumps, thus it is not convenient for patients to use them outside hospitals or rehabilitation centers. Combining the advantages of both structural designs, the BME innovative robotic arm is light in weight, compact in size, fast in response and demands minimal power supply, therefore it is suitable for use in both indoor and outdoor environment.

 

The robotic arm is unique in performing outstanding rehabilitation effect by further integrating the external mechanical force design with the PolyU-patented Neuro-muscular Electrical Stimulation (NMES) technology. Upon detecting the electromyography signals at the user’s muscles, the device will respond by applying NMES to contract the muscles, as well as exerting external mechanical forces to assist the joint’s desired voluntary movement. Research studies found that the combination of muscle strength triggered by NMES and external mechanical forces is 40 percent more effective for stroke rehabilitation than applying external mechanical forces alone.

Rehabilitation Effect Proven in Trials
An initial trial of the robotic arm on 10 stroke patients indicated better muscle coordination, wrist and finger functions, and lower muscle spasticity of all after they have completed 20 two-hour training sessions. Further clinical trials will be carried out in collaboration with hospitals and clinics.

The robotic arm consists of components for wrist/hand, elbow, and fingers which can be worn separately or together for different functional training needs. The sportswear design, using washable fabric with ultraviolet protection and good ventilation, also makes the robotic arm a comfortable wear for the patients.

The device also has a value-added feature of connecting to a mobile application (APP) where users can use the APP interface to control their own training. The APP also records real-time training data for better monitoring of the rehabilitation progress by both healthcare practitioners and the patients themselves. It can also serve as a social network platform for stroke patients to communicate online with each other for mutual support.

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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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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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Benefits Of Wearable Technology In The Health Sector

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

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

 

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

 

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

 

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

 

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


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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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Servers In Medical Centres

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

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

 

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

 

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

 

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

 

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

 

Our hot tips are:

 

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

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

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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The Promising Future For AI In Orthopedics

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

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

 

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

 

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

 

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

 

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

 

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

 

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

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

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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Advanced Software Offers Metal Artifact Reduction For Extremities

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

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

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

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

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

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

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

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

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In Situ Cured Silicone Could Enable Personalized Implants

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

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


Key features of the packaging system include:

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

 

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

 

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

 

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

 

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FDA Clears IlluminOss Medical's Bone Stabilization System

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

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

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

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

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

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

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

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

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

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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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'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation

'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation | IT Support and Hardware for Clinics | Scoop.it

Hip replacement surgery is highly successful in relieving pain, restoring mobility, and improving quality of life. More than 330,000 procedures are performed each year in the United States, and that number is expected to almost double by the year 2030.

As with all surgical procedures, the possibility of a complication exists, and dislocation is the most common problem. The risk of dislocation is higher in patients who have had a second hip replacement, known as revision surgery. Some people need revision surgery many years after their first hip replacement when the original implant wears out. Hip instability after joint replacement is another reason a patient might need a revision surgery.

Research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery and other joint replacement centers indicates that a newer type of artificial hip known as a "modular dual mobility" implant could be a good option for patients who need a revision surgery. Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas this month.

"Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States," said Dr. Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. "Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery."

"Dual mobility" refers to the bearing surface of the implant—where the joint surfaces come together to support one's body weight. A hip replacement implant is a ball-in-socket mechanism, designed to simulate a human hip joint. Typical components include a stem that inserts into the femur (thigh bone), a ball that replaces the round head of the thigh bone, and a shell that lines the hip socket.

Modular dual mobility implants provide an additional bearing surface compared to a traditional implant. With the dual mobility hip, a large polyethylene plastic head fits inside a polished metal hip socket component, and an additional smaller metal or ceramic head is snap-fit within the polyethylene head.

"Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement," Dr. Westrich noted. "We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant and report on the functional outcomes."

The study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic, and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. "At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation," Dr. Westrich noted. "While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery."

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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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Is it ok to store my clinic data in the cloud?

Is it ok to store my clinic data in the cloud? | IT Support and Hardware for Clinics | Scoop.it

If like me you enjoyed gazing out of the window at school, watching the clouds go by during double maths this is for you. Everything seems to be in the cloud these days; music, pictures and all the app things I use to try and make my life a little easier. But as much as I enjoy gazing upwards what is it all really about? What does it mean for you and your clinic? Let’s start at the beginning.

What is the cloud?

In the simplest terms, the cloud means storing and accessing data and programs over the Internet instead of your computer’s hard drive. That’s probably almost as much as you need to know but please read on!

 

When you store data on or run programs from the hard drive, that’s called local storage. Everything you need is physically close to you, which means accessing your data can be fast and easy, for that one computer. But there are downsides. When information is only stored on your computer’s hard drive you are at risk from all of the usual dangers in life; coffee spills, loss of computer …. computer dying, I’m sure we all have stories along those lines. So what does it mean to have your information in the cloud?

 

Well, “The Cloud” is a buzzword that suggests everything is floating in the sky. But the reality is that the cloud is not floating above our heads, it is a physical infrastructure, its many computers all over the world. Unsurprisingly many people don’t take the time to wonder where their data actually goes or how it gets there they are just happy that it works.

What are the benefits to working in the cloud?

Working in the cloud can allow your clinic to be nimble, efficient and cost-effective. If your clinic quickly needs access to more resources, it can be scaled up quickly in the cloud. Also, if you experience any of the events mentioned above which would have a serious impact on your business your information will be safe as it’s not directly inside the damaged or lost computer. I hope that all makes sense now? Now for the really clever TM3 bit.

Cloud and Data storage

At Blue-Zinc we have a systems team who manage and develop the TM3 business cloud and as we are always trying to improve things we came up with the best possible solution available. The team has taken the flexibility of the cloud but rather than having your information roaming on random servers somewhere your data is stored in the UK (data centres certified with ISO 27001 and ISO 9001) on dedicated servers which Blue-Zinc own and the guys lovingly maintain and polish on your behalf. Security patches are regularly applied to our servers to ensure that any vulnerabilities are patched as soon as they’re identified. In addition, the SQL server database with encrypted VPN services gives users the highest levels of security available and all data is automatically backed up for you!

Feature-rich private practice software

So, with TM3, you have flexibility and safety all in one. It also means that you have access to our other cloud services Pronto, Online bookings and many more features which 10,000 practitioners worldwide enjoy on a daily basis. So, for now, my head might be in the clouds but at least I know where my data is!

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