So You Would like to Work from Home

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So You Would Like To Work from Home? Remote Access over Broadband Paul Bromley The Stockwell Surgery - Leek

Gareth Send Apologies: 

Gareth Send Apologies New Job No longer in Healthcare Send any technical queries to

KISS – Keep it Simple : 

KISS – Keep it Simple Easy Guide to connecting over Broadband SIMPLEST way to connect Speediest connection Jargon will be kept to a minimum

Working from Home - Fiction: 

Working from Home - Fiction Might be nice to ‘switch’ the odd patient off?

The Reality - Relaxing with a beer in the Garden?: 

The Reality - Relaxing with a beer in the Garden? ‘I don’t like taking work home ….. BUT! Saves me time! Far more productive. Less time at work. Our practice – limited rooms – ideal for catching up. Wireless – NO security threat – encrypted ‘tunnel’ BEFORE wireless.

You can take things too far!: 

You can take things too far!

Around 11 Years ago -: 

Around 11 Years ago - Second or third EMIS NUG Conference. Dialling in to EMIS system. 1200/1200 Modem. Demonstrated Live. I’ve no more sense today!!

Benefits of Broadband vs ‘dial in’: 

Benefits of Broadband vs ‘dial in’ ‘Always on’ – little delay connecting. 256K at Practice – relatively quick. N3 – New National Network – Faster 2MB – delays in implementation though . More robust – fewer lost connections. Multiple users to EMIS server. Multiple logons per user. Attachments, Wordmerge, Popman. Network Browsing using Remote Desktop Connection .

Any Internet Service Provider: 

Any Internet Service Provider Cable & Wireless solution, BUT your home ISP can be anyone. Unable to use AOL last year – need to check on this.

2 Key concepts to understand: 

2 Key concepts to understand ‘Direct Login’ to EMIS server – i.e. merely logging on to the EMIS clinical system. ‘Remote Desktop Connection’ – You are logging on to a workstation in the practice, and then using the full facilities of this workstation as though you were sitting in front of it at the practice. Concurrent Direct & Remote Desktop logins possible.

Direct Login Using LV Client: 

Direct Login Using LV Client Similar to Surgery Login. ‘Direct’ login to practice server – IP address. Fine for normal data entry and using Population Manager. Not ideal for :- Attachment Viewing. Wordmerge.

Problems with Direct Login: 

Problems with Direct Login Slow performance:- Attachment Viewing. Wordmerge. Major issues getting this working ? Ports Issues ? Network Paths Direct Login will not be discussed in any great depth – flawed. Important EMIS functions cannot be used.

Remote Desktop Connection: 

Remote Desktop Connection Windows XP Professional at the Host (Surgery). Remote Desktop Client Software at home – all flavours of Windows – 95 - XP. Terminal Services Client – 2 connections to Windows 2000 Server.

Remote Desktop Connection 2: 

Remote Desktop Connection 2 Advantages Full access to your Workstation. Network access – browsing, copying, moving, pasting of files. Attachment Viewing & Wordmerge faster. Full Internet access at same time. Access to NHSNET exclusive services:- NHSNet Sites External Agencies – e.g. Direct Booking.

Remote Desktop Connection 3: 

Remote Desktop Connection 3 Best option to go for All EMIS functionality at a reasonable speed General EMIS use Print to slave & system printers Browsing Attachments Wordmerge Population Manager Scanning even! Main disadvantage – requires use of a Workstation at the surgery.

Practice Network Accessible: 

Practice Network Accessible Network fully browsable – depending on permissions. Copying/Moving/Pasting files. Open documents. Network Printing.

A Holiday Snap!: 

A Holiday Snap!

SecureID token : 

SecureID token Key-fob style Token. 4 digit PIN number. 6 digit security code generated by token. New code generated every minute. Do not use within 20 seconds of code changing.

C&W User Access Tokens: 

C&W User Access Tokens Administrator Token required – or use HealthVPN Managed service Administrator token can be used as ‘User Token’ Purchase Via HealthVPN site 2-3 week delivery

Quarterly Token Charges: 

Quarterly Token Charges 1 to 24 £91.65 25 to 49 £82.49 50 to 99 £73.32 100 to 199 £59.57 200 to 499 £54.99 500 to 999 £50.41 1000+ £45.83 Administration by HealthVPN 1st User £35.25 per quarter Subsequent Users £29.38 (one-off setup fee)

Nortel Contivity Client.: 

Nortel Contivity Client. IP secure tunnel between user & remote system. Wireless connection IS secure. ‘Tunnel’ formed before wireless connection. All network connections to client PC – Disconnected. NO Internet Access apart from NWW sites (at home site PC).


Portability Can be used from any Internet Connection. Nortel Contivity Client Required on machine. IP address asigned by VPN Concentrator is recognised by your practice router.

Explanation of Service: 

Explanation of Service Users connected to the public internet gain secure, authenticated access to NHSnet. User is challenged to input a PIN number plus a code from a SecureID token. If authenticated - VPN tunnel is created between the user computer and the Nortel Contivity VPN Concentrator within NHSnet. The laptop/PC runs a point and click application that sets up an encrypted virtual private network (VPN) tunnel from the PC to NHSnet. Once the VPN tunnel is created the user has access to NHSnet. From NHSnet they can access the services within their own organisation that they are set up to use.

Schematic Diagram of the Solution : 

Schematic Diagram of the Solution

Snakes – I hate Snakes!: 

Snakes – I hate Snakes! Problems! Readesmoor – none. Stockwell – several! Delays with tokens - ? Cable & Wireless. Direct Connection. NAT External IP > Internal IP 192 .x.x.x > 172.x.x.x BT! 9 months before functional!

The difficult bits – made easy!: 

The difficult bits – made easy! TCP/IP Ports needing to be opened on router. Direct login requires a number of ports. Remote Desktop – 1 port No path issues No major problem with NAT Ask for following port to be opened.

Whats involved …: 

Whats involved … Fill in the web-based order form on for the ‘Token Only VPN Service’ (Ensure you have your BT SIN number ready) Await contract from Cable & Wireless to be e-mailed back. Print, sign and faxback form to fax number given Wait approximately 2 - 3 weeks for the new tokens to arrive with NHSNet routable IP Addresses and a new Cable & Wireless SIN Number.

Whats involved … Part 2: 

Whats involved … Part 2 NHSNet - Firewall Change Form, available at: enter:- Cable & Wireless SIN Number IP Addresses given by Cable & Wireless Port to be opened – 3389 Remote Desktop N3 – Complete Firewall Change Form available from your PCT. Follow instructions given by Cable & Wireless for configuration of the Tokens on client machines, once configured it should be possible to use EMIS as if you were sitting in the surgery.


Resources. Millbeck Communications informatiks Http://

Thanks for listening: 

Thanks for listening Jenson – Our new family member!

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