LYT2 Task 2
Western Governors University

Part A - Technological Solutions for NHS, Inc.

1. DSL Technology
Sims, J. (September 13, 2014). The Future of DSL. Retrieved September 14, 2015 from http://www.highspeedexperts.com/future-of-dsl/.
Solution - This article describes the DSL technologies that are available and which direction most companies are going with. DSL services offer much higher speeds than a typical dial-up solution while utilizing the existing phone lines to transfer data. With this technology there are two main DSL options that are available. SDSL (Symmetrical Digital Subscriber Line) is an older technology which is targeted at businesses and enterprises that offers equal and fast upstream and downstream speeds. The other option is VDSL which is a faster solution for larger businesses.
Use - VDSL (Very high speed Digital Subscriber Line) is the dominant DSL technology at the moment. VDSL is also in its 2nd generation which is referred to as VDSL2 which offers speeds of 100 Mbps downstream and 20 Mbps upstream. GDSL (Gigabit Digital Subscriber Line) is the upcoming technology that is promising but the specifications are still being proposed and debated.
Application - DSL technology is a solution that NHS, Inc. can utilize given that all their clinics are supplied or are in reach of a landline telephone company and have the infrastructure in place. DSL would also be fast enough to handle the 100MB of files being transferred between offices and would not be effected by bad weather since the phone cables are mostly underground.

DSL: Get the Reliability and Speed Your Business Needs. Retrieved October 10, 2015 from http://www.cisco.com/en/US/netsol/ns339/ns392/ns399/ns401/netbr0900aecd800c3d30.html.
Solution: DSL is an internet solution that operates over existing phone lines and runs at 25 to 100 times faster than a standard 56k modem. By using digital coding techniques the phone lines will provide 99 percent more capacity without jeopardizing the regular phone line service.
Use: The providers that are out there are offering business-class DSL solutions which will provide businesses with (QoS) guarantees. These packages also provide more robust offerings for faster internet service.
Application: With these business type DSL offerings, NHS will be able to utilize their existing phone lines and provide their clinics with high speed, secure and reliable internet service. NHS will also be able to connect their offices by a VPN because of the QoS guarantee that is given by the providers.

2. T1 or T3 Dedicated Leased Lines
Wachtel, Bob. All You Wanted to Know About T1 But Were Afraid to Ask. Retrieved October 7, 2015 from http://www.dcbnet.com/notes/9611t1.html.
Solution: A T1 is a high-speed technology that uses the Public Switched Telephone Network (PSTN) to provide internet service to businesses. The T1 uses a pair of standard phone wires and provides 1.544 Mbps of data speed. The T2 operates at 6.312 Mbps and the T3 at 44.736 Mbps.
Use: The bandwidth that is provided by a T1/T3 is synchronous which means that the speed is the same for both uploads and downloads. With a T1 is the guaranteed quality of network that comes with it. AT&T states that the performance objective is about 95% Error Free Seconds (EFS) on a daily basis.
Application: The T1 solution is a solid choice for NHS, Inc. and their needs because of the dependability of the connection and the fact that any issues will be fixed promptly. A T3 connection would be a better option for NHS because their clinics need the extra bandwidth to send the 100MB files. The only drawback of the T3 is the price increase over the T1.

Rucker, Laura (November 12, 2008). DSL vs. T1 – The Advantages and Disadvantages. Retrieved September 15, 2015 from http://www.articlesbase.com/networks-articles/dsl-vs-t1-the-advantages-and-disadvantages-639510.html.
Solution: The author in this article describes the differences between a DSL and T1 connection and explains the factors to consider when making a decision on which one to choose. The article mentions that businesses consider reliability as the single most important factor when deciding what network connections to go with. A T1 is geared more for businesses than a DSL connection because of the reliability although the T1 isn’t as affordable.
Use: Reliability and timeliness according to the author are the main factors in driving your business to success. A business can’t afford to lose productivity due to unreliable internet service and they need to think beyond saving money when making a decision on which one to go with. The author summarized the article by saying that if price is the guiding factor in the decision then go with the DSL, but if reliability is the central focus then the T1 is the better way to go.
Application: The purchase of a leased T1 from the local phone company is an option for NHS Inc. because of the access to the phone company and because of the fact that NHS needs a reliable connection that can handle large imaging files. It would be a reliable connection because a T1 or T3 is not subject to bad weather and if there was any down time the phone company would make it a very high priority.

3. Cable Internet
Chianis, Alexia (November 1st, 2013). Cable Internet vs. DSL: Is One Really Better for Business?. Retrieved September 15, 2015 from http://www.businessbee.com/resources/news/technology-buzz/cable-internet-vs-dsl-one-really-better-business/.
Solution: Cable internet utilizes a modem to transmit data over existing cable television lines which are provided by the cable company. Cable internet can reach speeds of up to 107 Mbps but most providers offer only 20 to 100 Mbps download speeds.
Use: The cable internet that is provided by the cable company is called an “always-on” connection which means as long as your computer is on then you will be connected. If the cable gets damaged in any way then the business will lose service. Cable internet isn’t as reliable and it is not guaranteed by the cable company.
Application: In the case with NHS, since they need large data files to be sent to New York, bandwidth may be an issue depending on the amount of users at any given time. However since they are currently supplied with cable TV they can utilize the existing infrastructure which cuts down on installation costs. Cable internet is a viable option for NHS because of the cost savings from the already installed cable and the speeds it could provide. Torres, Gabriel (September 10, 2013). How the Cable TV is used for Internet Access. Received October 10, 2015 from http://www.hardwaresecrets.com/how-the-cable-tv-is-used-for-internet-access/.
Solution: Cable companies offer cable service through a standard called Data Over Cable Service Interface Specification (DOCSIS). This standard allows cable companies to deliver high-speed data through their existing coaxial cable. The connection between the provider’s central office and the distribution points is made using fiber optics.
Use: Cable providers can limit the amount of bandwidth delivered depending on how much is paid for. DOCSIS 2.0 and 3.0 can get up to speeds of 42Mbps download and 30 Mbps upload and can be either asymmetrical or symmetrical. The data rate is also dependent on the amount of users connected to the optical node at the same time.
Application: Cable internet should be seriously considered for NHS, Inc. because of the upload and download speeds it can provide and the cost savings from already having the infrastructure in place. This solution would not be affected by weather and could easily handle the data needs of NHS.

4. Satellite Internet
Ground Control: How Does Satellite Internet Work. Retrieved October 7, 2015 from http://www.groundcontrol.com/How_Does_Satellite_Internet_Work.htm.
Solution: Satellite internet provides internet service to homes and businesses from a small dish that is installed and transmits communication with an orbiting satellite 22,300 miles above Earth. The data then gets sent to the NOC or Network Operations Center which itself is connected to the internet. All communication that is made from a satellite dish to the internet must travel through the NOC. From the NOC, data gets sent back to the orbiting satellite and back to the small dish at the customer’s site which is connected to a router.
Use: By using a satellite connection one issue that will come up is latency. Latency is the amount of time it takes data to be sent to the satellite and back. Since light speed is 186,000 miles per second, and the satellite that is orbiting Earth is 22,300 miles away, this will increase the amount of time it takes to send and receive data.
Application: This solution is a good possibility for NHS because of rural areas that the clinics will be at. The dish allows for very little installation and can be setup very quickly. The downside to satellite is the latency issue. If NHS decides to setup a VPN for security through this type of connection they will have some latency problems.

Satellite Internet connection definition. Retrieved October 7, 2015 from http://searchnetworking.techtarget.com/definition/satellite-Internet-connection. Solution: Each satellite subscriber or customer is installed with a dish antenna and a transceiver to send and receive data. Data that is uploaded to the satellite are typically slower than the download speeds. This makes the connection asymmetrical and the bandwidth speed will depend on factors such as the amount of users, capacity of the server, and the size of files being downloaded.
Use: This article explains that satellite service is an excellent choice for those in rural areas where DSL and other solutions are not available. However satellites are also prone to rain fade or solar interference at times.
Application: NHS has clinics that are in rural areas so this solution is available to them. They will need to deal with the possibility of downtime with this solution because of bad weather or solar flares. The speed of this solution is not as fast as other solutions especially if a VPN is setup for security.

5. Fiber-optic connectivity
Fiber Types in Gigabit Optical Communications. Retrieved on October 7, 2015 from http://www.cisco.com/c/en/us/products/collateral/interfaces-modules/transceiver-modules/white_paper_c11-463661.html.
Solution: This article explains the technology behind fiber optics in great detail. Fiber optic is created by using a flexible filament of very clear glass that is able to carry data in the form of light. Two types of fiber optics are used which are single-mode and multimode fiber and the one used depends on the distance needed. Single-mode fiber is typically used for distances over 1,000 meters and multimode is used for shorter distances.
Use: Fiber can reach speeds of up to 1,000 Mbps and can be either asymmetrical or symmetrical bandwidth connection. Fiber is also immune to electrical interference and will not pick up noise from the environment or cross-talk between signals in other cables nearby. Fiber Transceivers need to be installed at both ends of the fiber cable to transmit the data.
Application: NHS requires 100 Meg files to be transferred from their clinics and fiber optic is the fastest solution. This will allow them to reach speeds of up to 1 Gbps which allows for very fast data transmission. They will also be able to setup a secure VPN with no latency and since the fiber will already be installed, this solution will be cost effective. BroadbandUSA: Connecting America’s Communities. Retrieved 9/24/15 from: http://www.ntia.doc.gov/legacy/broadbandgrants/BTOPAward_BiddefordInternetCorpME_121709.pdf.
Solution: The Three Ring Binder fiber project created open access fiber-optic network across the most rural and disadvantaged areas of Maine. The fiber reached more than 100 communities and made broadband more available to 600 community institutions and 110,000 households.
Use: This fiber will provide 100Mbps broadband capabilities to rural healthcare facilities and hospitals. The fiber project benefits clinics and hospitals by allowing more immediate contact with specialists and increasing collaboration with local healthcare providers with specialists in major metropolitan areas.
Application: This fiber project allows NHS to reach the professionals they need to send information to and do so with very high speeds. The speeds and reliability of fiber will allow NHS to use a VPN without any latency and will not be affected by any weather conditions.

Part B – Recommendation for NHS, Inc.

According to NHS, Inc. their goal is to reach rural Maine with healthcare clinics so they can provide the state-of-the-art health services to its client base. To accomplish this goal NHS will need to offer complete medical imaging services with a very quick turnaround of results and diagnoses. They need a reliable and high-speed internet access that can send these large image files to a major hospital in New York. I have evaluated five different options that NHS can use for their internet access. All five technologies are options that would potentially work for NHS and their surrounding clinics. Because of the fact that the Maine Fiber Company has built a very strong fiber infrastructure reaching the rural areas of Maine called the Three Ring Binder project, I strongly believe that NHS should go with this option. MFC mentioned the importance of reaching out to these areas because of health services like NHS who are trying to address the needs of the underserved patients of rural Maine. This fiber connection will provide NHS with speeds of up to 1 Gbps of reliable and secure internet access. Although I believe that NHS should go with the 100 Mbps option because of the costs associated with 1 Gbps. They will also be able to encrypt their very large files without losing much bandwidth. In order to make the files secure NHS could setup a VPN or virtual private network to keep those files or documents from getting stolen. The following table 1 shows the speeds of each of the solutions that were discussed and considered. According to NHS the files that they will be sending to New York can be upwards of 100MB each. If we were looking at 100MB of data being transferred, it would take just around 10 seconds for those files to get to New York using fiber. In comparison it would take several minutes for the T1 and the Wi-Fi solutions to transfer the data. The closest solution is the cable modem with 50 Mbps which would be twice as slow as the fiber option.

Connection Type 100MB transfer speed
Dedicated T1 - 1.5 Mbps 9 minutes
Broadband Wi-Fi - 5 Mbps 3 minutes
DSL - 8 Mbps 2.5 minutes
Cable Modem - 50 Mbps 20 seconds
Fiber Optic - 100 Mbps 10 seconds Table 1
The other reason for choosing fiber as a solution for NHS is the reliability of the connection. With a broadband Wi-Fi or a DSL connection the priority for these connections is low. If the connection goes down for any reason the time it would take to fix the issue could take days. This is unacceptable for a healthcare facility that needs connection 24/7. The same applies with a cable modem connection. If there is a break in the cable line, it could take several hours or days for the cable company to find the break and fix it. The T1 is the closest reliable connection for NHS but unfortunately it is the slowest of the connections and also just as costly as the fiber. A fiber connection is much more reliable than any other solution presented. It has the highest priority in case of a damaged line or disruption in service. The fiber that was installed by MFC connects 51 anchor institutions, 10 campuses and outreach centers of the University of Maine System, 3 community colleges, and 38 government facilities. It’s very important that this fiber stays in service because of the number of businesses and schools that it provides service to.
The last reason for NHS to go with this fiber connection is for future expansion. NHS will continue to grow and the need for greater speeds will be there in the future. The possibility that they will go with 1 Gbps instead of the 100 Mbps in the future is very good. They will need those faster speeds and greater bandwidth to reach more facilities and provide better service to their patients. The other solutions that were considered will not be able to handle the needs of NHS in the future.
The technological acceptance curve is a great model that helps businesses understand how new ideas and technologies are spread and how they are accepted. I believe that NHS, Inc. falls in the Early Majority part of the curve because they accept the technology that is out there and want to use it for their advantage. The Early Majority part of the curve are for those companies that are a little more conservative than innovators but are open to new ideas and technology. They are also active in the community and influence others as well. NHS has that desire to be active in the community and reach those underserved patients in rural Maine. They also are open to new technologies such as the fiber that MFC has provided and want to utilize it for their clinics. They are searching for ways to improve and aren’t afraid to make the necessary changes that will help their business grow and provide the services that are needed in Maine.
I believe that the proposed solution would be accepted by NHS, Inc. because they fall in the early majority part of the curve which means they would accept new technology and are very active in the community. NHS wants to provide state-of-the-art technology to their patients and a fiber connection will give them the speed, reliability and security to give them that. It will also set them up for future growth and will enable them to stay current and comparable with other major hospitals and facilities. With that being said NHS, Inc. would be very successful with a fiber connection to their clinics and would accept this recommendation.