Electronic Health Record (EHR) systems and its affiliated databases continued to dominate the technology discussion in 2014 and probably will again in 2015. But there are some major technological advances that will effect physician practices both in 2015 and certainly in future years to come. Here are just three of them:
1) Move over Anti-Virus, Micro-Virtualization is the up-and-coming new end user device security platform.
For decades, users have been protecting their laptops and desktops with anti-virus software - the McAfees, Trend-Micros, Nortons, etc. of the world. And they have provided some good protection. These end user device security applications use signatures (what's in the code), heuristics (file emulation and sandbox testing) and behaviors to check or inspect files for malware. However, we have learned over the years that these methodologies are far from foolproof. There is the added burden of constantly updating those anti-virus software to capture the latest infestations. Even so, zero-day attacks can still infect devices. There is nothing worse than, having opened an attached document in an e-mail you thought you could trust, to find yourself facing the dreaded a blue screen.
Enter micro-virtualization. The technique, developed by Simon Crosby (Ph.D. Computer Science, Cambridge University) and others, has the end user's device distrust everything (Crosby, 2014). That's right - everything. So when one downloads the malware infested file, it simply “virtualizes every instance”. While one can view the infected document, the infection doesn't have access to the kernel or registry of their device, and Walla! - no malware! The great news is that this nation-state level of security software that will soon be available to the public-at-large.
Bromium (www.bromium.com) (Simon Crosby's company) is currently focused on large end user sites such as major medical centers, banks, etc., the code currently runs on Windows 7 and Mac OS, and is compatible with Windows Internet Explorer and Google Chrome browsers. The next target is by the end of 2015, early 2016, Bromium will be available to smaller user groups, run on any operating system, and with any browser. Personally, I have had Bromium (and no anti-virus software) on my laptop for three months and have yet to get any adware, viruses, Trojans, bots, rootkits - ANY malware.
The best estimate is that in the small end market the software will be about $150 a license - but it's a one-time fee only (perpetual license). Small investment the big return - keeping the really bad guys out and freed up from constantly updating anti-virus software.
2) 4G-LTE will play a major IT role outside of the phone, iPad and tablet.
4G-LTE is normally thought of as a connectivity medium - phones, iPads, and tablets. However, 4G-LTE is about to take on some expanded roles - that of acting as cellular modems and becoming a network failover system. Why? Because with the upload and download speeds that 4G-LTE provides, it's now very viable as a failover system for ISP networks. But here's the real skinny - manufacturers are providing this failover in super single form factors. These not only include failover capabilities, but wireless capabilities, along with built in network security, encryption, and web-filtering. (Just think: segmented wireless network where patients, guests are not on the clinic's wireless network but their own network!) For example, Cradlepoint (www.cradlepoint.com) announced this week that it has partnered with zScaler (www.zscaler.com) so that its shoe box size device will provide web-filtering (Cradlepoint, 2015). While web filtering has been around for a while, it's not been seen in failover networks at the physician's office scale. zScaler, for example, has over 100 data centers located throughout the world, examines about 10 Billion packets a day, and handles over 100,000 pieces of malware a day. So what does this all mean? One can now have an automated failover network system that offers high data throughput (4G-LTE speeds), wireless segmentation, and rich and deep security protection (for example - it meets PCi compliancy standards). And here is the best news - the entire cost for the equipment ranges roughly $1,100 to $1,800, depending on exactly what one wishes to do and how much throughput they will need. This cost includes an exceptional Panorama antenna, installation, etc. Even if an organization has numerous offices - all failover units can be controlled from one simple, intuitive screen. A clinic will also incur the cost of around $50 a month for an activated 4G-LTE wireless broadband circuit. Not a bad investment for a complete failover, wireless segmented network. Some may even want this to be their primary network. The cost is certainly attractive.
3) Ahhh… And my favorite, the Internet of Things (IoT).
Okay. What is all of this IoT about, and why is it taking place? According to Goldman Sachs' analyst (Simona Jankowski, 2014), there are several resource cost factors creating this mega-wave. The cost of sensors are less than half that of ten years ago. More, the cost decreases of bandwidth have declined 40 fold in the same time period. Processing costs have even decreased further - 60 fold over the last decade. With wireless becoming prevalent in almost every surrounding - and smartphones becoming the end user device of choice - you have, if you will, the perfect environment for IoT.
First, IoT can be viewed from many different perspectives. Some see it as an entire ecosystem that shares information about people or the specific environment to things that relate to people. (Example: a customer passes by a store, IoT applications immediately recognize their previous purchases and - via their smartphone - immediately offers them a special on a similar item.) Others view smaller systems (such as physicians' offices) naturally evolving and eventually migrating into larger systems. Apple Pay is a good example of this. To whichever IoT development theory one subscribes, IoT applications are being developed at break-neck speeds. Consider this - the person who opens the clinic each day is detected (via their smartphone) at exactly 7 minutes away from their office and the heat (or air-conditioning) is turned on exactly at that moment. Can't find a specific piece of diagnostic equipment? One's smartphone or tablet and it will tell them in real time exactly where it's located. Want faster patient check out? Then Apple Pay is a great example of a M2M-IoT application. With it, just a simple swipe of a phone (while the patient's thumbprint is read on the phone) allows them to immediately pay and the receipt is delivered to the patient's phone - not to mention the positive effect on the office's cash flow. This is a great service for the patient's convenience also.
Every office has its list of time-sinks and frustrations - only your imagination will limit what IoT could accomplish for you. Stand by. 2015 will be a watershed year for IoT's advancement; and yes, in your office.
Cradlepoint. (2015). Cradlepoint Strengthens Branch Security with zScaler. Internet: https://cradlepoint.com/news-and-events/news/cradlepoint-strengthens-branch-security-zscaler.
Crosby, S. (2014). Why Bromium? Internet: http://www.bromium.com/why-bromium.html .
Simona Jankowski, J. C. (2014, September 3). The Internet of Things: Making sense of the next mega-trend. Goldman Sachs Equity Research, p. 15.
About the Author
Lee Williams, member IEEE, is the CEO of Digital Connections, Inc., technologist, and teaches computer theory and applications, systems analysis and design, enterprise architecture, and advanced networking. He also appreciates the help of his best research assistant, Bogie, his Corgi.