University of Minnesota Information Technology in Healthcare Medical Industry Leadership Institute Course: MILI/PUBH 6562 Fall Semester B, 2013 David L. Edgerton, Jr., BSEE, MBA Instructor

Health IT Hardware Overview Computer Components Virtual Components Tour Evolution of Health IT Processing Network Fundamentals Data Switches for the Health Internet

The Health IT Pyramid Hardware Decision Support Software Life Support Software Clinical & Financial Data

Hands On Components of Health Information Technology

Major Components of a Computer System Input Output 1. Arithmetic/Logic 2. Control Unit 3. Registers Secondary Storage Primary Storage CPU Information Control

Central Processing Unit (CPU) Arithmetic/Logic Unit – e.g., if diagnosis=diabetes then count patient Control Unit – home of the machine code Registers – place-holders within the CPU as it processes data.

Primary Storage Core memory: – Read-only memory – Random-access memory – Cache memory Started off being very expensive Extremely cheap today relatively to a few years ago (32 MB, $1,280 in 1993; 32 MB, <$1 in 2012)

Secondary Storage Magnetic disks (e.g., Hard drives) Magnetic tapes (e.g., Tape drives) Optical disks – CD (700 MB) – DVD (4,300 or 4.3 GB) – Blu-Ray (25/50 GB) Smart cards Solid state drives (e.g., SSD / USB drives)

Input Devices Keyboard Pointing device – mouse – trackball – pointing stick Scanner Handwriting recognition devices Voice input

Output Devices Printer – Dot matrix – Laser – Inkjet Monitor Speakers

Motion Activated Security Quad Processor Servers Satellite Uplink Welcome to Prof. Parentes Enterprise Servers

Secondary Storage Dual Mainframe Tape Drives

Secondary Storage: Mainframe Tape Drive

One of Eight Server Fans

I/O Peripheral Slots

Dual Processors & Heat Sinks

Basic PC Entrails

CPU

Connecting the Computer to Input & Output Devices Keyboard Serial Ports SCSI Port Speaker & MIC Video Port Network Port

Secondary Storage II Floppy Drive Hard Drive

Secondary Storage III SCSI/SATA Hard Drive DVD

Primary Storage RAM Peripheral Slots

Power Supply Backup & Modem Modem Uninterruptable Power Supply (UPS)

Central Mainframe

1970s - Setting the Stage for Bigger Things Hardware innovations opened up new opportunities: – On-line computer systems – Still used batch for big jobs (payroll) Minicomputers Packaged systems

1970s - continued Packages developed: – accounts receivable – admissions – bed census – inventory control – medical records Turn-key packages: Vendor supplies hardware, software, installation support and training. Shared systems – use a hub – use terminals – forerunner of networks

1980s Microcomputers make rapid advances Institutions faced with more managers wanting systems tailored to their needs. Led to Balkanization of HMIS. Why? – Technology is cheap – Hospital departments start buying their own stuff – Although stuff was cheap, the new product cycle rapidly accelerated.

1990s-Realizing integrated IS Radical market change in health markets has completed radical in IT change. – mergers – integrated delivery systems – Health reforms promise, threat and debris – Health data standards – Internet/intranet capability – Privacy & security issues – Consumers enter the health care market informed with MEDLINE data and clinical data from the web.

Intel processor mainstream purchase timeline: : 8 bit XT : 16 bit AT : 16 bit : 32 bit : Pentium (80586) 1997: Pentium MMX/Pentium Pro (80686) 1998: Pentium II (80686 w/MMX) 1999: Pentium III (80686 Slot 2) 2000: Pentium IV above 1 Ghz.

Overview of Networks Central Mainframe Configuration Client/Server Computing File/Server Architecture Distributed Data Processing

Central Mainframe

Client/Server

HSI Client-Server Platform Cooling Fans RAID Disk Array, 6 Drive Bays RAID Defined: Redundant Array of Inexpensive Disks

File Server

Distributed Data Processing

Network Topologies Bus topology Ring Topology Star Topology

Software Fundamentals Programming Languages System Management Software – Operating systems – Utility programs Application Software – General office suite – Statistical analysis – Custom, visual programming design tools

Programming Language Evolution GenerationCharacteristics 1Machine Language (0,1) 2Assembly Language 3Procedural Language 4Application Language 5Natural Language

System Management Software Operating Systems – UNIX – LINUX – Microsoft (Windows XP, Vista, Server 7) Utility programs – File management – Anti-virus – Backup and security

Internet Networking 101 LAN (local area network) WAN (wide area network) EDI (electronic data interchange) TCP/IP (Internet protocol) TCP (Transmission control protocol)

Circuit switching

The IS-way: Packet Switching

Multicasting