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ITGS Presentation 2013. Conversations, Security Keys, and BYOD. Dull & Boring Stuff. Communication Protocols. TCP. Transmission Control Protocol Transport layer protocol Breaks transmission into pieces (packets) Supports resending of packets Only supports one-to-one communication
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ITGS Presentation 2013 Conversations, Security Keys, and BYOD
Dull & Boring Stuff Communication Protocols
TCP • Transmission Control Protocol • Transport layer protocol • Breaks transmission into pieces (packets) • Supports resending of packets • Only supports one-to-one communication http://www.dummies.com/how-to/content/the-tcpip-networking-protocol-suite.html
IP • Internet Protocol • Network layer protocol • Delivers packets • Uses logical addresses instead of MAC addresses • IP address is comprised of two parts • Network part • Host part • Allows for communication to another network http://www.dummies.com/how-to/content/the-tcpip-networking-protocol-suite.html
TCP/IP, URL, DNS blah blah blah • URL • Uniform Resource Location • More English-Like than TCP/IP address • Domain Name Server (DNS) • Translates URL to TCP/IP address • Lets you type www.hectic-dad.com and get to a real website http://computer.howstuffworks.com/dns1.htm
TCP/IP Protocol Architecture • Envelope Example http://www.thegeekstuff.com/2011/11/tcp-ip-fundamentals/ http://technet.microsoft.com/en-us/library/cc786128(v=ws.10).aspx
TCP/IP Addressing • Internet Protocol addressing • IPv4 • Address every device on the planet (hahahaha) • 232 addresses (4,294,967,296) • 4 octets (192.168.1.1) • IPv6 • 2128 addresses (way more) • 16 octets (192.168.1.1.1.0.0.0.2.0.0.3.0.0.0.0) • Address like phone number, same evolution http://en.wikipedia.org/wiki/IP_address
Growth of Addressing • 2345 • MO-2345 • MO2-2345 • 620-662-2345 • 1-620-662-2345 • 0011-1-620-662-2345
HTTP • Hypertext Transport Protocol • Request-Response protocol (ask & ye shall receive) • Not limited to world wide web (www) communication • Can be used for other purposes • Runs on top of TCP network • Utilizes structured text • It’s a conversation http://en.wikipedia.org/wiki/Hypertext_Transfer_Protocol
HTTP Example • Example: You type www.janie-patterson.com • User request to go to the URL • GET / HTTP/1.1 • Accept: text/*, image/jpeg, image/png, image/*, */* • Accept-Language: en, en_US • Host: www.janie-patterson.com • HTTP/1.1 200 OK • Date: Thu, 24 Jan 2002 17:33:52 GMT • Server: Apache/1.3.14 • Last-Modified: Mon, 21 Jan 2002 22:08:33 GMT • Accept-Ranges: bytes • Content-Length: 9696 • Connection: close • Content-Type: text/html note: URL = Universal Resource Locator. Translated to a TCP/IP address 66.39.89.30 http://www.silicon-press.com/briefs/brief.http/brief.pdf
FTP • File Transfer Protocol • Used to transfer entire files • Request-Response protocol (ask & ye shall receive) • Client-server architecture • Runs on top of TCP-based connection • Separate control and data connections • It’s two conversations at once http://www.webmonkey.com/2010/02/ftp_for_beginners/
FTP Example • User request to transfer a file • Status:Connecting to ftp.fakesite.org ... • Status:Connected with ftp.fakesite.org. • Response:220 ProFTPD 1.2.4 Server (ProFTPD) [109.41.xx.xxx] • Command:USER mcalore • Response:331 Password required for mcalore. • Command:PASS ********** • Response:230 User mcalore logged in. • Status:Connected • Status:Retrieving directory listing... • Command:PWD • Response:257 "/users/mcalore" is current directory. • Command:LIST • Response:150 Opening ASCII mode data connection for file list. • Response:226 Transfer complete. • Status:Directory listing successful
Slightly More Interesting Stuff EHR Security, Using EHRs, BYOD, VPN, Intranets, and TANSTAAFL
Electronic Health Records An alphabet soup and a can of worms
Electronic Health Records • Lots of names • CPR • EMR • EHR • PHR • Two varieties • Specialty • Patient or Longitudinal • Beware of data silos
EHR Advantages • Information accessibility • Information transportability • Improved Clinical Outcomes • Quality • Reduced Medical errors • Reduced Costs • Individual • Societal • Data mining
EHR Disadvantages • Upfront acquisition costs • Training costs • Ongoing maintenance costs • Disruptions in workflows • Losses in productivity • Transfer of data entry tasks to providers • Inaccuracy • Physician liability risks
EHR (DIS)Advantages • Information accessibility • Information transportability • Improved Clinical Outcomes • Quality • Reduced Medical errors • Reduced Costs • Individual • Societal • Data mining
EHR Complications & Concerns • Complications • Interoperability • Transferability • Data siloage • Lexicon / Terminology • Concerns • Security • Privacy • Patient Targeting http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270933/
EHR Security • Authentication • One step • Two step • Underlying computer security • Underlying network security • No holes allowed
EHR Access Practicum • Computer/network steps • EHR login • Patient selection • Patient view • By encounter • By diagnosis • By treatment
BYOD It’s really easy until you have to actually support it
BYOD • Policy-based • Allow employees to bring personally owned mobile devices to work and use those devices to access privileged company information and applications http://en.wikipedia.org/wiki/BYOD
BYOD Advantages • Save company money • Appease workers • Users select their own devices • High device familiarity • Increased mobility • Higher job satisfaction • Improvements in efficiency and productivity http://www.businesszone.co.uk/blogs/scott-drayton/optimus-sourcing/advantages-and-disadvantages-byod http://www.mcpc.com/benefits-of-BYOD
BYOD Disadvantages • Heterogenous devices • Lack of control over data • Security • Privacy • Device control / Acceptable use • Cost-sharing Complications • Support nightmares http://searchconsumerization.techtarget.com/guides/How-to-weigh-BYOD-benefits-and-risks http://searchconsumerization.techtarget.com/tip/BYOD-pros-and-cons-Spend-less-on-devices-more-on-support
Virtual Private Networks Playing hide-and-seek on the world wide web
Virtual Private Networks • Method of connecting distant computers • Goes through a public network • Extends a private network across public network • Shares functionality • Security is main goal http://en.wikipedia.org/wiki/Virtual_private_network
Intranets Playing in your own sandbox
Intranets • Collection of local network items • Utilize standard network items • Hardware • Software • Ethernet, Wi-Fi, TCP/IP • Web browsers • Web servers • Local network using internet technologies http://compnetworking.about.com/cs/intranets/g/bldef_intranet.htm http://medicalexecutivepost.com/2009/06/26/healthcare-intranets-and-extranets/
Intranets & Extranets • Lightning can be VPN • Really *should be* http://www.skullbox.net/intranet.php
TAANSTAFL Any guesses?
TANSTAAFL • There Ain’t No Such Thing As A Free Lunch • Costs associated with technologies • TCP/IP - overhead • HTTP - overhead, interpretation time • FTP - overhead • EHR Security - hassle, inaccuracy, not perfect • BYOD - support, heterogenous nature, security • VPN - support, complexity • Intranet - support, complexity, overhead
Project Simulation Kill me now...this is too hard
Implementation Scenario • The Seven Questions • Who • What • When • Why • Where • How • What aren’t you telling me?
Single Provider’s Office • The Seven Questions • Who - Dr. Hanna Schreiber • What - Wired network • When - Yesterday (it’s always yesterday) • Why - To allow the practice to function • Where - New Building • How - Computer network • What aren’t you telling me? - I dunno
Single Provider’s Office • Wired workstations • Limited connectivity http://en.wikipedia.org/wiki/Computer_network_diagram
Multiple Providers • The Seven Questions • Who - Dr. Hanna Schreiber & Dr. Maddie Page • What - Wired + Wireless network • When - Yesterday (it’s always yesterday) • Why - To allow the practice to function • What aren’t you telling me? - I dunno
Drs. Schreiber & Page http://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png
Dr. Colton “I can do better” Harper • The Seven Questions • Who - Dr. Colton “I can do better” Harper • What - Wired + Wireless network • Why - Because I can provider better medical care • Where - Right next door in the same building • What aren’t you telling me? - I want to crush them
Dr. Colton “I can do better” Harper • Two networks - one wireless airspace http://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png
Dr. Josh “Rule the world” Patterson • The Seven Questions • What - Wired + Wireless + Patient Access • Who - Dr. Josh “Rule the world” Patterson • Why - To provide one-stop medical care • Where - The entire floor above the other practices • What aren’t you telling me? - Mwahahaha
Inter-office Network Issues • Bandwidth • Wireless cross-over • Privacy • Security