there's plenty of human dwellings with a well at one end of their property and a septic tank& leaching field at the other.
The septic tank is the key difference. It doesn't go from the toilet to the drainage field directly. The tank is effectively a mini-sewage treatment plant.
The analogy would only be apt if the pipe from the house to the septic tank was assumed to be leaking.
TFA suggests the problem is leakage from pipes carrying waste to the sewage treatment plants.
It seems you are saying that those people really, really NEED to have all the best and latest features (cloud integration, remote support, Saas,..., yet they can't be bothered to pay for a recent software version?
No, its driven by economics: SaaS means they don't have to buy anything. No servers, no local IT, no big software license, just monthly payments.
So when their 7 year old server starts getting noisy, and they look at the replacement costs... SaaS can look pretty attractive to them.
Cloud backup -- same thing: simple and cheaper and more reliable then anything else they could do -- it gets them offsite backups with no human factors for a few bucks a month.
Remote support -- same thing: simple and cheaper, with less downtime as incidents are resolved quicker.
Either these improvements are worth 10.000 $
What do they get from THAT particular $10,000 upgrade? In many cases, all they get is Windows 7 compatibility for their old instrument.
Or they can just cling to XP; then they don't have to buy it.
or there is no need for them to complain about the limitations of an old airgapped software.
Or they can just leave XP connected to the network, then they don't have to airgap it.
Plus if they've got 10,000 to spend there's almost always a laundry list of things a LOT more important to the customer than making sure they aren't using XP after its end of life date. "vague security improvements" are a generally low priority and a tough sell.
They'd generally rather buy a different instrument that does something else -- and add to their practices diagnostic abilities, and add a revenue stream (by charging for exams, etc) rather than just upgrade an older unit that is still working fine.
There's clearly a cognitive disconnect between people working in IT for a large corporation and people who actually need to get work done in other environments.
That's certainly true. But what is a small medical practice (think optometric office, or dentists office) going to do? They can't do it themselves and it would be irresponsible. They can't hire some "smart teenager for 10-20$" because that would be irresponsible too, because as much as the kid knows about windows and general networking, and general applications they aren't really prepared to take medical instruments, medical imaging software, etc.
So that leaves "professional outsourced IT shops" and that runs $100/hr minimum for onsite, or $150, $200 or beyond, and either they are specialists in supporting medical practices and charge even more because they actually have a clue about the equipment in the practice, the software, how to set it up, how to network it, how its licensing is managed, or they aren't really much further ahead then the smart teenager and spend half the time on the phone with the medical instrument suppliers racking up support bills while charging for their own time...
And those support calls to the medical instrument suppliers aren't usually cheap.
This has worked remarkably well. In the (extremely rare) event that an US picture needs to be emailed, the US computer is briefly connected to the internet behind a NAT firewall.
And this pretty much sums up why it's worked remarkably well. The old system -can- largely be isolated, and its extremely rare that it needs to be connected.
Its not hard to find a counter example where the medical imaging itself, or files derived from that imaging are sent off for manufacture.
With contact lenses, for example, orders for custom asymmettrics for scarred post-lasik eyes are transmitted electronically now directly based on the corneal topography. So the workflow is "take the exam", "design the a 3d lens on top of the 3d model of the cornea captured in the exam", "transmit the 3d lens file to a manufacturer"... you don't want to have to physically plug the internal network the internet for every order.
In other fields, dentists for example, making a crown take a physical mold and send it out, but we may see that whole system go to computer modelling and then instead of molds, they'll send out computer models based on 3D imaging... or not... I honestly don't know much about dentistry or where its headed.
And as the records in general go online, it makes a lot more sense to exchange them electronically (e.g. when your doctor refers you to a specialist) etc then to print things out and send them on paper. Doubly so as a lot of the new imaging processes are 3D models and much is obviously lost if they are printed.
We have to figure out how to put things online as securely as possible. You can only avoid it for so long.
Setup a Windows 7 image for for email / internet access, Setup an XP image for old hardware / internal network
a) The customer wants the same software, the practice management system, to communicate with the old hardware AND and the new hardware, AND the internet. Which image do you put the practice management system on?
b) You can't assume the old hardware/software will run in a VM. In many cases it just won't. Medical equipment in particular can be very particular, especially if its using proprietary PCI cards and even manufacturer customized drivers as the interface. How much will you charge the customer to (re)discover that the vendors approved pc configuration can't be just ignored after all.
c) And what is the customer going to do if one day the instrument doesn't work? When the vendor finds out its being operated through a Xen VM the support conversation is over; it doesn't matter whether that is the actual problem, they aren't generally going to troubleshoot a system that isn't set up exactly according to their specifications. Its a medical instrument -- if you want it to work you set it up exactly as your told. If you don't set it up that way, its NOT their problem if it doesn't work.
d) That set up is going to be expensive. How much would it cost to bring someone in to build that network, deploy those systems, setup and test those images, etc?
You're easily looking at several thousands of dollars going that way too, and that's a lot to spend on an unsupported system with reduced functionality.
I'd just subnet it and not allow much besides RDP through the internal firewall to reach it. The machines running XP are on VM-hosts in the back office except for the ones that need special hardware, which remain on physical boxes.
Now consider what that would cost.
Someone calls you up, says they have a bunch of XP boxes, some XP only software, and some medical instruments, but want to upgrade to Windows 7/8/9(?). They need the xp stuff on its own subnet, migrate to vmhost, plus they need to preserve all data, deploy new computers except when attached to the instruments (thus reinstall their practice management system, getting its the licensing sorted out), etc. You'll also need to setup VM-hosts and remote access etc, and a bit of training, and update the backup system.
Its not hard to see a quote for that coming in at several thousand for labor alone, plus there is hardware too, and all that does is let them continue to operate the old stuff without paying to upgrade it.
If you have the skill to do it yourself, sure, and if your posting here perhaps you do. But if not, if you are going to have to hire an outside IT firm to do?
I bet a lot of that $10k fee is due to the software requiring FDA certification.
Not really, although FDA, Health Canada, EMEA (Europe), TGA (Australia), SFDA (China), etc... do definitely take a toll.
But quite simply a lot of that $10k fee comes from having to pay people qualified to write the interface software for medical devices which frequently sell fewer than a 1000 copies a year.
And to develop, support, and write a Windows Vista/7/8 update for a 10 year old medical instrument. That's targeting an even smaller market. Many of the original units have been retired / replaced. Some customers will choose to upgrade to a more modern instrument rather than pay big bucks for a software update for a 10 year old unit. And a good chunk of the market will cling to the original unit and software.
To add to that there is often a hardware engineering component too. A lot of the old equipment is serial, and may not work well on a simple USB adapter without significant effort. And the video stuff is even more of a hassle; often using weird proprietary 3rd party video capture boards in the PC that have since been discontinued, and/or for which there is no driver support in Windows 7, so the old instrument may need to be retrofitted in addition to new software.
Plus the upgrade itself is labor intensive, usually outside the comfort level of the doctors, and even their IT people (in house or outsourced tend to want some hand holding. And because you want to migrate and upgrade the old data to the new computer/new system its actually more complicated to install than a "fresh install".
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.
Plus you can also add in make and model and color and range of years on the vehicle it's attached to and getting even a couple of the license plate numbers can be valuable information.
Would someone be violating your privacy if they just took the pictures and kept them for themself, or mailed them to friends?
Depends. Am I the subject of the photos? Or am I just wandering by in the background? What are they doing with the photos? Why did they send the photos to their friends? Did it have anything to do with me, or am I again just incidentally in the frame?
If there are problem with privacy, deal with them using rights and laws that already exist. Don't blame the tool.
The problem isn't the tool it is the SCALE. Things that are innocuous and acceptable in small levels are entirely different at large scales.
I do not mind if the mall security camera catches me walking into the store. Or if you capture me in the background of a photo you took. Or if my neighbor happens to know what time I leave for work. Or that the guy at starbucks knows what my favorite coffee is. Or that my daughters friend knows what day my birthday is. Or that my favorite restaurant knows what my anniversary is.
Those individual factoids about me individually being in the hands of independent parties isn't a problem. I don't feel the least bit violated.
However, if each of those individuals chooses to publicize that information about me to an organization that collates all that information into one data set, then suddenly that changes everything, and my privacy is invaded. Now its not a random entitity (person or corporation) with a random datum, its ONE entity with all the data, and in aggregate it becomes a more compete profile about me then I'm comfortable with that entity having, and far more than I'd have ever voluntarily given them. The only way the could have gotten it all "on their own" would be to illegally stalk me. But now they can collect it and aggrate it over the internet from a wide net of sources. The end result is the same my privacy has been violated.
Its the same issue that leads to such consternation with abortion. An egg and sperm is not a person. Then the egg is fertilized and some people think that's a person but most people don't, then you've got a little blob of cells and most people still don't think that's a person either. But it keep growing and adding cells and specializing those cells and eventually you've got something that everyone agrees is a person.
The guy at starbucks knowing what my favorite coffee is like a handful of cells. The profile entities like google and facebook want to have on me by taking all those cells and putting them together and organizing it all... well that's something else entirely. It is NOT the same thing, no more than a person is the same thing as a couple cells.
Essentially you're that idiot that looks at the paper to see plus six minus eight, [...wtf...]
Um... that's got to be about the worst analogy I've ever tried to read.
Only to find out that every single game that came out for both asked for one extra gigabyte of RAM for 7 in comparison to XP. Because after all the improvements, 7 was still so bloated that it ended up in a net negative.
Most of the extra ram required for 7 is actually due to the vast majority of 7 installs being 64-bit which is chunkier in large part because of the side-by-side support for 32-bit. And to count this as a net-negative for 7 is silly, especially given the current price for RAM.
Same goes for eight.
Same does not go for eight. This is flat out nonsense. No one is asking higher specs on an 8 system then for a 7 system when writing up requirements docs, or even a Vista system. All 3 get the same specs profile in every case I've seen.
If anything Windows has gotten lighter and faster for 3 successive iterations now.
And I don't begrudge the bump in specs required to go from XP to Vista, given how much better Windows has gotten.
Windows 8 marks the beginning of the fall of Microsoft.
Yeah, that's what they said with XP what with its "candy colored green start button"... how did that turn out? Oh right, even today 10 years on huge groups still refuse to let it go.
And then they said Vista was the beginning of the fall, but it turned out most of the issues were just the growing pains to get to the now almost beloved Windows 7.
So now, Windows 8 is the beginning of the end and this time its real? Whatever.
But now that model is going to rot from the ground up,
One day perhaps, but not any time soon. Lots of big companies are still stuck on IE6 and so forth. Tons of line-of-business applications are built on microsoft tech. Its pretty entrenched and isn't going away just because you got a new chromebook at home.
at least three other major players have good inroads to eat Microsoft's lunch
Who?
Apple? They're not even consumer friendly -- they aren't remotely enterprise friendly.
Android? ChromeOS? Linux? Give me a break. There's a lot of places for competing non-Microsoft systems to get some traction, and the market will be better overall if they do, but microsoft is going to be not just a 'player' in the enterprise market, but the 'dominant player' for the foreseeable future.
When you talk about the "fall of Microsoft" and someone "eating their lunch" about the worst I see realistically happening is that Microsoft follows the footsteps of IBM... and that hasn't really worked out all that badly for IBM.
No, I get that "reality" shows a la COPS is equally unwatchable.
But there is a middle ground, the original Law & Order was really great TV while being grounded in reality. The first season of CSI was also really quite good. And there have been other good police shows...
Hell even Castle is more watchable then what the CSI franchise has become, in large part because it's got the sense to do enough self-parody that the audience isn't expected to take it too seriously.
So it -has- to be a sexually charged soap opera with impossible physics, speculative technology, and outrageous levels of no-expense-spared investigation on every case in order for people to watch it?
-shrug- maybe. I stopped watching CSI early on... i really liked the first few episodes, thought they were doing a modern sherlock holmes with science... still not entirely realistic but emminently watchable television.
And then it rapidly turned into the aforementioned schlock.
Yeah, that must be it. I'm sure she has no idea what options were available, and that you were were able to find a solution based on 3 sentences I dashed off largely off the cuff. Bravo!
Many, many professions are eligible, including physicians.
Yes, but she's not a physician, does not have a doctorate, or even a university degree as I recall. She's got some college and certification in what she does, as well as several years experience... I guess more specifically she's a radiology technician - the person who operates the equipment and is trained in its operation, safety protocols, and can judge whether or not the resulting exam is good, but is not the person who is responsible for the analysis of the results and actually diagnoses the patient, -- she's not a physician.
Didn't see what she does on the list. Not sure if medical lab tech qualifies or not.
Moreover it was her husband that had the job offer not her; and to get TN status she needs a job offer, which is hard to do without status... she'd have to find someone that wants to do the work to "sponsor" her in. Plus I -think- she still would need to recertify in the US / State they were in etc.
So no, its not a matter of just applying for a job, and you're in. Its easier than some ways in for sure, but still not easy.
She got TD status due to her husband, but that's "unable to work".
I'm not saying that every Muslim is bad, but the fact is, most of those bombings are connected with Islam...
And most of the drone strikes on muslims are connected with us.
It shouldn't take a rocket science to see that the "war on terror" is going to generate a backlash. Doesn't matter at all "who started it" or "who is in the right". All that matters at this point is that as long as one side pokes the other side with a stick the other side will poke back.
A war on terror can't be won, it will only generate a perpetual backlash. The only winning move is not to play.
Who else? Who else would you have do it? China? Iran? Mexico? Germany?
How about all of the above, in some sort of collective organization that isn't controlled by any one government.
United Nations WTO OECD
Probably in that order.
As dysfunctional and impotent as the UN is, it is -precisely- the sort of organization for this. And the dysfunction and impotence is -precisely- the desired operational mode; you don't want an efficient dictator. you want the near deadlock that ensures little gets done that isn't acceptable to pretty much everyone.
Oh good, that's just what we need, even less of the personal touch.
Yeah, I think that's pretty weak too... but I do sympathize with the plight of HR faced with 100s of applicants for the same job.
Something has to pare the job down to manageable, especially when some people looking for work will just carpet bomb every job posting they can find whether they are qualified or not, only takes a few seconds to attach a resume to an online form or email after all, and what have they got to lose?
Actually, free movement and all, if I were in my 20's living in Canada, I'd move to the US,
Not as easy to get a green card as you'd think. I know a couples who have transferred south husband was in embedded programming and the wife (a professional radiologist in Canada was unable to get a green card to work at all, never mind in her field, in the states for several years) -- they didn't expect it would be that tough. The pay raise and lower taxes didn't account for much since she couldn't work, his employer at least offered health care though, which was at least good.
because I would bet that I would not likely need medical care.
And that bet on medical care isn't all that great. A family member broke his leg skiing a few weeks ago, that'd be enough to royally screw him over stateside. Between surgery, a couple custom carbon fiber casts, physio, and going on 4+ months of not being able to work... yeah.
You can bet you won't need medical care, but that's a bet you can lose. A broken leg is pretty minor and the cost is in the 10s of thousands... what if it had been a spinal injury instead?
What happens if you lose the bet?
THEN when I started to get older and sicker, move back to Canada for all the free healthcare I never had to pay for.
Yep, that's sounds like planned abuse of the system to me.
And now, you know why Socialism doesn't work unless everyone is forced into it.
Canada should simply deny you re-entry to the country unless you are paid-up with respect to your accumulated share of health care costs. Citizenship isn't free. If you'd like to visit get a VISA and if you stay longer than that we'll deport you back where you came from.
Honestly I think that's the direction things will eventually take, and there are already rumblings in that direction as people absolutely are out looking to abuse the system in unsustainable ways.
And that is not freedom.
Forcing socialized medicine is no more or less free then forcing socialized public works like police, fire, roads, pollution controls, parks, schools.
I personally think the type of "freedom" you seem to long for is not as good as its cracked up to be. There's a few places in Africa and South America that should be free enough for you though... none of them places I'd want to live.
Americophiles are surprisingly common there, and "moving to America" is a goal of quite a few young Canadians
However the number that wish to actually become Americans is much smaller.
with ambitions that go beyond free healthcare.
Right. The assumption for most of them is that they will working for something that covers it, or will be paid well enough to easily afford the private insurance themselves and still be ahead of where they are now.
The rest of them want to live in America to be near something specific... the New York scene, Hollywood. If that infatuation pans out into a real career great... otherwise they outgrow it and move back home.
I don't think you realize how many jobs request word format. It's not an exception to the rule if it happens so often that it becomes the rule.
Frankly, I'm with you, I prefer pdf all the way for any sort of non-collaborative inter-business documentation, including resumes.
However, the reality out there is that more often than not they want MS Word format.
I think its one part because the HR person doesn't know better, one part because some non-trivial fraction of PDF applications are something containing pictures of the pages of a resume that were scanned in upside down after uncrumpling the paper copy they pulled out of the trash
In large enterprises there's also the group that wants to pre-process the applications automatically with some tool that handles word documents before even looking at them.
If one is going to go through that much trouble, why not simply switch to another platform like Linux, *BSD or OS X? (I know I will.)
Because their accounting software, video games, and so forth all still work just fine in Windows 8 and would either have to be purchased in an OSX version or discarded outright in many cases.
I like Linux as much as anyone on slashdot can, but I've got 100+ games from GoG, Steam, HumbleBundles etc. Only a fraction of those work on other platforms.
I don't really want to start over with a new accounting system, so I'll be sticking with windows for that.
More over, most of the stuff in that article was superflous, the average person who wants to "fix" win8 doesn't need to do 3/4s of it. Spend a few minutes cleaning up the live tiles and start screen, fix a few default file associations so that they launch suitable desktop apps, and those are the big two.
Adding a start menu app maybe. Personally I like to disable hot corners and put in a start menu button that launches the Win8 start screen... because in my case once the start screen is cleaned up its actually pretty good... but I still hate hot corners.
Apple had absolutely nothing to do with it...other than being the first major computer manufacturer to standardize on it and make it viable for peripheral makers to start building for thereby overcoming the chicken/egg problem fairly efficiently.
Not even close. Apple ditched ADB to standardize on USB for keyboards and mice, and that's about it. ADB was a crappy apple-only thing that nobody missed.
It did maybe potentially slightly encourage PC makers to eventually drop PS/2 ports for keyboards and mice but that's about it.
USB was widely available on PCs before apple standardized on it with the first imacs. USB PC peripherals were widely available for it -- cameras, pre-ipod mp3 players, scanners, printers, etc.
PCs were just late to the USB party with keyboards and mice because Windows 95 didn't support USB out of the box until "Win95 service release 2" and you often had to install chipset drivers. So while you could use a USB keyboard and mouse with Windows 95 "eventually", you couldn't reliably setup windows 95 with a usb keyboard and mouse. Not to mention that if you went into BIOS the usb keyboard likely didn't work.
So it took a lot longer to dump the PS/2 slots and switch over to USB entirely.
But -other- then keyboards and mice, USB was widely available on PCs well before Apple committed to it.
I think you have a very misguided view of "intent".
In that I recognize that he had no intention of damaging America?
He intended to publicly release the documents.
And he made a point of releasing to what he believed was a trustworthy organization that shared his desire to ensure no was was put in danger by the release. An organization that would take the time to sift through the information, organize it, and redact anything that would put an individual at risk.
And wikileaks did in fact do all of this. The un-redacted data was even encrypted to prevent accidental disclosure. The information was only released un-redacted to the public as a result a journalist from another organization (The Gaurdian) publishing the decryption key by mistake.
Are you really going to try and pin intent for that on Manning?
Any reasonable person with an IQ over 70 would understand that publicly releasing documents would mean that everyone, including the US's adversaries, could get a hold of them.
He didn't want anything untoward to happen to the US as a result, and took multiple affirmative steps to safegaurd the data. He didn't just dump the unredacted torrent online unecnrypted for the world to see. Not even wikileaks did that.
If Manning had read these documents,
He read several hundred, probably several thousand. He perceived a pattern of lying and corruption and actions he couldn't morally accept and took the step of whistle blowing to clear his conscious. That you or I might have seen the pattern of lying and corruption etc that he saw as "ok" and he didn't realize that is how it would be viewed is evidence of poor judgment, nothing more sinister than that.
By your logic, murder isn't murder if the perpetrator says they just wanted to shoot someone in the face but didn't really want to kill them.
Really? Is that what you think happened? All the attempt he took to release to a credible american news organization first, the steps he took to release it to an international organization second, the steps that were taken along the way to secure the data so that it could be properly curated before the public saw it.
That's the same as a guy trying to shoot you in the face?
Slashdot Mirror
there's plenty of human dwellings with a well at one end of their property and a septic tank& leaching field at the other.
The septic tank is the key difference. It doesn't go from the toilet to the drainage field directly. The tank is effectively a mini-sewage treatment plant.
The analogy would only be apt if the pipe from the house to the septic tank was assumed to be leaking.
TFA suggests the problem is leakage from pipes carrying waste to the sewage treatment plants.
It seems you are saying that those people really, really NEED to have all the best and latest features (cloud integration, remote support, Saas, ..., yet they can't be bothered to pay for a recent software version?
No, its driven by economics: SaaS means they don't have to buy anything. No servers, no local IT, no big software license, just monthly payments.
So when their 7 year old server starts getting noisy, and they look at the replacement costs... SaaS can look pretty attractive to them.
Cloud backup -- same thing: simple and cheaper and more reliable then anything else they could do -- it gets them offsite backups with no human factors for a few bucks a month.
Remote support -- same thing: simple and cheaper, with less downtime as incidents are resolved quicker.
Either these improvements are worth 10.000 $
What do they get from THAT particular $10,000 upgrade? In many cases, all they get is Windows 7 compatibility for their old instrument.
Or they can just cling to XP; then they don't have to buy it.
or there is no need for them to complain about the limitations of an old airgapped software.
Or they can just leave XP connected to the network, then they don't have to airgap it.
Plus if they've got 10,000 to spend there's almost always a laundry list of things a LOT more important to the customer than making sure they aren't using XP after its end of life date. "vague security improvements" are a generally low priority and a tough sell.
They'd generally rather buy a different instrument that does something else -- and add to their practices diagnostic abilities, and add a revenue stream (by charging for exams, etc) rather than just upgrade an older unit that is still working fine.
There's clearly a cognitive disconnect between people working in IT for a large corporation and people who actually need to get work done in other environments.
That's certainly true. But what is a small medical practice (think optometric office, or dentists office) going to do? They can't do it themselves and it would be irresponsible. They can't hire some "smart teenager for 10-20$" because that would be irresponsible too, because as much as the kid knows about windows and general networking, and general applications they aren't really prepared to take medical instruments, medical imaging software, etc.
So that leaves "professional outsourced IT shops" and that runs $100/hr minimum for onsite, or $150, $200 or beyond, and either they are specialists in supporting medical practices and charge even more because they actually have a clue about the equipment in the practice, the software, how to set it up, how to network it, how its licensing is managed, or they aren't really much further ahead then the smart teenager and spend half the time on the phone with the medical instrument suppliers racking up support bills while charging for their own time...
And those support calls to the medical instrument suppliers aren't usually cheap.
This has worked remarkably well. In the (extremely rare) event that an US picture needs to be emailed, the US computer is briefly connected to the internet behind a NAT firewall.
And this pretty much sums up why it's worked remarkably well. The old system -can- largely be isolated, and its extremely rare that it needs to be connected.
Its not hard to find a counter example where the medical imaging itself, or files derived from that imaging are sent off for manufacture.
With contact lenses, for example, orders for custom asymmettrics for scarred post-lasik eyes are transmitted electronically now directly based on the corneal topography. So the workflow is "take the exam", "design the a 3d lens on top of the 3d model of the cornea captured in the exam", "transmit the 3d lens file to a manufacturer"... you don't want to have to physically plug the internal network the internet for every order.
In other fields, dentists for example, making a crown take a physical mold and send it out, but we may see that whole system go to computer modelling and then instead of molds, they'll send out computer models based on 3D imaging... or not... I honestly don't know much about dentistry or where its headed.
And as the records in general go online, it makes a lot more sense to exchange them electronically (e.g. when your doctor refers you to a specialist) etc then to print things out and send them on paper. Doubly so as a lot of the new imaging processes are 3D models and much is obviously lost if they are printed.
We have to figure out how to put things online as securely as possible. You can only avoid it for so long.
Setup a Windows 7 image for for email / internet access, Setup an XP image for old hardware / internal network
a) The customer wants the same software, the practice management system, to communicate with the old hardware AND and the new hardware, AND the internet. Which image do you put the practice management system on?
b) You can't assume the old hardware/software will run in a VM. In many cases it just won't. Medical equipment in particular can be very particular, especially if its using proprietary PCI cards and even manufacturer customized drivers as the interface. How much will you charge the customer to (re)discover that the vendors approved pc configuration can't be just ignored after all.
c) And what is the customer going to do if one day the instrument doesn't work? When the vendor finds out its being operated through a Xen VM the support conversation is over; it doesn't matter whether that is the actual problem, they aren't generally going to troubleshoot a system that isn't set up exactly according to their specifications. Its a medical instrument -- if you want it to work you set it up exactly as your told. If you don't set it up that way, its NOT their problem if it doesn't work.
d) That set up is going to be expensive. How much would it cost to bring someone in to build that network, deploy those systems, setup and test those images, etc?
You're easily looking at several thousands of dollars going that way too, and that's a lot to spend on an unsupported system with reduced functionality.
I'd just subnet it and not allow much besides RDP through the internal firewall to reach it. The machines running XP are on VM-hosts in the back office except for the ones that need special hardware, which remain on physical boxes.
Now consider what that would cost.
Someone calls you up, says they have a bunch of XP boxes, some XP only software, and some medical instruments, but want to upgrade to Windows 7/8/9(?). They need the xp stuff on its own subnet, migrate to vmhost, plus they need to preserve all data, deploy new computers except when attached to the instruments (thus reinstall their practice management system, getting its the licensing sorted out), etc. You'll also need to setup VM-hosts and remote access etc, and a bit of training, and update the backup system.
Its not hard to see a quote for that coming in at several thousand for labor alone, plus there is hardware too, and all that does is let them continue to operate the old stuff without paying to upgrade it.
If you have the skill to do it yourself, sure, and if your posting here perhaps you do. But if not, if you are going to have to hire an outside IT firm to do?
That's going to be a tough sell.
I bet a lot of that $10k fee is due to the software requiring FDA certification.
Not really, although FDA, Health Canada, EMEA (Europe), TGA (Australia), SFDA (China), etc... do definitely take a toll.
But quite simply a lot of that $10k fee comes from having to pay people qualified to write the interface software for medical devices which frequently sell fewer than a 1000 copies a year.
And to develop, support, and write a Windows Vista/7/8 update for a 10 year old medical instrument. That's targeting an even smaller market. Many of the original units have been retired / replaced. Some customers will choose to upgrade to a more modern instrument rather than pay big bucks for a software update for a 10 year old unit. And a good chunk of the market will cling to the original unit and software.
To add to that there is often a hardware engineering component too. A lot of the old equipment is serial, and may not work well on a simple USB adapter without significant effort. And the video stuff is even more of a hassle; often using weird proprietary 3rd party video capture boards in the PC that have since been discontinued, and/or for which there is no driver support in Windows 7, so the old instrument may need to be retrofitted in addition to new software.
Plus the upgrade itself is labor intensive, usually outside the comfort level of the doctors, and even their IT people (in house or outsourced tend to want some hand holding. And because you want to migrate and upgrade the old data to the new computer/new system its actually more complicated to install than a "fresh install".
Everything costs.
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.
Plus you can also add in make and model and color and range of years on the vehicle it's attached to and getting even a couple of the license plate numbers can be valuable information.
Would someone be violating your privacy if they just took the pictures and kept them for themself, or mailed them to friends?
Depends. Am I the subject of the photos? Or am I just wandering by in the background? What are they doing with the photos? Why did they send the photos to their friends? Did it have anything to do with me, or am I again just incidentally in the frame?
If there are problem with privacy, deal with them using rights and laws that already exist. Don't blame the tool.
The problem isn't the tool it is the SCALE. Things that are innocuous and acceptable in small levels are entirely different at large scales.
I do not mind if the mall security camera catches me walking into the store. Or if you capture me in the background of a photo you took. Or if my neighbor happens to know what time I leave for work. Or that the guy at starbucks knows what my favorite coffee is. Or that my daughters friend knows what day my birthday is. Or that my favorite restaurant knows what my anniversary is.
Those individual factoids about me individually being in the hands of independent parties isn't a problem. I don't feel the least bit violated.
However, if each of those individuals chooses to publicize that information about me to an organization that collates all that information into one data set, then suddenly that changes everything, and my privacy is invaded. Now its not a random entitity (person or corporation) with a random datum, its ONE entity with all the data, and in aggregate it becomes a more compete profile about me then I'm comfortable with that entity having, and far more than I'd have ever voluntarily given them. The only way the could have gotten it all "on their own" would be to illegally stalk me. But now they can collect it and aggrate it over the internet from a wide net of sources. The end result is the same my privacy has been violated.
Its the same issue that leads to such consternation with abortion. An egg and sperm is not a person. Then the egg is fertilized and some people think that's a person but most people don't, then you've got a little blob of cells and most people still don't think that's a person either. But it keep growing and adding cells and specializing those cells and eventually you've got something that everyone agrees is a person.
The guy at starbucks knowing what my favorite coffee is like a handful of cells. The profile entities like google and facebook want to have on me by taking all those cells and putting them together and organizing it all ... well that's something else entirely. It is NOT the same thing, no more than a person is the same thing as a couple cells.
These are pretty much the same kind of PR bullshit claims that were made with most windows releases.
Well, except for the fact that the claims were true.
http://usabilitygeek.com/windows-8-vs-windows-7-speed-and-performance-testing/
Essentially you're that idiot that looks at the paper to see plus six minus eight, [...wtf...]
Um... that's got to be about the worst analogy I've ever tried to read.
Only to find out that every single game that came out for both asked for one extra gigabyte of RAM for 7 in comparison to XP. Because after all the improvements, 7 was still so bloated that it ended up in a net negative.
Most of the extra ram required for 7 is actually due to the vast majority of 7 installs being 64-bit which is chunkier in large part because of the side-by-side support for 32-bit. And to count this as a net-negative for 7 is silly, especially given the current price for RAM.
Same goes for eight.
Same does not go for eight. This is flat out nonsense. No one is asking higher specs on an 8 system then for a 7 system when writing up requirements docs, or even a Vista system. All 3 get the same specs profile in every case I've seen.
If anything Windows has gotten lighter and faster for 3 successive iterations now.
And I don't begrudge the bump in specs required to go from XP to Vista, given how much better Windows has gotten.
Windows 8 marks the beginning of the fall of Microsoft.
Yeah, that's what they said with XP what with its "candy colored green start button"... how did that turn out? Oh right, even today 10 years on huge groups still refuse to let it go.
And then they said Vista was the beginning of the fall, but it turned out most of the issues were just the growing pains to get to the now almost beloved Windows 7.
So now, Windows 8 is the beginning of the end and this time its real? Whatever.
But now that model is going to rot from the ground up,
One day perhaps, but not any time soon. Lots of big companies are still stuck on IE6 and so forth. Tons of line-of-business applications are built on microsoft tech. Its pretty entrenched and isn't going away just because you got a new chromebook at home.
at least three other major players have good inroads to eat Microsoft's lunch
Who?
Apple? They're not even consumer friendly -- they aren't remotely enterprise friendly.
Android? ChromeOS? Linux? Give me a break. There's a lot of places for competing non-Microsoft systems to get some traction, and the market will be better overall if they do, but microsoft is going to be not just a 'player' in the enterprise market, but the 'dominant player' for the foreseeable future.
When you talk about the "fall of Microsoft" and someone "eating their lunch" about the worst I see realistically happening is that Microsoft follows the footsteps of IBM... and that hasn't really worked out all that badly for IBM.
Compare CSI with one of the reality cop shows.
No, I get that "reality" shows a la COPS is equally unwatchable.
But there is a middle ground, the original Law & Order was really great TV while being grounded in reality. The first season of CSI was also really quite good. And there have been other good police shows...
Hell even Castle is more watchable then what the CSI franchise has become, in large part because it's got the sense to do enough self-parody that the audience isn't expected to take it too seriously.
So it -has- to be a sexually charged soap opera with impossible physics, speculative technology, and outrageous levels of no-expense-spared investigation on every case in order for people to watch it?
-shrug- maybe. I stopped watching CSI early on... i really liked the first few episodes, thought they were doing a modern sherlock holmes with science ... still not entirely realistic but emminently watchable television.
And then it rapidly turned into the aforementioned schlock.
Well, your radiologist friend isn't that bright.
Yeah, that must be it. I'm sure she has no idea what options were available, and that you were were able to find a solution based on 3 sentences I dashed off largely off the cuff. Bravo!
Many, many professions are eligible, including physicians.
Yes, but she's not a physician, does not have a doctorate, or even a university degree as I recall. She's got some college and certification in what she does, as well as several years experience... I guess more specifically she's a radiology technician - the person who operates the equipment and is trained in its operation, safety protocols, and can judge whether or not the resulting exam is good, but is not the person who is responsible for the analysis of the results and actually diagnoses the patient, -- she's not a physician.
Didn't see what she does on the list. Not sure if medical lab tech qualifies or not.
Moreover it was her husband that had the job offer not her; and to get TN status she needs a job offer, which is hard to do without status... she'd have to find someone that wants to do the work to "sponsor" her in. Plus I -think- she still would need to recertify in the US / State they were in etc.
So no, its not a matter of just applying for a job, and you're in. Its easier than some ways in for sure, but still not easy.
She got TD status due to her husband, but that's "unable to work".
I'm not saying that every Muslim is bad, but the fact is, most of those bombings are connected with Islam ...
And most of the drone strikes on muslims are connected with us.
It shouldn't take a rocket science to see that the "war on terror" is going to generate a backlash. Doesn't matter at all "who started it" or "who is in the right". All that matters at this point is that as long as one side pokes the other side with a stick the other side will poke back.
A war on terror can't be won, it will only generate a perpetual backlash. The only winning move is not to play.
Who else? Who else would you have do it? China? Iran? Mexico? Germany?
How about all of the above, in some sort of collective organization that isn't controlled by any one government.
United Nations
WTO
OECD
Probably in that order.
As dysfunctional and impotent as the UN is, it is -precisely- the sort of organization for this. And the dysfunction and impotence is -precisely- the desired operational mode; you don't want an efficient dictator. you want the near deadlock that ensures little gets done that isn't acceptable to pretty much everyone.
Oh good, that's just what we need, even less of the personal touch.
Yeah, I think that's pretty weak too... but I do sympathize with the plight of HR faced with 100s of applicants for the same job.
Something has to pare the job down to manageable, especially when some people looking for work will just carpet bomb every job posting they can find whether they are qualified or not, only takes a few seconds to attach a resume to an online form or email after all, and what have they got to lose?
Actually, free movement and all, if I were in my 20's living in Canada, I'd move to the US,
Not as easy to get a green card as you'd think. I know a couples who have transferred south husband was in embedded programming and the wife (a professional radiologist in Canada was unable to get a green card to work at all, never mind in her field, in the states for several years) -- they didn't expect it would be that tough. The pay raise and lower taxes didn't account for much since she couldn't work, his employer at least offered health care though, which was at least good.
because I would bet that I would not likely need medical care.
And that bet on medical care isn't all that great. A family member broke his leg skiing a few weeks ago, that'd be enough to royally screw him over stateside. Between surgery, a couple custom carbon fiber casts, physio, and going on 4+ months of not being able to work... yeah.
You can bet you won't need medical care, but that's a bet you can lose. A broken leg is pretty minor and the cost is in the 10s of thousands... what if it had been a spinal injury instead?
What happens if you lose the bet?
THEN when I started to get older and sicker, move back to Canada for all the free healthcare I never had to pay for.
Yep, that's sounds like planned abuse of the system to me.
And now, you know why Socialism doesn't work unless everyone is forced into it.
Canada should simply deny you re-entry to the country unless you are paid-up with respect to your accumulated share of health care costs. Citizenship isn't free. If you'd like to visit get a VISA and if you stay longer than that we'll deport you back where you came from.
Honestly I think that's the direction things will eventually take, and there are already rumblings in that direction as people absolutely are out looking to abuse the system in unsustainable ways.
And that is not freedom.
Forcing socialized medicine is no more or less free then forcing socialized public works like police, fire, roads, pollution controls, parks, schools.
I personally think the type of "freedom" you seem to long for is not as good as its cracked up to be. There's a few places in Africa and South America that should be free enough for you though... none of them places I'd want to live.
Americophiles are surprisingly common there, and "moving to America" is a goal of quite a few young Canadians
However the number that wish to actually become Americans is much smaller.
with ambitions that go beyond free healthcare.
Right. The assumption for most of them is that they will working for something that covers it, or will be paid well enough to easily afford the private insurance themselves and still be ahead of where they are now.
The rest of them want to live in America to be near something specific ... the New York scene, Hollywood. If that infatuation pans out into a real career great... otherwise they outgrow it and move back home.
I don't think you realize how many jobs request word format. It's not an exception to the rule if it happens so often that it becomes the rule.
Frankly, I'm with you, I prefer pdf all the way for any sort of non-collaborative inter-business documentation, including resumes.
However, the reality out there is that more often than not they want MS Word format.
I think its one part because the HR person doesn't know better, one part because some non-trivial fraction of PDF applications are something containing pictures of the pages of a resume that were scanned in upside down after uncrumpling the paper copy they pulled out of the trash
In large enterprises there's also the group that wants to pre-process the applications automatically with some tool that handles word documents before even looking at them.
If one is going to go through that much trouble, why not simply switch to another platform like Linux, *BSD or OS X? (I know I will.)
Because their accounting software, video games, and so forth all still work just fine in Windows 8 and would either have to be purchased in an OSX version or discarded outright in many cases.
I like Linux as much as anyone on slashdot can, but I've got 100+ games from GoG, Steam, HumbleBundles etc. Only a fraction of those work on other platforms.
I don't really want to start over with a new accounting system, so I'll be sticking with windows for that.
More over, most of the stuff in that article was superflous, the average person who wants to "fix" win8 doesn't need to do 3/4s of it. Spend a few minutes cleaning up the live tiles and start screen, fix a few default file associations so that they launch suitable desktop apps, and those are the big two.
Adding a start menu app maybe. Personally I like to disable hot corners and put in a start menu button that launches the Win8 start screen ... because in my case once the start screen is cleaned up its actually pretty good... but I still hate hot corners.
A hint: Don't send out resumes in docx format unless you're trying to get a job as an MCSE. Use pdf.
A better hint: Read the resume submission guidelines for the job you are applying for. If they specify docx, then use docx.
Apple had absolutely nothing to do with it...other than being the first major computer manufacturer to standardize on it and make it viable for peripheral makers to start building for thereby overcoming the chicken/egg problem fairly efficiently.
Not even close. Apple ditched ADB to standardize on USB for keyboards and mice, and that's about it. ADB was a crappy apple-only thing that nobody missed.
It did maybe potentially slightly encourage PC makers to eventually drop PS/2 ports for keyboards and mice but that's about it.
USB was widely available on PCs before apple standardized on it with the first imacs. USB PC peripherals were widely available for it -- cameras, pre-ipod mp3 players, scanners, printers, etc.
PCs were just late to the USB party with keyboards and mice because Windows 95 didn't support USB out of the box until "Win95 service release 2" and you often had to install chipset drivers. So while you could use a USB keyboard and mouse with Windows 95 "eventually", you couldn't reliably setup windows 95 with a usb keyboard and mouse. Not to mention that if you went into BIOS the usb keyboard likely didn't work.
So it took a lot longer to dump the PS/2 slots and switch over to USB entirely.
But -other- then keyboards and mice, USB was widely available on PCs well before Apple committed to it.
I think you have a very misguided view of "intent".
In that I recognize that he had no intention of damaging America?
He intended to publicly release the documents.
And he made a point of releasing to what he believed was a trustworthy organization that shared his desire to ensure no was was put in danger by the release. An organization that would take the time to sift through the information, organize it, and redact anything that would put an individual at risk.
And wikileaks did in fact do all of this. The un-redacted data was even encrypted to prevent accidental disclosure. The information was only released un-redacted to the public as a result a journalist from another organization (The Gaurdian) publishing the decryption key by mistake.
Are you really going to try and pin intent for that on Manning?
Any reasonable person with an IQ over 70 would understand that publicly releasing documents would mean that everyone, including the US's adversaries, could get a hold of them.
He didn't want anything untoward to happen to the US as a result, and took multiple affirmative steps to safegaurd the data. He didn't just dump the unredacted torrent online unecnrypted for the world to see. Not even wikileaks did that.
If Manning had read these documents,
He read several hundred, probably several thousand. He perceived a pattern of lying and corruption and actions he couldn't morally accept and took the step of whistle blowing to clear his conscious. That you or I might have seen the pattern of lying and corruption etc that he saw as "ok" and he didn't realize that is how it would be viewed is evidence of poor judgment, nothing more sinister than that.
By your logic, murder isn't murder if the perpetrator says they just wanted to shoot someone in the face but didn't really want to kill them.
Really? Is that what you think happened? All the attempt he took to release to a credible american news organization first, the steps he took to release it to an international organization second, the steps that were taken along the way to secure the data so that it could be properly curated before the public saw it.
That's the same as a guy trying to shoot you in the face?