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RUNNING HEAD: The title Title again but can be shorter Edward ...

  1. 1. HEADER WITH TITLE OF PAPER 1 RUNNING HEAD: The title Title again but can be shorter Edward Spratte CMGT 554 September 20, 2010 Mark Kolesinsky
  2. 2. HEADER WITH TITLE OF PAPER 2 This paper needs a starting paragraph. FUNCTIONAL STRUCTURE The Patton-Fuller Community Hospital is serving the public and they have the responsibility of providing good service and protecting each patient’s rights. The Health Insurance Portability and Accountability Act (HIPAA) outlines the principles and requirements that the hospital must use to ensure they are protecting patient’s rights. In the Patton-Fuller Community Hospital there are a large amount of Protected Hospital Information that needs to remain protected to meet the standards that HIPAA defines. It is up to the IT Department to guarantee that the PHI being stored electronically on their systems remains protected and private. The Patton-Fuller Community Hospital IT Department currently protects this PHI data by making sure all PHI is encrypted using Advanced Encryption Standard (AES). The Patton-Fuller Community Hospital makes sure that requiring that all employees have unique usernames and passwords protects the PHI on their network. The network is a 1000BASE-T, which supplies 1Gigabit of Ethernet connectivity over 5 cables (CAT5). (Hewlett-Packard, 2000 pg1) This long-haul, copper-based standard is ideally suited for use within the data center because which is used in all the clinical areas of the hospital such as Emergency rooms (ER’s), Operating rooms (OR’s), Pharmacy, Labs, doctor’s offices, Wards, Outpatient examining rooms, and Intensive Care Units (ICU’s) but the throughput of copper wire connections leaves room for improvement. The Administrative sections of the hospital such as IT Department, Admitting/Discharge, Facilities, Human Resources (HR), Finances,
  3. 3. HEADER WITH TITLE OF PAPER 3 and Hospital Senior Management are using 1000BASE-T network structure. “The backbone network structure for the entire hospital is 1000BASE-T. Individual sections of departmental networks such as Radiology use different standards such as 1000 BaseF. ” (Apollo Group a, 2008). The reason the only clinical area of the hospital using 1000BASE-F network arrangement is Radiology is because Radiology has different standards to meet. “1000BaseF, also known as 1000Base-F, is a 1000-Mbps baseband specification for Ethernet communications over optical fibers. 1000Base-F uses 8B/10B ANSI X3T11 Fibre Channel FC-1 frame encoding, serializer/deserializer (SERDES) and NRZ on the fiber, clocked at 1250 Mbaud. These standards will be increased to the entire hospital. “1000BaseF can support a fiber cable length of 500m full duplex on multimode fiber, and of 2-3km full duplex on single mode fiber.” (Network Dictionary, 2010) Radiology is using 1000BASE-F because they need to have higher standards to meet the Digital Imaging and Communications in Medicine (DICOM) protocol to ensure that the images can be transmitted and viewed on the Picture Archiving System (PACS). For images to be viewed and in diagnostic condition they need to be in DICOM format. The updated design for Patton-Fuller hospital must take many potential issues into account such as security, HIPAA compliance, and network speed and accuracy. Avoiding potential issues, and providing the tools necessary for the hospital to continue providing exceptional patient care and remaining operationally sound, is vital to the ongoing success of the hospital.
  4. 4. HEADER WITH TITLE OF PAPER 4 Network Cabling Fiber should be used for all systems and centralized data storage system that reside in the data center, and should also be used for all networking connections to switches on each floor or area of the hospital. The switches will be updated to accommodate this change. Fiber is already in use in all clinical areas, but should also be implemented to the network switches in the administrative areas. CAT6 cable is acceptable to be run from the local switches to the individual PC’s, but having a fiber connection from the switch back to the data center will increase speed tremendously. Updating each computer connection to fiber as well is a benefit for future changes but as the systems are designed now, the update would still produce a bottleneck at the client systems. With the expectation of new systems in the scheduled rotation, adding fiber network cards are a viable option. Currently each room has one network connection. The network connections to each patient room should be for the clinical PC used in the room for providing care and charting. These connections will be secured to only allow the hospital systems connectivity. These PC’s should not be available for patient use because that puts the network and company data at greater risk, and open to the possibility that a patient crashes the PC making delivering care that much more difficult. Patients requesting access to PC resources should be allowed to connect to the unsecured wireless guest network limiting the exposure of Patton-Fuller’s network.
  5. 5. HEADER WITH TITLE OF PAPER 5 Wireless Network Patton-Fuller should implement two separate wireless networks: one inside their firewall that is connected to the wired network for use by employees and company equipment, and a second wireless network located outside the firewall for guest access as seen in figure 5. The guest access wireless network will not be encrypted or secured in any way, and allows anyone to connect to it after agreeing to a user agreement. The internal wireless network should be secured using WPA2 encryption, and should require authentication to use including MAC address filtering. This will provide the needed data security for HIPAA and other laws and regulations while providing a way for the hospitals patients to utilize the Internet. Data Storage Patton-Fuller Community Hospital should implement a centralized data storage solution for all company and patient information. This storage separates the data systems to an encrypted internal network at seen in figure 6. Due to the severity and strictness of HIPAA laws it is risky and insecure to have any type of patient information stored on the hard drives of the individual machines in each room. Furthermore, the patient information should only be accessible by employees who have a business need for accessing the information. This is a HIPAA requirement, and the penalties for violation can be very severe. By having this information only accessible through the systems in use in the company by employees with authentication rights and business need to do so will protect the information, allow for better redundancy and backup, and help to justify the cost of having upgraded fiber connections for better speed.
  6. 6. HEADER WITH TITLE OF PAPER 6 Internet Access The current security for the Internet server, and its location in the network, is not adequately protected or the most appropriate design. The Internet facing server should be located outside the company firewall protecting the internal network and systems. This design is shown in figure 5 and 6. This also separates the remote server system where that system has proper authentication and the connection through that system allows access to the rest of the needed network. Users inside the firewall who needs to access the Internet can do so by authentication through a proxy system that allows them to communicate with the Internet server outside the firewall to retrieve whatever information is needed from the Internet. This is a better solution because it provides security to the network and systems, and makes it so the only vulnerability of the company facing the Internet is this server. Since the server is outside the firewall, and the only communication allowed with this server is with an internal user authenticated through proxy it should remove the majority of Internet related vulnerability for the hospital. Encryption The objective is to meet the terms of PFCH’s request for upgrading its system and data security is a priority. This is partially because of HIPAA laws and changes recently made. Encrypted data is not vulnerable but personal health information (PHI) of patients must not be accessible to unauthorized parties. Addressing this concern was updates in the Health Information Technology for Economic and Clinical Heath (HITECH) Act. In the HITECH Act Breach Notice requirements, every person who infringed upon PHI that was entered, obtained, applied or made available as a consequence of the
  7. 7. HEADER WITH TITLE OF PAPER 7 violation ought to receive communication during the following 60 consecutive days from the detection of the event (Apollo Group, 2010, para. 7). One of the concerns is the ability to decipher the code. According to Conn (2009), “HIPAA states that if a record has 18 specified ‘identifiers’ removed, it can be considered ‘de-identified’ and shared without patient consent or fear of liability under HIPAA privacy and security rules” (para. 25). PFCH requires that the data is secure. The organization is capable of making changes as needed as long as it keeps the security intact. Several methods of encrypting data are available. The customary format for encrypting Internet message relies on the 128-bit encryption known as the Secure Socket Layer (SSL) (PC Stats, 2010b, para. 5). “Public-key encryption (PKE)” permits every individual to acquire a set of “digital keys” which are mathematical figures that encrypt and decrypt information one unrestricted one confidential (PC Stats, 2010a, para. 1). The users must have the correlating confidential key to undo encoding of the message (para 2). This method is time-consuming. Symmetrical encryption permits receiver and sender to have access to the key. This is a requirement prior to launching the connection, which will encrypt the information. Severing the link cause a breach of the communication (para. 2-3). Overcoming the drawbacks is possible with digital certificates. According to PC States (2010), “a digital certificate is a method of validation which both confirms the identity of the server and passes the public key over to allow the encryption process to begin” (para. 7). The digital certificate will confirm the server. Cross-referencing this
  8. 8. HEADER WITH TITLE OF PAPER 8 information with the authentication from user id and password acceptance should validate prior to sending the key. It is important that companies that retain personal information adhere to the data privacy for both trust and safety. The need for standards alludes to the importance of data security. Triple Data Encryption Standard (DES) and Advanced Encryption Standard (AES). Triple DES uses “three 64-bit keys” and AES has higher protection and more rapidly. This method uses “key lengths in 128, 192, and 256 bits” (Diana, 2003, para 3). The Triple DES algorithm older, dependable and more widely used whereas the AES is as dependable, newer, and gaining popularity. Blowish is another encryption method. Blowish can provide well-built encryption. The key uses multiples of eight bytes up to 56 bytes (Webnet77, 2010). Cost will be the determining factor of the kind of encryption to use. In addition, the required transmission rates for encryption messages add costs to any network. Processing encrypted characters can create slower transmission rates. The single fiber optic cable will handle the demand of transmitting encrypted files. The cable bolsters speeds to 10 Gbps. “Industrial Ethernet will provide the backbone to support the speed. The latest /CSG14 converter switches from GarrettCom Europe will permit ‘single-mode fibre cable’ lengths up to 2,000 meters” (Jones, 2008, p. 43). This will address concerns regarding a reduction of bandwidth for in-house users and outside users like insurance companies. The Current networking architecture at Patton Fuller Community Hospital includes Hospital Information System (HIS) which is a 10 Tera Byte Network Attached Storage
  9. 9. HEADER WITH TITLE OF PAPER 9 (NAS) computer connected to a IBM Series with a OS=Linux, DB=DB2, 18 Processors, 32 GB RAM, and AES Security. NAS is used for file-based data storage. The current process for transfer and security of patient information includes patient information that is stored in the computers for each section in the Radiology Department. In radiology the images are on the diagnostic PACS or viewing stations for MRI, Cat Scan (CT), X-ray, Mammography (Mammo), PET, and Nuclear Medicine (NUC). The patient’s information is protected on each computer for each modality by password and username. The computers are password protected so that someone random cannot just walk-up and view patient’ images. The PACS/viewing stations properties include: MAC pc, 1-3 GHz quad processor, 16 GB RAM, 4-750 MB HD in RAID, Nividia FX 4500 image card, FO Network card, 2 Apple 30’ Cinema flat panel displays, OS Visualization with MAC OS X Leopard and Windows XP Pro, and 2 APC UPS. (Apollo Group, 2008a) Patient’s information is secure to follow the regulations of HIPAA that are required of hospitals. Patient’s demographics information is stored on the HIS this way even though there are multiple systems in each department and section of the hospital there is a single unit where patient’s information is consolidated. A way to improve their HIS is to have it integrated with their RIS system and/or PACS system using Health Level 7 integration (HL7) interface. The DICOM messages from the PACS and the messages from the Radiology Information System (RIS) can communicate and make the system seamless by using the HIS. The process will be that the images are sent in the PACS which will with the HL7 integration create an order in the RIS since there is limited patient demographic information on the images themselves such as only name, MRN, procedure name, and
  10. 10. HEADER WITH TITLE OF PAPER 10 Accession number the other patient information will be received via the HIS system with the integration of HL7. The current storage backup is by using RAID, which is disk storage. RAID is an unpractical use of data storage because so many disks accumulate. The purpose of going digital with Radiology exams instead of using the hardcopies is so that Radiologists anywhere can read the exams, but also for easy storage and storing in less amount of space. Using RAID is less practical instead of just getting a back-up server. RAID is the cheaper and outdated means of redundancy. It may be cheaper, but it is not the most safe or efficient. Disks can be easily lost or damaged and sorting through them is not efficient. Having multiple servers is not the most cost-effective, but it will pay off in the long run because it will be the most resourceful and proficient. Stricter rules for entry into sections of the hospital are a way to ensure that patient’s information is not unprofessionally being viewed. Having less unnecessary systems and computers on the network that may be clogging up the system and increasing bandwidth will help to improve network speed. The accuracy of the systems can be improved by providing monthly calibration on the dicom monitors using a device called the Spyder 3Express monitor color calibration device. Keeping monitors maintenance and calibrated on a scheduled monthly basis will guarantee that the images the radiologists are reading are the correct gray scale and meet their standards. There is an also a program that can easily be installed on the dicom monitors using Internet called Cxtra. It can be downloaded of the Internet and then when there are upgrades the software for the upgrade can be easily downloaded off their website. Cxtra is useful because it is a self-calibration program.
  11. 11. HEADER WITH TITLE OF PAPER 11 The storage methods, reliable back-up, security of patient information, and encryption methods if modified can improve the networks speed and accuracy Storage Area Network Companies need storage to house vital information about its customers. For PFCH, storage is a necessity because of the volume of clients the organization services each year. Making available the patient’s information is important because of ongoing care. This data includes the home of record, patient care data, insurance provider and account information, or government account data for Medicare and Medicaid. A storage area network (SAN) permits the organization to store large amounts of files in a discrete manner. Expansion of the SAN sells is rising, in part, through the motivation for records maintenance beginning with legal guidelines such as Sarbanes-Oxley which involves considerably lengthened files preservation periods (Greiner, 2009, para. 2). These rules dictate organizational compliance, which is readily available. Top Storage Processes A variety of companies offer solutions for meeting the storage needs of businesses. EMC provides options in “hardware and software” applications. One of them is the “Symmetrix storage system,” “Clariion AXR with Serial ATA (SATA) disks” for small-size companies; “Clariion CX series” allows the network to combine “Fibre Channel and ATA drives;” and, “Documentum division” provides “storage-aware content management” (Greiner, 2009, para. 11). IBM features a wide variety of SAN products under the TotalStorage brand in the form of “hardware, software . . . consulting, implementation, management services and its Enterprise Storage Server” (para. 12). Hitachi Data Systems
  12. 12. HEADER WITH TITLE OF PAPER 12 offers “the Adaptable Modular Storage (AMS) series . . . Universal Storage Platform” plus the “iSCSI SAN solution” for small-size and mid-size businesses, and “a Plug and Play Fibre Channel SAN kit in partnership with Microsoft and QLogic” (para. 13). Hewlett Packard (HP) provides “management software, switches, hubs, and bridges, and also provides the services necessary to implement SANs;” the StorageWorks series for “SAN and NAS” which is appropriate for “entry-level, mid-range, and enterprise class” organizational needs (para. 14). The kind of hardware, software or combination of products will depend on the size of the company and its network configuration. Price of Storage In PFCH, a SAN Fibre Channel connection would be appropriate. According to Greiner (2009), “in SANs with Fibre Channel interconnection, Fibre Channel switches are the key pieces of hardware that provide flexible configuration of storage and computing resources” (para. 18). The primary issue of storage is cost. Despite government regulations, companies monitor the budgetary expenses for IT equipment. Fibre Channel switches is more expensive; however, the sensitivity of medical records warrants top-notch hardware solutions. According to NexTag (2010), the “EMC Emulex Lightpulse LP21002 Fibre Channel Host BUS adapter – 2 X LC – PCI-X 1.0A is an intelligent multi-protocol adapter that provide host LAN and Fibre Channel SAN connectivity over 10Gbps Ethernet.” This product ranges from $2,371 to $2,389. System threats are a genuine concern for PFCH. Requirement for Dependable Backup
  13. 13. HEADER WITH TITLE OF PAPER 13 The need for reliable file backup systems is because of potential threats to the system. This can include natural disasters such as hurricanes and tornadoes, regional issues like energy drains from excessively hot summers, and localized problems such as malware or viruses unintentionally introduced by system users. Downtime for any system is lost revenue for a company because it affects performance. Disconnecting the file storehouse “from the server” reduces the amount of hardware machinery and volume of record movement from data entry to output (Barr, 2010, para. 3). The recommended improvement is to add a SAN to provide the OR, ICU, and Ward floor system. This backup would support pharmacy workstation activities of providing drug scheduling and dosage from requesting pharmacies. In addition, laboratory data would continue to be accessible from workstations. An off-site SAN such as the Symmetrix DMX-4 storage system would be a good supplement to the current network attached storage. Network attached storage has drawbacks such as an inability to backup files and the potential exists that hackers can access the data. Other issues deal with the performance in the network. “Separating the storage from the server . . . decreasing I/O bottlenecks” (Barr, 2010, para. 10). Input/output movement is frequent in servers and affects performance by overburdening the system. In health care, time is critical to decision-making and responsiveness to patient medical treatments. Adding the SAN to the NAS currently in use will improve backup deficiency present in the system. Current Storage Capabilities
  14. 14. HEADER WITH TITLE OF PAPER 14 Patton-Fuller uses a NAS (Network-Attached Storage) that has a ten terabyte capacity on the Hospital Information System (HIS). The HIS is used for the administrative operation within the hospital. They also have ten terabytes of storage for the RIS Data Center. The NAS is a file-based storage designed for network devices. Patton-Fuller stores file-based data from the network in the NAS. The storage includes information from the Windows Exchange Server, the Internet Server, the Remote Access Server (RAS) and information from the rest of the eighteen processors attached to the mainframe of the data center network. A NAS usually has different types of disks for different types of storage. Patton-Fuller uses RAID (Redundant array of Independent Disks) disks for storage from the Internet and Windows Exchange servers. The concept of RAID disks are centered on having data saved across multiple disks but to the pc using the info it appears to be coming from one disk. A following number such as RAID 1 or RAID 0 usually designates RAID. The number denotes the differences in the set-up or design. RAID disks are used prevalently on this network. Radiology and Emergency Room The radiology department uses RAID as well for general radiology services or in the Emergency room. They also have additional sophisticated add-ons that fulfill the imaging needs. The radiology hardware includes high RAM to run quality graphics programs, a high performance image card for ultra high resolution, OsiriX imaging software for high volume imaging and MAC OS X Leopard, which is basically the only OS with built in support for Microsoft Exchange. The MAC equipment coupled with PC equipment works very well in a hospital environment. OS Virtualization may be one of the most defining factors in the
  15. 15. HEADER WITH TITLE OF PAPER 15 hospital-imaging environment. With operating system virtualization nothing is pre- installed or permanently loaded on the local device and no hard-disk drive is needed. Everything is run from the network using a kind of virtual disk. With the current implementations, this virtual disk is actually a disk image file stored on a remote server, SAN or NAS. The client will be connected via the network to this virtual disk and will boot with the operating system installed on the virtual disk. (Van Bragt, 2008 para.3). The OS Virtualization allows for the management of images that are stored on the NAS or SAN and they are managed within the system. The management of large imaging files is made possible through OS Virtualization. The following will show how it works. The first component is the OS Virtualization server. This server is the focal point in the OS Virtualization infrastructure. The server arranges the streaming of the information on the virtual disks to the client and also determines which client will be connected to which virtual disk (using a database in which this information is stored). Also the server can host the storage for the virtual disk locally or the server is connected to the virtual disks via a SAN or File Share. In high availability environments there can be more OS Virtualization servers to create redundancy and load balancing. The server also insures that the client will be unique within the infrastructure. There is a client, which contacts the server to get connected to the virtual disk and asks for components stored on the virtual disk to run the operating system. The available supporting components are a database for storing the configuration and settings for the server, a streaming service for the virtual disk content, a (optional) TFTP service and a (also optional) PXE boot service for connecting the client to the OS Virtualization servers.
  16. 16. HEADER WITH TITLE OF PAPER 16 The virtual disk contains an image of a physical disk from a system that is reflecting the configuration and the settings of those systems which will be using the virtual disk. When the virtual disk is created the disk needs to be assigned to the client that will be using this disk to start. The connection between the client and the disk is made via the administrative tool and saved within the database. When a client has a disk assigned, the machine can be started with the virtual disk using the following process as displayed in figure 7. Connecting to the OS Virtualization server. First we start the machine and set up a connection with the OS Virtualization server. Most products offer several possible methods to connect to the server. One of the most used methods is using a PXE service, but also a boot strap is used a lot (because of the disadvantages of the PXE service). However each method initializes the network interface card, receiving a (DHCP-based) IP address and a connection to the server. Connecting the Virtual Disk. When the connection is established between the client and the server, the server will look through its database to check if the client is known and which virtual disk(s) are assigned to the client. When more than one virtual disk is connected then a boot menu will be displayed on the client. If only one disk is assigned, this disk will be connected to the client in step 3. VDisk connected to the client.
  17. 17. HEADER WITH TITLE OF PAPER 17 After the desired virtual disk is selected or the only virtual disk assigned to the client has been determined, the virtual disk is connected through the OS Virtualization server to the client. On the back-end, the OS Virtualization server makes sure that the client will be unique (think of computer name and identifier) within the infrastructure. OS is “streamed” to the client. As soon the disk is connected the server starts streaming the content of the virtual disk. The software “knows” which parts are necessary to start the operating system smoothly, so these parts are streamed first. The information streamed to the system should be stored somewhere (in other words cached). Most products offer several ways to cache this information. Examples are the memory of the client, on the disk of the OS Virtualization server or locally on the client hard disk. Additional Streaming. After that the first part is streamed so the operating system is running as expected. Additional virtual disk data will be streamed when required for running or starting a function called by the user for example starting an application available within the virtual disk. (Van Bragt, 2008 para.6) The management of x-rays and all other large images are managed through virtualization because it save space, time and it simplifies the use of high resolution images. Patton Fuller uses NAS storage and OS virtualization technology to manage its radiology storage requirements. Network Improvement
  18. 18. HEADER WITH TITLE OF PAPER 18 The present system that uses single core fiber is the best for its speed and distance. The changes that need to take place is as mentioned in the figure 1-6 that uses single core fiber instead of CAT6 for all connections. The network media is already shown to have compatibility to the present switches and other network media... the switches being the bottle neck of course due to the transference of data through copper connections within the switches and back to the fiber for inter-office connectivity. The price of the switches and supplies for this upgrade are seen in table 1. Patton Fuller will need to upgrade the network to increase network speed and performance to support scalability, support the advance imaging equipment applications, enhance efficiencies, and to manage administrative processes. Patton Fuller will meet the needs of a growing hospital patient and employee base. In the process, network traffic will likely increase, in dramatic fashion. The traffic will grow, but it has to be managed because rapid growth can lead to a congested network. That means network performance and tolerance will be compromised, or diminished. Patton Fuller will need more computers and network connections and more shared equipment such as printers, fax machines, servers, or other networked devices. Every device requires a network port for connectivity, and more ports must be added if there are not enough. They will also have to add more hubs and switches to accommodate growth of personnel and equipment. The entire improvement can be seen through comparing the old design and the new design along with seeing the cost assessment for these improvements in figure 1a through figure 6 and table 1. Network Problems
  19. 19. HEADER WITH TITLE OF PAPER 19 Four years ago, when Barrett assumed his present position, network infrastructure was a major problem area for the DHHA. “The network would go down and come up and no one would know why," Barrett says. "When this happened, a lot of people were unable to do their jobs and had to wait idly until service was restored. Some of the more critical areas of the hospital, such as the operating room and emergency room, had to rely entirely on paper-based systems because they couldn't depend on the network being up when they needed it.” “The problem, in my opinion, was that the network had never been properly architected," Barrett adds. "As the computerization of core and satellite facilities proceeded, new systems were grafted onto old, resulting in a hodgepodge of technology that was difficult to troubleshoot or even understand. Without a logical structure, it was very difficult to identify problems that were causing outages on a regular basis. This situation was unacceptable, and one of my first priorities when I joined the DHHA was to fix it." (Apollo Group, 2008a) Barrett recognized that the DHHA did not have the internal technical and project management resources needed for the project, and handpicked Interlink for the assignment. "I selected Interlink as the technology partner for this project because they clearly had the competencies and resources needed to handle a large networking infrastructure project," Barrett says. "I felt that their experience implementing network solutions for a variety of companies across multiple industries would help to speed up delivery and minimize risk and downtime. I also liked the fact that they have developed
  20. 20. HEADER WITH TITLE OF PAPER 20 prebuilt architectures and templates, each of which has been proven in previous projects." (Apollo Group, 2008a) PLANNING PHASE "Using our architecture analysis and design methodology as our road map, we began planning sessions between DHHA executives and the Interlink project team to clarify DHHA's business objectives," says Jason McGregor, managing director of Interlink's Network Solutions. "This was necessary for the development of a new mission-critical infrastructure that would be done right the first time. Frank and his team explained the importance of providing consistently reliable access with remote facilities and providing 100% assured service to critical departments. "Our next step was to discover and document the existing infrastructure so that the new architecture could consider incorporating some of the many investments that DHHA had already made, as well as creating a migration plan that would be least disruptive for the end-user community," McGregor continues. "We found that the existing infrastructure was inadequate for supporting current needs, and especially not prepared to address DHHA's future objectives. For example, DHHA was using several shared 10 MB Ethernet networks connected by routers, an antiquated design that caused sluggish and unpredictable performance across the hospital. "We looked at current usage trends, along with future technology projections, to create the new architecture," McGregor recalls. "Our number one goal was to make swift
  21. 21. HEADER WITH TITLE OF PAPER 21 enhancements to the existing network to greatly improve stability, while implementing the new infrastructure that would deliver reliable and scalable access for the increasing number of mission-critical applications that were being installed on the network. Our design effort concluded with an architecture and migration plan that was to take DHHA into a whole new era of information technology." DRAMATIC IMPROVEMENTS The new networking infrastructure dramatically outperforms the old, according to Barrett. "The proof of the pudding is that we haven't had a network outage in nearly two years," Barrett says. "As a result, we have been able to move ahead with confidence in the installation of major clinical and business applications that have had a significant impact on our business performance. For example, we will soon be rolling out a clinical record relational database to provide a long-term clinical repository that will eventually maintain all of our patient records online. The next major application will be one that will provide instantaneous access to diagnostic images throughout our facilities by authorized personnel. "But it's limiting to look at the impact of the networking improvements from purely an IT perspective, because from a higher-level viewpoint they have had a significant business impact, as well," Barrett continues. "We have begun to utilize existing and new systems to a much higher level than in the past," he adds, "to streamline the workflow of the organization, eliminate paper-based
  22. 22. HEADER WITH TITLE OF PAPER 22 processes and provide information in a form that helps make better decisions. This impact is difficult to measure, but there's no doubt in my mind that it has been one of the major factors in the improved clinical and financial performance of this institution(2000 Nelson Publishing) Patton-Fuller Community Hospital currently uses a mix of methods to satisfy their network needs. The administration network currently is using 1000 BaseT with CAT 6 cable. This has a rating of 100 meters (Apollo Group, Inc., 2008). The IT Data Center currently uses 1000 BaseT with CAT 6. All the operating rooms, intensive care units and ward floor system are currently networking with 1000 BaseF with single mode fiber. The option is rated at 5 kilometers and it allows serialize/deserialize to be performed. The advantages of fiber over CAT 6 are that it has a much larger bandwidth and it can carry more channels that CAT 6 also (2010). What I am suggesting is too change the areas that are currently using CAT 6 to fiber. The price for CAT 6 which sell for 41 cents a foot and fiber is currently at $1.06 a foot. This is a substantial jump in price but the hospital will see the savings immediately. The current system is overwhelmed with users and it can’t handle the peak periods when the hospital needs the network the most. Along with the wiring upgrade I would like to suggest a solution to lack of printers. The hospital presently has entire departments using one printer and when it’s needed by more than one personnel there’s a long wait. Breaking the department up into sub-groups that each have a printer located in their area will cut down on travel to and from the printer and the long wait for it to be free up. This will allow faster responses to our patients and increased efficiency.
  25. 25. HEADER WITH TITLE OF PAPER 25 Old OR Network Figure 1a
  26. 26. HEADER WITH TITLE OF PAPER 26 New OR Datacenter change Figure 1b
  28. 28. HEADER WITH TITLE OF PAPER 28 Old Admin Network Figure 2a New Admin Network (no change) Figure 2b
  30. 30. HEADER WITH TITLE OF PAPER 30 Old Overview Figure 3a
  31. 31. HEADER WITH TITLE OF PAPER 31 New Overview Figure 3b
  32. 32. HEADER WITH TITLE OF PAPER 32 Old Radiology Network Figure 4a
  33. 33. HEADER WITH TITLE OF PAPER 33 New Radiology (No change) Figure 4b
  34. 34. HEADER WITH TITLE OF PAPER 34 New separated public access Figure 5
  35. 35. HEADER WITH TITLE OF PAPER 35 New Isolation of Encrypted Data Figure 6
  36. 36. HEADER WITH TITLE OF PAPER 36 Operating System virtualization and streaming process Figure 7
  37. 37. HEADER WITH TITLE OF PAPER 37 Cost Assessment of product for suggested changes Table 1. Item Cost Per Unit Link Fiber 13.06+SH Meter stst.html 24 port fiber switch 1849.00+S H Unit ml Fiber module for CES2326B 398.95+SH Unit (uses 2 per switch) switches/fiber-network-switches/sc-fiber-module-for- ces2326b-mf08sc/prodMF08SC.html Fiber Network Card (MAC Compatible ) 85.00+SH Unit (one per networke d appliance) ethernet-pci-card.aspx?CAWELAID=513156787 References
  38. 38. HEADER WITH TITLE OF PAPER 38 Apollo Group, Inc. (2010). Patton-Fuller Community Hospital. Coummications – CFO. Retrieved August 24, 2010. from: VOP/Healthcare/PFCH/HosDepts/CCO/docs/HIPAAStatus.pdf Conn, J. (2009). Data encryption just one option under security law. Retrieved August 28, 2010, from: Diana, A. (2003). Benchmarking encryption technology. E-Commerce Times. Retrieved August 28, 2010, from: Jones, S. (2008, March 3). Communication conundrum. Engineering & Technology, 3(5), 42– 44, Retrieved August 16, 2010, from: PC Stats. (2010a). Beginners guide: encryption and online privacy. Public key encryption and symmetrical key encryption. Retrieved August 28, 2010, from: PC Stats. (2010b). Beginners guide: encryption and online privacy. SSL introduced (and a brief TCP?IP primer). Retrieved August 28, 2010, from: Webnet77. (2010). Blowfish encrypt and decrypt online. Retrieved August 28, 2010, from:
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