2017 Winter Conference – Technology: Balancing Profit, Lifestyle & Patient Care

By Dr. Doug Depew

The 2017 AAO Winter Conference is quickly approaching. Our theme of this year’s meeting Technology: Balancing Profit, Lifestyle and Patient Care.  It promises to be a meeting filled with information for both newer and established practices to help make those tough decisions on what technology is important to use in our practices and when we may wish to invest in it.

The meeting will begin with keynote speaker Jack Shaw.   Mr. Shaw is a world- renowned technology futurist who will be discussing how cutting edge and disrupting technologies will change the way we do business and run our practices in the coming years.

IT guru Steve McEvoy will be answering some of those pesky questions we all have about computer hardware, effective and cost-efficient data backup, and security.   In the ever changing world of computers, what you hear at this meeting will certainly be different than what Mr. McEvoy would have talked about even a couple of years ago.

On Friday afternoon we’ll have a lively discussion by Drs. Greg Jorgensen and Neil Kravitz regarding building our practices through social media, websites, and Internet marketing. Their success in these areas has been paramount in growing their thriving practices.

Saturday morning will begin with Dr. Aaron Molen sharing his experience and thoughts on bringing emerging technology into our practices to help create more efficient and more comfortable patient care.

We’re excited to have Drs. Ed Lin and Christian Groth discussing how to integrate some of the latest technology hardware into our orthodontic practices. This includes workflows for using CBCT, Scanners and 3D Printing.

The conference will conclude with Chris Bentson and Charles Loretto with a discussion on how technology can affect the value and profitability in our practices. This should help answer the question about at what stage of practice a doctor might consider investing in advanced technology.

The location for the meeting is at the gorgeous Marriott Harbor Beach Resort and Spa in Ft. Lauderdale, Florida. The dates are February 10-11, 2017. The schedule is organized in a way to allow some time for afternoon recreation.

There will be plenty of time allotted for attendees to ask questions of the speakers to be sure all bases are covered.   To learn more and to register, visit https://www.aaoinfo.org/meetings/2017-winter-conference-technology-balancing-profit-lifestyle-patient-care

Windows 10 – Should I Wait?

By Steve McEvoy, Technology Consultant

steveMMicrosoft has recently released the latest version of its operating system (OS) for PCs – Windows 10 (let’s call it WinX).

This is the first time Microsoft is offering the upgrade for free to existing users of Windows 7 and 8 (until July 2016 – and maybe longer).   They are intending to make upgrades to their OS less of a big deal in the future, giving it away and moving to a more automatic update format.   Apple and Android have been following this model for years.   It’s a good idea for the most part – keeping your OS up to date means it has the latest security & features.

WinX Notifier

Screen Shot 2016-03-21 at 4.47.51 PMMany of you may have seen a little notifier popping up on your PCs prompting you to reserve or upgrade to your free copy of WinX now.   With great joy and vigor many of you have done just so.   But is this a good idea? Staff clicking on it can trigger a disaster if this isn’t thought through.

Upgrading any Microsoft OS in the past has typically been an ordeal. You have to consider several things before you undertake an upgrade:

  • Will the new OS have drivers that support my hardware (video card, sound card, etc.)?   Often they don’t for older hardware (even systems a year old may not have drivers). Checking with your hardware vendor in advance is a good idea (for example going to the support website for Dell or HP and look to see if WinX drivers are available for your PC).
  • Will it work with all my peripherals?   Often you need specific OS drivers from Vendors to make these work.   Check with your vendors in advance to be sure they are available for things like:
    • Printers
    • Document Scanners
    • Signature Pads
    • Credit card scanners
    • X-Ray systems (this is usually a HUGE problem – they lag far behind)
  • Will the applications I own work on WinX?   You need to check with each vendor in advance if they full support WinX. Many don’t immediately after the initial release (and still aren’t as of this writing).
    • Practice Management software (like Dolphin, Orthotrac, Dentrix, etc.)
    • X-ray system software (like Romexis, Cliniview, Anatomage, etc.)
    • Antivirus software (most need upgraded to support WinX)
    • Backup software
    • Even Microsoft Office (older versions are not fully supported)
  • Will I have to retrain my staff? The changes in the user interface often give less adaptable staff fits.

Initial reviews of WinX are mixed. They’ve added some new features (Cortana assistant and the new Edge web browser) – most of which don’t matter to a Dental Specialty Practice.   They’ve changed the look and feel of the Desktop and Start Menu system yet again (the Metro interface is gone thankfully).   As with any new version of their OS, lots of little problems are being discovered as it rolls out to millions of users.

What would I do?

Screen Shot 2016-03-21 at 4.48.02 PMMy stance is typically to wait out the initial release and let others debug the 1.0 version. At the time of this writing Microsoft has released build 1511 (which is essentially Service Pack 1), and this generally marks the ‘safe to go in the water’ if you’re interested.

For your Home I’d say the risks of upgrading are pretty low if you have fairly recent hardware and you might want to give WinX a try. I’d still take time to confirm if your peripherals (like your printers) are compatible.

For the Practice I would recommend waiting until there was a compelling reason to change. I believe it’s easiest on the staff if ALL the PC’s in the Practice are on the same version so they have a consistent experience and don’t have to keep adapting.   If you were getting all new PCs, I’d seriously consider making the change. If you have a fleet of Windows 7 PCs that are working fine, I wouldn’t bother.

If you have your heart set on jumping in, involve your IT person. They can do the checking for you and advise you on a pathway and any bumps in the road that might be expected.

CryptoWall Virus Affecting Practices

By Steve McEvoy, Technology Consultant

steveMWe are seeing a fast spreading outbreak of a new virus called CryptoWall affecting many practices.   Similar to the Cryptolocker virus that emerged last year, this virus seeks to encrypt all your precious data on your computer, and hold it for ransom (asking you to send them $500 USD in Bitcoin to get the decryption key).

What makes this virus so alarming is that as of a few days ago ZERO out of nearly 50 antivirus programs were able to detect it. None.

How to protect yourself

Eventually the Antivirus programs will catch up and learn how to detect it, but at this point in time you need to rely on your own wits and acting responsibly.

So far the virus has been arriving as an attachment to an email message (usually a ZIP or PDF file). We’ve seen it claiming to be airline ticket confirmations, monthly statements from the power company, shipping receipts, etc. Avoid ANY email with attachments that you are not 100% expecting. If you receive an email that you are unsure of – DON’T OPEN IT – and contact the sender by other means and confirm that they did send it to you.   Reading the email doesn’t infect your PC, only opening the attachment will.

Signs that you are infected

2The virus needs time to tackle the encryption.   The longer it goes undetected, the more of your data it can encrypt.   You will notice the PC running much slower than normal (since it is using the computers processing power to encrypt your files). You may see files named DECRYPT_INSTRUCTION.TXT and DECRYPT_INSTRUCTION.HTML on the desktop, documents, pictures, mapped drives or any location where you have data saved.

1

What to do if you suspect an infection

Open the DECRYPT_INSTRUCTION.HTML file and note the time remaining to decrypt your data (they only allow you a short period of time to send them the money before they destroy the data permanently). Once you have that information TURN OFF THE PC. The longer it remains online the more data it can encrypt. Do not attempt to run scans and clean the system, this only buys it more time to encrypt data. Do not connect any external drives to restore backups of data as it will attempt to encrypt your backups when it sees the drives. Contact your IT person IMMEDIATELY for their assistance in recovery.

Encrypting your Laptop

By Steve McEvoy, Technology Consultant

steveMDepending on your interpretation of the HIPAA regulations your Practice’s HIPAA policy (you have one right?) might mandate that Protected Health Information (PHI) on portable electronic devices within your Practice should be encrypted.

Let me interpret that last sentence into English – If there is any chance that you have any information related to your patients on your laptop, it’s probably a good idea to encrypt the laptop to keep the attorneys and HIPAA Nazi’s away in the event that it is stolen or lost.   You probably have your own personal data on the laptop too, so this is good for several reasons.

I would expect that if I could canvas all of you reading this article that 90+% have PHI on your laptop in some form (as minor as an email message) and less than 1% of you will have your laptop data encrypted. I expect that most laptops that get stolen or lost now don’t get reported and the Doctors are just silently hoping it doesn’t get discovered.

You want to encrypt your laptop, but how do you accomplish this?   I’d like to be able to tell you the how to is simple “Just do this…” but I can’t.   Depending on your equipment you have to consider your options. If you invest the time to read through the article below the conclusions at the bottom will get you started on getting this done.

The Background that Matters

Encryption is basically a process where data stored on a computer is scrambled in a pattern using an encryption key.   The process is complicated, but renders the information useless to anyone unless they possess the key.

There are various levels of encryption, you might have heard of it described as 128 or 256 bit encryption.   This is referring to the length of the key.   A key is a string of 0’s and 1’s (binary language) and the bits mentioned describe how many characters there are.   For example, 8 bit encryption would be 2 to the power of 8 possible combinations of 0’s and 1’s, so 256 possible keys if you do the math.   If you used 8 bit encryption it would be pretty easy to just try each of the 256 keys to unlock your data.   Now consider that 128 bit encryption has 3.438 possible keys, specifically 340,282,366,920,938,463,463,374,607,431,768,211,456. That is a lot!   256 bit encryption has 1.1577 possible keys, and is generally considered unhackable (unless you’re the NSA). Fun fact – many banking websites now use 2048 bit encryption!

I’ve heard rumors that the number of bits used matters to HIPAA, but I have NOT been able to confirm for myself.   The rumor goes that 128 bit is NOT good enough for safe harbor. ‘Safe harbor’ meaning that if you lose it you don’t have to report it. It suggests that 256 bit is good enough for safe harbor.     Personally I think any level of encryption will keep your data safe since no one is likely to invest the time or effort to decrypt Dental records. They are going to take your stolen laptop, reload Windows and resell it on eBay or Craigslist for a quick buck.

If we agree that we want encryption and we’ll go with 256 bit, now what? It gets tricky here, so hang in with me.

Your two choices for Encryption

The encryption process (taking your data and mashing it up using the encryption algorithm with your key) takes computing power.   Something has to actually ‘do’ all that work.   That something can be one of two methods generally:

  • Software based encryption that has a little program plugged into Windows that is converting all the information on the fly, and thus this method uses some of your laptops CPU power and memory to get it done.
    • This is great because it is a solution that can work on any computer, in particular those that don’t have the special hardware.
    • On older laptops this can make them feel even slower (noticeably so) and can turn it from marginal to use to no fun at all to use.   Some older laptops just can’t deal with the load. I’ve seen it make a cheap 5 year old laptop nearly unusable.
    • There is some cost to this usually, ranging from free to perhaps $130.
  • Hardware based encryption is a solution where there is a special encryption chip (either on the hard drive storing the data or within the laptop) to do all the thinking. This method doesn’t borrow any resources from your laptop’s CPU or memory.
    • This is great since it won’t slow down your computer, even if it’s an older model.
    • Even new computers or hard drives don’t all have this hardware standard – you need to look for it.   When you order a new Dell or HP business laptop you need to select a hard drive with Opal security.   The cost increase is minimal, typical $20 to $50.

Software encryption is appealing to many since Microsoft began to include BitLocker for free in specific versions starting with Windows Vista.   There are only two versions of Windows Vista/7 that do include it, Ultimate and Enterprise editions. Unfortunately the vast majority of Windows 7 out there is Home or Professional editions. You can do an ‘In Place Upgrade’ of Windows 7 Professional to Ultimate, but it costs ~$130.   The good news comes in Windows 8 – Microsoft now includes BitLocker as standard in both the Pro and Enterprise versions of Windows 8.   So, if you have Windows 7 Ultimate, Enterprise or Windows 8 Pro version on your laptop enabling software encryption is as easy as going to Control Panel and clicking on BitLocker and following the prompts.   Allow from a few hours to 2 days for the initial encryption to complete (knowing you need to leave the laptop alone and plugged in for that period).   Pay close attention to the performance impact after BitLocker is setup. If you can’t notice the difference you are in great shape. If performance sucks afterwards, you can always turn it off and go back to normal again.

It is possible to replace your old slow hard drive with a new drive that includes hardware encryption.   A fancy super-fast Solid State Drive (SSD) with Opal security can be had for as little as $114 now (I am a big fan of the Samsung 840 Pro, and others like Intel make good units). The move to SSD will likely speed up your laptop substantially in general so it might be worth it on its own. Remember to factor in the cost of having your IT person help you copy your old drive to the new one and enable the encryption.

Just because you have an Opal compliant drive installed doesn’t mean it’s turned on.   Something has to work with it to turn it on and provide a key.   Unfortunately Windows 7 Ultimate and Enterprise editions can ONLY do software encryption – they have no idea about Opal drives or what to do with it. The good news is that Windows 8 BitLocker now has the intelligence to work with Opal drives and can control it for you. So, Windows 7 BitLocker you will get Software encryptions only, Windows 8 you can get Software or Hardware if your drive is compliant.

There are more Software encryption options than Windows BitLocker. As with many Microsoft features, BitLocker is sort of the bare bones of what is needed.   Third party companies such as Dell and Sophos have add-in applications for Windows that can do the same thing as BitLocker, maybe even better with less of a performance impact.   Dell Data Protection Encryption (DDPE) is available in several versions, but for about $50 you can add it to any version of Windows and turn on Software OR hardware encryption if you drive is compliant.

Auditing

None of these personal solutions may be truly 100% HIPAA compliant. If you believe that there needs to be a constant level of electronic auditing to be able to prove that your laptop was encrypted at the moment of loss, you need a better solution. DDPE for example has an ‘Enterprise’ level license that will include this kind of auditing, but at a cost. The individual license cost only goes up marginally, to perhaps $80, but you need to have an armada of Server software running somewhere that does the auditing process and an IT person to set it all up.

Personally I think this is overkill, and if your Practice’s HIPAA policy states that you shall BitLocker 256 bit encrypt, and you do it, just write a letter to yourself (or from your IT person) that states that “On this date we enabled 256 bit Bitlocker encryption on Laptop with serial number 1234, and stored the encryption key in this safe place” and sign it. Keep this document someplace safe.   You could add a periodic audit to this on an annual basis where you check that BitLocker is enabled (remember that it can be as easily turned off as it was to turn on) and document that you checked on the specific date.

Caveats

Really, really, really read this section and follow its suggestions. It’s based on the school of hard knocks I have personally attended.

Backup

If you enable encryption on your laptop I guarantee you this will cause a nightmare for your IT person down the road if you have a hardware failure (like a drive failure, Windows corruption due to spyware or virus, etc). I have lived this multiple times.   Without encryption, IT people have a substantial bag of tricks to try and recover fragments of data from your dead or dying hard drive (most of the time we can get part or all of your data back). With encryption, the drive thinks your IT person is just a bad guy and works to prevent access.   So, all those precious family photos or lectures you’ve prepared are at risk of complete loss.

You need a regular backup of your laptop data. We all know you should be doing this already, but rarely does anyone take the time to do it.   If you are, kudos to you!

My suggestion is to invest in an Internet Backup solution for your laptop in order to keep a near real-time backup copy of your data on your drive.   Other than the initial setup (which is very easy), you don’t need to do anything else. It will just run in the background anytime you are connected to the Internet.   The solutions are cheap now from companies like Carbonite, Mozy and Oak Tree Storage. A personal plan from Carbonite with unlimited storage is just $5 per month now, less than a quad shot vente latte at your favorite coffee shop. [One of you is going to ask “Is an Internet Backup HIPAA Compliant?” and that is a good questions but I don’t have space to answer here in detail other than “Probably Yes”]

Make sure your backup is complete BEFORE you turn on the encryption. An Internet backup might take from a few hours to a few weeks to complete the initial sync depending on how much data you have.

Don’t Lose your Key!

Regardless of what method of encryption you enable, all of the solutions are going to need to store a copy of the encryption key. Some solutions might use a special chip on your laptop called a Trusted Platform Module (TPM chip), and others might want you to attach a USB thumb drive.   If you use a thumb drive, just get a drive specifically for this purpose (they cost as little as $10 now) and then store the USB drive in a safe place (like a safe or lock box). Label the drive what it’s for “Encryption Key for my Laptop” and DON’T carry this drive around or use it like a regular USB key for your files, etc.   Think about it, if you lose the key someone has a critical part of your encryption process.   You might be able to make a copy of the encryption key file in several safe places (like a folder on your laptop that is then sucked up in the Internet backup).

Don’t keep the only copy on your laptop thinking that the encrypted drive is the safest place.   When the drive fails, your IT person will be asking you for a copy and you will be stuck with your keys locked in the car essentially. Another reason you might need a copy on USB key is that some laptops can sense ‘tampering’ and will lock themselves down if they think someone is trying something fishy to hack the encryption. The only way to unlock the drive and get your laptop functioning again will be to present the encryption key.

Encrypt it All or Don’t Bother

Some solutions offer you a way to have just an encrypted folder or similar setup where only a portion of the laptop hard drive is encrypted. It wouldn’t take much of a lawyer to tear you apart on this, essentially requiring you to prove that there was no possibility of there being PHI on the unprotected portion of the drive. Don’t use a half measure – use a solution that encrypts the entire drive.

A Password is Essential

There isn’t much point to encrypting your laptop if you don’t have a good password on your Laptop.   Imagine if your laptop was set to just automatically login without stopping for a username and password.  The thief would have direct access to your data without even needing to consider hacking the encryption.  Make sure you have a strong password.   Check out our previous Blog post on this.

What about Mac’s?

I am no Mac expert so I won’t try to be. A little research with Google points out that the latest versions of the Mac OS now include FIleVault2 (it appears that all you need to do is just enable it).   It will fully encrypt you Mac hard drive at the 128 bit level.   I don’t know if this is Software or Hardware encryption. I am not sure how this will play with Mac’s setup with BootCamp partitions, but I suggest you do a little research or enlist your Mac genius of needed. I’d still advise that you make sure you have a full regular backup in place.

What Would I Do?

Ok, you’ve suffered through the entire article to get to this. Here’s what I would do based on a few scenarios:

  • If I had an older laptop I was ready to replace – get a new laptop with Opal drive included and Windows 8 Pro and then enable BitLocker
  • If I had a decent existing laptop on a Windows version that already included BitLocker, I would just enable Software encryption and know the performance hit will be a little bit but not enough to matter
  • If I had a decent existing laptop on a version of Windows that did NOT include BitLocker and I didn’t want to replace the drive and OS (due to the hassles) I would get a third party encryption application like Dell Date Protection Engine (DDPE) or Sophos and setup software encryption.
  • If I had a decent existing laptop and was willing to upgrade the hardware and OS, I would get a new fancy SSD with Opal drive and then install Windows 8 Pro and use BitLocker to control it.
  • For any of these solutions I would add the Do-It-Yourself auditing to document the setup was completed and periodically review that it’s still enabled.
  • I would be sure to keep one copy of the encryption key on a USB drive in my safe, and another copy in a folder on my encrypted drive that would also get backed up by my Internet Backup plan.

If I had done one of these scenarios and my laptop was lost or stolen, I would rest easy that the data was safe.

Cloud Computing: The Questions you Need to Ask Vendors

By Steve McEvoy, Technology Consultant

steveM

Many Practices are starting to seriously look at whether using a Cloud based Practice Management app would be beneficial.  But most aren’t clear about the issues they should be evaluating.   

During my AAO session I will focus on those issues so that you can better understand the benefits and challenges of the Cloud.  Here are some of the things we’ll be talking about and why:
  • A Discussion of what the Cloud is.
  • Why does any of this Cloud stuff matter to an Orthodontic Practice?
  • What forms can benefits materialize within your Practice?
  • What are the key questions to be asking vendors?   Some of them are:
o   Will it work with my existing equipment?  This matters if you are trying to extend the life of your existing hardware and defer a large capital expenditure.
 
o   Will there be a data conversion?   Even if you are staying with the same vendor, you may be facing the challenges of a data conversion.
 –  What won’t convert?  You need to know what data will be left behind by the process.
 
o   How fast does my Internet connection need to be?   All Cloud solutions need a good Internet connection – but just how fast? 
 
o   What happens with the Internet goes out?  You need to know how to handle the inevitable.
 
o   What about Imaging?  Does it include an Imaging app?   Can I continue to use my existing app?
 
o   What about 3D Data?   More people have CBCT data than ever and there are significant challenges with running it from the Cloud.
 
o   What about Patient Education Applications?  Can you keep using your existing app or is there a new one to learn?
 
o   What about 3rd party integration support?  Can the app work with other programs and services you use.
 
o   What about Security?  Is your data safe?
 
o   What kind of hardware is running the solution?  Is the solution used fast, safe and redundant?
 
o   What about backup?   What approach are they taking?
 
o   Can you get a Demo login to be able to use it from your PCs on your own Internet connection?
 
o   If I don’t like the Cloud experience can I switch back?  How easily can this be done?
 
  • How can it save Money?   A key discussion in determining if the benefits are worth it.
o   No Server required – is this really possible?
 
o   Cheaper Workstations – How much cheaper?
 
o   A simpler network will lead to reduced IT support.  How much can be saved?
 
o   How does the vendor charge for Software, Support and Hosting?
  •      How to work out of the Cloud might be right for your Practice.  Some situations will be no brainers, and others may need more careful evaluation.
If you are considering the Cloud for your Practice please attend and bring along your questions and concerns – I want to hear them so we can all discuss.
 
Check the AAO Onsite Program guide to confirm the lecture time and location, but at the moment it looks like it will be on Saturday April 26th at 2pm.   Look forward to seeing you there!

 

A New Virus Threat Emerges

By Steve McEvoy, Technology Consultant

steveM

There is a new Virus threat spreading quickly across the Internet currently that is particularly wicked.  It’s called CryptoLocker.    I am writing this because I think there is some chance you could be at risk, either with your home PC or work computers.  We had five people call us infected on the first day the virus was out.  Please take a minute and read through this to the end where I suggest what you can do to help prevent getting infected.

The virus’s design has made it so that even current Antivirus products running in your firewall and antivirus software on your PCs aren’t detecting it until it’s too late, if at all.  The antivirus companies are trying to respond, but the virus ‘morphs’ each time it replicates, so its slippery for them to detect and block or quarantine.

What does it do?
In short, the virus is a form of Ransomware.  Once it gets into your PC, it ‘encrypts’ all your personal files and data, and then holds your data hostage for ransom.  In this case they want $300 to provide you with the unlock code to decrypt your files and remove their application.

To motivate the affected user to quick action, they only give you 72 hours to act, then the data is lost forever.

Its design is such that if your IT person then tries to remove it, this will leave your files encrypted forever.

It gets worse.  If your PC has external media like USB hard drives and USB keys attached, it encrypts those too.  Imagine if your Backup drive was attached, it would be encrypted and unusable to restore your data from before the attack.  Even worse, if your infected PC is connected to a network and you have connections to a Server, it reaches out and encrypts the data on the Server too.   If you use a Cloud based storage like Dropbox or Google Drive, it will encrypt the data within those folders as well.   If you use Internet Backup, the backup will pick up copies of the encrypted files.  A giant mess.

What can you do if it happens to you?
If you get hit by this virus – make a note of the time you have left (in the 72 hours) and then SHUT OFF THE PC entirely!  The longer it remains on, the more time it has to search and encrypt more files.   It might be prudent to disconnect the network cable too if you are connected to an office network. Contact your IT person immediately for their assistance in recovery.

Our experiences so far indicate there is no way to simply clean it and recover like other spyware or viruses.  If you have a backup that is safe somewhere (not connected to the infected PC), this is your best option for recovery, but don’t try to recover data to a machine infected with CryptoLocker, it will just destroy that precious backup.   Backups come in many forms, so I can’t tell you exactly how to best use it, but your IT person can.  Its highly likely that you will need to reinstall Windows to your PC, and then restore your data to this Clean PC (huge hassle).  If your Server’s data got infected, you’ll need to restore that data as well.

Your very, very last option is to pay the ransom.  In most Ransomware attacks, paying the ransom does not unlock your data (why would they?).  We have seen reports that people paying the ransom in this particular case has been unlocking the data as indicated.  You are paying criminals, who will just use that money to do more evil things.  Think hard about this before you consider it.   Might it be better to lose the data you ‘sort of need but could reconstruct’ than to propagate this issue and reward a criminal.

How it’s getting in
I can’t tell you for certain how it’s been getting in (which is troubling).  With its ability to slip through the Antivirus filters it comes down to there is no defense (yet) other than you using your smarts.   Reports to date seem to indicate it gets in using one of two methods:

As an attachment to an email message.  Typically something claiming to be a shipping notice or receipt for your review.  A common lure to get you to try and open the attachment to see what it is, and if you open that attachment the virus sets in.

If your computer is already infected with some mild spyware (pop ups, other nuisances) they have found a way to exploit the Spyware’s communication methods to slip in and get started that way.  This doesn’t need a user’s interaction, and is crazy scary.

To Defend Yourself:
Don’t open attachments that come with emails unless you are 100% certain to the validity of the attached file. Meaning you should know who is sending it to you, why they are sending it, and you should have been expecting it.  Even an emailed attachment from someone you know could be a cleverly disguised virus, so be SURE before you open it.  You can always pick up the phone and contact that person to be sure they sent you something.  YOU CAN’T rely on your antivirus software to defend you at the moment.  You have to use your own smarts and avoid things that will trigger it.

If you suspect that your PC has Spyware in any other way (acting weird, slow, pop-ups) contact your IT person to address this immediately.  When in doubt, turn off the PC until your IT person evaluates it.

Keep your Antivirus program up to date on a daily (or more frequent) basis.   (If you are an MME client running Symantec Endpoint Protection, this happens automatically several times per day without your interaction needed.)

Basically, responsible surfing is the best defense.

I wish I had better news, but I thought I would at least give you a heads up for now.

Please spread the word to others in your office.

If you have any questions or concerns, please let me know.

Take Care,
Steve

_________________________________
Steve McEvoy
MME Consulting, Inc.
4714 Duckhorn Drive
Sacramento, CA  95834-2592
Toll Free: (866) 419-1102 (ext. 2008)
Fax: (916) 419-1103
Email: steve@mmeconsulting.com

An Introduction to Windows 8, Or How to Survive Without the Start Button

By Dr. Greg Jorgensen
Rio Rancho, NM – www.gregjorgensen.com

 

As you recently read in a post on this blog by Steve McEvoy of our technology committee, Windows XP is on its last leg. If you have any XP machines in your office, you really need to plan to replace those soon, not just because they are using software technology a decade old, but because the stuff out there now is just so much better. For those who are comfortable with Windows 7, get ready because your next machine will probably come with Windows 8. After hearing nothing but complaints, I was scared to get my first Windows 8 machine. The transition however wasn’t as bad as I thought. Here are some things I’ve learned that will help make your first experience a little easier.

The first thing you’ll notice when you boot up your Windows 8 computer is that you won’t end up on the familiar Windows desktop. The desktop has now been replaced by what Microsoft calls the “Metro Interface.” Next, the Start Button which has been the “go to” point for most Windows functions for over a decade is conspicuously missing. This was where you would go if you wanted to start an app, search your computer, change computer settings, or even shut down. All of these features have now been replaced by tiles on the Metro start screen representing the apps you want to open or the settings you need to access. The inspiration for this change was the industry-wide shift to mobile computing on smartphones and tablets. The tile structure is more convenient when selecting options with your finger. It also works just fine on a laptop or desktop computer once you understand where everything is. So to open Word or Excel, you will now just click on a tile representing the program rather than select it from the start menu or from the taskbar.

Many of the other features previously found on the Start Button have now been moved to a pop-out menu on the right side of the screen that can be accessed by moving your mouse pointer to the upper or lower right-hand corners. The icons that appear on that pop-out toolbar are called “charms.” The top charm takes you to the search function that used to be located on the start menu. To search for apps, settings, or files, just click on the magnifying glass charm and type what you are looking for into the search box. A useful feature of the Metro Interface is that you can just start typing what you want and the search box will automatically appear.

The second charm is the Share function. When inside of an app, you can use the share function to share pictures or documents with someone else without leaving the app. The third charm is the Start Charm which is merely a link to the Metro Interface start screen. The fourth charm is labeled Devices and gives you the same options as the old Devices and Printers link on the Windows 7 start menu. Finally, the last charm is a link to the Settings of your computer and your apps. The Shutdown, Restart, and Sleep commands that were previously found on the Start Menu are now associated with the Power icon found when you select the Settings charm.

Once you get past the start screen and launch your familiar programs (Word, Excel, Chrome, etc.) you will feel right at home. Most apps run in the Windows 8 “desktop” environment which looks and feels exactly like the desktop in Windows 7. You can also get to the desktop by clicking the Desktop Tile on the Metro Interface screen. This desktop can be customized to look exactly like the desktop you now use in Windows 7 including the same icons and colors or picture schemes. Anytime you need to launch a new program or make changes to the settings however, you’ll probably be redirected back to the Metro Interface.

Although this is not an exhaustive tutorial for Windows 8, it should at least help you survive the loss of your familiar Start Button. Once you get used to starting programs by clicking tiles rather than icons and looking to the pop-out menu on the right to search and shut down, you’ll be on your way. I actually like Windows 8. Remember that technology always keeps moving forward, so you can either climb aboard or get left behind. Good luck!

Windows XP is Dead!

By Steve McEvoy, Technology Consultant

Microsoft is discontinuing support for Windows XP and Office 2003 on April 8, 2014.

WHY SHOULD YOU CARE?
If you don’t have a PC with either of these products in your office, then stop reading and go do something more fun. If you DO have a PC with Windows XP in your office you may end up having new risks you didn’t plan on and you should read this article through.

WHY IS THIS HAPPENING?
Two reasons:

  • Microsoft has been upfront about it for years; they generally only support a product for 10 years and time is up.
  • Microsoft is a business and they want you to dump your 10 year old computers and go get new ones with a new version of Windows on it (increasing their sales).

WHAT IMPACT DOES THIS HAVE ON YOUR PRACTICE?
Once Microsoft stops supporting XP you may have new risks in your Practice:
Your Practice Management software may no longer be supported or work
You will potentially be vulnerable to new security weaknesses discovered
You will potentially be vulnerable to new viruses exploiting security weaknesses

Some Practice Management software companies (Ortho2 for example) are using this as an opportunity to stop supporting their products on Windows XP as well. They are doing this for three logical reasons:

They only want their software running on computers that are kept up to date and patched.
They want you to get rid of those old PC and run their software on newer PCs that will make their software work better.

They want you to get rid of those old PCs that are probably less reliable than a new PC, and thus reduce the load on their support center.

Based on their notice – if you are an Ortho2 user they expect you to replace your XP operating systems and Office 2003 software before April 2014. This might mean reloading existing PCs with new software (upgrading from XP to Windows 7 requires reloading the whole PC), or much more likely purchasing new PCs to replace the old ones.

So far I only know of Ortho2 taking a hard line with requiring all its clients to upgrade before the April 2014 deadline, but I wouldn’t be surprised if other vendors start making the same noises.

WHAT ABOUT MY X-RAY PC?
Many X-ray systems in Practices today are run on only Windows XP (typically older digital Pan/Ceph units, iCats, etc.). I’ve seen whole Practices that are all Windows 7 except for one PC, the X-ray PC. The reason being is that the software they use was designed for XP and may not be compatible with Windows 7. If it is available it may not be free and it may be a huge PITA to change the software out.

So what should you do if you have an X-Ray machine running Windows XP? I would ask your X-Ray machine vendor if the existing machine can be run on a Windows 7 PC.

If Yes:
Does it require new software?

  • If Yes – ask about the details (costs, implementation process, etc.)
  • If No –This is the path to follow.

Can the software run on 64-bit Windows 7?

  • If Yes – this is the path to follow.
  • If No – 32-bit Windows 7 compatible is OK and the path to follow.

If No:
What suggestion might they have for getting off Windows XP? If none, now you know you’ll have to make do with the existing XP machine and potential risk.

WHAT ELSE MIGHT BE AFFECTED?
I can think of several other situations that changing out the old XP PC might be problematic. For example, if you run the old Televox HouseCalls system with a special card to make nightly phone calls, you’ll have no supported option for migrating.

WHAT ABOUT OFFICE 2003?
Microsoft is dropping support for Office 2003 at the same time for the same reasons. It won’t stop working, but they are stopping patches for it as well. Ortho2 says they won’t be supporting their products with it anymore either. I would agree that it’s time to start planning upgrades for this. Office 2003 isn’t even compatible with Microsoft Exchange 2013 or Office 365 Cloud, so it’s time to upgrade to Office 2013.

CONCLUSION
Other situations will exist. You need to start talking about this transition with your IT person and finding out if there are solutions.

Ultimately I don’t think it will be a big deal to have just one XP box remaining in the network if needed. Apply all the updates that are available to it, keep a current antivirus program on it, and do your best with it. Start planning what you can to replace it eventually. If the PC dies for other reasons, you’ll be back in the same situation

Windows 8 – Should I Wait?

By Steve McEvoy, Technology Consultant

In October 2012 Microsoft released their latest version of their operating system – Windows 8.  The dilemma that arises for the Orthodontic Practice is about whether it’s appropriate to start using it.  Early adopters are generally all fired up to try it out, and the conservatives amongst us aren’t interested at all.  What factors are there to consider in the decision?

  • You likely have a mix of either Windows XP or Windows 7 systems in your office now.  Remember Windows Vista (or Windows Me)?  It came and went and most people went out of their way to avoid it.  It wasn’t well received in the business market due to compatibility issues with older equipment and the significant changes in the user interface that impacts the staff learning curve.  Windows 8 appears to have some of the same challenges.
  • Will your Orthodontic specialty applications (Practice Management, X-Ray, Patient Education, Credit Processing, etc.) all work properly on Windows 8?   There is usually a significant lag in application compatibility, sometime several years.  Some still don’t support Windows 7.  You should not change to a newer operating system unless you are POSITIVE your applications will work.   If you are interested in upgrading, put in the leg work to determine if your apps are compatible before you buy.
  • Windows 8 features a completely revised user interface called Metro.  Think of your computer monitor as a large cell phone screen that no longer has a ‘Desktop’ and is rather a series of ‘Tiles’.  Some may love it, but personally I don’t like the interface (so far) since I am well trained in the old ways.  I find it slows me down.  You can decide for yourself.
  • The newer operating systems generally need a faster computer underneath them to run well.  If you run Windows XP or Windows 7 now on an existing PC, I would suggest they are best left as-is and skip the upgrade until it’s time to replace the entire PC.
  • Having a mixture of Windows versions in the office adds a burden to your staff having to know how to work with all of them.  I am a big fan of having all the PCs the same whether it is all XP or all 7.


Windows 8 – would I wait?  Yes. 
If I was buying ALL new PCs for my office and I had checked and ALL the applications I planned on running were fully Windows 8 compatible, I might take the plunge.

Otherwise I would stick with Windows 7 for maximum compatibility and staff happiness.  I suspect we’ll be skipping Windows 8 like we did with Vista.

If you’d prefer not to use Windows 8 on a new PC, how can you still get Windows 7?  This is a tricky question.  We are in the overlap time now between the two.  If you walk into your local retailer like BestBuy or Staples, they will likely have mostly PCs preloaded with Windows 8 (Microsoft encourages this).  You may be able to find a few models with Windows 7.  To get more exactly what you want I suggest you look at purchasing your system directly from the Manufacturers websites like Dell.com or HP.com.   Looking at systems offered in the “Business” sections of their websites, you will find that they offer both Windows 7 and 8 as options.  Large corporate customers will be demanding Window 7 be available for several years to come.

Creating Content for Your Orthodontic Practice’s Social Media Channels

social-media-bannersCreating a social media presence for your orthodontic practice from scratch may initially sound like a daunting task, but the reality is it’s easier than most first think. There’s simply no reason not to get started if you haven’t done so already. A social media presence for your practice is the perfect way to tell your story, build your brand, and enhance your overall online presence.

If you or your staff needs assistance or advice setting up a social media presence, please know that the AAO is here to assist. Simply contact, Burt Bollinger, Sr. Manager of Marketing/Communications at (314) 292-6556 or via email. As someone who works with the AAO’s social media sites, I am more than happy to walk you or your chosen social media staff member(s) thru the basic steps necessary to start a Facebook page or other social media site.

Having assisted many of our members in setting up their fan pages, the question I hear more than any other is: “Now what? What kind of content should my staff and I be posting?”

Now What?
Just as important as having an online presence is making sure you are keeping it up-to-date. There are several ways to ensure that your practice’s social media output remains vibrant and timely by publishing meaningful content a few times each week.
Your goal should be quality over quantity. Aim for approximately 2-3 posts per week. Remember, each post works to increase your online visibility. But be careful not to overload your followers with too many postings. You don’t want to be added to their block list, which is a lot like a social media “death sentence” for your page.

So…what exactly should you post?
The obvious first step is to use and repurpose your existing content. For example, if your practice has a traditional newsletter or blog, plenty of ideas for postings can be cultivated from these pre-existing resources. Remember, on social media sites like Facebook and Twitter, you’re not in the “sales” business. You’re in the “relationship-building” business, so remember the 80-20 rule. So pluck from existing content, but don’t focus solely on trying to “sell” your services.

Other posts you’ll want to make will be links to different areas of your practice’s existing web site. If your site needs a bit of updating to get into shape before sharing, now is the perfect time to do so. For example, make your “About Us” section something worth sharing. Consider doing bios of different staff. Also consider sharing photos of your office.

Another ideal resource for postings is using video captured by you and your staff.

Don’t forget that if you’re going to use video and photos of your patients online, you’ll want to be sure you have had them sign a photo release form.

Finally, in the world of social media, there is no shame in researching what other orthodontists are up to online, and incorporating some of their better ideas into your own efforts. There are plenty of practices out there with active Facebook fan pages, so start searching, exploring, and using their postings to your fans’ benefit. Examples of content include contest ideas you may not have thought of, or new ways to feature successful treatments. Always keep moving forward, and don’t be afraid to try new things.

Promoting Yourself Using Practice Marketing Solutions
Another way to find fresh content is via the AAO. The AAO has also complied many different materials that are ideal for sharing. These materials are contained in an area of the AAO member website called “Practice Marketing Solutions.”This is an area of the web site only available once AAO members are logged in. (Access Practice Marketing Solutions via the My Practice / Marketing section of AAOinfo.org. Or log in, and then click the small banner on the left side of the home page.)The AAO has prepared a video that walks the viewer through AAO Practice Marketing Solutions and addresses how tools offered by the AAO can be used by individual members or groups of members. View the Practice Marketing Solutions Video @ 1:20 for a featurette on Practice Marketing Solutions.In short, you’ll find a wealth of information, much of it perfect for sharing on your sites. The information includes a series of sharable videos from the My Life. My Smile. My Orthodontist.SM series, including numerous patient testimonial videos, a brand new series of instructional videos, a series of AAO webisodes, and the latest television commercials.

So that you can easily share the videos, the AAO is permanently hosting them on both YouTube and Vimeo.

Alternately, you may also download and keep permanent copies of the videos to use where applicable, including hosting them on your own servers.In addition to the great video content, why not select a single AAO brochure

to share each week? Simply download a brochure, re-host it on your own web site, and link to it. It’s a great way to spread helpful information to your patients while also driving traffic back to your practice web site.These are just a few of the ways you can keep your social media sites up-to-date with meaningful content. If you have any other ideas, I’d love to hear them. Please contact me so that I can share them in future postings.