Some Windows XP Users Can't Afford To Upgrade 953
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?"
I'm gonna say... (Score:5, Informative)
VMWare.
Helps but not a complete solution. (Score:5, Insightful)
That helps with hardware incompatibility but not security.
Re:Helps but not a complete solution. (Score:5, Insightful)
Unless your WinXP-reliant software is also needs access to the internet.
Re:Helps but not a complete solution. (Score:5, Insightful)
Unless your WinXP-reliant software is also needs access to the internet.
Considering this particular summary is in regards to medical software, I certainly hope that's not the case.
Although I can see it being an issue for other industries.
Re:Helps but not a complete solution. (Score:5, Informative)
Having worked in hospitals, and currently working more in the background in the medical field, you would be really surprised how much of it needs access to the internet. Most of the software I've worked with in the medical field does, and it's only going more in the direction of needing access to the internet than away from such.
I can't speak for software in smaller clinics and stuff, as I'm not real experienced there. For a lot of hospitals and stuff, though, there's a lot of server farms hosted far off site that they have to connect to in order to do anything with the software.
Re:Helps but not a complete solution. (Score:5, Informative)
Medicare billing. I have done several medical software installations, they all have a strong need for internet access for electronic transfer of medicare records.
Re:Helps but not a complete solution. (Score:5, Informative)
Re:Helps but not a complete solution. (Score:5, Interesting)
I'm in agreement with you.
On the flip side, I can think of one hospital I worked at that was a constant back and forth between the guys doing the network security and the doctors. The doctors won every time, with the guys doing the network security walking away with scraps of their generally good ideas. They eventually found a good compromise that didn't leave a bunch of security issues, but the doctors had the better leverage and wanted ease of use if they were going to use the computers at all. They just wouldn't use your computers if you made it too difficult (which was not very difficult at all, but not as easy as the old ways they did things). That said, they were able to figure things out, but if security makes the doctors' life more difficult, they'd rather just do it all without the computers, making the whole thing a moot point.
Re:Helps but not a complete solution. (Score:5, Interesting)
Doctors can do what they want, netops are happy with what they get to lock down, and we even pass a lot of the DSD compliance ratings (not that we're audited, but it's a good benchmark).
*Can't solve your problem in 10 minutes, a further 5 minutes to blow the machine back to standard image. 5 more to reconfigure default accounts and such (which is automated, but we also need to wait for download/ sync of emails etc.). 20 minutes downtime from start of call to end, maximum.
Re:Helps but not a complete solution. (Score:4, Informative)
I just talked to a friend of mine who is a doc who now spends his evenings entering medical records data because he only gets 15 minutes to see patients at his hospital. So I have some sympathy for the docs... if IT just "adds a little difficulty" to a process that is already excruciatingly painful, the docs aren't going to embrace it.
Re:Helps but not a complete solution. (Score:4, Insightful)
Re: (Score:3)
What, you expect software that shares records between your doctors, your local hospital, and the specialist 3 cities over to have its own private network that in no way interacts with the internet? Not even a VPN over the top of it? It's own, completely separate, private, cabling and all, network? That would certainly explain the $10000 a license cost.
Re: (Score:3, Insightful)
Re:Helps but not a complete solution. (Score:5, Insightful)
Run it through a WHAT? Why am I running XP inside of a window? Oh no, I just deleted it. Did you break my computer? I don't care if you think you're smarter than me. I just need things to work. I have a lot of patients to see.
Re:Helps but not a complete solution. (Score:5, Insightful)
This. Pretty much sums it up. We can engineer all sorts of solutions but in the end they will be calling you to run it for them.
Don't let them try an barter services for it either, they will *own* you.
Re:I'm gonna say... (Score:4, Insightful)
It's possible that the machine is actually more of an embedded system, acting as a front-end for a device whose drivers won't work in a VM.
dom
Re: (Score:3)
It's possible that the machine is actually more of an embedded system, acting as a front-end for a device whose drivers won't work in a VM.
dom
If it's a really embedded system, upgrading it is going to happen with a forklift or with not-inexpensive cooperation from the vendor.
If it's just an unsupported peripheral, contemporary virtualization software can(with an IOMMU) actually attach a physical device to a VM's bus. Very cute.
Re:I'm gonna say... (Score:5, Interesting)
Re:Disconnect XP from Internet (Score:4, Insightful)
That's an awesome way to run a business.
If your business is sticking forks in your eyes.
Re:Disconnect XP from Internet (Score:4, Funny)
Re: (Score:3)
specialty software prices (Score:5, Funny)
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.
Kind of like college textbooks?
*ducks*
Some industrial stuff is still on ISA cards (Score:4, Informative)
Some industrial stuff is still on ISA cards.
It's just that to go to new stuff needs lot's of change to work.
Re:specialty software prices (Score:5, Insightful)
Re:specialty software prices (Score:5, Insightful)
Now, I don't see any reason for there to be new editions as often as there are. Many of the textbooks I read in my spare time are actually pretty old, but outside of some of the topics that rely on technology there isn't a whole lot of reason to have new editions. Even something such as numerical analysis (which should probably have a technology based theme for CAS) doesn't really need to be updated very often as the algorithms don't change, just the languages that may be used.
Perhaps I'm just biased, but a well written text book seems much more useful than gleaning bits of information from a variety of sources that all use different notations and symbols for learning about a topic in math.
Re:specialty software prices (Score:5, Interesting)
Actually—(a) they're just called "papers," the "white" part is a specific piece of IT jargon, and should be pronounced "scientific-sounding marketing material," as white papers are almost never rigorous or unbiased, and (b) there are plenty of books published at levels above the expected comprehension of a graduate course; these are usually bundles of papers and protocols (procedures). They're sometimes called "textbooks," but more properly "monographs [wikipedia.org]."
And for what it's worth, graduate textbooks and monographs are cheaper than undergraduate textbooks because they involve fewer writers, as the material is more narrow and there are fewer experts available. Monographs in particular are exceptionally cheap because the idea of publishing a book generally comes up after the material has already been written.
Regarding the availability of content, however, the Internet is really not all that it seems when it comes to content for fourth-year undergrads and grad students. Textbooks targeted at such groups generally require combing a great deal of journal articles, which are generally available, but may not necessarily be in a consumable format. My favourite example is this paper [sciencedirect.com], which outlines a method of constructing a solution to a problem (WJISP in polynomial time) and then completely fails to explain how the method works (It takes about half an hour to work out even when you know what they're talking about.)
This is where having a competently-written textbook becomes invaluable, and were it not for Wikipedia, many more topics would be completely unrepresented in any electronic secondary source.
Re:specialty software prices (Score:5, Informative)
The term "white paper" [wikipedia.org] originally comes from UK parliamentary procedures and referred to documents containing an official policy statement of the government, as opposed to a "green paper" [wikipedia.org] which only contained tentative proposals for the purposes of debate and discussion.
Re:specialty software prices (Score:4, Insightful)
College textbooks are largely irrelevant in the age of Internet. They only exist to keep publishers and bought teachers rich.
The textbook may be, but the content contained therein is not irrelevant. Regardless of whether or not it is printed on paper or simply stored as magnetic bits, should not the authors of such works be rewarded for their efforts?
You speak of the internet as if somehow resources magically appear there. To take your comment to its logical conclusion, not only are college textbooks largely irrelevant in the age of internent, but if everything that is needed for one's course of study is free and online, then college itself is irrelevant, too.
Unplug the computer from the WWW (Score:4, Insightful)
Who cares if XP is unpatched?
Special dental application to track intervention history, show X-rays associated, etc should not communicate with the internet.
Same goes to timetables / reservations.
If they need machines connected for mobility : make an internal network.
I don't see such a problem here.
Re: (Score:3)
The sibling post made the point about finding replacement parts for when things die. That was always my motivation for a complete system upgrade - something dieing and needing to be replaced without me digging deep enough to find something that would work with the old system.
Secondly, some things do need to be connected to the internet. Sure you can make an internal network, but what if you need to connect to another doctor's office? What if you need to connect to any other doctor using the same software?
Easy solution...virtualization. (Score:5, Insightful)
The sibling post made the point about finding replacement parts for when things die. That was always my motivation for a complete system upgrade - something dieing and needing to be replaced without me digging deep enough to find something that would work with the old system.
Buy new machine running Win7/8, install free vmware/virtualbox, run specialist software in VM fullscreen. Done
Re:Easy solution...virtualization. (Score:5, Interesting)
And who sets this all up for the doctor or dentist, and how much are they going to charge, and what is the maintenance charge to make sure it keeps working and the person who set it up is available to fix it in a day's time if necessary?
Re:Unplug the computer from the WWW (Score:5, Insightful)
Since you have no experience with the software - of course you don't see a problem. You just wave your magic wand from your ivory tower and state that it "should not connect to the internet", and *poof* problem solved.
Re:Unplug the computer from the WWW (Score:4, Insightful)
The "problem" is on the end of the end-user. They want to not have to upgrade and to recieve security updates in perpetuity, which was never in the deal when they bought XP.
For the record, XP is of the same vintage as Linux 2.4. Its time to upgrade, guys. You probably should have budgeted for this years ago, its not like this is some huge suprise. XP's EOL has overtaken us with the breakneck pace of a glacier.
Re:Unplug the computer from the WWW (Score:5, Insightful)
Yea, not being able to afford an upgrade is not an excuse. That's like a truck driver saying he can't afford to buy new tires. At some point he's going to have to or he's not going to be driving his truck.
Not so simple in real life (Score:3)
The military already does this. It's common to have three different computers with different security levels on one desk, all of them air gapped from each other. But you're looking at three switches,
Re:Unplug the computer from the WWW (Score:5, Informative)
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.
Re:Unplug the computer from the WWW (Score:5, Interesting)
Two separate networks run on two separate switches (yes, VLAN's could have been used, but the switches didn't support them). Each port in the building can be configured to the internal or external network. Wireless is only available on the external network.
To this end:
1) The ultrasound computer is airgapped because it's running Windows XP. Specifically, the software for the US machine is very old and only runs on XP, and upgrading would be a $10,000+ purchase (new US machine, not just the software cost).
2) The records keeping and accounting is separate from the internet. Customer records are only available on the internal network, and not connected directly to the internet. These computers are thin clients with USB mass storage support disabled.
3) The internet computer is a disposable kiosk computer, which has no access to customer records. If someone wants to look something up (ie. rare disease), that computer is available for that. It's also accessible for emails.
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. We've had zero viruses or known intrusions on the internal network in 10 years.
The doctors at this office are accustomed to the inconveniences that this brings, but they work around those issues. They did business for over 30 years with paper records, and they see no need to switch. The idea that some sensitive data gets leaked or hacked is more important than the minor efficiency gains they could achieve. However, this is a rare case. Most of my customers demand all their computers be internet-connected.
Re: (Score:3)
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 dat
Re: (Score:3)
Problem is if that machine breaks it is pretty hard to buy a replacement running XP as new. It would have to be a custom build. It will only get harder as driver support dries up for new hardware and second hand machines become increasingly likely to be running Vista (which is six years old now).
At least in Windows 7 there was XP mode which worked very well. It was removed from Windows 8.
This has all happened before of course. Years ago I had a customer who owned a vinyl sign cutting machine with a parallel
Re: (Score:3)
PATA and floppy drives were already out of style when service packs were still being released for XP.
From a support perspective, XP just isn't that old. It's a recently discontinued product regardless of how long of a supported service life it had.
Re: (Score:3)
XP is as old as Linux 2.4, which for the record was EOL'd 2 years ago. When's the last time you worked with a non-embedded copy of 2.4 that was expected to act as a normal citizen on the internet?
Certification (Score:5, Insightful)
I bet a lot of that $10k fee is due to the software requiring FDA certification.
Re:Certification (Score:5, Insightful)
Yea, its not like medical software errors ever killed anybody. Eh Therac-25?
Re:Certification (Score:5, Insightful)
You can probably count on one hand all the directly life critical software running as a regular app on XP, in the whole world.
It's very unlikely there's anything at the eye doctor's office that falls in that category. This is a case of simple vendor lock-in. That's all.
Re:Certification (Score:4, Insightful)
Your right, it's probably running on NT4 or something like that. I have seen many instances of embedded NT or 2000 still in use in the medical field. (Radiology labs is where I see it but I would guess that maturity and stability of the software and drivers negates the need for upgrades in many medical devices)
Comment removed (Score:5, Interesting)
Re:Certification (Score:5, Interesting)
I bet a lot of that $10k fee is due to the software requiring FDA certification.
Oh that wouldn't surprise me, back oh 15 years ago I helped due a transition from paper to electronic. It was right up along the lines of $38k here in Canada for the software. And my family doctor just dumped their old version of Wolf Medical to a new version, total cost for 6 computers? $118k.
Re:Certification (Score:5, Informative)
On the off chance you're not trolling:
Just because the example in the summary is a medical example doesn't mean that they're the only types of software that are expansive. I use some $20k/seat engineering software that isn't certified by anybody except me knowing what it's doing and putting my own name to it. Stop looking for big-government boogey men under every bed.
Re:Certification (Score:5, Informative)
Coincidentally, you've never worked in the medical industry. The software itself may cost $5-$10k, then the SEPARATE cost of validation tacks on that 20k.
Re:Certification (Score:4, Interesting)
Re:Certification (Score:5, Funny)
Most of the Doctors I know have 2 or 3 ex wives and several child support payments that eat up a lot of their money. Then there is the current wife and mistress.
Re:Certification (Score:4, Interesting)
Re:Certification (Score:5, Informative)
No, I don't think that a housekeeping database that doesn't ever touch the patient needs an FDA approval. Not any more than MS Windows or MS Office do, at least.
A $10K price is a common sight in niche markets. Even in non-niche markets specialty s/w, especially with lock-in, command prices of $20K and above. Have this here CNC milling center? Then you need SolidWorks and MasterCAM (or whatever CAM you pick.) That may easily cost you about half the price of the machine.
The price is driven by the need and the opportunity. The need lies in fact that a very complex piece of software has to be designed for sale to a handful of customers. A smaller ISV may see tens of sales per YEAR, and each of those customers will bitch and moan about economic downturn, trolling for a discount. The ISV needs the high price to stay afloat, and to survive periods between orders.
The opportunity lies in fact that the customer has to have this software - if not yours then one from your two competitors; and you know how to play that game. The prices will be set to the maximum that the customer can afford.
Re: (Score:3)
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
Disable Networking (Score:5, Interesting)
Prevent those few computers that are running the program from touching the Internet in anyway. No networking services, web, email, ... or anything else. Make them strictly one function standalone devices.
Specialty Software (Score:3, Insightful)
Re:Specialty Software (Score:5, Insightful)
A lot of "professional" users of computers (doctors, lawyers, bankers, etc) seem to think that they gotta have really special software to handle everything they do, because everything they do is so special. Much of this is due to people who think they're smart being duped by people who are smarter into thinking they need special software. Is the solution here that these professionals need to do a better job of buying their IT support in the first place? Admittedly, there is certainly some software that has to be written for very narrow and specialized needs, but a lot of these needs can be met by pretty much off-the-shelf solutions implemented by people who know what they're doing. I think these professionals start off by trying to do it themselves (because they are smart, you know?), find that it's not as easy as they thought, and then buy into the pitch that they need REALLY smart IT people doing specialized stuff for them. I'd laugh at all this, but it's part of why our health care costs so damn much.
Well I can certainly tell that you're not a physician, as a physician I can tell you that you have no idea how many limitations, restrictions, and compliance requirements exist in medical software. The issue isn't that you need these things, sure you could host your patient information on Google docs, but when someone breaks into that it can cost you 250K per patient that is lost, there isn't an upper limit on that either, I don't see that many doctors with that kind of cash willing to take those risks. I am not saying it is better to be running on unsupported systems, but it isn't like you can go download some mysql database and front-end designed to organize your DVD collection and safely store patient information. Also most doctors don't have the time or knowledge to do it well themselves so they are stuck with what is 1) out there, and 2) compliant.
Re: (Score:3, Insightful)
Re: (Score:3)
Specialty software is necessary for doctors, lawyers, and bankers because of all the applicable regulations. Doctors have to deal with HIPAA, which sets strict rules for the protection of privacy of patient information. Have you noticed that when you fill a prescription at Costco's pharmacy, the receipt doesn't say what it's for, and the pharmacist simply staples the bag shut? That's HIPAA compliance. Similarly, doctors can't just use Dropbox to store information because it might get hacked. Lawyers have to
Re: (Score:3)
Don't forget the special add-on modules to come up with a different spelling of your name each visit.
Nothing new (Score:5, Insightful)
Is this stupid? Yes. Is there anything I can do about it? No.
I just got done negotiating the purchase of a 2-million-dollar piece of equipment that comes with Windows. We actually have a purchasing requirement that all software be provided with patches as necessary, including OS upgrades, and that all source code be held in escrow in case the company goes under. However, when we negotiate the purchase specs, those lines get crossed out, because the vendor refuses to comply and we have no leverage, so we buckle.
Personally I think that anyone who uses something like Windows (a desktop OS with known, SHORT service lifetime, suitable for desktop computing in non-critical applications) in an industrial tool with 10+ year lifetime, should be fired immediately, and this should have been the case from the very beginning, but I was not around back then, and it became acceptable. Nobody ever got fired for buying Microsoft, even when it's an idiotic thing to do.
Re: (Score:3)
Personally I think that anyone who uses something like Windows (a desktop OS with known, SHORT service lifetime, suitable for desktop computing in non-critical applications) in an industrial tool with 10+ year lifetime, should be fired immediately
What is your alternative? Unix? You might get 10+ years service life if you are willing to provide that service yourself, back-porting security patches to an ancient version of the kernel or re-certifying your app on a new one.
Any device with an OS, in fact any device that has a network port or USB socket is going to be vulnerable and need a constant and endless supply of patches for decades. The only sensible thing is to isolate it.
XP might be old...but your computer isn't (Score:3)
XP is 12 years old. It'll be 13 when it's EOL'd.
...why are you measuring from when it was first sold, not when it was last bought. The XP lifecycle is a little strange as it was so awful it needed a major (and pretty good) service pack 2. Even when Vista was released many machines (famously those on i915) ran badly...or not at all; many machines still came without Vista. In fact a whole range of machines (nettops and netbooks) still came with XP until Microsoft killed it with and the whole net* products with Windows starter (and crippled intel hardware),
More importantly, can anything be done about it? (Score:3)
Yes, something can be done about it. Not overnight, but it can be done.
What?
Use Open Source.
Your either need to pay 10.000 because it really costs 10.000 in which case you wouldn't be making a case out of it, you would just pay for it as part as your making business costs, or it doesn't costs 10.000 but you end paying 10.000 because third parties controlling your business instead of you.
If you think you are in the second case, just ally with other "eye doctors" and make a software factory to produce the software in your behalf as open sourced. On one hand, you'll pay the real cost; on the other, the old producers will be forced to either down their prices to the new market standard or fold down. Any case, a win-win situation.
Re: (Score:3)
If you think you are in the second case, just ally with other "eye doctors" and make a software factory to produce the software in your behalf as open sourced. On one hand, you'll pay the real cost; on the other, the old producers will be forced to either down their prices to the new market standard or fold down. Any case, a win-win situation.
This is what I was thinking as well; just get together with peers in a similar situation, and 'Kickstart' an OSS version of the program, thus forever freeing yourselves from the shackles of proprietary software.
Plus, if you do it right and the software is good stuff, you might even be able make a few extra bucks on the side selling an enterprise version or support.
Re: (Score:3)
And if the software fails or does nasty things to your medical data... who are you going to sue? Have you even looked at F/OSS EULAs? I have seen a few EULAs for Windows-based medical software and upon buying the software, there's actually some (not perfect but some) accountability from the vendor. You can sue them if they mess up.
Very common (Score:5, Interesting)
My old hospital was hit by this already. They couldn't afford an enterprise license from Microsoft that allows them to pick which version of windows to install on their PC's, (hundreds of thousands of dollars), some of our critical EMR software was only XP compatibe and would not work on WIndows7. When Microsoft quit selling XP and wouldn't allow us to downgrade our Windows 7 systems, we were in a bind. We were able to find some XP licenses in the wild but still are between a rock and a hard place. FDA certification for our EMR vendors is a pain and moving to the new version of windows is hard. I have no idea how we will overcome the sunsetting of XP.
Misleading headlines are misleading (Score:3, Insightful)
In the linked article, the doctor couldn't afford to upgrade her specialty medical software.
1. It's unlikely that the version she currently uses does not run on Win7
2. It's unlikely that the version she would upgrade to does not run on XP
3. It's likely that the upgrade would cost $10,000 even if she wasn't changing OS versions
So what does this have to do with Windows? Nothing. The only information in the article is that specialty software can be very expensive. That fact stands alone and would do so on any OS and any version.
Has Slashdot become this gullible??
Re:Misleading headlines are misleading (Score:4, Insightful)
If she tried firing it up on Windows 7, it would probably run, yes, although having it fail is more likely than you might think. But it's not *certified* on Windows 7, so she can't do that. She likely would be legally liable if she did.
Same deal as #1. It's not certified, you can't do that.
Yes, but she doesn't need to upgrade unless she changes the OS.
Re: (Score:3)
1. It's unlikely that the version she currently uses does not run on Win7
If she tried firing it up on Windows 7, it would probably run, yes, although having it fail is more likely than you might think. But it's not *certified* on Windows 7, so she can't do that. She likely would be legally liable if she did.
You simply do not know that. The guy that wrote the linked article doesn't know that. He in fact, doesn't even state that it isn't the case. It seems like important information don't you think? He could have erased any doubt by simply stating the name of the software and the version. But that would be counter-productive since it would probably demolish the premise of his idiotic article.
2. It's unlikely that the version she would upgrade to does not run on XP
Same deal as #1. It's not certified, you can't do that.
You're stating with so much confidence something that you simply do not know. It's absolutely not unheard of to
3. It's likely that the upgrade would cost $10,000 even if she wasn't changing OS versions
Yes, but she doesn't need to upgrade unless she changes the OS.
You don
Bad example (Score:5, Insightful)
This is a really bad example to make your case. She has HIPAA data and needs to upgrade as her computer can't be patched anymore next year. No sympathy for someone with HIPAA data trying to get out of patching their system.
Now, if you had picked an example of someone who didn't have HIPAA data I'd point to options that could be done. However to be frank I am all out of sympathy for anyone in this situation. Microsoft announced end of life on this a very long time ago and frankly gave a lot longer on the EOL and support for the OS than Mac or any of the Linux variants.
This reminds me of the gas station owners put out of business by the new standards for underground tanks. They had years of advanced notice, yet they still refused to modernize something critical to their business that they knew they needed to. Time came that they could no longer be grandfathered in and all of a sudden a bunch of stations went out of business.
Why, because they didn't want to spend money for tanks that were resistant to leaks that could ruin the environment? A doctor that doesn't want to spend money to help prevent leaks (patient data) is no better than the gas station owner. It's a business expense just like any other and a business owner that refuses to give IT it's due as they should. Quit supporting IT neglect by helping people like this out.
To be more specific (Score:5, Insightful)
They announced their end of life date on the day of release. MS sets EOL 10 years from day of release on their OSes. Now, in the case of XP, it was extended. They do that sometimes. However 10 years is the norm, it is what you can count on, so it is what you plan for. Like with Windows 8 we already know the end of support date: 10/1/2023. It is always possible that will get extended, but it very well may not. So if you put an 8 system in place now, you know when you need to start thinking upgrade (at the latest).
MS is real, real, good with the support lifecycle thing. They have a standard policy, and current information is always available on their site. So planning for when upgrades need to happen is not hard.
The XP drop dead date has been a long time in coming, and is still over a year out. There has been, and still is, plenty of time to deal with it.
Re:Bad example (Score:5, Insightful)
They have had years to budget for this in advance. I don't think budgeting $1000/year for 10 years for an eventual software update is out of the question for a doctor's office, or any other business. Create your budget as far in advance as possible and when you need the money it will be there.
Re: (Score:3)
She's an eye doctor... and she wants us to believe she can't afford a basic business expense? Really?
$10,000 is a fairly minor expense for a medical practice, especially one that, as you say, could easily have been planned for over the past 5 years or so.
Hell you have to budget that shit at home (Score:3)
If you own a house, you get familiar with that kind of thing. I had to replace my A/C a couple years ago. Ran me about $7000 for a nice efficient one. Well guess what? That won't be the last time I have to replace it. So it is something I'm budgeting for. Not now, not next year, but in the future (I'm targeting 15-20 years out of this unit) I'll need to get a new one. So I'm making sure, to the best of my ability, that I'll have the money lined up. Same for other appliances, vehicle, and so on.
This is just
Virtualise (Score:3)
Just because a piece of software needs to run on an obsolete operating system, it doesn't mean that should be their main operating system. Stick it in a VM and don't attach it to the network unless necessary.
A Dickhead's Idiom (Score:5, Insightful)
You made your bed, now lie in it.
That's Why Your Doctor Bill Is So High (Score:3)
The problem is not XP. The problem is speciality software vendors charging ten grand for a software update.
This kind of stuff is why it costs the rest of us $2120.14 to have a hangnail treated at our MD.
Maybe they don’t know all their options (Score:4, Interesting)
Mandatory Obamacare Slam (Score:5, Insightful)
TFA was fine, until the writer threw this in:
And you have to remember that medical professionals are already reeling from a huge medical equipment tax courtesy of ObamaCare. One physical therapist told me of 14 medical centers that shut down because they couldn't handle the tax. And that's in Orange County. This area isn't exactly poor.
I call BS. That huge tax is 2.3%. The "14 medical centers" is an offhand rumor that doesn't pass the sniff test. In related news, a number of medical device manufacturers are blaming the device tax for their decisions to move existing and/or new plants overseas.... a tax that falls on all devices, regardless of where they're made. If Mr. Patrizio (or his Network World editor) don't like the PPACA, they can go to town. But, some research would have been nice.
Time for GNU/Linux for the medical community (Score:4, Insightful)
Re:Should run on Win7 (Score:5, Informative)
Re:Should run on Win7 (Score:5, Informative)
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.
Re:Should run on Win7 (Score:4, Insightful)
How well does this interact with hardware?
We tried using a virtual machine to run National Instrument's LabView. It did not get along well with the NI Elvis breadboard systems we are using. Using it on native Win7 machines didn't work either.
XP mode is a VM based technology, though admittedly not the same as we used. Does it communicate better with external hardware than VMware?
I don't know the nature of the software she was using, but some I have seen in optomitrists' offices *does* run hardware. If that's the case, XP mode and other virtual machines might not be good a solution.
Re:Should run on Win7 (Score:5, Informative)
Re: (Score:3)
Re:Should run on Win7 (Score:4, Informative)
Why doesn't XP mode work? XP mode is just a virtual machine running Windows XP. Maybe Microsoft left something out is all I can think of.
Because support for XP mode will end next year, too.
Re: (Score:3)
True. However, there may be issues of vendor support. Some business apps are, and this includes specialist medical apps, mission critical, or at least sufficiently important that business may be compromised in the event of failure.
I know one hospital that recently upgraded their hardware. However, some of the middleware needed to make their various medical records applications work together, was only supported by the vendor on XP SP1. There were several problems:
1. The critical nature of this middleware, an
Re:Should run on Win7 (Score:5, Interesting)
No need to upgrade to new software, it should run on Win7. There are multiple ways to configure compatibility.
FWIW, Win7 seems to be much more friedly to this than win8.
I've had two 16-bit programs (one used for point-of-sale another a game my mom likes to play) hobbling along since win95. WinXP worked okay (some compatibility flags made it work), Win7 was a bear to make work with the printer and the point-of-sale program, and finally win8 broke both of them. No application error message, just win8 says, you can't run them anymore (the troubleshooter recommends using winxp mode sp3, but that doesn't work, nor do any of the other modes from win95, 98, me, XP-sp2, Vista, or win7, w/ or w/o administrator priviledges, or in reduced color mode). The orginal publisher of both pieces of software are no longer in business, so purchasing upgrades to the new OS is a non-starter.
I've had to downgrade two new computers back to win7 and winxp (didn't have more than one spare win7 licence, so I had to reach back to xp) to support these programs for now, but now the writing is on the wall. I'm sure that my case is not unique and given my predicament, I'm sure that there are some applications that just won't run on win7 either even in compatibility mode.
Re:Should run on Win7 (Score:4)
It's kind of the opposite problem, but I encountered governmental agencies- for a large American city to remain nameless- who, today, continue to produce Web applications that require Internet Explorer 6 on Windows XP or earlier. When we encountered problems accessing them on 64 bit Windows 7 w/IE 9 (Compatibility Mode turned out to be the workaround), I called the head of the department in question to tell her that, well, most new machines today would be running 64 bit Windows 7 + IE 9 (or better), so it might help them to write code that didn't require IE 6.
She asked me to call her (apparently so that she could tell me something off the record) and told me that, for her department, a "new computer" was anything about 5 years old. Apparently, 5 years back, they got a bunch of Windows XP computers w/MS development tools, and that's where they still are today. Budget issues won't allow them to upgrade, so they're stuck writing code that would have been mediocre 5 years back, and is utterly horrid now. Wouldn't surprise me at all to see many governmental entities in the same boat.
Re:Should run on Win7 (Score:5, Informative)
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.
Re:Wrong platform (Score:5, Insightful)
Re:Wrong platform (Score:5, Interesting)
The problem is customers. I work at a major hospital and a local consortium is looking to purchase some new medical records software, worth about $10 million.
We've been drafting the new contract for tender, and line 1 of the tender instructions is "The software will run on Windows Server 2008 R2 or Windows Server 2012 64-bit on the servers, and on Windows XP, 7 and 8 32-bit and 64-bit on the client side". I protested at this, but was told by the technical chair, that this term was not negotiable as it was a critical part of the spec; they simply did not have the in-house experience to manage a *nix system.
Later on, there was another line in the tender instructions. "The distribution of the source code of the product must be strictly controlled with appropriate audit trails for persons who have seen it, includes the source code of any 3rd party components used within the product". Again, I protested about this, but the chair of information governance and security said, that this term was non-negotiable due to the large volume and the critical nature of the data stored in this system!!
Re:Virtualize the environment (Score:5, Informative)
If you can do a fresh install, this would be a good opportunity to do so:
1. Install XP from scratch, with all the latest fixes and whatnot. Get it nice and pristine with no crap milling about beyond the barebones stuff. Get the licensing happy. :-)
2. SNAPSHOT
3. Get your custom software installed.
4. SNAPSHOT
5. BACK IT ALL UP.
6. Use gingerly
Re: (Score:3)
Take an image of the workstation running XP, convert it to a virtual machine. Take your new Windows 7 Machine, load up VMWare.. and tada.. you're running in a more secure, easy to manage virtual XP environment which you can keep protected and unchanged for years to come.
Might work if there's no hardware involved. If there is... I'd give 50-50 odds that even under VMware it will still fail.
These people don't write these things to standards. That's the whole problem. If they did it'd already just work under Windows 7 and wouldn't need virtualising.
Re: (Score:3)
no, that won't pass a HIPAA audit, a virtual machine running an obsolete OS is non-compliant, regardless of whether the hosting OS is compliant. this is also true in the realm of finance with PCI audits.
Re: (Score:3)
You know what, I was thinking the same. It's good I browse through comments before rushing to the "reply" button.
Also, dental business is lucrative business, if you're a good doctor you can make 10K profit in a month. My uncle (retired dentist) used to make 12-14K EUR monthly profit in Germany on average. Granted, he worked his ass off in 12 hour shifts at his own clinic, but customers kept pouring in.
The real reason is "I can't be arsed to do it" or "the new version of the software is not backwards compati
Re: (Score:3)
From what I've seen, professionals are generally super-penny pinchers. Something to do with the fact that they've went through university and all that extra training and therefore are smarter that the gener
Re: (Score:3)
She have already too much problems with money and want that have problems with alcohol now?
But the best solution would be going that road if the apps runs under wine, or there are already open source programs (EyePACS [nih.gov]?) that do most if not all of what she needs.