4 ms·

Crazy to think about the consequences of a mistake like this. This was sent by a friend to an email list I'm on: "Well, consider this community hospital fubare

by tumblen 16y ago

Crazy to think about the consequences of a mistake like this. This was sent by a friend to an email list I'm on: "Well, consider this community hospital fubared. IT dudes running around pulling out their hair. If it wasn't affecting patient care it would be a humorous scene-but I can't check xray's, or labs or anything. Took out a horrendously bloody gallbladder this morning, and I can't tell (labwise) if she's still bleeding...not good."

billybob 16y ago
Wow. Kinda makes me wonder if we should be using general-purpose computers for so many things. The anti-virus is kind of a major single point of failure for machines that need to do just a few specific things.
- chbarts 16y ago
  Best Practices, n.: Making the same mistakes everyone else does. However, what are the odds of someone being able to make special-purpose machines to do everything COTS boxes are used for, and making those machines as fast, cheap, and reliable as COTS systems are now? Some things seem obvious (x-ray machines, lab machines) but accounting and record-keeping? Going back to adding machines and purely manual filing is not an option in a large hospital, especially if it has to maintain modern standards of patient care over a large patient population.
  - smhinsey 16y ago
    I think virtualization takes you a long way towards the solution to this issue. With Win7 I've gotten into the habit of routinely working on virtual instances using the boot from .vhd feature. This means that if something goes wrong my host is not impacted and I can revert to an earlier version of my .vhd to solve problems like this one. The standard IT "wait and see" policy makes this something that will take awhile to become common but I think it is the way to go for pretty much any critical path task you do on a Windows PC (other OSes such as OS X have similar features as well but I only use OS X for "media" stuff).
    - eru 16y ago
      And if you use a Type-1 hypervisor (i.e. one that runs on the bar metal) you should be even safer.
- cookiecaper 16y ago
  I don't think we need to move to special machines, we just need to move to sensibility in choices. Why do these need to be running Windows? Even if they're running Windows, why do they need an antivirus? Are you letting people on attachments from their email or browse the internet on the same box that you're using to read X-rays and other medical imagery? Kind of weird to do that, right? I need to think about how to exploit this to promote the installation of *nix-based systems and get people to hire my company to do it.
  - niels_olson 16y ago
    Doc here: do you run a subversion client or an IDE on the same machine you check email or browse the web with? kind of weird to do that, right? I'm all for nix-based systems. Please, oh please, convince these people to go to nix and web app (that aren't slaved to IE: eg, AHLTA, or Fuji's Synapse imaging software). I will give you their numbers.
    - cookiecaper 16y ago
      I actually freelance with a group that is making a web app for viewing medical imagery. Has a Flex-based frontend, though. I guess I don't understand the use case -- I had assumed that the computers needed to tell if a patient was bleeding or not were connected to a machine that did some kind of image-taking or internal measurement, and that that machine was the stationary "is patient bleeding machine" computer. Do doctors generally perform analyses like that one on personal computers or normal workstations? I guess I just got a false impression from medical dramas or something.
      - jonknee 16y ago
        What if the doctor reading the scan is in another city/country? That's becoming increasingly more common. Though on the AV front it doesn't make sense to have all of your organization's computers running critical software to update at the same time (no matter what software, it just happened to be the anti-virus this time).
    - 16y ago
- joezydeco 16y ago
  It'll all move to thin clients and the cloud. Just watch. Not saying it's better, and in fact it'll be worse. The net goes down way more than the AntiVirus gets a bogus config file. But you'll see cash-strapped facilities get sold on the idea of cheaper clients on-site and a large server with a juicy maintenance package behind it.
- azharcs 16y ago
  reminds me of this funny XKCD http://xkcd.com/463/ http://xkcd.com/463/
- houseabsolute 16y ago
  A better solution is to disable all kinds of automatic updating on computers you manage and canary changes on just a couple of machines first.
deleted 16y ago
[deleted]

by tumblen 16y ago

billybob 16y ago

Wow. Kinda makes me wonder if we should be using general-purpose computers for so many things. The anti-virus is kind of a major single point of failure for machines that need to do just a few specific things.

chbarts 16y ago
Best Practices, n.: Making the same mistakes everyone else does. However, what are the odds of someone being able to make special-purpose machines to do everything COTS boxes are used for, and making those machines as fast, cheap, and reliable as COTS systems are now? Some things seem obvious (x-ray machines, lab machines) but accounting and record-keeping? Going back to adding machines and purely manual filing is not an option in a large hospital, especially if it has to maintain modern standards of patient care over a large patient population.
- smhinsey 16y ago
  I think virtualization takes you a long way towards the solution to this issue. With Win7 I've gotten into the habit of routinely working on virtual instances using the boot from .vhd feature. This means that if something goes wrong my host is not impacted and I can revert to an earlier version of my .vhd to solve problems like this one. The standard IT "wait and see" policy makes this something that will take awhile to become common but I think it is the way to go for pretty much any critical path task you do on a Windows PC (other OSes such as OS X have similar features as well but I only use OS X for "media" stuff).
  - eru 16y ago
    And if you use a Type-1 hypervisor (i.e. one that runs on the bar metal) you should be even safer.
cookiecaper 16y ago
I don't think we need to move to special machines, we just need to move to sensibility in choices. Why do these need to be running Windows? Even if they're running Windows, why do they need an antivirus? Are you letting people on attachments from their email or browse the internet on the same box that you're using to read X-rays and other medical imagery? Kind of weird to do that, right? I need to think about how to exploit this to promote the installation of *nix-based systems and get people to hire my company to do it.
- niels_olson 16y ago
  Doc here: do you run a subversion client or an IDE on the same machine you check email or browse the web with? kind of weird to do that, right? I'm all for nix-based systems. Please, oh please, convince these people to go to nix and web app (that aren't slaved to IE: eg, AHLTA, or Fuji's Synapse imaging software). I will give you their numbers.
  - cookiecaper 16y ago
    I actually freelance with a group that is making a web app for viewing medical imagery. Has a Flex-based frontend, though. I guess I don't understand the use case -- I had assumed that the computers needed to tell if a patient was bleeding or not were connected to a machine that did some kind of image-taking or internal measurement, and that that machine was the stationary "is patient bleeding machine" computer. Do doctors generally perform analyses like that one on personal computers or normal workstations? I guess I just got a false impression from medical dramas or something.
    - jonknee 16y ago
      What if the doctor reading the scan is in another city/country? That's becoming increasingly more common. Though on the AV front it doesn't make sense to have all of your organization's computers running critical software to update at the same time (no matter what software, it just happened to be the anti-virus this time).
  - 16y ago
joezydeco 16y ago
It'll all move to thin clients and the cloud. Just watch. Not saying it's better, and in fact it'll be worse. The net goes down way more than the AntiVirus gets a bogus config file. But you'll see cash-strapped facilities get sold on the idea of cheaper clients on-site and a large server with a juicy maintenance package behind it.
azharcs 16y ago
reminds me of this funny XKCD http://xkcd.com/463/ http://xkcd.com/463/
houseabsolute 16y ago
A better solution is to disable all kinds of automatic updating on computers you manage and canary changes on just a couple of machines first.

deleted 16y ago

[deleted]