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 part 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 these 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.

Resources and Timeline

Software requirement for implementation of client-server architecture include .Net Framework, windows PowerShell, internet explorer software, and windows 2012 R2 server software. Other software required are windows seven, SQL server, SharePoint server, and print server (Stanek, 2013).

Hardware requirements

Before implementing client-server architecture, it is very important to consider hardware requirements. The table below lists hardware requirement for deployment of client-server architecture

Table 1: Hardware requirement

Component	Minimum	Recommended
Processor with Video Cam	2.5GHz	Dual core processor each 3GHz
RAM	1 GB	4 GB
Hard-disk	NTFS file-system with 32GB free space	NTFD file-system with 40 GB free space
Drive	DVD-ROM drive	DVD-ROM drive
Display	1024 by 768 super VGA	1024 by 768 or a higher resolution XGA monitor
Network	56 Kbps connection between server and client computers	100Kpbs or a faster connection between server and client computers

Table two list Client desktop specifications

Component	Recommendation
Operating system	Windows 7 32 bit
Web browser	Chrome, internet explorer
Document management	Microsoft Office 2007 or 2013, Adobe reader, and open office
Virtumedix	Telehealth Software

To deploy client server architecture, the project manager need to organize their deployment team and assign specific role to every team member. Table three below lists deployment team for client-server architecture with their respective responsibilities.

Table 3: Personnel requirement

Team	Roles
Project sponsor	This is the person who fund the whole project
Information security analyst	This is the person who develops standards for extranet, internet, domain security
Infrastructure designer	This person addresses the domain model. Local Area network issues, global file access, remote access, Domain Name system
Network administrators	Develops directory-enable networking solutions for the organization. Additionally, makes sure that all the cabling is well done
System administrator	Tests and resolves software related issues, upgrade and migration issue
Steering lead member	This a strategic member from the organization. They also perform all other teams to perform overall communication and coordination. The person also supports and training issues (Manasi, 2014).

Other requirements and their roles include

Server	Role	Edition
Server 1	Printing and file sharing	Data center edition
Server 2	Application services	Standard edition
Server 3	Back-up	Data center edition.

Costs

For health care I would recommend standard server and data center edition. This is featured by two virtual OSE. The licensing model is processor+. The server pricing for this edition goes for $890. Data center edition goes for $1000. Hardware requirement as listed above will account up to $1000 while software requirement will go up to $500. High cost will be experienced in the personnel needed for the implementation. The cost will go up to $2000

Project Timeline

Project timeline communicates the important milestones for a certain project. For this project, the important milestones are installation of client computers with windows seven, server 2012 R2 installation and installation of all health care application services.

Major project deliverable

The primary goals for this project is to deliver a system that captures organization goals. Deploying client/server architecture can be an overwhelming task. The primary deliverable for this project is to deliver a quality client-server system. The client system must support some services which billing are, transfer of information from one location to another, allow video transmission, and be able to book appointments. Additionally, all the workstations must be connected to the central computer.

Duration to complete each task

The table shows project plan for full implementation of client-server architecture

Task name	Duration
Initial Planning	3 days
Windows 7 deployment to desktops	5 days
Windows server Installation	2 days
Install windows server updates	1 day
Install virtual server	2 days
Install windows 7 updates	1 day
Install Virtumedix Software	1 day
Customize client computers	1 day
Create application packages	2 days
Test windows 7 deployment	1 day
Configuration of client computers with server	2 days
Documentation	1 day
Testing of whole client/server system	2 days
Finalize and deliver documentation	2 days

Gantt Chart

Duration in Days

Initial Planning

Windows 7 deployment to desktops

Windows server Installation

Install windows server updates

Install virtual server

Install windows 7 updates

Install Virtumedix

Customize client computers

Create application packages

Test windows 7 deployment

Test Virtumedix

Configuration of client computers with server

Documentation

Testing of whole client/server system

Finalize and deliver documentation

Charts to display timelines

References

Manasi, M. (2014). Mastering Windows Server 2012 R2. Indianapolis: Sybex.

Stanek, W. R. (2013). Microsoft Windows server 2012 inside out. Redmond, Wash: Microsoft Press.

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