Introduction to Healthcare Informatics, Second Edition
Chapter 4:
Information Infrastructure
© 2017 American Health Information Management Association
© 2017 American Health Information Management Association
Objectives
Understand the goals of a distributed system
List and give examples of distributed systems
Recognize the differences between two- and three-tiered network architectures
Discuss the purpose of middleware
Define collaborative computing
Understand the design models of distributed systems
Describe the development process of a distributed system
Discuss the basic principles of cloud computing
Describe the five basic characteristics of a cloud computing system
List and give examples of the three major cloud computing service models
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Using Technology
Computer Concepts
Hardware
Software
Architectural Models
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Hardware
Monitor
Keyboard
Mouse
Printer
CPU
Memory
Hard drive
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Software
Program that directs hardware
Operating System
Windows, Linux, Apple Mac OSX
Applications
Microsoft Word
Databases
Statistics programs
Games and apps
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Architectural Models
Definition
“Languages” for information modeling
Enterprise Knowledge Development (EKD)
Service-Oriented Architecture (SOA)
Business Process Simulation (BPS)
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Assess Systems for Regulatory Requirements
Design and development
Physical models
Wireless versus wired
Topology
Mobile computing
Electronic signatures
Audit logs
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Design and Development
Physical models
Mobile computing
Electronic signatures
Audit logs
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Physical Models
Definition
Cabled communication media
Noncabled communication media
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Physical Model Topologies
| Network Topology | Advantages | Disadvantages |
| Point-to-Point | Speed | Limited to two devices |
| Star | Easy installation and device connectionCan connect and remove devices without disruptionProblems are easily identified | Requires more cable than bus topologyFailure of a hub, switch, or concentrator disables nodesMore expensive than bus topology |
| Bus | Easy device connectionUses less cable than other topologies | One break disables network Terminators required at both ends of the backboneProblems are hard to identify |
| Tree | Point-to-point wiring for certain segmentsVendor neutral | Length of a segment is limited by type of cable usedIf backbone breaks an entire segment failsMore difficult to configure and wire |
| Ring | Can support better performance than a star topologyProvides for orderly data transmission | High performance under low loadsExpensive to implementAny fault can cause network failure |
| Mesh | Extensive redundancy with multiple connections“Self-configuring” when new nodes are added“Self-healing” to continue operations even when some nodes failMore nodes increases speed | Still in development, with no standardsWireless is inherently unreliableThey are not completely seamless; moving nodes may result in failure |
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Mobile Computing
Definition
Issues
Type of device
Ownership of the device
Compatibility
Technical requirements
Access to be supported
Application access
More expanded methods of communication
Who has access
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Mobile Data Breaches
Data breaches common on mobile devices
Polices and procedures
Data encryption
Computer audit checks
Computer cables for physical security
No commonly accepted security standards
HIPAA and mobile devices
Increased HIPAA monetary penalties for not securing mobile devices
NIST recommends strong passwords and email encryption
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Protecting PHI on Mobile Devices
Types of security
Virus protection
Backups
Firewalls
Encryption
Disaster recovery
Annual security training
Routine security audits and updates
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Electronic Signatures
E-Signing is the process of electronically signing a record
Process includes:
initial access of the user to the systems
authentication of the user with strong passwords or PINs
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Audit Logs
Where are they located?
Clinical applications
Databases
EDMS systems
Many other healthcare systems
What do they contain?
User’s identification
Machine and software used to access system
Date and time of access
Method of authentication
Files or applications used
Actions performed
Date and time of logoff
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Device Selection Recommendations
Ergonomics
Computers on wheels
Cost
Security features
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Computers on Wheels (COWs)
Definition
Uses
Concurrent charting
Inventory management
Nursing medication administration
Point-of-care documentation
Selection considerations
Screen size
Battery life
Cart size
Ergonomics
Security
Wireless network
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Development of Systems
Communication technologies
Internet technologies
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Firewalls
Virtual Private Network: extends the firewall protection boundaries
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Network Distribution Methods
Terminal-to-host
File server
Client-server
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Layers of Web Services Architecture
Discovery
Description
Messaging
Networking
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Evaluate Systems
Systems testing
Interface management
Electronic structure and relationship of health data
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Distributed System Configuration
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Goals of a Distributed System
Resource sharing
Openness
Concurrency
Scalability
Fault tolerance
Transparency
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Distributed Systems
Evolution of distributed systems
Two-tiered systems
Three-tiered architecture
Web services architecture
Collaborative computing
Cloud computing
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Distributed Systems
Centralized
Decentralized
Local area network (LAN) or wide area network (WAN)
Web-interfaced applications for user communication
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Evolution of Distributed Systems
Two-tiered systems
Servers
LAN
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Three-tiered systems
Addition of application server
“Thin clients”
Advantages
Evolution of Distributed Systems
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Web services architecture (WSA)
Distributed computing
Web service
Evolution of Distributed Systems
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Collaborative Computing
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Cloud Computing
Definition
Advantages
Characteristics that define a cloud
On-demand self-service
Broad network access
Resource pooling
Rapid elasticity
Measured service
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Benefits of Cloud Computing
Scalability
Preconfigured operating systems images
Virtual servers or physical servers
Dedicated IP addresses
Communication
Replication and distribution
Persistence
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Cloud Computing
Major cloud computing models
Software as a service (SaaS)
Platform as a service (PaaS)
Infrastructure as a service (IaaS)
Deployment models
Private cloud
Community cloud
Public cloud
Hybrid cloud
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Cloud Computing Considerations for Healthcare Organizations
Cost of ownership
Dependability
Scalability
Mobility
Future-proofing
Security
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