ITGS Presentation
2013
Conversations, Security Keys,
and BYOD
Dull & Boring Stuff
Communication Protocols
TCP
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Transmission Control Protocol
Transport layer protocol
o Breaks transmission into pieces (packets)
o Supports resending of packets
o Only supports one-to-one communication
o
http://www.dummies.com/how-to/content/the-tcpip-networking-protocol-suite.html
IP
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Internet Protocol
Network layer protocol
o Delivers packets
o Uses logical addresses instead of MAC addresses
o IP address is comprised of two parts
 Network part
 Host part
o Allows for communication to another network
o
TCP/IP, URL, DNS blah blah blah
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URL
Uniform Resource Location
o More English-Like than TCP/IP address
o Domain Name Server (DNS)
 Translates URL to TCP/IP address
o Lets you type www.hectic-dad.com and get to a real
website
o
http://computer.howstuffworks.com/dns1.htm
TCP/IP Protocol Architecture
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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
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Internet Protocol addressing
o
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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)
Growth of Addressing
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2345
MO-2345
MO2-2345
620-662-2345
1-620-662-2345
0011-1-620-662-2345
HTTP
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Hypertext Transport Protocol
Request-Response protocol (ask & ye shall receive)
o Not limited to world wide web (www) communication
o Can be used for other purposes
o Runs on top of TCP network
o Utilizes structured text
o It’s a conversation
o
http://en.wikipedia.org/wiki/Hypertext_Transfer_Protocol
HTTP Example
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Example: You type www.janiepatterson.com
User request to go to the URL

GET / HTTP/1.1
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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
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Last-Modified: Mon, 21 Jan 2002 22:08:33 GMT

Accept-Ranges: bytes
FTP
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File Transfer Protocol
Used to transfer entire files
o Request-Response protocol (ask & ye shall receive)
o Client-server architecture
o Runs on top of TCP-based connection
o Separate control and data connections
o It’s two conversations at once
o
http://www.webmonkey.com/2010/02/ftp_for_beginners/
FTP Example
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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 **********
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Response:230 User mcalore logged in.

Status:Connected

Status:Retrieving directory listing...

Command:PWD
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Response:257 "/users/mcalore" is current directory.
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Command:LIST
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Response:150 Opening ASCII mode data connection for file list.
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
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Lots of names
CPR
o EMR
o EHR
o PHR
o
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Two varieties
o
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Specialty
Patient or Longitudinal
EHR Advantages
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Information accessibility
Information transportability
Improved Clinical Outcomes
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Quality
Reduced Medical errors
Reduced Costs
Individual
o Societal
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EHR Disadvantages
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Upfront acquisition costs
Training costs
Ongoing maintenance costs
Disruptions in workflows
Losses in productivity
Transfer of data entry tasks to providers
Inaccuracy
EHR (DIS)Advantages
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Information accessibility
Information transportability
Improved Clinical Outcomes
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Quality
Reduced Medical errors
Reduced Costs
Individual
o Societal
o
EHR Complications & Concerns
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Complications
Interoperability
o Transferability
o Data siloage
o Lexicon / Terminology
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Concerns
o
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Security
Privacy
EHR Security
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Authentication
o
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One step
Two step
Underlying computer security
Underlying network security
No holes allowed
EHR Access Practicum
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Computer/network steps
EHR login
Patient selection
Patient view
o
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By encounter
By diagnosis
By treatment
BYOD
It’s really easy until you have to
actually support it
BYOD
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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
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Save company money
Appease workers
Users select their own devices
High device familiarity
Increased mobility
Higher job satisfaction
Improvements in efficiency and
BYOD Disadvantages
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Heterogenous devices
Lack of control over data
Security
Privacy
Device control / Acceptable use
Cost-sharing Complications
Support nightmares
Virtual Private
Networks
Playing hide-and-seek on the
world wide web
Virtual Private Networks
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Method of connecting distant computers
Goes through a public network
Extends a private network across public
network
Shares functionality
Security is main goal
Intranets
Playing in your own sandbox
Intranets
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Collection of local network items
Utilize standard network items
Hardware
o Software
o Ethernet, Wi-Fi, TCP/IP
o Web browsers
o Web servers
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Local network using internet technologies
Intranets & Extranets
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Lightning can be VPN
Really *should be*
http://www.skullbox.net/intranet.php
TAANSTAFL
Any guesses?
TANSTAAFL
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There Ain’t No Such Thing As A Free Lunch
Costs associated with technologies
o TCP/IP - overhead
o HTTP - overhead, interpretation time
o FTP - overhead
o EHR Security - hassle, inaccuracy, not perfect
o BYOD - support, heterogenous nature, security
o VPN - support, complexity
o Intranet - support, complexity, overhead
Project Simulation
Kill me now...this is too hard
Implementation Scenario
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The Seven Questions
Who
o What
o When
o Why
o Where
o How
o What aren’t you telling me?
o
Single Provider’s Office
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The Seven Questions
Who - Dr. Hanna Schreiber
o What - Wired network
o When - Yesterday (it’s always yesterday)
o Why - To allow the practice to function
o Where - New Building
o How - Computer network
o What aren’t you telling me? - I dunno
o
Single Provider’s Office
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Wired workstations
Limited connectivity
http://en.wikipedia.org/wiki/Computer_network_diagram
Multiple Providers
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The Seven Questions
Who - Dr. Hanna Schreiber & Dr. Maddie Page
o What - Wired + Wireless network
o When - Yesterday (it’s always yesterday)
o Why - To allow the practice to function
o What aren’t you telling me? - I dunno
o
Drs. Schreiber & Page
http://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png
Dr. Colton “I can do better” Harper
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The Seven Questions
Who - Dr. Colton “I can do better” Harper
o What - Wired + Wireless network
o Why - Because I can provider better medical care
o Where - Right next door in the same building
o What aren’t you telling me? - I want to crush them
o
Dr. Colton “I can do better” Harper
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Two networks - one wireless airspace
http://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png
Dr. Josh “Rule the world” Patterson
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The Seven Questions
o What - Wired + Wireless + Patient Access
o Who - Dr. Josh “Rule the world” Patterson
o Why - To provide one-stop medical care
o Where - The entire floor above the other practices
o What aren’t you telling me? - Mwahahaha
Even more complex
Inter-office Network Issues
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Bandwidth
Wireless cross-over
Privacy
Security