John Luo, MD

A patient with schizophrenia or Alzheimer’s disease can function at home, but his family fears he would suddenly “run off”—potentially harming himself or others—unless he is watched around the clock. Can this patient avoid more-restrictive, institutionalized care without burdening the family?

Enter global positioning and radio frequency tracking technologies that are gaining wider acceptance and could one day play a role in caring for the chronically mentally ill.

Tracking technologies

The global positioning system (GPS) was created in 1993, when the United States Air Force launched the 24 th Navstar satellite.¹ The system contains both military and civilian signals, but civilian accuracy initially was limited to 100 feet compared with 60 feet for the military signals. This limitation has since been lifted from civilian devices.

At first, GPS technology was used to navigate vehicles; later, specialized handheld devices provide navigation for hikers.

Today, GPS receivers are available for personal digital assistants, as are specialized wrist devices. Wherify Wireless offers GPS wrist devices, including GPS Locator for Kids, which allows parents or guardians to locate children within minutes and relay a message telling them to come home. GPS devices are increasingly popular and are used in the game of Geocaching,² where players use GPS technology to hunt for a cache.

Radio frequency identification devices (RFIDs) are microchips the size of a grain of rice that allow retailers to track goods from warehouse to retail shelf. The chip contains no power source, but utilizes the energy within the initial radio signal.

RFID tags do not harbor information other than an identification number, which can be linked to a medical record or other database. Unlike bar codes, which require direct exposure to scan, hidden RFIDs broadcast themselves when activated by the radio signal, making transactions faster and more convenient.

RFIDs have caught on. Cards with RFID tags have been used at the Academy Awards ceremony to control access. Guards at jails throughout the United States use RFID tags to verify inmates’ whereabouts. Customers at Exxon and Mobil gasoline stations use RFID devices (called Speedpass) to facilitate purchases at the pump or register.

In 2002, RFID implants became available at medical clinics³ and are beginning to reach the mainstream. At the Baja Beach nightclub in Barcelona, for example, guests with the implant in their arms gain access to VIP areas once they pass through the scanner (which automatically assesses the cover charge to their tab).⁴

Approximately 1,000 persons have received VeriChip RFID implants over 2 years.⁵

How GPS, RFID can help caretakers

GPS. Caretakers can use GPS tracking devices to track a patient with a chronic mental disorder.

For example, the patient can wear a Wherify Wireless GPS locator wristwatch. To track the patient, the caretaker would log on to Wherify’s demo Web site (http://www.wherifywireless.com/demo.htm) and enter the device’s ID number. After clicking on the “locate” button, the locator device is contacted and its position and time of position is displayed on a map. Alternately, subscribers can call an 800 number and ask the operator to relay the locator address.

The wristwatch or locator phone costs about $200, and a monthly subscription ranges from $20 to $45 depending on number of location queries. The wristwatch comes with a remote-activated safety lock feature to prevent the patient from taking it off.

RFID. VeriChip implants are geared for indoor use, but can supplement a GPS device to track a chronically mentally ill patient.

The 11-millimeter chip, commonly used for standard security applications, is injected into the fatty tissue of the right tricep. When the recipient is near a VeriChip scanning device, the chip radios an ID number to the scanner. If the number matches an ID number in the database, the person with the implant can enter a secured room or complete a financial transaction.⁵

The FDA is reviewing whether hospitals can use RFID implants to identify patients and allow staff access to medical records without violating patients’ privacy.⁵

RFID tags located in wristbands could be used to identify hospitalized patients and prevent medication errors. RFID-tagged identification cards could help authenticate staff for access to the electronic medical record. Tags embedded in the bottle cap could measure medication compliance,⁶ and blister packs reveal when the medication was last taken.⁷ Special probes also could determine if the medication has expired or been stored properly.

Inviting ‘Big Brother’?

Critics, however, say use of GPS or RFID technology threatens privacy. The group Consumers Against Supermarket Privacy Invasion and Numbering (CASPIAN) complains that unique ID tags identify who purchased which product and where. Because the monitoring is passive via radio waves, these tags can be hidden and read at a distance—meaning that people can be monitored without their knowledge or consent. Critics also fear that the radio waves may pose a health hazard.⁸

Accuracy is another concern. Although GPS technology provides location information, the locator device still depends on cellular phone technology to transmit the information. Poor cellular coverage areas may decrease the device’s usefulness. More importantly, because GPS devices require a clear view of the sky to access the satellites, they do not work indoors. Thus, a patient must have escaped the house for the device to work.

Related Resources

1. World Research Group: Leveraging RFID for hospitals. http://www.worldrg.com/HW455/agenda.asp

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

A patient with schizophrenia or Alzheimer’s disease can function at home, but his family fears he would suddenly “run off”—potentially harming himself or others—unless he is watched around the clock. Can this patient avoid more-restrictive, institutionalized care without burdening the family?

Enter global positioning and radio frequency tracking technologies that are gaining wider acceptance and could one day play a role in caring for the chronically mentally ill.

Tracking technologies

The global positioning system (GPS) was created in 1993, when the United States Air Force launched the 24 th Navstar satellite.¹ The system contains both military and civilian signals, but civilian accuracy initially was limited to 100 feet compared with 60 feet for the military signals. This limitation has since been lifted from civilian devices.

At first, GPS technology was used to navigate vehicles; later, specialized handheld devices provide navigation for hikers.

Today, GPS receivers are available for personal digital assistants, as are specialized wrist devices. Wherify Wireless offers GPS wrist devices, including GPS Locator for Kids, which allows parents or guardians to locate children within minutes and relay a message telling them to come home. GPS devices are increasingly popular and are used in the game of Geocaching,² where players use GPS technology to hunt for a cache.

Radio frequency identification devices (RFIDs) are microchips the size of a grain of rice that allow retailers to track goods from warehouse to retail shelf. The chip contains no power source, but utilizes the energy within the initial radio signal.

RFID tags do not harbor information other than an identification number, which can be linked to a medical record or other database. Unlike bar codes, which require direct exposure to scan, hidden RFIDs broadcast themselves when activated by the radio signal, making transactions faster and more convenient.

RFIDs have caught on. Cards with RFID tags have been used at the Academy Awards ceremony to control access. Guards at jails throughout the United States use RFID tags to verify inmates’ whereabouts. Customers at Exxon and Mobil gasoline stations use RFID devices (called Speedpass) to facilitate purchases at the pump or register.

In 2002, RFID implants became available at medical clinics³ and are beginning to reach the mainstream. At the Baja Beach nightclub in Barcelona, for example, guests with the implant in their arms gain access to VIP areas once they pass through the scanner (which automatically assesses the cover charge to their tab).⁴

Approximately 1,000 persons have received VeriChip RFID implants over 2 years.⁵

How GPS, RFID can help caretakers

GPS. Caretakers can use GPS tracking devices to track a patient with a chronic mental disorder.

For example, the patient can wear a Wherify Wireless GPS locator wristwatch. To track the patient, the caretaker would log on to Wherify’s demo Web site (http://www.wherifywireless.com/demo.htm) and enter the device’s ID number. After clicking on the “locate” button, the locator device is contacted and its position and time of position is displayed on a map. Alternately, subscribers can call an 800 number and ask the operator to relay the locator address.

The wristwatch or locator phone costs about $200, and a monthly subscription ranges from $20 to $45 depending on number of location queries. The wristwatch comes with a remote-activated safety lock feature to prevent the patient from taking it off.

RFID. VeriChip implants are geared for indoor use, but can supplement a GPS device to track a chronically mentally ill patient.

The 11-millimeter chip, commonly used for standard security applications, is injected into the fatty tissue of the right tricep. When the recipient is near a VeriChip scanning device, the chip radios an ID number to the scanner. If the number matches an ID number in the database, the person with the implant can enter a secured room or complete a financial transaction.⁵

The FDA is reviewing whether hospitals can use RFID implants to identify patients and allow staff access to medical records without violating patients’ privacy.⁵

RFID tags located in wristbands could be used to identify hospitalized patients and prevent medication errors. RFID-tagged identification cards could help authenticate staff for access to the electronic medical record. Tags embedded in the bottle cap could measure medication compliance,⁶ and blister packs reveal when the medication was last taken.⁷ Special probes also could determine if the medication has expired or been stored properly.

Inviting ‘Big Brother’?

Critics, however, say use of GPS or RFID technology threatens privacy. The group Consumers Against Supermarket Privacy Invasion and Numbering (CASPIAN) complains that unique ID tags identify who purchased which product and where. Because the monitoring is passive via radio waves, these tags can be hidden and read at a distance—meaning that people can be monitored without their knowledge or consent. Critics also fear that the radio waves may pose a health hazard.⁸

Accuracy is another concern. Although GPS technology provides location information, the locator device still depends on cellular phone technology to transmit the information. Poor cellular coverage areas may decrease the device’s usefulness. More importantly, because GPS devices require a clear view of the sky to access the satellites, they do not work indoors. Thus, a patient must have escaped the house for the device to work.

Related Resources

1. World Research Group: Leveraging RFID for hospitals. http://www.worldrg.com/HW455/agenda.asp

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

A patient with schizophrenia or Alzheimer’s disease can function at home, but his family fears he would suddenly “run off”—potentially harming himself or others—unless he is watched around the clock. Can this patient avoid more-restrictive, institutionalized care without burdening the family?

Enter global positioning and radio frequency tracking technologies that are gaining wider acceptance and could one day play a role in caring for the chronically mentally ill.

Tracking technologies

The global positioning system (GPS) was created in 1993, when the United States Air Force launched the 24 th Navstar satellite.¹ The system contains both military and civilian signals, but civilian accuracy initially was limited to 100 feet compared with 60 feet for the military signals. This limitation has since been lifted from civilian devices.

At first, GPS technology was used to navigate vehicles; later, specialized handheld devices provide navigation for hikers.

Today, GPS receivers are available for personal digital assistants, as are specialized wrist devices. Wherify Wireless offers GPS wrist devices, including GPS Locator for Kids, which allows parents or guardians to locate children within minutes and relay a message telling them to come home. GPS devices are increasingly popular and are used in the game of Geocaching,² where players use GPS technology to hunt for a cache.

Radio frequency identification devices (RFIDs) are microchips the size of a grain of rice that allow retailers to track goods from warehouse to retail shelf. The chip contains no power source, but utilizes the energy within the initial radio signal.

RFID tags do not harbor information other than an identification number, which can be linked to a medical record or other database. Unlike bar codes, which require direct exposure to scan, hidden RFIDs broadcast themselves when activated by the radio signal, making transactions faster and more convenient.

RFIDs have caught on. Cards with RFID tags have been used at the Academy Awards ceremony to control access. Guards at jails throughout the United States use RFID tags to verify inmates’ whereabouts. Customers at Exxon and Mobil gasoline stations use RFID devices (called Speedpass) to facilitate purchases at the pump or register.

In 2002, RFID implants became available at medical clinics³ and are beginning to reach the mainstream. At the Baja Beach nightclub in Barcelona, for example, guests with the implant in their arms gain access to VIP areas once they pass through the scanner (which automatically assesses the cover charge to their tab).⁴

Approximately 1,000 persons have received VeriChip RFID implants over 2 years.⁵

How GPS, RFID can help caretakers

GPS. Caretakers can use GPS tracking devices to track a patient with a chronic mental disorder.

For example, the patient can wear a Wherify Wireless GPS locator wristwatch. To track the patient, the caretaker would log on to Wherify’s demo Web site (http://www.wherifywireless.com/demo.htm) and enter the device’s ID number. After clicking on the “locate” button, the locator device is contacted and its position and time of position is displayed on a map. Alternately, subscribers can call an 800 number and ask the operator to relay the locator address.

The wristwatch or locator phone costs about $200, and a monthly subscription ranges from $20 to $45 depending on number of location queries. The wristwatch comes with a remote-activated safety lock feature to prevent the patient from taking it off.

RFID. VeriChip implants are geared for indoor use, but can supplement a GPS device to track a chronically mentally ill patient.

The 11-millimeter chip, commonly used for standard security applications, is injected into the fatty tissue of the right tricep. When the recipient is near a VeriChip scanning device, the chip radios an ID number to the scanner. If the number matches an ID number in the database, the person with the implant can enter a secured room or complete a financial transaction.⁵

The FDA is reviewing whether hospitals can use RFID implants to identify patients and allow staff access to medical records without violating patients’ privacy.⁵

RFID tags located in wristbands could be used to identify hospitalized patients and prevent medication errors. RFID-tagged identification cards could help authenticate staff for access to the electronic medical record. Tags embedded in the bottle cap could measure medication compliance,⁶ and blister packs reveal when the medication was last taken.⁷ Special probes also could determine if the medication has expired or been stored properly.

Inviting ‘Big Brother’?

Critics, however, say use of GPS or RFID technology threatens privacy. The group Consumers Against Supermarket Privacy Invasion and Numbering (CASPIAN) complains that unique ID tags identify who purchased which product and where. Because the monitoring is passive via radio waves, these tags can be hidden and read at a distance—meaning that people can be monitored without their knowledge or consent. Critics also fear that the radio waves may pose a health hazard.⁸

Accuracy is another concern. Although GPS technology provides location information, the locator device still depends on cellular phone technology to transmit the information. Poor cellular coverage areas may decrease the device’s usefulness. More importantly, because GPS devices require a clear view of the sky to access the satellites, they do not work indoors. Thus, a patient must have escaped the house for the device to work.

Related Resources

1. World Research Group: Leveraging RFID for hospitals. http://www.worldrg.com/HW455/agenda.asp

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

In a practice that lives on frequent typing and computer use, repetitive strain injuries pose an occupational hazard. These painful injuries can dampen quality of life and disable you or a staff member.

The best way to deal with repetitive strain injuries is to avoid them. Here are some simple precautions.

How repetitive strain injuries happen

Repetitive strain injuries result from repeated physical movements. Symptoms vary, but include tightness, stiffness, soreness, or burning in the hands, wrists, fingers, and/or elbows. Tingling, coldness, or numbness in these joints may also occur. Persons with such injuries might be awoken at night by the pain, or they may lose strength and coordination and become clumsy. Pain after a few seconds of typing may signal a repetitive strain injury, as can moderate wrist pain after typing a lengthy document.

Computer typing and mouse use require repeated movements that strain or damage tendons, nerves, and muscles in the hands, arms, wrists, shoulders, and neck. A touch typist who can type fast without looking at the keyboard is at higher risk of repetitive strain injuries than a slower typist who “hunts and pecks” at keys, because slower typing does not cause as much strain.

Today’s medicolegal climate, however, demands that clinicians keep legible (ie, electronic) records, which means additional typing and clicking for you and your staff.

What is worse, computers often are placed in spots for which they were not designed, making mouse and keyboard work awkward and physically taxing. This is particularly true in older hospitals, where charting areas typically were designed for writing but not typing.

Prevention strategies

Harvard RSI Action, a Harvard University student group dedicated to repetitive strain injury education and prevention, offers the following advice:^{Text-entry solutions: which ‘type’ is right for you ?” Psyber Psychiatry, February 2003). Do not type if you cannot do so for more than 10 minutes without pain.1}

Voice recognition software not only processes text but can also be used for Web browsing, launching applications, sending e-mail, and completing forms. But although this technology has improved dramatically in recent years, it is not yet 100% accurate or integrated into all computer applications used by physicians. Popular voice recognition programs include Scansoft Dragon Naturally Speaking and IBM ViaVoice.

Related resources

Typing Injury Frequently Asked Questions. http://www.tifaq.com

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

In a practice that lives on frequent typing and computer use, repetitive strain injuries pose an occupational hazard. These painful injuries can dampen quality of life and disable you or a staff member.

The best way to deal with repetitive strain injuries is to avoid them. Here are some simple precautions.

How repetitive strain injuries happen

Repetitive strain injuries result from repeated physical movements. Symptoms vary, but include tightness, stiffness, soreness, or burning in the hands, wrists, fingers, and/or elbows. Tingling, coldness, or numbness in these joints may also occur. Persons with such injuries might be awoken at night by the pain, or they may lose strength and coordination and become clumsy. Pain after a few seconds of typing may signal a repetitive strain injury, as can moderate wrist pain after typing a lengthy document.

Computer typing and mouse use require repeated movements that strain or damage tendons, nerves, and muscles in the hands, arms, wrists, shoulders, and neck. A touch typist who can type fast without looking at the keyboard is at higher risk of repetitive strain injuries than a slower typist who “hunts and pecks” at keys, because slower typing does not cause as much strain.

Today’s medicolegal climate, however, demands that clinicians keep legible (ie, electronic) records, which means additional typing and clicking for you and your staff.

What is worse, computers often are placed in spots for which they were not designed, making mouse and keyboard work awkward and physically taxing. This is particularly true in older hospitals, where charting areas typically were designed for writing but not typing.

Prevention strategies

Harvard RSI Action, a Harvard University student group dedicated to repetitive strain injury education and prevention, offers the following advice:^{Text-entry solutions: which ‘type’ is right for you ?” Psyber Psychiatry, February 2003). Do not type if you cannot do so for more than 10 minutes without pain.1}

Voice recognition software not only processes text but can also be used for Web browsing, launching applications, sending e-mail, and completing forms. But although this technology has improved dramatically in recent years, it is not yet 100% accurate or integrated into all computer applications used by physicians. Popular voice recognition programs include Scansoft Dragon Naturally Speaking and IBM ViaVoice.

Related resources

Typing Injury Frequently Asked Questions. http://www.tifaq.com

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

In a practice that lives on frequent typing and computer use, repetitive strain injuries pose an occupational hazard. These painful injuries can dampen quality of life and disable you or a staff member.

The best way to deal with repetitive strain injuries is to avoid them. Here are some simple precautions.

How repetitive strain injuries happen

Repetitive strain injuries result from repeated physical movements. Symptoms vary, but include tightness, stiffness, soreness, or burning in the hands, wrists, fingers, and/or elbows. Tingling, coldness, or numbness in these joints may also occur. Persons with such injuries might be awoken at night by the pain, or they may lose strength and coordination and become clumsy. Pain after a few seconds of typing may signal a repetitive strain injury, as can moderate wrist pain after typing a lengthy document.

Computer typing and mouse use require repeated movements that strain or damage tendons, nerves, and muscles in the hands, arms, wrists, shoulders, and neck. A touch typist who can type fast without looking at the keyboard is at higher risk of repetitive strain injuries than a slower typist who “hunts and pecks” at keys, because slower typing does not cause as much strain.

Today’s medicolegal climate, however, demands that clinicians keep legible (ie, electronic) records, which means additional typing and clicking for you and your staff.

What is worse, computers often are placed in spots for which they were not designed, making mouse and keyboard work awkward and physically taxing. This is particularly true in older hospitals, where charting areas typically were designed for writing but not typing.

Prevention strategies

Harvard RSI Action, a Harvard University student group dedicated to repetitive strain injury education and prevention, offers the following advice:^{Text-entry solutions: which ‘type’ is right for you ?” Psyber Psychiatry, February 2003). Do not type if you cannot do so for more than 10 minutes without pain.1}

Voice recognition software not only processes text but can also be used for Web browsing, launching applications, sending e-mail, and completing forms. But although this technology has improved dramatically in recent years, it is not yet 100% accurate or integrated into all computer applications used by physicians. Popular voice recognition programs include Scansoft Dragon Naturally Speaking and IBM ViaVoice.

Related resources

Typing Injury Frequently Asked Questions. http://www.tifaq.com

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

Is your office computer system-and the confidential patient records it contains-safe from hackers?

Maintaining office computer security isn’t just good practice-it’s the law. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires physicians to ensure that patient records are kept confidential.^{click here.}

Hardware tokens are pocket-size devices that, when connected to the computer, allow access by entering the proper password. Hardware tokens are suitable for managing off-site remote access and add another layer of security for local access.

Medical records programs. Most software programs allow administrators to restrict access to medical records by setting up levels of ability to access and modifying electronic records for different users. Each user should have a unique password for authentication. The software also should have an audit trail capability, so that each user’s activity with electronic patient records can be reviewed.

Security breaches

An Internet connection-however brief-can invite security breaches that allow hackers to access patient information, delete programs, steal passwords, disrupt other Internet-connected computers, and erase the hard drive. Avoiding Internet connections altogether would increase security, but this is not feasible.

• Viruses reproduce using the host computer, most commonly by infiltrating the e-mail program and making it hard to detect corrupted files.
• Worms are similar to viruses but are self-contained, whereas a virus must attach to another file.
• Trojan horse programs, usually disguised within seemingly legitimate Internet programs, are less common than viruses or worms. They do not replicate but are equally dangerous. You unknowingly start the Trojan horse after downloading what looks like a useful program. The Trojan horse then self-installs silently, giving the hacker who created it access to your computer.
• Port attacks are malicious attempts to connect and eventually take over another computer. A ‘port’ is a software ‘location’ where a program on another computer can connect to a host computer.
• NEVER open e-mails from unfamiliar sources. Viruses are commonly sent as attachments, which you should never open unless you know they are safe.
• Turn off your computer or disconnect from the Internet when not in use.
• Back up your data regularly. Put patient files in one folder or directory, then copy them to a backup medium such as CD-ROM, zip drive, or portable hard drive. Of course, keep the disks in a secure place.

Anti-intrusion programs

Antivirus programs can check for the latest viruses and their variants and remove them. To do this, automatically update the program with new virus signature files- files created by antivirus program vendors to help the software identify viruses. Most antivirus programs will automatically check the vendor’s Web site for updated files if the computer is connected to the Internet.

Virus signature files should be updated daily to provide maximum protection. Most companies provide a 1-year subscription to the updates, which must be renewed upon expiration for new virus definition files.

Manual updating is acceptable but may be too time-consuming for a busy office.

Well-known antivirus programs include Wireless Internet 101,” Psyber Psychiatry, December 2003)

If your computer is connected directly to the DSL or cable modem or a telephone line, you probably need a firewall. The most recent Microsoft Windows XP and Mac OS X versions each include a software firewall, which should be activated upon installation.

Windows-compatible firewall programs include ZoneAlarm, Sygate Personal Firewall, Symantec Norton Personal Firewall, and Tiny Software Personal. Mac OS-compatible firewalls include Intego NetBarrier, Sustainable Softworks IPNetSentryX, and Norton Personal Firewall.

Once your firewall is installed, check it to verify that all ports are protected. Gibson Research Corp. has two excellent (and free) security checks: ShieldsUP! and LeakTest. Run these tests, then follow the listed suggestions to secure your computer.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

Is your office computer system-and the confidential patient records it contains-safe from hackers?

Maintaining office computer security isn’t just good practice-it’s the law. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires physicians to ensure that patient records are kept confidential.^{click here.}

Hardware tokens are pocket-size devices that, when connected to the computer, allow access by entering the proper password. Hardware tokens are suitable for managing off-site remote access and add another layer of security for local access.

Medical records programs. Most software programs allow administrators to restrict access to medical records by setting up levels of ability to access and modifying electronic records for different users. Each user should have a unique password for authentication. The software also should have an audit trail capability, so that each user’s activity with electronic patient records can be reviewed.

Security breaches

An Internet connection-however brief-can invite security breaches that allow hackers to access patient information, delete programs, steal passwords, disrupt other Internet-connected computers, and erase the hard drive. Avoiding Internet connections altogether would increase security, but this is not feasible.

• Viruses reproduce using the host computer, most commonly by infiltrating the e-mail program and making it hard to detect corrupted files.
• Worms are similar to viruses but are self-contained, whereas a virus must attach to another file.
• Trojan horse programs, usually disguised within seemingly legitimate Internet programs, are less common than viruses or worms. They do not replicate but are equally dangerous. You unknowingly start the Trojan horse after downloading what looks like a useful program. The Trojan horse then self-installs silently, giving the hacker who created it access to your computer.
• Port attacks are malicious attempts to connect and eventually take over another computer. A ‘port’ is a software ‘location’ where a program on another computer can connect to a host computer.
• NEVER open e-mails from unfamiliar sources. Viruses are commonly sent as attachments, which you should never open unless you know they are safe.
• Turn off your computer or disconnect from the Internet when not in use.
• Back up your data regularly. Put patient files in one folder or directory, then copy them to a backup medium such as CD-ROM, zip drive, or portable hard drive. Of course, keep the disks in a secure place.

Anti-intrusion programs

Antivirus programs can check for the latest viruses and their variants and remove them. To do this, automatically update the program with new virus signature files- files created by antivirus program vendors to help the software identify viruses. Most antivirus programs will automatically check the vendor’s Web site for updated files if the computer is connected to the Internet.

Virus signature files should be updated daily to provide maximum protection. Most companies provide a 1-year subscription to the updates, which must be renewed upon expiration for new virus definition files.

Manual updating is acceptable but may be too time-consuming for a busy office.

Well-known antivirus programs include Wireless Internet 101,” Psyber Psychiatry, December 2003)

If your computer is connected directly to the DSL or cable modem or a telephone line, you probably need a firewall. The most recent Microsoft Windows XP and Mac OS X versions each include a software firewall, which should be activated upon installation.

Windows-compatible firewall programs include ZoneAlarm, Sygate Personal Firewall, Symantec Norton Personal Firewall, and Tiny Software Personal. Mac OS-compatible firewalls include Intego NetBarrier, Sustainable Softworks IPNetSentryX, and Norton Personal Firewall.

Once your firewall is installed, check it to verify that all ports are protected. Gibson Research Corp. has two excellent (and free) security checks: ShieldsUP! and LeakTest. Run these tests, then follow the listed suggestions to secure your computer.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

Is your office computer system-and the confidential patient records it contains-safe from hackers?

Maintaining office computer security isn’t just good practice-it’s the law. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires physicians to ensure that patient records are kept confidential.^{click here.}

Hardware tokens are pocket-size devices that, when connected to the computer, allow access by entering the proper password. Hardware tokens are suitable for managing off-site remote access and add another layer of security for local access.

Medical records programs. Most software programs allow administrators to restrict access to medical records by setting up levels of ability to access and modifying electronic records for different users. Each user should have a unique password for authentication. The software also should have an audit trail capability, so that each user’s activity with electronic patient records can be reviewed.

Security breaches

An Internet connection-however brief-can invite security breaches that allow hackers to access patient information, delete programs, steal passwords, disrupt other Internet-connected computers, and erase the hard drive. Avoiding Internet connections altogether would increase security, but this is not feasible.

• Viruses reproduce using the host computer, most commonly by infiltrating the e-mail program and making it hard to detect corrupted files.
• Worms are similar to viruses but are self-contained, whereas a virus must attach to another file.
• Trojan horse programs, usually disguised within seemingly legitimate Internet programs, are less common than viruses or worms. They do not replicate but are equally dangerous. You unknowingly start the Trojan horse after downloading what looks like a useful program. The Trojan horse then self-installs silently, giving the hacker who created it access to your computer.
• Port attacks are malicious attempts to connect and eventually take over another computer. A ‘port’ is a software ‘location’ where a program on another computer can connect to a host computer.
• NEVER open e-mails from unfamiliar sources. Viruses are commonly sent as attachments, which you should never open unless you know they are safe.
• Turn off your computer or disconnect from the Internet when not in use.
• Back up your data regularly. Put patient files in one folder or directory, then copy them to a backup medium such as CD-ROM, zip drive, or portable hard drive. Of course, keep the disks in a secure place.

Anti-intrusion programs

Antivirus programs can check for the latest viruses and their variants and remove them. To do this, automatically update the program with new virus signature files- files created by antivirus program vendors to help the software identify viruses. Most antivirus programs will automatically check the vendor’s Web site for updated files if the computer is connected to the Internet.

Virus signature files should be updated daily to provide maximum protection. Most companies provide a 1-year subscription to the updates, which must be renewed upon expiration for new virus definition files.

Manual updating is acceptable but may be too time-consuming for a busy office.

Well-known antivirus programs include Wireless Internet 101,” Psyber Psychiatry, December 2003)

If your computer is connected directly to the DSL or cable modem or a telephone line, you probably need a firewall. The most recent Microsoft Windows XP and Mac OS X versions each include a software firewall, which should be activated upon installation.

Windows-compatible firewall programs include ZoneAlarm, Sygate Personal Firewall, Symantec Norton Personal Firewall, and Tiny Software Personal. Mac OS-compatible firewalls include Intego NetBarrier, Sustainable Softworks IPNetSentryX, and Norton Personal Firewall.

Once your firewall is installed, check it to verify that all ports are protected. Gibson Research Corp. has two excellent (and free) security checks: ShieldsUP! and LeakTest. Run these tests, then follow the listed suggestions to secure your computer.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of CURRENT PSYCHIATRY.

Personal digital assistants (PDA) are in a state of flux. Thanks to a flurry of hardware and operating system improvements over the last 18 months, PDAs that were cutting-edge last year pale in comparison to newer models.

Should you buy a new PDA now, or stick with your current model and wait for still more innovations? This article can help you decide.

Why upgrade?

Pros. Today’s PDAs are more versatile and intuitive. For example, many combination PDA/mobile phones have newer operating systems, more memory, and greater software compatibility than earlier devices.

A frequent PDA user who craves more speed or added features might want to upgrade now. Likewise, users who are constantly on the road might want a new combination PDA/global positioning system.

Cons. PDA operating systems are updated frequently, reflecting continuing improvements in handheld hardware. Microsoft late last year upgraded its Pocket PC operating system and changed its name to Windows Mobile.

Although frequent users will rejoice in the opportunity to do more, others might not want to spend $300 or more to get the latest features—only to see their new device become outmoded in a few months.

Hardware advances

Processors. The processor, the heart of a PDA, has also seen much change. Newer Palm and Pocket PC devices are based on the strongARM microprocessor produced by Intel under the Xscale brand. Each new processor has more speed, better multimedia, an improved camera interface, and lower power consumption than previous processors.

Smartphones, which reached the market in 2002, are geared to physicians who rely mostly on email and calendar functions and have little need for mobile medical information.

A Windows Mobile smartphone typically looks like a mobile phone but has basic Pocket PC capabilities, such as viewing mail, a calendar, to-do list, and notes.

Windows Mobile smartphones, however, are compatible only with smartphone-specific programs, not with general Pocket PC software. This means that drug reference guides, DSM-IV-TR, and other commonly used medical programs cannot be viewed on a smartphone. If you love the idea of a smartphone but want a specialized program, check out www.smartphone.net.

Pocket PC phone. By contrast, the Pocket PC phone looks and works more like a PDA than a phone. Because it is connected to the cellular network, the device has wider Internet access than does a WiFi-enabled Pocket PC3. At 3.5-by-3.5 inches, the screen size is about twice that of the smartphone’s screen. The device also is compatible with all Pocket PC software.

Pocket PC phones typically have more main memory than smartphones. Smartphones are limited to secure digital-based external memory, but Pocket PC phones have infrared and other connectivity options.

Palm-based smartphones can run most Palm software, depending upon operating system compatibility. Previous Palm smartphones were more limited because of an older operating system and lack of external memory cards.

The palmOne Treo 600, based on the new Palm Version 5 operating system, offers an external memory slot, built-in digital camera, and text messaging. palmOne offers a GSM (global system for mobile communication) protocol version for the T-Mobile, Cingular, and AT&T networks, and a CDMA (code-division multiple access) protocol version for the Sprint network.

Operating system improvements

Palm Source has released version 6 of its operating system—code named “Cobalt”—to hardware developers. This versatile new version—with higher resolution, Word and JPEG file support, simultaneous multiple communications, and other features—could reach the market around the winter holiday.

Microsoft has released Windows Mobile 2003 Second Edition. With certain devices, the operating system will help users read text or browse the Web by using more of the screen. With larger screen resolutions packed into a smaller area, fonts are smaller and hard to read. Windows Mobile 2003 Second Edition provides additional font-size controls to compensate for this change.

The new Windows Mobile version also features a start menu that displays frequently used applications, and WiFi security is improved compared with the previous version.

The future

Tiquit, OQO, and FlipStart plan to release fully operable handheld computers later this year.

These new devices will run on Windows XP and other operating systems and will feature full central processing units, hard disks, liquid crystal display panels, USB connectivity, and built-in QWERTY keyboards. It remains to be seen if these computers will supersede Palm and Windows Mobile PDAs.

Sony’s new Vaio U70 handheld computer, recently released in Japan, is available in the United States via specialty retailers such as dynamism.com.

Personal digital assistants (PDA) are in a state of flux. Thanks to a flurry of hardware and operating system improvements over the last 18 months, PDAs that were cutting-edge last year pale in comparison to newer models.

Should you buy a new PDA now, or stick with your current model and wait for still more innovations? This article can help you decide.

Why upgrade?

Pros. Today’s PDAs are more versatile and intuitive. For example, many combination PDA/mobile phones have newer operating systems, more memory, and greater software compatibility than earlier devices.

A frequent PDA user who craves more speed or added features might want to upgrade now. Likewise, users who are constantly on the road might want a new combination PDA/global positioning system.

Cons. PDA operating systems are updated frequently, reflecting continuing improvements in handheld hardware. Microsoft late last year upgraded its Pocket PC operating system and changed its name to Windows Mobile.

Although frequent users will rejoice in the opportunity to do more, others might not want to spend $300 or more to get the latest features—only to see their new device become outmoded in a few months.

Hardware advances

Processors. The processor, the heart of a PDA, has also seen much change. Newer Palm and Pocket PC devices are based on the strongARM microprocessor produced by Intel under the Xscale brand. Each new processor has more speed, better multimedia, an improved camera interface, and lower power consumption than previous processors.

Smartphones, which reached the market in 2002, are geared to physicians who rely mostly on email and calendar functions and have little need for mobile medical information.

A Windows Mobile smartphone typically looks like a mobile phone but has basic Pocket PC capabilities, such as viewing mail, a calendar, to-do list, and notes.

Windows Mobile smartphones, however, are compatible only with smartphone-specific programs, not with general Pocket PC software. This means that drug reference guides, DSM-IV-TR, and other commonly used medical programs cannot be viewed on a smartphone. If you love the idea of a smartphone but want a specialized program, check out www.smartphone.net.

Pocket PC phone. By contrast, the Pocket PC phone looks and works more like a PDA than a phone. Because it is connected to the cellular network, the device has wider Internet access than does a WiFi-enabled Pocket PC3. At 3.5-by-3.5 inches, the screen size is about twice that of the smartphone’s screen. The device also is compatible with all Pocket PC software.

Pocket PC phones typically have more main memory than smartphones. Smartphones are limited to secure digital-based external memory, but Pocket PC phones have infrared and other connectivity options.

Palm-based smartphones can run most Palm software, depending upon operating system compatibility. Previous Palm smartphones were more limited because of an older operating system and lack of external memory cards.

The palmOne Treo 600, based on the new Palm Version 5 operating system, offers an external memory slot, built-in digital camera, and text messaging. palmOne offers a GSM (global system for mobile communication) protocol version for the T-Mobile, Cingular, and AT&T networks, and a CDMA (code-division multiple access) protocol version for the Sprint network.

Operating system improvements

Palm Source has released version 6 of its operating system—code named “Cobalt”—to hardware developers. This versatile new version—with higher resolution, Word and JPEG file support, simultaneous multiple communications, and other features—could reach the market around the winter holiday.

Microsoft has released Windows Mobile 2003 Second Edition. With certain devices, the operating system will help users read text or browse the Web by using more of the screen. With larger screen resolutions packed into a smaller area, fonts are smaller and hard to read. Windows Mobile 2003 Second Edition provides additional font-size controls to compensate for this change.

The new Windows Mobile version also features a start menu that displays frequently used applications, and WiFi security is improved compared with the previous version.

The future

Tiquit, OQO, and FlipStart plan to release fully operable handheld computers later this year.

These new devices will run on Windows XP and other operating systems and will feature full central processing units, hard disks, liquid crystal display panels, USB connectivity, and built-in QWERTY keyboards. It remains to be seen if these computers will supersede Palm and Windows Mobile PDAs.

Sony’s new Vaio U70 handheld computer, recently released in Japan, is available in the United States via specialty retailers such as dynamism.com.

Personal digital assistants (PDA) are in a state of flux. Thanks to a flurry of hardware and operating system improvements over the last 18 months, PDAs that were cutting-edge last year pale in comparison to newer models.

Should you buy a new PDA now, or stick with your current model and wait for still more innovations? This article can help you decide.

Why upgrade?

Pros. Today’s PDAs are more versatile and intuitive. For example, many combination PDA/mobile phones have newer operating systems, more memory, and greater software compatibility than earlier devices.

A frequent PDA user who craves more speed or added features might want to upgrade now. Likewise, users who are constantly on the road might want a new combination PDA/global positioning system.

Cons. PDA operating systems are updated frequently, reflecting continuing improvements in handheld hardware. Microsoft late last year upgraded its Pocket PC operating system and changed its name to Windows Mobile.

Although frequent users will rejoice in the opportunity to do more, others might not want to spend $300 or more to get the latest features—only to see their new device become outmoded in a few months.

Hardware advances

Processors. The processor, the heart of a PDA, has also seen much change. Newer Palm and Pocket PC devices are based on the strongARM microprocessor produced by Intel under the Xscale brand. Each new processor has more speed, better multimedia, an improved camera interface, and lower power consumption than previous processors.

Smartphones, which reached the market in 2002, are geared to physicians who rely mostly on email and calendar functions and have little need for mobile medical information.

A Windows Mobile smartphone typically looks like a mobile phone but has basic Pocket PC capabilities, such as viewing mail, a calendar, to-do list, and notes.

Windows Mobile smartphones, however, are compatible only with smartphone-specific programs, not with general Pocket PC software. This means that drug reference guides, DSM-IV-TR, and other commonly used medical programs cannot be viewed on a smartphone. If you love the idea of a smartphone but want a specialized program, check out www.smartphone.net.

Pocket PC phone. By contrast, the Pocket PC phone looks and works more like a PDA than a phone. Because it is connected to the cellular network, the device has wider Internet access than does a WiFi-enabled Pocket PC3. At 3.5-by-3.5 inches, the screen size is about twice that of the smartphone’s screen. The device also is compatible with all Pocket PC software.

Pocket PC phones typically have more main memory than smartphones. Smartphones are limited to secure digital-based external memory, but Pocket PC phones have infrared and other connectivity options.

Palm-based smartphones can run most Palm software, depending upon operating system compatibility. Previous Palm smartphones were more limited because of an older operating system and lack of external memory cards.

The palmOne Treo 600, based on the new Palm Version 5 operating system, offers an external memory slot, built-in digital camera, and text messaging. palmOne offers a GSM (global system for mobile communication) protocol version for the T-Mobile, Cingular, and AT&T networks, and a CDMA (code-division multiple access) protocol version for the Sprint network.

Operating system improvements

Palm Source has released version 6 of its operating system—code named “Cobalt”—to hardware developers. This versatile new version—with higher resolution, Word and JPEG file support, simultaneous multiple communications, and other features—could reach the market around the winter holiday.

Microsoft has released Windows Mobile 2003 Second Edition. With certain devices, the operating system will help users read text or browse the Web by using more of the screen. With larger screen resolutions packed into a smaller area, fonts are smaller and hard to read. Windows Mobile 2003 Second Edition provides additional font-size controls to compensate for this change.

The new Windows Mobile version also features a start menu that displays frequently used applications, and WiFi security is improved compared with the previous version.

The future

Tiquit, OQO, and FlipStart plan to release fully operable handheld computers later this year.

These new devices will run on Windows XP and other operating systems and will feature full central processing units, hard disks, liquid crystal display panels, USB connectivity, and built-in QWERTY keyboards. It remains to be seen if these computers will supersede Palm and Windows Mobile PDAs.

Sony’s new Vaio U70 handheld computer, recently released in Japan, is available in the United States via specialty retailers such as dynamism.com.

Want to take an online audio CME course or view educational film clips while traveling? Don’t forget your handheld.

Once limited to text-based information, today’s more powerful personal digital assistants (PDAs) can also play audio and video files. Innovations in capture and conversion technology allow you to store media-rich online files on your PDA, letting you access multimedia Internet content while you are offline.

File portability

PEG-audio layer 3 (MP3) is a compression algorithm used to decrease an audio file’s size, allowing numerous audio files to be stored onto an MP3 player.

Other formats-including WAV, Real Audio, and Ogg-Vorbis-can be used to compress files, but MP3 is the most popular and has become the standard.

Video files usually contain massive amounts of data-including synchronized audio-and are quite large. Files created via advanced systems format (ASF) typically are uncompressed general video files. Windows Media and Real Media are other common online video formats.

Several compression algorithms exist for online video, including MPEG-1, MPEG-2, and MPEG-4. Each compression type is geared towards a specific media delivery mechanism.

Playing online audio on PDAs

Pocket PC devices come with Windows Media Player, which enables users to play MP3s. Alternate programs-such as RealOne Player, Pocket Mind, Pocket Player, and withMP3 (Table 1)-offer features such as an equalizer and can handle streaming audio and play audio books.

To store an MP3 file onto your PDA, simply download the file and store it in the “My Pocket PC” folder on your computer desktop. Storing the file this way, however, consumes much of the PDA’s main memory. To preserve PDA memory:

• Store the file in the PDA’s compact flash or secure digital card by enter your Pocket PC via the “Activesync” window, then store the file in the device’s secure digital card
• Or use a separate USB memory card reader to transfer the file to the memory card, then place the card into the Pocket PC. This is the fastest option.

Palm OS devices can play MP3 files with RealOne Player, Aero Player, and Pocket Tunes. Audio files are easily installed using Palm Quick Install.

Drag a copy of the file into the expansion card, and it will be transferred at the next HotSync (synchronization of information from PDA to desktop). However, this process takes about 10 minutes depending on the file’s size because the file must go through the Palm memory. To save time, place the file on a separate USB memory card reader, then transfer the file directly.

Playing video files

Older PDAs could not display video data quickly enough, making images appear jerky and blotchy. Today’s Palm OS and Pocket PC PDAs have faster processors, more memory, and can display video at decent quality.

Pocket PC devices can play Windows Media Video and ASF video files with the Pocket PC version of Windows Media Player. Other third-party video players include Project Mayo, Pocket MVP, Pocket TV, and RealOne Player.

Because these video players are not compatible with older Palm OS devices, vendors have created converters that can convert video files for use with the vendors’ proprietary video formats (Table 2). All video files must be converted via the desktop and then installed onto the PDA or memory card.

By contrast, newer Palm OS devices (such as OS 5) have enough processing power to display MPEG-4 files using software such as MMPlayer.

Portability issues

Video. Online grand rounds or other lectures are designed for viewing online. “Streaming” allows a Web site to distribute the video to many users at once. 1 Web casts typically are created in Real Media or Windows Media format, but the streaming is not stored on the computer hard drive for later use. More importantly, the link from the Web site does not contain the media when accessed, but actually is a command to the streaming server.

To capture the video stream, try WM Recorder or HiDownload.

Audio files cannot be heard on PDAs without headphones, making them difficult to listen to while driving. FM radio broadcast devices such as the iRock 400 or Belkin Tunecast solve this problem by transmitting a low-strength signal that can be picked up on a car radio.

Other devices

Aside from PDAs, other portable devices are made for viewing audio and video, and others are being invented.

Many MP3 players are smaller and more portable than PDAs. Video “jukeboxes” such as the Archos AV320 and TightSystems TAZ are also available.

Tiquit, OQO, and FlipStart plan later this year to release fully capable computers. They contain hard drives, central processing units and other necessities of full-sized computers, but are only the size of a PDA. These innovations could make the aforementioned devices and programs obsolete by year’s end. (For information on these developing technologies, watch for future installments of Psyber Psychiatry.)

Table 1

Audio player programs for PDA

Table 2

Video conversion programs for Palm OS devices

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Related Resources

• NPI Webcasting. UCLA grand rounds, Department of Psychiatry and Behavioral Sciences. http://www.mentalhealth.ucla.edu/opce/gr.html
• Prelinger Archives. Movie archives of patients with schizophrenia. http://www.archive.org/movies/movieslisting-browse.php?collection=prelinger (Click on “schizophrenia” in subject index)
• Luo J. Psyber Psychiatry: A world of information in your pocket. Current Psychiatry April online edition. http://www.currentpsychiatry.com/psyber_psy.asp.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Want to take an online audio CME course or view educational film clips while traveling? Don’t forget your handheld.

Once limited to text-based information, today’s more powerful personal digital assistants (PDAs) can also play audio and video files. Innovations in capture and conversion technology allow you to store media-rich online files on your PDA, letting you access multimedia Internet content while you are offline.

File portability

PEG-audio layer 3 (MP3) is a compression algorithm used to decrease an audio file’s size, allowing numerous audio files to be stored onto an MP3 player.

Other formats-including WAV, Real Audio, and Ogg-Vorbis-can be used to compress files, but MP3 is the most popular and has become the standard.

Video files usually contain massive amounts of data-including synchronized audio-and are quite large. Files created via advanced systems format (ASF) typically are uncompressed general video files. Windows Media and Real Media are other common online video formats.

Several compression algorithms exist for online video, including MPEG-1, MPEG-2, and MPEG-4. Each compression type is geared towards a specific media delivery mechanism.

Playing online audio on PDAs

Pocket PC devices come with Windows Media Player, which enables users to play MP3s. Alternate programs-such as RealOne Player, Pocket Mind, Pocket Player, and withMP3 (Table 1)-offer features such as an equalizer and can handle streaming audio and play audio books.

To store an MP3 file onto your PDA, simply download the file and store it in the “My Pocket PC” folder on your computer desktop. Storing the file this way, however, consumes much of the PDA’s main memory. To preserve PDA memory:

• Store the file in the PDA’s compact flash or secure digital card by enter your Pocket PC via the “Activesync” window, then store the file in the device’s secure digital card
• Or use a separate USB memory card reader to transfer the file to the memory card, then place the card into the Pocket PC. This is the fastest option.

Palm OS devices can play MP3 files with RealOne Player, Aero Player, and Pocket Tunes. Audio files are easily installed using Palm Quick Install.

Drag a copy of the file into the expansion card, and it will be transferred at the next HotSync (synchronization of information from PDA to desktop). However, this process takes about 10 minutes depending on the file’s size because the file must go through the Palm memory. To save time, place the file on a separate USB memory card reader, then transfer the file directly.

Playing video files

Older PDAs could not display video data quickly enough, making images appear jerky and blotchy. Today’s Palm OS and Pocket PC PDAs have faster processors, more memory, and can display video at decent quality.

Pocket PC devices can play Windows Media Video and ASF video files with the Pocket PC version of Windows Media Player. Other third-party video players include Project Mayo, Pocket MVP, Pocket TV, and RealOne Player.

Because these video players are not compatible with older Palm OS devices, vendors have created converters that can convert video files for use with the vendors’ proprietary video formats (Table 2). All video files must be converted via the desktop and then installed onto the PDA or memory card.

By contrast, newer Palm OS devices (such as OS 5) have enough processing power to display MPEG-4 files using software such as MMPlayer.

Portability issues

Video. Online grand rounds or other lectures are designed for viewing online. “Streaming” allows a Web site to distribute the video to many users at once. 1 Web casts typically are created in Real Media or Windows Media format, but the streaming is not stored on the computer hard drive for later use. More importantly, the link from the Web site does not contain the media when accessed, but actually is a command to the streaming server.

To capture the video stream, try WM Recorder or HiDownload.

Audio files cannot be heard on PDAs without headphones, making them difficult to listen to while driving. FM radio broadcast devices such as the iRock 400 or Belkin Tunecast solve this problem by transmitting a low-strength signal that can be picked up on a car radio.

Other devices

Aside from PDAs, other portable devices are made for viewing audio and video, and others are being invented.

Many MP3 players are smaller and more portable than PDAs. Video “jukeboxes” such as the Archos AV320 and TightSystems TAZ are also available.

Tiquit, OQO, and FlipStart plan later this year to release fully capable computers. They contain hard drives, central processing units and other necessities of full-sized computers, but are only the size of a PDA. These innovations could make the aforementioned devices and programs obsolete by year’s end. (For information on these developing technologies, watch for future installments of Psyber Psychiatry.)

Table 1

Audio player programs for PDA

Table 2

Video conversion programs for Palm OS devices

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Related Resources

• NPI Webcasting. UCLA grand rounds, Department of Psychiatry and Behavioral Sciences. http://www.mentalhealth.ucla.edu/opce/gr.html
• Prelinger Archives. Movie archives of patients with schizophrenia. http://www.archive.org/movies/movieslisting-browse.php?collection=prelinger (Click on “schizophrenia” in subject index)
• Luo J. Psyber Psychiatry: A world of information in your pocket. Current Psychiatry April online edition. http://www.currentpsychiatry.com/psyber_psy.asp.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Want to take an online audio CME course or view educational film clips while traveling? Don’t forget your handheld.

Once limited to text-based information, today’s more powerful personal digital assistants (PDAs) can also play audio and video files. Innovations in capture and conversion technology allow you to store media-rich online files on your PDA, letting you access multimedia Internet content while you are offline.

File portability

PEG-audio layer 3 (MP3) is a compression algorithm used to decrease an audio file’s size, allowing numerous audio files to be stored onto an MP3 player.

Other formats-including WAV, Real Audio, and Ogg-Vorbis-can be used to compress files, but MP3 is the most popular and has become the standard.

Video files usually contain massive amounts of data-including synchronized audio-and are quite large. Files created via advanced systems format (ASF) typically are uncompressed general video files. Windows Media and Real Media are other common online video formats.

Several compression algorithms exist for online video, including MPEG-1, MPEG-2, and MPEG-4. Each compression type is geared towards a specific media delivery mechanism.

Playing online audio on PDAs

Pocket PC devices come with Windows Media Player, which enables users to play MP3s. Alternate programs-such as RealOne Player, Pocket Mind, Pocket Player, and withMP3 (Table 1)-offer features such as an equalizer and can handle streaming audio and play audio books.

To store an MP3 file onto your PDA, simply download the file and store it in the “My Pocket PC” folder on your computer desktop. Storing the file this way, however, consumes much of the PDA’s main memory. To preserve PDA memory:

• Store the file in the PDA’s compact flash or secure digital card by enter your Pocket PC via the “Activesync” window, then store the file in the device’s secure digital card
• Or use a separate USB memory card reader to transfer the file to the memory card, then place the card into the Pocket PC. This is the fastest option.

Palm OS devices can play MP3 files with RealOne Player, Aero Player, and Pocket Tunes. Audio files are easily installed using Palm Quick Install.

Drag a copy of the file into the expansion card, and it will be transferred at the next HotSync (synchronization of information from PDA to desktop). However, this process takes about 10 minutes depending on the file’s size because the file must go through the Palm memory. To save time, place the file on a separate USB memory card reader, then transfer the file directly.

Playing video files

Older PDAs could not display video data quickly enough, making images appear jerky and blotchy. Today’s Palm OS and Pocket PC PDAs have faster processors, more memory, and can display video at decent quality.

Pocket PC devices can play Windows Media Video and ASF video files with the Pocket PC version of Windows Media Player. Other third-party video players include Project Mayo, Pocket MVP, Pocket TV, and RealOne Player.

Because these video players are not compatible with older Palm OS devices, vendors have created converters that can convert video files for use with the vendors’ proprietary video formats (Table 2). All video files must be converted via the desktop and then installed onto the PDA or memory card.

By contrast, newer Palm OS devices (such as OS 5) have enough processing power to display MPEG-4 files using software such as MMPlayer.

Portability issues

Video. Online grand rounds or other lectures are designed for viewing online. “Streaming” allows a Web site to distribute the video to many users at once. 1 Web casts typically are created in Real Media or Windows Media format, but the streaming is not stored on the computer hard drive for later use. More importantly, the link from the Web site does not contain the media when accessed, but actually is a command to the streaming server.

To capture the video stream, try WM Recorder or HiDownload.

Audio files cannot be heard on PDAs without headphones, making them difficult to listen to while driving. FM radio broadcast devices such as the iRock 400 or Belkin Tunecast solve this problem by transmitting a low-strength signal that can be picked up on a car radio.

Other devices

Aside from PDAs, other portable devices are made for viewing audio and video, and others are being invented.

Many MP3 players are smaller and more portable than PDAs. Video “jukeboxes” such as the Archos AV320 and TightSystems TAZ are also available.

Tiquit, OQO, and FlipStart plan later this year to release fully capable computers. They contain hard drives, central processing units and other necessities of full-sized computers, but are only the size of a PDA. These innovations could make the aforementioned devices and programs obsolete by year’s end. (For information on these developing technologies, watch for future installments of Psyber Psychiatry.)

Table 1

Audio player programs for PDA

Table 2

Video conversion programs for Palm OS devices

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Related Resources

• NPI Webcasting. UCLA grand rounds, Department of Psychiatry and Behavioral Sciences. http://www.mentalhealth.ucla.edu/opce/gr.html
• Prelinger Archives. Movie archives of patients with schizophrenia. http://www.archive.org/movies/movieslisting-browse.php?collection=prelinger (Click on “schizophrenia” in subject index)
• Luo J. Psyber Psychiatry: A world of information in your pocket. Current Psychiatry April online edition. http://www.currentpsychiatry.com/psyber_psy.asp.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

With wireless Internet available in hospitals, coffee shops, airports, universities, and libraries, real-time Internet access away from the home or office is just a click away on your personal digital assistant (PDA). But what if you’re somewhere without wireless Internet-such as in flight or at the local department of motor vehicles?

Transferring and storing online content onto your PDA lets you access critical online information in places without a connection, making your down time more productive.

Portable online content

Much Web-based information can easily be captured or stored onto your PDA.

Electronic books, or e-books, have long been one of the pleasures of using PDAs and handheld devices such as the Beating the high cost of software,” Psyber Psychiatry, March 2004.)

Plucker also is free, but it creates documents primarily for Palm OS handhelds. A Pocket PC version of Plucker is in development. iSiloX documents can be viewed on Pocket PC or Palm OS devices, but the paid version of the viewer iSilo, available for $20, is required to use the navigational links. The free version of iSilo can read but cannot navigate with hyperlinks. Adobe Acrobat PDFs can be viewed on Pocket PC and Palm OS devices, but these PDFs must be distilled a second time for the handheld.

One disadvantage of all viewing systems is that Web pages with complicated formatting or specialized layers may not be accurately captured or well viewed on a PDA’s small screen.

Table

Sample systems for viewing Web-based content on PDAs

Related Resources

• Microsoft Windows XP. Make web pages available for offline viewing.
• Kansas City Clinical Oncology Program. Mobile users help page.
• PDACorps discussion forum (topic: Plucker for Pocket PC).

If you have any questions about these products or comments about Current Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

With wireless Internet available in hospitals, coffee shops, airports, universities, and libraries, real-time Internet access away from the home or office is just a click away on your personal digital assistant (PDA). But what if you’re somewhere without wireless Internet-such as in flight or at the local department of motor vehicles?

Transferring and storing online content onto your PDA lets you access critical online information in places without a connection, making your down time more productive.

Portable online content

Much Web-based information can easily be captured or stored onto your PDA.

Electronic books, or e-books, have long been one of the pleasures of using PDAs and handheld devices such as the Beating the high cost of software,” Psyber Psychiatry, March 2004.)

Plucker also is free, but it creates documents primarily for Palm OS handhelds. A Pocket PC version of Plucker is in development. iSiloX documents can be viewed on Pocket PC or Palm OS devices, but the paid version of the viewer iSilo, available for $20, is required to use the navigational links. The free version of iSilo can read but cannot navigate with hyperlinks. Adobe Acrobat PDFs can be viewed on Pocket PC and Palm OS devices, but these PDFs must be distilled a second time for the handheld.

One disadvantage of all viewing systems is that Web pages with complicated formatting or specialized layers may not be accurately captured or well viewed on a PDA’s small screen.

Table

Sample systems for viewing Web-based content on PDAs

Related Resources

• Microsoft Windows XP. Make web pages available for offline viewing.
• Kansas City Clinical Oncology Program. Mobile users help page.
• PDACorps discussion forum (topic: Plucker for Pocket PC).

If you have any questions about these products or comments about Current Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

With wireless Internet available in hospitals, coffee shops, airports, universities, and libraries, real-time Internet access away from the home or office is just a click away on your personal digital assistant (PDA). But what if you’re somewhere without wireless Internet-such as in flight or at the local department of motor vehicles?

Transferring and storing online content onto your PDA lets you access critical online information in places without a connection, making your down time more productive.

Portable online content

Much Web-based information can easily be captured or stored onto your PDA.

Electronic books, or e-books, have long been one of the pleasures of using PDAs and handheld devices such as the Beating the high cost of software,” Psyber Psychiatry, March 2004.)

Plucker also is free, but it creates documents primarily for Palm OS handhelds. A Pocket PC version of Plucker is in development. iSiloX documents can be viewed on Pocket PC or Palm OS devices, but the paid version of the viewer iSilo, available for $20, is required to use the navigational links. The free version of iSilo can read but cannot navigate with hyperlinks. Adobe Acrobat PDFs can be viewed on Pocket PC and Palm OS devices, but these PDFs must be distilled a second time for the handheld.

One disadvantage of all viewing systems is that Web pages with complicated formatting or specialized layers may not be accurately captured or well viewed on a PDA’s small screen.

Table

Sample systems for viewing Web-based content on PDAs

Related Resources

• Microsoft Windows XP. Make web pages available for offline viewing.
• Kansas City Clinical Oncology Program. Mobile users help page.
• PDACorps discussion forum (topic: Plucker for Pocket PC).

If you have any questions about these products or comments about Current Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Name-brand practice-management software can cost hundreds or even thousands of dollars-no small expense, especially for a new practice. Still, you and your staff need the word processing, spreadsheet, documentation, patient tracking, and appointment-scheduling capabilities these programs provide.

Open-source and general public licensing (GPL) software titles-available free or at minimal cost-may offer a budget-friendly alternative.

Open-source versus GPL

There are two types of “free” software:

• “free” as in no charge for its use. For example, Steve Gibson of Speeding up your Web search,” Psyber Psychiatry, May 2003). Use key words such as “freeware,” “free,” or “open source” in conjunction with the type of program (eg, “document” or “database”).
  Many open-source or GPL projects are centrally stored at two sites, SourceForge and Freshmeat. Browse the categories for the type of program you need, such as databases, utilities, firewalls, etc. These sites offer source code and version information for programmers as well as precompiled software for the public.
  Table Relevant open-source and GPL software titles

  Type	Software	URL
  Office document	OpenOffice *	www.openoffice.org
  Instant messaging	GAIM *	http://gaim.sourceforge.net
  Web browser	Firefox *	www.mozilla.org/products/firefox/
  Database	Firebird *	http://firebird.sourceforge.net
  Application server	Zope *	www.zope.org
  Practice management	FreeMED	www.freemed.org
  Clinical database	SQL Clinic	www.sqlclinic.net
  Electronic Medical Record	Open EMR	www.openemr.net
  * available in binary format and ready to use

  Related Resources (accessed Feb. 20, 2004) GNU Project. GNU General Public License (example of free-distribution license). http://www.gnu.org/copyleft/gpl.html
  GNU Project. Various licenses and comments about them. http://www.gnu.org/licenses/license-list.html.
  GNU Project. Terms and conditions for copying, distribution, and modification http://www.gnu.org/copyleft/gpl.html#SEC3
  Open Source Initiative. The open source definition. http://www.opensource.org/docs/definition.php
  If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.
  Disclosure Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Name-brand practice-management software can cost hundreds or even thousands of dollars-no small expense, especially for a new practice. Still, you and your staff need the word processing, spreadsheet, documentation, patient tracking, and appointment-scheduling capabilities these programs provide.

Open-source and general public licensing (GPL) software titles-available free or at minimal cost-may offer a budget-friendly alternative.

Open-source versus GPL

There are two types of “free” software:

• “free” as in no charge for its use. For example, Steve Gibson of Speeding up your Web search,” Psyber Psychiatry, May 2003). Use key words such as “freeware,” “free,” or “open source” in conjunction with the type of program (eg, “document” or “database”).
  Many open-source or GPL projects are centrally stored at two sites, SourceForge and Freshmeat. Browse the categories for the type of program you need, such as databases, utilities, firewalls, etc. These sites offer source code and version information for programmers as well as precompiled software for the public.
  Table Relevant open-source and GPL software titles

  Type	Software	URL
  Office document	OpenOffice *	www.openoffice.org
  Instant messaging	GAIM *	http://gaim.sourceforge.net
  Web browser	Firefox *	www.mozilla.org/products/firefox/
  Database	Firebird *	http://firebird.sourceforge.net
  Application server	Zope *	www.zope.org
  Practice management	FreeMED	www.freemed.org
  Clinical database	SQL Clinic	www.sqlclinic.net
  Electronic Medical Record	Open EMR	www.openemr.net
  * available in binary format and ready to use

  Related Resources (accessed Feb. 20, 2004) GNU Project. GNU General Public License (example of free-distribution license). http://www.gnu.org/copyleft/gpl.html
  GNU Project. Various licenses and comments about them. http://www.gnu.org/licenses/license-list.html.
  GNU Project. Terms and conditions for copying, distribution, and modification http://www.gnu.org/copyleft/gpl.html#SEC3
  Open Source Initiative. The open source definition. http://www.opensource.org/docs/definition.php
  If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.
  Disclosure Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Name-brand practice-management software can cost hundreds or even thousands of dollars-no small expense, especially for a new practice. Still, you and your staff need the word processing, spreadsheet, documentation, patient tracking, and appointment-scheduling capabilities these programs provide.

Open-source and general public licensing (GPL) software titles-available free or at minimal cost-may offer a budget-friendly alternative.

Open-source versus GPL

There are two types of “free” software:

• “free” as in no charge for its use. For example, Steve Gibson of Speeding up your Web search,” Psyber Psychiatry, May 2003). Use key words such as “freeware,” “free,” or “open source” in conjunction with the type of program (eg, “document” or “database”).
  Many open-source or GPL projects are centrally stored at two sites, SourceForge and Freshmeat. Browse the categories for the type of program you need, such as databases, utilities, firewalls, etc. These sites offer source code and version information for programmers as well as precompiled software for the public.
  Table Relevant open-source and GPL software titles

  Type	Software	URL
  Office document	OpenOffice *	www.openoffice.org
  Instant messaging	GAIM *	http://gaim.sourceforge.net
  Web browser	Firefox *	www.mozilla.org/products/firefox/
  Database	Firebird *	http://firebird.sourceforge.net
  Application server	Zope *	www.zope.org
  Practice management	FreeMED	www.freemed.org
  Clinical database	SQL Clinic	www.sqlclinic.net
  Electronic Medical Record	Open EMR	www.openemr.net
  * available in binary format and ready to use

  Related Resources (accessed Feb. 20, 2004) GNU Project. GNU General Public License (example of free-distribution license). http://www.gnu.org/copyleft/gpl.html
  GNU Project. Various licenses and comments about them. http://www.gnu.org/licenses/license-list.html.
  GNU Project. Terms and conditions for copying, distribution, and modification http://www.gnu.org/copyleft/gpl.html#SEC3
  Open Source Initiative. The open source definition. http://www.opensource.org/docs/definition.php
  If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.
  Disclosure Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Next time you meet someone at a clinical conference, don’t just hand that person a business card.

Instead, invite the colleague to join your online social network. Within days, your new acquaintance will have access to hundreds of potential business contacts-an ever-expanding network that otherwise would have taken years to build.

How online networks work

In the Internet age, people connect by meeting online in chat forums devoted to a favorite subject, exchanging e-mails after reading a mailing list or Web log, or finding relevant Web sites.

Online social networking takes this interaction one step further: Users join social networks and then invite others to join, allowing people to meet friends of friends for business or pleasure.

With popular file-sharing networks such as Kazaa and Napster, strangers can share music and other computer files. Online social networking sites work differently, but the idea is the same: to share resources.

For social purposes, these sites let users see lists of other peoples’ contacts, providing an opportunity to make new friends based on common interests. For business, interaction may be done directly by reviewing a profile or indirectly via a chain of mutual contacts in a network. As others on the network keep inviting new members and opening paths to new contact lists, your social and/or professional network will continuously grow.

How online networking can help you

Developing contacts at clinical conferences is crucial to our livelihood, but too often business cards are lost or the contact’s context is forgotten.

By contrast, with online social networking, contacts are developed and stay online. What’s more, the contact’s profile information enhances the context.

This service not only cements existing connections but may open the door to new, more worthwhile contacts. For example, the network may provide:

• a mechanism to discreetly market your services and seek job openings.
• a source of referrals for your patients who are moving to areas where you know few or no physicians. Each contact can check his or her network for area doctors. This could also lead to more patients for a doctor in that area.

Online social networking also can promote an exchange of ideas and expertise. Many large companies use this technology to solicit strategic planning ideas from their workforces. This saves companies the expense of an outside consultant.¹

How to get started

Most social networking sites provide free accounts, using a valid e-mail address as the primary method of contact (Table).

Once you activate your account, you should set up a profile that highlights your interests, specialties, and types of offers you wish to receive. You are now ready to invite friends to join your network. From there, you can find other members with common interests (eg, colleagues in medical practice).

Most sites let you determine which information to make public or private, such as your e-mail address or phone number. Sites such as LinkedIn give you additional control by blocking communications from sources other than your trusted connections; you can also elect to anonymously decline requests for contact.

Some sites offer premium accounts, which for $5 to $10 a month offer services such as resume management, advanced searches, and information on who has reviewed your profile.

Risks

Some networking sites are not secure.² This may open your social network to spam, or another user might be able to change your information. To prevent this, only use social network providers who implement SSL-level security.

Level of trust from network to network is another issue. For example, if you do not trust one colleague’s opinion, that person’s network may be not worth keeping. You may wish to keep the contact anyway because some knowledge-good or bad-may be better than no information at all.

Table

Online Networking Sites

Related Resources

www.ringo.com. Click on “take a tour” for a quick tutorial on online social networking.

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Next time you meet someone at a clinical conference, don’t just hand that person a business card.

Instead, invite the colleague to join your online social network. Within days, your new acquaintance will have access to hundreds of potential business contacts-an ever-expanding network that otherwise would have taken years to build.

How online networks work

In the Internet age, people connect by meeting online in chat forums devoted to a favorite subject, exchanging e-mails after reading a mailing list or Web log, or finding relevant Web sites.

Online social networking takes this interaction one step further: Users join social networks and then invite others to join, allowing people to meet friends of friends for business or pleasure.

With popular file-sharing networks such as Kazaa and Napster, strangers can share music and other computer files. Online social networking sites work differently, but the idea is the same: to share resources.

For social purposes, these sites let users see lists of other peoples’ contacts, providing an opportunity to make new friends based on common interests. For business, interaction may be done directly by reviewing a profile or indirectly via a chain of mutual contacts in a network. As others on the network keep inviting new members and opening paths to new contact lists, your social and/or professional network will continuously grow.

How online networking can help you

Developing contacts at clinical conferences is crucial to our livelihood, but too often business cards are lost or the contact’s context is forgotten.

By contrast, with online social networking, contacts are developed and stay online. What’s more, the contact’s profile information enhances the context.

This service not only cements existing connections but may open the door to new, more worthwhile contacts. For example, the network may provide:

• a mechanism to discreetly market your services and seek job openings.
• a source of referrals for your patients who are moving to areas where you know few or no physicians. Each contact can check his or her network for area doctors. This could also lead to more patients for a doctor in that area.

Online social networking also can promote an exchange of ideas and expertise. Many large companies use this technology to solicit strategic planning ideas from their workforces. This saves companies the expense of an outside consultant.¹

How to get started

Most social networking sites provide free accounts, using a valid e-mail address as the primary method of contact (Table).

Once you activate your account, you should set up a profile that highlights your interests, specialties, and types of offers you wish to receive. You are now ready to invite friends to join your network. From there, you can find other members with common interests (eg, colleagues in medical practice).

Most sites let you determine which information to make public or private, such as your e-mail address or phone number. Sites such as LinkedIn give you additional control by blocking communications from sources other than your trusted connections; you can also elect to anonymously decline requests for contact.

Some sites offer premium accounts, which for $5 to $10 a month offer services such as resume management, advanced searches, and information on who has reviewed your profile.

Risks

Some networking sites are not secure.² This may open your social network to spam, or another user might be able to change your information. To prevent this, only use social network providers who implement SSL-level security.

Level of trust from network to network is another issue. For example, if you do not trust one colleague’s opinion, that person’s network may be not worth keeping. You may wish to keep the contact anyway because some knowledge-good or bad-may be better than no information at all.

Table

Online Networking Sites

Related Resources

www.ringo.com. Click on “take a tour” for a quick tutorial on online social networking.

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Next time you meet someone at a clinical conference, don’t just hand that person a business card.

Instead, invite the colleague to join your online social network. Within days, your new acquaintance will have access to hundreds of potential business contacts-an ever-expanding network that otherwise would have taken years to build.

How online networks work

In the Internet age, people connect by meeting online in chat forums devoted to a favorite subject, exchanging e-mails after reading a mailing list or Web log, or finding relevant Web sites.

Online social networking takes this interaction one step further: Users join social networks and then invite others to join, allowing people to meet friends of friends for business or pleasure.

With popular file-sharing networks such as Kazaa and Napster, strangers can share music and other computer files. Online social networking sites work differently, but the idea is the same: to share resources.

For social purposes, these sites let users see lists of other peoples’ contacts, providing an opportunity to make new friends based on common interests. For business, interaction may be done directly by reviewing a profile or indirectly via a chain of mutual contacts in a network. As others on the network keep inviting new members and opening paths to new contact lists, your social and/or professional network will continuously grow.

How online networking can help you

Developing contacts at clinical conferences is crucial to our livelihood, but too often business cards are lost or the contact’s context is forgotten.

By contrast, with online social networking, contacts are developed and stay online. What’s more, the contact’s profile information enhances the context.

This service not only cements existing connections but may open the door to new, more worthwhile contacts. For example, the network may provide:

• a mechanism to discreetly market your services and seek job openings.
• a source of referrals for your patients who are moving to areas where you know few or no physicians. Each contact can check his or her network for area doctors. This could also lead to more patients for a doctor in that area.

Online social networking also can promote an exchange of ideas and expertise. Many large companies use this technology to solicit strategic planning ideas from their workforces. This saves companies the expense of an outside consultant.¹

How to get started

Most social networking sites provide free accounts, using a valid e-mail address as the primary method of contact (Table).

Once you activate your account, you should set up a profile that highlights your interests, specialties, and types of offers you wish to receive. You are now ready to invite friends to join your network. From there, you can find other members with common interests (eg, colleagues in medical practice).

Most sites let you determine which information to make public or private, such as your e-mail address or phone number. Sites such as LinkedIn give you additional control by blocking communications from sources other than your trusted connections; you can also elect to anonymously decline requests for contact.

Some sites offer premium accounts, which for $5 to $10 a month offer services such as resume management, advanced searches, and information on who has reviewed your profile.

Risks

Some networking sites are not secure.² This may open your social network to spam, or another user might be able to change your information. To prevent this, only use social network providers who implement SSL-level security.

Level of trust from network to network is another issue. For example, if you do not trust one colleague’s opinion, that person’s network may be not worth keeping. You may wish to keep the contact anyway because some knowledge-good or bad-may be better than no information at all.

Table

Online Networking Sites

Related Resources

www.ringo.com. Click on “take a tour” for a quick tutorial on online social networking.

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

If you cannot get to a phone and you need to make immediate contact, instant messaging (IM) may be the right call.

IM, the equivalent of ‘instant e-mail,’ allows almost real-time communication and exchange of information over the Internet. IM is most popular among teenagers and college students, but medical providers and other professionals have begun to recognize its potential for speeding communication.

How IM started

Before the World Wide Web existed, electronic bulletin boards (BBS) were a popular mode of communication. Users would log in and browse various message topics, posting comments and questions for others to answer. Users also could check who was logged into the BBS and post messages to one or more of those contacts. This was done in a Telnet session, which is a method for connecting to another computer on the Internet. Telnet sessions hark back to mainframe computing, when computer terminals without processing power provided access to the central computer.

In 1996, Mirabilis released ICQ, which enabled Internet users to locate each other on the Internet without connecting to a BBS-by creating direct peer-to-peer communication channels. Companies such as America On Line, Microsoft, and Yahoo! also developed IM systems, but none could connect with one another because there is no common standard. AOL later purchased Mirabilis and incorporated its technology into the AOL Instant Messenger (AIM).

Doing IM: What you need

To do instant messaging, you need an Internet connection and the appropriate client. Keep in mind that your client should be:

• compatible with several systems
• or the same client that your messaging partner uses. New users typically choose an IM system that a friend or colleague is using.

Choosing an IM client is a matter of preference because all systems offer similar features (E-therapy: Alerting patients to the benefits, risks,“ November 2002).

Because IM is a direct communication channel with visual references to previous dialogue, it creates the environment of an active conversation. One drawback is that a participant’s typing speed typically limits the conversation’s pace. Using the voice feature overcomes this limitation, but this feature will not work properly without a broadband Internet connection, such as over a cable modem or digital subscriber line.

Risks of IM-based therapy

The IM communication channel’s lack of security poses a significant risk, particularly when used for psychotherapy. This active connection broadcasts its availability over the Internet, making it vulnerable to hackers. What’s more, the IM client may change your security settings for your Web browser¹ or allow remote access to your computer by a hacker.²

Making your IM system secure

On the corporate level, vendors such as Yahoo!, Microsoft, AOL and others have created products to secure public IM systems, such as Akonix and Endeavors Technology. These products are gateways that maintain corporate data within the company network, encrypt information, specify and limit certain features, and log conversations. This level of security does not exist over major public IM networks for individual users.

Secure Shuttle Transport, DBabble, and PSST provide encrypted communication to individual users.

Table

Instant messaging clients

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or e-mail him at: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

If you cannot get to a phone and you need to make immediate contact, instant messaging (IM) may be the right call.

IM, the equivalent of ‘instant e-mail,’ allows almost real-time communication and exchange of information over the Internet. IM is most popular among teenagers and college students, but medical providers and other professionals have begun to recognize its potential for speeding communication.

How IM started

Before the World Wide Web existed, electronic bulletin boards (BBS) were a popular mode of communication. Users would log in and browse various message topics, posting comments and questions for others to answer. Users also could check who was logged into the BBS and post messages to one or more of those contacts. This was done in a Telnet session, which is a method for connecting to another computer on the Internet. Telnet sessions hark back to mainframe computing, when computer terminals without processing power provided access to the central computer.

In 1996, Mirabilis released ICQ, which enabled Internet users to locate each other on the Internet without connecting to a BBS-by creating direct peer-to-peer communication channels. Companies such as America On Line, Microsoft, and Yahoo! also developed IM systems, but none could connect with one another because there is no common standard. AOL later purchased Mirabilis and incorporated its technology into the AOL Instant Messenger (AIM).

Doing IM: What you need

To do instant messaging, you need an Internet connection and the appropriate client. Keep in mind that your client should be:

• compatible with several systems
• or the same client that your messaging partner uses. New users typically choose an IM system that a friend or colleague is using.

Choosing an IM client is a matter of preference because all systems offer similar features (E-therapy: Alerting patients to the benefits, risks,“ November 2002).

Because IM is a direct communication channel with visual references to previous dialogue, it creates the environment of an active conversation. One drawback is that a participant’s typing speed typically limits the conversation’s pace. Using the voice feature overcomes this limitation, but this feature will not work properly without a broadband Internet connection, such as over a cable modem or digital subscriber line.

Risks of IM-based therapy

The IM communication channel’s lack of security poses a significant risk, particularly when used for psychotherapy. This active connection broadcasts its availability over the Internet, making it vulnerable to hackers. What’s more, the IM client may change your security settings for your Web browser¹ or allow remote access to your computer by a hacker.²

Making your IM system secure

On the corporate level, vendors such as Yahoo!, Microsoft, AOL and others have created products to secure public IM systems, such as Akonix and Endeavors Technology. These products are gateways that maintain corporate data within the company network, encrypt information, specify and limit certain features, and log conversations. This level of security does not exist over major public IM networks for individual users.

Secure Shuttle Transport, DBabble, and PSST provide encrypted communication to individual users.

Table

Instant messaging clients

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or e-mail him at: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

If you cannot get to a phone and you need to make immediate contact, instant messaging (IM) may be the right call.

IM, the equivalent of ‘instant e-mail,’ allows almost real-time communication and exchange of information over the Internet. IM is most popular among teenagers and college students, but medical providers and other professionals have begun to recognize its potential for speeding communication.

How IM started

Before the World Wide Web existed, electronic bulletin boards (BBS) were a popular mode of communication. Users would log in and browse various message topics, posting comments and questions for others to answer. Users also could check who was logged into the BBS and post messages to one or more of those contacts. This was done in a Telnet session, which is a method for connecting to another computer on the Internet. Telnet sessions hark back to mainframe computing, when computer terminals without processing power provided access to the central computer.

In 1996, Mirabilis released ICQ, which enabled Internet users to locate each other on the Internet without connecting to a BBS-by creating direct peer-to-peer communication channels. Companies such as America On Line, Microsoft, and Yahoo! also developed IM systems, but none could connect with one another because there is no common standard. AOL later purchased Mirabilis and incorporated its technology into the AOL Instant Messenger (AIM).

Doing IM: What you need

To do instant messaging, you need an Internet connection and the appropriate client. Keep in mind that your client should be:

• compatible with several systems
• or the same client that your messaging partner uses. New users typically choose an IM system that a friend or colleague is using.

Choosing an IM client is a matter of preference because all systems offer similar features (E-therapy: Alerting patients to the benefits, risks,“ November 2002).

Because IM is a direct communication channel with visual references to previous dialogue, it creates the environment of an active conversation. One drawback is that a participant’s typing speed typically limits the conversation’s pace. Using the voice feature overcomes this limitation, but this feature will not work properly without a broadband Internet connection, such as over a cable modem or digital subscriber line.

Risks of IM-based therapy

The IM communication channel’s lack of security poses a significant risk, particularly when used for psychotherapy. This active connection broadcasts its availability over the Internet, making it vulnerable to hackers. What’s more, the IM client may change your security settings for your Web browser¹ or allow remote access to your computer by a hacker.²

Making your IM system secure

On the corporate level, vendors such as Yahoo!, Microsoft, AOL and others have created products to secure public IM systems, such as Akonix and Endeavors Technology. These products are gateways that maintain corporate data within the company network, encrypt information, specify and limit certain features, and log conversations. This level of security does not exist over major public IM networks for individual users.

Secure Shuttle Transport, DBabble, and PSST provide encrypted communication to individual users.

Table

Instant messaging clients

If you have questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or e-mail him at: Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Wireless fidelity, or “Wi-Fi,” is gaining popularity in the medical profession and elsewhere. Some medical professionals are using Wi-Fi’s anytime, anywhere Internet connectivity to access electronic medical information during hospital rounds and to immediately enter demographic information when admitting patients.

What it is-and how it works

Wi-Fi is a certification given by the Wi-Fi Alliance, a nonprofit international trade organization that tests 802.11-based wireless Internet products. The “Wi-Fi Certified” logo signals to purchasers that the product has met rigorous interoperability testing requirements and is compatible with products from different vendors.

Today, the term “Wi-Fi” also commonly describes wireless Internet. Technically speaking, Wi-Fi is the use of radio technology to provide Ethernet connectivity in the unlicensed 2.4 and 5 GHz radio frequencies. By contrast, Internet access provided by wireless modems is based on technology used in cellular phones.

802.11 is the standard protocol ratified by the Institute of Electrical and Electronics Engineers. 802.11b is the most commonly used standard; 802.11a and 802.11g are other options (Table).

Why Wi-Fi?

Wireless Internet access via the 802.11 protocol offers:

• freedom to surf the Internet in your office, back yard, or elsewhere
• the ability to avoid using unsightly wires to connect computers in a local area network (LAN)
• significantly faster access than wireless modems and higher connection speeds than are available via telephone lines or electrical outlets.

Hitting the hot spots

Aside from office and home, Wi-Fi can be used at “hot spots”-public access points at cafes, restaurants, coffee shops, hotels, airports, downtown business districts, malls, and retail stores. Some retailers provide free access to attract business,¹ while others pay to partner with wireless Internet service providers such as T-Mobile ² and Boingo.³

It helps to check online for hot spots before heading out (visit the T- Mobile or Boingo sites or try the Wi-Fi FreeSpot Directory or other Web site guide). Because most network connections are automatic, however, you can turn on your notebook computer anytime and find out in seconds if a wireless Internet service is available. An indication usually appears on the screen if you are connected to a wireless LAN with Windows XP or Mac OS X, but older operating systems may require additional software. A Wi-Fi signal does not guarantee Internet access because many Wi-Fi providers require the user to log in.

An alternative is to look for ‘warchalking’-a series of sidewalk symbols that appear on your screen to indicate nearby wireless access⁴ (click here to view warchalking symbols). Warchalking has raised legal and moral issues, though to my knowledge this tracking method is seldom used.

Getting started

Several components are necessary for wireless Internet in the home or office. First, broadband Internet access via a cable modem, digital subscriber line (DSL), or satellite must be established. Connecting via a dial-up modem is another option, but its connection rate is too slow to be shared among several computers.

A wireless access point, which serves as the ‘base station,’ is then connected to the modem. Access points often are sold in combination with a built-in router, which delivers network information to the appropriate destination.

Each computer connecting to the access point must have a wireless network adapter. For desktop computers, this can either be a peripheral component interconnect (PCI) card or a Universal Serial Bus (USB) device. Many notebook computers come with a built-in wireless network adapter but can also use a PCI card or USB device.

Once these devices are installed, the wireless network must be set up so that each device can communicate. Most network setups are automatically established and require little user intervention; however, the user must decide which wireless channel to use and whether a security key is required.

Security risks

Wireless network use poses one major drawback: lack of security.

All wireless LANs have built-in wired equivalent privacy security, which uses a security key to limit access. In 2001, researchers at the University of California at Berkeley discovered flaws in the encryption algorithm designed to protect wireless LANs.⁵ Software has since been designed to exploit this flaw and identify the security key in the wireless traffic, rendering this level of security useless.⁶

In health care, this risk raises the issue of whether wireless networking is compliant with the Health Insurance Portability and Accountability Act (HIPAA). Medical Records Institute Executive Director C. Peter Waegeman n indicates that access via 802.11b is clearly not HIPAA-compliant⁷ and that other standards such as 802.11a or 802.11g should be used. Most healthcare systems, however, continue to use 802.11b because it is widely available and economical.

Making your network secure

Although the 802.11b standard is extremely insecure, several practical issues ameliorate the security risk. For one, finding the security key provides access to the wireless network but does not guarantee access to private information. Disabling shared access to network computers offers additional security but will eliminate the benefit of sharing information over a network.

Several hardware and software innovations aimed at increasing remote network security are scheduled to be launched in the coming weeks.⁸ Until these products reach the mainstream, you can prevent unauthorized network access by:

• Choosing an access point that restricts media access control (MAC). The MAC address is the hardware address of a node in the network, such as a network adapter. By designating which MAC addresses have wireless access, unauthorized access is eliminated.
• Setting up the access point to stop broadcasting its Service Set Identifier (SSID). The SSID is part of the automated connection process that tells network adapters which 802.11b network it is joining. Only authorized users will know the SSID and security key, which are needed to establish a connection.

Internet communications that implement the secure socket layer (SSL) protocol will be encrypted, thus ensuring that the information is sent, unchanged, only to the intended server. Online shopping sites and banks use SSL technology to safeguard sensitive information.

Table

Current Wi-Fi standards

Related Resources

Wi-Fi Alliance: Wi-Fi Overview. Available at: http://www.weca.net/OpenSection/why_Wi-Fi.asp?TID=2. Accessed Nov. 18, 2003

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Wireless fidelity, or “Wi-Fi,” is gaining popularity in the medical profession and elsewhere. Some medical professionals are using Wi-Fi’s anytime, anywhere Internet connectivity to access electronic medical information during hospital rounds and to immediately enter demographic information when admitting patients.

What it is-and how it works

Wi-Fi is a certification given by the Wi-Fi Alliance, a nonprofit international trade organization that tests 802.11-based wireless Internet products. The “Wi-Fi Certified” logo signals to purchasers that the product has met rigorous interoperability testing requirements and is compatible with products from different vendors.

Today, the term “Wi-Fi” also commonly describes wireless Internet. Technically speaking, Wi-Fi is the use of radio technology to provide Ethernet connectivity in the unlicensed 2.4 and 5 GHz radio frequencies. By contrast, Internet access provided by wireless modems is based on technology used in cellular phones.

802.11 is the standard protocol ratified by the Institute of Electrical and Electronics Engineers. 802.11b is the most commonly used standard; 802.11a and 802.11g are other options (Table).

Why Wi-Fi?

Wireless Internet access via the 802.11 protocol offers:

• freedom to surf the Internet in your office, back yard, or elsewhere
• the ability to avoid using unsightly wires to connect computers in a local area network (LAN)
• significantly faster access than wireless modems and higher connection speeds than are available via telephone lines or electrical outlets.

Hitting the hot spots

Aside from office and home, Wi-Fi can be used at “hot spots”-public access points at cafes, restaurants, coffee shops, hotels, airports, downtown business districts, malls, and retail stores. Some retailers provide free access to attract business,¹ while others pay to partner with wireless Internet service providers such as T-Mobile ² and Boingo.³

It helps to check online for hot spots before heading out (visit the T- Mobile or Boingo sites or try the Wi-Fi FreeSpot Directory or other Web site guide). Because most network connections are automatic, however, you can turn on your notebook computer anytime and find out in seconds if a wireless Internet service is available. An indication usually appears on the screen if you are connected to a wireless LAN with Windows XP or Mac OS X, but older operating systems may require additional software. A Wi-Fi signal does not guarantee Internet access because many Wi-Fi providers require the user to log in.

An alternative is to look for ‘warchalking’-a series of sidewalk symbols that appear on your screen to indicate nearby wireless access⁴ (click here to view warchalking symbols). Warchalking has raised legal and moral issues, though to my knowledge this tracking method is seldom used.

Getting started

Several components are necessary for wireless Internet in the home or office. First, broadband Internet access via a cable modem, digital subscriber line (DSL), or satellite must be established. Connecting via a dial-up modem is another option, but its connection rate is too slow to be shared among several computers.

A wireless access point, which serves as the ‘base station,’ is then connected to the modem. Access points often are sold in combination with a built-in router, which delivers network information to the appropriate destination.

Each computer connecting to the access point must have a wireless network adapter. For desktop computers, this can either be a peripheral component interconnect (PCI) card or a Universal Serial Bus (USB) device. Many notebook computers come with a built-in wireless network adapter but can also use a PCI card or USB device.

Once these devices are installed, the wireless network must be set up so that each device can communicate. Most network setups are automatically established and require little user intervention; however, the user must decide which wireless channel to use and whether a security key is required.

Security risks

Wireless network use poses one major drawback: lack of security.

All wireless LANs have built-in wired equivalent privacy security, which uses a security key to limit access. In 2001, researchers at the University of California at Berkeley discovered flaws in the encryption algorithm designed to protect wireless LANs.⁵ Software has since been designed to exploit this flaw and identify the security key in the wireless traffic, rendering this level of security useless.⁶

In health care, this risk raises the issue of whether wireless networking is compliant with the Health Insurance Portability and Accountability Act (HIPAA). Medical Records Institute Executive Director C. Peter Waegeman n indicates that access via 802.11b is clearly not HIPAA-compliant⁷ and that other standards such as 802.11a or 802.11g should be used. Most healthcare systems, however, continue to use 802.11b because it is widely available and economical.

Making your network secure

Although the 802.11b standard is extremely insecure, several practical issues ameliorate the security risk. For one, finding the security key provides access to the wireless network but does not guarantee access to private information. Disabling shared access to network computers offers additional security but will eliminate the benefit of sharing information over a network.

Several hardware and software innovations aimed at increasing remote network security are scheduled to be launched in the coming weeks.⁸ Until these products reach the mainstream, you can prevent unauthorized network access by:

• Choosing an access point that restricts media access control (MAC). The MAC address is the hardware address of a node in the network, such as a network adapter. By designating which MAC addresses have wireless access, unauthorized access is eliminated.
• Setting up the access point to stop broadcasting its Service Set Identifier (SSID). The SSID is part of the automated connection process that tells network adapters which 802.11b network it is joining. Only authorized users will know the SSID and security key, which are needed to establish a connection.

Internet communications that implement the secure socket layer (SSL) protocol will be encrypted, thus ensuring that the information is sent, unchanged, only to the intended server. Online shopping sites and banks use SSL technology to safeguard sensitive information.

Table

Current Wi-Fi standards

Related Resources

Wi-Fi Alliance: Wi-Fi Overview. Available at: http://www.weca.net/OpenSection/why_Wi-Fi.asp?TID=2. Accessed Nov. 18, 2003

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

Wireless fidelity, or “Wi-Fi,” is gaining popularity in the medical profession and elsewhere. Some medical professionals are using Wi-Fi’s anytime, anywhere Internet connectivity to access electronic medical information during hospital rounds and to immediately enter demographic information when admitting patients.

What it is-and how it works

Wi-Fi is a certification given by the Wi-Fi Alliance, a nonprofit international trade organization that tests 802.11-based wireless Internet products. The “Wi-Fi Certified” logo signals to purchasers that the product has met rigorous interoperability testing requirements and is compatible with products from different vendors.

Today, the term “Wi-Fi” also commonly describes wireless Internet. Technically speaking, Wi-Fi is the use of radio technology to provide Ethernet connectivity in the unlicensed 2.4 and 5 GHz radio frequencies. By contrast, Internet access provided by wireless modems is based on technology used in cellular phones.

802.11 is the standard protocol ratified by the Institute of Electrical and Electronics Engineers. 802.11b is the most commonly used standard; 802.11a and 802.11g are other options (Table).

Why Wi-Fi?

Wireless Internet access via the 802.11 protocol offers:

• freedom to surf the Internet in your office, back yard, or elsewhere
• the ability to avoid using unsightly wires to connect computers in a local area network (LAN)
• significantly faster access than wireless modems and higher connection speeds than are available via telephone lines or electrical outlets.

Hitting the hot spots

Aside from office and home, Wi-Fi can be used at “hot spots”-public access points at cafes, restaurants, coffee shops, hotels, airports, downtown business districts, malls, and retail stores. Some retailers provide free access to attract business,¹ while others pay to partner with wireless Internet service providers such as T-Mobile ² and Boingo.³

It helps to check online for hot spots before heading out (visit the T- Mobile or Boingo sites or try the Wi-Fi FreeSpot Directory or other Web site guide). Because most network connections are automatic, however, you can turn on your notebook computer anytime and find out in seconds if a wireless Internet service is available. An indication usually appears on the screen if you are connected to a wireless LAN with Windows XP or Mac OS X, but older operating systems may require additional software. A Wi-Fi signal does not guarantee Internet access because many Wi-Fi providers require the user to log in.

An alternative is to look for ‘warchalking’-a series of sidewalk symbols that appear on your screen to indicate nearby wireless access⁴ (click here to view warchalking symbols). Warchalking has raised legal and moral issues, though to my knowledge this tracking method is seldom used.

Getting started

Several components are necessary for wireless Internet in the home or office. First, broadband Internet access via a cable modem, digital subscriber line (DSL), or satellite must be established. Connecting via a dial-up modem is another option, but its connection rate is too slow to be shared among several computers.

A wireless access point, which serves as the ‘base station,’ is then connected to the modem. Access points often are sold in combination with a built-in router, which delivers network information to the appropriate destination.

Each computer connecting to the access point must have a wireless network adapter. For desktop computers, this can either be a peripheral component interconnect (PCI) card or a Universal Serial Bus (USB) device. Many notebook computers come with a built-in wireless network adapter but can also use a PCI card or USB device.

Once these devices are installed, the wireless network must be set up so that each device can communicate. Most network setups are automatically established and require little user intervention; however, the user must decide which wireless channel to use and whether a security key is required.

Security risks

Wireless network use poses one major drawback: lack of security.

All wireless LANs have built-in wired equivalent privacy security, which uses a security key to limit access. In 2001, researchers at the University of California at Berkeley discovered flaws in the encryption algorithm designed to protect wireless LANs.⁵ Software has since been designed to exploit this flaw and identify the security key in the wireless traffic, rendering this level of security useless.⁶

In health care, this risk raises the issue of whether wireless networking is compliant with the Health Insurance Portability and Accountability Act (HIPAA). Medical Records Institute Executive Director C. Peter Waegeman n indicates that access via 802.11b is clearly not HIPAA-compliant⁷ and that other standards such as 802.11a or 802.11g should be used. Most healthcare systems, however, continue to use 802.11b because it is widely available and economical.

Making your network secure

Although the 802.11b standard is extremely insecure, several practical issues ameliorate the security risk. For one, finding the security key provides access to the wireless network but does not guarantee access to private information. Disabling shared access to network computers offers additional security but will eliminate the benefit of sharing information over a network.

Several hardware and software innovations aimed at increasing remote network security are scheduled to be launched in the coming weeks.⁸ Until these products reach the mainstream, you can prevent unauthorized network access by:

• Choosing an access point that restricts media access control (MAC). The MAC address is the hardware address of a node in the network, such as a network adapter. By designating which MAC addresses have wireless access, unauthorized access is eliminated.
• Setting up the access point to stop broadcasting its Service Set Identifier (SSID). The SSID is part of the automated connection process that tells network adapters which 802.11b network it is joining. Only authorized users will know the SSID and security key, which are needed to establish a connection.

Internet communications that implement the secure socket layer (SSL) protocol will be encrypted, thus ensuring that the information is sent, unchanged, only to the intended server. Online shopping sites and banks use SSL technology to safeguard sensitive information.

Table

Current Wi-Fi standards

Related Resources

Wi-Fi Alliance: Wi-Fi Overview. Available at: http://www.weca.net/OpenSection/why_Wi-Fi.asp?TID=2. Accessed Nov. 18, 2003

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to Current.Psychiatry@dowdenhealth.com.

Disclosure

Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.