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Best Practices, n.: Making the same mistakes everyone else does.

However, what are the odds of someone being able to make special-purpose machines to do everything COTS boxes are used for, and making those machines as fast, cheap, and reliable as COTS systems are now? Some things seem obvious (x-ray machines, lab machines) but accounting and record-keeping? Going back to adding machines and purely manual filing is not an option in a large hospital, especially if it has to maintain modern standards of patient care over a large patient population.

I think virtualization takes you a long way towards the solution to this issue. With Win7 I've gotten into the habit of routinely working on virtual instances using the boot from .vhd feature. This means that if something goes wrong my host is not impacted and I can revert to an earlier version of my .vhd to solve problems like this one. The standard IT "wait and see" policy makes this something that will take awhile to become common but I think it is the way to go for pretty much any critical path task you do on a Windows PC (other OSes such as OS X have similar features as well but I only use OS X for "media" stuff).

And if you use a Type-1 hypervisor (i.e. one that runs on the bar metal) you should be even safer.

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