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Patton-Fuller Community Hospital Networking Project

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Patton-Fuller Community Hospital Networking Project
Deepa Mathur

University of Phoenix
IT Infrastructure (CMGT/554)
Instructor: La Shanda Perry

22 October 2012

The purpose of this document is to identify how data is transmitted within Patton-Fuller Community Hospital and externally. The paper also attempts to identify and describe the OSI layers directly involved in the hospital network and also provides evidence of each layer identified. Last, the paper attempts to identify the various protocols that are available for use and provides a recommended standard that should be used for the hospital. The website of Patton-Fuller Community Hospital contains a top view diagram that represents the hospital structure from an IT network perspective. The Red outlined boxes are the areas related to clinics including Drs Personal Offices, ORs and ERs, Labs, Pharmacy, Radiology, Outpatient Examining Rooms, Wards, and ICUa. The Black outlined boxes represent functions related to administration, including Discharging and Admissions, Technology, HR, Facilities, Finance, and Hospital Senior Management.
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For all kinds of data transmission, the entire hospital has an overall network using 1000 BaseT using CAT 6 cable. Some of the individual departments have separate network structure, such as Radiology use different standards, such as 1000 BaseF using single mode fiber, as shown in the logical network diagram below. The Ethernet cable runs throughout the hospital, connecting all areas through a Network Bridge located between the network containing the clinical areas and administrative function areas of the hospital. The bus architecture of the networks is shown in the diagram below, with nodes connected to the Ethernet backbone.

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In all Radiology modalities the DICOM (Digital Imaging and Communication in Medicine) standard and PACS (Picture Archiving and Communication System) are used. The RIS Data Center is made up of Apple Cluster Servers. The servers are connected via a 4 gigabit fiber link to a 10 terabyte disk storage device. The hospital network has many layers that fall into the OSI model of networking. The "physical layer" is defined as electrical and physical specifications for devices. To be specific, it defines the how a device and the medium of transmission are related, such as a copper or fiber optical cable. Having said that, the Ethernet cabling using 1000 BaseT using CAT 6 cable and 1000 BaseF using single mode fiber can be classified as the physical layer, which is the bottom-most layer. Going all the way up, the "application layer" is the layer that is nearest to the end user. This is the layer which interacts directly with the software application, along with the end user. According to the Administration Network Details on the hospital's website, the executive management and other senior management uses Apple iMACs as workstations. Also there are some thin Client computers for data entry, using Hewlett-Packard Model L1706. Each major department has two black and white laser printers and one color laser printer. All these computers and accessories can be classified as the top-most Application layer. Between these two top and bottom layers, there are some middle layers also. For example, the Network bridge shown in the logical diagram can be classified under the "Data Link" layer, which is the layer next to the physical layer and is defined as a layer that provides the functional and procedural means to transfer data between network entities. The IT Data Center of the hospital connects to external Internet using couple of Cisco Routers. This can be classified as "Network Layer" of OSI because, per Wikipedia, "the network layer provides the functional and procedural means of transferring variable length data sequences from a source host on one network to a destination host on a different network (in contrast to the data link layer which connects hosts within the same network)." There are various network protocols in use at the hospital. The hospital website indicates that any data related to patients is secured. This means that the transmission of any such data must use the HTPPS (Secure HTTP) or FTPS (Secured FTP) protocols. The connection of hospital to the outside world is done using Cisco Routers model 7609 and Cisco ASA 5510 VPN Router, using TCP/IP protocol. The most common network protocols in the industry include Ethernet Powerlink,EtherNet/IP, Modbus-TCP, EtherCAT, SERCOS III, Profinet. Ethernet has been the standard solution for many types of industries, including health care. According to EeTimes.com, "The main reason being it is an open, proven, cost-effective, world-wide standard that's easy to implement and use. However, Ethernet alone is not sufficient to support the complexities of industrial networks. Even though standard Ethernet protocols define communications from the physical hardware layer to the communications application layer of a network, they do not include user application levels e.g. the data formatting to enable data exchange between equipment." According to the article, additional protocol layers are being established to enable this equipment interoperability. This will enable a very wide range of applications to take benefit from Ethernet-based industrial network protocols in the health care industry, such as Home Health Monitoring, Imaging, Patient Monitoring, Management of Cardiac Rhythm, Dialysis Machines, Equipment for Hearing Analysis, Powered Beds, etc. According to a report on E-health Standards and Interoperability on scribid.co, "Rapid advancements in the development of e-health standards must accompany three trends in electronic healthcare in the coming decade: 1. Advancements in healthcare delivery via mo-bile and wireless e-health technologies; 2. Personalized medicine, including personal health records, medical diagnostic devices, and biometric records; and 3. Interactive healthcare via social media and Web 2.0 applications." The report also describes some of the companies engaged in development of standards in e-health, including DICOM, CEN/TC 251, HL7, ISO/IEEE11073, ISO/TC 215. The article also mentions "the work ITU-T is doing in e-health standards areas such as telecommunications and mobile infrastructure, multimedia e-health applications, and emergency, and disaster response". According to an article on cablinginstall.com, the information technology is becoming more and more vital to the healthcare industry with time and it has become quite challenging for many healthcare facilities. There is a steep increase in the operating expenses becuase of factors like old age population, increase in cases of chronic illness, industry and government laws and regulations, etc. According to the article, "To control costs and improve the safety and accountability of healthcare systems, governments are putting pressure on hospitals and healthcare providers to increase their use of electronic health records (EHR), using standards-based communications technologies. These initiatives are spurring many hospitals to upgrade their IT platform by consolidating multiple systems and applications on a centrally controlled infrastructure–the low-voltage cabling system supporting the facility's wired and wireless voice, data and video communications." The article also states that "migration to a converged Internet Protocol (IP)-enabled Ethernet network can help hospitals improve performance and efficiency". At the same time, it will reduce maintenance cost and time. Healthcare facilities have a lot of technology-based applications and systems, which are eligible for convergence of IP based upon a strong and steady infrastructure using cables. Some of the systems can be: •Patient monitoring systems •CIS: (Clinical information systems) : this collects and stores clinical information and images •Interactive patient systems •Nurse call systems •Intercom systems • VoIP (Voice over Internet Protocol) for economic telephone communications. •Security systems, like CCTV surveillance, alarms etc •Audio-visual (AV) systems for auditoriums, conference rooms, etc.
Conclusion
The Patton-Fuller Community Hospital uses Ethernet as a backbone network structure for all kinds of data transmission, through-out the hospital, connecting all areas through a Network Bridge which is located between the clinical and administrative areas. The network at the hospital contains multiple layers of OSI model, for data transmission within the hospital and outside. The layers that are identified are: Physical, Application, Data link, Network, etc. There are various network protocols in use at the hospital. The data is transmitted internally and externally using different protocols. One example being the security of patient's data is maintained by secured protocols like HTPPS and FTPS. The hospital is also following the industry standard in healthcare when it comes to the type of network, that is, Ethernet based protocols. But the industry standard also includes additional protocol layers to enable equipment interoperability. This technology enables an extensive range of applications to benefit from Ethernet-based industrial network protocols in the health care industry. The pressure on the Healthcare facilities to survive today's operating costs and demands is forcing them to have a great many technology-based systems and applications, all of which are viable candidates for IP convergence on a robust cabling infrastructure.

References

UoP Virtual Organizations Portal

https://ecampus.phoenix.edu/secure/aapd/cist/vop/index.html

Wikipedia http://en.wikipedia.org/wiki/OSI_model EETimes.com http://www.eetimes.com/design/industrial-control/4013718/Why-so-many-Industrial-Network-Protocols-?pageNumber=0 E-health Standards and Interoperability (April 2012) http://www.scribd.com/doc/90164400/E-Health-Standards-and-Interoperability Cablinginstall.com
http://www.cablinginstall.com/articles/print/volume-19/issue-9/features/evolution-of-healthcare-it-drives-migration-to-ip-converged-ethernet.html

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