Health care delivery systems are complex sociotechnical systems, characterized by dynamic interchanges with their environments (e.g., markets, payers, regulators, and consumers) and interactions among internal system components. These components include people, physical settings, technologies, care processes, and organization (e.g., rules, structure, information systems, communication, rewards, work flow, culture). ("Agency for Healthcare Research and Quality,", 2012) A local medical facility has requested an analysis to determine what will be required to update the current system and include video consults for the patients. This company has locations in 7 states of the southeastern past of the US. The process will be implemented at 21 locations. Over the next few weeks I will research the details which will include software, hardware, cost for equipment upgrades, and other extra cost that may be involved according to system requirements listed below. Network configuration will be discussed in the functions of the system. The need for the time frame for the project will also be considered. The main concern is to deliver a quality system. The final product will include a system where patients will be able to have face to face consultations with the doctor or PA through video capability.

System Requirements

. The first step is that the operating systems be updated with Microsoft 64 or 32-bit Windows 10 Pro, Windows 8 Pro, or Windows 7 Professional for best performance. Systems utilizing the architecture will have processors that are Intel Core i5-3470 3.2GHz LGA 1155 77W Quad-Core Desktop Processor equivalent or higher. The architecture requires 6 GB DDR3 RAM for memory and 250 GB of free space or higher for the hard drive. Uninterruptible Power Supply (UPS) is required for the client’s Information Technology (IT) professional to install. The HP LaserJet 3000 or 4000 Series printers are recommended. Broadband internet connections (specifically Cable) are recommended. For the 21 locations Logitech Meetup 4K HD Video Conference Camera with Integrated Audio will be purchased and installed. ("Hardware Specifications - American Medical Software", 2018)

The Functions of the System

The functions of this system will be to perform the basic functions of any medical offices. The system will be able to book appointments, retain patient records, update system to reflect appointments, billing, transfer information from one location to another location across the country and should be able to handle the load for all the facilities across the country. The main addition to the system will be to allow video transmission for consultations between doctor and patient.

This system will use a client-server, using a 100 Mbps Network Interface Card able to support full-duplex operation. All workstations absolutely need Full Control NTFS permissions and Full Control share permissions to the AMS data folder. Administrators should only user routers that have WPA2 encryption capabilities. WPA2 has the necessary security to ensure PHI will not be compromised (i.e. 256-bit AES encryption, SHA-1 hashing, password/key authentication). We will be using Pervasive PSQL v11.30 32-bit Client Engine as a server. ("Hardware Specifications - American Medical Software", 2018) Telemedicine software is needed for this project also, the technical infrastructure requirements to use this process are, access to broadband internet, imaging technology or peripherals since theses devices are the backbone of telehealth, access to technical support staff for any questions and staff training to teach staff how to use telehealth technology.

This will target two classes of users: approved users and public users. Supports two classes of users: approved users and public users. The element management and conservation subsystems are just public to the approved users. Approved clients are additionally sorted to useful authorities and System directors or supervisors. The accompanying records the authorities and chiefs. The main concern right now is the cost of the new hardware and the time required to get all locations up and running in a reasonable amount of time and keep with the original requirements for this project. If everything goes as planned the new infrastructure will be able to perform as planned.

Architecture Selection

For this area the architectures, I am comparing are Client/Server Architectural, Service-Oriented Architectural Style, and N-Tier / 3-Tier Architectural. Starting with client-server, the most common distributed system architecture. It can be classified into a thin client or thick client. The main advantages are the simplicity of the design and use of resources very effective with a high-performance server. (" Distributed Architecture", 2017) Example

Service-Oriented Architecture is well-defined and self-contained, independent and is a client-server design. It provides, reusability, interoperability, composability is a distributed deployment. This is an example of SOA (" Distributed Architecture", 2017)

N-Tier / 3-Tier Architectural

This architectural deployment style describes the separation of functionality into segments in much the same way as the layered style, but with each segment being a tier that can be located on a physically separate computer. This architecture provides Maintainability scalability, flexibility and availability ("Architectural Patterns and Styles", 2016)

Client-Server

My choice out of the above will be the client-server because this server is formed to make the best of your employees’ productivity using enhanced security, reliability, and accessibility features. The server is always-on, always available, files and applications are available at any time. Client-server network also acts like a centralized hub that stores and shares files. This architecture can be configured to automatically backup files and restore data on the back up images in case of hard drive crashes. Detecting and correcting memory errors can protect critical date automatically. Client-Server architecture will also work well with the telehealth software provided by Virtumedix.

Development Processes for Distributed Systems

References:

McDunnigan, M. Advantages & Disadvantages of Distributed Systems. techwalla. Retrieved 3 February 2018, from https://www.techwalla.com/articles/advantages-disadvantages-of-distributed-systems

client/server (client/server model, client/server architecture). (2008). techtarget.com. Retrieved 12 February 2018, from http://searchnetworking.techtarget.com/definition/client-server

Agency for Healthcare Research and Quality, (2012). Ahrq.Gov, System Design: AHRQ Resources. Retrieved from System Design: AHRQ Resources. Content last reviewed January 2015. Agency for Healthcare Research and Quality, Rockville, MD.

Hardware Specifications - American Medical Software. (2018). American Medical Software. Retrieved 20 February 2018, from http://americanmedical.com/hardware-specifications

What are the technical infrastructure requirements of telehealth. (2014). healthit.gov. Retrieved 22 February 2018, from http://www.healthit.gov/providers-professionals/faqs/what-are-technical-infrastructure-requirements-telehealth

Architectural Patterns and Styles. (2016). msdn.microsoft.com. Retrieved 23 February 2018, from https://https://msdn.microsoft.com/en-us/library/ee658117.aspx#ClientServerStyle Architectural Patterns and Styles

Distributed Architecture. (2017). tutorialspoint.com. Retrieved 15 February 2018, from http://www.tutorialspoint.com/software_architecture_design/distributed_architecture.htm