We're a citrix shop so we primarily use secure gateway for remote access. We have two factor authentication using RSA keyfobs. Vendors are provided account credentials but we retain control of the corresponding keyfob. They must be in contact with the appropriate personnel to even login. Most of the time, one of our employees is shadowing the remote session as the vendor accounts have very limited privileges. It can be a pain having to babysit, but we're constantly in the loop and we havent had system brought down by a hair trigger 3rd party support person in quite some time.
- Sean On Aug 18, 2010, at 7:52 PM, "Raper, Jonathan - Eagle" <jra...@eaglemds.com > wrote: > I have my own opinions about eCW, but I doubt a significant % of the > list cares. > > However, I would be interested to know what everyone uses for > allowing vendors remote access and how that is logged/tracked in > such a way that could be audited. > > I'm not making excuses, but the type of access for remote access by > a vendor that you describe is not atypical. They use a VPN client > that we supplied to them, but aside from that, we have no way of > knowing which specific technician has logged into a system, and we > aren't restricting access - yet. The problem with restricting access > then creates the bottleneck/excuse from the vendor of, "we tried to > contact you to fix your problem, but we couldn't reach you in order > to gain access..." I've been down that road as well. Not a fun one > to try and explain to the shareholders. > > Other vendors have similar access. Before that, they had dial-in > access that had zero audit trail without court order. > > How would you propose tracking individual user access for your > vendors? > > Jonathan L. Raper, MCSE > > Thumb-typed from my HTC Incredible (and yes, it really is) Droid. > Please excuse brevity & any misspellings. > > ----- Reply message ----- > From: "Ziots, Edward" <ezi...@lifespan.org> > Date: Wed, Aug 18, 2010 6:03 pm > Subject: Off topic - Career Job Advice > To: "NT System Admin Issues" <ntsysadmin@lyris.sunbelt-software.com> > > Do you also have the Eclinical Works, wonderful support and upgrade > model using Logmein as a method of access. ( Can’t properly audit ac > cess to clinical systems ( workstations) because you don’t control t > he Logmein logs, can’t tie it into a actual user, can gain access wi > thout prior authorization, see where I am going with this type of st > uff, but the risk of not implementing the EMR is greater than all th > e little ways that it can be breached.) (Hate to see how folks are g > oing to justify it meeting MASS CMR 201.17, or HITRUST framework, or > HIPAA Regulation, or HITECH) > > Talk about a POS App, on top of a POS Support system, I almost > shudder the security flaws in the storage of PII/EPHI within that > system. ( Ohh yeah it runs apache tomcat, and MYSQL, and a Fax > service that is a true treat ( another POS). > > Talk about a risk-management nightmare.. but I digress… > > Its pretty sick, that is the best some of these companies that are > selling solutions to healthcare are providing. On one side they tout > the EMR as a benefit pushing towards govt’s initiative of nation wid > e EMR adoption, and on another side, vendors are actually providing > systems that can’t even meet the security requirements set forth in > the regulations ( Abeit, weak as they are) and might be putting hosp > itals and physicians practices at even more risk from breach accordi > ngly, because the basic security aspects of storing and protecting t > he confidentiality, integrity and availability of EPHI/PII was never > thought of when designing these systems. > > Then couple that with what is going on with meaningful use, and you > have a real appetite for destruction. > > Food for thought, > Z > > Edward E. Ziots > CISSP, Network +, Security + > Network Engineer > Lifespan Organization > Email:ezi...@lifespan.org > Cell:401-639-3505 > > From: Eldridge, Dave [mailto:d...@parkviewmc.com] > Sent: Wednesday, August 18, 2010 5:06 PM > To: NT System Admin Issues > Subject: RE: Off topic - Career Job Advice > > Very well put. I have seen a number of Docs here that have > calculated to the end when penalties will kick in and will retire > rather than accepting an EHR. We’ve also seen a big trend in Docs be > coming employees of the hospital rather than take on the task of imp > lementing an EHR also. Our hospital based Physicians group is boomin > g. Thus the eclinicalworks. > > I fourth/fifth the suckiness of eclinicalworks. I would have never > picked it but I wasn’t asked. Their support is next to last if not t > he bottom. > > From: Raper, Jonathan - Eagle [mailto:jra...@eaglemds.com] > Sent: Wednesday, August 18, 2010 2:31 PM > To: NT System Admin Issues > Subject: RE: Off topic - Career Job Advice > > I hear ya, but believe it or not, that’s only a fraction of the cost > of healthcare. Malpractice insurance is absolutely ridiculous. But > I digress. > > Regardless, healthcare CAN be a good place to be if you’re in IT (at > least for now until the government gets a hold of it and then all b > ets are off). The number of (particularly leading edge) technologies > I’ve been able to touch and implement over the years has been amazi > ng. Non line-of-sight RF, Free Space Optics, MetroE, plus everything > else I mentioned earlier. > > Part of the reasoning for me saying this (Healthcare IT being a good > place to be) is that doctors have been practicing medicine on paper > since the dawn of time. It takes 8+ years to learn how to become a > doctor, because the decision trees used for treating patients are > very complex. In a matter of moments/seconds, a physician makes > possibly a hundred micro decisions in the course of treatment. It > truly has become second nature to them and is practically a > subconscious thought process to get to a desired outcome/treatment > plan. Put a computer in front of them, and now they have to > consciously think through each of those little decisions in the > charting process, which slows them down considerably. So, up to now/ > recently, the idea of moving a doc from the paper world has been an > insurmountable task, because it is almost like telling a doc that > they, after 20 years of practicing medicine on paper, have to go > back to school – so that they can learn how to practice medicine usi > ng a computer. Computers bring to the forefront how truly complex th > e decision processes are that a physician goes through for each and > every patient. In putting a computer in front of a physician, they l > iterally have to cut their office schedule in half until they can ge > t up to speed on the new system. Some docs take only weeks to get ba > ck to 100%, but for many, it can take MONTHS. > > > Jonathan L. Raper, A+, MCSA, MCSE > Technology Coordinator > Eagle Physicians & Associates, PA > jra...@eaglemds.com<BLOCKED::mailto:%20jra...@eaglemds.com> > www.eaglemds.com<BLOCKED::http://www.eaglemds.com/> > > ________________________________ > From: Roger Wright [mailto:rhw...@gmail.com] > Sent: Wednesday, August 18, 2010 2:00 PM > To: NT System Admin Issues > Subject: Re: Off topic - Career Job Advice > > Wow, no wonder our healthcare costs are zooming upward! > > > Roger Wright > ___ > > When it's GOOD there ain't nothin' like it, and when it's BAD there > ain't nothin' like it! > > On Wed, Aug 18, 2010 at 12:10 PM, Raper, Jonathan - Eagle > <jra...@eaglemds.com > <mailto:jra...@eaglemds.com>> wrote: > +1000 > > In the past 15 months, we’ve implemented Citrix XenApp, EMC Avamar, > Cisco 802.11n with 802.1x over roughly 70 Cisco 1142 lightweight APs > , a complete network forklift encompassing 3750 & 3560 switches and > a number of Cisco 5510 & 5520 ASA firewalls, rolled out an additiona > l 160 Lenovo Tablet PCs, and converted more than 250 phone lines & 1 > ,900 phone numbers for 13 facilities from Windstream to PaeTec. > > Oh yeah, and we successfully rolled out eClinicalWorks EMR for 70 > providers/400 employees at 12 medical offices. > > Crazy/busy doesn’t even begin to describe life here over the past ye > ar. Things are finally settling down, though. > > Jonathan L. Raper, A+, MCSA, MCSE > Technology Coordinator > Eagle Physicians & Associates, PA > jra...@eaglemds.com > www.eaglemds.com > > ________________________________ > From: Eldridge, Dave [mailto:d...@parkviewmc.com<mailto:d...@parkviewmc.com > >] > Sent: Wednesday, August 18, 2010 11:38 AM > > To: NT System Admin Issues > Subject: Re: Off topic - Career Job Advice > > ++1 > > Things here are crazy and exciting at the same time. I have never > been busier in my life. > -------------------------- > Sent using BlackBerry > > ________________________________ > From: pdw1...@hotmail.com<mailto:pdw1...@hotmail.com> <pdw1...@hotmail.com > <mailto:pdw1...@hotmail.com>> > To: NT System Admin Issues > <ntsysadmin@lyris.sunbelt-software.com<mailto:ntsysadmin@lyris.sunbelt-software.com > > >> > Sent: Wed Aug 18 09:28:50 2010 > Subject: RE: Off topic - Career Job Advice > That's really true in the healthcare field. With the Hitech Act and > meaninful use criteria, a lot of hospitals and private practices are > looking to either upgrade or install an EMR. Standard for > consultants is away from home Mon - Thu and home for the weekend. > > For anybody who has clinical experience and knows computers (and how > the two mesh together), it's a great time to be looking for a new > position. > ________________________________ > Date: Wed, 18 Aug 2010 08:51:12 -0400 > Subject: Re: Off topic - Career Job Advice > From: asbz...@gmail.com<mailto:asbz...@gmail.com> > To: > ntsysadmin@lyris.sunbelt-software.com<mailto:ntsysadmin@lyris.sunbelt-software.com > > > > I know globe trotters in the unmarried AND married categories. > > Globe trotters don't necessarily have to be gone out to sea for > months at a time. > > It is possible to be gone only for a week at a time, or to travel > extensively during the week and be back on weekends. There are a > lot of options, but it depends on the personalities and dispositions > of all involved (candidate and family) and the skill and clout of > the candidate. > > Number and age of children, length of the relationship, and other > statistics of life might be factors as well. > > Every situation is tailor made. > > ASB (My XeeSM Profile)<http://XeeSM.com/AndrewBaker> > Exploiting Technology for Business Advantage... > > Signature powered by WiseStamp<http://www.wisestamp.com/email-install> > > On Wed, Aug 18, 2010 at 8:40 AM, Ziots, Edward > <ezi...@lifespan.org<mailto:ezi...@lifespan.org > >> wrote: > I have been dis-abused…. > > I agree there is a lot of water between Sydney and Boston…. That and > a long plane ride ( I think its like 17 hrs). I know a few globe t > rotters myself, they enjoy the life, and they are single, for the si > mple fact, they are never in one place to start a relationship accor > dingly, and those that are married, if you aren’t home for months at > a time, its going to make the wifey very unhappy and you in divorce > court faster than you can blink in the long run. Thus the reference > to globe-trotting and single, it’s the more common scenario. > > But again to each its own… > Z > > Edward E. Ziots > CISSP, Network +, Security + > Network Engineer > Lifespan Organization > Email:ezi...@lifespan.org<mailto:Email:ezi...@lifespan.org> > Cell:401-639-3505 > > From: Ken Schaefer [mailto:k...@adopenstatic.com<mailto:k...@adopenstatic.com > >] > Sent: Tuesday, August 17, 2010 9:55 PM > > To: NT System Admin Issues > Subject: RE: Off topic - Career Job Advice > > There’s nothing about having to be single to be a “globe > trotter” – let me disabuse you of that notion – I meet all of > the criteria you list below. If you choose not to, then that’s obvio > usly a legitimate choice. But nothing is that far away on a plane th > ese days (except maybe travelling from Sydney to Boston) > > Cheers > Ken > > From: Ziots, Edward [mailto:ezi...@lifespan.org<mailto:ezi...@lifespan.org > >] > Sent: Wednesday, 18 August 2010 1:52 AM > To: NT System Admin Issues > Subject: RE: Off topic - Career Job Advice > > > Good views, defintely been lurking and following this thread. Some > of us, are stuck for certain reasons in the place we live, or within > the area that we have put down roots (for those that are married, > having extended family, or own a home, or any combination of the > three and other circumstances) and don’t have the flexibility, to be > single, and globetrot the world in search of the latest big project > to work on in a global environment, for those so career inclined an > d focus, then definitely follow your dreams and go for it, nothing i > s stopping you, and the experience will be something you can be prou > d of. > > As for the situation in Denmark, it’s a much different story in the > states as most know, so comparing Denmark to US or even UK is like c > omparing apples to oranges and might not be a fair comparison. > > There are pro’s and con’s in any job or position, but I truly > believe this above all else. If you work on a good team, and each me > mber of the team has your back and you have their’s when the stuff g > ets deep, that counts for a lot. If you are constantly challenged in > your job, and you feel you are at least moving ahead a little bit c > areer wise, then that is also a good thing. > > My view is your don’t always take a job for the money, its about car > eer advancement and the impact that your skills and experience bring > to the new job. There is always going to be new challenges, new peo > ple to meet, and build a team environment with, and the organization > /business/industry you are looking into should weight equally. > > Work/Life Balance, and benefits I believe these days are trumping > the insane amounts of money that was throw at prospective employees > (Salary, raises, bonus) back in the .COM era and before the stock > market bust. There is a new global reality coming about, and a lot > of the job loss that has happened might not be made up in the next > 10-15 yrs or if at all, no matter what the gov’t tells us, and no ma > tter which govt it is spitting the rhetoric. > > Just my two cents, agree or disagree its well within your rights, > because everyones situation is different and needs are different, > but in the end all the money in the world isn’t going to make you ha > ppy, and you certainly can’t take it with you to the flipside :) > > Z > > Edward E. Ziots > CISSP, Network +, Security + > Network Engineer > Lifespan Organization > Email:ezi...@lifespan.org<mailto:Email:ezi...@lifespan.org> > Cell:401-639-3505 > > From: Ken Schaefer [mailto:k...@adopenstatic.com<mailto:k...@adopenstatic.com > >] > Sent: Tuesday, August 17, 2010 1:22 PM > > To: NT System Admin Issues > Subject: RE: Off topic - Career Job Advice > > > Denmark has the benefit of an extremely flexible labour market – > it’s small economy where benefits are good, but workers acknowledge > the need for flexibility. There is very little long-term unemploymen > t in Denmark. They will bounce back fairly quickly. > > From my personal perspective – in the last few months I went from a > Tier 1 consulting firm to an architecture position on an enterprise > project (in another country). This project is crying out for good pe > ople. Worldwide, there are plenty of opportunities, as various compa > nies and governments still have money to spend. > > If you want to spend your life living in <Florida|etc> then that > will limit the opportunities available. It may be better to seek > something further afield if the job opportunity is worthwhile (and > the pay can compensate you for the cost in moving) > > Cheers > Ken > > > From: Andrew S. Baker [mailto:asbz...@gmail.com<mailto:asbz...@gmail.com > >] > Sent: Wednesday, 18 August 2010 12:35 AM > To: NT System Admin Issues > Subject: Re: Off topic - Career Job Advice > > > Even the most protected economies are hurting right now... > > http://www.nytimes.com/2010/08/17/business/global/17denmark.html?_r=1&partner=rss&emc=rss > > As Ken said, make sure you're doing what you like (to the degree > that you have control over it). Also, take every opportunity to > become as good as you can be. It doesn't completely insulate you -- > because the planet rarely operates as a meritocracy -- but it does > give you more options. > > ASB (My XeeSM Profile)<http://XeeSM.com/AndrewBaker> > Exploiting Technology for Business Advantage... > > > Signature powered by WiseStamp<http://www.wisestamp.com/email-install> > > On Mon, Aug 16, 2010 at 6:26 PM, Jon Harris > <jk.har...@gmail.com<mailto:jk.har...@gmail.com > >> wrote: > Florida has been hit hard by this economy and from where I was, I > saw a lot of the last in first out layoffs. That did not mean the > best was kept and in fact most of the good ones seemed to be > targeted. The longer a lot of Florida state workers (not at the > county or city levels but at the state level only) that I saw the > less they did and the more they pushed off to the less experienced > workers. The people at the top liked to build pyramids under them. > This did several things. Gave them more apparent power, protected > them from their own lack of knowledge/skill/brains, and allowed them > to point to someone else as the cause of the problem. > > Jon > On Mon, Aug 16, 2010 at 6:08 PM, Joseph Heaton > <jhea...@dfg.ca.gov<mailto:jhea...@dfg.ca.gov > >> wrote: > I wish my salary was equal to the private sector. Everything I've > read/heard/etc. shows me around 25% below an "equal" position in > private sector. Same goes for pretty much any IT job in the public > sector. > > Here's the rub with private sector vs. public sector employment. > And this will be my last comment, so as not to take this thread too > much more OT. The main reason, in the past, that people went into > public sector jobs was for the security, and the retirement. You > got paid less, but in the end, you would retire with a percentage of > your final salary for the rest of your life. This is a great perk, > in my opinion. You also have to understand the environments that > public employees are working in. For instance, DMV employees, while > you hear all kinds of stories of how they can be rude, deal with the > public directly, all day, and have to listen to people complain > about issues that the worker has nothing to do with, etc. Bottom > line, there are a lot of public positions that are not "nice" jobs. > But people do them, for "lower" salaries, working towards that > retirement. If the state(s) go to a 401K type retirement, vs. the > pension plans in place now, that then eliminates the greatest reason > for taking the lower paid public sector job. Imagine the type of > person that you'll get then... you think the quality of service is > bad now... how many people can you think of that will sit there and > take the abuse that some public employees suffer, at lower salaries, > and lower benefits? Something to think about, instead of just > blindly blaming the situation on state workers. > > That being said, I don't completely disagree with the comments being > made here. The greatest Bane and Boon to state workers, in my > opinion, are the unions. Bane, because (at least in my state), it > is virtually impossible to actually fire someone. I don't object to > downsizing/layoffs, etc. I object to how they are implemented. > I'll use my state as my example, again. In California, you have > around 80% of the state workforce within 5 years of retirement age. > The figures I've most commonly heard thrown around is a desire to > reduce the workforce by about 20%. The method brought up in 2008 by > our Governor? Layoffs... The way layoffs work in state work is > that a figure is attained, as to how many people are to get laid > off. These layoffs come from the least senior people, i.e., the > last hired (Last in, first out). Which means, if you layoff the > lowest 20% of your workforce, and the upper 80% is within 5 years of > retirement, who's going to be doing the work? Who's going to > process all the unemployment claims? Who's going to process your > vehicle registration, your medical claims, etc.? I don't object to > layoffs in general, but I think that agencies/departments should be > able to do layoffs based on performance, not how long their butt has > been in the chair. > > Anyway, I apologize if I've offended anyone, that is never my > intention, but, being a state worker, with less than 3 years in > service, I think about this stuff a lot... and worry about it a lot > too. > >>>> Jacob <ja...@excaliburfilms.com<mailto:ja...@excaliburfilms.com>> >>>> 8/16/2010 2:42 PM >>> > Agree.. you are going to start seeing more 401K type retirements and > workers will start paying more into insurance. In about 5 years or > less, salaries and benefits of government jobs will equal private > jobs. > > -----Original Message----- > From: Kurt Buff > [mailto:kurt.b...@gmail.com<mailto:kurt.b...@gmail.com>] > Sent: Monday, August 16, 2010 1:57 PM > To: NT System Admin Issues > Subject: Re: Off topic - Career Job Advice > > Take the private sector job. > > Government employment levels are unsustainable at their current > levels, in every State of which I'm aware, and cuts are coming, IMHO. > > Kurt > On Mon, Aug 16, 2010 at 03:34, Andy > <pn1...@yahoo.co.uk<mailto:pn1...@yahoo.co.uk > >> wrote: >> Hello >> I'm currently a Infrastructure and Support manager for a mid size >> (1000 employees) retail company. My job basically means I manage a >> team off 8 people and look after the service desk and support team, >> manage our external contracts and run any infrastructure projects >> we have eg WAN upgrades/Server consolidations etc... Anyway I've >> been looking to leave and have been offered 2 jobs. One is in the >> public sector as a Infrastructure Delivery Manager. The job >> involves managing a team of 20, with 3 direct reports, creating >> KPIs, improving uptime etc.. While the other one is a >> Infrastructure Project Manager for a private firm. The job involves >> running all infrastructure projects, no direct reports. >> >> Both jobs are good ones, the project manager job pay a few thousand >> more and has bonuses but has no pension/other benefits. While the >> public sector one includes final salary pension, more holidays. >> >> I'm really having a difficult time choosing which one to take and I >> was hoping you guys could share your thoughts on it. >> >> Thanks > > > > > > > > > > > This e-mail contains the thoughts and opinions of the sender and > does not represent official Parkview Medical Center policy. > This communication is intended only for the recipient(s) named > above, may be confidential and/or legally privileged: and, must be > treated as such in accordance with state and federal laws. If you > are not the intended recipient, you are hereby notified that any use > of this communication, or any of its contents, is prohibited. If you > have received this communication in error, please return to sender > and delete the message from your computer system. > > > > > ________________________________ > Any medical information contained in this electronic message is > CONFIDENTIAL and privileged. It is unlawful for unauthorized persons > to view, copy, disclose, or disseminate CONFIDENTIAL information. > This electronic message may contain information that is confidential > and/or legally privileged. It is intended only for the use of the > individual(s) and/or entity named as recipients in the message. If > you are not an intended recipient of this message, please notify the > sender immediately and delete this material from your computer. Do > not deliver, distribute or copy this message, and do not disclose > its contents or take any action in reliance on the information that > it contains. > > > > > > > > > > > > > > > > > > > > > > > ~ Finally, powerful endpoint security that ISN'T a resource hog! ~ > ~ <http://www.sunbeltsoftware.com/Business/VIPRE-Enterprise/> ~ > ~ Finally, powerful endpoint security that ISN'T a resource hog! ~ ~ <http://www.sunbeltsoftware.com/Business/VIPRE-Enterprise/> ~
