C9-1 CASE STUDY 9 ST. LUKES HEALTH CARE SYSTEM .docx

C9-1
CASE STUDY 9
ST. LUKE'S HEALTH CARE SYSTEM
Hospitals have been some of the earliest adopters of wireless
local area
networks (WLANs). The clinician user population is typically
mobile and
spread out across a number of buildings, with a need to enter
and access
data in real time. St. Luke's Episcopal Health System in
Houston, Texas
(www.stlukestexas.com) is a good example of a hospital that
has made
effective use wireless technologies to streamline clinical work
processes.
Their wireless network is distributed throughout several
hospital buildings
and is used in many different applications. The majority of the
St. Luke’s

staff uses wireless devices to access data in real-time, 24 hours
a day.
Examples include the following:
• Diagnosing patients and charting their progress: Doctors and
nurses use wireless laptops and tablet PCs to track and chart
patient
care data.
• Prescriptions: Medications are dispensed from a cart that is
wheeled
from room to room. Clinician uses a wireless scanner to scan
the
patient's ID bracelet. If a prescription order has been changed or
cancelled, the clinician will know immediately because the
mobile device
displays current patient data.
http://www.stlukestexas.com/
C9-2
• Critical care units: These areas use the WLAN because
running hard
wires would mean moving ceiling panels. The dust and microbes

that
such work stirs up would pose a threat to patients.
• Case management: The case managers in the Utilization
Management
Department use the WLAN to document patient reviews,
insurance
calls/authorization information, and denial information. The
wireless
session enables real time access to information that ensures the
correct
level of care for a patient and/or timely discharge.
• Blood management: Blood management is a complex process
that
involves monitoring both patients and blood products during all
stages of
a treatment process. To ensure that blood products and patients
are
matched correctly, St. Luke’s uses a wireless bar code scanning
process
that involves scanning both patient and blood product bar codes
during
the infusion process. This enables clinicians to confirm patient
and blood

product identification before proceeding with treatment.
• Nutrition and diet: Dietary service representatives collect
patient
menus at each nursing unit and enter them as they go. This
allows more
menus to be submitted before the cutoff time, giving more
patients
more choice. The dietitian can also see current patient
information, such
as supplement or tube feeding data, and view what the patient
actually
received for a certain meal.
• Mobile x-ray and neurologic units: St. Luke’s has
implemented the
wireless network infrastructure necessary to enable doctors and
clinicians to use mobile x-ray and neurologic scanning units.
This makes
it possible to take x-rays or to perform neurological studies in
patient
rooms. This minimizes the need to schedule patients for
neurology or
radiology lab visits. The mobile units also enable equipment to
be

brought to the bedside of patients that cannot be easily moved.
The
wireless neurology and x-ray units have also helped to reduce
the time
between diagnosis and the beginning patient care.
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Original WLAN
St. Luke's first WLAN was deployed in January 1998 and made
the hospital
an early pioneer in wireless health care applications. St. Luke’s
first wireless
LAN was implemented in a single building using access points
(APs) made by
Proxim (www.proxim.com).
A principal goal of this initial installation was to improve
efficiency.
However, sometimes the WLAN had the opposite effect. The
main problem
was dropped connections. As a user moved about the building,
there was a
tendency for the WLAN to drop the connection rather than
performing the

desired handoff to another access point. As a result, a user had
to
reestablish the connection, log into the application again, and
reenter
whatever data might have been lost.
There were physical problems as well. The walls in part of the
building
were constructed around chicken wire, which interfered with
radio waves.
Some patients' rooms were located in pockets with weak radio
signals. For
these rooms, a nurse or doctor would sometimes lose a
connection and have
to step out into the hallway to reconnect. Microwave ovens in
the
kitchenettes on each floor were also a source of interference.
Finally, as more users were added to the system, the Proxim
APs, with a
capacity of 1.2 Mbps, became increasingly inadequate, causing
ongoing
performance issues.
Enhanced LAN

To overcome the problems with their original WLAN and reap
the potential
benefits listed earlier in this case study, St. Luke's made two
changes
[CONR03, NETM03]. First, the hospital phased out the Proxim
APs and
replaced them with Cisco Aironet (www.cisco.com) APs. The
Cisco APs, using
IEEE 802.11b, operated at 11 Mbps. Also, the Cisco APs used
direct
C9-4
sequence spread spectrum (DSSS), which is more reliable than
the
frequency-hopping technique used in the Proxim APs.
The second measure taken by St Luke's was to acquire a
software
solution from NetMotion Wireless (netmotionwireless.com)
called Mobility.
The basic layout of the Mobility solution is shown in Figure
C9.1. Mobility

software is installed in each wireless client device (typically a
laptop,
handheld, or tablet PC) and in two NetMotion servers whose
task is to
maintain connections. The two servers provide a backup
capability in case
C9-5
one server fails. The Mobility software maintains the state of an
application
even if a wireless device moves out of range, experiences
interference, or
switches to standby mode. When a user comes back into range
or switches
into active mode, the user's application resumes where it left
off.
In essence, Mobility works as follows: Upon connecting, each
Mobility
client is assigned a virtual IP address by the Mobility server on
the wired
network. The Mobility server manages network traffic on behalf
of the client,
intercepting packets destined for the client's virtual address and
forwarding

them to the client's current POP (point of presence) address.
While the POP
address may change when the device moves to a different
subnet, from one
coverage area to another, or even from one network to another,
the virtual
address remains constant while any connections are active.
Thus, the
Mobility server is a proxy device inserted between a client
device and an
application server.
Enhancing WLAN Security
In 2007, St. Luke’s upgraded to Mobility XE mobile VPN
solution [NETM07].
This migration was undertaken to enhance security and
compliance with
HIPPA data transmission and privacy requirements. Mobility
XE server
software was deployed in the IT department’s data center and
client
software was installed on laptops, handheld devices, and tablet
PCs.
With Mobility XE running on both clients and servers, all

transmitted
data passed between them is encrypted using AES (Advanced
Encryption
Standard) 128-bit encryption. Mobility XE also serves as an
additional
firewall; devices that are not recognized by the Mobility XE
server are not
allowed to access the network. This arrangement helped St.
Luke’s achieve
its IT goal of having encryption for all wireless data
communications.
Mobility XE also enables the IT department to centrally
manage all
wireless devices used by clinicians. This allows them to monitor
the
C9-6
applications currently being used by any device or user, the
amount of data
being transmitted, and even the remaining battery life of the
wireless device.
If a Mobility XE device is stolen or lost, it can be immediately
quarantined by

network managers.
IT executives at St. Luke’s view wireless networking as key
lever in their
quest to increase clinician productivity and improved patient
care. Mobile
EKG units have been deployed bringing the total of wireless
devices in use to
nearly a 1,000.
Discussion Questions
1. Visit the NetMotion Web site (www.netmotionwireless.com)
and access
and read other Mobility XE success stories. Discuss the patterns
that
can be observed in the benefits that Mobility XE users have
realized via
its deployment and use.
2. Do some Internet research on the security implications of
HIPPA
requirements for hospital networks. Discuss the major types of
security mechanisms that must be in place to ensure hospital
compliance with HIPPA requirements.
3. Do some Internet research on the use of VLANs in hospitals.
Summarize the benefits of using VLANs in hospitals and

identify
examples of how St. Luke’s could further enhance its wireless
network
by implementing VLANs.
Sources
[CONR03] Conery-Murray, A. “Hospital Cures Wireless LAN
of Dropped
Connections.” Network Magazine, January 2003.
[NETM03] Netmotion Wireless, Inc. “NetMotion Mobility:
Curing the
Wireless LAN at St. Luke’s Episcopal Hospital. Case Study,
2003.
Netmotionwireless.com/resources/case_studies.aspx.
[NETM07] Netmotion Wireless, Inc. “St. Luke’s Episcopal
Health System: A
Case Study in Healthcare Productivity.” 2007. Retrieved online
at:
http://www.netmotionwireless.com/st-lukes-case-study.aspx
http://www.netmotionwireless.com/
http://www.netmotionwireless.com/st-lukes-case-
study.aspxCASE STUDY 9Original WLANEnhanced
LANEnhancing WLAN SecurityDiscussion QuestionsSources
you will write a two-part mini-paper on our topic this week,
Women's Health and Feminist Ideals.
Before starting your paper, make sure that you have read the
five (5) short articles in this week's Modules 4 required for
Mini-paper 2.
Your paper should include the following:
· Part 1: Describe the history of nursing in the US since the
Civil War and how the values of ethics of care; critical self-

reflection, and commitment to social change been a part of
nursing's heritage and ethics?
· Part 2: Based on the articles you were required to read for
Mini-paper 2, how do you think gender bias/gap functions in
institutional medicine?
Paper Requirements:
· For Part 1, write four (4) paragraphs on Part 1 your Mini-
paper 2.
· For Part 2, write four (4) paragraphs on how you think gender
bias/gap functions in institutional medicine.
· Part 2 can be independent of Part 1, however, your paragraphs
must flow into a cohesive narrative.
· Using APA formatting, cite any sources you use to support
your responses.
· Mini-papers should be free of grammatical, spelling and
punctuation errors.
· Submit your papers via Textbox entry on Canvas.
· If it is easier for you, you can compose your mini-paper in the
word processor of your choice (MS Word, Notes, Pages, etc.)
and then copy and paste it into the textbox.
CS634 Final Exam – Formal Research Report or Q/A
The Final Exam is due xx/xx/20xx. Late assignments will not be
accepted. Posting must occur in the appropriate area of Moodle.
Hardcopy, email, etc. will not be accepted. A total of 700 points
will be awarded for a perfect score for this exercise. Each
student may choose ONLY one (1) of the two options outlined
below. Option 1 is a Research Report
A student wishing to continue with his/her education beyond the
Master’s Degree and considering advancing to the Ph.D. level
may wish to select Option 1 as it will provide a foundation for a
Master’s Thesis and Dissertation. Option 2 is a Question /
Answer summary of (specify discipline).
This option provides the less engaged student with the
opportunity and challenges of creating a proper Q/A sequence
derived from the specific domain under study. If selected, this

option will also allow entries to be added to the question pool in
subsequent terms. If proper format is followed, insertion into
the question pool can easily be accommodated by the Learning
House folks.Option 1: Research Report / Individual Project (700
points)
Write a scholarly research report on a topic related to Software
Engineering (see Appropriate Topics). Please see Important
Notes and Document Details for detailed specifications.
Appropriate Topics:
The Research Report, select one of the following research areas:
i) Cloud Computing (Intranet, Extranet, and Internet)
ii) Machine Learning
iii) Artificial Intelligence
iv) Internet of Things (IoT)
v) Robotics
vi) Medical Technology
vii) Artificial Intelligence
viii) Business Intelligence
ix) Brain Linked Virtual Reality
x) Nanotechnology
xi) Game Programming Algorithms
xii) Video Gaming Algorithms
xiii) Knowledge Management Systems
Important Student Notes:
· Each student submission should be checked for plagiarism.
Students should be warned that Turnitin has a very good
historical memory and is capable of accessing reports from both
internal and external resources (i.e. Universities, Governments,
etc.) including those originally written in non-English written
languages. Plagiarism will result in a grade of zero (non-
negotiable) for the assignment and may results in other
university actions. The department chairperson will be notified

of the violation. Additional Campbellsville University penalties
may be applicable. Please see class syllabus for additional
details.
· Only one submission attempt is permitted – AS THE
STUDENT TO BE SURE BEFORE DEPRESSING ENTER.
· Acceptable file formats for submissions include Microsoft
Word (doc, docx) or Adobe Acrobat (PDF). No other formats
are acceptable.
· The research paper must be at least 2,500 words supported by
evidence (citations from peer-reviewed sources).
· A minimum of four (4) peer-reviewed journal citations are
required.
· Formatting should be double-spaced, one-inch boarders, no
extra space for headings, no extra white space, no more than
two levels of heading, page numbers, front and back matter).
· Extra white space use to enhance page count will negatively
affect student grade.
· Chapter 1 illustrates the document details of the research
report and constitutes Background/Introduction, Problem
Statement(s), Goal(s), Research Question(s), Relevance and
Significance, Barriers and Issues related to topic chosen.
Chapter 2 should consist of student paraphrasing the cited
research material (i.e. what happened in case study x). Chapter
3 should be the reasoning for doing a basic compare/contrast or
advantages/disadvantage of what was stated in Chapter 2 (do
not state because the professor said so). Chapter 4 is a complete
analysis, synthesis, and evaluation of what was stated in chapter
2. In effect, chapter 3 is a statement of what will be done and
chapter 4 is what was done and what the findings were. Again,
thus far the writing is objective and must not contain student
opinion. Chapter 5 states results, conclusion, and future work
recommendations. Here is where student opinion (or any
researcher) can state their respective opinion as the student has
now “done the work” and are justified in stating results.
· Graduate student are expected to be proficient in the use of the
English language. Errors in grammar, spelling, or syntax will

affect student grade. The Professor, will not provide remedial
help for writing problems. If the student is unable to write
clearly and correctly, the student should be urged to contact the
program office for sources of remedial help.
· IMPORTANT - please refer to the following url for additional
help on writing skills necessary at the graduate level
(https://owl.purdue.edu/site_map.html).
· Final Submission - the final report is due no later than the last
day (Sunday) of Week x. A total of at least xx full pages is
required (no extra whitespace). (700 points). Only Microsoft
Word or Adobe PDF submission is acceptable.
· The research paper must only include materials derived solely
from peer reviewed journals or peer reviewed conference
proceedings. Newspapers, websites (URLs), magazines,
technical journals, hearsay, personal opinions, and white papers
are NOT acceptable citations. Please access the CU Library at
http://campbellsville.libguides.com/?b=g&d=a for appropriate
materials.
· APA formatted citations are required for the final submission.
IMPORTANT - please refer to the following url for help with
APA:
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa
_style_introduction.html. Please reach out to our librarians for
additional citation management and APA help.
· All images, tables, figures are to be included in the appendices
and IS NOT included in the 15 page requirement. This means
appendices are not included in the 15 page requirement.
· Long quotations (i.e. paragraphs) are NOT permitted. Only
one quoted short sentence (less than 14 words) is permitted per
page.
· Footnotes are NOT permitted.
Document Details
This area provides additional details about the content of
each of the needed Research Report Chapters (5). For those
instructing in Hybrid format, the instructor may want to
consider having the instantiated teams work on: 1) an outline of

the final research report and 2) a preliminary research report
that includes Chapters 1 and 2. For those instructing in Online
or F2F formats the instructor may want to consider using the
Hybrid format (teams) or single student submission format. The
final submission should include DETAILS of each of following:
1) Chapter 1 – Introduction
2) Chapter 2 – Literature Review
3) Chapter 3 – Methodology Specifics (comparative analysis)
4) Chapter 4 – Findings and Results
5) Chapter 5 – Conclusion and Future Recommendations
6) References - APA
7) Appendices
Chapter 1 Introduction
Background/Introduction
In this section, present enough information about the proposed
work such that the reader understands the general context or
setting. It is also helpful to include a summary of how the rest
of this document is organized.
Problem Statement
In this section, present a concise statement of a research-worthy
problem addressed (i.e., why the work should be undertaken –
don’t say required for the class). Follow the statement of the
problem with a well-supported discussion of its scope and
nature. The discussion of the problem should include: what the
problem is, why it is a problem, how the problem evolved or
developed, and the issues and events leading to the problem.
Goal
Next, include a concise definition of the goal of the work (i.e.,
what the work will accomplish). Aim to define a goal that is
measurable.
Research Questions
Research questions are developed to help guide the authors
through the literature for a given problem area. What were the
open-ended questions asked and why did the student find (or not
find) them adequate.
Relevance and Significance

The student should consider the following questions as they
read through an article stating how the author(s) supported, or
left unsupported the evidence, relevance, and significance of
their research literature:
Why is there a problem? What groups or individuals are
affected?
How far-ranging is the problem and how great is its impact?
What’s the benefit of solving the problem?
What has been tried without success to correct the situation?
Why weren’t those attempts successful? What are the
consequences of not solving the problem?
How does the goal of the study address the research problem
and how will the proposed study offer promise as a resolution to
the problem?
How will the research add to the knowledge base?
What is the potential for generalization of the results?
What is the potential for original work?
Barriers and Issues
In these paragraphs, identify how the problem is inherently
difficult to solve. How did the solution the author(s) propose
address the difficulties?
Chapter 2 Literature Review
In this section, it is important to clearly identify the major areas
on which the student will need to focus the student research in
order to build a solid foundation for the study in the existing
body of knowledge. The literature review is the presentation of
quality literature in a particular field that serves as the
foundation and justification for the research problem, research
questions or hypothesis, and methodology. The student will
develop a more comprehensive review of the literature as part
of the research.
Chapter 3 Approach/Methodology
This chapter includes a summary of how the student are going
to proceed with the evaluation of the problem statement and
associated research question(s). Given the short time of this
course, a compare / contrast or advantage / disadvantage

analysis is recommended that
Chapter 4: Findings, Analysis, Synthesis
Include an objective description and analysis of the findings,
results or outcomes of the research. Limit the use of charts,
tables, figures to those that are needed to support the narrative.
Most of these illustrations should be included as part of the
Appendix.
The following topics are intended to serve as a guide:
Data analysis
Findings & discussion
Analysis
Synthesis
Discussion
Chapter 5: Conclusions
Conclusions - Clearly state the conclusions of the study based
on the analysis performed and results achieved. Indicate by the
evidence or logical development the extent to which the
specified objectives have been accomplished. If the research has
been guided by hypotheses, make a statement as to whether the
data supported or rejected these hypotheses. Discuss alternative
explanations for the findings, if appropriate. Delineate
strengths, weaknesses, and limitations of the study.
Implications - Discuss the impact of the work on the field of
study and its contributions to knowledge and professional
practice. Discuss implications for future research.
Recommendations - Present recommendations for future
research or for changes in research methods or theoretical
concepts. As appropriate, present recommendations for changes
in academic practice, professional practice, or organizational
procedures, practices, and behavior.
References
Follow the most current version of APA to format the
references. However, each reference should be single-spaced
with a double space in between each entry.
Formatting Details

Margins
The left-hand margin must be 1inches (4 cm.). Margins at the
right, top, and bottom of the page should be 1.0 inch. (See
exception for chapter title pages below.) The Research Report
text may be left-aligned (leaving a ragged right edge) or may be
both left- and right-aligned (justified).
Line Spacing
Double-spacing is required for most of the text in documents
submitted during the Research Report process.
Paragraph Spacing
The text of the document is double-spaced. There should be no
extra spaces between paragraphs in sections; however, indent
the first line of each paragraphs five spaces.
Page Numbering
All pages should have page numbers in Arabic numerals in the
upper right-hand corner.
Type Style
The body text, the student should use 12-point Times New
Roman. Text for the cover page may be larger but should not
exceed 14-point size. Text for the chapter title text should be
14-point size. Be consistent in the use of typefaces throughout
the document. Do not use a compressed typeface or any settings
on the word processor that would decrease the spacing between
letters or words. Sans serif typefaces such as Helvetica or Arial
may be used for relatively short blocks of text such as chapter
headings and captions but should be avoided in long passages of
text as they impede readability.
Title Page
Every document that is submitted must have a title page. The
title page includes the exact title of the research report, date of
submission, the team name, and the name of each team member.
Chapter Title Heading, Subheadings, and Sub-Subheadings
It is required that submitted Research Report use no more than
three levels of headings in the body text. All headings should
have only the first letter of each word capitalized except that
non-major words shorter than four letters have no capital

letters.
Instructions for heading levels follow:
Level 1: Chapter Title Heading
This heading starts two inches from the top of the page, is
centered on the page, and is set in 14point type. The first line
contains the chapter number (e.g., Chapter 4). The second line
is blank. The third line displays the chapter title, is centered on
the page, and is set in 14-point type.
Level 2: Subheading
Start the subheading at the left margin of the page, four spaces
(i.e., two returns when the document is set for double-spacing)
down from the title, set in bold 12-point type. Double-space
(one return) to the subheading body text. Indent the first line of
the body text five spaces.
Level 3: Sub-Subheading
Start the sub–subheading at the left margin of the page, double-
spaced (i.e., one return when the document is set up for double-
spacing) from the subheading, set in 12-point italics. Double-
space (one return) to the sub-subheading body text. Indent the
first line of the body text five spaces. Option 2 is a Question /
Answer Bank (700 Points)
This option asks the student to thoroughly review the assigned
course materials (xx chapters of the assigned textbook, PPTs,
and Discussion Forums). If this option is selected, the student is
to create a final exam derived from the materials previously
under study and as specifically outlined below. Questions
posted in the textbook, textbook website, or derived from Chegg
or related websites will result in a final grade of zero for the
Final Exam. The question / answers must be in the student’s
own words as each submission should be checked for plagiarism
by Turnitin.
Create at least 5 questions per assigned textbook chapters (xx).
The total number of questions / answers is 70. Four Q/A and
one Essay for each Chapter. The Q/A may only be in the
following formats: 1) Multiple Choice “MC”; 2) Fill-in “FI”; 3)

Multiple Answers “MA”. Highlight the correct answer as
indicated below.
1. Questions must identify the Chapter “Ch” and page number
“P” (if derived from the assigned textbook(s)), or Slide number
“S” indicating where the Q/A sequence was derived. Please note
the highlighting of the correct answer.
2.
The format of the question/answer are as follows:
· Sample MC
1. Ch1 P11 - Software Engineering includes:
a. Functional Requirements Gathering
b. Non-Functional Requirements Gathering
c. Both Functional and Non-Functional Requirements Gathering
d. None of the above
· Sample MC
2. Ch1 S14 - Software Engineering does not include:
a. Functional Requirements Gathering
b. Non-Functional Requirements Gathering
c. GUI
d. None of the above
· Sample FI
1. Ch1 P24 - ______ testing dictates the Q/A person has access
to the source code:
a. White-Box
· Sample MA
1. Ch1 P12 – Software Engineering includes the following:
a. Requirements
b. Project Management
c. Configuration Management
d. Server Administration
e. Engineering Economics
f. Network Administration
2. Additionally, create one Essay question and suggested answer
derived from the assigned course materials.
· Sample Essay

1. Ch1 P15 – Identify each of the dimensions of Software
Engineering:
a. This first chapter begins with a 10,000 foot view of software
engineering knowledge areas. Specifically: Requirements,
Design, Construction, Testing, Maintenance, Configuration
Management, Engineering Management, Engineering Process,
Engineering Models and Methods, Quality, Engineering
Professional Practice, and Engineering Economics.
10

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