Study Notes on Health Information Systems Technology
Chapter 6-II: Technology Understanding Health Information Systems
Key Areas of Technology
Robust data communications are essential to support Health Information Systems (HIS) applications.
Two main areas of technology that facilitate this:
Telecommunications
Networking
Telecommunications and Networking
Telecommunications refers to the electrical transmission of data among systems. This may occur through various media:
Analog
Digital
Wireless
Major components of data communications networks:
Server: A system that provides resources and services to other computers (clients) over a network.
Client: A device or application that requests services from the server.
Circuit: The path over which data is transmitted between devices.
Types of Networks
Four primary network types:
Local Area Networks (LANs): Networks that connect computers located in a limited geographical area, such as an office or building.
Metropolitan Area Networks (MANs): Larger networks that cover a city or a significant area, connecting multiple LANs.
Wide Area Networks (WANs): Networks that extend over large geographical distances, such as between cities.
Backbone Networks (BNs): High-capacity networks that interconnect multiple networks, often supporting the internet and large organizations.
Backbone networks are designed for high data volume transmission with low latency.
Networks can be classified into two categories:
Intranets: Private networks that use internet protocols to securely share any part of an organization's information.
Extranets: Extend a company's intranet to authorized external users (business partners, suppliers, etc.).
Network Models
Open Systems Interconnection (OSI) model: A conceptual framework used to understand the interactions of different networking systems. It consists of seven layers:
Physical Layer (L1): Responsible for transmitting raw bit streams over physical cables.
Data Link Layer (L2): Manages node-to-node data transfer and handles error correction.
Network Layer (L3): Handles routing of data packets across the network (e.g., IP Address).
Transport Layer (L4): Ensures complete data transfer, managing error correction and flow control (uses TCP ports for end-to-end communication).
Session Layer (L5): Manages sessions between end-user applications (establishes and terminates connections).
Presentation Layer (L6): Translates data between the application layer and the network (data formatting, encryption, etc.).
Application Layer (L7): The layer where applications accessing the network interface, including protocols such as HTTP, FTP, SMTP.
Internet Model (TCP/IP model): A simplified network model that consists of four layers:
Network (Interface) Layer: Combines the Physical and Data Link layers from OSI.
Internet Layer: Corresponds to the Network Layer in OSI.
Transport Layer: Matches the Transport Layer in OSI.
Application Layer: Combines the functions of the Session, Presentation, and Application layers of OSI.
Local Area Networks (LAN)
LAN Components:
Network Interface Cards (NICs): Hardware to connect devices to a network.
Copper and Fiber-Optic Cables: Medium for data transmission.
Switches (Layer 2): Devices that forward data packets based on MAC addresses within a local area.
Router (Layer 3): Connects different networks and manages traffic between them.
Wireless Local Area Networks (WLANs)
Characteristics:
Fast-growing technology that allows devices to connect wirelessly.
Wireless Access Points (WAPs): Devices that allow wireless-enabled devices to connect to a wired network.
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Wide Area Networks (WAN)
Function: Connects multiple LANs or other WANs, providing communication over larger geographic distances.
The largest WAN currently is the Internet.
Importance of Bandwidth: WANs require high bandwidth for efficient data transfer.
Types of WAN Circuits:
T1 / T3 lines: Standard lines for dedicated circuit connections.
Optical lines: High-capacity fiber optic circuits.
Asynchronous Transfer Mode (ATM) lines: Data transmission method that encodes data into small fixed-sized cells.
Multiprotocol Label Switching (MPLS) circuits: Directs data from one node to the next based on short path labels rather than long network addresses.
Wireless Wide Area Networks (WWAN)
Definition: Provide service over large geographic areas broken into smaller "cells".
Also referred to as broadband networks or cellular networks.
Examples:
WiMAX: A standard for wireless broadband access.
LTE: Various generations of mobile networks (3G, 4G, 5G).
Storage Area Networks (SANs)
Definition: Specialized network designed to provide access to consolidated block storage, primarily used for storing large volumes of data efficiently.
Key Features:
Supports efficient data storage and retrieval in healthcare organizations.
Redundant Array of Independent Drives (RAID): A technology that uses multiple disk drives to provide data redundancy and performance improvements.
Types of SANs:
Fiber Channel (FC) SANs: High-speed network that interconnects multiple storage devices.
Network Attached Storage (NAS): File-level data storage connected to a network that provides data access to multiple clients.
Voice and Communications
Voice Technologies:
Voice over Internet Protocol (VoIP): Allows voice communication to be transmitted over IP networks.
Voice over Wireless Local Area Network (VoWLAN): Voice services using wireless networks.
Unified Communications (UC) Technologies: Integrated communications modes such as:
Instant Messaging: Real-time text communication.
Video and Web Conferencing: Online meetings via video or web.
Internet Protocol Television (IPTV): Delivery of television content through the internet.
Data Centers and Cloud Computing
Projected Trends in Data Centers:
Co-location: Using shared facility space by multiple customers.
Data Center Consolidation: Reducing the number of data centers to improve resource use.
Cloud Computing: Offloading computational resources to the cloud for storage or applications.
Cloud Computing Types in Healthcare:
Infrastructure-as-a-Service (IaaS): Provides virtualized computing resources over the internet.
Platform-as-a-Service (PaaS): Provides a platform allowing customers to develop, run, and manage applications.
Software-as-a-Service (SaaS): Software hosted online and delivered through the internet.
EMR-as-a-Service (EaaS): Subscription-based model for electronic medical records management.
Data Center Management Systems Components
Backup Systems:
Tape-based Backup Systems: Utilize magnetic tape for storage (DLT or LTO).
Disk-based Backup Systems: Use disk drives for data backup.
Virtual Tape Libraries (VTLs): Emulate tape libraries using disk technology.
Business Continuity and Disaster Recovery
IT Downtime: Example considerations, like Amazon.com down for one minute and the operational impacts on airports.
Key Definitions:
Business Continuity (BC): Processes ensuring essential functions of a healthcare organization continue during and after a disaster.
Disaster Recovery (DR): Plans and policies to restore IT services and data after incidents.
Business Continuity Plan (BCP): A plan that covers broader operational aspects.
Disaster Recovery Plan (DRP): Primarily focused on IT system and data recovery.
Server Computing
Servers: Special type of machines dedicated to processing requests from client devices, such as database queries, application processes, file transfers, etc.
Key Server Components:
Central Processing Units (CPUs): The primary component that executes instructions.
Random Access Memory (RAM): Memory for temporarily storing data currently being processed.
Input/Output (I/O) Systems: Manage data flow between the server and other devices.
Keyboard, Video, and Mouse over IP (KVMoIP): Allows remote access and management.
Access to Storage, Network, and Backup Systems: Critical for data handling and may include connection points for additional resources.
Infrastructure Servers
Key Infrastructure Servers:
Dynamic Host Configuration Protocol (DHCP) servers: Automatically assigns IP addresses and parameters to network devices.
Domain Name System (DNS) servers: Resolves human-readable domain names to IP addresses.
Web Server: Hosts websites and serves web pages.
File Server: Provides file storage and access.
E-mail Server: Manages electronic mail services.
Client Computing
Client Computing: Refers to the end-user computers and devices, like personal computers and laptops interacting with cloud services or applications.
Examples of Client computing: Utilization of components like Microsoft 365 applications (Outlook, Word, PowerPoint) to connect to remote services.
Mobile Computing
Emergence of mHealth: The rise of mobile health applications and initiatives, including Bring Your Own Device (BYOD) policies that allow the use of personal devices for health-related services.
Information Security
Key Information Security Technologies:
Firewalls: Systems that monitor and control incoming and outgoing network traffic based on predetermined security rules.
Virtual Private Networks (VPNs): Secure remote connections to private networks as if the user is directly connected.
Multi-Factor Authentication: A security measure requiring multiple forms of identification from users to access systems (e.g., passwords, smart cards, fingerprints).
Review Questions
Q1: T are defined as the electrical transmission of data among systems, whether through analog, digital, or wireless media.
Q2: Health organizations today leverage Remote H by engaging a third-party web-hosting company to manage external web content.
Q3: The I is the largest wide area network (WAN) in existence today.
Q4: Data center C_ describes reducing the number of data centers to enhance performance and efficiency.
Q5: VTL____ are backup systems using disk-based arrays to replicate tape library functionality while allowing for transitions from tapes to disks in existing backup software.
Q6: M__ - f authentication commonly includes elements like smart cards, fingerprints, and passwords.