introduction to healthcare information technology chapter four network it operations

Introduction to Healthcare Information Technology

Chapter FourNetwork IT Operations


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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Introduction to Healthcare Information Technology 4

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


Figure 4-1 OSI layers

© Cengage Learning 2013


Table 4-1 OSI reference model



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


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Figure 4-2 A hub is an older type of network device; today hubs have largely been replaced by switches



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



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© Cengage Learning 2013



• 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


Figure 4-5 DNS lookup© Cengage Learning 2013



• 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


Figure 4-6 FTP client software© Cengage Learning 2013



• 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



• 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


Basic Network Setup

• Setting up a network– Involves understanding connections to the network

devices and configuring network hardware• A variety of possible configurations exist


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

© ronstik/www.Shutterstock.com


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

© Oleksiy Mark/www.Shutterstock.com


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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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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• 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


Table 4-2 Wireless signal interference



Figure 4-17 Incorrect and correct wave propagation and multipath




• 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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introduction to healthcare information technology chapter four network it operations

Documents

network layer

office network

network segments

ehremr network technologies

older type of network

specific devices

standard networking

switches workgroup switches