Patton-Fuller Community Hospital Networking Project

Patton Fuller Networking Project

Patton-Fuller Community Hospital

Networking Project

shawn williams

IT Infrastructure

Tammy lee

November 24, 2011

Patton-Fuller Community Hospital (PFCH) was established in 1975 and is a for-profit hospital dedicated to serving the needs of its community by providing quality medical care. PFCH operates a 600-bed full-service hospital, providing a variety of programs (Apollo Group, 2006, 2010, 2011). PFCH uses several network systems, including wireless technology.

Multiple technologies are necessary to be used and combined to create a healthcare network infrastructure. Ideally, each of these technologies should integrate into a cohesive network platform capable of delivering network services that are protected, resilient, responsive, and interactive. It is the interconnection and combination of these technologies that provide value and enable clinical and business capabilities in the healthcare environment. PFCH is interested in examining how their network is performing as compared to similar companies.

In-House Data Transmission

PFCHs backbone network structure consists of a 1000Base-T and 1000Base-F standards. The 1000Base-T standard supports data transfer rates up to 1000 Mbps, or one gigabyte per second, and is used in the non-clinical areas of the hospital. PFCH is employing a CAT 6 cable infrastructure for these administrative areas. The clinical areas use the 1000Base-F standard, which is also a 1000 Mbps specification for Ethernet communications over optical fibers. PFCH is currently using single mode optical fiber cable infrastructure for its clinical areas.

The administrative areas are joined to the clinical areas via a network bridge. The administration network is composed primarily of Apple iMAC workstations, HP L1706 thin client computers, and a total of three network laser prints. The OR, ICU, and Ward floors also feature Apple iMAC workstations in both the OR and nurses stations with the RIS imaging utilizing Apple MAC PRO workstations. Each room has one network drop per bed, and at least one Wireless Access Point (WAP) per ICU area. A 24-port hub is used per Ward or ICU. One network printer per nurses station are also deployed.

The Radiology department includes many pieces of medical equipment that require an IP address such as the modality viewing stations, MRI, CT, X-Ray, Mammograms, PET, nuclear medicine, and Sonography. Each modality has its own viewing station complete with an Apple MAC and digital-to-film network printer. The emergency room has one workstation per bay with the portable X-Ray machine, and one regular workstation per ER bay. The laboratories contain networked workstations, and one color laser printer per lab. Pharmacy rounds out the Radiology department with networked workstations, and one laser printer.

The RIS Data Center is outfitted with Apple iMAC workstations, Apple cluster servers running PACS connected to 10 terabytes of storage via a four gigabyte fiber link and backed up to an APC UPS. The center contains one network printer, and one networked laser DICOM to film printer.

Administrative and clinical areas join the IT Data Center via the bridge appliance. The data center contains the hospital HIS system computer, which is an IBM series Z9EC mainframe. The mainframe is connected to a 10 terabyte NAS via a four gigabyte fiber link and is backed up to an APC UPS. The data center runs one Windows Exchange server for its e-mail, and an IBM System x3250 server for Internet services. The Internet server is connected to a Cisco 7609 router, and a RAS server is connected to a Cisco ASA 5510 VPN Router.

External Data Transmission

The hospital HIS system mainframe, Windows exchange server hosting PFHC’s e-mail, Internet server, and RAS server are cabled to 1000 Base-T category 6 Ethernet cable to a pair of routers, one of which is for VPN services, and finally are attached to PFHC’s network gateway, then out to the Internet.

Patton-Fuller OSI Data Model Layers

The Open Systems Interconnection Reference model (OSI) helped establish a framework of standards for computer-to-computer communications that was not based on any particular vendor (Fitzgerald & Dennis, 2009). The OSI model is comprised of seven layers.

Physical Layer

The physical layer represents the first layer of the OSI model and is chiefly concerned with transmitting data in its most basic form of zeros and ones. The physical layer can be seen in the form of an appliance in PFCH’s OR, ICU, and Ward floor systems, in which it uses 24-port FO Hubs. Because the physical layer does not have addresses, hubs function as a splitter.

Data Link Layer

The data link layer is the next layer up, where the physical transmission of data is managed. The data link layer creates and recognizes message boundaries. At this level hardware has media access control addresses (MAC), and here one would find a switch or a network bridge. A bridge, such as the one

Patton-Fuller OSI Data Model Layers (continued)

used by PFCH to connect its clinical and administrative networks, connects two segments of a private network together.

Network Layer

The network layer continues the management of the data by routing where the next computer message should be sent. This is the Internet level of the protocol stack. Routers forward packets of data to other routers or switches. PFCH’s IT data center uses a Cisco router model 7609 to perform these tasks.

Transport Layer

The transport layer is responsible for breaking large strings of data into manageable smaller packets, and other end-to-end issues. Some error checking and elimination of duplicate packets is also involved. A network gateway is a type of router that stands between private networks and the Internet. PFCH uses a network gateway device to interface both their clinical and administrative networks with the Internet.

Session Layer

The session layer manages the session for all users on the network. The session layer also manages the amount of time devoted to transferring the data, and who can transfer the data. Examples of the session layer at work could include interactive logins and file transfer sessions. As with the transport layer, the network gateway is also considered a session layer device or appliance.

Patton-Fuller OSI Data Model Layers (continued)

Presentation Layer

The presentation layer is concerned with formatting, and resolves differences of data format between two different systems. It also translates the data from application format to the network format. Typically encryption, such as PFCH’s AES encryption that it uses for storage, is one example of presentation layer protocol.

Application Layer

The application layer defines the interfaces for communication and data transfer. This is also the end user’s access to the Internet. Some examples of the application layer would include e-mail and web pages. As with the transport, session, and presentation layers, the network gateway appliance is also considered an application layer device or appliance.

Available Communication Protocols

Each of the layers of OSI model also contains communication protocols as detailed below.

Physical Layer – ISDN (integrated services digital network); IEEE 802 (Institute of Electrical and Electronics Engineers) standards restricted to networks carrying variable-sized packets, and IEEE802.2, which is logical link control.

Data Link Layer – Media Access Control; CSMA/CD (carrier sense multiple access with collision detection, also known as Internet).

Available Communication Protocols (continued)

Network Layer – IP (Internet protocol) and IPX (Internetwork packet exchange).

Transport Layer – TCP (transmission control protocol) and NETBIOS (network basic input/output system).

Session Layer – NETBIOS; RPC (remote procedure call); Mail Slots.

Presentation Layer – JPEG (joint photographic experts group); GIF (graphics interchange format); bitmap, all for image representations.

Application Layer – FTP (file transfer protocol); SMTP (simple mail transfer protocol); Telnet.

Recommendations

ANSI/TIA-1179 is the Healthcare Facility Telecommunications Cabling Systems standard. ANSI/TIA-1179 specifies requirements for healthcare infrastructure including cabling and ancillary requirements as well. Although not recommending a particular vendor, Cisco’s Medical-Grade Network (MGN) 2.0 envelopes ANSI/TIA-1179 standards and also outlines best practices for designing a framework to meet healthcare’s unique needs for productivity, security, and ability to exchange and use information with heterogeneous networks. The use of ANSI-TIA-1179 and Cisco’s MGN standards would assist PFHC to have the cabling design to achieve optimal bandwidth use, and implementation of a hierarchical design model using a layered approach in network design that has been used globally by many industries with frequent success (Cisco, 2011). According to the MGN, the principal advantages of the hierarchical model are found in its structure, ability to scale, modularity, and its resulting performance.

Conclusion

PFHC has the backbone network structure that offers sufficient bandwidth, though probably not optimal bandwidth for its current needs. It lacks however in possessing the cabling and architecture to meet future needs. The healthcare industry predicts ever increasing amounts of medical equipment will be digital and require network resources. Similarly, storage requirements are exploding with the expanded standardization and use of the Picture Archiving and Communication Systems (PACS) method of storing medical records. PFHC will also need to boost encryption and security to stay compliant with HIPPAA regulations, especially as it concerns the use of their wireless network. To address these needs, implementing a standard architecture, such as that recommended by Cisco’s MGN and ANSI/TIA-1179 standards could prove to be especially beneficial.

References

Apollo Group Inc. (2006, 2010, 2011). Intranet Home. Retrieved November 25, 2011, from https://ecampus.phoenix.edu/secure/aapd/CIST/VOP/Healthcare/PFCH/HosDepts/CFO/PFCH%202009%20Annual%20Report/2009%20PFCH%20Annual%20Report.pdf

Cisco. (2011). Internet Home. Retrieved November 25, 2001, from http://www.cisco.com/en/US/docs/solutions/Verticals/Healthcare/MGN_Campus.html

Fitzgerald, J. & Dennis, A. (2009). Business data communications & networking (10th ed.). 16-19. Hoboken, NJ: Wiley.

References: Apollo Group Inc. (2006, 2010, 2011). Intranet Home. Retrieved November 25, 2011, from https://ecampus.phoenix.edu/secure/aapd/CIST/VOP/Healthcare/PFCH/HosDepts/CFO/PFCH%202009%20Annual%20Report/2009%20PFCH%20Annual%20Report.pdf Cisco. (2011). Internet Home. Retrieved November 25, 2001, from http://www.cisco.com/en/US/docs/solutions/Verticals/Healthcare/MGN_Campus.html Fitzgerald, J. & Dennis, A. (2009). Business data communications & networking (10th ed.). 16-19. Hoboken, NJ: Wiley.