By Craig Cumbie

I’m sure the date April 8, 2014, means something to most healthcare technology management (HTM) professionals. It was the Windows XP end-of-life date that marked the transition to Windows 7. The transition was gradual; many health facilities went beyond the end-of-life date and took on the associated risks of having a device on the network with an unsupported operating system.

Craig Cumbie

Craig Cumbie

Now, we once again face a looming end-of-support deadline—this time for Windows 7. The deadline, Jan. 14, 2020, will be here in no time at all, and HTM professionals must proactively prepare by contacting vendors to learn which upgrade paths are available. After all, running an out-of-date operating system directly violates HIPAA, and health facilities assume all liability if patient health information is compromised.

With the launch of Windows 10, Microsoft made changes to their Windows product lifecycle that no longer guarantees 10 years of support. The tech giant has committed to releasing two “feature updates” to Windows 10 every year—and, with that, has shortened the lifespan from 10-plus years to 18 months. In my opinion, Microsoft’s “rapid release” cycle puts everyone in a bind because customers must upgrade to a new feature release every 18 months to continue to receive security updates from Microsoft.

The only version of Windows that is truly suitable for medical devices is long-term servicing branch (LTSB). The LTSB version of Windows 10 receives no feature updates—only security updates—and is supported for 10 years after release.

Unfortunately, only enterprise customers with volume licenses can employ it. For instance, the facility where I work currently only has one device with Windows 10 installed. This device has a service contract, but the vendor has been unresponsive regarding upgrades to Windows. Making matters worse, this device is on our network and will soon become a hazard when support for the version of Windows 10 that it is running ends. Needless to say, we plan to contact the vendor shortly to see how they will help us upgrade to a new version of Windows 10.

Biomed Beware

At no point should you ever open Windows Update and tell Windows 10 to check for updates if a feature update is available. You cannot select individual updates and Windows will attempt to download and install everything at once. If you have an update that causes your system to break, and you uninstall the offending update, expect to have it attempt to reinstall the next time Windows updates run.

Also, the vendor may need to provide software updates and/or driver updates before you update Windows. If you’ve watched what has happened recently with the Windows 10 1809 feature update, you’ll know that it was pulled due to it deleting user files during installation. And if you dive headlong into a Windows 10 feature update and it trashes the install, you’re going to have one unhappy customer.

Take note: You must have a backup before proceeding with one of these updates. Hopefully, my fellow 24×7 Magazine readers have full support from their IT departments—or, better yet, have integrated with their IT departments. But if you find yourself in a situation where you do not have IT support and are being told that the department won’t touch the computer due to it being “medical equipment,” be prepared to go it alone.

Fortunately, there are free resources available for HTM professionals looking to conduct back-ups. Personally, I developed a simple method for backing up our “medical computers” using a freeware Linux distribution called Clonezilla, which is designed to back up and image hard drives. To use Clonezilla, you must download and either burn it to a DVD or make a bootable USB stick. Personally, I use a program called UNetbootin (, which is also freely available, to create a bootable USB stick.

You’ll need the following supplies before you start imaging:

  • An external hard drive dock that supports 3.5-inch and 2.5-inch drives, both Serial Advanced Technology Attachment(SATA) and Integrated Drive Electronics (IDE). A complete set-up will cost under $100.
  • An external hard drive: Fortunately, our IT department provided us with one, so we didn’t have to purchase this.

All imaging is done offline, so if the device you want to image disables booting from discs and USB sticks, you can bypass it.

Now, remove the hard drive you want to image and place it into the hard drive dock. Plug the hard drive dock and external hard drive into your laptop; then, plug the Clonezilla USB into your laptop and boot from it. You will then be presented with a wizard that will guide you through the imaging process. The only shortfalls I have run into are imaging RAID 5 arrays and small computer system interface, or SCSI, drives.

Craig Cumbie is a biomedical technician at Central Peninsula Hospital in Soldotna, Alaska. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].