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Week 5 Replies:
Amand Wrote:
Discuss an element of the FSLA
The Fair Labor Standad Act (FLSA) is a federal law which
establishes minimum wage, overtime pay eligibility,
recordkeeping, and child labor standards affecting full-time and
part-time workers in the private sector and in federal, state, and
local governments. https://ofm.wa.gov/state-human-
resources/compensation-job-classes/compensation-
administration/fair-labor-standards-act-flsa
All employees that hold positions determined to be covered
under the mandatory overtime provisions of the FLSA are
covered. Overtime-eligible employees must be compensated
with overtime pay or compensatory time for all hours worked
over 40 in a single workweek. All overtime-eligible employees
must fill out a Time and Attendance Record in order to comply
with FLSA standards. https://ofm.wa.gov/state-human-
resources/compensation-job-classes/compensation-
administration/fair-labor-standards-act-flsa
How it is enforced.
The Wage & Hour Division's enforcement of the FLSA carried
out by investigators stationed across the United States These
investigators gather data on wages, hours, and other
employment conditions or practices, in order to determine
compliance with the law. Where violations are found, they also
may recommend changes in employment practices to bring an
employer into compliance. It is a violation to fire or in any
other manner discriminate against an employee for filing a
complaint or for participating in a legal proceeding under
FLSAhttps://www.dol.gov/general/topic/youthlabor/enforcement
Include who is and who is not exempt from this element’s
regulation.
Who is Covered? All employees of certain enterprises having
workers engaged in interstate commerce, producing goods for
interstate commerce, or handling, selling, or otherwise working
on goods or materials that have been moved in or produced for
such commerce by any person, are covered by
the FLSA https://www.dol.gov/whd/regs/compliance/hrg.htm
Employees of movie theaters and many agricultural workers are
not governed by the FLSA overtime rules. Another type of
exclusion is for jobs which are governed by some other specific
federal labor law. As a general rule, if a job is governed by
some other federal labor law, the FLSA does not
apply. https://www.flsa.com/coverage.html
Zach Wrote:
In 1938, Congress passed the Fair Labor Standards Act (FLSA)
to regulate pay, hours worked, and child labor (Bennett-
Alexander, 12/2014, p. 777). The FLSA also protects employees
from retaliation by their employer for exercising their rights
under the Act. Retaliation is often thought of as demotion or
termination, but can take other forms, such as intimidation or
overly harsh discipline. According to Fact Sheet # 77A:
Prohibiting Retaliation Under the Fair Labor Standards Act
(FLSA) on the Department of Labor website, employees are
protected from discharge or any other manner of discrimination
from filing a complaint, having ”instituted or caused to be
instituted any proceeding under or related to this Act, or has
testified or is about to testify in any such proceeding, or has
served or is about to serve on an industry committee” (U.S.
Department of Labor, 2011). If an employee is retaliated
against, they may file a claim with the Wage and Hours
Division of the U.S. Department of Labor, who will investigate
the claim with the employer and take appropriate action on the
employee’s behalf.
Reference:
Bennett-Alexander, D., Hartman, L. (12/2014). Employment
Law for Business, 8th Edition [VitalSource Bookshelf
version]. Retrieved from vbk://1259755428.
U.S. Department of Labor. (2011, December). Fact Sheet # 77A:
Prohibiting Retaliation Under the Fair Labor Standards Act
(FLSA). Retrieved November 20, 2019, from
https://www.dol.gov/whd/regs/compliance/whdfs77a.htm.
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.
C9-3
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

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  • 1. Week 5 Replies: Amand Wrote: Discuss an element of the FSLA The Fair Labor Standad Act (FLSA) is a federal law which establishes minimum wage, overtime pay eligibility, recordkeeping, and child labor standards affecting full-time and part-time workers in the private sector and in federal, state, and local governments. https://ofm.wa.gov/state-human- resources/compensation-job-classes/compensation- administration/fair-labor-standards-act-flsa All employees that hold positions determined to be covered under the mandatory overtime provisions of the FLSA are covered. Overtime-eligible employees must be compensated with overtime pay or compensatory time for all hours worked over 40 in a single workweek. All overtime-eligible employees must fill out a Time and Attendance Record in order to comply with FLSA standards. https://ofm.wa.gov/state-human- resources/compensation-job-classes/compensation- administration/fair-labor-standards-act-flsa How it is enforced. The Wage & Hour Division's enforcement of the FLSA carried out by investigators stationed across the United States These investigators gather data on wages, hours, and other employment conditions or practices, in order to determine compliance with the law. Where violations are found, they also may recommend changes in employment practices to bring an employer into compliance. It is a violation to fire or in any other manner discriminate against an employee for filing a complaint or for participating in a legal proceeding under FLSAhttps://www.dol.gov/general/topic/youthlabor/enforcement Include who is and who is not exempt from this element’s regulation. Who is Covered? All employees of certain enterprises having workers engaged in interstate commerce, producing goods for
  • 2. interstate commerce, or handling, selling, or otherwise working on goods or materials that have been moved in or produced for such commerce by any person, are covered by the FLSA https://www.dol.gov/whd/regs/compliance/hrg.htm Employees of movie theaters and many agricultural workers are not governed by the FLSA overtime rules. Another type of exclusion is for jobs which are governed by some other specific federal labor law. As a general rule, if a job is governed by some other federal labor law, the FLSA does not apply. https://www.flsa.com/coverage.html Zach Wrote: In 1938, Congress passed the Fair Labor Standards Act (FLSA) to regulate pay, hours worked, and child labor (Bennett- Alexander, 12/2014, p. 777). The FLSA also protects employees from retaliation by their employer for exercising their rights under the Act. Retaliation is often thought of as demotion or termination, but can take other forms, such as intimidation or overly harsh discipline. According to Fact Sheet # 77A: Prohibiting Retaliation Under the Fair Labor Standards Act (FLSA) on the Department of Labor website, employees are protected from discharge or any other manner of discrimination from filing a complaint, having ”instituted or caused to be instituted any proceeding under or related to this Act, or has testified or is about to testify in any such proceeding, or has served or is about to serve on an industry committee” (U.S. Department of Labor, 2011). If an employee is retaliated against, they may file a claim with the Wage and Hours Division of the U.S. Department of Labor, who will investigate the claim with the employer and take appropriate action on the employee’s behalf.
  • 3. Reference: Bennett-Alexander, D., Hartman, L. (12/2014). Employment Law for Business, 8th Edition [VitalSource Bookshelf version]. Retrieved from vbk://1259755428. U.S. Department of Labor. (2011, December). Fact Sheet # 77A: Prohibiting Retaliation Under the Fair Labor Standards Act (FLSA). Retrieved November 20, 2019, from https://www.dol.gov/whd/regs/compliance/whdfs77a.htm. 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
  • 4. 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.
  • 5. 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
  • 6. 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
  • 7. 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. C9-3 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
  • 8. 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.
  • 9. 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.
  • 10. 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
  • 11. 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
  • 12. 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
  • 13. 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
  • 14. 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-
  • 15. study.aspxCASE STUDY 9Original WLANEnhanced LANEnhancing WLAN SecurityDiscussion QuestionsSources