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Windows Businesses Medicine Software The Almighty Buck Upgrades

Some Windows XP Users Can't Afford To Upgrade 953

Posted by samzenpus
from the high-cost-of-upgrading dept.
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?"
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Some Windows XP Users Can't Afford To Upgrade

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  • by HaeMaker (221642) on Monday April 22, 2013 @04:18PM (#43519141) Homepage

    That helps with hardware incompatibility but not security.

  • by Anonymous Coward on Monday April 22, 2013 @04:19PM (#43519149)

    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.

  • Certification (Score:5, Insightful)

    by OverlordQ (264228) on Monday April 22, 2013 @04:20PM (#43519159) Journal

    I bet a lot of that $10k fee is due to the software requiring FDA certification.

  • by Anonymous Coward on Monday April 22, 2013 @04:20PM (#43519161)

    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:Certification (Score:5, Insightful)

    by Nadaka (224565) on Monday April 22, 2013 @04:24PM (#43519215)

    Yea, its not like medical software errors ever killed anybody. Eh Therac-25?

  • Specialty Software (Score:3, Insightful)

    by jasnw (1913892) on Monday April 22, 2013 @04:26PM (#43519223)
    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.
  • Nothing new (Score:5, Insightful)

    by BetterSense (1398915) on Monday April 22, 2013 @04:31PM (#43519281)
    I work in a very large semiconductor fab that is full of dozens, probably hundreds, of DOS, Windows 2000, Windows 98, Windows ME, and Windows XP machines. They will never be upgraded or patched.

    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.
  • by DragonWriter (970822) on Monday April 22, 2013 @04:32PM (#43519293)

    You can run Windows XP as a VM which is isolated from the internet through a firewall. That will probably help.

    Unless your WinXP-reliant software is also needs access to the internet.

  • Re:Wrong platform (Score:5, Insightful)

    by PhreakinPenguin (454482) * on Monday April 22, 2013 @04:32PM (#43519299) Homepage Journal
    Sounds like someone has never had to use medical software. As much as the "zealots" would like to think, not everything is best run on OpenSource. It's not a troll, it's based on 15 years working with medical offices and doctors that don't have time to figure out how to get things to work. And yes, a lot of doctors offices don't have any support on staff or contract other than the EMR or EPM company they are dealing with.
  • by Anonymous Coward on Monday April 22, 2013 @04:33PM (#43519317)

    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.

  • by dhavleak (912889) on Monday April 22, 2013 @04:34PM (#43519321)

    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??

  • Bad example (Score:5, Insightful)

    by onyxruby (118189) <.onyxruby. .at. .comcast.net.> on Monday April 22, 2013 @04:36PM (#43519341)

    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.

  • by Hylandr (813770) on Monday April 22, 2013 @04:38PM (#43519377) Homepage

    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.

  • by steveg (55825) on Monday April 22, 2013 @04:40PM (#43519397)

    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.

  • by Anonymous Coward on Monday April 22, 2013 @04:40PM (#43519401)

    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.

  • by CanHasDIY (1672858) on Monday April 22, 2013 @04:42PM (#43519435) Homepage Journal

    You can run Windows XP as a VM which is isolated from the internet through a firewall. That will probably help.

    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.

  • A Dickhead's Idiom (Score:5, Insightful)

    by CanHasDIY (1672858) on Monday April 22, 2013 @04:44PM (#43519473) Homepage Journal

    You made your bed, now lie in it.

  • by Scared Rabbit (1526125) on Monday April 22, 2013 @04:49PM (#43519527)
    That may be the case in some fields, but in most cases I haven't seen materials available online that compare to the texts that I use as a student in advanced mathematics.
  • by RoknrolZombie (2504888) on Monday April 22, 2013 @04:49PM (#43519533) Homepage
    ...starting with doctors buying software that's appropriately priced for their task.

    I was involved in a full system upgrade for a medical facility. There were two huge problems that I had with the upgrade, and both of them had to do with the cost. After rolling out the software for a few million dollars, the company decided that the software that had been specialty-built was not going to work for them and a few more million dollars later they upgraded (again) to a better system. I've left since that second system was rolled out, but everyone that I've spoken to at the company has informed me that it's a polished turd (as much of that software is).
    These small software companys CAN recoup their costs, they're simply marking up the price because they're dealing with doctors. All they see are dollars and cents and who *wouldn't* want to make a few mil for a years' worth of work? They get to take the next year off to travel the world and rent hookers until the next OS release, then they get to change a few lines of code and roll it out again (with a significant markup, of course). It's a racket, but I think they're just taking a cue from the rest of corporate America.
  • by Chris Mattern (191822) on Monday April 22, 2013 @04:50PM (#43519557)

    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.

    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.

    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.

  • by DerekLyons (302214) <(fairwater) (at) (gmail.com)> on Monday April 22, 2013 @04:52PM (#43519577) Homepage

    I don't see such a problem here.

    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.

  • by Anonymous Coward on Monday April 22, 2013 @04:52PM (#43519585)

    That's an awesome way to run a business.

    If your business is sticking forks in your eyes.

  • by fredprado (2569351) on Monday April 22, 2013 @05:01PM (#43519699)
    If the financial risk for data disclosure is so great you shouldn't be running windows at all.
  • by Anonymous Coward on Monday April 22, 2013 @05:02PM (#43519707)

    No shit ... however with embedded systems, the vendor is responsible for such things, because the software is all hands-off .. you agree not to touch their shit and they agree to make sure it keeps working.

    If MS support (e.g., security updates because for whatever reason that monitoring hardware is attached to the internet) is required for "keep working", this falls on the vendor, because you have a support contract. (You do have a support contract for the highly expensive medical hardware that peoples' lives depend on, right?) If it doesn't depend on this ... well, MS's EOL doesn't mean XP magically stops working, why break what works?

  • Re:Bad example (Score:5, Insightful)

    by Anonymous Coward on Monday April 22, 2013 @05:02PM (#43519709)

    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.

  • by girlintraining (1395911) on Monday April 22, 2013 @05:03PM (#43519729)

    Prevent those few computers that are running the program from touching the Internet in anyway.

    That's one of the stupidest things I've read on slashdot in awhile, and I'm really disappointed you got modded up for it. The main thing the average person uses their computer for is the internet. Poor people, especially, need it for things like, I don't know, looking for a job, paying bills, etc. The past 8 years, during which time Windows 7 debuted and XP was introduced, and then phased out, has been one continuous economic depression for many. The computers out there that many people are using are 5+ years old; They couldn't upgrade even if they wanted to.

    So rather than suggesting that they just give up, log off, and throw away their computer, why not suggest something that might actually let them continue using the devices; Like switching to Linux. Maybe link to a distribution that will let them continue to use it to browse the internet, with the option to auto-upgrade for years to come.

    Or, you know, we could throw them under the bus for being poor.

  • by Sycraft-fu (314770) on Monday April 22, 2013 @05:06PM (#43519767)

    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:Certification (Score:5, Insightful)

    by nametaken (610866) on Monday April 22, 2013 @05:09PM (#43519795)

    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.

  • by Scared Rabbit (1526125) on Monday April 22, 2013 @05:17PM (#43519905)
    When I've looked I've come across a complete lack of material for most topics beyond say third semester calculus and second semester differential equations that one can read to actually learn a subject. While there are certainly some example problems out there, a cohesive narration of how to go about solving more advanced problems especially with a consistent notation seems to be lacking. Sure there's resources like Pauls Online Math Notes, but that drops off before then. Wikipedia has some formulas and descriptions, but often doesn't have example problems. For many topics, you can find small pieces of information all over the web, but if you want to actually read up on a specific subject I haven't seen anything on the internet that rivals a good old fashioned text book.

    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:Certification (Score:4, Insightful)

    by Holi (250190) on Monday April 22, 2013 @05:31PM (#43520051)

    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)

  • by varkk (1366053) on Monday April 22, 2013 @05:32PM (#43520073)
    A lot of medical software has legitimate reasons for network connectivity. For example lab tests/results, GP practice software can integrate with the local providers and a doctor can order blood tests done directly to the lab and have the results sent straight to the GP practice electronically. Also support is another big one, if you are paying $10k for some software and you are having an issue it is always good to have a technician able to remote in and solve it quickly. The answer for this sort of software is to not buy it outright but instead be paying for it yearly/quarterly. This moves it from being a capital expenditure to an operational one which can make things a bit easier when planning the budget. Also if your business depends on a critical piece of software you need it backed by someone to keep it working.
  • by LordLimecat (1103839) on Monday April 22, 2013 @05:39PM (#43520143)

    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.

  • by ArsonSmith (13997) on Monday April 22, 2013 @05:47PM (#43520219) Journal

    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.

  • by cmholm (69081) <cmholmNO@SPAMmauiholm.org> on Monday April 22, 2013 @06:21PM (#43520537) Homepage Journal

    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.

  • by Dcnjoe60 (682885) on Monday April 22, 2013 @06:24PM (#43520559)

    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.

  • by Chirs (87576) on Monday April 22, 2013 @06:52PM (#43520781)

    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

  • by ikhider (2837593) on Monday April 22, 2013 @08:54PM (#43521471)
    Windows had its time and place and it has now passed. Now the medical community ought to embrace GNU opensource and use this Windows experience as a lesson. Proprietary systems are not there for public benefit.
  • by countach74 (2484150) on Tuesday April 23, 2013 @12:32AM (#43522383)
    I just don't trust users. I suppose one could lock the box down so no surfing could occur. That would ultimately be my concern. It's late and I think more than likely I'm being retarded.

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