Home Forums Windows XP not HIPAA compliant after April 2014

Interesting read. And I agree.

http://www.emrandhipaa.com/emr-and-hipaa/2013/12/12/windows-xp-wont-be-hipaa-compliant-april-8-2014/

JamesNT

What is th opinion of using xp machines as remote desktop machines from a remote location that is not on the network?

The same as the article. If there is a security vulnerability found in the Remote Desktop application for XP, MS will not fix it.

JamesNT

Hi James,

I am a known thread hijacker in therapy, but I would be interested in your advice on improving on an upgrade plan from xp pro machines. This is what I've done already, so I hope you and others can improve on it for anyone yet to go through it. It took me three weekends for 25 clients.

First, I did an inventory of the machines I had. On the System Properties (Start-Control Panel-System) there is a listing of the CPU, the RAM, and it will state it is a 64 bit machine only if it is, and not a 32 bit machine as most are. I used this comparison of CPUs at http://www.passmark.com/cpubenchmark/cpu_list.php to compare machines in my office.

To me it is very subjective to decide which machines are too old to upgrade versus replace with new. I bought new machines for my exam rooms, and passed the old ones to the staff to replace even older machines that I gave to the staff with warnings about April 8, 2014.

This is a good time to vacuum the dust out of the machine and install more RAM if you only have 2 GB. I used this site to find out what memory exactly to order http://www.crucial.com/systemscanner/

I upgraded from XP Pro to 8 Pro with clean installs, because it was half as expensive as doing 7 Pro installs. Either way you will have to do a clean install, so plan for chaos. Know what programs each staff member uses and how they will be reinstalled. Back up all important data and browser favorite sites. Do it in sections so you don't disrupt the biller or the front desk until you're a pro at it. Maybe start at your own desk first.

I prepared the staff for Win 8 and didn't give them a choice. I gave them a handout on how to navigate on the desktop, how to get back to the desktop if they got lost, and how to restart or shut it down, and it has been fine. Zero issues over Win 8.

Then after the Win 8 install, you have to update windows, and there are about 70 updates, before the path to Win 8.1 will show up in the Windows Store as a free upgrade. Win 8.1 allows you to boot to the desktop, so your employees are happier.

Each of the three upgrades, XP to Win 8, Windows Updates, Win 8.1 update, can take a few hours depending on your bandwidth, but fortunately the labor is free.

If you are on a domain, go to the Systems Properties page and change the settings to add the domain.

Right click the taskbar and I like to change the taskbar buttons to Never Combine cause it is like XP. Then click the Navigation tab to change the Start screen check boxes to checked for the top 2 boxes to have the machine boot to the desktop.

Now you get to set up printers, scanners, programs and backup data.

Expect complications, but it is a lot cheaper than buying new machines, which still need all the printer, programs, and data setup, or paying IT guys to do this for you. The upgrade is the boring easy part compared to getting the machine ready to use.

Why not just get Windows 8.1 directly? This is where imaging is useful. We've been doing these types of upgrades on a regular basis. We have stock images of Windows 7 Pro and Windows 8.1 loaded up with everything from FoxIt PDF Reader to Amazing Charts. Then we just have to install drivers. Saves us several hours per computer.

We've been advising practices to stick with Windows 7 since a lot of Hospital portals only work with certain versions of IE. We tried everything in Windows 8/Developer tools of IE to get some of them working and we ended up just sticking with Windows 7. Windows 8 has no way to downgrade the version of IE you are using.

Another great program to speed up your install efforts is available at http://ninite.com. It will let you bulk install a lot of the freeware.

Dan and Sandeep,

There is nothing wrong with either of your approaches. For the non-IT person, Dan's approach is what I would recommend for most DIY doctors. It's time consuming, perhaps, but his approach doesn't require learning a lot of new IT skills other than Windows 8 and downloading drivers from the computer OEM's website. And, since this is probably a once-every-5-year thing, it's not a big deal.

If, however, you're a system builder like Sandeep, his approach is more ideal since it allows Sandeep to deploy hundreds of machines quickly. However, more skill is required and there is more to learn.

When recommending technical approaches to people, one of the most important things to ask yourself is what kind of situation that person is in. Like I said about Dan, he may do this once every 5 years so there is no need for him to develop a serious IT skill just to find out that 5 years from now that skill is totally obsolete (and he forgot it by then, anyway). We IT types complain about the "spousal install" but for a lot of people it is the most efficient way to go.

Related blog post: http://jamessummerlin.com/2012/06/22/the-disconnect-between-big-consultants-and-small-companies/


JamesNT

I was suggesting that he contact a professional rather than using the DIY approach. The pros can do it in a day and I'm pretty sure he makes more money seeing patients rather than installing all the little programs. Maybe schedule patients for Saturdays to make up the costs.

Make sure you use the right IT Guy. There was an individual here locally that billed for 9 hours of work for every reformat even though 80% is just waiting for things to load.

That's just my $0.02

I like your post about the consultants. There was one down here who convinced a physician to buy redundant servers, a spot air conditioner for his server room, 3 backup NAS devices, and redundant fax servers, UPS, and a generator. He was a solo physician. I mean the setup was great but it was complete overkill.

My Dad was a carpenter, and it is amazing what a pro with power tools can do to save time and money.

Wish I had posted my thoughts before i did it, but i grabbed the tiger by the tail and had to hold on to keep from being bitten.

Sandeep, I disagree about "complete overkill". We are a small office, have redundant everything, and 12 hr backup UPS. If it is you who has meningitis, its importance to you is every bit as big as it is to the individual in a whole city full of afflicted people. The risk of an event causing severe income and productivity loss is no less to a single user than to a large clinic, although the cost per individual provider to guard against it is greater. The total numbers may be different, but not the impact to the individual.

I'll have to disagree. The point of redundancy is to maintain uptime. That degree of resiliency is typically not necessary for a solo provider. If you come down with the flu, it's not like you will be seeing patients that day anyways. So a day of downtime isn't the end of the world for a solo provider. Now if you're someone like Amazon who loses $70,000 per minute of downtime, it's a different story.



If you're in a group practice, yes it makes sense to a degree to invest redundant solutions. The point of redundancy is to maintain uptime. But like we always say RAID is not backup. The ability to recover is more important than uptime. I see it all the time. Practices that have RAID drives, UPS, etc. but neglect backup. Now when it comes to backups, I will agree that you can never have too many backups. Not in the case of redundancy though. There's a limit to how much each business needs. The amount invested in redundancy should be proportionate with the expected loss of income per unit time. You don't need Amazon level redundancy for a solo provider. If a day of downtime costs you 1000 dollars, I don't see the point in investing 40,000 dollars in redundant equipment.

Also, a 12 hour backup UPS. The only way you could achieve something like is with a battery bank. It would make more sense to have a lower capacity UPS and a generator which can go on for days.

Actually, Sandeep, we have a 1500 amp/Hr. battery bank with inverter. This system was really engineered adequately and the specs are accurate. It does keep the system alive for 12 hrs. I think consultants in general underestimate the actual cash flow involved in a medical office. Our office bills $1200/hr for all 4 providers. I view investment in hardware it as cheap insurance.

That's very nice. But a generator/UPS combo would be better as you can keep refueling the generator. Honda makes some nice generators. Hondas have a special inverter board that makes them work well with electronics/computers. Since you have a battery bank, you can use a regular generator though.

Yea, it makes sense for larger practices. A battery bank would be hard to justify for a solo provider especially since you see many on the board hesitant to spend more than $1,000 on a server.

We went that route as we are in an office building and can do a battery bank for our office, but not a generator that would have to be outside and tie into the entire building power. My point, however, is that it is easy to look at just basic equipment costs, and forget how much you have to generate to make payroll once you hook your practice to the electronic record star. Going electronic creates vulnerabilities that are easy to overlook and not necessarily appreciated by users or consultants in the magical glow of incentives.

Going electronic also has its benefits though. That's what I made the cloud failover service for those docs who think the investment in battery banks, redundant services, etc. is too much.

Yes, exactly! And had it been available back then it would have suited perfectly. Again, my point is the financial risks of not having some sort of failover system in place are huge, and too easy to ignore when the tech bills start to come in.

It's still useful as you'll have an off-site fully functioning backup.

Does anyone have any experience with installing Windows embedded pos 2009 and running it in the office or using in remote office
Installing AC over it
How does it install on an existing Xp machine?
It has support till 2019 and you do not have to turn your office inside out with hardware, and possible a free cardiac stress to the practice doctor

Sunil,

I don't, and can't help you... other than to recommend you beg Bert to start another thread with your question so it gets more attention and can be found easier later if desired.

I suppose you could delete the post and start another one, but Administrators need begging every so often to reward them for all the work they do.