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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:

    1. Physical Layer (L1): Responsible for transmitting raw bit streams over physical cables.

    2. Data Link Layer (L2): Manages node-to-node data transfer and handles error correction.

    3. Network Layer (L3): Handles routing of data packets across the network (e.g., IP Address).

    4. Transport Layer (L4): Ensures complete data transfer, managing error correction and flow control (uses TCP ports for end-to-end communication).

    5. Session Layer (L5): Manages sessions between end-user applications (establishes and terminates connections).

    6. Presentation Layer (L6): Translates data between the application layer and the network (data formatting, encryption, etc.).

    7. 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:

    1. Network (Interface) Layer: Combines the Physical and Data Link layers from OSI.

    2. Internet Layer: Corresponds to the Network Layer in OSI.

    3. Transport Layer: Matches the Transport Layer in OSI.

    4. 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.

Wireless Network Diagram

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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.