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Introduction to Healthcare Information Technology

Chapter Four

Network IT Operations

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Objectives

List and describe standard networking devices

Explain the function of servers

Explain how to set up basic networking

List the steps for troubleshooting a network

Describe different options for EHR/EMR network technologies

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Healthcare IT: Challenges and Opportunities

Computer network

Foundation of computing technology in an office

Network IT operations support electronic health records

Chapter topics

Common network devices

Network servers

Setting up a network

Troubleshooting a network

Technologies used for EMRs and EHRs

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Standard Network Devices

International Organization for Standardization (ISO) reference model

First released in 1978

Describes how dissimilar computers can connect together on a network

1983 version of the model is still used today

Breaks networking steps into seven layers

Each layer contains different networking tasks

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Figure 4-1 OSI layers

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Table 4-1 OSI reference model

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Standard Network Devices (cont’d.)

Ethernet

Most common local area network (LAN) technology today

Divides data into small units called packets

Standard network devices

Classified by the OSI layer at which they function

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Hubs

Older devices

Connect multiple Ethernet devices on a network

Typically use shielded twisted-pair (STP) copper cables

Work at the Physical Layer (Layer 1) of the OSI model

Do not read any data passing through them

Ignorant of source and destination

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Figure 4-2 A hub is an older type of network device; today hubs have largely been replaced by switches

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Switches

Network switch

Device that connects network segments together

Has more intelligence than a hub

Operates at the Data Link Layer (Layer 2)

Identifies specific devices connected to its ports

Can forward frames intended for a specific device

Or all devices

MAC address (hardware address)

Used to identify each device connected to the switch

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Switches (cont’d.)

Core switches carry traffic between switches

Workgroup switches connect directly to network devices

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Figure 4-3 Core and workgroup switches

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Routers

Operate at Network Layer 3

Forward packets across computer networks

Steps

Read destination address

Send packet to next network toward its destination

Can filter out specific types of network traffic

Security function

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Domain Controllers

Domain

Collection of devices that share a central directory database

Domain controller

Server that manages security-related elements on the network for the user

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Servers

Several different types of services and servers

Several different protocols

Servers must be properly managed to be effective

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Services and Servers

Print services

Allow multiple users to share printers across a network

File services

Allow users to share files from a central location

Application services

Processes that run software for network clients

Communication services

Manage E-mail, telephony, and instant messaging

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Server Management

Common tasks associated with managing servers

Load balancing

Allocating storage space

Load balancing

Used to evenly distribute work across a network

Advantages of load-balancing technology

Reduces probability of overloading a single server

Optimizes resources for the benefit of each networked computer

Reduces network downtime

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Server Management (cont’d.)

Hardware load balancer

Also called a Layer 4-7 router

Managing storage

Important due to the large number of documents that are retained today

Electronically stored information subject to legal discovery

Storage virtualization

Hides the physical resources of storage from the user

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Protocols

Rules for communication

Essential for proper communication to take place between network devices

Three common protocols

Transmission control protocol / internet protocol (TCP/IP)

Wireless protocols

Remote desktop protocol (RDP)

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Protocols (cont’d.)

TCP/IP protocol

Several protocols that function together

IP protocol functions at layer 3 to provide addressing and routing

TCP is the main transport layer protocol that establishes connections between devices

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Figure 4-4 OSI model vs. TCP/IP model

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Protocols (cont’d.)

Domain Name System (DNS)

Maps an IP address to its symbolic name

Database divided and distributed to many different Internet servers

Dynamic Host Configuration Protocol (DHCP)

Assigns dynamic IP addresses rather than static

DHCP server leases an IP address to a computer

When computer is off the network, IP address can be reassigned to another computer

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Figure 4-5 DNS lookup

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Protocols (cont’d.)

File Transfer Protocol (FTP)

Method for transferring files across the Internet

Links servers

Methods for using FTP on a local host computer

Command prompt

Web browser

FTP client application

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Figure 4-6 FTP client software

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Protocols (cont’d.)

Wireless protocols

Enable mobile communication

Wireless local area network (WLAN) standards

IEEE 802.11-2007

IEEE 802.11n-2009

Advantages of 802.11n over previous standards

Higher speed (up to 600 Mbps)

Coverage area

Reduces interference

Improved security

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Protocols (cont’d.)

Remote desktop protocol (RDP)

Allows user to access another computer remotely over a network

Provides remote display and input capabilities over network connections

Designed to support different types of networks and protocols

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Basic Network Setup

Setting up a network

Involves understanding connections to the network devices and configuring network hardware

A variety of possible configurations exist

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Client Connections

Network interface card (NIC)

Also called client network adapter

Hardware needed to send and receive data on a wired network

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Figure 4-7 NIC and cable

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Client Connections (cont’d.)

Wireless client network interface card adapter

Performs same functions as a wired NIC

No external RJ-45 cable connection

Uses an antenna (may be embedded)

May plug into the USB port

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Figure 4-8 USB wireless NIC

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Network Hardware

Modem

Device that changes analog to signal to digital

Internet modem

Also called broadband modem

Connects computers and networks to the Internet

Router

Connects with Ethernet patch cable to the Internet modem

Generally preconfigured to act as a DHCP server

Can also be configured to support port forwarding

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Network Hardware (cont’d.)

Methods of communication between wireless clients

Ad hoc mode

Infrastructure mode

Wireless access point

Used in infrastructure mode

Receives all wireless signals

Serves as a bridge between wired and wireless networks

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Figure 4-12 Infrastructure mode with AP

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Network Hardware (cont’d.)

Access point should be located near the middle of the coverage area

Security settings for a wireless network

Turn on Wi-Fi Protected Access 2 (WPA2)

Disable Service Set Identifier (SSID)

Center antenna placement

Reduce power levels

Create guest network

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Network Troubleshooting

Connectivity problems

Check that network devices are receiving power

Use the command line utility ping to check for connectivity

If message “100% packet loss”, connectivity problem may be with ISP

Use tracert to display route (path) a packet travels

Shows where the transmission was stopped

Make sure cables are not crimped, broken, or torn loose from connectors

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Network Troubleshooting (cont’d.)

Interference

Strong external signal interferes with the signal being transmitted

Fiber optic cables immune to interference

Radio frequency interference

Caused by broadcast signals from a radio or TV transmitter

Electromagnetic interference

May be caused by phones, radios, appliances, lights, etc.

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Network Troubleshooting (cont’d.)

Wireless signal issues

Due to multiple paths the signal takes to reach the receiver

Wave propagation

Solution to wireless network interference

Move the AP or the source of the interference

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Table 4-2 Wireless signal interference

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Figure 4-17 Incorrect and correct wave propagation and multipath

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Network Troubleshooting (cont’d.)

IP settings

Network problems can occur if same IP address assigned to more than one device

Use Windows command-line utility ipconfig/all

Lists all settings for the device

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Network Technologies for EHR/EMR

Two broad categories of decisions

Cloud versus local network

Installed applications versus remote access

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Cloud Computing vs. Local Network

Cloud computing advantages

Can reduce hardware, software, and personnel costs

Pay only for computing resources needed at a given time

Resources can be adjusted as needs change

Cloud computing disadvantages

Separate entity responsible for managing security and privacy of the EHR/EMR

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Installed Applications vs. Remote Access

Remote access configurations

Can save time and cost

Not all applications may run efficiently in a remote access setting

Especially specialized healthcare applications

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Summary

OSI reference model is a conceptual representation of how data moves through a computer network

Several different types of servers exist

Network load balancing helps evenly distribute work across a network

Computer network protocols

Rules for communication between network devices

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Summary (cont’d.)

Wireless local area networks are based on IEEE standards 802.11 and 802.11n

Different types of network hardware perform different functions

Internet modem, router, wireless access point

Determining most appropriate network technology for managing EHRs and EMRs not an easy task

Advantages and disadvantages of remote and local access configurations

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