6 ms·

Is there a reason to believe that choosing Windows was a bad decision? The bad decision was installing antivirus software. Otherwise, most any modern OS would

Is there a reason to believe that choosing Windows was a bad decision? The bad decision was installing antivirus software. Otherwise, most any modern OS would be fine. This machine probably shouldn't be connected to a network (if it was), the USB ports should be disabled; data can come off on burned CDs, autorun should be disabled, etc. That's how you deal with IA concerns on a standalone mission-critical system, not by installing antivirus.

raverbashing 11y ago
You're right. My bet is that they use windows because they want to save or get something from the machine (either to a USB drive or network) And I would have followed the same steps you mentioned. The machine could work with Windows. Windows CE might have been a better pick, so you can have things like RO filesystem, etc "There is no reason to use Windows" is, as you mentioned, not a bad decision in itself, but since they do it the lazy way, it is awful. Not sure if there's an out-of-the-box way of firewalling everything in the Windows versions available at the time that machine was built
- enraged_camel 11y ago
  A lot of those machines have Windows embedded in them, because a lot of doctors and nurses are really, really bad with technology and cannot use anything more complicated than Windows's familiar user interface. Training involves "OK, now use the mouse and double-click this icon on the desktop to start the program." I wish I was kidding.
  - stephengillie 11y ago
    Windows is a familiar interface for computers. Is there a good reason for not using a familiar user interface?
    - tremon 11y ago
      Huh? Of course there is. "Familiar interface" isn't even a functional requirement, it is only of secondary importance for any system. Actual functionality is much more important. As an aside, if "familiar interface" is your only requirement, I'd suggest to install a door handle or light switch.
      - seanp2k2 11y ago
        Your comment may sound sarcastic on the first read, but I agree with the point; don't use Windows when what you needed could be done with a micro controller or a physical circuit. Not sure if the application here fits that at all, but I've definitely seen things like you-do-it check-outs, ATMs, billboards, etc running Windows. I would think that these systems would be much better off with something like a hardened micro controller running a remote display system vs a multi-gigabyte operating system. With Windows 10, this problem will likely get a whole lot worse. What do you do when MS pushes a forced update to your deployed devices and it bricks some of them? http://m.theregister.co.uk/2016/05/06/microsoft_update_asus_windows_7/ http://m.theregister.co.uk/2016/05/06/microsoft_update_asus_... What about when you can't disable Cortana (without breaking the start menu) and you're in a HIPAA / PCI environment? http://winaero.com/blog/how-to-uninstall-and-remove-cortana-in-windows-10/ http://winaero.com/blog/how-to-uninstall-and-remove-cortana-... As we've seen with things like SCADA, switching from Windows is not a silver bullet, but in terms of minimizing the complexity and attack surface, Windows seems to be starting at the opposite end of the spectrum.
        tremon 11y ago
        Oh, I didn't even mean my comment to be about Windows vs dedicated OS, at least not directly. When administered correctly and properly fenced off, using a modern Windows system is not a cardinal sin. Although I will admit that Windows 10, with its non-optional feature cadence, brings additional uncertainty. However, I do question "it looks like Windows" as a valid rationale for what appears to be a single-purpose machine. I don't think it's likely that staff are using the operating room equipment as a desktop machine, so presumably they only care about the in-app user interface. And an application interface can be made to "look like Windows" regardless of what OS it's running on.
  - afarrell 11y ago
    > I wish I was kidding I know that "tired person in a hurry" is a trope, but considering how masochistic the health professions are about sleep, it really applies here.
  - et2o 11y ago
    Surprised I had to scroll this far to find someone blaming a physicians.
- x0x0 11y ago
  I worked on similar software that ran on Windows, though the decision was made 18 years ago. It was driven by: * GUI dev tools were an order of magnitude better than under linux * nidaq (very common daq and dio cards) didn't have or had flaky linux drivers. usb may be a better choice today but was not then available. Plus it's convenient/less expensive to push functionality to the computer side and minimize embedded development. * in the beginning (though we fixed this mistake), we shipped software, our machine, and a ni-daq card; users provided a computer. This was a nightmare. We ended up shipping whole computers custom built by Dell to our specs with ni-daq cards installed (and later glued in to prevent them slipping out during shipping) plus our custom system images. At the time, I don't think Dell would do this for linux; you could find other vendors that would, but they weren't easy to work with or much more expensive. * Nobody is eager to switch OSes because every software update to the machine has to be FDA certified (ie kiss at least $100k goodbye), so the company is very risk averse. Beyond even the cost to rewrite what has evolved into a relatively complicated gui app. * As mentioned elsewhere, once you leave windows you have to train people to use linux guis that historically had window managers / gui toolkits that didn't work like windows. All of the above is complicated by the fact most of these medical device companies pay their devs shit and have trouble hiring good devs. (Engineering shortage, obviously!)
  - tremon 11y ago
    every software update to the machine has to be FDA certified Interesting. Does that imply that every Windows update Microsoft releases has been FDA-certified already?
    - icegreentea 11y ago
      I don't know how it works out for stuff used during surgery, but for diagnostic devices (where if a device fails by becoming inoperable, the stakes are a lot lower), you can lump basically any software that you don't have total control and design history on (so this includes random proprietary software and most FOSS stuff) as "software of unknown providence" (SOUP). Now based on the class of medical device you are developing, you can either get to use SOUP without justifying at all, or you have to explain/justify why you can use SOUP at all. For example, even if your OS was Linux, because you don't have formal documentation on verifying that Linux infact does all the things its suppose to do (hell, does Linux even have a true spec?), you would then have to justify why you're using Linux. If a kernel update comes out, you then have to justify why you're using it. What you WOULD have to do is verify/validate that your software that interacts with SOUP (so in this case running on an OS) still works correctly. You would not have to verify/validate the OS update per se.
ChuckMcM 11y ago
I think you have it backwards (no disrespect intended). When you evaluate the choice of Windows you have to acknowledge that it brings with it the vulnerability of viruses and so the necessity of anti-virus software. Either you own that decision, and as part of your support your tool provides the necessary antivirus and you also insure through testing configuration management that its configured appropriately, or you choose a different option up to an including writing your own system to manage the "time critical bits". Having their software run in a Windows ecosystem that they do not have strict configuration management control over was a bad decision and on the basis of this failure report. That it did not result in patient injury or death was fortunate but is certainly not guaranteed.
- Amezarak 11y ago
  > When you evaluate the choice of Windows you have to acknowledge that it brings with it the vulnerability of viruses and so the necessity of anti-virus software. No matter what OS you choose it is vulnerable to viruses. You and I will agree that the odds are your Windows system is much more at risk by at least an order of magnitude. But the IA people who demanded that this system run antivirus are just as likely to demand that Linux run antivirus, simply because the vulnerability theoretically exists and making that demand fulfills their CYA requirements. I've worked on standalone Linux systems that IA demanded have antivirus. > Either you own that decision, and as part of your support your tool provides the necessary antivirus and you also insure through testing configuration management that its configured appropriately, or you choose a different option up to an including writing your own system to manage the "time critical bits". According to the article, the software runs on the user's hardware. While they certainly could have made a decision to provide their own controlled hardware, it's entirely possible that hospital was not open to that option for cost reasons, for IT management reasons, whatever.
  - Diederich 11y ago
    Is the day to day impact of antivirus on Linux the same as on Windows?
    - 11y ago
deleted 11y ago
[deleted]

raverbashing 11y ago

You're right. My bet is that they use windows because they want to save or get something from the machine (either to a USB drive or network) And I would have followed the same steps you mentioned. The machine could work with Windows. Windows CE might have been a better pick, so you can have things like RO filesystem, etc "There is no reason to use Windows" is, as you mentioned, not a bad decision in itself, but since they do it the lazy way, it is awful. Not sure if there's an out-of-the-box way of firewalling everything in the Windows versions available at the time that machine was built

enraged_camel 11y ago
A lot of those machines have Windows embedded in them, because a lot of doctors and nurses are really, really bad with technology and cannot use anything more complicated than Windows's familiar user interface. Training involves "OK, now use the mouse and double-click this icon on the desktop to start the program." I wish I was kidding.
- stephengillie 11y ago
  Windows is a familiar interface for computers. Is there a good reason for not using a familiar user interface?
  - tremon 11y ago
    Huh? Of course there is. "Familiar interface" isn't even a functional requirement, it is only of secondary importance for any system. Actual functionality is much more important. As an aside, if "familiar interface" is your only requirement, I'd suggest to install a door handle or light switch.
    - seanp2k2 11y ago
      Your comment may sound sarcastic on the first read, but I agree with the point; don't use Windows when what you needed could be done with a micro controller or a physical circuit. Not sure if the application here fits that at all, but I've definitely seen things like you-do-it check-outs, ATMs, billboards, etc running Windows. I would think that these systems would be much better off with something like a hardened micro controller running a remote display system vs a multi-gigabyte operating system. With Windows 10, this problem will likely get a whole lot worse. What do you do when MS pushes a forced update to your deployed devices and it bricks some of them? http://m.theregister.co.uk/2016/05/06/microsoft_update_asus_windows_7/ http://m.theregister.co.uk/2016/05/06/microsoft_update_asus_... What about when you can't disable Cortana (without breaking the start menu) and you're in a HIPAA / PCI environment? http://winaero.com/blog/how-to-uninstall-and-remove-cortana-in-windows-10/ http://winaero.com/blog/how-to-uninstall-and-remove-cortana-... As we've seen with things like SCADA, switching from Windows is not a silver bullet, but in terms of minimizing the complexity and attack surface, Windows seems to be starting at the opposite end of the spectrum.
      - tremon 11y ago
        Oh, I didn't even mean my comment to be about Windows vs dedicated OS, at least not directly. When administered correctly and properly fenced off, using a modern Windows system is not a cardinal sin. Although I will admit that Windows 10, with its non-optional feature cadence, brings additional uncertainty. However, I do question "it looks like Windows" as a valid rationale for what appears to be a single-purpose machine. I don't think it's likely that staff are using the operating room equipment as a desktop machine, so presumably they only care about the in-app user interface. And an application interface can be made to "look like Windows" regardless of what OS it's running on.
- afarrell 11y ago
  > I wish I was kidding I know that "tired person in a hurry" is a trope, but considering how masochistic the health professions are about sleep, it really applies here.
- et2o 11y ago
  Surprised I had to scroll this far to find someone blaming a physicians.
x0x0 11y ago
I worked on similar software that ran on Windows, though the decision was made 18 years ago. It was driven by: * GUI dev tools were an order of magnitude better than under linux * nidaq (very common daq and dio cards) didn't have or had flaky linux drivers. usb may be a better choice today but was not then available. Plus it's convenient/less expensive to push functionality to the computer side and minimize embedded development. * in the beginning (though we fixed this mistake), we shipped software, our machine, and a ni-daq card; users provided a computer. This was a nightmare. We ended up shipping whole computers custom built by Dell to our specs with ni-daq cards installed (and later glued in to prevent them slipping out during shipping) plus our custom system images. At the time, I don't think Dell would do this for linux; you could find other vendors that would, but they weren't easy to work with or much more expensive. * Nobody is eager to switch OSes because every software update to the machine has to be FDA certified (ie kiss at least $100k goodbye), so the company is very risk averse. Beyond even the cost to rewrite what has evolved into a relatively complicated gui app. * As mentioned elsewhere, once you leave windows you have to train people to use linux guis that historically had window managers / gui toolkits that didn't work like windows. All of the above is complicated by the fact most of these medical device companies pay their devs shit and have trouble hiring good devs. (Engineering shortage, obviously!)
- tremon 11y ago
  every software update to the machine has to be FDA certified Interesting. Does that imply that every Windows update Microsoft releases has been FDA-certified already?
  - icegreentea 11y ago
    I don't know how it works out for stuff used during surgery, but for diagnostic devices (where if a device fails by becoming inoperable, the stakes are a lot lower), you can lump basically any software that you don't have total control and design history on (so this includes random proprietary software and most FOSS stuff) as "software of unknown providence" (SOUP). Now based on the class of medical device you are developing, you can either get to use SOUP without justifying at all, or you have to explain/justify why you can use SOUP at all. For example, even if your OS was Linux, because you don't have formal documentation on verifying that Linux infact does all the things its suppose to do (hell, does Linux even have a true spec?), you would then have to justify why you're using Linux. If a kernel update comes out, you then have to justify why you're using it. What you WOULD have to do is verify/validate that your software that interacts with SOUP (so in this case running on an OS) still works correctly. You would not have to verify/validate the OS update per se.

ChuckMcM 11y ago

I think you have it backwards (no disrespect intended). When you evaluate the choice of Windows you have to acknowledge that it brings with it the vulnerability of viruses and so the necessity of anti-virus software. Either you own that decision, and as part of your support your tool provides the necessary antivirus and you also insure through testing configuration management that its configured appropriately, or you choose a different option up to an including writing your own system to manage the "time critical bits". Having their software run in a Windows ecosystem that they do not have strict configuration management control over was a bad decision and on the basis of this failure report. That it did not result in patient injury or death was fortunate but is certainly not guaranteed.

Amezarak 11y ago
> When you evaluate the choice of Windows you have to acknowledge that it brings with it the vulnerability of viruses and so the necessity of anti-virus software. No matter what OS you choose it is vulnerable to viruses. You and I will agree that the odds are your Windows system is much more at risk by at least an order of magnitude. But the IA people who demanded that this system run antivirus are just as likely to demand that Linux run antivirus, simply because the vulnerability theoretically exists and making that demand fulfills their CYA requirements. I've worked on standalone Linux systems that IA demanded have antivirus. > Either you own that decision, and as part of your support your tool provides the necessary antivirus and you also insure through testing configuration management that its configured appropriately, or you choose a different option up to an including writing your own system to manage the "time critical bits". According to the article, the software runs on the user's hardware. While they certainly could have made a decision to provide their own controlled hardware, it's entirely possible that hospital was not open to that option for cost reasons, for IT management reasons, whatever.
- Diederich 11y ago
  Is the day to day impact of antivirus on Linux the same as on Windows?
  - 11y ago

deleted 11y ago

[deleted]