The Great Home Office Avalanche, or how to securely dig our IT from the snow

Measures taken against coronavirus pandemic have showered us with several actions reflecting trends which were already present, but were not so relevant before.

One such trend is using Home Office, which brings several changes in corporate IT procedures.

First of all, we need to give secure VPN connection to (almost) every team members, to access corporate resources. It is the first point that we may experience limits to extend our VPN network – it may be a limit of available licences, the limit of our current Internet bandwith, or the capacity of our firewalls.

Solutions offered by Watchguard and Fortinet firewall products can partially solve this problem, and, although we might not be in a position to get larger bandwith from our Internet service provider, the user experience can be improved by configuring „Quality of Service” (QoS) settings

These suppliers offer firewall products which enable domain syncronised, group membership-based and differentiated access control of corporate resources, thus reducing risks of a potential attack.

Unfortunately, the situation also requires to access systems from remote which were normally managed locally beforehand. To increase security level of these access points, multi-factor authentication can be a solution, which can be used via the Microsoft Authenticator mobile app, in case you use Fortinet, while if you use Watchguard, its own AuthPoint application can be the right option.  Using Watchguard, the secure access can be fortified by implementing Access Portal, which can be run on firewall, enabling both operational and user web access, also with an external multifactor authentication tool.

As a side effect of Home Office, Internet traffic of users is no longer controlled by the corporate firewall.  Only a few organisations can afford that the default Internet gateway for VPN users is the corporate firewall, and all internet traffic generated by users is routed through the corporate internet connection, therefore, „gateway antivirus”, “, IPS – Intrusion Prevention System, DNS and webURL filtering may become unavailable for Home Office users.  This problem highlights the importance of centrally manageable endpoint protection, and utilisation of its abilities.  The Panda Adaptive Defense 360 package can provide targeted protection against zero day threats and targeted threats, while Web filtering can protect users at home against risks threating by malicious URLs.  The same solution can be extended with disk encryption and „Data control module to identify and control files with personal data, also with reporting, patch management and remote management modules.

If that has not been implemented before, introducing a corporate e-mail system which supports teamwork and accessible from anywhere, also from mobile devices can be a top priority. It could be a Microsoft Exchange-based, on-premise system or its cloud-based version Exchange Online, however, it may also worth consindering the Axigen Business Message solution as it may be a bit friendlier to shrinking
corporate budgets.

Microsoft Sharepoint Portal can be a good solution, either in on-premise or MS Cloud version for the managed access and share of documents, version tracking and teamworking. The advantages of cloud access can be configured in a way that data do not leave devices controlled by the enterprise, while high level, GDPR-compliant logging and regulatory compliance can also be ensured if we use Enterprise File Fabric, a product of Storage Made Easy.  This solution can provide the controlled and audited access of any other file access services of the company, such as existing fileshare, Azure or Amazon cloud service sor integration with Dropbox, using an easy-to-maintain virtual applicance solution.  We should not be afraid to use this even in an SME environment, as, if we use CentreStack, from as low as 20 user/month we can provide secure, synchronised file access integrated to Windows AD, from our own infrastructure, using Windows servers.  Both CentreStack and Storage Made Easy have the benefit of synchronisation of work folders of users, which means that at least part of remote working is possible even if internet connection is temporarily unavailable. 

Personal trust and loyalty is key when you work from Home Office, but there is some sensitive information which needs to be particularly protected, using Data Loss Prevention functionalities, combined with the two  solutions outlined in the previous paragraph
of this article.

It might be the case, unfortunately, that our company cannot provide a corporate laptop for each remote team member, which means many of them are forced to use their own device while working from home. The security of the employee’s network environment and devices is also important, and Panda Security now provides a free endpoint protection for corporate clients to provide additional support and prevention for home office workers.

Publishing web applications in Watchguard Access Portal, we can provide a full-scale virtual working environment in Microsoft Windows Server RDS (Remote Desktop Service) or VDI (Virtual Desktop Infrastructure) environment. As the above solution requires not only server resources but also licences, it is likely that a hybrid environment will be set up, because of longer than usual delivery times. Licencing is made a bit easier that a 120 day grace period is provided for Microsoft RDS users until licence is activated. It is also a crucial and substantial issue that all meetings and training sessions are virtualised, rather than held in a meeting room. Based on our own experience, we recommend the solution of Microsoft Teams, which, integrated with Exchange calendar, which is suitable for having good quality meetings, with screen sharing, chat and messageboard functions.

Author: Zoltan Mathe

ALSAD and me – when the shoemaker’s son does not walk around barefoot – in other words: walk your talk!

Business CEO’s and startup founders are usually too busy to lead a health-conscious lifestyle, we often think. But what happens if your business has a mission to improve people’s health by transforming everyday lifestyle? As a CEO/Founder, can you represent these values if you have BMI of 29, rely on snacks during working hours and dismiss the active life of student years? Our Founder/CEO Laszlo Varga tells how development in his professional life changed his private life in 2019.

Authenticity has always been of great importance to me on all aspects of life, including my work.

Our team created a fantastic lifestyle advisory system in 2019, which needed a „face”, someone representing corporate values. This „face” is usually the head of the organisation – but I could not represent these values if I was struggling with obesity myself. So let me share my own personal story.

From the active student to the overworked, overweight businessman

After finishing my university studies (in 2002) my weight was 68 kgs to my 175 cms height. I used to do sports about 2-3 times a week, which meant mainly playing as a football team member, in rather fierce matches and competitions.

I have always been fond of doing my tasks with maximum intensity, which applies to my work style as well.

As my professional career started to rise, which also meant higher level commitments, I tended to invest more and more time into my job. I worked 10-12 hours a day, undertaking tasks and challenges of increased level of responsibility.

I started to treat my job as a kind of sport. If our team had won a large and significant business, or managed to complete a strategic project, my body reacted by releasing a big dose of adrenaline.

However, this also meant that the time I could spend with “real” sport had been reduced to 4-5 occasions per month, and, which was even more important, my eating habits had been changed.

My eating routine had become very hectic, while I also noticed that I started snacking more and more during my long working hours. So my body gained 15-17 kgs during 15 years of professional business career.

When my second child, Bogi was born on the 8 February 2019, I was already 85 kgs.

(At this time the main modules and pillars of our application, ALSAD – Automated LifeStyle ADvice – started to emerge)

I had been working continuosly, while at home I had to do my share as a husband and a father of two (Rebi and Bogi) as well. My eating habits became a real mess, consuming very little fruit. Needless to say, the only means of exercise at that time was pushing the stroller.

And the time has come (in the last week of April 2019) when the scale showed 89 kgs which corresponds to a 29,1 BMI index. Frankly speaking, I was overweight. So at this point I said ‘STOP’.

Figure 1: The start – my initial health data 

We have been developing a fantastic system. I am the one person behind the concept, the one who elaborated the strategy of this application to achieve a healthier lifestyle, and, look at me, I am the one continously gaining weight. Am I doing what I am supposed to do? Nope. This has to be stopped. Immediately.

I was aware for some time that things were not going the right direction. Earlier, in 2012 spring I completed a 4-week-long, strict low carb diet and managed to achieve 7 kgs weight loss. However by August I gained back 8 kgs which means that overall my weight increased by 1 kg, experiencing the typical yo-yo effect.

I was reading a lot about diets on websites and in facebook groups, but did not understand why a woman (1,6 m, 84 kgs) was asking a man (1,92 m, 145 kgs) how he managed to lose 42 kgs.

They have different body types, with different BMI indexes. They obviously have different needs and daily calorie consumption. Then I have realized that most people are simply not educated well enough to know about diets and and their impact on their body and individual health status. This can – and should – be improved.

The journey begins – testing our application, my body and my level of commitment

Atthe end of April, 2019, my colleagues János and Béla demonstrated me features of the application. At this time the system was almost fully functional. We were about to launch a pilot for patients with kidney diseases, diabetes and obesity. Then I thought that why not include myself in this pilot? It could be the perfect time to get rid of that obsolete weight.

Therefore, on the 2nd of May I started using our own application.

I was doing it with great enthusiasm, I consulted a dietitian and set my goals.

My first goal was to reach a body weight value which starts with a 7, namely 79 kgs.

In order to reach this value I had to intake 2500-2600 calories (15% Protein, 55% Carbohydrate, 30% Lipid). The system informed me that in case of proper performance I can reach my goal by 5th of September.

Figure 2: Initial settings (diet goals)

I was very happy seeing this date, because this was almost coinciding with the birthday of my older daughter, Rebeka.

I tried to grasp this mentally, thus I quickly managed to switch to a routine of having 5 meals a day. First I thought it would be difficult, however, as mentioned before, it had been a mental decision.

Rather than starting eating whenever I felt hungry, my days became planned and organised. I have developed a new daily routine, which was fully supported by my family. My wife was particularly supportive and happy about my new lifestyle.

I was planning my days according to the recommendations of the system. And soon the results have reflected to these changes, and I started losing weight.

Figure 3: Diagram how my weight changed

I felt encouraged and enthusiastic, which has been noticed by all my family members, colleagues and business partners. They were asking how I was doing that.

Keeping it simple: personalised change of lifestyle combined with awareness. However, the first step for me was designing my diet.

Figure 4: Diet and menu plan

Getting a professional dietitian to create my personal menus seemed mission impossible, as it had two bottlenecks straight away: capacity of dietitians and available financial resources. But this is where technology could help me: after we configured my objectives and main guidelines with a professional (human) dietitian, the application was able to plan suitable (and enjoyable) daily menus, adjusted to my actual health and personal data, my goals, and some of my personal preferences.

Regarding sweets and snacks, I decreased the quantity to the bare minimum. To my surprise, I did not feel the urge to go for something sweet very often after my diet changed. When I felt like having a snack, I chose fruits and focused my attention to reach my goals with the help, or rather the guidance of the application.

Of course, I have some “days of sin”, but who does not have them?

I have my share of the birthday cake when celebrating my daughter or my wife, although I keep it in mind that I will have to manage this on the following days. I register these in the list of “consumed meals” which means that I am in the “red zone” in ALSAD on that particular day.

Is it worth lying? No! That would mean lying to myself what I have been done in the last 10 years – the price was 1 kgs weight gain in every single year.

Share your experience to help others to find their own path

My awareness has gradually developed, not only for me but my entire family. When we go shopping together, the first thing we check on food labels is not the warranty date of products and ingredients, but the table of nutritional values.

Sharing awareness with others for me is part of my job (in terms of sales), while sharing the experience is also an education process. Being able to educate each other is an important factor for me.

Not incidentally, authenticity stems not exclusively from the data delivered by the application, but my laboratory evidences. My laboratory results show excellent values concerning liver function, blood glucose level, cholesterol, while blood pressure and ECG results are also said to be ideal.

I arrived where I wanted to. My new objectives are to lose additional 4-5 kgs of weight, and then retain this result. However, I would like to achieve this not just by diet, but by doing regular sport.

My work, my little children, my family cannot be blamed anymore for not doing at least one hour’s vigorous exercise at least 1-2 times per week.

I got the proudest when my elder daughter once told me “Dad, I also want that salad and meal what you have” although she had the option to choose her favourite spaghetti bolognese.

Why I am telling all this to you?

I want to stress that „it is all in our heads”. Our mental approach is key, while our gadgets (smartwatch, mobile phone in our pockets, non-invasive blood glucose meter, intelligent scale, etc..) can help us effectively to navigate our lifestyles in a proper direction.

Figure 5: better BMI

And what is more: we can also help and motivate others. We are able to educate our mates without a medical degree, based on our own experience. Fashion and fad diets, however, are short-term solutions. The real solutions should come from professional medical and patient experience (We are all born as patients).

The most effective way of assistance I think is using a smart combination of personalised methodologies and tools, once our objectives are clear.

I am proud to say that ALSAD (Automated LifeStyle ADvice) application was also helping me to achieve my goals, and so “the shoemaker’s son does not walk around barefoot” 😊.

ICT in Healthcare projects: Expertise without borders

International cooperation can support digital transformation in healthcare in many ways. However, healthcare is special when it comes to digital transformation.

A global industry in a locally regulated and locally managed service domain

While ICT is probably the most global industry on Earth, with global supply chains, global players and global standards, healthcare is still very „local” as a service – local processes, local protocols and local culture.

In many ways Healthcare applies global standards and best practices (people tend to have similar health challenges around the world). However, local regulatory and management practices can be very different, as well as protocols, administration or even financial background.

Global technology now has the power to penetrate local healthcare systems. Global IT providers co-operate with clinicians and academic experts, often using a collaborative approach with specialists to support this process. Therefore, technology and best practice is now available across various countries and industries.

The patient – acting as a customer, though more vulnerable

We should not forget about the consumer. The consumer is called „the patient” in this case.

Patients are more vulnerable than the average customer, as their situation is very special, and they are often not in a situation to properly assess their status, have options and make a fully informed decision. However, the patients now tend to have expectations, which come from customer experience in other service industries: personalisation, user experience, information at his/her fingertips, even gamification and empowerment. This is the journey that we are now embracing in healthcare.

Too busy to embrace innovation? Too busy to save time and resources?

Healthcare is SPECIAL. Any good healthcare specialist I know (in any country) is overloaded with work. AND they feel there are more innovations out there from innovators than they can possibly absorb – some examples might be new innovations in diagnostic imaging, robot-assisted surgery tools, using AI in patient data analysis and many more.

We exhibited this year at the Dementia and Nursing Care Show in Birmingham. I met several health specialists and experienced care managers. My overall experience was that many of them feel somewhat uncomfortable with technology. They feel they lack knowledge and experience, while learning these would require even more resources. However, technology is there to serve them – I remember when we implemented a solution for Fresenius Medical Care which saved more than 30 minutes on every single patient’s administration, not to mention increased patient safety as technology reduced the risk of human errors. It was about real impact for the patient and the staff.

Safety comes first

Healthcare is about patient safety. Not a single innovation can be implemented unless it is proved to be absolute safe. This may lead to slow decision making processes – in a very fast changing tech environment.

Technology also raises several NEW questions related to healthcare: shall we use robots to combat loneliness? Is it OK to give patients tools to self-manage their condition? Can we trust software to classify diagnostic images to support decision making of radiologists?

Startups and innovations in the spotlight

The good news is that current innovation trends encourage large tech companies and small innovators to contribute to our collective digital health future. This means more attention, acceptance and funding all around the world. Institutions and governments identified opportunities in digital transformation in healthcare: Germany has passed a law to acknowledge digital treatments: the E-Health Act was followed by the Digital Care Act. Prescription of digital tools such as health bands is now part of treatment options. This trend is also being seen in the UK.

Interoperability, cloud environments and 4G, 5G networks can support this process – enabling global solutions to be used in local healthcare. (Just a few examples: DICOM files can now travel a bit easier than before, services from the cloud give fast and seamless access to applications and data, while less physical travel is required to perform technical support tasks.)

We need this computing capacity to analyse the aggregated health data, by health imaging tools or IoT widgets or collected in patient records. The magic is in the relationships! Scientists can find new information and solutions just by connecting the dots and reveal relationships too complex for a human eye or the human brain.

Share your experience with us

I am more than interested in hearing some of your views.

Does anyone have direct experience with….

  • Digital transformation projects and challenges in Health?
  • Do you have any direct experience as a PATIENT who actually knew that it would have been possible to personalise their treatment if data is used more effectively?
  • Does anyone have experience with unused „data silos” or important data that is not used to provide better treatment? (Just think about smart wearables, as data is often NEVER shown to a doctor.)
  • Any IT specialists struggling with specific challenges of healthcare? (Regulatory/GDPR? Clinical testing? Specific patient groups with cognitive difficulties? Interoperability issues? Just to name a few we have already seen in NETIS.)
  • Anyone who thinks the solution does exist…but there is not enough time, money or knowledge to implement it? (It may be easier and cheaper than you think, and can bring very, very tangible results.)

These are all issues which are challenging, however, not impossible to solve.

International collaboration does matter – and can make a real difference

It might be the case that if you are a clinician, your International clinical peers can share with you successes in Australia/Germany/Estonia… If you are a health IT specialist, it may just happen that your perfect Machine Learning Expert sits only 2 hours’ travel and a phone call away. They may be currently working on a Horizon2020 project reflecting YOUR problem. Global talent pools can provide the best value for money –while YOUR expertise may be sought somewhere in Spain, US or Hungary – if you are connected to the right channels.

Thinking global (or at least at the European level) can also be useful when you have a short term project, if you need some rare skills or your budget is very limited. (If you face ALL these at the same time, you may be in trouble. Heading to Mars having only training shoes and a bicycle?)

Your startup can scale up with international talent, while you can outsource some non-core, repetitive but important tasks.

Let me illustrate this with our recent project for Medway Community Healthcare, which had a telecare solution for elderly households. They could maintain this with our team’s help and do necessary updates (including a complete redevelopment of a particular application) as all tasks could be safely done remotely, within a tight budget.

Forms of international collaboration: from outsourcing to team augmentation

Some of you may not be absolutely familiar with some forms of international collaborations but let’s quickly go through a few examples.

You OUTSOURCE if there is a particular task to be performed, especially in a market which is not your home market, when the activity is not your core activity but important. It can also be a cost saving exercise (some countries like Hungary may have excellent technical talent pools, and much lower cost of living, with a similar average living standards like in the UK) but again I’d say value for money is key. Outsourcing is focusing on deliverables, while the team is not managed directly, and communication between the entities can be formal and standardised.

Partnerships are perfect when the organisations have complimentary skills and services. You may need us if you are a mobile expert, but need a company with Microsoft expertise, and we may need you if you are a professional medical content provider.

If you have a startup, you could benefit from team augmentation – this gives more security than freelancers and more industry knowledge than agencies. It might be useful to know that in the case of team augmentation your extended team works ONLY on your project.

Avoid traps and mitigate risks

Be careful when you are offered a service which is Cheap, High Quality AND Fast – to avoid any disappointment. You may also find out that you and your partner use exactly the same term but you mean completely different things by it (you may test this by defining „server”). However, you can use standards and some main principles of Accessibility, Sustainability and Compatibility to mitigate such risks.

At the very end, where does NETIS fit in this puzzle? We have 10 years’ experience in healthcare ICT, product development and infrastructure support and integration.  We are committed to patient empowerment and patient education, data-driven healthcare as well as supporting the British economy and the United Kingdom. We trust our organisations can collaborate well together – and hope to meet our potential international partners in one-to-one meetings or smaller and larger events related to digital healthcare. Progress comes through trusted collaboration and we hope that our workshop in London was- the first step towards new relationships.

This is an edited version of my presentation delivered on 17 October, 2019, at the Hungarian Embassy in London, for a professional audience involved in digital healthcare. You may visit Prezi for the associated slides and images used in the presentation.

Author: Eva Lajko

Coming soon: Workshop in London

After fundamental changes in several sectors and industries, digital transformation now means rapid changes in healthcare.  Digital treatments, automated patient education, big data analysis or sensor-supported patient monitoring are all part of the change.

Except for a few cases, most of the changes seem to be technology-led, while it would be crucial to involve medical professionals, patients and health service provider organisations to fully benefit from what technology can offer.

We are tech companies, working closely with industry, health providers, researchers, doctors and other health specialists to develop solutions which provide real support and assistance both for patients and medical pros. We need an active discussion with users and specialists to have a real understanding about needs and elements where we can add value – from reducing time of patient education and prevention or offering fine-tuned, personalised diet suggestions for those with a serious chronic condition to reliable solutions to fight hospital superbugs or super-fast and super-reliable CT segmentation.

As an industry professional, you might already be aware what digital technologies can offer in healthcare and would be open for a discussion with tech professionals how blockchain, mobile technologies, image  and data analysis or digital patient assistance/digital treatments can improve the efficiency of medical diagnoses and treatment.

Come and join our workshop at the prestigious location of the Hungarian Embassy in central London on 17 October 2019 to discuss various aspects of digital health technologies to support UK and European healthcare and patient safety together.

Join the event

Due to seating and security limits, the event is invitation-only, however, if interested to attend, please contact us directly if an invitation can be issued.

How to use artificial intelligence to treat diabetes and dialysis patients

Millions of patients enter their doctors’ office every day around the world seeking information on how to better manage their diabetes. And while getting information on blood glucose trends can be helpful, patients are largely on their own the moment their appointment is over.

That’s where artificial intelligence (AI) enters the picture. Imagine getting real-time information on blood glucose levels without having to prick your finger. Imagine changing your diet because you can identify which foods are causing your blood to spike. Imagine having the ability to predict your blood sugar levels up to an hour in advance.

Continuous real-time information is the key to futuristic care for diabetes and dialysis patients, and it’s all thanks to artificial intelligence.

Diabetes meets AI

New technology, such as Abbott Freestyle Libre and Dexcom G6 (among various competitors), have slowly been making massive ripples in the way patients self-manage their diabetes. This new technology, known as Continuous Glucose Monitoring (CGM), is innovative because it’s FDA-approved and helps patients to make decisions on insulin dosage with the tap of a button.

CGM devices send wireless transmissions to your smartphone, delivering real-time information about glucose levels. This allows patients to continuously monitor their levels and take immediate action in the event of a severe spike. Medtronic, a competitor of Abbott Freestyle Libre and Dexcom G6, even offers technology that claims to predict low blood sugar 10 – 60 minutes before it happens.

“Predict” is the keyword here. By continuously monitoring blood sugar levels, Medtronic learns your highs and lows which enables it to predict when these moments may occur, alerting patients to take immediate action (such as taking an insulin shot).

Diabetes coaching in real time

Continuous monitoring is one way to manage diabetes; real-time coaching in the palm of your hand is another. Apps such as BlueStar diabetes acts as a diabetes coach that sits in your pocket. Patients can enter their blood glucose results (that they receive from their CGM) and immediately receive suggestions on what they should do next.

BlueStar solves a significant issue in diabetes care that doctors often fear the most – a patient’s ability to manage their own symptoms when they’re alone. This technology gives patients advice the moment they need it, allowing them to record what they eat, how it affects their blood sugar levels and removing much of the guesswork required by doctors.

Connecting the dots

The hope is that technology will begin to play a much more significant role in diabetes care which in turn can help patients to find a correlation between their behaviors (such as the foods they eat) and how it’s affecting their health.

Artificial intelligence has the potential to revolutionize the way we manage diabetes. Not only are patients given information in real-time, but they’re also given guidance on what they should do to manage their symptoms.

Freestyle Libre, Dexcom G6, Medtronic and BlueStar are all positive signs that artificial intelligence has the potential to transform diabetes care. As the technology improves and becomes more popular patients will be given more power over their ability to self-manage their condition, improving their quality of life and eliminating the need for guesswork the next time they visit their doctor.

Author: Laszlo Varga


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