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Figure 4-2 A hub is an older type of network device; today hubs have largely been replaced by switches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

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