I would like the option to remote access my amazing charts from my home pc. I don't really want to get into having a laptop and then syncing with the office database. Does anyone remote access from home? If so, how does one go about doing this? It would be greatly helpful especially when oncall

I think the easiest way is using one of the remote control software like logmein.com or gotomypc.

We let our docs use Remote Desktop Connection to connect to the server using Terminal Services. A great option is 2x http://www.2x.com/applicationserver/download.html which makes the application feel like it's on your remote computer.

I have been using Logmein for over a year now and it works very well for me. I can take my laptop anywhere (recently to Rocky Mountain National Park) and access not only my AC but also all my incoming faxes. The best part....it is free.

Leslie

I use gotomypc.com which works just fine. Sounds like Leslie has it better ( I can't access faxes )and, on top of that, for free.

There are at least 15 ways to log in from home. But, LogMeIn is the easiest and is free. GoToMyPC is just as good, but I never know how they do it when they don't have a free alternative. On the other hand, I don't know how LogMeIn does it for free even though they have a Pro version.

Remote Desktop supplied free by Windows with XP Pro and Vista, is the fastest and is very secure, but it takes a bit more know how to set up, and although you can use it with a dynamic IP, it is easier with a static, which you may not have. It's just nice, because I can log into my computer from home in less than three seconds where with RWW or LogMeIn it takes about 30 seconds. Doesn't seem like much, but when I am crawling out of bed at 7AM on a Saturday to fax in Vigamox, 27 seconds is a long time.

Lost in this discussion sometimes is LogMeIn Ignition, although for around $39 a year it's the antithesis of how inexpensive it can be. It seems a bit much for what it does unless you use your remote connection 20 to 30 times per month.

LogMeIn ignition allow you to click on one button and be seeing your desktop in seconds rather than having to go through your browser. Just an idea.

I use logmein, have for years. Used the free version until recently when I went over to pro (ability to print in local computer). I also use logmein ignition from a thumb drive and love it. I use logmein daily from the office, hospital, laptop, heck you can even use it from your iphone

Dadburn it, I want an IPHONE!! But AT&T just is not that great in my area.

Leslie

Gerardo and Bert are correct
logmein is a great and relatively inexpensive utility program - the pro version (and ignition adds icing on the cake -its so easy to use "a cave man can do it")
i have it on my iphone as well and it is great to look up any information on your patients - obviously i wouldnt use it to chart pts records it's a little bit too small

I tried a VPN on my server, but the problem is speed is not that great, anyone have any luck with this?

I have Logmein on all 4 machines in the practice as it helps troubleshooting. I have pro version on the server as it helps me do transfering files etc. I also use logmein Ignition and it is just awesome for that one click desktop access.

I do have VPN setup using openVPN between our house and office, so that my wife can use her Dragon dictation from the laptop at home, but it is slow ( even with cable speed).

I have logmein on all computers for servicing and have 4 computers that have pro. The advantage to pro is that I can remotely print among other things.

I have two offices on separate databases. I will sometimes remotely log into the other office to chart on patients. It's slightly slow but functional.

Jack - VPN speed will usually be limited mainly by your bandwidth at the location you are at. Changing the remote desktop settings can help. Try opening Remote Desktop, and clicking "Options>>" if the options are not already displayed (tabs at the top will be visible). Go to "Experience" then try selecting "Modem" in the dropdown box. This should help. Firewall settings (on the server or on the switch/router) may also cause things to be slow. If you change firewall settings, read up on how you should go about that for your setup. Leaving ports open all the time can leave your network exposed to exploits.

Thanks for the suggestion, I will try!

Jack, I've had VPN and RDP and Logmein. Bert is right, there are over a dozen options to remote in.

I find Logmein the simplest and easiest.
It's very fast and simple. You are doing everything in real time on the computer in the office. And you have full control over that computer to do anything you would do as if you were actually in the office.

You only need internet connection, I use it from the E.D., while on vacation or traveling, and from my bedroom. Basically from wherever and whenever you wish.

You can also log into any computer (i.e. all the office computers, the server, your home PC) and perform diagnostics or repairs, run any program.

My recommenedation for you is Logmein.

I also use Logmein Free and it works great - I can log in from ED, fax last chart notes, x-rays, etc. Certainly works anywhere you can get DSL speed access. Best part is that it is free - try it out and if you don't like it--stop.

Wow, actually have 4 Docs to agree on something (logmein)

Certainly try the free version. The paid version adds printing, the ability to transfer files and a couple other things I never use or think about. I have selected computers for logging into and all are on there just for diagnostic purposes. It is worth checking out, see if it meets your needs.

come on if you like the stuff so much go ahead and pay for it(that is the chief reason I pay for it). The company went public last week, so I am sure the days of free logmein are numbered. They have 2 millions free customers and about 90K paid customers.

They also have a VPN solution ( called Himachi) and I did try it but was not very happy about it. I still use VPN.

But wait for Windows 2008 R2(Win 7 server), there are some awesome remote access tools. It maybe a while before it will catch on, but I like what I am seeing.

I agree with Srini. At times it does make sense to chip in and help, but then again no one is giving me the extra $50 I am losing on my Medicaid patients, lol.

I do think that the pro version should come with ignition. I would suggest for anyone who has three or four Pros to contact the company and see if they will throw in some ignitions.

By the way, moving files is cool, but has anyone really said, "Gee, I wish I had pro so I could print this out?"

There is also such things as Virtual Network Computing with RealVPN, UltraVPN and TightVPN, etc. I have tried those, and they are fun. RWW allows you to set up a split second VPN connection and run RDP over it for added security.

Personally, I think that the term VPN gets thrown around way too much. There are some software versions which allow desktop access, but if you set up a real old-fashioned router to router VPN, you are going to need some type of terminal services, Citrix, ICA, whatever to see the desktop. VPN can allow for two way transmission of data, which can cause some issues. VPN is the technology one uses for connecting two or more offices together, done best with router to router. But, when just remoting in from home, LogMeIn is about all you need.

Srini, I am not sure what 2008 has, but I bet it is about the same or an improvement on Remote Web Workplace. I know people just read RWW, and dismiss it, because it is basically only with SBS, but it allows everything faster and more secure than just about anything. And, it allows for authentication three times in three ways. The nice thing about it is, after you log into the server, you can log into ANY or ALL PCs on your LAN. Plus it enables you (or maybe you can anyway) to set up RPC/HTTP for Outlook, which is way too cool.

Another thing not mentioned here is Remoting in with RDP or LogMeIn and then using the Remote Desktop Connection feature to log into other machines. This works great although it can get a little sticky at times backing out.

Which reminds me of a story brought back to me, because it happened while I was talking to Adam about RDP. I was headed home late on a Friday night last year. I just gotten by GPS and was excited about my new technology. So, I come to the main intersection before my last stretch of road through Hampden to my house. There are like 25 police cars and firetrucks, etc. so I was told I had to go right. Now, I have been here for twelve years, and I still only know three towns and about five roads. So, after about 30 minutes of trying to find a way around, I was lost. So, no problem. I pulled out my trusty GPS, programmed in my address, and let it guide me home. I never even stopped to think that the best way home according to the GPS was to direct me to that intersection.

We did not want to tie up an office computer for remote access. So, we opted for a VPN. We are succesfully connecting remotely through an SSL VPN (e.g. no client software to buy, just connect through webbroswer) using a CISCO RVL200 VPN Router ($150). On the remote computer, we mapped a network drive to the folder on the local computer with the AC files. Once logged in to the VPN, AC can be run on the remote computer and directed to the mapped drive. It takes a little longer for the initial startup of AC, since the data is pulled through the net, but once loaded, it runs as quickly as in the office.

morgansrm,

Wow. Thanks for sharing that. It sounds like a great solution. I am hoping to ask you if you could expound a bit on it, e.g. give a lot more detail and step by step instructions as it was a little hard to follow. I don't think most people who read it are going to understand what you did.

Also, if you can use terminology for each computer so we are all talking the same language. Host = computer at office which you are logging into remotely. And, Remote = computer at home that is going to connect to the office.

Based on that terminology, it sounds as if you are mapped a network drive from your home to the office.

Definitely cool to use a VPN. Just wondering out of curiosity why tying up a computer would be detrimental when you are probably remoting in at night or do you have a lot of people who need to remote in after work?

morgansrm,

We tried using a VPN between our two offices similar to how you described. Our internet speeds are 2MB/sec and we found it way too slow to communicate between the two offices, especially trying to view imported items at the remote location. So we eneded going back to using Remote Desktop to login to the server.

What bandwith speeds are you using and why is your system working so much quicker than most others who have tried VPN between 2 locations?

I would love a fast VPN between our two offices -- it would allow me to use Dragon Medical much more efficiently at the Remote location.

James P. Clayton, M.D.
US Virgin Islands

hi
I have two offices. I thought one license was all I would need, but I am told I need two and that the databases will be distinct.

Does anyone keep one database and access the other office's AC and use it in real time to input progress notes, etc on a regular basis.

It seems like the VPN issue gets mixed responses for speed and reliability.

I'd love some guidance before I need to commit to two licenses and two databases.

Thanks
David Schechter, MD
schechterd@aol.com

What is your broadband speed both ways?

Just a note of clarification....I am using logmein-free very succeessfully. However, when I first started, I didn't realize I needed to have the Host (server) computer turned on. Also, any other computers in the office which you will want to access must be turned on. Make sure as well that they are set to not hibernate or go into sleep mode. This will not allow you to connect. This info is for those of you non-geeks, like me. I just got the logmein for iphone and am excited to further work with this...going to Tahoe next week.

Used the logmein app on my iPhone a day after I downloaded it. I was able to log onto my office main computer and retrieve some very critical info on AC...really made a difference for the patient.

More Detail on Using SSL VPN:

1. We installed a Cisco RVL200 VPN router in our office. We configured it, using the setup screens, to allow access for a logged in user to see the Host computer with AC. (We also set the router to assign a static IP address to the Host Computer to avoid having to search for it if the Router reassigned addresses).

2. On the Remote Computer (e.g. at home, netbook on the road, etc.) the user logs in by typing our IP address, assigned by our ISP (cable company), and then supplying their uwername and password. (We actually got a url from dyndns.org pointing to the IP address to avoid having to remember the IP address for our network. That's also helpful if your IP address from your ISP is not static.)

3. The router establishes a Secure Sockets Layer (SSL) connection, which exposes the office network to the Remote Computer, including the Host Computer (with encryption between the Host and Remote computers).

4. Then we mapped a network drive ("M:\") on the Remote Computer to the Amazing Charts directory (e..g. "//192.162.1.149/AmazingCharts"), in Windows Explorer.

5. With the VPN connection active, when AC is run on the Remote Computer, and asks for the location of the AC data files, we direct it to the mapped drive ("M:\").

6. We have a 8mb download\2mb upload cable internet connection in the office. ($99/month in our area.) The remote connection depends on where we are. Usually at home or when travelling it is a highspeed connection of some sort. (Home is a 5mb/500kb cable connection; hotels and relatives - who knows?) Not an expert, but apparently the type of VPN and specific model of VPN router used can significantly impact speed (i.e. for encryption/decryption), so other types of VPNs may be slower.

5. Why not just use remote access? (1) Small office, with the main files on the computer used by our frontdesk staff. If using remote desktop accesss while they are there, it keeps them from using the computer. Otherwise, would have to leave another computer running in the office for remote access. (2) VPN allows access to network resources, e.g. printers, drives, etc. without having to funnel it through the local computer (3) Cost -One time $150 cost, for up to 5 simultaneous users.

Go to www.logmein.com and sign up. Costs about $70 a year. I use it frequently from the hospital, the nursing home, and from home. It works flawlessly. Good luck.

@morgansm I forgot to thank you. I appreciate the specifics on your system.

@everyone I don't think LogMeIn is a good option for what David is asking. From what I read, he is saying he has one office which has the database on one computer (obviously). He wants to run the office and access the database IN REAL TIME. To connect (and I am guessing) six to eight computers on a daily basis to that database using something like LogMeIn is not practical.

First, you can only log in one at a time. Second, you are depending on an Internet connection being up all the time, which is not going to happen without glitches.

This is going to require some type of VPN with terminal services. As I always say, if you need to do something like this which requires connecting two offices to one database, you are going to need professional IT help. If you are able to do it on your own, please post how you did it.

Most computer IT companies will come to your office and give quotes.

A lot of people have been having trouble since the Sept 2009 upgrade to Logmein version 4.

I can no longer access my host computer from my linux Firefox 3 netbook. All I get is a black screen.

Several key features have been taken away from Version 4. Many paying users (users that pay $1000's a year) are really upset as detailed in the logmein forums.

The Chief of Marketing for logmein resigned today.

Something has really changed at the company.

Anybody got any suggestions for an alternative (preferably free), to logmein.

I have been using it sporadically for seems like 4 years and it works well in order to access patient charts away from the office during night, weekends, vacations.

I was using gotomypc before and that worked well, but that is $15 a month. I could pay it but I probably only use the service one hour a month.
Thanks.

Hey, Dr:

I know we discussed this privately (via email) but if we were hosting AC on our Medisoft Network then you would be able to access AC remotely by connecting via our website and you could use a Tablet PC to access PC.

Steve

@ken

I use Teamviewer (in addition to logmein depending on the situation). Teamviewer for me has been faster than logmein. The free version includes file transfer (which logmein only has in paid version). Also instead the ten or more clicks to access logmein, Teamviewer is like three. I like it.

I am having no issues connecting with LogMeIn with version 4. I use it only to connect to home since I never need to anyway. If it does go belly up, I wouldn't be surprised. I have never known how they sell any of the pro versions with a free one available?

@Ken Are you talking about users with over 25 PCs as far as the $1,000 per year? A single PC for the pro version is only $70.

If one has Windows XP, I still don't know why they aren't just using the free Remote Desktop, which is free, fast and secure.

For me, part of the reason is that these other options are quick, user friendly, and out in the open. I can download logmein or teamviewer and be up and going in five minutes. I have yet to find out anything about remote desktop, even though presumably it's sitting right in front of me. Also, something about it being part of my OS, from Microsoft, makes me nervous.

I realize all of my above points are debatable. And once familiar with that option, as you are, maybe it IS better. Other folks must have similar reasons because, as you say, no one is talking about RDT much.

@solomio

I checked out Teamviewer today, but correct me if I am wrong, it looks like the remote computer needs to be running Windows too?

Of note I can still access amazing charts (office computer) using logmein on a remote windows based computer, but the version 4 upgrade of logmein doesn't seem to be compatible with Firefox 3 running on a remote linux computer, while logmein version 3 was.

My workaround will be to just downgrade to Firefox 2 as it seems to work with logmein version 4.

Ah yeah, good point. If you look carefully, it does state on the TV website that it operates "crossplatform" between Win and MacOS. In another place it states there is "Browser-based Access" which can connect "from almost any operating system," but then the question would be whether all that is still included in the free version. May be worth asking them about it.

People need to be very careful with HIPPA and data storage. I just paid 8 G's for a thorough security analysis of my network. I've been using WEP which doesn't cut it, RDP/logmein/gotomypc are all not secure enough. All of our hard drives should be encrypted real time. They also busted AC for not being secure. All the passwords are in a file in the database in plain english. They contacted AC and were told, they're working on it. Hopefully in V5

Oh, by the way. I use Citrix, remote access, extremely fast but it costs lots.

Jnolte,

I admire your attention to security. (Did you really pay $8,000 for a private company to look at your security?). But, I am fine with my security. Sure RWW with SBS is about as secure as it gets, but I am not going to encrypt my hard drives, nor worry about RDP, which is very secure. I always compare to paper. So, for years we were violating HIPAA, because we didn't have all of our charts locked up in vaults with only one combination? Were we supposed to somehow encode the data? Yes WAP should be used over WEP.

But, as I generally say about security, at some point you have to do just do the best you can. If someone hacks into my data, well then they just hack into my data. My cleaning lady could steal my server. And, I am sure someone could unencrypt it. We can't be doctors and full time IT people as well.

As a very good IT person from Cisco once told me, "Are their people out there that can hack into your system? Definitely. Hundreds. But, are their people out there that want to hack into your system? Doubtful."

I love logmein. Is that not really secure? I though it was. It asks me for a password everytime.

I think people have different ideas about what is secure - my hospital made it a royal pain to log onto their system with incomprehensible passwords x 2 and logging onto their remote serve who then used CITRIX to log onto the other server - what it succeded in doing was making it so I never logged on and would let my documents requiring signatures really stack up (which when I signed and 100 of them printed at medical records made them really crabby).

I think the 2 passwords required at Logmein is great - feel like fear of some HIPAA police make people paranoid. I also think there are too many "experts" on HIPAA - some don't really have a clue.

Bert, actually it was $7,850 but who's counting. Things cost more up north. The report was 85 pages and a CD. I lot was fluff but I did get some valuable info. A lot of the recommendations were policies that we do but haven't been spelled out on paper or in the employee handbook. We are a small FP clinic in Anchorage - 6 FTE providers. These guys knew their stuff.

Yes I think some of it is overboard, but, if something happens I think it helpful that we have had a security assessment and a "plan" to fix things. Just so long as we follow our new plan I think I'll put disk encryption on the list for when we do our next upgrade. I was buying new stuff at Dell and saw they included that on their new laptops.

Adam, I'll look at the report again Monday and see what it said about Logmein.

JNOlte,

Well, thanks for laying the groundwork for everyone else. I do think one of the consistent things for all "agencies" is having a written plan, whether it's immunizations or HIPAA or whatever. They love the written plan.

Regarding gotomypc not being secure enough,
"All data is protected with AES encryption using 128-bit keys. Dual passwords and end-to-end user authentication. Optional One-Time Passwords provide maximum security."

I've used the onetime password feature before, pretty neat. You print out a list of 100 tertiary passwords and keep in on your person. every time you login you use one of these passwords (which then immediately expires) in addition to the primary and secondary password. Therefore keystroke loggers are foiled if you are using some unsecure computer. Seems pretty secure to me!

I am not putting down/trashing anyone's security, but IMHO a reasonable goal is to protect against improper disclosure of patient data using "reasonable measures."

Can the CIA hack into my data? Probably. Could a determined thief assisted by a team of East European computer geeks crack my code? Yep, if any of these groups were interested enough.

But in all likelihood the data is safe from the more likely threats, such as a nosey employee, cleaning lady, or patient; or the casual computer snatcher. And I recently discovered that Indiana has the most stringent, most penal law regarding protection of electronic patient data out of all 50 states--yet I would meet their criteria.

Everything uses basic encryption (AES etc etc) and the computer is bolted down VERY firmly. I have good locks on my door and video surveillance.

Update - Okay I looked through the report again. The issue the security police had was with the VPN. They say Microsoft PPTP has issues associated with its use as a VPN solution and should be replaced with a more robust method of remote access. They reference www.sans.org/resources/malwarefaq/pptp-vpn.php and www. schneier.com/paper-pptpv2.html. Cisco, OpenVPN can be configureed to suport both certificate and pssword authentication.
We have a Cisco ASA router but we were using Microsoft PPTP so need to enable Cisco's VPN.
They also rec a proxy server to reduce risk and data loss by logging and analysis.

Nice router!

J, this is all good information, but my guess is < 5% of the people on this board (including me) will have a clue as to what you just said.

I use VPN access. Works well, except it requires a certain screen resolution which I don't have so the field is slightly smaller than AC. That issue does not interfere with what I need to do anyway.

For those of you using logmein , I have just learned that you can add a secondary password on your host computer that is only stored on that computer. When you log in remotely, the system asks for 3 random characters of your secondary password, and makes you choose them from a drop down list using the mouse(not pressing any keys). Therefore keystroke loggers at pubic internet cafes are foiled. Nice option and is free. It is buried in the advanced security section on preferences on the logmein program running in the tray.

Thanks Ken,

That is just way too cool. I just added that to mine. I can't believe even IT comes with the free version.

I just have two questions:

1) How does Logmein make money when their free version is so good. I know you can transfer files and stuff, but that isn't necessarily worth paying for the pro version.

2) How in the world does GoToMyPC stay in business with Logmein available?

I think the IT section is temporary. After time they will start charging for it. They upgraded their interface a couple months ago with that addition. I must admit it is nice (that's how I found my 6 G backup drive was full)

Logmein free doesn't print. There are workarounds but it is worth the money just to remote print. It automatically makes your remote printer the default printer when you log in. No muss no fuss. It is nice in transferring small files, you can drag and drop as well as manage through a detail like screen. Nice but not worth the money

I think GoToMyPC does a lot more advertising. Can't understand how they compete. Even their regular prices are higher last time I looked.

I choose to support it because it is so good and use the pro version. I do need to print locally (from the hospital, second office, home) for prescriptions and print notes, etc. It makes it oh so much more convenient. I also use logmein ignition which allows you to access your computer even faster without having to use a browser. I suggest you give it a try, but be warned it is addictive.

Bert,
I think that logmein makes money by bringing people in with the free and then getting them to convert to pro.

I agree, gotomypc does a lot of advertising and so they must stay in business that way.

As far as remote printing, I have my Brother All in One connected to the host computer so I can print to fax and fax to the hospital, although I agree remote printing feature is nice (used to have that when I was a gotomypc subscriber)

Agreed, except that even I (who almost ALWAYS pays for the pro version of everything or the pay version) cannot find enough features in the pro version that is worth it.

It seems that a lot of features should only be involved in the pro version or pay version, whatever it is called. For instance, you would think they would limit you to so many hours.

LOL. Wendell I was referring to Ken's great tip on the 2nd password. Looking back, I can see how it may be taken as IT as in Information Techonology. Either way, your comment is helpful and probably true.

Can you guys explain to me how remote printing is helpful for you. I have just never seen the need. Maybe if you gave me some examples. Thanks.

Sorry to resurrect an old post.

I print prescriptions, Op notes, H&P, Orders (which thankfully my hospital takes on my letterhead. It is nice to go to the hospital, see a patient, log on through logmein ignition, access AC, type my note, print it, type prescriptions, type a letter to the PCP, etc so the referring physician has it available right away. And while you are at it, I fax a note to their office so they get it before they even get to the office)
etc.
I could do without it, but it is "so nice" to have it. (picture Ferris Bueller saying it)

Not for everyone, I know.