Introduction to Healthcare Information Technology Chapter Four Network 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

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

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 © Cengage Learning 2013

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

Figure 4-2 A hub is an older type of network device; today hubs have largely been replaced by switches © Cengage Learning 2013

Switches Network switch MAC address (hardware address) 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

Switches (cont’d.) Core switches carry traffic between switches Workgroup switches connect directly to network devices

Figure 4-3 Core and workgroup switches © Cengage Learning 2013

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

Domain Controllers Domain Domain controller Collection of devices that share a central directory database Domain controller Server that manages security-related elements on the network for the user

Servers Several different types of services and servers Several different protocols Servers must be properly managed to be effective

Services and Servers Print services File services Application 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

Server Management Common tasks associated with managing servers Load balancing Allocating storage space 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

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

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)

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

Figure 4-4 OSI model vs. TCP/IP model © Cengage Learning 2013

Protocols (cont’d.) 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

Protocols (cont’d.) 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

Protocols (cont’d.) 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

Protocols (cont’d.) 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 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 Figure 4-8 USB wireless NIC © Oleksiy Mark/www.Shutterstock.com

Network Hardware Modem Internet modem Router 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

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

Figure 4-12 Infrastructure mode with AP © Cengage Learning 2013

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

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

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.

Network Troubleshooting (cont’d.) 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 © Cengage Learning 2013

Figure 4-17 Incorrect and correct wave propagation and multipath © Cengage Learning 2013

Network Troubleshooting (cont’d.) 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

Network Technologies for EHR/EMR Two broad categories of decisions Cloud versus local network Installed applications versus remote access

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

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

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

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