I have my own opinions about eCW, but I doubt a significant % of the list cares.
However, I would be interested to know what everyone uses for allowing vendors remote access and how that is logged/tracked in such a way that could be audited. I'm not making excuses, but the type of access for remote access by a vendor that you describe is not atypical. They use a VPN client that we supplied to them, but aside from that, we have no way of knowing which specific technician has logged into a system, and we aren't restricting access - yet. The problem with restricting access then creates the bottleneck/excuse from the vendor of, "we tried to contact you to fix your problem, but we couldn't reach you in order to gain access..." I've been down that road as well. Not a fun one to try and explain to the shareholders. Other vendors have similar access. Before that, they had dial-in access that had zero audit trail without court order. How would you propose tracking individual user access for your vendors? Jonathan L. Raper, MCSE Thumb-typed from my HTC Incredible (and yes, it really is) Droid. Please excuse brevity & any misspellings. ----- Reply message ----- From: "Ziots, Edward" <[email protected]> Date: Wed, Aug 18, 2010 6:03 pm Subject: Off topic - Career Job Advice To: "NT System Admin Issues" <[email protected]> Do you also have the Eclinical Works, wonderful support and upgrade model using Logmein as a method of access. ( Can’t properly audit access to clinical systems ( workstations) because you don’t control the Logmein logs, can’t tie it into a actual user, can gain access without prior authorization, see where I am going with this type of stuff, but the risk of not implementing the EMR is greater than all the little ways that it can be breached.) (Hate to see how folks are going to justify it meeting MASS CMR 201.17, or HITRUST framework, or HIPAA Regulation, or HITECH) Talk about a POS App, on top of a POS Support system, I almost shudder the security flaws in the storage of PII/EPHI within that system. ( Ohh yeah it runs apache tomcat, and MYSQL, and a Fax service that is a true treat ( another POS). Talk about a risk-management nightmare.. but I digress… Its pretty sick, that is the best some of these companies that are selling solutions to healthcare are providing. On one side they tout the EMR as a benefit pushing towards govt’s initiative of nation wide EMR adoption, and on another side, vendors are actually providing systems that can’t even meet the security requirements set forth in the regulations ( Abeit, weak as they are) and might be putting hospitals and physicians practices at even more risk from breach accordingly, because the basic security aspects of storing and protecting the confidentiality, integrity and availability of EPHI/PII was never thought of when designing these systems. Then couple that with what is going on with meaningful use, and you have a real appetite for destruction. Food for thought, Z Edward E. Ziots CISSP, Network +, Security + Network Engineer Lifespan Organization Email:[email protected] Cell:401-639-3505 From: Eldridge, Dave [mailto:[email protected]] Sent: Wednesday, August 18, 2010 5:06 PM To: NT System Admin Issues Subject: RE: Off topic - Career Job Advice Very well put. I have seen a number of Docs here that have calculated to the end when penalties will kick in and will retire rather than accepting an EHR. We’ve also seen a big trend in Docs becoming employees of the hospital rather than take on the task of implementing an EHR also. Our hospital based Physicians group is booming. Thus the eclinicalworks. I fourth/fifth the suckiness of eclinicalworks. I would have never picked it but I wasn’t asked. Their support is next to last if not the bottom. From: Raper, Jonathan - Eagle [mailto:[email protected]] Sent: Wednesday, August 18, 2010 2:31 PM To: NT System Admin Issues Subject: RE: Off topic - Career Job Advice I hear ya, but believe it or not, that’s only a fraction of the cost of healthcare. Malpractice insurance is absolutely ridiculous. But I digress. Regardless, healthcare CAN be a good place to be if you’re in IT (at least for now until the government gets a hold of it and then all bets are off). The number of (particularly leading edge) technologies I’ve been able to touch and implement over the years has been amazing. Non line-of-sight RF, Free Space Optics, MetroE, plus everything else I mentioned earlier. Part of the reasoning for me saying this (Healthcare IT being a good place to be) is that doctors have been practicing medicine on paper since the dawn of time. It takes 8+ years to learn how to become a doctor, because the decision trees used for treating patients are very complex. In a matter of moments/seconds, a physician makes possibly a hundred micro decisions in the course of treatment. It truly has become second nature to them and is practically a subconscious thought process to get to a desired outcome/treatment plan. Put a computer in front of them, and now they have to consciously think through each of those little decisions in the charting process, which slows them down considerably. So, up to now/recently, the idea of moving a doc from the paper world has been an insurmountable task, because it is almost like telling a doc that they, after 20 years of practicing medicine on paper, have to go back to school – so that they can learn how to practice medicine using a computer. Computers bring to the forefront how truly complex the decision processes are that a physician goes through for each and every patient. In putting a computer in front of a physician, they literally have to cut their office schedule in half until they can get up to speed on the new system. Some docs take only weeks to get back to 100%, but for many, it can take MONTHS. Jonathan L. Raper, A+, MCSA, MCSE Technology Coordinator Eagle Physicians & Associates, PA [email protected]<BLOCKED::mailto:%[email protected]> www.eaglemds.com<BLOCKED::http://www.eaglemds.com/> ________________________________ From: Roger Wright [mailto:[email protected]] Sent: Wednesday, August 18, 2010 2:00 PM To: NT System Admin Issues Subject: Re: Off topic - Career Job Advice Wow, no wonder our healthcare costs are zooming upward! Roger Wright ___ When it's GOOD there ain't nothin' like it, and when it's BAD there ain't nothin' like it! On Wed, Aug 18, 2010 at 12:10 PM, Raper, Jonathan - Eagle <[email protected]<mailto:[email protected]>> wrote: +1000 In the past 15 months, we’ve implemented Citrix XenApp, EMC Avamar, Cisco 802.11n with 802.1x over roughly 70 Cisco 1142 lightweight APs, a complete network forklift encompassing 3750 & 3560 switches and a number of Cisco 5510 & 5520 ASA firewalls, rolled out an additional 160 Lenovo Tablet PCs, and converted more than 250 phone lines & 1,900 phone numbers for 13 facilities from Windstream to PaeTec. Oh yeah, and we successfully rolled out eClinicalWorks EMR for 70 providers/400 employees at 12 medical offices. Crazy/busy doesn’t even begin to describe life here over the past year. Things are finally settling down, though. Jonathan L. Raper, A+, MCSA, MCSE Technology Coordinator Eagle Physicians & Associates, PA [email protected] www.eaglemds.com ________________________________ From: Eldridge, Dave [mailto:[email protected]<mailto:[email protected]>] Sent: Wednesday, August 18, 2010 11:38 AM To: NT System Admin Issues Subject: Re: Off topic - Career Job Advice ++1 Things here are crazy and exciting at the same time. I have never been busier in my life. -------------------------- Sent using BlackBerry ________________________________ From: [email protected]<mailto:[email protected]> <[email protected]<mailto:[email protected]>> To: NT System Admin Issues <[email protected]<mailto:[email protected]>> Sent: Wed Aug 18 09:28:50 2010 Subject: RE: Off topic - Career Job Advice That's really true in the healthcare field. With the Hitech Act and meaninful use criteria, a lot of hospitals and private practices are looking to either upgrade or install an EMR. Standard for consultants is away from home Mon - Thu and home for the weekend. For anybody who has clinical experience and knows computers (and how the two mesh together), it's a great time to be looking for a new position. ________________________________ Date: Wed, 18 Aug 2010 08:51:12 -0400 Subject: Re: Off topic - Career Job Advice From: [email protected]<mailto:[email protected]> To: [email protected]<mailto:[email protected]> I know globe trotters in the unmarried AND married categories. Globe trotters don't necessarily have to be gone out to sea for months at a time. It is possible to be gone only for a week at a time, or to travel extensively during the week and be back on weekends. There are a lot of options, but it depends on the personalities and dispositions of all involved (candidate and family) and the skill and clout of the candidate. Number and age of children, length of the relationship, and other statistics of life might be factors as well. Every situation is tailor made. ASB (My XeeSM Profile)<http://XeeSM.com/AndrewBaker> Exploiting Technology for Business Advantage... Signature powered by WiseStamp<http://www.wisestamp.com/email-install> On Wed, Aug 18, 2010 at 8:40 AM, Ziots, Edward <[email protected]<mailto:[email protected]>> wrote: I have been dis-abused…. I agree there is a lot of water between Sydney and Boston…. That and a long plane ride ( I think its like 17 hrs). I know a few globe trotters myself, they enjoy the life, and they are single, for the simple fact, they are never in one place to start a relationship accordingly, and those that are married, if you aren’t home for months at a time, its going to make the wifey very unhappy and you in divorce court faster than you can blink in the long run. Thus the reference to globe-trotting and single, it’s the more common scenario. But again to each its own… Z Edward E. Ziots CISSP, Network +, Security + Network Engineer Lifespan Organization Email:[email protected]<mailto:Email:[email protected]> Cell:401-639-3505 From: Ken Schaefer [mailto:[email protected]<mailto:[email protected]>] Sent: Tuesday, August 17, 2010 9:55 PM To: NT System Admin Issues Subject: RE: Off topic - Career Job Advice There’s nothing about having to be single to be a “globe trotter” – let me disabuse you of that notion – I meet all of the criteria you list below. If you choose not to, then that’s obviously a legitimate choice. But nothing is that far away on a plane these days (except maybe travelling from Sydney to Boston) Cheers Ken From: Ziots, Edward [mailto:[email protected]<mailto:[email protected]>] Sent: Wednesday, 18 August 2010 1:52 AM To: NT System Admin Issues Subject: RE: Off topic - Career Job Advice Good views, defintely been lurking and following this thread. Some of us, are stuck for certain reasons in the place we live, or within the area that we have put down roots (for those that are married, having extended family, or own a home, or any combination of the three and other circumstances) and don’t have the flexibility, to be single, and globetrot the world in search of the latest big project to work on in a global environment, for those so career inclined and focus, then definitely follow your dreams and go for it, nothing is stopping you, and the experience will be something you can be proud of. As for the situation in Denmark, it’s a much different story in the states as most know, so comparing Denmark to US or even UK is like comparing apples to oranges and might not be a fair comparison. There are pro’s and con’s in any job or position, but I truly believe this above all else. If you work on a good team, and each member of the team has your back and you have their’s when the stuff gets deep, that counts for a lot. If you are constantly challenged in your job, and you feel you are at least moving ahead a little bit career wise, then that is also a good thing. My view is your don’t always take a job for the money, its about career advancement and the impact that your skills and experience bring to the new job. There is always going to be new challenges, new people to meet, and build a team environment with, and the organization/business/industry you are looking into should weight equally. Work/Life Balance, and benefits I believe these days are trumping the insane amounts of money that was throw at prospective employees (Salary, raises, bonus) back in the .COM era and before the stock market bust. There is a new global reality coming about, and a lot of the job loss that has happened might not be made up in the next 10-15 yrs or if at all, no matter what the gov’t tells us, and no matter which govt it is spitting the rhetoric. Just my two cents, agree or disagree its well within your rights, because everyones situation is different and needs are different, but in the end all the money in the world isn’t going to make you happy, and you certainly can’t take it with you to the flipside :) Z Edward E. Ziots CISSP, Network +, Security + Network Engineer Lifespan Organization Email:[email protected]<mailto:Email:[email protected]> Cell:401-639-3505 From: Ken Schaefer [mailto:[email protected]<mailto:[email protected]>] Sent: Tuesday, August 17, 2010 1:22 PM To: NT System Admin Issues Subject: RE: Off topic - Career Job Advice Denmark has the benefit of an extremely flexible labour market – it’s small economy where benefits are good, but workers acknowledge the need for flexibility. There is very little long-term unemployment in Denmark. They will bounce back fairly quickly. >From my personal perspective – in the last few months I went from a Tier 1 >consulting firm to an architecture position on an enterprise project (in >another country). This project is crying out for good people. Worldwide, there >are plenty of opportunities, as various companies and governments still have >money to spend. If you want to spend your life living in <Florida|etc> then that will limit the opportunities available. It may be better to seek something further afield if the job opportunity is worthwhile (and the pay can compensate you for the cost in moving) Cheers Ken From: Andrew S. Baker [mailto:[email protected]<mailto:[email protected]>] Sent: Wednesday, 18 August 2010 12:35 AM To: NT System Admin Issues Subject: Re: Off topic - Career Job Advice Even the most protected economies are hurting right now... http://www.nytimes.com/2010/08/17/business/global/17denmark.html?_r=1&partner=rss&emc=rss As Ken said, make sure you're doing what you like (to the degree that you have control over it). Also, take every opportunity to become as good as you can be. It doesn't completely insulate you -- because the planet rarely operates as a meritocracy -- but it does give you more options. ASB (My XeeSM Profile)<http://XeeSM.com/AndrewBaker> Exploiting Technology for Business Advantage... Signature powered by WiseStamp<http://www.wisestamp.com/email-install> On Mon, Aug 16, 2010 at 6:26 PM, Jon Harris <[email protected]<mailto:[email protected]>> wrote: Florida has been hit hard by this economy and from where I was, I saw a lot of the last in first out layoffs. That did not mean the best was kept and in fact most of the good ones seemed to be targeted. The longer a lot of Florida state workers (not at the county or city levels but at the state level only) that I saw the less they did and the more they pushed off to the less experienced workers. The people at the top liked to build pyramids under them. This did several things. Gave them more apparent power, protected them from their own lack of knowledge/skill/brains, and allowed them to point to someone else as the cause of the problem. Jon On Mon, Aug 16, 2010 at 6:08 PM, Joseph Heaton <[email protected]<mailto:[email protected]>> wrote: I wish my salary was equal to the private sector. Everything I've read/heard/etc. shows me around 25% below an "equal" position in private sector. Same goes for pretty much any IT job in the public sector. Here's the rub with private sector vs. public sector employment. And this will be my last comment, so as not to take this thread too much more OT. The main reason, in the past, that people went into public sector jobs was for the security, and the retirement. You got paid less, but in the end, you would retire with a percentage of your final salary for the rest of your life. This is a great perk, in my opinion. You also have to understand the environments that public employees are working in. For instance, DMV employees, while you hear all kinds of stories of how they can be rude, deal with the public directly, all day, and have to listen to people complain about issues that the worker has nothing to do with, etc. Bottom line, there are a lot of public positions that are not "nice" jobs. But people do them, for "lower" salaries, working towards that retirement. If the state(s) go to a 401K type retirement, vs. the pension plans in place now, that then eliminates the greatest reason for taking the lower paid public sector job. Imagine the type of person that you'll get then... you think the quality of service is bad now... how many people can you think of that will sit there and take the abuse that some public employees suffer, at lower salaries, and lower benefits? Something to think about, instead of just blindly blaming the situation on state workers. That being said, I don't completely disagree with the comments being made here. The greatest Bane and Boon to state workers, in my opinion, are the unions. Bane, because (at least in my state), it is virtually impossible to actually fire someone. I don't object to downsizing/layoffs, etc. I object to how they are implemented. I'll use my state as my example, again. In California, you have around 80% of the state workforce within 5 years of retirement age. The figures I've most commonly heard thrown around is a desire to reduce the workforce by about 20%. The method brought up in 2008 by our Governor? Layoffs... The way layoffs work in state work is that a figure is attained, as to how many people are to get laid off. These layoffs come from the least senior people, i.e., the last hired (Last in, first out). Which means, if you layoff the lowest 20% of your workforce, and the upper 80% is within 5 years of retirement, who's going to be doing the work? Who's going to process all the unemployment claims? Who's going to process your vehicle registration, your medical claims, etc.? I don't object to layoffs in general, but I think that agencies/departments should be able to do layoffs based on performance, not how long their butt has been in the chair. Anyway, I apologize if I've offended anyone, that is never my intention, but, being a state worker, with less than 3 years in service, I think about this stuff a lot... and worry about it a lot too. >>> Jacob <[email protected]<mailto:[email protected]>> 8/16/2010 >>> 2:42 PM >>> Agree.. you are going to start seeing more 401K type retirements and workers will start paying more into insurance. In about 5 years or less, salaries and benefits of government jobs will equal private jobs. -----Original Message----- From: Kurt Buff [mailto:[email protected]<mailto:[email protected]>] Sent: Monday, August 16, 2010 1:57 PM To: NT System Admin Issues Subject: Re: Off topic - Career Job Advice Take the private sector job. Government employment levels are unsustainable at their current levels, in every State of which I'm aware, and cuts are coming, IMHO. Kurt On Mon, Aug 16, 2010 at 03:34, Andy <[email protected]<mailto:[email protected]>> wrote: > Hello > I'm currently a Infrastructure and Support manager for a mid size (1000 > employees) retail company. My job basically means I manage a team off 8 > people and look after the service desk and support team, manage our external > contracts and run any infrastructure projects we have eg WAN upgrades/Server > consolidations etc... Anyway I've been looking to leave and have been offered > 2 jobs. One is in the public sector as a Infrastructure Delivery Manager. The > job involves managing a team of 20, with 3 direct reports, creating KPIs, > improving uptime etc.. While the other one is a Infrastructure Project > Manager for a private firm. The job involves running all infrastructure > projects, no direct reports. > > Both jobs are good ones, the project manager job pay a few thousand more and > has bonuses but has no pension/other benefits. While the public sector one > includes final salary pension, more holidays. > > I'm really having a difficult time choosing which one to take and I was > hoping you guys could share your thoughts on it. > > Thanks This e-mail contains the thoughts and opinions of the sender and does not represent official Parkview Medical Center policy. This communication is intended only for the recipient(s) named above, may be confidential and/or legally privileged: and, must be treated as such in accordance with state and federal laws. If you are not the intended recipient, you are hereby notified that any use of this communication, or any of its contents, is prohibited. If you have received this communication in error, please return to sender and delete the message from your computer system. ________________________________ Any medical information contained in this electronic message is CONFIDENTIAL and privileged. 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