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Some Windows XP Users Can't Afford To Upgrade
colinneagle writes "During a recent trip to an eye doctor, I noticed that she was still using Windows XP. After I suggested that she might need to upgrade soon, she said she couldn't because she couldn't afford the $10,000 fee involved with the specialty medical software that has been upgraded for Windows 7. Software written for medical professionals is not like mass market software. They have a limited market and can't make back their money in volume because there isn't the volume for an eye doctor's database product like there is for Office or Quicken. With many expecting Microsoft's upcoming end-of-support for XP to cause a security nightmare of unsupported Windows devices in the wild, it seems a good time to ask how many users may fall into the category of wanting an upgrade, but being priced out by expensive but necessary third-party software. More importantly, can anything be done about it?"
VMWare.
Yup. The easiest is to upgrade to windows 7 Pro or Ultimate and install XP Mode
The issue is that medical devices require certified tested/verified drivers to ensure accurate results.
Due to the changes between XP and 7, some instruments require updates software with the corresponding "certified" drivers.
I recently ran across this with pulmonary function testing software at our mine.
No need to upgrade to new software, it should run on Win7. There are multiple ways to configure compatibility.
"Should" is most certainly not "will". There's a piece of somewhat exotic medical hardware I have the misfortune of knowing which has drivers which only work on XP - mostly because it uses an extremely cheap and badly designed anti-piracy dongle. And no, it does not run on Windows 7 with compatibility mode, and no, it does not run in Virtual PC either. Because dongle.
(Because when a piece of hardware costs $10,000 and up, and the software which connects to it is utterly useless without that expensive hardware - because it's basically just a dial showing a readout - of course a practical use of programer time is to add an extra pointless $1 anti-piracy hardware component to stop the millions of free copies which will soon flood the intertubes. Sigh.)
Anyway, tldr, yes, this is a huge problem in medical (or any special-purpose, critical-path) software. It's written by a hybrid of Ebenezer Scrooge and Bizarro Iron Man. Exorbitantly expensive, cheaply written, full of edge cases and bugs, hugely dependent on the manufacturer's support whims, will only run or be supported on extremely vanilla OS, and built without any concept of security or ability to work with a patching plan.
And then there's actual "security" software, that runs cameras and such, and if anything that's worse.
You are not a brain: http://books.google.com/books?id=2oV61CeDx-YC
Special dental application to track intervention history, show X-rays associated, etc should not communicate with the internet.
See this is just plain nonsense.
I'm working with these sorts of customers, and the bottom line is that air-gapping the internal network is absurd. They need things like internet access and email in the various exam rooms at the front desk, in their offices etc. They also need to be able to review exam data in many of these places.
For example, the front receptionist needs to be able to send and receive email, send out email reminders, email invoices, track shipments online, and other stuff like that. So that computer needs to be online. But they also need to be able to access the patient management system, pull up patient history for invoicing, etc.
The patient management system is also tied into the medical equipment, as many instruments will submit the captured exams to the patient management system via DICOM and so forth. So that computer also needs to be on the so-called "internal network".
You want support for a medical instrument / software -- you can't even theoretically take that to futureshop's geeksquad to sort out... but remote support via teamviewer/gotomypc/etc now saves shipping expensive equipment around or flying expensive technicians around in many cases. The equipment has to be online for that. Nevermind that they usually outsource IT because they're pretty small shops that can't support in-house IT, and remote admin / support for routine maintenance is a lot cheaper than onsite.
Meanwhile doctors want to be able to send exams to partners, manufacturers, consultants, and so forth. Doctors want to back up the data to the cloud. Two computers at every desk, separate networks, and moving the data across an airgap each time would be a major hassle and expense.
And that's just the tip of the iceberg.
The software itself has started moving towards cloud storage and cloud backup integration, and there are even patient management systems now that are SaaS. The new and the old collide... people are using 10 year old instruments with new practice management systems and a lot of the new stuff available either outright has to be online, or at best you lose a lot of functionality if it is not.
I don't see such a problem here.
That's because you obviously haven't tried to solve it for a real practice in the real world.
Special dental application to track intervention history, show X-rays associated, etc should not communicate with the internet.
In the real world it does. Patients like email reminders of their appointments, they like to get emailed copies of their invoices for insurance claims and so forth. Doctors routinely need to send patient records to other doctors, specialists, consultants and so forth. Things need to be backed up offsite -- and online backup is the most practical solution by far for that.
Many doctors work in mutiple practices, Tuesdays here, Thursday's there... and they want to be able to review and analyze on patients cross-sites so the in some cases mutiple offices are linked via VPNs etc.
Nobody today would tolerate having all the exams from a particular instrument available only on a single air gapped unit or even an air gapped network.
Medicare billing. I have done several medical software installations, they all have a strong need for internet access for electronic transfer of medicare records.
Sorry, teleporters just kill you and then make a copy. A perfect, soul-less copy.
We have Medisoft running in Windows XP Mode under Windows 7 right now. It works like a champ. It's only compatible with XP so we waited a long time to upgrade but we finally did it with a virtual machine and Windows 7.