Annotated Bibliography
Dial-up Internet Access
Reynolds, D. (1993). Evaluating Dial-Up Internet access options. Computers In Libraries, 13(8), 86. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=a4049de6-8035-470b-bb50-77b0b3baaebd%40sessionmgr113&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=9312014331
Dial-up internet access uses the regular telephone lines to connect customers to the internet. The remote locations will only need to a computer with a modem to “dial” out to an Internet Service Provider (ISP) using the phone lines currently available. The major advantage to dial-up internet access is that it is very simple to set up and is quite possible the cheapest way for an individual to get to the internet. A primary disadvantage to using dial-up internet access is that it is extremely slow with transfer speeds. The article provides some insight into how to determine the best dial up provider for an end user. It also describes some of the alternate costs associated with using dial up service, as well as some limited discussion of system performance and functionality considerations. I believe the article would be best used as general reference for NHS to determine the best dial-up provider to use at the various remote offices. The article also contains a section discussing regarding the speed of the dial-up in relationship to the connection time which is an important factor for users who intend to send large files across the internet.

Spanbauer, S. (2001). 5 Reasons We (Still) Love Dial-up. PC World, 19(1), 96. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=1d35a782-8e50-4481-80ee-1fd00d6369c2%40sessionmgr113&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=3832110
Continuing our discussion of dial-up internet access, another advantage is that if the remote have to move to alternate locations they can simple take the equipment with them without assistance from providers. Another drawback to dial-up internet access is that the same line cannot be used to transmit telephone (voice) communications while it is being used for internet access. The article from PC World provides some simple benefits of dial-up access focusing on the cost, ease of use, and security of the computer itself – but not the connection. It is important to note that any persistent modem connection can be used as an exploitation vector for the computer and is usually configured with little or no security to protect the system. NHS can use this article to further examine dial-up access solution for the remote sites. A major focus of the article was on the simplicity but I believe that NHS is looking to use a technology solution that is more modern to enable the goal of providing customers leading edge care.

Digital Subscriber Lines (DSL)
Rae-Dupree, J. (2000). Surfing the Web at warp speed with minimal expense. U.S. News & World Report, 128(24), 54. Retrieved October 2014, from Ebscohost Online Library: http://eds.a.ebscohost.com/ehost/detail/detail?sid=d95f0624-25ec-42d5-b7a3-483a63bbf9d8%40sessionmgr4002&vid=0&hid=4203&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=3198881
DSL provides internet access over the regular telephone lines as well, but uses a different bandwidth than voice communications. The remote offices can install special equipment to use both phone and high speed internet at the same time across telephone lines. The transmission speeds of DSL are much faster than that of dial-up internet access but the necessity of special equipment and installation from the provider is a drawback. This article provides an excellent overview of the technology of DSL and a brief discussion regarding security of a computer system that is always connected to the internet. I think that NHS will be able to see that DSL providers often offer some network protection to customers. While the requirement set forth by NHS is to consider the security of the files in transit the security of the network should also be considered. Protection of the total remote office is important and makes DSL a very attractive option for internet service to NHS.

Weldon, M. K., Landegem, T. v., & Szurkowski, E. S. (2008). Next-generation access networks: A preview. Bell Labs Technical Journal, 13(1), 1-10. doi:10.1002/bltj.20278. Retrieved October 2014, from Ebscohost Online Library: http://eds.a.ebscohost.com/ehost/detail/detail?sid=7e665b8a-cb56-4e30-80bc-5ebc1ddccd7f%40sessionmgr4001&vid=0&hid=4203&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=32182949
The remote locations already have phone lines installed but that does not mean there is DSL service available at the locations. Additionally, the transmission speeds are dependent on the location of the offices to the DSL service providers. The article provided here is from Bell Labs and discusses more appropriately the current deployment of DSL access. There are a few diagrams and illustrations that are extremely helpful in explaining the technology and how it is used to access the internet. The article will be most useful for NHS to learn the technical details of DSL connections and how it will enable them to interconnect the remote offices. More specifically, figure 1 and the preceding discussion about quality of service should enable NHS to better compare DSL connections to other broadband solutions.

Cable – Broadband Internet Connection
McGrath, M. (2011). Zeroing the divide: Promoting broadband use and media savvy in underserved communities. National Civic Review, 100(3), 24-28. doi:10.1002/ncr.20068. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=25d7943d-4a13-4e77-b308-49f919ac15f6%40sessionmgr112&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=66793534
Cable internet access provides broadband internet access to users over the cable television lines. The remote locations with access to cable lines would need special equipment but then they could have broadband access. The transmission speeds for cable access can be even higher than DSL depending on the service provided. One disadvantage of cable internet access is that all customers within an area (such as a neighborhood) are sharing the same main trunk line which can lead to congestion during peak communication hours. The article provided from National Civic Review discusses spreading broadband internet access to areas that currently do not have access. This article provides an excellent discussion that NHS can use for future sites that it chooses to open or expand to. While all of the current locations have telephone and cable access, this article discusses how infrastructure can be delivered and installed to remote locations. The information is additionally applicable to DSL connections.

Access to Telecommunications Technology: Bridging the Digital Divide in the United States. (2013). Congressional Digest, 92(4), 2-5. Retrieved October 2014, from Ebscohost Online Library: http://eds.a.ebscohost.com/ehost/detail/detail?sid=3924ce40-65dc-48a2-97da-0332ee3b3eb7%40sessionmgr4004&vid=0&hid=4102&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=86157825
Cable broadband internet access can be a great choice for the remote locations because the performance is not based on location to the service provider like DSL. A point to consider with cable internet access is that the cost can be higher than DSL and dial-up services. This was a very interesting article discussing the adoption of broadband internet access in the United States. The article has a large section discussing the difference of deployment between urban and rural areas. NHS can use this information as a guide to see the relation to cost and the geographical location of remote offices. In addition to purchasing DSL lines as a business, the remote locations are farther from other customers and the article shows that this leads to increased costs associated with providing the internet service. NHS can rest easy as costs should stabilize due to the National Broadband Plan (NBP).

Wireless Internet Connections
Shahriar, A. M., Atiquzzaman, M., & Ivancic, W. (2013). Network Mobility in satellite networks: architecture and the protocol. International Journal Of Communication Systems, 26(2), 177-197. doi:10.1002/dac.1338 Retrieved October 2014, from Ebscohost Online Library: http://eds.a.ebscohost.com/ehost/detail/detail?sid=41c95e51-a929-4cc7-b24a-c2432c950b77%40sessionmgr4003&vid=0&hid=4203&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=85102144
Satellite internet access, like the name implies, uses satellite signals to provide internet access. The remote offices would need to have special equipment installed in order for them to access the internet without any dedicated line of communication being installed to any building. The major advantage to satellite access is that it is available anywhere a user can obtain line of site to the satellite. The largest disadvantage to satellite internet access is that it is fairly expensive to install the specialized equipment. The service fees are also close to, but usually more expensive, than cable internet access. This article provides some insight into the technology of satellite internet access. The focus was primarily on how the satellites manage connections to other networks. NHS can see how satellite internet access works from an overview and then evaluate this is an option compared to other access types. Based on the requirements from NHS I would argue that this is the least favorable option based on the quality of service that would be provided per the discussion later in this article.

Modarres, A. (2011). Beyond the digital divide. National Civic Review, 100(3), 4-7. doi:10.1002/ncr.20069. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=ab91f68f-4bad-413f-83e3-0031831eb42c%40sessionmgr114&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=66793538
The remote locations could all use the satellite access with no need to install telephone or cable lines to the buildings. Satellite internet access can also be installed very quickly since there really is no infrastructure (phone or cable lines) installed – this access only requires the specialized equipment installed at the building. A large drawback to using satellite internet is that while this provides faster transmissions speeds than dial-up it is generally slower than cable and DSL. The article from the National Civic Review discusses the importance of providing internet access to remote areas. NHS is fortunate enough to have locations that all have access to telephone and cable access but satellite access can additionally be used for mobile and future sites that are even more remote than current locations. The article discusses access speeds and NHS would be able to use this information to compare satellite access to other broadband internet access.

Leased Lines
Edwards, M. (1998). Tunneling the Internet. Communications News, 35(3), 96-97. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=016054ed-68ee-4431-baf6-e48db7e7ea61%40sessionmgr113&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ofm&AN=511048622
Leased lines use a dedicated communication line between locations. The remote locations and partner in New York City would all have dedicated communication lines installed physically from the provider to each building. These are normally services from an ISP that are used to link geographically distant offices. The dedicated lines make this option the most secure means to transmit the files but it is the most expensive to install and has the highest service fees. This article provided insight into connecting entire network together. This level of connectivity is not necessary for our scenario but is the most secure option for sending files between the various sites. NHS can use the information, while dated, to compare the characteristics of leased lines with those of additional broadband internet services. This article also discusses the use of virtual private networks (VPN) which could be used for interconnecting business partners. NHS should use the information from this article to understand that VPNs would allow more connectivity and sharing of resources than they require and should not be used in this case. The article clearly states the additional network devices, the additional support staff and maintenance it would require to use VPNs. The cost to NHS using leased lines or even VPN over internet would be too high when compared to other available options.

Shah, K. (1998). An independent approach to the Internet. Telephony, 23452. Retrieved October 2014, from Ebscohost Online Library: http://eds.b.ebscohost.com/ehost/detail/detail?sid=9dcc742f-ff6b-4b2f-98cc-0fc7cc46d07f%40sessionmgr114&vid=0&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ofm&AN=511040231
The leased line option will also provide the remote locations with the most reliable connection to each other and the business partner in New York City. The option may not be available however, based on geographic location of the remote offices and service provider availability. The article from Telephony was interesting because it discussed the changing telecommunications market and how a major opportunity for growth is selling leased lines to small and medium sized businesses. NHS can use the information in this article to compare transmission speeds and bandwidth of T-1 and T-3 lines to other broadband access types. The article also provides some excellent information regarding the dedicated infrastructure that would need to be completed in order for leased lines to be an effective solution for NHS.

Recommended Technological Solution
In order to meet NHS’s goal to provide state-of-the-art health services to its client base I recommend a mix of broadband internet access and a secure file transfer application. NHS should accept this plan based on the moderate cost to implement and maintain the solution. While the ultimate solution would be to install private leased lines between all of the facilities the costs to install those lines would be astronomical. The overall cost for broadband has dropped to relatively affordable prices and all have transfer speeds that enable the transmission of these relatively large files without problem. In order to rapidly transmit the large files I would recommend the cable broadband service since every location has access to a local cable television provider. The installation costs would be minimal and the maintenance costs will be comparable or lower to other options. Cable internet access will also meet the needs of NHS without the concern for weather that has the potential to impede wireless internet access.
The use of broadband internet access does not meet all of NHS’s requirements, however, so an additional solution is necessary to secure the communication between the remote offices and the major hospital in the New York area. The transmission speeds of cable internet access will be able to quickly transmit the files but a secure file transmission system should be configured and deployed. The easiest and most cost efficient manner to accomplish this would be to use a secure file transfer application (secure FTP) to send the image files. Sending the files encrypted without connecting the networks will save NHS from installing and configuring a secure virtual private network (SSLVPN) or generic routing encapsulation (GRE) tunnel with the business partner which would require additional technology hardware, maintenance, and upkeep. Secure FTP would package and encrypt the files so that they would only be readable by the intended recipient. There are free and paid services that can be utilized to send the image files. The application will encrypt the files so they can be transmitted safely between the sites.
Based on the information provided from the scenario I would argue that NHS is in the late majority category of Technology Acceptance. The company appears to be less technically savvy compared to other health care providers and must catch up to meet patient health needs. NHS is aware of the situation and is working to correct it through open cooperation with business partners and across the various offices. I also believe that NHS management would accept this solution as it is proposed. More details would need to be gathered and a legitimate technology plan presented, but this assignment provided enough information for the management team to see that a mix of solutions would be able to meet their needs.