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Computer Virus Forces Hospital To Divert Ambulances

McGruber writes "The Atlanta Journal Constitution newspaper is reporting that a hospital with campuses in Lawrenceville and Duluth, Georgia turned ambulances away after the discovery of 'a system-wide computer virus that slowed patient registration and other operations.' They're only currently accepting patients with 'dire emergencies.' A spokeswoman for the hospital said the diversion happened because 'it's a trauma center and needs to be able to respond rapidly.' The situation began on Thursday afternoon and is expected to last through the weekend."

213 comments

  1. Great by Anonymous Coward · · Score: 0

    I happen to live in Duluth. I guess I`ll postpone any plans of being sick and/or injured.

  2. We're in a sad state when... by kryptKnight · · Score: 5, Insightful

    The hospital is still treating patients in emergency situations but is asking people with minor ailments, such as sore throats or sprained ankles, to contact their regular providers, Okun said.

    We're in a sad state when people need to go to the hospital to deal with sore throats and sprained ankles.

    --
    Facts do not cease to exist because they are ignored. -Aldous Huxley
    1. Re:We're in a sad state when... by Anonymous Coward · · Score: 2, Insightful

      And when hospital computers run Microsoft operating systems!

    2. Re:We're in a sad state when... by utkonos · · Score: 0

      You must have insurance. What if you don't have insurance, and it is Saturday?

    3. Re:We're in a sad state when... by hedwards · · Score: 3, Informative

      Yes, but until the health care reform package runs most of the for profit insurance companies out of business that's going to remain to be the case.

      Sprained ankles though I wouldn't lump as a minor ailment. You don't necessarily always know if it's a sprain or a minor factor or torn ligament. Delaying care can end up costing a lot more money and result in inferior recovery.

    4. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      ... that's why he says it's a sad state, genius.

    5. Re:We're in a sad state when... by The+Pirou · · Score: 3, Insightful

      Catch a sore throat on the weekend as someone with an issue with their immune system when your regular care provider is unavailable, I think I'd go to the hospital too. Likewise if I was aged and fell, causing a swelling of the ankle. The injury could potentially be life threatening.

      Just because we're young and durable doesn't mean that there aren't a good number of others who have genuine health concerns that seem trivial to us.

    6. Re:We're in a sad state when... by stevedog · · Score: 2

      A sore throat is actually a pretty good patient. At least they have a diagnosable condition, and that puts them at least in the Top 40%. You'd be surprised how many patients' chief complaint is "my back hurts. It's been like this for the past year. I'm just tired of it."

    7. Re:We're in a sad state when... by Anonymous Coward · · Score: 1

      Sounds like the problem might be more related to paramedic training in the ambulance system. In Australia if you call an ambulance they will treat and advise you on site for minor ailments and then be on their way (no trip to hospital). Of course the problem with that is the government thinks we don't need as many paramedics if less people are being transported to hospital so they slash funding. OK so its actually moronic politicians that cause the problems. Surprise surprise.

    8. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      What if you don't have insurance, and it is Saturday?

      Then you wait until the clinic is open to get your sore throat or sprained ankled examined.

    9. Re:We're in a sad state when... by ClioCJS · · Score: 4, Informative

      Then I'd go to an urgent care clinic, which takes both my insurance and cash-only payments from people who don't have insurance. If you want to win your argument against the parent post you responded to, you're going to have to beat my argument I just submitted just now. Urgent care clincs outnumber hospitals. There may be rural exceptions, but I don't think this place is rural.

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    10. Re:We're in a sad state when... by Anonymous Coward · · Score: 1

      I have insurance and there is zero reason to pay a co-pay for treatment of a sore throat and/or sprained ankle. Those ailments are easy to diagnose and treat at home. Rushing for healthcare over every sneeze is a terrible waste of money.

    11. Re:We're in a sad state when... by Ethanol-fueled · · Score: 3, Insightful

      Yes, but until the health care reform package runs most of the for profit insurance companies out of business

      Whatever profits are to be purportedly "lost" during the healthcare reform will be made up by others' mandatory enrollment. It's all feelgood bullshit to keep the same ridiculously bloated healthcare complex fat. There are no real compromises here, and as usual, the common man loses.

      It's funny how all the big-business parrots are decrying it as "socialism," the for-profit healthcare complex is a big-businessman's wet dream.

      Also, the computer virus was because Windows.

    12. Re:We're in a sad state when... by rbowen · · Score: 1

      I know folks who go to the hospital for that and things even more trivial. Like - I am not making this up - heartburn. For me I have to be just about dying before I go to the ER and wait 4 hours to be told to go home and rest and drink plenty of fluids.

      --
      Apache guy, Open Source enthusiast, runner
    13. Re:We're in a sad state when... by ColdWetDog · · Score: 1

      Sprained ankles though I wouldn't lump as a minor ailment. You don't necessarily always know if it's a sprain or a minor factor or torn ligament. Delaying care can end up costing a lot more money and result in inferior recovery.

      Not really. Unless your managed to fracture more than one bone, in which case the pain would likely drive you to seek care, if you elevated it, put some ice on it, took some OTC pain meds you could easily wait out a weekend.

      --
      Faster! Faster! Faster would be better!
    14. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      "What if you don't have insurance, and it is Saturday?"

      Then they give you a call, and you pay for it. What's your phone number?

    15. Re:We're in a sad state when... by jd · · Score: 4, Insightful

      A sore throat can be something trivial, but it can also be something major. Going to a GP to have it checked out rather than waiting and seeing is the height of common sense. A hospital, not so much. Hospitals can do nothing a GP can't do, for those sorts of ailments. Hospitals only make sense if you actually need centralized, high-end medical treatment. You can't fit an MRI into a GP's office and a doctor certainly can't take one with them if they're doing house calls, nor will smaller facilities be able to detect everything in-house.

      Oh, I thought you were referring to a society with sensible health-care!

      The most intelligent health-care systems are ones where the method of delivery is one that suits the complaint. That doesn't necessarily mean the best - a poor but intelligent system will be more effective than a poor but stupid one, and will also be more reliable and more responsive than a rich but stupid one, but the rich but stupid system will still deliver better results in the end. What you want is rich and intelligent, but no country currently does that.

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    16. Re:We're in a sad state when... by Anonymous Coward · · Score: 1

      In my area, urgent care clinics require payment up front and are a bit more expensive. Not having insurance is a good sign that you can't afford a visit. Some people will go to the hospital when they need treatment but cannot afford it.

    17. Re:We're in a sad state when... by jd · · Score: 4, Funny

      Yes, but in Australia you've salt water crocodiles to solve your problems with politicians.

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    18. Re:We're in a sad state when... by hedwards · · Score: 1

      Actually, the problem with that theory is that the health care reform package limits overhead to 15% for group packages and 20% for individual packages. The question is how that's going to be defined and the DHHS is making them include sales charges as overhead. Ultimately, they might be still around as private insurers, but the profit is going to be absolute crap as they'll have to rebate any money they take in on premiums above that back to the subscribers.

      Ultimately everybody enrolls in health insurance at some point. There are a small number of Christian Scientists and similar that do opt out, but essentially nobody truly opts out. The question is whether you make them a part of the system early enough to do the preventative care necessary to stave off major health problems or if you wait until they hit Medicare enrollment age and try to fix what you can.

      http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/

    19. Re:We're in a sad state when... by dingram17 · · Score: 1

      By being 'in a sad state', I think the GP meant 'in the United States'.

    20. Re:We're in a sad state when... by damiangerous · · Score: 1

      Go to a seven day a week walk in clinic?

    21. Re:We're in a sad state when... by broken_chaos · · Score: 2

      Depending on the context, sprained ankles can make sense -- some sprains are difficult for the layperson to differentiate from a break.

      Sore throats... Well, not unless someone is immune suppressed or they're in a situation where a walk-in clinic or their regular general practitioner is unavailable.

    22. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Why the hell would a paramedic do that and invite funding a lawyer with their paycheck? Oh wait, In our united states, lawyers write the rules.

    23. Re:We're in a sad state when... by fsckmnky · · Score: 3, Funny

      It didn't have to be mentioned, because everyone knows Windows has all the viruses. ;)

    24. Re:We're in a sad state when... by hawkinspeter · · Score: 3, Informative

      Going to hospital with heartburn is actually very common, especially for people with angina. Heart attacks and heartburn have almost identical symptoms, so it makes a lot of sense to go to hospital when you've got an existing condition.

      --
      You're a temporary arrangement of matter sliding towards oblivion in a cold, uncaring universe
    25. Re:We're in a sad state when... by stephanruby · · Score: 1

      We're in a sad state when people need to go to the hospital to deal with sore throats and sprained ankles.

      You're not very good at reading between the lines of a Cover-Your-Ass Public Relations statement. Are you?

      Having a "sore throat" in a US Hospital ER is a very specific code word which means vomiting blood, writhing on the floor in agony, and basically dying slowly in front of the ER nurses while they still refuse to treat you. Go ahead, listen to the 911 tapes and watch the actual video of the waiting room.

      I'm sure that they would have said a similar thing "don't come to the hospital if you just have a sore throat or a sprained ankle", not that they said anything of the sort. But that's basically what an ER hospital would say because it never would want to be perceived as overwhelmed. The fact is, they refused this lady service for three hours (basically until she died) because she didn't come via ambulance. And 911 wouldn't send an ambulance because the couple was already located at the ER.

      And having a "sprained ankle", that's a good one! The people with "sprained ankles" who actually go to the ER generally don't know they have a sprained ankle. It's not like most people enjoy going to their ER in the first place. If they're at the ER, it's usually because they think something is broken, but the PR lady is not going to say something like that, that could land her into trouble. Just imagine if she said: "Don't come to the ER, even if you think you broke your ankle. Having lots of pain doesn't necessarily mean anything is broken anyway, so if you're lucky, and you probably are -- it's probably just a sprain. Just stay off it for a while and take some ibuprofen."

    26. Re:We're in a sad state when... by Ultra64 · · Score: 1, Flamebait

      What other operating system has viruses?

    27. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Well, no, it's not an ambulance issue, the ambulance diversion is separate from the "patient stay away request" though it is a bit hard to read between the lines.

    28. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Emergency rooms around here are notorious for being full of quacks. And for making you wait 2 hours in the lobby. And for charging 500$ for a bandaid (no, really). Don't have a relative to sign your papers and pay while you bleed out? Expect even shittier service.

    29. Re:We're in a sad state when... by Zapotek · · Score: 1

      The first one more often than not is a symptom of something else and the second one can cause long term problems if not treated properly. Of course you should get professional advice for both. I'm of course not talking about a simple cough here but if you start spewing brownish stuff then it's time to visit a doctor.

    30. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      We all know that ignoring a sore throat and waiting for it to heal can't have tragic consequences: http://en.wikipedia.org/wiki/Jim_Henson#Illness_and_death

      I broke my leg and walked on it for a while before I finally drove to the emergency room where they put a cast on it after x-rays. The reason I went for treatment was because it was having circulation issues because of the swelling. (They made me STAND at the counter of the emergency room and fill out forms )

      Probably hairline cracked my arm when I was a kid and had no insurance and just toughed it out. Felt about the same and could not really use it for a few weeks.

      Everyone should have access to basic medical care at reasonable costs

    31. Re:We're in a sad state when... by kesuki · · Score: 1

      if you'd ever had a sprained ankle you'd know it's not easily extinguishable from a break in the bone. so x-rays and thus a hospital visit.

    32. Re:We're in a sad state when... by Grishnakh · · Score: 4, Insightful

      What if you're poor? You have two choices:
      1) Urgent care, which takes cash-only payments (and usually requires them up-front), or
      2) Emergency rooms, which are free; you just have to say "I don't have insurance and I don't have any money". Or even better, you can say "No habla Ingles". The hospital is required to treat you, and then pass the bill on to all the other patients by charging them $10 for a tylenol pill and $20 for a band-aid.

    33. Re:We're in a sad state when... by Grishnakh · · Score: 2

      There's a reason for this stuff: long waits are necessary because there's dozens of people there bringing their kids in for runny noses and sore throats. Charging $500 for a bandaid is necessary because all those dozens of people there for common colds aren't going to pay, so they have to pass the costs for all the non-payers on to people who do pay.

      Fix the healthcare system in this county and you wouldn't see this crap.

    34. Re:We're in a sad state when... by ClioCJS · · Score: 0

      Up front? Hmm, well. Okay then. You convinced me.

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    35. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Then I'd go to an urgent care clinic, which takes both my insurance and cash-only payments from people who don't have insurance. If you want to win your argument against the parent post you responded to, you're going to have to beat my argument I just submitted just now. Urgent care clincs outnumber hospitals. There may be rural exceptions, but I don't think this place is rural.

      Many urgent care clinics are an extension of full health care facilities. If their CR processor or CPOE system can't communicate back to the "core" then those facilities are just as affected as the "core". Of course, this all depends on the infrastructure of the affiliate. If the facility was designed as a true hub/spoke environment then each should operate independent of the other but will effect services that rely on each other

    36. Re:We're in a sad state when... by Anonymous Coward · · Score: 0, Flamebait

      Run them out of business? My dear boy, has the wool been pulled over your eyes that far? The "health reform" that was handed down was a fucking bailout to the health care industry. Now instead of having a choice to pay or die you'll be forced to pay unless Obama gets your name off the list for certain levels of re-election support...
       
      You've been sleeping. Wake up and see what will happen when you're beholden to a private industry by the force of federal law. If you can't see the pitfalls that await you than you seriously need to drop the video gaming for a while and do some research.
       
      And I should know, I work in the health care industry and the high ranking management are happier than a pig in a foot of shit. They're beside themselves with joy and there are dollar signs in their eyes. We're already expanding certain health care departments faster than we can fill seats because of the windfall this is going to cause.
       
      But don't believe me, go out and google it yourself! There are tons of articles about this being a burden on the tax payer and a boon for the industry that Obama and company claimed they were going to battle for you. You've been fucked like a two bit whore.

    37. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Any Linux distro and Mac OS.

    38. Re:We're in a sad state when... by thelonesun · · Score: 1

      Android?

    39. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      You don't want to be at Gwinnett Medical if you don't have insurance anyway...

    40. Re:We're in a sad state when... by Datamonstar · · Score: 5, Informative

      I'm currently inside a hospital data center and I can tell you that windows is behind the scenes of a lot of the systems we use. Everyone in "the know" thinks it sucks that the majority of the problems we encounter is because of borked hardware configurations in appliance machines or Windows servers. We are on mainframe (as of today, it's still the only way to get everyone's critical data to almost a dozen moajor sites at once with 99.9 uptime and I don't see us abandoning it anytime soon) and there is a god-damned Windows server that is only used to encode EDI transactions to the JES2 spooler that always crashes, causing the spool to fill up, endangering the entire system. It's a very serious problem as the only solution to it once JES is full is to IPL the system.

      The server in question doesn't even show an error message. Well, sometimes it does, sometimes it doesn't. you can stop and start the services all you like, but you're just wasting time as the JES2 spool gets bigger. The only solution is to reboot the Windows Server. It is redundantly mirrored, but we any of you with any sense will know that this does not make the situation any less frightening. The mirror is bound to be subject to the exact same problem, since it's software-related, which would put you back at square 1 in the event of a fail-over.

      Don't even get me started about malware. Of course, all the workstations throughout the system are Windows systems. Those should not matter in case of a power outage or system-wide failure because we have downtime procedures in place, but let's face it, we'd be majorly crippled if we were to ever loose our entire network and it would likely impair our ability to serve customers. Although it shouldn't. So far we've been lucky.

      --
      The eternal struggle of good vs. evil begins within one's self.
    41. Re:We're in a sad state when... by Ultra64 · · Score: 1

      Oh yeah, I heard about that one mac virus, and that other virus for Linux

    42. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      If you'd ever had a broken ankle you'd know there was no confusing it for a sprain.

    43. Re:We're in a sad state when... by Culture20 · · Score: 1

      If you'd ever had a broken ankle you'd know there was no confusing it for a sprain.

      I've had both (hairline fractures, not full-on busted ankle), and they're very similar.

    44. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      All versions of Windows, all versions of Linux, all versions of Mac OS X, all versions of Android.

    45. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      or that any emergency situation can cause a hospital to stop accepting patients due to robot issues

      Administrative staff should be terminated for lacking
      a distinct procedure for exactly this situation.

      sounds like self-fornication rather than crisis mitigation.

    46. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Sigh, standard Microsoft Apologist script. Can't you guys do anything original at all?

    47. Re:We're in a sad state when... by jc42 · · Score: 1

      If you'd ever had a broken ankle you'd know there was no confusing it for a sprain.

      Maybe, but for the other 99% of us, if we have some sort of accident that results in serious pain in an ankle, how do we determine which we have?

      The obvious way is to go to a hospital and ask them. But if you know a better (i.e., more reliable) way, how about telling us inexperienced folks how to tell the two apart.

      --
      Those who do study history are doomed to stand helplessly by while everyone else repeats it.
    48. Re:We're in a sad state when... by dmr001 · · Score: 2
      Why, you use the Ottawa Ankle Rules, which are an evidence-based method to determine whose sprained ankles deserve an x-ray to rule out a fracture. It turns out the same mechanism of injury - getting your foot bent under (usually the outside part going down, called inversion) is not only an excellent way to cause a painful ankle sprain, but has a habit of tearing the very bottom part of your fibula off, which will buy you a few weeks in a walking boot or similar cast.

      In case I'm still not being clear, this means that the parent's suggestion of going to a hospital, urgent care clinic, or your primary physician's office is reasonable. Using the Ottawa ankle rule rule on yourself, I suppose, might save you a trip, though in my experience it tends to rule most people in for an x-ray, so you'll be headed in anyhow.

    49. Re:We're in a sad state when... by dmr001 · · Score: 1

      I don't know who you're working for, but in my health care system we're happy about the potential for health care reform because in an Accountable Care Organization we can direct more resources toward keeping a population of people healthy, rather than racking up as many procedures as possible to keep the lights on. (It turns out we primary care physicians get paid more for paring corns on your feet than spending half an hour providing evidence-based preventive care for your 2 year old's checkup.) It makes more sense to get paid to keep a population of patients healthy than treading water (and racking up charges) for often pointless medical piecework with misdirected incentives. Our current expansion involves trying to figure out how to take care of more patients more efficiently by keeping them out of the office, when possible, including e-visits and better phone triage. No one I know (in our 5 state organization) seems to have significant dollar sign eye-flashing.

    50. Re:We're in a sad state when... by baegucb · · Score: 2

      You can dynamically add volumes to the JES2 spool. No need for an IPL. That's what your system programmer should doing. And automation should be running a command such as $DJOBQ,SPL=(%>3.0) every 5 minutes or so to check for jobs with high spool utilization, triggering an alert to the consoles.

    51. Re:We're in a sad state when... by DarwinSurvivor · · Score: 1

      He asked what operating system HAVE viruses, not which operating systems have at one point had A virus.

    52. Re:We're in a sad state when... by DarwinSurvivor · · Score: 1

      Anyone that monopolizes hospital resources for a band-aid or tylenol damn well BETTER be charged at least that much, unless they are getting a cast to go with that band-aid.

    53. Re:We're in a sad state when... by DarwinSurvivor · · Score: 1

      There is a very easy way to tell the difference. If the pain is in a location the size of your finger tip, then go to the hospital (probably a bone issue). if the pain is over a larger area than that, it's muscle/tissue damage and ice will suffice. And before you say that broken/fractured bones also have muscle/tissue damage, the body does a very good job of making you only notice the bone damage.

      This is just one of the many diagnostic tricks taught during almost every level of first aid.

    54. Re:We're in a sad state when... by Grishnakh · · Score: 1

      I think it's pretty safe to assume that anyone that gets a tylenol in a hospital, and actually pays for it (or their insurance pays for it), is probably there for some much more urgent reason than a simple headache.

    55. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Those are your customers you're talking to.

    56. Re:We're in a sad state when... by Runaway1956 · · Score: 1

      While that may be so, an idiot is an idiot, whether he be a customer or not.

      In fact, much of American business is dedicated to exploiting idiots. Half or more? There really are a lot of legitimate businesses, that have products to sell to intelligent people. The rest? Bank of America comes to mind. They do provide some invaluable services that are necessary to the economy. At the same time, they enjoy ripping off the clueless idiots who can't survive without an 18% (or higher) interest credit cart.

      What was I saying? Idiots. Corporate America loves idiots!

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    57. Re:We're in a sad state when... by Runaway1956 · · Score: 2

      Every single operating system known to man is prone to viruses - some more so than others. More to the point, would be asking about exploits, rather than viruses. All systems have exploits. The only reason Linux and/or Mac is more secure than Windows, is the philosophy behind security. Windows sacrifices security for convenience, Linux sacrifices some convenience for security, and Mac is somewhere between the two.

      But, an idiot can compromise any system, in about two heartbeats, if he is given admin powers.

      The user is key, when it comes to security! No Linux user is willing to trust the health of his system to Symantec. Millions of users are willing to trust Symantec.

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    58. Re:We're in a sad state when... by houghi · · Score: 1

      I go to my doctor. If it is not during standard visiting hours, I go to the doctor on duty. If my doctor is not in, I go to a different one.

      I once went there with a sprained ankle and he told me to go to the hospital immediately. The time I would have won if I would have gone directly to the hospital is about 30 minutes.

      All of them take my insurance. I am not even sure the hospital takes cash.

      Hospitals will let me wait for much longer to deal with people who actually need hospital care. They will not send you away, but explain that the next time to please not waste their time but contact a doctor first. This can also mean just calling him and explaining the situation.
      He will know you and will be able to decide if coming over is a good idea or directly going to the hospital is better.

      So the solution would be to contact your doctor and ask HIM what you must do. Oh yeah, I am from communist Europe, so we don't bother that much about insured or non-insured.

      --
      Don't fight for your country, if your country does not fight for you.
    59. Re:We're in a sad state when... by gl4ss · · Score: 1

      The OS they're running isn't mentioned you dumb faggotlord fanboy.

      of course it runs windows. it's a hospital. wouldn't it be fun if their sw stopped working when they upgrade to lion or 3.0 kernel ?

      --
      world was created 5 seconds before this post as it is.
    60. Re:We're in a sad state when... by GNious · · Score: 1

      how can you guys be relying on anything less that HP NonStop or similar systems?

    61. Re:We're in a sad state when... by GNious · · Score: 1

      I once went there with a sprained ankle and he told me to go to the hospital immediately. The time I would have won if I would have gone directly to the hospital is about 30 minutes.

      I broke my leg once. Wasn't sure it was a complete fracture, so waited a day to check. Concluded that, yes, it'll likely need a cast, I biked down to see a doctor. He agreed, it was broken, and thanked me for waiting instead of rushing to the hospital/ER for something this minor.

      Went to the hospital, they checked it, xray'd it, and agreed: Its broken. Then gave me a crutch and sent me home (no cast).

      Lesson learnt: A lot of stuff don't require you to go to hospitals, and don't require you to go immediately.

    62. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      You must be in a utopian blue state. As a nurse in a southern red state I can tell you that gubbement provided "free" healthcare means that the ER is your doctors office for some people. A sore throat or sprained ankle is considered trauma in some circles.

    63. Re:We're in a sad state when... by craigminah · · Score: 0

      It's because of two reasons: hospital care is perceived as "free" due to insurance or governmental aid and because people don't get regular check-ups. It's like taxes, we'd be more offended about the taxes they take from us if we had to pay our annual federal and state taxes via a check every year...so we could see the actual amount and feel the pain. Medical insurance needs to be overhauled as does the drug industry (which may actually mean the FDA). It's a shame the hospital's down...problems like this are going to become more prevalent as SCADA moves to Windows... Sorry for the smattering of thoughts but I woke up a few minutes ago and to quote Cookie Monster, "me sleepy and me need cookie."

    64. Re:We're in a sad state when... by DarwinSurvivor · · Score: 1

      You would be *amazed* what some people will go to the hospital for. Then again, I'm in Canada, so they don't charge us anything anyways. But good LORD do they give dirty looks to the "I have a headache" people when they get to the sign-in counter!

    65. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      because HP nonstop is a reasonably limited system for modern development. We were contracted to port just the DB of our system to it and found we couldn't. Nonstop is a fine thing in itself, but you really need to design for it in the first place.

      We write Windows systems for emergency services too, and the only answer we give to security is "run it on an isolated network". Simple as that, we never advise anything else. Even then, we get the odd issue - such as the 3rd party contractor who connected a USB drive to the system to deliver software and infected everything with conficker. That took 2 whole f***ing weeks to remove and required the services of a Microsoft consultant (at great expense).

    66. Re:We're in a sad state when... by Rich0 · · Score: 1

      Yup - a few Saturdays ago I made an emergency call to a doctor (on a holiday weekend no less) and after discussion brought a urine sample to a hospital over a suspected urinary tract infection.

      Now, for an ordinary person it might not have been the right call, but in this case the person it concerned had been in the hospital intensive care unit three times (a week each) with sepsis that originated in urinary tract infections. It has been kept under control for a few years now with vigilance and a bottle of antibiotics in the cabinet at all times. While an average person could probably put up with it for a few days that would be taking a risk of serious escalation in this particular case.

      The doctor understood this, and being a Saturday there aren't a lot of options when you have a container full of urine that either is going to get tested or spoil. The testing was necessary since obviously the doctors like staying on top of what is going on, and beyond that they can't legally be writing prescriptions for antibiotics without any kind of evidence that the patient needs them.

      Plus, if a patient is suffering I just don't see the value in making them wait several days for an office appointment. One of my pet-peeves with the medical system in general is that it largely runs on a M-F 9-5 basis. When aforementioned patient has been in the hospital or other acute therapy providers on a weekend they basically just keep you in a holding pattern with no real progression in care unless the therapy you're already on just happens to be working. I'm fine with letting doctors have more convenient schedules, but surely we can keep hospitals fully operational on weekends, let alone at night?

    67. Re:We're in a sad state when... by jbengt · · Score: 1

      I know folks who go to the hospital for that and things even more trivial. Like - I am not making this up - heartburn.

      Like my uncle, who went to the emergency room with chest pain, only to be treated for heartburn and sent home, only to come back to the emergency room several hours later and die of the heart attack he was actually having.
      FYI, symptoms of heartburn are similar to symptoms heart attacks.

    68. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      I find that almost unbelievable. I've a small network, and I couldn't imagine not having a Unix based OS running it. A perfect example is upgrading the OS. Anybody who has done it knows that with 'nix it's as transparent as it gets. Why somebody would use IIS before Apache is mind boggling. Oh wait, they are stuck in the MS ecosystem. I feel for you brother...

    69. Re:We're in a sad state when... by DavidTC · · Score: 1

      There's basically no way in which non-medical personal can use any of those rules besides 'An inability to bear weight both immediately and in the emergency department for four steps.'.

      If you cannot do that, you need an x-ray. (I am assuming by 'in the emergency department' they mean 'ten to twenty minutes later', not that there is some magical property of emergency departments.) If you can take four steps, you still might need one. So people can rule themselves into needing an x-ray, but can't possibly rule themselves out of one.

      So there's really no point of them doing the test in the first place. Just go see the doctor.

      Granted, we don't need actual doctors to do the test. In fact, I think an RN could legally do the test. (I think collecting symptoms to find out if a test is needed is generally within their bailiwick.)

      Of course, we refuse to set up any sort of system where you might see medically knowledgeable people who aren't doctors who then tell you basically what's going on, and send you to a doctor if it appears to be an actual problem. (And we refuse to actually have enough doctors to do it how we do it now.)

      --
      If corporations are people, aren't stockholders guilty of slavery?
    70. Re:We're in a sad state when... by Jawnn · · Score: 1

      You (probably) do no know just how right you are.
      The oft-parroted "greatest healthcare system in the world" meme is often trotted out in the same sentence with "...accessible to everyone...", because yes, it's true, if you have not the means to access the greatest healthcare system in the world via more appropriate avenues, the local E.R. must treat you. And that is perhaps the biggest problem with this system. We (those of us who pay taxes AND insurance premiums) pay to have the sore throats and sprained ankles of a rapidly growing number of our fellow citizens treated in the most expensive venue possible - the hospital emergency room. That insane reality is part of the reason why we spend more per person on health care than any other nation on the planet, and yet receive far far less for our money.

    71. Re:We're in a sad state when... by Jawnn · · Score: 2

      Then I'd go to an urgent care clinic, which takes both my insurance and cash-only payments from people who don't have insurance.

      Typical out-of-touch-fuckwit response. How many of those who don't have health insurance can afford even the lower rates that urgent care clinics charge? Hmmm?

    72. Re:We're in a sad state when... by Grishnakh · · Score: 1

      Why don't they just refuse to admit them, and send them to the nearest urgent care clinic?

      I can't say this is completely universal over here in the US, but for most people who have insurance, you usually have to pay something called a "co-pay" any time you visit a doctor or medical facility. This charge varies by insurance provider and by what kind of facility you're going to. So, for instance, with my insurance, if I go to a doctor's office for any kind of visit (checkup with primary care physician or visit to specialist), it's only $15. If I go to urgent care, it's $35. But if I show up in the ER, I have to pay $150. So obviously, I'll avoid the ER unless I really don't have a choice, because I'd highly prefer to save that $115 difference between the UC and ER if I can.

    73. Re:We're in a sad state when... by ClioCJS · · Score: 1

      Look who's response is out-of-touch fuckwit: You just admitted that it's cheaper. So why would someone without insurance go to the more expensive hospital? They're going to go to one or the other regardless of price if it's truly necessary (i.e. will go into debt). So far your argument actually reinforces my "fuckwit" point by saying urgent care is a cheaper choice, which was exactly my point: Why not go to urgent care instead of a hospital? Your response is they can't afford either. Last I checked, people who can't afford treatment still seek it out. I used to review medical records of the uninsured. You stay at a hospital after a fistfight? $100,000. So again: Why was my suggestion that an urgent care clinic is a better choice than a hospital an "out-of-touch fuckwit response"? I mean, did you think that I don't know there are people who don't have insurance, or that I don't know they can't afford either? Or does it just make you feel better to pretend that anyone who submits an argument that goes over your head is out of touch and not in the know, so that you can strawman-attack a persona completely of your own invention?

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    74. Re:We're in a sad state when... by sjames · · Score: 1

      Welcome to health care in "the most advanced country on earth".

    75. Re:We're in a sad state when... by sjames · · Score: 1

      If you have neither insurance nor cash, you have to go to the emergency room where they have to provide you with at least a minimum of care. You'll be hounded for the money you don't have later, but at least you get healthy enough to go stand in the unemployment line.

    76. Re:We're in a sad state when... by ClioCJS · · Score: 1

      And the urgent care center that I go to doesn't even ask for a copay until weeks after you've gone. So you'd get a minimum level of care (actually quicker and better than the hospital in my experience), but obviously you couldn't get something like surgery. So you see, not having insurance doesn't make a difference in the situation. (Unless an urgent care center isn't nearby, or there are ones that operate differently than the ones I've gone to.)

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    77. Re:We're in a sad state when... by Entropius · · Score: 1

      Does Linux sacrifice that much convenience for security?

      I have to type in my root password once in a while when using the GUI, and I have to write "sudo" occasionally. It's not really a pain at all.

    78. Re:We're in a sad state when... by Nethead · · Score: 1

      This. And $deity help you if you have a tooth go south on a weekend.

      --
      -- I have a private email server in my basement.
    79. Re:We're in a sad state when... by sjames · · Score: 1

      A copay implies that there is insurance. Try showing up without insurance or cash and see how you do.

    80. Re:We're in a sad state when... by ClioCJS · · Score: 1

      In this case -- They didn't actually ask for insurance until after the services were rendered.

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    81. Re:We're in a sad state when... by Runaway1956 · · Score: 1

      Linux sacrifices a bit of convenience, yes. Depending, of course, on what one means by "convenience". Most of the world's computer users have conveniently forgotten all about DOS, and CLI. You and I rely on the terminal, but we are a rare breed. Several people have commented many times, among them Hairyfeet, that until Linux forgets about terminals, we'll never compete with Windows.

      Convenience. Installation is more "convenient" in Windows, for sure. Click the installation file, click through all the nag screens, and you're done. Here, in the Linux world, I either install from a trusted repository, using a dedicated application for that purpose, OR, I find a .bin, .run, or a tar file somewhere, and run them. That sometimes gets pretty complicated.

      Of course, you and I believe that the end result is worth the effort. We pretty much know our systems. Windows users usually know squat about their system, instead "trusting" Microsoft and whoever created their little installation files. "Do you want to install DancingPonies.exe?"

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    82. Re:We're in a sad state when... by HiThere · · Score: 1

      No. Every system is vulnerable to trojans (barring the embedded systems, of course). Viruses, however, are something else. Most varieties of system are not host to viruses (though this wasn't always the case). Worms are, again, something else. They can infest any system using certain networking protocols.

      I can't give you the technical distinctions between these classes, but they exist and are significant.

      N.B.: Linux could be a lot more secure than it is. No questions about that. But only at the cost of being slightly less convenient.

      P.S.: Is Android host to viruses? It may be, I don't know. But note that this would be because of features which are different between Android and Linux. (There are, indeed, a lot of those.) Generally, however, when I hear that Android is host to malware, I assume that what is being talked about are trojans.

      --

      I think we've pushed this "anyone can grow up to be president" thing too far.
    83. Re:We're in a sad state when... by ClioCJS · · Score: 1

      A lot of people don't make decisions like you, i.e. logical. "I'm gonna die and a hospital is my #1 chance to not die". I remember when I finally went to an ER first time in my life at age 35 at behest of everyone else BUT me. All I could think of was the wasted $100 co pay, and it WAS a waste! I should have ignored them all. (Blood clot? Nope. Just effects of wearing a night boot.)

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    84. Re:We're in a sad state when... by HiThere · · Score: 1

      Don't count on the hospital being a decent fall-back. I got an attack of what turned out to be celluliits on a Friday night, and spend around 12 hours in the emergency room fainting, vomiting, etc. before I ever saw a doctor. I ended up with a week of intravenous anti-biotic treatment. Sometimes it's not that bad, but you can't count on it.

      These days if I need help, I usually ask a neighbor, or wait until Monday. The Emergency room is only if you're likely to die otherwise...and then don't expect help. You might get it, but don't expect it.

      P.S.: Don't count on athlete's foot being a minor problem. After several recurrences of cellulitis I got to a doctor who identified the cracks between my toes as the entrance site of the bacteria. Then ... well, the answer turned out to be hunks of raw wool between my toes, changed every day. This was difficult as tracking down a supply of un-dyed raw wool fiber was ... interesting. Drugstores don't carry that kind of thing. Eventually I found it at an on-line supplier of goods for Spinners.

      --

      I think we've pushed this "anyone can grow up to be president" thing too far.
    85. Re:We're in a sad state when... by dmr001 · · Score: 1

      Bone tenderness along the distal 6cm of the posterior edge of the tibia or fibula just means "does it hurt when you press on the back bottom part of the bones sticking out on either side of your ankle." You really can do this (and I have successfully gotten people to do it over the phone);

      Scope of practice laws vary from state to state; an RN could probably get an x-ray ordered after doing such a test provided there was a written protocol signed off by a physician in most places, though I know of know actual emergency departments that do this. Having an RN (who is not an independenty practicing nurse practitioner anyway) do this on their own in the absence such a protocol would probably illegally stray into the actual practice of medicine.

      We have such a system where you can see medically knowledgeable people who aren't doctors. They are called nurse practitioners and physician assistants in the US, and "medical officers" in other places.

    86. Re:We're in a sad state when... by sjames · · Score: 1

      I still wonder what happens if they ask and you show them empty pockets. That is a very rare place you go to. Most do want arrangements up front and will suggest the ER if you can't pay.

    87. Re:We're in a sad state when... by Rich0 · · Score: 1

      Actually, nothing puzzles me more about the medical system than the fact that teeth are treated differently than everything else. Obviously there is history at work here.

      Look, I can understand not having ordinary medical insurance cover somebody wanting to have their teeth whitened, or maybe even having it cleaned. However, when somebody breaks a tooth how is that different from breaking a bone? You're talking about pain and potential permanent injury to some part of your body.

      I know somebody whose kid needed serious orthodontics work. We're not talking about a cosmetic gap in the teeth - we're talking about pulling several teeth and straightening others out (well, the extra teeth fell out on their own mostly with the corrections). Now, we treat ingrown toenails under medical insurance - why not seriously out-of-whack teeth (where we're talking about long-term pain and damage if they aren't fixed).

      Cosmetic surgery is one thing, but there is no reason that serious dental problems should be treated in the way that they are.

    88. Re:We're in a sad state when... by Kalriath · · Score: 1

      As I'm constantly having to point out to you goddamned biased *nix fanboys, a Windows network in the hands of competent administration can be just as reliable as a *nix network. And a *nix network in the hands of incompetent administration can be just as unreliable as a Windows network in the hands of incompetent administration.

      That means no browsing the internet on servers, no removable media on desktops, no administration rights, and so on.

      --
      For a site about things like basic rights, Slashdot users sure do like to censor "dissent".
    89. Re:We're in a sad state when... by Datamonstar · · Score: 1

      We do receive an alert at 80% utilization> it's just the fact that we only have ONE operator on each shift at night and there's always the chance that something could go wrong elsewhere and the message is missed. The powers that be have made this decision against the advice of our Sys Admin, so they know the risks. I hope.

      I will ask him about adding volumes dynamically, but I'd gamble that's something he'd rather not do for whatever reason.

      --
      The eternal struggle of good vs. evil begins within one's self.
    90. Re:We're in a sad state when... by Anonymous Coward · · Score: 0

      Which is why I answered what I answered.

    91. Re:We're in a sad state when... by TheSpoom · · Score: 1

      Mod parent up. I'm pretty far left, supported Obama when he was elected, but the parent is absolutely speaking truth. The only good solution I can see to getting the insurance companies out of the mix is single payer, and the second anyone sees that they think "OMG SOCIALISM" because that's what they've been taught, even though it works in just about every other first world country.

      --
      It's better to vote for what you want and not get it than to vote for what you don't want and get it.
      - E. Debs
    92. Re:We're in a sad state when... by Muad'Dave · · Score: 1

      "No habla Ingles"

      Saying "You don't speak English" isn't going to be very convincing.

      --
      Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
    93. Re:We're in a sad state when... by Muad'Dave · · Score: 1

      So why would someone without insurance go to the more expensive hospital?

      As has been repeatedly mentioned, hospitals in the US (more specifically, emergency rooms) must provide basic care to everyone that walks thru the door without regard to their ability to pay.

      The question then becomes, "So why would someone without insurance go to the more expensive Urgent Care Facility when the ER is free?"

      --
      Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
    94. Re:We're in a sad state when... by Grishnakh · · Score: 1

      Sure it will; it's not like the hospital workers can tell the difference.

    95. Re:We're in a sad state when... by utkonos · · Score: 1

      I repeat. You must have insurance just like the OP does. So, you've never visited an urgent care clinic? Go check it out, then come back and tell me I'm wrong. See if they will treat you for anything at all if you don't have enough cash on you. See if they don't call the police if your poor ass stays there too long and you don't have cash.

    96. Re:We're in a sad state when... by utkonos · · Score: 1

      That's not legal. An emergency room has to care for you.

    97. Re:We're in a sad state when... by Grishnakh · · Score: 1

      Not completely true. They have to stabilize you, and that's it. If you show up in an ER with cancer and you need long-term hospice care for that, for instance, they're not going to do anything for you. If you're bleeding out, they have to stop the bleeding and stabilize you, but they don't have to deal with your longer-term care afterwards. If you have a cold, they have to check you out and probably have to just make sure you don't have pneumonia or whatever, but beyond that they don't have to do anything (since, after all, there's absolutely nothing you can do for a cold except eat chicken soup).

    98. Re:We're in a sad state when... by utkonos · · Score: 1

      Thankfully doctors are more likely to be nice people and not slashdotters like you all. Fuck em if they're poor. Government handouts are for commies.

      In reality doctors swear an oath to practice medicine ethically. That means giving care and then worrying about payment and money, not the other way around.

      I know quite a few doctors who work with people without insurance, and they do things like gather bags of drug samples to give to patients who can't afford the medicine from a pharmacy, or who will lower their payment drastically if they know you are paying cash and don't have insurance.

      There is even the slightly darker side of it (I have friends who are photographers and artists, and they know and use many doctors like this): doctors who will proscribe you what you need without a visit, or with the briefest of visits to simply explain what you think you need. These are probably the same doctors that routinely get busted for handing out oxycontin, but it's not the only thing they do.

    99. Re:We're in a sad state when... by ClioCJS · · Score: 1

      I repeat (pasting the very comment you replied to -- did you read it?) -- "Up front? Hmm, well. Okay then. You convinced me."

      --
      -Clio
      Karma: Bad (mostly from not giving a fuck)
      Blog: http://clintjcl.wordpress.com
    100. Re:We're in a sad state when... by Jawnn · · Score: 1

      (typing slowly, so you can grasp the esoteric concepts involved...)
      Because for the indigent patient, the E.R. will not show him/her the door if he/she is unable to pay. The urgent care clinic will because they do not operate under the same mandate as does the E.R.
      Dude, you really need to educate yourself on how this works. You are out of touch. Seriously.

  3. which o/s by TheGratefulNet · · Score: 1

    as if I have to ask...

    the article mentioned nothing about which o/s or apps they run. or their network topology. things that matter, you know.

    bet they thought about mentioning windows but their legal team said 'meh, why create trouble?'.

    omissions like that are dishonest.

    --

    --
    "It is now safe to switch off your computer."
    1. Re:which o/s by Locutus · · Score: 1

      it's blown me away when I asked an admissions person if she had an internet connect that worked with Internet Explorer and she said yes.

      LoB

      --
      "Anyone who stands out in the middle of a road looks like roadkill to me." --Linus
    2. Re:which o/s by crutchy · · Score: 0

      the hospital is probably OWNED by Microsoft

    3. Re:which o/s by Billly+Gates · · Score: 1

      With medical billing and ERP software being intranet based they use it. That is a good thing to cut down on cost and quickly save lives so the records are there for the staff.

    4. Re:which o/s by Anonymous Coward · · Score: 1

      You mean pwned because of Microsoft.

    5. Re:which o/s by jd · · Score: 4, Insightful

      Perhaps, but IE is a major security hole. At the very least, hospitals should be absolutely required to use a secure browser. Secondly, with ERP, etc, being browser based, there's no difference from an operator standpoint between Windows and OpenBSD. You still click links, you still open tabs, you still get to set the wallpaper on the background. Ergo, there's no rational reason to use something that's expensive and insecure over something that's cheap and secure. If there are no platform-specific apps (they're all web-based) then go with the OS that is least likely to endanger service.

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    6. Re:which o/s by Anonymous Coward · · Score: 0

      I should hope their security staff sets up a whitelist on the gateway for the computers, and doesn't allow anyone outside the intranet unless there's a business need for it.

    7. Re:which o/s by jd · · Score: 0

      Troll much, or is this your first time?

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    8. Re:which o/s by JustNiz · · Score: 1

      Wait.. you're accusing him of trolling just because he said IE is a major security hole, Which is pretty much a well known fact?
      So you work for Microsoft corporate or something?

    9. Re:which o/s by JustNiz · · Score: 1

      dammit appologies... stupid slashdot thresholds...

    10. Re:which o/s by jd · · Score: 1

      NP. The problem with snarky comebacks is that Slashdot doesn't have a way of unthresholding the thing a person is snarkily replying to. I'm mentally taking it that you're really replying to the AC I snarked at. :)

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    11. Re:which o/s by JDG1980 · · Score: 2

      Perhaps, but IE is a major security hole.

      IE8 and IE9 are fairly secure, especially if paired with Vista or Windows 7, which support protected mode. Now, if they're still using IE6 on XP, then they're screwed.

    12. Re:which o/s by Billly+Gates · · Score: 1

      Where I worked their credit card scanners and signature keypads needed to integrate with the browser. Therefore it had to be activeX based which was IE. Also anything that hooks into a computer, but the backed is browser based has to be IE. No other browser talks to hardware with maybe the exception of future releases of Chrome when NACL is finished.

      IE 6 is standardized too if the app is more than 2 years old which blows. In 2009 companies sold IE 6 rendered intranet software which means no OpenBSD unless you run a VM or something retarded. I am talking SAP, Oracle and others and not just small medical software consulting companies. This is why XP is having a hard time dying in the largest companies.

      There are software that is developed for Windows because that is what everyone else also uses that is not intranet based as well. Think VB client server apps and mix in portable medical scanners and very very expensive diagnostic equipment and that too runs on Windows and is something you do not throw out every Windows release.

      I do agree that it is a problem, even if IE is no longer insecure if you read earlier stories from today (why everyone is flaming you).

      With such high security requirements where lives are in danger and lawsuits with HIPA.

      Here is my solution would be to have trusted Ethernet connections setup through the CISCO routers where doctors looking at MRI images with IE 6 can do much else but interact with medical software and intranet apps. For uses on client computers to access email from patients and browse the web I would setup a second network for that. Something like an intranet DMZ with subnet would be ideal! It would surprising easy if they already have CISCO and $1000 and a week with a local IT firm could set it up and work with the I.T. staff. I understand devices come with Windows but who gives a crap about a medical scanner accessing facebook. It is for a single task and does not deserve to be on the same network. I know it is a pain and some doctors may complain but where I worked in Alaska earlier this year all the nurses and secretaries had their own PCs anyway for email. So give them their own network. Then they can use Firefox or Chrome and keep ancient versions of IE for reviewing cat skins to trusted clients for doctors only.

    13. Re:which o/s by bsturner · · Score: 1

      You had me until "secure browser". It doesn't exist. I'm guess you mean firefox or chrome. The browser isn't the issue. It's the lack of stricter policy for these types of applications. Disconnect that $&#^ from the internet. Seriously. Allow traffic out to the five sites that are required for the docs to do their job, and the rest get blocked. I support a clinic that attends to non-life-threatening issues. The top dog in the clinic can't stay off Facebook while in the office, and nobody higher up the food chain than me will say he can't be on Facebook. So guess what? My group gets to remove malware every few weeks from the machines in said clinic.

    14. Re:which o/s by Anonymous Coward · · Score: 0

      You don't read /. much do you

    15. Re:which o/s by Anonymous Coward · · Score: 0

      nope i mean owned as in ms probably bought it and now calls the shots as its owner. feel sorry for its IT staff

  4. My goodness! by Vinegar+Joe · · Score: 0

    I wonder what OS they're running.......

    --
    "The average reporter we talk to is 27 years old......They literally know nothing." - Ben Rhodes
  5. linux by Duncan+J+Murray · · Score: 1

    at my hospital we use webapps for 99% of access to results/radiography etc... with office365, isn't linux becoming the obvious answer? (ok, no outlook replacement maybe... - but all anyone uses it for is email!)

    1. Re:linux by Killall+-9+Bash · · Score: 1

      People also (ab)use the calendar function... specifically (ab)using shared calendars as a scheduling platform. They load up one calendar with 5 years of catering crap, then want to complain "why is this so slow?" and "why aren't we syncing?"

      --
      "Prediction: within 10 years, Windows will be a Linux distribution." Me, 7-6-2016
  6. Nuisance, Not Crisis by stevedog · · Score: 5, Informative

    I work at a trauma center, and we go to diversion all the time. It happens whenever the ER gets backed up to the point that the patients would be better served by going to a less-full ER than by coming to ours, even if that ER is a little further away. This happens at least twice weekly, although perhaps not as often as other, less busy ERs. Yes, the virus undoubtedly brought them to this clogged state much faster, but this isn't nearly the crisis the summary (or the article it is summarizing) makes it out to be.

  7. darn by Anonymous Coward · · Score: 0

    i better stay healthy, i live in this area

  8. Runners? by Anonymous Coward · · Score: 0

    From talking to some patients it appears thet the worstaions are operating, but they have functioning network connectivty. They are using runners to get documents from one location to another. I once worked in a hospital where a worm started affecting the WIndows servers, thankfully my unix machines were not targeted, and that support team had to shut down all their servers, restart them offline, install patches, then bring them back online. The worm came from a high level executives latop that one of his relatives had used to download something that appeared innocuous,away from work, but proved otherwise once it was connected to the company network. I don't know that is what happened in this case, but I would not be surprised if it were a similar scenario.

    1. Re:Runners? by spokenoise · · Score: 1

      Stuxnet for hospitals? The major trauma for the hospital admin was that they might not be able to determine your insurance or billable status... ED's can do most thing in the diagnostic and treatment pathway in house, be an awful shame not to bill you for it all

    2. Re:Runners? by damiangerous · · Score: 1

      From talking to some patients it appears thet the worstaions are operating, but they have functioning network connectivty.

      That's awful. I hope the network goes down soon.

  9. Wait a second by EmagGeek · · Score: 0

    So, I guess the lack of a computer make it completely impossible for a doctor to treat a patient.

    How did Doctors do it before computers? I guess we just didn't have medical care back then...

    1. Re:Wait a second by Nidi62 · · Score: 4, Insightful

      What happened back then was it took a lot more staff to treat a lot more people. This issue isn't keeping doctors from treating patients, it's keeping them from treating as many patients. Everything is probably having to be done on paper, which means that someone (a nurse more than likely) has to walk that paper where ever it needs to be. This has the double impact of taking more time than it normally would, and requiring someone to take time out their normal duty to move it. That is why they are still taking actual emergency cases, and turning away non-life threatening, less serious cases. So that the ER does not get completely backed up that they can't treat a life-threatening case that may show up.

      --
      The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
    2. Re:Wait a second by ColdWetDog · · Score: 3, Interesting

      If the computer system shuts down and workflow speeds up then you know you have a problem.

      --
      Faster! Faster! Faster would be better!
    3. Re:Wait a second by Anonymous Coward · · Score: 0

      Everything is probably having to be done on paper, which means that someone (a nurse more than likely) has to walk that paper where ever it needs to be.

      The hospitals I'm most familiar with have those pneumatic tube systems, for transporting lab samples and such.

    4. Re:Wait a second by Billly+Gates · · Score: 1

      The issue is documentation and looking up patient records.

      If you do a treatment and it kills the patient, but the records show he/she was allergic to something or another doctor did the same treatment a year ago, or something related to that can land you in a lawsuit and a revocation of your license.

      Electronic records are a life saver and a CYA in court in case the worse happens. So if the system is down you have to watch your back. Also people have different shifts throughout the day/night and need to know the data on existing patients as well.

  10. Bad IT isn't uncommon in hospitals by ChumpusRex2003 · · Score: 4, Insightful

    Hospitals are often quite badly prepared for this sort of thing. A big problem is the number of computerised "medical devices" where the vendor insists on a very specific update policy (or very specific restrictions on 3rd party software).

    I worked at one hospital where Confiker took the whole IT system down. A big problem in repairing the damage was that there were a lot of PACS (digital X-ray/CT/MRI viewing/storage) workstations where the PACS vendor would not permit the relevant windows updates or a 3rd party anti-virus to be installed on the servers/workstations. They relented after a 24 hour stand-off, after they realised that they was nothing they could do to keep the system happy enough to meet the SLA without the updates and a suitable anti-malware.

    I work at another hospital now, where similar lack of updates due to comparability with old business apps prevents updates. E.g. The PCs still run XP SP1 (even the brand-new quad core xeons). There also doesn't appear to be funding for updating anti-malware - the hospital use Sophos 7 (which became unsupported last year).

    This hospital has chronic problems with virus/malware infestation on a number of office machines - but while IT can clean the computers manually, there seems to be a reservoir if infection on file-servers, USB drives, etc. So the infections come straight back after a manual deletion. This hasn't caused a catastrophe locally, so management don't seem to care, but it is a major annoyance, as infected documents frequently end-up getting e-mailed out to other hospitals/doctors and destroyed without trace by the recipient's e-mail system. Docs have been known to put the files on a USB stick, take it home, clean it with an up-to-date virus scanner and then e-mail it out.

    1. Re:Bad IT isn't uncommon in hospitals by Billly+Gates · · Score: 1

      That is allowed?No one should email or bring flash drives to work. HIPPA issues are scary enough. I did a contract with a hospital last February and well aware of obsolete software. That hopsital had a policy at least of disabling USB ports, put a big red warning screen for anyone daring to go to the internet with IE 6, and encrypting the hard drives.

      I did cringe and asked if they would at least use SP 3 for the Windows workstaitons and leave SP 2 for the custom devices. IT is not like someone will browse facebook while using the MRI. They said they had to do more testing and I just shook my head in disbelief.

    2. Re:Bad IT isn't uncommon in hospitals by Anachragnome · · Score: 2

      "This hospital has chronic problems with virus/malware infestation on a number of office machines - but while IT can clean the computers manually, there seems to be a reservoir if infection on file-servers, USB drives, etc. So the infections come straight back after a manual deletion. This hasn't caused a catastrophe locally, so management don't seem to care, but it is a major annoyance, as infected documents frequently end-up getting e-mailed out to other hospitals/doctors and destroyed without trace by the recipient's e-mail system. Docs have been known to put the files on a USB stick, take it home, clean it with an up-to-date virus scanner and then e-mail it out."

      It sounds like you're describing the MRSA phenomenon that many hospitals are experiencing. Perhaps the root of both problems lies in a common practice that, once addressed, could solve both issues?

    3. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      No. Of course it's not allowed to take confidential material out of the hospital. However, IT were unable to help in this matter, so "nature found a way".

      However, the usual sort of situation where it would happen would be:
      Where a doctor had prepared a lecture for the university as part of his job, using anonymized images from a patient's record as a teaching case (this use of anoymized data, even if a real case is permitted, as long as there is no way to undo the anonymization). He needs to take the powerpoint presentation to the university, in order to give his talk. The only way to do this is by USB drive or e-mail to the university A/V department (but they might have a shredding e-mail anti-vir system)

    4. Re:Bad IT isn't uncommon in hospitals by datavirtue · · Score: 2

      That was my first thought. No plan. As a technologist I'm peeved by the fact that people assume a system will always function properly because it always has in the past. Therefore it is terribly difficult to get a business to plan for outages.

      --
      I object to power without constructive purpose. --Spock
    5. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      I had the same issues (I do outsourced IT for small/medium sized businesses) at several clinics. We still have a problem with AllScripts. It's web based, and half the modules don't work outside of IE6.

    6. Re:Bad IT isn't uncommon in hospitals by JDG1980 · · Score: 1

      That is allowed?No one should email or bring flash drives to work.

      Part of the problem is that you can't tell doctors what to do. Thanks to the AMA cartel, there are always fewer doctors than we need, so the result is that they hold the whip hand in employment relationships. That's not necessarily a bad thing, but it gets annoying when they have that kind of privilege and no one else does.

    7. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      In my hospital, this kind of infection just doesn't happen. Between desktop patching, server patching, taking a hard line with software vendors and forcing them to allow our patches and software (or no contract) some of the last "major" waves of viruses just pass right over us. Some of our sister hospitals, on the other hand... Exactly like the one in the story. We've even gone so far as to strip out most attachment's from company emails, and disallow use of USB storage media without an encrypted drive.

    8. Re:Bad IT isn't uncommon in hospitals by jombee · · Score: 2

      Yes, for very good reason network medical device vendors are specific as to what client software modifications can be made. This includes client-side security measures such as service packs, security patches, and antivirus. This is primarily due to FDA regulations which require full software qualification, validation, testing, and documentation. The full scope and diligent execution of an FDA-compliant quality safety process takes time and costs money. This is not like IT operations patching a web server; a patient on the table in a procedure requires all device imaging and monitoring systems to work flawlessly, exactly as designed. Any issues that arise will require an FDA adverse event report from the manufacturer and if the device has been modified from its FDA approved baseline then responsibility may fall on the hospital; then watch as the lawyers pull out all the stops, especially if patient treatment was affected.

      I work directly in this field. Once hospital IT get their head around these facts, it's time to think outside of using traditional client-side security mitigation techniques. It's routine for me to find hospital IT networks with no mitigating network security controls controls, no VLAN segmentation, no ACL entries, no routing chokepoints, firewall rulesets with ANY/ANY permitted, and the inevitable infected medical devices. It's a shame for patient safety.

    9. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      Why doesn't the IT department segment the computer systems, servers, et cetera needed for the healthcare services from everything else behind firewalls that doesn't allow them access to external resources, or only allows individual port access to external sources via ACL's or webfilters?

      Combine that with GPO's that block external USB connections, disables unneeded services, and turns on firewall rules on the local computers and you should be pretty safe. You might even consider 802.1X or MAC filtering on the switch/wireless networks. I'm sure there are other things that can be done and this type of stuff should be 101 in a critical environment.

      Getting viruses/malware on these systems is unacceptable and either the IT department or the upper management needs to be fired for this type of nonsense. I know there are regulations that mandate this be configured for energy and oil companies. I would have figured the same for the healthcare industry too.

    10. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      It's very reasonable that "medical devices" are subject to considerable scrutiny as to any field updates. The problem, as you rightly point out is that they are often not segregated from the rest of the network, or that access controls are not adequate, which is particularly important if devices cannot have software updated.

      This also assumes that these "medical devices" work correctly at the best of times. Having used a number of PACS systems - which conceptually are very simple - store some images, and display them on demand - I've found the majority of products to be horrendously buggy: race conditions causing one patient's images to be displayed, while a second patient's record is opened for the reading doctor to record their reading of the images; server freezes (requiring reboot) when importing CD data where the image format is not supported (although it is standards compliant); corrupted display of images because the software doesn't honor the "bits per pixel" field in the image file header (seriously!); expiration of login credentials without warning, or explanation of why logins are failing. These are all examples of bugs that affect production PACS systems that I currently use. At one site, some of the docs have ended up bringing in iMacs to review CT/MRI scans, because they don't believe that the PACS system is safe.

      However, the problems I have seen on a regular basis in hospitals go far beyond medical devices - and include the regular desktop PCs which run unpatched XP SP2, and similar software. Heck, I even worked at one hospital where the guest account had full r/w access to every single server. (Over a period of about 2 months, the 2 PCs in the office shared by 20 doctors, gradually blew-up. 1 with a suspected blown PSU, and 1 with a dead HD. IT took the tickets, but warned that it would be months before a repair would be possible. Some bright spark decided to try an ubuntu live CD, which to everyone's relief provided access to internal e-mail and intranet, but also to the instigator's surprise provided completely unrestricted and unauthenticated access to every server on the LAN. Want a copy of the CEO's .pst file? - no problem, just browse to the roaming profiles directory on the main NAS and help yourself)

    11. Re:Bad IT isn't uncommon in hospitals by Billly+Gates · · Score: 1

      Ok here is what the hopital needs to do then.

      If they have Cisco routers go setup a DMZ and invest several thousand hiring a Cisco consultant from an I.T. shop to setup a private intranet that is trusted with obsolete medical devices and printers and things of that nature. Setup the regular network to run updated software. Baracuda networks and others are coming up with virus scanning and deletions in hardware as well.

      Client PCs need to be updated regularly and the hospitals I have seen the secretaries and nurses have their own desktops anyway as do the doctors in their offices. It is not expensive to setup if you have the infrastructure with Cisco and Ethernet already. Where I worked patients had their own private wifi network that was seperate from facility anyway if they brought in iphones or laptops. I think that is a great idea.

      Why does a renal care scanner need facebook access anyway or internet? IE 6 is insecure because it was the pre-internet age where AOL and MSN is what MS was really fighting and it shows with obsolete software that is inappropriate today.

      Maybe I am overlooking other issues but to me it means hospitals can finally upgrade and not care what the other devices are using.

    12. Re:Bad IT isn't uncommon in hospitals by Billly+Gates · · Score: 1

      I would give you mod points if I could.

      Seriously, there are somethings that do not need the internet. an operating room sure as hell is one of them! It is negligent not to do it and if a hospital can afford expensive doctors and $300,000 pieces of equipment it can afford to pay several thousand for a Cisco engineer to setup a DMZ network and firewall to separate devices from regular PCs.

    13. Re:Bad IT isn't uncommon in hospitals by Bert64 · · Score: 1

      At a hospital you also often have lots of really flakey embedded devices and custom applications which don't react well to being probed... Once a worm starts spreading around the network and scanning, these devices can also crash under the load despite not being directly infected.

      --
      http://spamdecoy.net - free throwaway anonymous email - avoid spam!
    14. Re:Bad IT isn't uncommon in hospitals by Bert64 · · Score: 1

      People will indeed browser facebook from the MRI...
      If you have a browser on the machine which can access the internet then sooner or later it will be used.
      People also browse the internet from "servers" for the same reason.

      The solution is for machines which don't need browsers to not have any installed, and for those which only need to access internal web based applications to be restricted to only accessing those.

      --
      http://spamdecoy.net - free throwaway anonymous email - avoid spam!
    15. Re:Bad IT isn't uncommon in hospitals by Anonymous Coward · · Score: 0

      As a consultant recently hired to rearchitect a large hospital network's corporate IT, I appreciate your insight. Although I'm not touching clinical or medical devices, its good to know these types of restrictions (and their implications) exist at the hospital level.

    16. Re:Bad IT isn't uncommon in hospitals by garyebickford · · Score: 1

      the very first internet hack of a medical system (back in the late 1980s or mid 1990s IIRC) was, in fact, an MRI or CAT scanner in San Diego. This predated virus problems - it was just a computer that was on the internet, and someone was able to figure out the default user/pass. I suspect it was a CAT scanner, because according to what I read back then, the penetrator could have adjusted the parameters in such a way as to cause lethal injury. I can't imagine how an MRI could do that. In this case, the penetrator was a white hat - a researcher, IIRC.

      --
      It's easier to be a result of the past, but more fun to be a cause of the future! http://www.spacefinancegroup.com/
    17. Re:Bad IT isn't uncommon in hospitals by guruevi · · Score: 1

      There may be significant reasons for this though:
      FDA approval - Siemens doesn't update some of our systems because the configuration is not FDA approved. So yes, we're still on XP SP1.
      DLL hell - Still a major problem and Microsoft is not shy of changing a metric ton of obscure API's in a Service Pack and medical software is all but well-written or stable. All of a sudden a build will fail for the only reason that MS started including .NET 2.0 components in one of the Service Packs. If you think Linux changes API's as kernel versions go up, be thankful that at least it's visible.
      It works - As I said, the medical software is classically broken, badly written and very unstable unless you stick to whatever the vendor released it on. The vendor usually goes out of business 30 minutes after the purchase has been completed and thus you're stuck with whatever you got. Also, middleware gets developed by another outside contractor who then leaves and nobody has anything but the compiled version of something that looks awful. I think some of the worst decisions get made by medical management, not because they're stupid but because they're smart in their respective fields and they think that because they're smart and have an MD, PhD that listening to the associates or bachelors in Computer Science is below their pay grade (and usually those people are 5 levels of management separated anyway).

      --
      Custom electronics and digital signage for your business: www.evcircuits.com
  11. Hospitals have terrible obsolete platforms by Billly+Gates · · Score: 5, Interesting

    I did a contract with one last March which was upgrading to new state of the art medical billing system to be Obamacare compliant.

    Ran Windows 7? No. Windows XP Service pack 3 right? No. Windows XP SP 2 with IE 6?!

    Normally it is not an issue but with HIPPA it is very serious this irritated me. Someone can literally hold the hospital hostage if these medical records for tens of millions of dollars and they need at least a patched and still supported version of XP like corporate America does. The problem is custom medical software and custom devices for Xrays and MRIs use IE 6 still and are not certifed with XP SP 3 ... unless you give them $$$$ to buy all new epuipment over again. This is new software being developed in 2010 I may add requiring IE 6 and some software wont even run with SP 3 on XP. This means no security patches.

    It does not surprise me there are viruses on hospital computers as they can't be patched. WIth HIPPA you would think a hospital would always demand and use state of the art fully patched systems for security. But if were the medical records software company or make MRI machines I would be still requiring IE 6 too so I can then price gouch and double dip and charge3 another $400,000 in 2013 when support ends. I can make even MORE money. ... end rant

    The greed is incredible in the industry, but doctors can be the most and worst clients and users if you chat with anyone who supports them. THey feel supperior because they have those PHDs and make tons of money. Luckily I just helped install stuff and ignored the rest of the staff. As a result I.T. staff just never upgrade as they do not want to deal with these users at all

    1. Re:Hospitals have terrible obsolete platforms by jclarke · · Score: 1

      You'd think someone who claims to have worked on a medical billing system would know how to spell HIPAA.

    2. Re:Hospitals have terrible obsolete platforms by anomrabbit · · Score: 2

      And you'd think that someone who claims to have worked on something relating to medicine would know that doctors have MDs.

    3. Re:Hospitals have terrible obsolete platforms by Morpeth · · Score: 1

      So much about this post screams BS... doesn't know it's HIPAA, and doctors have MDs, and I can tell you as someone married to a physician the 'make tons of money' myth is utter bullshit. A FEW doctors in sub-specialties are highly paid (surgeons, cardiologists, anesthesiologist) but the bulk of doctors you see (primary care, pediatrics, internal medicine and family medicine) are grossly UNDERpaid given the amount of training relative to other jobs. A primary care/internal medicine doc working for an HMO might make 130-140k/yr, not much considering...

      4 yrs undergrad (which yes, most of will do anyway hopefully)
      4 yrs of medical school (not only not making any money at this point, but going into about 150k+ debt)
      3-6 yrs of residency (dependent on specialty, as resident you barely make shit, maybe 30k or so a year, basically a stipend to cover living expenses, and working 80/hr weeks, used to be more when my wife was a resident but they legally maxxed it to 80 now, so that translates to about $7.50/hr..)

      So by the time you're around 30 and starting 'real' work, you're looking at pretty substantial debt and having delayed making any money to speak of for 10yrs.
      And even then, expect long hours (for my wife 60/hr week is the norm, plus the occasional overnights during hospital rounding)

      And most of the doctors I know, don't feel 'superior', but they are highly educated, often very high achieving and very bright -- it's not they're fault you feel inferior.

      --

      'The unexamined life is not worth living' - Socrates
  12. why can't 3rd partys be forced by hipaa by Joe_Dragon · · Score: 2

    to let IT install updates / anti-virus?

    1. Re:why can't 3rd partys be forced by hipaa by Anonymous Coward · · Score: 0

      They can.. People replying ITT basically have no idea what they are doing. If it's just a minor number of pc's getting a virus, that's understandable. But HIPAA does indeed allow/recommend that system be protected against virus.

  13. not an infrequent occurrence by Caesar+Tjalbo · · Score: 2

    Viruses are not an infrequent occurrence at the hospital, she said, but it’s never seen anything like this one.

    What gave it away? The patients had mice attached to them?

    --
    "I'm not much interested in interoperability. I want substitutability. I want to be able to throw your software out."
  14. The Onion? by ClickOnThis · · Score: 2

    Am I the only one who parsed this headline and thought it was something from The Onion?

    Net we'll see "CERT Advisory Issued for Swine Flu Virus"...

    --
    If it weren't for deadlines, nothing would be late.
  15. SO HOW COME NO ONE GETS CANCER OF THIN PINKY ?? by Anonymous Coward · · Score: 0

    Always things like lung, brain, prostate, liver, colon, rectum and other important parts. Why not cancer of the pinky ??

    1. Re:SO HOW COME NO ONE GETS CANCER OF THIN PINKY ?? by Smurf · · Score: 1

      Always things like lung, brain, prostate, liver, colon, rectum and other important parts. Why not cancer of the pinky ??

      Because your pinky is essentially just bone, muscle, and skin, with a little fat. So when people get cancers originating in their pinkies, they get lumped up with the rest of cancers of the bones, muscles, skin, and (more rarely) adipose tissue.

  16. not just Hospitals are stuck with XP / IE6 by Joe_Dragon · · Score: 1

    lot's of other places still have XP and they are big places like BP.

    1. Re:not just Hospitals are stuck with XP / IE6 by Billly+Gates · · Score: 1

      They use SP 3 which still gets security updates. Even that is not as secure as Windows 7. I doubt BP runs SP 2 with no updates

    2. Re:not just Hospitals are stuck with XP / IE6 by symbolset · · Score: 1

      I happen to be typing this from a rebuild machine I'm working on at the moment, building from XP Pro x86 SP1a (long story, not my choice. License issues. Naturally not for me, since I run Linux and BSD exclusively). Microsoft is rate-limiting the download speed of the XP SP3 to near dialup speeds. Maybe this is to encourage folks to migrate to W7. It downloaded much quicker through Citrix from a share in our CoLo three states away, through the same pipe at the same time, so I got our copy rather than the public one to update this box. I was getting 8,000kbps through the VPN over wireless, and 28.8kbps through technet wired Ethernet at the same time. I have 50Mbps cable internet. If you want SP3 as an executable and don't have it yet, downloading it now while you still can seems advisable before they drop that rate to 300bps. Be prepared for a long wait because it's nearly 300MB and at 56kbps it will take quite a while if it completes at all. The first 12 times I tried it I got "server reset" try again.

      I've six hours work before me, and six behind me, to make this box work safely in Windows. At the start I had a pendrive to boot Linux and get to work in 15 seconds with a comfy work environment no matter what hardware you have.

      --
      Help stamp out iliturcy.
    3. Re:not just Hospitals are stuck with XP / IE6 by Anonymous Coward · · Score: 0

      Rating limiting the download of XP SP3? Are you serious? Got any real proof?
      I gave it a try right now and I'm getting 650KB/sec...that's one hell of a dial-up modem!
      You sound like a standard (l)user..."the internet is slow"

  17. so why can't hippa let IT brake the certifed / DRM by Joe_Dragon · · Score: 1

    so the software can run in a VM / under a newer OS.

  18. This is by Dunbal · · Score: 3, Insightful

    Yet another example of how technology makes us stupid. How ever did we manage BEFORE computers and computer records... I guess patients just died in the hallways. The other day I went to a tire shop and asked the guy for some tires. He said he didn't have any. I asked him if he could check to see if another store in the chain across town had some. He said the computer network was down, and he couldn't do it from there. I guess telephones no longer work for calling the other store up and asking them like they did 20 years ago.

    --
    Seven puppies were harmed during the making of this post.
    1. Re:This is by zootie · · Score: 4, Insightful

      While I might agree that some people do become stupid with tech (and oversimplify the complexity that computers are covering up and compensating), we also can't oversimplify the fact that it's not trivial to go back 20+ years to pre-computer procedures overnight for a temporary problem that will go away in a few days (or minutes or hours, as in the case of the tire shop employee).

      Besides employees not getting paid enough to go the extra mile (or that they're supposed to be doing something else), the likely end reason is likely that it isn't affordable or efficient or even possible. As it is, a common complain in the healthcare industry is that they're understaffed, and with automation, the number of employees has been reduced so much they would never be able to deal with the backlog manually (assuming that enough employees had the training to deal with pre-computer issues). Not to mention that in a complex team workflow, exceptions would make it risky (ie, if the patient isn't registered in the system, his/hers tests can't be attached, so the doctors can't access them properly, opening the hospital to liabilities).

      Old systems likely broke down and got replaced by digital systems that require much less from their operators. Before they might have been able to print, but maybe that printer isn't there anymore. Going all the way back to pre-computers might mean leaches.

      As for your tire experience. Maybe the employee was lazy and wasn't willing to go the extra mile. Or maybe he didn't have a yellow pages or a company directory (which might have been on-line). Or, likely, he is supposed to tend the counter, and isn't allowed to do something else when he is supposed to be servicing people coming in the door (or answering the phone). In the "olden days", we might have been dealing with the store owner, which would be more inclined to GEM, but with franchises and staffs cut to a minimum for the sake of 80%+ normalcy, it's no surprise that the quality of service suffers.

      In spirit, I agree that computers have made it too easy for stupidity to thrive. In fact, they have made it so easy that it is endemic at the business level, not just at the employee level. Rather than doing the work, businesses just farm it out to someone else, and then to someone else (ie, the "Cloud philosophy"), and you end up dealing with shells that are so far removed from the data that have no knowledge or interest in providing a reasonable service that falls slightly outside the normal expectation. And even when it's a typical offering, quality is often substandard and it only fulfills the need in the most general sense. But I'm starting to digress to another topic, so I'll stop.

    2. Re:This is by Anonymous Coward · · Score: 2, Informative

      As someone who works in a hospital i can tell you that reverting to a paper and pencil system requires at least 10x the number of workers for the same number of patients. And they would make many life threatening record keeping mistakes mistakes that are time consuming to identify since they would have to use this system infrequently if ever.

      As an example transcribing dozens of lab values on possibly hundreds of patients and a worker transposes a potassium of 7.3 to 3.7. That patient could die from that simple mistake.

    3. Re:This is by Datamonstar · · Score: 1

      The example I was always given was to imagine being open on an operating table and the operating doctor needs to access your records to confirm something before proceeding and your records cannot be reached, so he sends a runner to obtain them, adding an extra 5 - 10 minutes to the procedure. time during which you're cut open and vulnerable to infection and blood loss. Not a fun scenario, but a very realistic one.

      --
      The eternal struggle of good vs. evil begins within one's self.
    4. Re:This is by Dunbal · · Score: 1

      Preaching to the choir - I am a physician. I don't believe you because I work in a country that isn't computerized yet. If you transpose 3.7 and 7.3 so easily without a computer to double-check things for you then you prove my argument: computers make us stupid.

      --
      Seven puppies were harmed during the making of this post.
    5. Re:This is by Dunbal · · Score: 1

      Imaginary and hypothetical scenarios are fun aren't they? Have you ever held a scalpel and made the incision? Have you every done it for god knows how many thousands of hours, at any and all possible times, when you felt good, when you felt sick, and when you should have gone to bed 10 hours ago? Don't worry, your scenario is absolutely the last thing that will ever happen to you. There's no last minute "oh I forgot something" once the operation has already begun. Usually you are worked on by professionals and it's not their first time. Just like you will never find a commercial airline pilot who forgets to - I dunno - put the gear down before landing.

      --
      Seven puppies were harmed during the making of this post.
    6. Re:This is by Anonymous Coward · · Score: 0

      Yet another example of how technology makes us stupid. How ever did we manage BEFORE computers and computer records... I guess patients just died in the hallways. The other day I went to a tire shop and asked the guy for some tires. He said he didn't have any. I asked him if he could check to see if another store in the chain across town had some. He said the computer network was down, and he couldn't do it from there. I guess telephones no longer work for calling the other store up and asking them like they did 20 years ago.

      Or, just as likely, the tire store is part of a mega-chain with 25 stores in the city (Economies of Scale) and he just didn't feel like making a dozen phone calls when they've already told him that if he doesn't get pro-active and sell that extra bottle of windshield washer fluid on the counter that there are plenty of people out on the street who will.

    7. Re:This is by Rich0 · · Score: 1

      Studies have shown that even very careful workers make transcription errors from time to time. Being careful or smart isn't adequate to prevent them. The only thing that really does work is having a process that checks for errors, and ensuring that the number of transcriptions is minimized (often using computer systems). In some health-related fields such processes are required by law.

      A hospital in a first-world nation that isn't computerized will have adequate staff to implement these kinds of processes, and training on them. A hospital in a first-world nation that is computerized won't - and if it has to implement manual processes in an emergency it will make more mistakes. That isn't because people are dumb - it is because they are not operating in the manner in which they are accustomed.

      If somebody threw you in an ER in a hospital that made extensive use of computers you'd look pretty "stupid" as well - you'd have no idea where to find information you need and you'd be the slowest person in the hospital. That doesn't reflect on your intelligence - just that you are out of your element.

      At work we use lots of computer systems in a regulated industry. We always talk about what to do when systems are down, but I think the reality is that unless they were down for more than a week most people would just try to work on other things or let work come to a halt. Things like paper forms don't exist any longer, and where we used to have armies of people to scan and file required paperwork we might now have one or two since the volume of paper is so much lower. If people had to work on paper it would probably take them a day or two just to find some acid-free paper to write on, and once they're done chances are the paper would sit in their drawers until the building burns down because nobody would know what to do with it, despite the company being legally required to be able to produce it.

      Could a company use computers but maintain the ability to work without them? Sure. However, such a thing costs money, and if your competitors aren't preparing for doomsday then chances are you'll be out of business before doomsday actually arrives.

    8. Re:This is by Datamonstar · · Score: 1

      I'm pretty sure the person telling me this was a fucking MD and acting director of IT services for the non-profit health care org I work for.

      Also, you're assuming that the only reason a doctor would need to see a record is when something goes wrong, but that's not the case. Records in this case could mean anything from treatment history to images. If you can't conceive of a situation where a surgeon would want imagery of what a patient looked like before they were cut open... uhhh...

      Also, do you feel the same way about making system backups? I mean, I've done upgrades like this one a thousand times in my sleep, when I was sick and should have been in bed days ago. There's no way it'll fail this time, right? Na, no need to have a backup handy.

      --
      The eternal struggle of good vs. evil begins within one's self.
    9. Re:This is by Anonymous Coward · · Score: 0

      We did do it fine back then... just not as fast, good, safe, or cheaper (ok, that last one is debatable) as we do it now. Back then, our error detection capabilities weren't even good enough to obtain comparable data to today. Meaning we couldn't tell you how much faster, better, and safer we do it today cause the data back then was worse.

      In your example, I would say it is a poor application of technology than someone getting dumber. Making a phone call takes time, for not one person, but for atleast three or more. Time that is expensive, a cost that their customer base (probably even you) is not willing to pay for. To take your example further, take it back really old school; why didn't you just run to the other shops? There is your answer.

      Back to my point of poor application of technology: They should have made their inventory searchable on the net, so that you could have searched them and the other local stores for your part. You could have called the closest one that had it and gotten a confirmation. All before leaving the comfort of your chair.

    10. Re:This is by Dunbal · · Score: 1

      I'm pretty sure the person telling me this was a fucking MD

      I'm a "fucking MD". Surprise.

      --
      Seven puppies were harmed during the making of this post.
    11. Re:This is by Datamonstar · · Score: 1

      Well then, get back at me when you know something about computers, Doc.

      --
      The eternal struggle of good vs. evil begins within one's self.
    12. Re:This is by Dunbal · · Score: 1

      Irrelevant to the argument at hand. Now you just feel like handing out insults. Er, by the way I can code in assembler, pascal, fortran, and c++. Computers and computer medical records are convenient but not critical to patient care. Turning away patients from a hospital because of computer problems is a defensive move to avoid litigation and nothing more. That's all very well, unless the patient dies in the ambulance on the way to the other hospital. It has nothing to do with medicine and everything to do with bureaucracy. What will happen in a disaster when computers and record-keeping abilities are overwhelmed or unavailable? There is no pen and paper backup at all?

      --
      Seven puppies were harmed during the making of this post.
  19. It's all abount billing by witherstaff · · Score: 1

    I wonder if this is giving anonymous any ideas for a social hack, close the hospitals country wide because they can't do billing or check on insurance. This shows hospitals would rather close than treat someone for free.

    1. Re:It's all abount billing by Rich0 · · Score: 1

      This shows hospitals would rather close than treat someone for free.

      While I agree that this is backwards, can we possibly envision a society where important things like medical care actually are funded adequately, and where we don't spend such a huge amount of money on billing?

      It might just be possible to spend less per patient to treat them, to have enough doctors to cover everybody, and to find some equitable way to pay for it all without there being a class of people who have to pay 10x as much for the same care, except for the 80% of time they just go bankrupt and pay 1% of the bill (after they're done losing their homes/etc).

      There isn't a magic bullet that will cure the US healthcare system, but there are a bazillion ways to improve it...

  20. The Real Story... by sycodon · · Score: 5, Insightful

    ...is that they have created a system where in they can't function as a hospital without computers.

    --
    When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
    1. Re:The Real Story... by Anonymous Coward · · Score: 3, Insightful

      they can't function as a hospital without computers.

      Change "computers" to "Windows" and you'll be getting to the heart of the problem.

    2. Re:The Real Story... by Runaway1956 · · Score: 1

      I don't have any points left, or you'd be +5 right now.

      I always amazes me when business comes to a screeching halt, when the power goes out. Or the computer crashes. Or, whatever. FFS, people, life goes on, with or without computers! The grocer can sell milk and eggs without a computer, traffic lights can work without a computer, manufacturing can go on without computers, and doctors can operate without a computer!

      I just LOVE computers - but I can perform any job given me, without a damned computer to hold my hand, or look over my shoulder, or whatever.

      Granted, a hospital is a huge, complex organization. But, they don't have any backup systems, just in case their computers go haywire?

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    3. Re:The Real Story... by prisoner-of-enigma · · Score: 3, Insightful

      There are two main reasons this has become true: electronic medical records and efficiency. The former is being mandated by the government. The latter is due to the lack of enough people to fill slots in the healthcare industry due to the personnel crunch, requiring hospitals to do more with less.

      I do technology consulting for hospitals. One thing that's always pissed me off is the nursing shortage. Hospitals go out of their way to woo doctors to their facilities, but nursing pay remains pathetic by comparison. Yet nurses work the same crappy hours and put up with the same ornery patients. Is there any wonder why there's a shortage of people entering the nursing field? And yet the hospitals *can't* really pay the nurses more because nearly all of them are teetering on the verge of bankruptcy at any given time due to Medicare's payment schedule.

      --
      In the end they will lay their freedom at our feet and say to us, Make us your slaves, but feed us. - Fyodor Dostoyevsky
    4. Re:The Real Story... by TheLink · · Score: 2

      I on the other hand can't do my job without computers - not so easy to VPN in to a remote server to do stuff without a computer. The tech has gone beyond manual "pulse dialling" by tapping the phone hook, and then whistling the modem tones :). Of course without computers, there wouldn't be servers at the other end to VPN to either... ;)

      Seriously though, a lot of manual work has been replaced by computers. So there are actually a lot fewer people doing those jobs. When the computers stop working, those few people might be able to do some stuff, but 1) they can't handle the same amount of transactions and 2) When the computer systems come back online, it's going to take yet more work to key everything in, and depending on how things work, you might have to wait till everything is keyed in, before you can proceed to handle new transactions with the computer system (this might be true for stuff like banks). So it's often just better for staff to wait till the computer system is back up.

      Anyway, I wonder what sort of virus it was, or it was just someone's excuse for some SNAFU/FUBAR ;).

      --
    5. Re:The Real Story... by Anonymous Coward · · Score: 1

      You're assuming a lot. Modern POS systems ("cash registers") cannot operate without power - and very frequently without a central computer to provide price info and inventory adjustment. Cashiers aren't given a pad of hand-enterable receipts to pass out to customers in case of refunds or price disputes. Assuming even that the till opens manually, you're not talking Drucker's General Store here, you're mostly talking chains where employees are usually not trusted nor permitted to operate outside rote procedures.

      Traffic lights go out all the time. They fall back to flash mode. When the intersection is major, a cop gets dispatched to operate the controls manually.

      Computers are reliable enough that management often doesn't want to waste time and money on business continuity. Kind of like the old saw that there are 2 types of backup policies - people who don't back up and those who've already lost data.

      Modern business relies heavily on bean counting, and one of the biggest dangers of that is that beans that are mostly or wholly invisible don't get counted when business strategies are formulated. Even that would be tolerable, but the pressure for continual efficiency means that even "100%" isn't efficient enough - it's supposed to be "110%". Except that when you're running 100% efficiency, that means that you have exactly ZERO percent contingency capacity.

      Computers have made efficiency possible, but making efficiency a religion is what leads to things like widespread pain when Thailand floods because the world's disk drive factories are all efficiently centralized in the same flooded area.

    6. Re:The Real Story... by sjames · · Score: 1

      They haven't come to a screeching halt. They are still handling the most critical emergencies. They are at reduced capacity. Why should it surprise you that they are able to do more with the computers than without? Isn't that the whole reason they have them? If you took a carpenter's hammers away, wouldn't you expect him to lose productivity?

      Are you claiming you can get just as much done w/ pencil and paper as with a spreadsheet and take no longer to do it? That you replaced a pencil and papoer costing under a dollar with a computer just because you like overspending?

      I'm guessing you CAN manage with pencil and paper to do whatever a spreadsheet can do, but it will take you (depending on the complexity of the spreadsheet) 10 to 100 times longer.

    7. Re:The Real Story... by Runaway1956 · · Score: 1

      Businesses DO come to a screeching halt, when the computer quits. I've seen it at banks, grocery stores, gas stations - you name it. The lights flicker, the computers all go offline, and business stops.

      In this case, the hospital is indeed handling emergency cases - but the hospital remains crippled. If/when a hospital gets a virus on their network, that should not impact their ability to care for people, simple as that. Life and death should come before considerations of speed, convenience, profitability. or whatever excuses anyone might throw out there for relying on computers.

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    8. Re:The Real Story... by sjames · · Score: 1

      Nobody's dieing here. Are you prepared to pay more so they can not depend on the computers? Are you prepared to help others afford it?

    9. Re:The Real Story... by Kalriath · · Score: 1

      You just described the situation where I come from as well, except all our hospitals are government owned and paid on time every time. The reason ours can't afford more nurses is because the doctor's union demands that every doctor get a 6% per year pay rise, the nurses get a 3% pay rise per year, while the administration staff get 0% and the hospital itself takes a 5% funding cut per year.

      --
      For a site about things like basic rights, Slashdot users sure do like to censor "dissent".
    10. Re:The Real Story... by Runaway1956 · · Score: 1

      Somehow, you're missing a point. It is stupid to rely on computers to the point that business comes to a halt when the computers die. You continue to point at this one instance, and proclaim "No one is dieing here." You simply miss the point.

      PEOPLE should run businesses, not computers.

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
    11. Re:The Real Story... by sjames · · Score: 1

      Considering that TFA and the first few postings in this thread are about this one instance, that's what I talked about. I made no claims as to the more general condition, pork belly futures, or the price of tea in China.

      Besides, you clearly missed the point. It's far more stupid to mess around with Jim and you didn't even mention it!

      I do agree, by the way that people should run businesses. I also agree that it's better to be able to bypass ANY single point of failure in a business (not just computers). However, I also realize that there are costs involved in that and sometimes they're so high that paying them would cause a failure as well.

  21. ASAP! by sgt+scrub · · Score: 2

    a trauma center and needs to be able to respond rapidly

    And we all know verifying insurance without a computer slows down medical procedures.

    --
    Having to work for a living is the root of all evil.
  22. Wrong... by CrankinOut · · Score: 1

    You might consider trying to gather some actual information before forming an opinion. The healthcare complex is not fat. That's not to say it's not big, but 100% of people can and do consume healthcare.

    For analysis, you can break your healthcare complex down into pharmaceuticals (medications), medical and laboratory equipment (x-ray and lab equipment), and providers, further divided into hospitals and ambulatory services. The margins start highest at pharmaceuticals and decline in the listed order. But pharmaceuticals have R&D expenses, FDA approval testing, and litigation liability. Medical and laboratory equipment(CT,MRI, and lab equipment) also have to get FDA testing and certification. Hospitals generally run with an excess revenue (income minus expenses, it's not considered "profit" in a not-for-profit or community hospital) of between a negative number and maybe 8-10%, with the average in the 5-6% neighborhood) and likely 60-80% of the budget is for nursing salaries to provide your care. For doctors, after 4 years of college, 4 years of medical school, and 3 to 8 years of post-graduate training (age 29 to 34), generally have educational debts the size of a house mortgage. And their average salaries ARE good at $175,000. Sure, you can find outliers like neurosurgeons and obstetricians, but then they pay malpractice insurance between $200K to 500,000 /year, because some people believe that bad medicine is the cause of all bad outcomes, and ignore the statistical variation of the real world and human biology, and so file suits for multiple millions of dollars.

    I dislike the fact that the senior executives of health insurance companies, like most other large corporation businesses, get annual compensations the size of which could run a small hospital, but you're talking about maybe hundreds of people, and hospital executives and administration, while compensated well, are for the most part deserving of their compensation for the size of operation they manage, and likely would make a lot more in any other field.

    The economic problem is that government wants to promise everyone the same set of benefits and services, so that the person on Medicaid can get the same liver transplant that someone with expensive insurance can get. While the latter is paid for by premiums paid by the insured, the former is paid for NOT by the beneficiary, but by taxes on everyone who works.

    1. Re:Wrong... by garyebickford · · Score: 1

      A long time ago I worked for a medical equipment company, and learned that there are also some systemic biases that greatly increase the costs. Note I did not say 'inflate', because it truly is a complex problem with no magic solution.

      So, this company made dialysis machines, which were largely sold to hospitals. These machines included a blood pump, which is basically a piece of clear 1/2" vinyl tubing formed into about 2/3 of a circle, with a triangular 'cam' with little rollers that went around and around, squeezing the tubing and forcing the blood to proceed. A simple, elegant machine.

      The following factors applied:
      The tubing had to be replaced for each dialysis. For liability reasons, the hospitals had to buy it from the company - if a patient experienced any problem during dialysis, the fact that the hospital used an 'off-brand' tube supplier would make them effectively 100% liable in court regardless of whether the tubing had anything to do with the problem.

      The tubing could not be sterilized and re-used. In the olden days hospital tools were commonly autoclaved and re-used, but in modern hospitals everything - scissors, scalpels, whatever - is disposable because this eliminates a whole raft of liability issues, and simplifies the supply chain inside the hospital.

      The number of dialysis machines is not that large, so most pieces of medical equipment are not in the commodity marketplace. Think fancy CAD workstations vs. desktop PCs.

      Anything that has to be approved by FDA (or FCC, or FAA, etc., plus UL and/or CSA, etc.) has a very large upfront certification cost - $millions. This has to be amortized over a relatively small number of items, and if even a resistor is changed in a piece of medical equipment, it has to be re-certified. If the original supplier of the tubing changes, it also has to be recertified.

      From other experience of mine, the company's liability insurance costs were most likely in the range of 30% of gross revenues.

      The result of all this was that a piece of vinyl tubing that was AFAICT identical to tubing that you buy at the hardware store for $1 per foot today, was cut in one foot pieces, sterilized and packaged by the company and sold to hospitals for $150 per piece back then, in the late 1970s. And they only made about 22% profit. This was/is a relatively small company, and not inhabited by a bunch of overpaid financial manipulators. The overall cost of the system just added up.

      I think the biggest problem is that the present liability climate, though better than it used to be, is still greatly to the advantage of the insurance companies. The insurance companies, after all, make their profits as a relatively stable percentage of gross revenues, which are related to accounted and perceived risk. The worse the liability situation, the better for both plaintiffs and defendants, and worse for the rest of us. And, since government sees every failure as an excuse for more regulation and bureaucracy, that is also true of government.

      --
      It's easier to be a result of the past, but more fun to be a cause of the future! http://www.spacefinancegroup.com/
    2. Re:Wrong... by sjames · · Score: 1

      It IS fat, it's just not the doctors and hospitals themselves that are fat. The U.S. spends more per-capita on healthcare than any other country in the world, but we aren't even in the top ten for results. That money is going somewhere and that somewhere is fat.

      The problem is that people in Washington think insurance is magic. The best insurance can do is charge you the average actual cost of healthcare plus extra for profit and overhead. That's not helpful to someone who can't afford X.

    3. Re:Wrong... by CrankinOut · · Score: 1

      Your per-capita expenditures and results levels are accurate. However, those statistics ignore geographic issues (healthcare for 4.8 million Norwegians in a nation the size of Montana will not be the same as for Montana, with a population of 1 million), as population density or sparsity affect service distribution.

      The original comment implied that most of the people in our health care system were making lots of money, and that was the fat.
      I would argue that complexity is not fat, but better defined as friction, where it takes more energy (dollars) to manage the system. Creating a simpler, more uniform (but not necessarily federally operated) system would reduce that complexity.

      insurance operates at a cost plus general/administrative + profit. That G/A + profit for insurance companies is now limited to 15% by the new regulations, but it's still 15% of the cost of private healthcare.

      I believe that the federal government will do no better job of managing insured costs than insurance companies, because we will be replacing government bureaucracy for the G/A + P, and then throwing in politics and vote-buying to boot.

      I agree that the overarching complexity of financial reimbursement leads to very large billing and finance departments of hospitals, which are part of the cost structure. The departments are so large because of the need to manage billing and insurance for hundreds of different insurance plans, and the plans vary from state to state. A better approach, I think, would have been to standardize insurance benefits into basic, premium, and comprehensive tiers, restrict the premiums to a 3X range (highest premium no more than 3 times lowest premium in each tier), and remove state-by-state insurance regulation of health insurance. By creating a simpler system, it will eliminate state budgets for insurance regulation and approvals, reduce the complexity of the hospital and insurance financial operation, eliminate the overhead of periodic contract negotiation, and streamline cash flow.

      We need to recognize that it is impossible for the federal government to provide every citizen with the same level of care. We don't currently provide citizens with the same level of food, shelter, or transportation services. If we choose to provide everyone with the same level of care, then the average cost will go up, the level of service will go down, and premium services will move out of the system.

      I've seen the health system in some government-provided European countries, and there is an active, readily available private health services industry for those who want to pay for it to get better service than the government programs. And some of those countries are now crumbling under their financial obligations.

    4. Re:Wrong... by sjames · · Score: 1

      REALLY!?! The old geography argument is thin enough for poor bandwidth, it's outrageous for healthcare. I can see itr adding some costs, but nowhere near enough to give the results we see, especially when you consier that we also have much denser areas than Norway to balance that out.

      We need to recognize that it is impossible for the federal government to provide every citizen with the same level of care. We don't currently provide citizens with the same level of food, shelter, or transportation services. If we choose to provide everyone with the same level of care, then the average cost will go up, the level of service will go down, and premium services will move out of the system.

      We're nowhere NEAR discussing providing the same level of care for all, we're more at the point of deciding if we should provide any at all for a lot of people, and asking why a typical American must spend so much more than anyone else in the world to get adequate care (and JUST adequate at that in many cases).

      There is no doubt that there are incredible inefficiencies all through the system (so much for the market sorting it out) but that's not nearly enough to explain the differences.

    5. Re:Wrong... by CrankinOut · · Score: 1

      Interesting discussion.

      Please explain why geographic dispersion doesn't affect such costs as labor markets, patient demographics, distribution of medical resources and capital access.

      By law, anyone below the poverty level is eligible for Medicaid- all that has to be done is to enroll. By the Hill-Burton Act, a healthcare organization cannot deny care to anyone in an emergent situation. So, "any healthcare at at all" is legally required now.

      In response to your comment about a typical American spending more than anyone else, we don't. In countries with government-provided health benefits, those benefits are paid for by the the tax dollars collected from the employed citizens or, in the case of countries like, say, Greece and Italy, borrowed with little chance to pay off the debt.

      The market can sort a lot of things out, but when it's perterbed by political pressure, it doesn't sort itself out on purely economic measures. When the federal government went beyond setting rules to keep the game fair, it became a political issue solved with political processes, not a market problem addressed by market forces.

      I think we agree that there's room for change and improvement, but with Medicare running out of reserves in 2017, and the reserves lent to the general budget in the form of "special class of bonds" purchases, the federal government has already spent the Medicare trust fund, and has to borrow more money or gather more taxes to pay the money back to the Trust to pay for benefits.

      The federal government has a strong role to play in rule setting and refereeing, but when the referee is in the game, it's not a fair game.

      Thanks for the interesting conversation.

    6. Re:Wrong... by sjames · · Score: 1

      Please explain why geographic dispersion doesn't affect such costs as labor markets, patient demographics, distribution of medical resources and capital access.

      Labor in rural areas is cheaper by far than in urban areas where the cost of living is higher. Rural areas simply spread the facilities further apart to compensate for the small populations. They generally consist of smaller cheaper regional emergency centers that refer to one or two central medical centers. That allows for costs to scale with population to a great degree.

      Meanwhile, this just in, according to this, the U.S. population density is greater than Norway's, so if that's a factor, their costs should be higher than ours. We may have areas much more sparse than Norway, but that is balanced against the U.S. having cities with more people than all of Norway.

      Note that Canada and Australia both spend less per capita and rank higher in results than the U.S. both countries have dense cities and large sparsely populated areas like the U.S.

      There really isn't some special excuse for the situation in the U.S. it all comes right back to our healthcare policies.

      By law, anyone below the poverty level is eligible for Medicaid- all that has to be done is to enroll. By the Hill-Burton Act, a healthcare organization cannot deny care to anyone in an emergent situation. So, "any healthcare at at all" is legally required now.

      There's a vast area between the poverty line and able to afford health insurance. So much so that 1/3 of the U.S. is without health insurance. I suppose 'any care at all' is a bit of an exaggeration. They are required to provide the bare minimum to keep you from actually dropping dead in the hospital. Thus their objective is to patch you up well enough to go home and die. You would be amazed how treatment changes when you don't have insurance (or even when they think you don't).

      In response to your comment about a typical American spending more than anyone else, we don't. In countries with government-provided health benefits, those benefits are paid for by the the tax dollars collected from the employed citizens or, in the case of countries like, say, Greece and Italy, borrowed with little chance to pay off the debt.

      Yes, we do. We spend more on healthcare per capita in the U.S. than anywhere else in the world. We spend DOUBLE what Canada spends, for example. That includes personal payment AND tax funded payments summed together.

      I think we agree that there's room for change and improvement, but with Medicare running out of reserves in 2017, and the reserves lent to the general budget in the form of "special class of bonds" purchases, the federal government has already spent the Medicare trust fund, and has to borrow more money or gather more taxes to pay the money back to the Trust to pay for benefits.

      So really, medicare is doing OK except that it's funds have been misappropriated by congress crooks who will stop at nothing to prove medicare is a failure, including inducing that failure without regard for the people they will hurt in the process. I'm sure if medicare goes away, they'll just start raiding retirement funds, the post office (again), basically anything but the DEA and DoD. The money they might have to borrow and taxes they might have to raise to pay back the stolen funds are NOT healthcare costs, they are costs related to whatever the stolen funds were spent on.

      As for removing regulation, it'll never happen, no matter how good an idea it might be since that would mean allowing anyone who wants to buy a bottle of oxy at the pharmacy. That WOULD get rid of the pill mills, but only because people wouldn't need to pay for a fake prescription anymore to get the drugs they want. Prescription laws are a regulation on the market. Requiring a medical

  23. This is exactly why Medical Databases suck by Anonymous Coward · · Score: 0

    This is exactly why I don't like Online Medical Databases, if it was a paper record, you couldn't steal or destroy everyone's shit all at once.

  24. Medical Device Patching Conundrum by tstacysd · · Score: 2

    I deal with IT departments everyday for Hospitals, Schools, and other business in the South East and the biggest issue I see is lack of patching on Windows and Linux machines while keeping the virus definitions up-to-date. The IT departments know that patching is important but feel they can't patch an approved FDA device or the staff lacks the bandwidth to implement a proper patch testing cycle. The only solution that I see that consistently works for these type business is to virtually patch these machines with a host based network filter until they have been approved by the FDA. This also allows them time to test the new patches on their internal servers before rolling out to the rest of their infrastructure. No vulnerability = no mass infection.

  25. You and me both by Garybaldy · · Score: 1

    I am working in Duluth all weekend. With high voltages so. Hmm maybe i'll be..... wait i am already careful.

  26. RTFA by Hentes · · Score: 2

    They can function, and still treat patients in emergency situations. But the virus slowed down administration, as it now has to be done by hand.

  27. Treat Hospital networks like Launch Facilities by Anonymous Coward · · Score: 0

    Hospital networks need to be treated like missile launch control workstations.
    * Private network for all those devices
    * USB ports locked down 100%
    * No DVDs
    * No floppy drives
    * No unauthorized software use or installed. Lock down each workstation and server 100%.
    * Unused network ports, disabled.
    * HID devices need to be signed / protected.

    These all need to be configured as dumb workstations with the software loaded strictly controlled and validated daily if not more often. A read-only filesystem or VDI downloaded at each shift change. Joe-Doctor or chief of surgery shouldn't be able to plug in a USB drive and run any app off it.

    Networking should demand authentication to get into the private part.

    Sure, there needs to be a client LAN completely different from the "production LAN" for medical use. Servers need to be completely firewalled and segmented from the doctor/nurse LAN. Specific ports for specific services open only.

    Blaming MS-Windows for the problem doesn't make patients get better or change any facts. Dealing with issues head on and responsibly does.

    BTW, I live in Atlanta, but on a different side of town. One of my employees contracted at the main L1-trauma center here helping their CIS group. They had some issues, but were addressing them as budget allowed. I don't know any work place that doesn't have some security issues to be addressed. Usually the upper management chooses productivity and convenience over security every time. 3 years of a chronic virus problem seems worth it when compared to a completely locked down infrastructure. That is easy to understand.

    The term "industry standard security" is used all the time. It doesn't matter that is insecure and the root cause. As long as everyone uses the same less-than-secure standards and still get infected, that's fine. No malpractice, right?

  28. Employee Training by Anonymous Coward · · Score: 0

    Monkeys push buttons but NASA a trained a few to sit in the chair

    Humans + Internet = Porn sub Virus sub broken network

  29. Sad State by Anonymous Coward · · Score: 0

    Why in the hell is a hospital turning patients away just because the !@#$ computers are hosed?

    Healthcare is still the physicians treating their patients - at least it was last I heard.

    Someone at that hospital needs to take a hard look at the level they have sunken to.

  30. Re:so why can't hippa let IT brake the certifed / by Rich0 · · Score: 1

    The issue is liability. For good reason there are a lot of regulations around medical devices, but often in the end these regulations can conspire to make things worse.

    The regulations say that you need to prove that your device works as intended. That means strict configuration control. That means testing before making changes, and tons of paperwork. Lots of testing and paperwork before making changes isn't that compatible with patch Tuesday.

    Now, the guy selling the X-Ray machine gets $200k for selling you an X-Ray machine. They don't make much money testing its software every month when MS comes out with another patch. The easiest option for them is to certify it as it originally shipped and tell you that any changes are on you.

    So, now the hospital can either leave the machine alone, or THEY incur all the costs on patch Tuesday.

    Then the question comes up of who to sue every time a patient dies. The question really isn't what caused the patient to die - the question is who has money and can be shown to have violated some regulation who had anything to do with the patient's care. So, following the process is critical to minimizing the cost of litigation.

    I can imagine that people working in that field could get quite fatalistic about all of it. Yup, it sucks, and yup, it kills more people than it should - but hey, my part of the process is being run by the book so go look elsewhere to fire somebody. In the end you can't lose your job because the system sucks, but you can easily lose it if you didn't fill out form 123A in triplicate while the virus was busy propagating.

  31. STOP. UsINg. WINDOWS. by Anonymous Coward · · Score: 0

    You bring it on yourselves, you FFFFING IDIOTS.