Among businesses these questions are becoming more common and are actually legitimate and timely questions. The decision to go into the cloud has cost, productivity, and portability ramifications for any business regardless of size. Some will want to jump in before they really understand the best way to utilize the new technology, while others will be hesitant to make any changes at all. The question for every business should be, “How will I use this new technology to best advance our core business goals?”

Virtualization has now become the norm for a company’s servers. Now a company knows they can have one or two physical servers (V-hosts) running six to eight virtual servers or more and have more functionality with less cost. Virtualization saves money on the cost of hardware and software, saves on electricity and cuts down on cooling costs because less heat is being created. It also cuts down on maintenance because there are less moving parts to keep running.

The question of virtualization has now been answered. The next question for businesses is the use of the Cloud. It is not a matter of whether to use cloud technology or not but a matter of how much of our systems should be cloud-based and whether to use public or private clouds.

There are advantages and disadvantages to using a public or private cloud scenario. Public cloud offerings have the advantage of cost. It may cost a little less because they are able to use the same resources to offer a service to a lot of people. One disadvantage of using a public cloud was exemplified in the last couple months when Amazon Web Services and Microsoft’s Windows Azure cloud both went down at different times. Businesses that wholly depended on them were dead in the water; in the case of Azure they were down for over twelve hours! For more on outages, click HERE. Another disadvantage to the public cloud is security and control. A private cloud may cost a little more but the data is under the control of the company so the security and privacy is as tight as they want it to be. Also, there is more control over how the programs work, data is displayed, etc. Companies that have more stringent security requirements due to regulations such as HIPAA are better off using a private cloud because there are more DEMONSTRATIVE securities in place. Finally, some companies use applications that have unique requirements that cannot be met with off-the-shelf self-service public clouds. The decision then comes down to cost vs. control. That is why many companies use a mixture of public and private; sometimes the answer is a little of both and can be customized to get the costs down but still have control over the more important data.

The overall plan must be thought through with the understanding that one method will not solve all issues. Some processes work well on a public cloud and others work best on a virtualized server onsite. The Private Cloud infrastructure is one of the most versatile and beneficial of the cloud deployment models. It can be on premise or off or a combination of both. Certain data may be found on a shared private cloud while highly sensitive information may stay on site with encrypted off-site backups. Email and applications could be in a private or public cloud while AutoCAD files will most likely be kept onsite so they render and modify with little latency. The scenarios are endless and so are the solutions. All processes must be analyzed and the best solution for each must be explored. The final roadmap must be in place before implementation.  ThinkTankIT is, in many ways, the vCIO (Virtual Chief Information Officer) for many companies and can help put these roadmaps together for your company. We also host a secure private cloud that could fit many of your company’s needs. If you are in the Portland, OR  or Vancouver, WA area and would like a free consultation to see how your company can benefit from a solid Cloud solution, please call us at 360.213.0015 or email us at help@thinktankit.com.

Our language is changing and so is the face of organized crime. Twenty years ago malware was created by pocked-faced kids as pranks. We would click on a link and a caterpillar would eat our screen. That was the first wave. During the second wave individuals found ways to monetize malware and started to steal identities. This third wave now includes organized criminals who have seen the opportunities created by e-trade and e-commerce and have become so prolific the internet has gone from 5,000 malicious codes a day to 95,000 unique malicious codes introduced into the network every day. They are gunning for us and they are gunning hard.

We spend over $4 billion dollars each year fighting malicious software. As with any virus, we create the “cures” and the “virus strains” get stronger. These viruses are also in different classes and affect our systems in varied ways. Some viruses will create just minor annoyances, like popup ads in our browser, while others can steal confidential information, destroy data, or even bring our whole network down.

One such malicious code that uses both a Trojan and social engineering is a new variant of malware that circumvents mobile SMS security procedures and goes right after your wallet. The SpyEye financial Trojan steals banking codes by tricking users into changing the phone number connected with their accounts. Click Here for more information. Other codes, like the DroidDream Trojan went after the Droid phones specifically and was masked as an app to download. Once downloaded it could steal information on the phone. Now our phones are being targeted as well as our computers!

How do we protect ourselves from all the malware out there? The following are just a few tips to help avoid malware and protect yourself from those who want to do you harm:

• Windows updates – make sure you are updating your OS at least a couple times a month. This is the first line of defense and needs to be done on your phone as well as your computer.

• Anti-Virus Software – there are many out there so choose carefully. We highly recommend avast! because they are “Best in Class” when it comes to the most recent definitions, ease of use, and the tightest security. Contact us for aggressive pricing.

• Firewalls – A firewall is hardware or software that acts like a gate to protect your network from malware and hackers. Most routers have firewalls built in but need to be configured. Don’t assume this is automatically set up; ask your administrator (or your 14 yr old kid if this is at home).

• Suspicious offers – Don’t open any text, SMS, or offer that comes to your phone. Know the source or delete.

• Alternate Browser – Browsers such as Firefox or Safari are less susceptible to the evils on the internet as IE.

• Active X – If you are using Internet Explorer tighten the security settings.

To do this, Open IE and Click Tools > Internet Options > Security > Internet (Globe Icon) > Click Default Level and APPLY.
NEXT, Click the Custom Level Button and adjust the settings as follows (some settings will already be properly set):
* SET Download signed ActiveX controls to Prompt
* SET Download unsigned ActiveX controls to Disable
* SET Initialize and script ActiveX controls not marked as safe to Disable
* SET Installation of desktop items to Prompt
* SET Launching programs and files in an IFRAME to Prompt
* SET Navigate sub-frames across different domains to Prompt
After changing these settings as noted, please Click OK. If you are prompted to save the settings, click YES.
Finally, click APPLY and OK to finalize these settings.

There are many other advanced tips but this is a good start. Above all, be paranoid. If it seems suspicious, be suspicious.

Though a law has not been passed to require the use of an EMR, the word “mandate” has been used quite often. The Federal Government has made incentives-and penalties-for using an EMR/EHR system. They will also be requiring certain reporting by all physicians and will keep a central database. Although these reports can be filled out manually it would be more cumbersome. EMRs are a near future reality in an industry that has stayed the least technological than most any other industry. The great migration from paper to digital is happening now!

The real “mandate” will not really come from the government but from the market. NORC at the University of Chicago published a study recently which found an overwhelming percentage of consumers are very supportive of the adoption of EMRs.

• 78% believe EMR will improve patient care
• 59% believe EMR will reduce health care costs
• 72% support interoperability and information sharing
• 80% support e-prescribing

Not only are the patients favorable to digitizing their medical care but up-and-coming health care providers are expecting to walk in and use computers like they have their whole lives. If a clinic wants to attract younger doctors and have a higher re-sale value they will need to adopt an EMR system.

If everyone seems to be on board with digitizing our medical records why is there a black cloud over the subject? Cost. “Financing is an issue. It’s not just the hardware and software, but also the implementation process. There will be a productivity loss at first”, said Joe Wivoda, a technology consultant for the National Rural Health Resource Center in Duluth. Over half the hospitals who have implemented an EMR went down to less than 5% margins and 25% were running in the red as they got back up to speed, which took months or years. Many are still getting back up to previous numbers. This track record could kill a small clinic that doesn’t have the buffer large hospitals have. Experts say choosing the correct EMR the first time can be one of the biggest decisions a clinic has to make at this time.

Bottom line: you will choose, choose wisely.

NOTE: EMR (electronic medical records) & EHR (electronic health records) are interchangeable

Doctors Using Fully Implemented EHRs Report Lower Costs, Higher Productivity, MGMA Finds
By Joseph Conn, Modern Healthcare (April 6, 2011)

Ambulatory-care physicians who have implemented an electronic health-record system are largely satisfied with their purchases, and their satisfaction increases if they have their EHR systems optimized, according to data from a survey by the Medical Group Management Association.

The survey also indicates that financial benefits accruing to the practices tend to follow levels of optimization.

More than seven in 10 practices (72%) that had completed an EHR implementation were either “satisfied” or “very satisfied” with their systems, according to the survey. Those that claimed they had fully optimized their systems were even more pleased—86% were “satisfied” or “very satisfied.”

In addition, the financial rewards of EHR adoption were greater for those who had fully optimized their systems. According to the survey, 61% of respondents who reported their EHR had been fully optimized indicated their systems had 1) increased provider productivity and 2) boosted practice revenue, compared with 37% and 42% respectively, for those practices that had an EHR implemented but were still focusing on getting dialed in with their systems.

Veteran numbers cruncher Dave Gans, the MGMA’s vice president of innovation and research, oversaw the survey project and said that what jumped out of the data for him was that “organizations not only are acquiring electronic health records, they’re embracing electronic health records.” He added: “It’s changing the way they’re doing business. We’re re-engineering healthcare. That’s what’s coming through.”

“(For) the majority of the organizations, they reduce their cost, and increase their productivity,” Gans said. “The popular conception is that electronic health records slow you down, they cost you money, and we wouldn’t want them. And now we have a very large sample of people who say we’ve embraced it, it’s making a difference and we’re satisfied with what we’re doing.”

The MGMA study gleans information from a cross-section of physician group practices, including independent medical practices, 59%; hospital- or integrated delivery system-owned practices, 17%; academic faculty practices, 5%; federally qualified health centers or community health centers, 3%; and more than a half dozen other practice arrangements, representing workplaces of more than 120,000 physicians in total. Data was collected between Oct. 1, 2010, and Nov. 9, 2010. There was a “profusion” of 148 EHR systems in use by survey participants, with no one system capturing more than an 11% share of the systems reported.

More than half (52%) of those practices surveyed reported that they used an EHR system. In comparison, 36% used paper charts and 6% used a document scanning system. Of the practices still using paper records, 63% plan to adopt an EHR system and seek federal incentive payments under the American Recovery and Reinvestment Act of 2009. The survey was open to practices of all sizes, and nearly 10% were one- and two-physician practices; while 23% had three or fewer physicians.

EHR adoption rates in the MGMA survey comport with preliminary estimates from the 2010 survey by the National Center for health Statistics, which found that 51% were using at least a partial EHR system.

But among the practices in the MGMA study that claim to have an EHR system, nearly a quarter (24%) said the system is still being implemented. Only 16% indicated they have completed implementation and believe they have optimized their systems.

Even among provides with fully optimized systems, a lack of EHR interoperability functions could be a barrier to meeting federal meaningful-use criteria and qualifying for federal EHR incentive payments under the American Recovery and Reinvestment Act, according to the survey.

Only 44% of practices with optimized systems reported their EHRs could meet meaningful-use criteria for clinical decision support and exchanging clinical information with other providers. Only 38% of optimizers reported their systems could send clinical quality measures to CMS or to states.

Article Source: http://www.modernhealthcare.com/article/20110406/NEWS/304069984?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMZmJVUDBIRWxiNUtpQzMyWmV2NTNvWUpiU2w#

Not only does gloStream meet our criteria but they are also HIPAA compliant, 2011/2012 compliant, and are certified as a Complete EHR by the Certification Commission for Health Information Technology (CCHIT®), an ONC‐ATCB, in accordance with the applicable eligible provider certification criteria adopted by the Secretary of Health and Human Services. The 2011/2012 criteria support the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA). To help providers keep track of their meaningful use requirements, which are attached to the stimulus incentives, they have provided a stimulus dashboard within gloEMR so providers can quickly view their performance against all meaningful use requirements. They really have thought of everything a provider would want.

Here are a few of the highlights:

An EMR solution that is easy to implement: Practice Manager Amanda Wood put it best when she said, “We went live with gloEMR on a Monday and four days later we were already up to full patient load.” Stories like Amanda’s affirmed to us that we picked the right partner. Many EMR “solutions” we researched were not easy to implement, and the offices took months to get back to full patient load. A number of clinics never got back to full patient load. gloStream is so confident of their solution they actually guarantee an office will be back to full patient load within 15 business days. No one else offers anything even close to this bold guarantee.

Familiarity: gloStream is the only EMR built on the Microsoft Office platform. Because Microsoft Word and Outlook are embedded in the program, scheduling is very intuitive and forms, memos and charts are easy to create and complete. Those who already use Microsoft Office will feel very comfortable with this EMR solution so the training time will be condensed and more relaxed.

Improved efficiency and productivity: “We’ve been able to streamline processes within our office and that’s led to a level of productivity and efficiency we just didn’t have before we began working with gloStream.” – Dr. Dominick Roto. Many medical professionals would agree that chart chasing and leafing through reams of paper charts to find an answer to a simple question is not the most efficient use of time. Lack of efficiency can also lead to lower “SAT” scores (satisfaction scores) and that can affect stimulus reimbursements. If the EMR/EHR solution can make charting and scheduling more efficient, is not cumbersome to use, and provides patients with better quality of care, it’s a win-win situation for both the patient and the provider. We feel we’ve found that in gloStream’s gloEMR.

We at ThinkTank look forward to working with gloStream to help even more people in Oregon and Washington with their IT needs. ThinkTank has the experience to serve the client’s technology infrastructure needs and gloStream provides the software to serve the client’s EMR needs. Together we will be able to better serve the Portland/Vancouver medical community and, in turn, the community they serve as they provide better health care.

Click here for more information!

Click here for more information!

Our Prepaid Block SLA arrangement is such that our Clients prepay a predetermined amount each month, of which a small portion pays for monitoring and the remainder is available for services and preapproved
product purchases.

Some benefits of our Agreement structure are:

• Clients can see where their money is being spent, dollar for dollar
• There are no per-device charges
• Prepay limits the number of invoices received and how often payments need to be made
• Prepaid money can be applied to equipment purchases when there are unused dollars available and it’s     mutually agreed upon between Client and ThinkTankIT
• Prepaid money rolls over to the next month if not depleted

SLA Advantages:

• Peace of Mind – Expert network administration and IT strategy guidance for your network
• Proactive monitoring of the network to ensure that problems are caught and resolved before they result in     expensive down time
• Proactive maintenance to ensure that your technology investment is performing at the highest level     possible and is supporting the goals of your business rather than impeding productivity
• Reduced hourly service rates and extended service hours
• Guaranteed response times to business critical issues
• Fifteen minute onsite minimum charge for service calls
• Monthly billing cycle
• Online billing statement and work order viewing
• Online service requests
• Remote problem resolution via remote PC management account. Many problems can be resolved     immediately via the internet without requiring a technician on-site
• Site LAN / WAN configuration documentation, ISP Contact and configuration documentation, User account      passwords, Email passwords and configuration settings documentation, Application passwords and     configuration documentation. Thorough tracking and documentation of this information can save time and     money in addressing IT related issues.