CTO Tech Blog

Inspiration for writing sometimes comes from odd places.  This week I had a lot of time to observe many of the ways computers and information technology are used by doctors and hospitals while spending an unplanned day in their company.  That, combined with my own experience installing and maintaining networks and electronic medical records (EMR) software for hospitals and clinics, seemed to be a good basis for this week's blog.

When I started working with healthcare over 10 years ago, computers were starting to come in to hospitals where they were used mainly for patient record transcription and some patient information.  Most of what was entered in to a computer would be printed and filed along with to typed and handwritten records.  Over time applications started to become available to assist with operating room booking, provincial health insurance submissions, and some specific diagnostic databases to assist physicians. In addition, the growing IT departments in hospitals would use databases to keep track of assets including medical instruments, beds, and even the computers themselves.  Many people had a vision of eliminating paper records in favour of electronic records, real time tracking and locating of assets such as heart monitors, and doctors carrying personal digital assistants (PDAs) or tablets to create and retrieve patient records and diagnostic information.  The hospitals were leading the charge by purchasing applications and systems to help manage many aspects of operating a hospital.  Security was and is a major focus for the It staff who implement and manage these systems which presented more challenges.  Security inherently adds complexity to any system which in turn decreases productivity and people's willingness to use the systems.  For hospitals, where doctors typically have a private practice as well as their use of hospital facilities, they need access to patient information in both locations but need to maintain the security and confidentiality of those records.  Private practices, if they even have computers, use many different software applications with different methods of access which causes more management challenges for hospital IT staff from a security perspective.

There have been two schools of thought regarding patient records in the medical community.  On the one hand, there are many benefits to using a standard common format for storing and sharing patient information.  Easy and rapid access to patient information would improve healthcare.  The provincial governments in BC and Alberta, among others, are proponents of this type of standard.  On the other hand, there is a sense of ownership that doctors have for patient information.  Giving someone easy access to information may cause too much reliance on this information and remove some elements of critical diagnoses.  Open sharing of patient information could have begin to eliminate the idea of family physicians who often know more about their patients than can be expressed in a document.  My experience yesterday showed me both sides of the coin.  We were at two private clinics and two hospitals where we saw technology assisting in many ways from locating the patient after I parked my car; to electronic medical imaging that could be transported easily and quickly from one location to another; to the mesh of communication that got us through a large and cumbersome system with relative speed.  Through the whole experience we noted that staff was well informed and informative as well as sensitive to us as people.

In the end, the body being the amazing machine that it is, the problem rectified itself in the nick of time and saved us the risk and stress of surgery.  While I did see many opportunities for IT to help further in the process, in our case I was grateful for the time taken to do some things manually.  During that time the body keeps fighting on its own and in this case won the battle.

I doubt I have any American Readers, but my Canadian audience will know that tomorrow is Remembrance Day.  Last Friday I woke up to the news of an army major who went on a shooting rampage after hearing that he was about to be deployed to Afghanistan.  I wondered about the irony of training a man to kill people only to have him turn against his peers.  I have heard some suggestions regarding his state of mind, but none of us will ever truly understand what drove him to do what he did.  I am thankful that my own brother who served in the military never had to see “action” and think of my grandfather who died when I was eight, but to me will be remembered as a retired Sergeant from WW2.  Both of them served in very different militaries than what we have today.

This is a technology blog, so why am I talking about war and honouring those who served?  War making has become one of the biggest drivers of innovation in technology.  Today’s Internet was created to connect educational institutions and driven part from a need to connect military minds across the US in the form of ARPANET.  The satellite imaging that many of us use from Google’s Satellite View has been collected from military images that were only recently released to the public sector.  And many of the security technologies that are used by businesses are based on, if not actual, military and government encryption schemes.  Aerospace, medicine and other industries have also been enhanced my military technologies.  I am not an advocate of war in any way, but wars have happened without asking my permission, so I try to look at any good that comes out of it.  We all know that there are people in the world who will take advantage of others so it’s good to see that there are other people developing technologies that help protect us.  Data encryption schemes protect our personal information and assets such as bank accounts from those who would try to steal.  Imaging technologies like Google’s mapping technologies help emergency personnel locate those in need of medical care more quickly.  I’m sure at this point there are a number of other technologies still being developed by the military, and hope that they will one day become part of the vast pool of resources available to the public domain that help improve our lives and health.  I think that the best way to honour someone who served to protect our country is to look at the lasting improvements that they have given us.

Email is a wonderful tool for communication, both at work and at home.  It's almost as common today to ask for someone's email address as their phone number.  Unfortunately most, if not all, of us have received some form of spam in our mailboxes as well as our intended communications.

Spam is officially known as unsolicited commercial email or UCE.  The more common term "spam" was reportedly borrowed from a Monty Pithon's Flying Circus comedy sketch of the same name.  The connection presumably being the annoying nature and apparent unavoidability of UCE and the similar use of the popular Hormel Foods canned ham in the sketch.  Unlike the food product, email spam comes in a variety of flavours.  Commonly we see prosthetic and drug advertising emails that use constantly changing techniques to attempt to thwart spam filters.  These messages frequently have return email addresses that are non existent or that have been hijacked from some innocent party (sender spoofing).  I'll walk through some methods of sending spam and discuss some techniques to help reduce the amount of spam you receive.

Since spammers, the people who originate spam email, need to protect themselves from being identified and blocked by intended recipients they have had to find ways to send a large number of emails from various locations in a very short period of time.  The most common method of doing this is to use an open mail relay somewhere on the Internet.  An open relay is a mail server that will forward email from anyone (or anyone who knows how to get around security measures) to any potential recipient on the Internet.   In the early days of spamming the sender would usually create a new email account on a large free mail hosting service such as Yahoo! or AOL and send emails to a large list of recipients.  As the hosting companies clamped down on this type of activity they began to use complex scripts with multiple open relay servers and large lists of recipients.  Today most commercial email providers block relaying, but many smaller companies who host their own email servers often don't have the technical skills required to turn off relaying while still allowing their users to send and receive emails that they need to.  The lists of email addresses that spammers send to are created using various methods.  Some companies sell lists of email addresses gathered from their web site.  Since email is sent unencrypted over the Internet, the addresses can often be gathered by "listening" to traffic between servers.  Sometimes they will even send email to random names in an email domain (a domain is the part after the @ in an email address) and see which ones don't bounce back to them (directory harvesting).

A few methods to help avoid spam are to not enter your email address in web forms or use it to enter draws.  In cases where you need to do this, consider creating a "spam account" with one of the online email providers like Yahoo! or GMail.  Use this account when you're dealing with companies on the web that you don't know.  If your Internet provider offers a spam filtering solution it may be worth subscribing to it.  On a larger network where email is hosted in house, an anti spam appliance or dedicated server software are the best defence as they offload the traffic from the mail server.  Some PC based spam filters work well, but they usually need a subscription to keep up to date so they can continue to work effectively.  Spammers are constantly changing their methods so new defences need to be defined and applied.  Junk mailboxes and blacklists that are built into applications such as Microsoft Outlook also help, but they tend to rely on filtering by the sender and these days the sender is changed with every mailing that goes out.

Just make sure you put my email address on your white list.

Last Thursday we saw the release of Windows 7 and along with it a new Mac commercial on television.  Apple is attacking Microsoft’s promises of a more stable feature rich operating system as expected, but this time I think they’ve missed the mark.  I have to admit that I love Apple’s commercials even though I believe PC’s are still the better choice for business even with XP or Vista.  Everyone knows about programming flaws and vulnerabilities in the Microsoft family so what makes it a better platform?  The entrenchment that XP has in business makes it the defacto standard.  Because of this most applications are written for Windows even though many are reworked to support Macs as well.  While some aspects of configuring and securing Windows are beyond many users abilities, they are more flexible and granular so that IT departments can employ more business aligned configurations.  In addition, a large part of the lack of known flaws in the Mac operating system is simple obscurity.  Hackers don’t spend as much time trying to break the code of systems that are not used as widely in business.  There have been viruses and security flaws in many versions of Mac OS but they are not as widely discussed as those in Windows.

I have been running Windows 7 at home and in my office for a number of months and my experience has been that it is living up to Microsoft’s claims of better speed and reliability.  At home I transitioned from Windows XP where I would experience unexplained slowdowns and a very slow boot process.  At work, speed was an issue as well as having a very cluttered start menu and desktop from all f the third party applications I needed to support all of the features I require.  In both cases Windows 7 has made a noticeable difference.  Boot time on both systems is short enough that I don’t have to go find something else to do while waiting and the systems are very responsive when opening new applications.  The user interface at first appears very different with an unlabeled circle instead of a start button and the way that windows fade in and out of view as I run my mouse over them on the taskbar.  The reality is that there was virtually no learning curve and I find the new nested task bar makes it much easier for me to find a certain window in the rash of applications that I tend to run concurrently.  There are a couple of security features that I’ve had to get used to.  The two main ones are; being prompted to do some things as an administrator even though my account has full privileges and not being able to download files to certain locations on my hard disk.  In both cases these new features force me to be aware of the security of my system, one by prompting me to accept that administrative privileges will be used and the other by only allowing files to be saved in certain folders, but the reality is that I used to do those things myself… most of the time.

Would I recommend running out and upgrading your computers all to Windows 7?  No.  The reality is that XP is still viable in most situations and it isn’t worth the expense of upgrading unless you have a specific need for some of the new features.  I would, however, say not to shy away from Windows 7 when purchasing a new system or when considering a major upgrade or reinstallation.

When I first started hearing about virtualization in the computer industry, it seemed about as tangible as the multi-headed monsters of Greek mythology.  Fortunately I’m surrounded by talented young technical staff who aren’t afraid of diving into new technologies head first.  Like many things, once I made a small leap in thinking, the technology wasn’t as daunting as it appeared.

Although server virtualization is typically marketed as an “enterprise solution”, I have come to see value for businesses of any size.  Before I dig into the value, I guess I’d better see if I can help all of you make that same leap in thinking.

Traditionally computer and network server operating systems each require dedicated hardware to run on.    In large enterprises there are often many servers each running a single purpose application.  This approach presents many challenges, but I will only discuss two that are mitigated by virtualization here.  The first issue is that each of these servers are typically running at less than 10% of their potential computing power, yet still draw almost as much electrical power, generate almost as much heat, and occupy exactly as much space as a server that is 100% utilized.  The second issue focuses on the Microsoft Windows operating system.  Windows based servers are prolific in businesses.  Probably the biggest drawback to Windows from a reliability perspective is a tendency to crash for seemingly unknown reasons.  Microsoft has collected data on many crashes and has determined that approximately 70% of crashes can be directly attributed to 3^rd party driver issues.

Virtualization could simply be defined as allowing a single physical server, or "host", to run multiple independent server operating systems at the same time.  This allows the combined utilization of the virtual servers, or "guests", to more optimally utilize the available resources of the physical hardware.  This approach saves power, cooling costs and physical space.

Another benefit of virtualization is that the virtualization software presents a common set of computing resources (ie: CPU, RAM, video card, etc) to the virtual server regardless of the physical differences of server hardware.  This means that virtualized servers run a common set of drivers instead of the 3^rd party drivers that cause 70% of server crashes, essentially eliminating that risk.  In addition, because of the use of a common driver set, a virtual server can be moved to any supported server without the need to rebuild operating systems or load new drivers.

Microsoft and VMware both offer free versions of their virtualization platforms that can help provide any business with more secure and stable computing environments.