Storage and Backup of Clinical Records

Clinicians should all be aware of the necessity of keeping secure and private clinical records. A major problem is where to store them. I have been engaged in a seemingly endless quest to find places to put my "stuff" following the sale of a large house in a rural-suburban area and the subsequent move into a much smaller apartment. This compacting process has included such trivial efforts as discarding standard sized Jewel Cases and using either the slim-line type or paper or vinyl sleeves to store CDs and DVDs. I have purchased a very large capacity but small sized Maxtor outboard hard drive. Along with efforts in the computer area, I have given away, donated, discarded, or sold items such as a breadmaker, fine, unused cooking equipment, antique furniture, and half my "wardrobe." The latter was comprised primarily of jeans with holes in the knees and flannel shirts with gaping rents at the elbow, so not much loss there. I have shredded many records and plan to store client records in .PDF file form soon. I had tried the free CutePDF Writer and free Converter and found them to be the best for my needs among the various types of .PDF programs. I liked them so much, really, that I purchased the CutePDF Pro version which included the CutePDF Form Filler for $49.95. Among the many other features provided in the Pro version are the ability to scan to PDF (scan your session notes directly into a PDF document,) the ability to FTP upload the document (for file sharing or for online storage,) and most important to compliance with HIPAA requirements, the ability to encrypt the document at a 40-bit or 128-bit level. With the Form Fill portion, one could easily produce a standard intake or interview form, save to PDF, encrypt it, and be compliant in storing it online, burned to disk, or saved on a hard drive. I'm sure by this point I must seem like I am doing a paid advertisement. I am not. Certainly there are other similar programs available, but I have used this one and am thoroughly satisfied with it.

Another aspect to consider when using any computer to produce important documents is the absolute certainty that it will crash or die, taking all your records with it, at the most inconvenient possible time. The answer to this is backup, backup, backup! I have had enough computers quit without giving the required two weeks notice that I have learned this lesson several times over. Again, I have tried and accepted a method to insure against this disaster. I use a Maxtor OneTouch 4 Plus 750 GB external drive which can be used with either a USB.2 or a FireWire 400 connection to the computer. A review of this drive by PC Magazine staff rated it very good and states that the bottom line is; "The Maxtor OneTouch 4 Plus exists as extra storage, but it's really there to save your butt. The next time your system crashes, this drive will get you on your feet again." The drive comes in 250, 500, and 750 GB models, with a very recent release of a 1000 GB (1TB) model, made by pairing two 500 GB drives in one case. One can store the usual documents, pictures, music, and the like on any of them. This series of drives also backs up everything on your computer, including the Operating System, to restore to a new drive in case of a catastrophe. Again, I know that there are similar drives and programs that allow the same types of backup, but after obsessively studying the specifications and abilities of everything I could find with these capabilities, this was my choice and it has worked well.

Backing up only files of whatever type can be accomplished by burning them, in encrypted form, to CD or DVD. There are many programs that will do this efficiently and effectively. I use Roxio's Easy Media Creator 8 (it has advanced to Easy Media Creator Suite 10 recently) and find it more than adequate to do what I want it to do.

Finally, there is online storage for files. I trust it enough for blogs, songs, pictures, and relatively unimportant documents. However, having had my EIN and SS numbers with all other personal and business information "lost" by a government agency, I am less than enthusiastic about the security of information stored anywhere not directly under my control. If you have a Google account and use the Firefox browser, there is an add-on available called G-Drive that allows one to store up to about 5 GB of information online free. A number of other companies offer free and paid storage with varying sizes, charges, and layers of security. I will simply mention MediaMax which offers 25 GB of free storage and increasingly larger amounts for increasing fees.

Until I write next, I'll be trying to force myself to part with my dissertation data (collected over 30 years ago) and deciding what to do with the toy airplanes with 16 foot wingspans. Even the cats seem a bit anxious.

Peace, Doc

Copyright © 2007, Thomas A. Blood, Ph.D.

Have You Noticed ... ?

Have you noticed a recent confusion within Microsoft about the design and marketing of its software? I think I am seeing one but I am not an expert.

Vista sales and installations have not been going as well as Microsoft had hoped when this operating system was introduced approximately one year ago. Some businesses have been reluctant to adopt it due to incompatibilities with other companies' software and due to some of its own internal instabilities. See this Google search which returns 51,200,000 responses to the search phrase - Vista problems. A Service Pack for Vista is already due out soon, according to many sources listed in the second link. Vista seems to be somewhat "heavy" for home computers and is not as willingly accepted as was XP, especially because the really neat features are only available in the premier business versions, and at a greatly increased cost. Of course the Vista OS was primarily developed for business use from the start. Several months back, there was a somewhat disparaging joke that Vista was little more than Windows XP SP3, at least as far as the home user was concerned. Now, however, it is evidently not a joke. Microsoft has already set a release date for XP Service Pack 3. Further, Microsoft has twice delayed the date that all new Windows computers must be supplied with a version of Vista. I believe the latest deadline is at the end of 2007. Some computer manufacturers are taking advantage of this delay to continue to supply Windows XP machines.

Microsoft has begun to compete more actively and directly with Google and Sun, its primary rivals for online services. Other free office suites are available, such as the free, downloadable OpenOffice.org suite, the free IBM Lotus Symphony, the free web based Zoho Office Suite and others. Since Google has affiliated with Sun Microsystems the two corporations have gone into direct competition with Microsoft. They are offering OpenOffice, the open source office suite which Sun helped develop in 2000, and the basis upon which Sun's commercial Star Office was built. This affiliation will provide much more than the free Docs, Spreadsheets, Gmail, Talk, Earth, etc., applications presently available from Google. Microsoft is apparently offering a free, advertising supported version of Microsoft Works 8. It is making Microsoft Office 2003 more functional and secure with a free download of Service Pack 3 (SP3.) I very recently read, but cannot recall where, that the full Microsoft Office Suite will become available as an online service, but only if you already have Office installed on your computer. Spaces Live versus Blogspot, LiveWriter versus Google's online editor, Microsoft Groups versus Google Groups. I don't believe Google has an equivalent for X-Box and Halo-3, however.

I'm not certain that I am doing anything other than mentioning to you that there is a cyber-"competition" going on among industry giants and that it is bound to have an effect on us. By "us" I refer to individuals, families, and tiny businesses. Microsoft appears to be more actively pursuing small business to enterprise size business. While Google may have aspirations in that direction planned for the future, it currently concentrates on the "small" end of the merchandising spectrum. If Google ever officially incorporates an Operating System of its own, "Katie, bar the door." Many of the hot links above are to searches or to summary articles. I strongly suggest to anyone planning on buying a new computer or "upgrading" (to some, that recently has meant switching back to XP from Vista) that you follow the breadcrumb trail to the real experts and draw your own conclusions. Given my current understanding of the situation, my personal choice is to stick with my XP-Pro OS and Office-Pro 2003 productivity suite for the foreseeable future. Of course I will continue to use many Google applications, as they fit my needs more closely, but my overall preference stays with Microsoft.

Peace, Doc

Copyright © 2007, Thomas A. Blood, Ph.D.

"4:00 PM 10/04/07 : GOOG $594.05 +15.02 +2.59% High $596.00 Low $587.01 Vol 05,073,044
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Sony Does It Again

I am including this post from another of my blogs as it may have compromised a clinician's computer or do so in the second round of rootkits. Especially troublesome is the information that one of the products that installs a rootkit is not a CD, but a USB fingerprint security device

Once upon a time in the not too far distant past I really liked Sony products. I still do. I have Sony tape deck, receiver, CD/DVD player, pocket recorder, and was drooling over several of their high-end cameras, but I have resolved never to buy another of their offerings because of their corporate behavior.

In 2005 there was a Sony BMG scandal in which rootkits were hidden in over 100 of the CD products manufactured and sold by them. When the customer played the "copy protected" "XCP" CD, a rootkit, otherwise known as spyware or malware, was installed in their computer without their knowledge. It interfered with the way in which Windows systems play CDs and opened several security holes for viruses to enter the unsuspecting owner's computer. Rather than go on at length here, I refer the reader to the wiki link above, for a thoroughly researched and well written explanation of the problem and the various electronic, ethical, and legal ramifications of their ploy. The first time, I was relatively quiet about it, but made my resolution and have abided by it.

Now they have done it again! "... F-Secure's Deep-Guard software has detected rootkits in more software distributed with Sony products." In my opinion, this goes beyond the point that I can simply shut up and not mention it to others whose computers may be affected. They not only did it, but they did it poorly in an attempt at security through obscurity. The TechRepublic Forum post I read most recently on this subject found many others with the same feelings about Sony as I have developed.

*Sigh* At least I'm not the only one who became really cranky over this.

Peace, Doc

Copyright © 2007, Thomas A. Blood, Ph.D.

"Experience is the best teacher, but the tuition is high." - Norwegian Proverb