NETWORK WORLD NEWSLETTER: GIBBS & BRADNER
08/31/04

Dear [EMAIL PROTECTED],

In this issue:

* Backspin columnist Mark Gibbs says the medical device upgrade 
��mess comes down to politics and economics, not computer 
��technology and IS people
* Links related to Gibbs & Bradner
* Featured reader resource
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Today's focus:  Market factors meet medical gear, upgrades

By Mark Gibbs

After last week's Backspin rant ( 
<http://www.nwfusion.com/columnists/2004/082304backspin.html> ) 
about the upgrading (or lack thereof) of medical devices, 
feedback was prompt. Reader Don Dickerson was one of the first 
to write in: "Concerning any unpatched operating system in 
medical devices . . . the solution is so obvious. Why are they 
using a commodity operating system in the first place? I am 
quite certain that those made with proprietary operating systems 
in ROM don't have this problem, and since when does a device 
such as a drug-dispensing pump, defibrillator, EKG, etc., need 
an operating system like Windows!?"

Dickerson went on to point out that while the GUI might be nice, 
it is "overkill [and even] Linux and other operating systems are 
rather inappropriate for this sort of application." He added 
that "MRI and CAT scan machines almost universally use their own 
[operating systems]. [The manufacturers] say they don't trust 
anyone's code but their own."

Dickerson concluded with the observation that "an operating 
system in ROM cannot be changed or attacked. And patches are 
only needed if the manufacturer's programmers make a mistake or 
want to add a feature."

Reader Rick Hampton was annoyed with me: "You have perpetuated 
all the stereotypes clinicians have of IS people. Namely, that 
IS types live in their own world and are not capable of 
understanding other people, the real world or how to solve a 
real problem."

Perhaps my point wasn't clear. To all clinicians who read 
Backspin let me make this unambiguous: The medical device 
upgrade mess is not any single entity's fault and certainly not 
the fault of IS folks.

What created this mess was the economics of the free market 
colliding with computer technology and the medical world. As I 
have discussed, the free market as it applies to computer 
technology votes as it does for a certain combination of values 
(such as cost of acquisition, implementation and return on 
investment), and the result is often at odds with political 
value (public policy and safety, the need to suck up to 
constituents and lobbies, and so on).

Hampton noted that "it's not exactly like the vendor is in the 
dark about their system's environment. It is not uncommon for a 
manufacturer to refuse to sell you the equipment or install it 
unless you specifically agree to all of their terms and 
conditions. So if the manufacturers install the stuff, is it not 
reasonable to expect them to design it to function properly and 
be readily upgradeable when needed?"

Interesting thought - I wonder how often the device vendors say, 
"Thou shalt not connect this device to a network or any other 
source of potential risk of malware or hackers." If the vendor 
doesn't say that, the onus of protecting the devices falls on 
owners. And if the vendor can't upgrade without the Food and 
Drug Administration's approval and the device is in a hostile 
environment and the owner can't protect it, then it is pretty 
easy to see where the responsibility lies.

It all comes down to politics and economics. That is the way it 
is. . . . If you can't replace the equipment and can't get the 
manufacturer to upgrade it, then that is the status quo, and 
short of getting some laws enacted or modified (both probably 
not good ideas) it will remain the status quo.

You could argue that the FDA is at fault. It is the authority 
that licenses medical equipment and has tied manufacturers' 
hands by making it a long, slow process for them to have 
upgrades approved. But the FDA is chartered with protecting 
public health, and that requires making sure manufacturers 
produce equipment that is safe (trusting manufacturers and 
commercial operating system vendors to get it right where lots 
of money is involved and liability is an issue seems unwise when 
lives are at stake).

The reality is it is all about politics and economics, not 
computer technology and IS people. I just want everybody 
involved to stop whining.

Dare I ask for responses to <mailto:[EMAIL PROTECTED]>?
_______________________________________________________________
To contact: Mark Gibbs

Mark Gibbs is a consultant, author, journalist, and columnist 
and he writes the weekly Backspin and Gearhead columns in 
Network World. We'll spare you the rest of the bio but if you 
want to know more, go to <http://www.gibbs.com/mgbio>. Contact 
him at <mailto:[EMAIL PROTECTED]> 
_______________________________________________________________
This newsletter is sponsored by Statscout 
Blanket Network Performance Monitoring  

Monitor your entire network every 60 seconds with minimal impact 
on the network.  Businesses and organizations seeking detailed 
performance and troubleshooting reporting on networks of 1000 to 
200,000 network interfaces in size will benefit substantially 
from using Statscout.  Request your 30-day trial now, click here 
http://www.fattail.com/redir/redirect.asp?CID=78749 
_______________________________________________________________
ARCHIVE LINKS

Gibbs archive:
http://www.nwfusion.com/columnists/gibbs.html

Bradner archive:
http://www.nwfusion.com/columnists/bradner.html
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