Hardware Issues

MSP Vendor Hardware Recommendations

Assuming your EHR vendor is not one of the remaining few that delivers software and hardware as a turnkey, integrated solution, you will be faced with selecting a vendor to provide the hardware that is recommended by your EHR vendor. You EHR vendor will give you a "recommended hardware list", which may or may not include recommended vendors and specific hardware models. Other vendors will provide a more "generic" list of hardware, leaving the selection of hardware vendor to the group practice. Here are some factors we recommend you consider in procuring hardware.

•   Purchase from a vendor that offers on-site, service support in your area of the country. This may be a national vendor with 3rd party contract service or a local vendor that has service in your immediate area, through their store or personnel. Buy the service contract for at least 3 years; they are worth the price.

•   Purchase from a vendor with a U.S. - based HELP desk. Talking to foreign help desk personnel is a frustrating experience in most cases. Something more than a command of English (which is not always present) is required but missing in many of the off-shore support desks. It's a cultural thing having to do with a sense of service and a sense that your are the customer and they are there to help you. Many of the off-shore folks we have dealt with at large companies like Dell and others, just don't have a sense of urgency about solving your problem. What they often have a sense of urgency about is following their procedures, getting your money and telling you why they can't solve your problem. There are notable exceptions, but they are exceptions. It's not the people themselves, but the challenge of the cultural differences and the policies that U.S. companies insist on.

•  Avoid computers that have Windows XP HOME edition or Windows Media edition for their operating system. For workstations, select only hardware that has Windows XP Professional edition, a version able to join network DOMAINS and has more robust networking. Home and Media editions cannot participate in domains, but must be configured as WORKGROUPS, which cripples the security and other capabilities you will need to protect sensitive patient data.

•  Select vendor models that are hardware frozen, not subject to being changed from one order to the next. Many consumers don't realize that if they purchase two computers of the same model, such as Dell's Inspiron series computers, they may have different hardware inside - particularly if the purchases are separated in time. Vendors often change internal hardware as they get "good deals" from their suppliers, or as a cheaper or hotter new hardware component is introduced. Group practices may want to keep all the hardware consistent across the office, which makes deployment of OS and patches much simpler and can save enormous installation time in thick client-server configurations. Dell also makes the Latitude series of computers. If you look at their products closely, you will note that the Inspiron and Latitude series offer the same performance, but the Latitude series is a bit more expensive. This is because the Latitude series does not change, but uses the same hardware configurations whenever you purchase a specific model, at least according to Dell. Not all vendors have two different hardware series - one of which is frozen. We recommend that physicians restrict their suppliers to those that can offer stable/fixed hardware configurations over a period of time. Discuss this with potential hardware suppliers before making a commitment to them.

•  Select hardware from vendors that recognize the unique needs of the healthcare environment and offer systems customized to satisfy those needs. Start with a simple question, "What models have you got that will help me be HIPAA compliant?" If there is a deafening silence at the other end of the line or a blank stare in the eyes of the computer salesperson standing next to you, you have the wrong supplier. Companies like Motion Computing, Fujitsu, Dell, Panasonic (some models), Electrovaya, Hewlett Packard and a few others, have healthcare divisions which are separate from their consumer divisions. Make sure that you ferret them out and are talking about computers suitable for healthcare. (See healthcare feature sets below)

• Get models with security and biometric healthcare features designed in. For example. The Motion Computing and some models of Fujitsu have biometric finger scanners built into their tablet and laptop computers. These are ideal for helping to assure HIPAA compliance and restrict access of the machine to people who may try to access it casually. The Motion computer tablets can be used in either portrait or landscape mode, but in BOTH modes have TWO noise-canceling microphones that optimize dictation without requiring a headset and microphone. Few of the consumer tablets offer a total of 3 noise canceling microphones, two or which are used in the landscape orientation and two of which are used in the Portrait configuration. The Motion Computing tablets offer bright and high contrast displays, suitable for use in well lighted or outside environments. They offer more advanced types of encryption than many conventional consumer products. There are differences in the features of the healthcare versions of tablets, laptops and desktop systems that group practices should be careful to select.

•  Consider optional, 3rd party add-on security devices, whether or not they are recommended by your EHR vendor. For example, proximity badges are not available that trigger the computer to blank or unblank their screens. These are far more secure than conventional screen savers. In order for the computer to be unblanked, an individual wearing such a badge must be right in front of it. If that person goes away for a time (to the bathroom or lunch or wherever) the screen will immediately go blank. The computer will remain blanked until the person returns and the computer senses the badge. It will then open the application to where it left off. Should a different authorized person with a badge sit down at that terminal, the system will close the application that was running, and unblank the screen to a login screen for the new healthcare provider. This keeps the patient (or other sensitive information) that the first user was working on, confidential. It helps (but is not sufficient of itself) with demonstrating a commitment to HIPAA compliance in your practice. The combination of these two optional technologies (biometric finger or eye ID for login and proximity-badge screen blanking) goes a long way to keeping sensitive data private. Panasonic makes an Eyes-on Scanner for security that is worth looking at. Of course nothing prevents people from compromising sensitive information by their carelessness.

SPECIFIC HARDWARE RECOMMENDATIONS

While we have covered some general guidelines, for those who Register, we have put together a more in-depth discussion and set of recommendations, covering such items as hardware types, systems configurations, backup strategies and other topics. We also provide access to formal, web-based, self-paced training programs for our registered users. Register now.