March 2020 - FIT Solutions

How to Quickly — and Securely — Enable Work-From-Home

Posted on March 24, 2020September 7, 2021 by CT Team

In response to current events, your business may be faced with the challenge of quickly putting a work-from-home program in place for your employees. Here’s the hard part: those employees will be largely on their own, with varying degrees of technical knowledge, connecting from their own home networks and accessing corporate data and resources. You need not only to get them connected, but equip them to work productively, with ample security in place so you don’t put your organization at unnecessary risk.

Considering the Alternatives

The best-practices approach — under normal circumstances — is to distribute preconfigured corporate-owned laptops. Aside from the expense, time might be the bigger issue in our current situation as businesses everywhere are rushing to equip remote workforces. Currently, the time from order to delivery of new laptops is around 15-30 days, for some suppliers.

A tempting short-term fix is to allow employees to connect to corporate resources directly using their own personal home computers, laptops, or tablets. However, this exposes corporate assets to a wide variety of risks that are outside of your control. These risks include outdated or insufficient endpoint protection, access of confidential data by others in employee households, and rogue devices on a poorly secured home network — among other threats.

The Right Technology, Right Now: Virtual Desktop Infrastructure

Virtual Desktop Infrastructure (VDI) is a widely used remote access approach with many advantages. With VDI, employees use their personal devices to access a virtual desktop — a computer that they control remotely. They view the screen, and control it via mouse or keyboard. The approach is much less expensive than provisioning and distributing laptops, and far more secure than a direct connection. With VDI, business owners can:

Provision remote access for tens or hundreds of users cost-effectively with a cloud-hosted solution
Allow secure access by a wide range of employees’ personal devices, from home PCs to laptops and tablets to smartphones
Tightly control access by combining standard login credentials with multi-factor authentication (MFA) to guard against weak or compromised passwords
Keep corporate data off of personal or public networks — the corporate data only appears superficially onscreen, and never actually enters or is stored on the user’s personal device
Provide a familiar environment and business access —the virtual desktop can be configured to look and behave exactly like an office-based system, with access to all corporate applications and data stores, productivity, email and collaboration software

At FIT Solutions, we can quickly set up a VDI for your employee remote access. It is housed in our data center in a private cloud, with all essential security measures provided. We connect the virtual desktops to any applications or data you need, whether those are in another public or private cloud, or in your own data center with access protected through a secure point-to-point VPN.

Have questions? We have the answers. For more information or to get started right away, give us a call at 888-339-5694. We’re also offering a free Remote Workforce Readiness assessment, which you can find here.

Step-by-Step EHR Migration Checklist for Senior Care Facilities

Posted on March 16, 2020September 1, 2021 by CT Team

Ownership changes are a fact of life in senior care. When a nursing home or LTPAC facility changes hands, you’re often faced with the challenge of migrating the electronic health record (EHR) system to a new platform — without sacrificing or impacting continuity of care. At FIT Solutions, we’ve supported many of these migrations. Over time, we’ve developed a roadmap and set of best practices for efficiently and successfully completing the handover to new ownership.

EHR Migration Roadmap: Planning Ahead

Preparation is key. In our experience, the more attention you pay to the first four steps here, the less likely you are to encounter unplanned obstacles downstream that could substantially delay your migration.

Determine the migration type. We anticipate that as the new owner, you’ll be using an EHR system hosted in the cloud. There are so many advantages to a cloud-based system that hardly anyone hosts their instance on-premises in their own data center anymore. Here are the possible scenarios.
- EHR to same EHR. If the outgoing and incoming owners use the same EHR system, the migration can be as simple as spinning up a new instance of the software in the cloud and copying the database over. Not all of the steps in this checklist will apply to you, but most assuredly, some of them will.
- Paper records to EHR. In some ways, moving from paper records is more straightforward than migrating across different EHRs. You’ll need to do some scanning and have the resources to do that available to you.
- EHR to different EHR. The majority of the time, this is the scenario you’ll be dealing with.
Obtain and inspect the final letter of agreement. We can’t emphasize this enough. You need to have the sale confirmed and letter of agreement finalized several months before the migration. The letter of agreement spells out whether the pre-existing computing, network and telephony equipment comes along with the sale. It also spells out which EHR records you’ll be allowed to copy. Policies vary from seller to seller — sometimes widely. The letter of agreement dictates what information you can migrate, and how. You can’t presume anything.
Assess the willingness of the outgoing owners to cooperate. Regardless of what’s in the letter of agreement, reach out and get an idea of the outgoing owner’s willingness to share information, grant access and respond to your inquiries. The entire process will go much smoother with a cooperative seller. Some limit access and support. Enlightened sellers understand that transferring ownership supports their overall strategy, and is just part of doing business.
Conduct a coordinated site survey. If you can, go onsite well in advance and do a thorough walk-through and site survey. Ideally, the IT team as well as electrical and other contractors will all go at the same time to work through and plan any potential changes. Typically, there is some IT work that’s dependent on the electrical work. This includes the need to relocate electrical outlets and network drops, or add new ones to accommodate new kiosks, Wi-Fi access points or other equipment. If backup power isn’t in place, this is the right time to rectify that shortfall if budget allows, or to at least put a contingency plan in place. Verify that there’s a contract for the essential electrical work, and clarify who owns it.

EHR Migration Roadmap – Setting the Stage

Once you understand the landscape, it’s time to start preparing the environment for the new EHR.

Purchase new equipment as necessary. Assuming you’ll be allowed to take over the old equipment, cloud-based EHR systems can often run on older hardware. However, the browser needs to be up to a certain standard and the hardware needs to support it.
Complete the electrical and cabling work. If any electrical service and network connections need to be provisioned to accommodate relocated computers, servers or Wi-Fi access points, schedule that work so it’s complete before the IT teams start to install the new equipment.
Identify effective, tech-savvy and smart superusers. You’ll need to press some staff into service for two jobs: handling data re-entry to populate the new EHR with the most essential data, and to serve as support for the other users during the transition.
Complete the IT-related work. This includes installing any new hardware, and configurations of the network, network devices, phone and/or fax systems. Now is the time to make sure that essential items are in place to support the transition, such as online storage and multifunction printers/scanners. If you’re switching ISPs, arrange for the connections. If you’re retaining the former ISP, make sure the contracts and new billing arrangements are in place to ensure continuity.

Migration Roadmap – Preparing to Execute

Two to three weeks prior to going live with the new EHR, start the process of migrating records to the new system and preparing your staff. You’ll be using paper charting during this interval, to cover any gaps.

Contact the EHR provider to create a new instance of the software. Assuming you’re already a customer with existing accounts for your other facilities, this is likely a simple phone call.
Prepare manual/paper processes to cover contingencies. During the time records are being converted and uploaded to the new EHR, you’ll need to have paper forms in place so caregivers can document their actions.
Start superusers on the data migration or export to .pdfs. This is where your letter of agreement dictates what you can do. The profile and MDS documents can usually be electronically copied. Census or basic resident information can be often be migrated by a third-party provider. However, the core of the records, including care plans, assessments, orders and ADL tasks typically need to be output as .pdfs or scanned in from paper copies, and attached to the patient records in the new EHR.
Put training materials in place. During the lead-up to adoption of the new EHR, make preparations to train the staff. Stage any training modules or videos, and ensure that all employees can access them. Set up a sandboxed system with simulated patient data, giving the caregivers the opportunity to practice. Prepare your superusers to conduct webinars and other training sessions, and schedule them during the first two weeks post-live.
Plan for staffing and superuser coverage. During at least the first two weeks post-cutover, make sure that one or two superusers are available to cover for each shift. Clarify which resources, whether the superusers, IT services team or EHR support, are to handle specific issues such as how-to questions, password resets, Internet or Wi-Fi issues, email issues and access to shared drives.
Execute training programs. Once the new EHR is populated with the essential data, you can roll out your training programs across all care teams. Rely on your superusers to train other nurses, CNAs and aides as you take the system live.

At FIT Solutions, we’ve handled and supported dozens of EHR migrations for senior care facilities. If you have an upcoming project or are planning an acquisition, feel free to reach out to our staff of experts. Give us a call at 888-339-5694.

Amazon Alexa & Google Assistant for Senior Care: 4 Considerations

Posted on March 4, 2020September 1, 2021 by CT Team

There is tremendous interest in using voice assistants such as Amazon Alexa and Google Assistant in skilled nursing, LTPAC facilities and assisted living settings. The devices that access these technologies — most often an Amazon Echo or Google Home speaker — can be used in conjunction with smart home technologies to control lighting, heating and cooling, home entertainment, communication and other various systems. With simple voice commands, residents can turn the lights and off, set the thermostat, communicate with loved ones, create a shopping list, turn music on, hear the news and get the latest weather report.

These devices address various concerns around safety, promote feelings of independence, help seniors stay connected, and do a host of other very good things. Especially for those with limited mobility, cognitive issues or other challenges, voice control can be enabling for everyday life and contribute to overall well-being. When they are used in in conjunction with sensors and other smart home-enabled technologies, you can appreciate why so many facility designers are beginning to incorporate these into their plans.

Sensors can detect whether the resident is active or inactive, or whether the refrigerator or medicine cabinet has been opened. They sense movement and turn pathway lighting on to prevent falls. Smart water systems monitor consumption to make sure residents are drinking enough water. Medication reminders and pill dispensers assist those with memory issues.

We love the advantages these technologies offer, but allow us to point out a few potential issues for facilities to consider.

Connectivity Requirements

These technologies rely heavily on the cloud for their fundamental operation, including the voice recognition that makes them tick. The various sensors and other smart-enabled devices and technologies are likewise “Internet of Things” (IoT) devices. They’re Internet-reliant — and the more functions they provide, the more residents rely on them for their everyday living. It’s a whole new world when “the lights won’t turn on” triggers an IT trouble ticket. Having highly reliable, regularly monitored and redundant Internet connections with failover capability and sufficient bandwidth is absolutely essential.

HIPAA Considerations

When voice assistants are used for medication reminders, gathering healthcare data or other medical matters, HIPAA regulations come into play. Amazon has recognized the medical applications for its technology, and has entered agreements with some third parties in the healthcare arena to deliver services over Alexa that are “HIPAA compliant.” This means that the data is collected and stored by the third party in a HIPAA-compliant manner; it does not mean that any or every use of Alexa is “HIPAA compliant.” Even seemingly routine discussions about healthcare matters that happen to be picked up while the voice assistant is listening can lead to HIPAA exposure.

Wi-Fi Security Implications

Voice assistants rely on Wi-Fi for connectivity. If they’re going to be used for gathering and transmitting healthcare data that’s subject to HIPAA, they absolutely must be connected to the same protected, healthcare-dedicated Wi-Fi network that handles your EHR and other medical systems. Allow voice assistants on the guest-and-resident network only if they’re resident-owned and -installed, and you can be sure they’re functioning in a way that’s outside the reach of HIPAA.

Remember the Network

In our conversations with senior care facilities, the enthusiasm for voice assistant and smart home technologies is evident, and we share it! But we encourage you to keep the network and security implications in mind to ensure that these assets do not become liabilities.

At FIT Solutions, our managed IT services come with tools and expertise in network design and connectivity, monitoring and troubleshooting. If you have a project like this in mind, give us a call at 888-339-5694.

Month: March 2020