Things To Consider When Buying Computers For Your Medical Practice

Things To Think About When Buying Computer Equipment For Your Medical Practice

Money can be tight when you’re starting up your medical practice or small business, and it can be very tempting to save money by buying cheap computers –  but this decision can end up costing you more in the long run in terms of lost productivity and early equipment replacement.

TLDR; Buy the most powerful PCs (for stationary positions) and laptops (for “mobile” staff)  you can afford, with the pro version of the latest Windows operating system (ie: Windows 10 Pro). Don’t worry about dedicated graphics – focus on getting the best CPU, with the most RAM and a solid state drive.

Here are some things to consider to help you buy the right equipment, keep costs down, but also future-proof yourself and improve your workflow.

Apple or Windows?

Windows. You’ll be hard pressed to find a server based EMR or practice management software that runs effectively on a Mac unless you’re using remote desktop or some other solution to connect to a dedicated server. Even web-based solutions require bridging software to talk to their peripherals, most of which will not work with Apple products. While there are ways around this, and it is certainly possible to have an Apple based office, save yourself a headache and the cost.

Do I need desktop computers if can we use laptops and tablets?

Straight answer – it depends on what you’re using them for:

For the reception, office manager, and other admin staff, which is an essentially stationary position, I would always go with actual PCs.

Check-in, and check-out positions tend to require extra peripherals to be connected directly to the computer such as webcams for taking pictures of the patients, signature pads, card scanners and credit card terminals. These all require extra ports to be available on the machines which laptops typically do not have enough of.

PCs also allow you the flexibility to have dual monitor setups which make working in an EMR considerably easier, especially when you have other programs as well. This increases efficiency, reducing the amount of time your front desk staff spends processing each patient.

It’s also easier to upgrade components in PCs than laptops which enables you to use the hardware longer and at a lower cost.

For staff who are mobile within the office, such as physicians, mid-levels, and nurses that are seeing patients, I would go with laptops.

Laptops are portable enough that you can bring them into the exam room with you and document while you are with the patient. I’ve seen this save between 5 and 10 minutes a patient allowing for a higher volume of patients to be seen during the day. It also helps prevent issues where a provider may forget to document something that was noted during the exam if they become distracted or are diverted after leaving the exam room and have to document later.

I wouldn’t use tablets. Tablets, while portable, tend to be underpowered and documenting on them tends to be considerably slower, even when they are equipped with a keyboard. – Sidenote – I’ve seen clinical staff almost cry when I’ve asked them to work on a device where the keyboard didn’t have a numeric keypad…

Use of tablets can also lead to issues relating to printing unless you take extra steps to prevent that.

Are you using a server or web-based EHR/EMR?

Server-based EMRs, whether the server is onsite or offsite, typically require you to install dedicated software on your computers in order to be able to use the system. In my experience, this software is typically enough to bog down slower computers, which reduces efficiency, and the requirements for this software only increase over time.

Web-based EHRs tend to have much lower requirements than server-based. Often all you need is a modern browser such as Google Chrome, Microsoft Edge or Firefox, and usually a small lightweight piece of software to bridge the gap between the browser and the peripherals.

Even for web-based solutions, I would caution against skimping here. Your PCs will have a lot of peripherals attached to them, many of which will also be running their own software. The combined load can significantly slow down older or less powerful PCs resulting in reduced efficiency, unhappy staff, unhappy patients, and reduced patient throughput.

What about my network?

Your network is definitely an area not to skimp on – all of your data, print connections, file shares, internet access, streaming audio and maybe even your VoIP phone connections will travel over your internal network so it had better be fast –  although fast doesn’t mean that it has to be expensive. Gigabit switches are cheap these days, and every switch on your network needs to have gigabit capacity or you will create a bottleneck and slow things down.

Your router is no exception. I’ve seen offices with Gigabit networks hampered by poor or aging routers acting as both their firewall and DHCP server. For example, I was recently at an office that despite having a robust network was using an older Cisco Security Appliance as their router and DHCP server. The appliance in question could handle 40000 packets per second, which was causing a bottleneck and resulted in IP addresses not always being released or assigned (which meant devices were sporadically unable to connect to the network). Replacing it with a newer router for less than $300 increased the throughput to 2 million packets per second and alleviated the issues.

Don’t use domestic wi-fi equipment for your office or guest networks. They’re just not built to take the number of devices you’ll have connected to it. For example -let’ss say you have 7 laptops, 10 cell phones (that’s one for each member of staff – let’s be honest everybody wants to use work’s data instead of their own), 4 tablets (used for patient check-in), 2 streaming audio devices such as Sonos (it’s nice to have music that’s not muzak in the clinical area), and you’re already up to 23 devices before you even think about adding a guest network.  Equipment such as Ubiquiti Unifi is as cheap as if not cheaper than many home wi-fi solutions but will be far more reliable with much higher capacity and allow for easier expansion.

What do I recommend?

Every situation is unique but in general,  I recommend that you focus on interoperability, expandability, performance, and cost first.

The easiest way to achieve this is with Windows-based PCs. They’re relatively cheap, work with almost everything and won’t limit your choice of EHR or practice management solution.

When purchasing, focus on getting the best processor, the most RAM (8 gigs minimum but 16 would future-proof you) and an SSD (solid state drive). It doesn’t have to be a large SSD – 128 Gigs should suffice most computers as important file storage should be centralized and backed up. You could go with a traditional hard drive here if storage space was more important to you than speed.

Don’t worry about spending money on graphics cards – the integrated graphics chips on modern PCs are more than a capable of driving dual displays and anything the standard office environment can throw at them. Your staff should not be playing Fallout 4 on them.

Laptops should also fit a similar description, but the important thing here is the form factor and screen resolution. To get the most efficiency out of your EHR you’ll require a screen resolution of typically 1920 x 1080. Smaller screens will start hiding menus forcing you to click around more.

The form factor or size of the laptop is a matter of personal preference. Keep in mind that you’ll be carrying the laptop around all day, so lighter is better, but don’t get too caught up in it. Most laptops, even the larger ones with full numeric keypads, are light enough to tote around all day as most of the time you’ll put them down when you get in the room.  An SSD is essential here though, as they have no moving parts which can help avoid damage which would occur to a traditional hard drive if there was a drop or bump.

Obviously, I haven’t covered everything that you need to think of here, such as implementing a refresh cycle, servers, on-site and off-site backups, redundancy etc, but I hope I have given you a good place to start.

Dear Podcasters, You’re Ruining My Run (Podcast Loudness)

Audio stereo WAV in Audition CCI’ve been making a concerted effort to get back into shape and while I’d love to say that my beer-gut is diminishing, sadly the most noticeable result has been a growing irritability caused by podcasts that are all published at different audio levels.

Let’s talk about LUFS:

Loudness, K-weighted, relative to Full Scale (or LKFS) is a loudness standard designed to enable normalization of audio levels for delivery of broadcast TV and other video.

LKFS is an abbreviation of:  Loudness K-weighted Full Scale, and one unit of LKFS is equal to one dB. The LKFS term is used in the ITU BS.1770 standard and the ATSC A/85 standard also operates with this term. Other organizations, such as The European Broadcast Union (EBU), uses the term LUFS, which is an abbreviation ofLoudness Units Full Scale. Despite the different names, LFKS and LUFS are  identical.

The LKFS standard (ITU standard) is what allows you to listen to the radio at a consistent level without having to turn the radio up or down every time a new tune is played (unless they’re cranking out some AC/DC then you have to turn up the stereo – it’s the law). That’s awesome right?

What’s not awesome is when I’m on the treadmill and every other podcast is barely audible over my headphones, while others are way too loud, forcing me to have to repeatedly fiddle with the audio levels on my phone.

Let’s face it – I’m not the most graceful of people at times. One of these days, pulling my phone out of my pocket while running is going to result in my breaking a leg as I go flying backwards off the treadmill and into the min-fridge.

The solution is to make sure that every podcast has consistent audio levels, and the magic number that has been settled on is -16 LUFS. I’ve embedded a tutorial by Mike Russel from Music Radio Creative so you can see just how ridiculously easy it is to do Adobe Audition CC.

I don’t know if Audacity can adjust LUFS out of the box (it’s been years since I’ve used it) but I’m sure there are plugins for it (a quick search found this LUFS meter), and even mobile podcasting apps like Auphonic can automatically adjust the levels as they process the audio.

So fellow podcasters, there’s really no excuse to now have your audio at the correct levels and give podcast listeners the best experience, is there?

Migrating Mozilla Thunderbird From One Computer To Another

Thunderbird 3Mozilla Thunderbird may be an excellent email client (and PIM with the right extensions) but for all the wealth of extensions available and it’s myriad of import options, it’s still incredibly difficult to export data such as email, accounts and settings.

I faced that very problem today.

When I’m developing or doing video editing on my main laptop I don’t want to have my email client running. Having it open is not only a distraction but sucks up valuable resources, so today I decided to install a second copy of Thunderbird on my other machine so I could access my email no matter what I was doing or running.

I access all of my email through IMAP, so if I had just a single email address I wouldn’t have worried too much about just installing Thunderbird and manually setting up the account. Unfortunately I am not blessed enough to get by with just a single email address, not even remotely close, so other methods were required.

The method I’m about to show you will work on Windows XP, Vista, Windows 7 & Windows 8 (Update: works with Windows 10), can be accomplished in less than 10 minutes and will allow you keep all of your email settings and email (doesn’t matter if you use POP3 or IMAP).

In order to make the migration, you’ll need a flash drive (preferably with a large storage capacity if you are a POP3 user), portable hard drive or a network connection with shared folders between both machines.

I’ll be explaining how to do it using a flash drive or portable hard drive.

Okay lets get started shall we?

Download the latest version of Thunderbird to the machine you want to install it on and start the installation process.

While that is installing go to the machine where your email currently exists.

Make sure that Thunderbird isn’t running and plug in your thumbdrive.

Windows Vista and Windows 7 navigate to the following location:

C:Users[Username]AppDataRoamingThuderbirdProfiles

Windows XP users browse to:

C:Documents and SettingsPaulApplication DataThunderbirdProfiles

Inside that folder you’ll see a file that should be named something like: XXXXXXX.default

Copy this file to your flash drive. You may need to compress it using a tool like 7Zip if it’s too large to fit on the flash drive.

Once it’s copied eject the thumbdrive and and take it back to the machine you just installed Thunderbird on.

Make sure Thunderbird is fully installed and then run Thunderbird for the first time.

Once it starts exit out immediately. Don’t enter any data or set anything up. By letting it run once it sets up all the folders you need in your Application Data folder which we can now replace with the file on your flash drive.

Once Thunderbird is closed, navigate to the same folder as you were at before (except on the new machine) and delete the XXXXXXX.default file you find in there.

Once it’s deleted copy the XXXXXXX.default file from your thumbdrive (decompress if necessary) into the folder.

Next Windows Vista and Windows 7 users should navigate to:

Windows Vista and Windows 7 navigate to the following location:

C:Users[Username]AppDataRoamingThuderbird

Windows XP users navigate to:

C:Documents and SettingsPaulApplication DataThunderbird

Inside this folder you’ll find a file called profiles.ini.

Open profiles.ini using Notepad or your favorite text editor.

It should look something like this:

[General]

StartWithLastProfile=1

[Profile0]

Name=default

IsRelative=1

Path=Profiles/XXXXXXX.default

Change the value of XXXXXXX.default in profiles.ini to match the value of the original XXXXXXX.default file you copied from your flash drive.

Save the file, close all open windows and start Thunderbird.

If you’ve done everything correctly Thunderbird should start up without problems.

If you get an error saying something like: “Thunderbird is already running in another window“, then recheck the value of XXXXXXX.default in profiles.ini.

If it doesn’t match the original value then things won’t work and Thunderbird will keep throwing that error.

If  you originally created your signatures for your email accounts inside Thunderbird then you’re all done.

If, like me, you’ve got them saved as text files then you’ll need to copy them to the new machine and go into the account settings for each email account and make sure that it is pointing to the correct location for you signature files.

That’s it, you’re all done 🙂

Dealing With Lack Of Attribution For Your Content

One of the problems that most bloggers and content creators face regularly is finding our content reposted on other sites without proper attribution.

In this short video, I give some tips from my own experience both as a content creator and as someone who run sites which aggregate content, to ensure that you can both receive the credit you deserve for your content and the issues surrounding sites that have posted your content without attribution.

I hope you find it useful 🙂

Favicons Are So Easy To Create. Where’s Yours? (How To)

favicons in tabsFavicons are those cool little graphics that site in the address bar and tab of your browser.

I’m amazed by how many sites either don’t have one, or are using which ever one shipped with their CMS.

Feed ReaderFavicons are a wonderful tool for branding as they provide a visual identifier to help your site stand out from all the other anonymous tabs a reader may have open. They also help your content stand out in feed readers such as Google Reader.

As I’m sure you can see from the image on the right, the blogs with favicons stand out and are far more identifiable than those which don’t have one. Those without favicons get stuck being displayed using the standard blue RSS icon in Google Reader.

Hopefully you can see mine above and have one already in place on your site.

If you don’t have one, here’s how to get one done in 3 easy steps.

  1. Fire up your favorite image editor and create a square image (200×200) and design the icon you’d like. Keep in mind that this will be reduced to 16×16 pixels in size, so don’t make it too intricate.
  2. Upload the 200×200 image to the Dynamic Drive FavIcon Generator. FavIcon Generator will reduce your image the necessary 16×16 size and output it as a favicon.ico file.
  3. Upload “favicon.ico” to the root of your site and then add the following code to the header of your site. It should be inserted before the “</head>” tag.

<link rel=”shortcut icon” type=”image/x-icon” href=”/favicon.ico”>

Clear your browsers cache and the cache on your site if you use one, hit refresh and enjoy your new piece of persistent visual branding.

FYI, there are a number of other favicon generator scripts online, but the Dynamic Drive one does the best job of reducing your image while keeping the best quality.

Enjoy!

FeedBurner Not Updating Your Feed? Check The Size

FeedBurnerIt can be hard to track down problems with your RSS feed and for the past two days I’ve been trying to figure out why FeedBurner wasn’t updating my feed.

Basically the problem with my feed was that it was too large as I had somehow managed to change the settings in WordPress to include the last 30 posts in the feed.

It was a pain in the ass to track down too, because the raw feed of this blog displayed in IE and could be subscribed to in feed readers without problems, yet tools like Feed Validator and the W3C feed validator insisted that there was no feed or an error.

As with so many things in this world, size is everything and in this case mine (RSS feed) was just too large. The tools mentioned above simply couldn’t handle the size and FeedBurner was so intimidated by it that it simply refused to update.

The fix, in this case, is a little cosmetic surgery to reduce the size. By dropping the number of posts from 30 to 10, everything started working again.

For future reference, if you want FeedBurner to let you on board, you may need to snip the tip a little and reduce your RSS feed file size to below 512K, which is about all it can handle.

20 Tips for creating fresh ideas

We all need fresh ideas. From our personal lives to our blogs, from business to entertainment, rehashing old ideas gets, well old, and very quickly.

It’s good to have variety, it’s great to have spice and it’s even better when we come up with an idea that nobody else has, or is implementing. Those kind of ideas lead to happiness, profit and in my case an 18+ hour work day.

I’m posting 5 of my favourite tips from Daily Blog Tips “20 Tips for Coming Up with Fresh Ideas”, which I couldn’t resist linking to simply because they’re first tip is so me.. “Be really grumpy!”

  • Be really grumpy! Keep track of the things that annoy you. This is a great place to start, as you know the problem intimately as well as being the first customer for any solution.
  • Go people-watching. Unleash your inner spy! Spend time watching people go about their everyday lives. What are they doing? How do they do it? Can you spot any obvious problems?
  • Distract yourself. Have a change of scene. Do something that you love doing that has nothing to do with your business or blog. Get lost in what you’re doing. Often we come up with solutions when we’re not even thinking about the problem in the first place.
  • Critique everything. Question everything, and ask yourself “why?”! Intelligently analyse your environment and think of improvements. See what lessons you can learn about the good and bad things in your environment. – (It’s what  kids do all the time – Paul)
  • Think like a child. Children have a fantastically simplistic and candid view of the world, something we lose as we become adults. Employ a strong sense of curiosity and simplicity when looking for solutions. So many things in this world happen due to convention or habit, so thinking like a child helps to break this pattern.

O’Flaherty Vidcast #02 – Auntie Akismet

Auntie Akismet!

In this screencast I show you how to easily check hundreds of WordPress comment spams for false positives.

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