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Health IT and EHRs: Principles and Practice, Sixth Edition

Chapter 11: Information Technology

© 2017 American Health Information Management Association

© 2017 American Health Information Management Association

System Architecture

The technical building blocks that support the operation and use of a computer system

Hardware architecture supports

Input/output

Processing

Storage

© 2017 American Health Information Management Association

Input/Output (I/O) Devices

Also known as human-computer interfaces or workstations, because they are the connection between a human and the computing power of the application in the computer

Input/output devices:

Personal computers

Workstations

Desktops

Laptops or notebooks

Tablets

PDAs

Smartphones

Keyboards

Display screens

Navigational devices

Optical character recognition (OCR)

Document scanners

Barcodes

RFID

Voice or speech input

Printers

© 2017 American Health Information Management Association

I/O Considerations

Source of power

Cabled to electrical outlet or battery

Network connectivity

Wired versus wireless connectivity

Portability

Consider size, weight, heat

Computers on wheels

Wireless on wheels (WOW)

Workstations on wheels (WOW)

Screen (real estate)

Size and resolution

Navigational devices

Consider ease of use and loss concerns

© 2017 American Health Information Management Association

Data Storage

Secondary storage devices (drives)

Secondary to primary storage in the computer’s processors

Storage media

Magnetic tape

Magnetic disks

Optical disks

Flash drives/USB drives

Storage configuration: RAID

Storage architecture

Direct-attached storage

Storage area network

Network-attached storage

Hybrid

Content-addressable storage

Storage management – planning and organizing how data are stored

© 2017 American Health Information Management Association

Processing Capability

CPU (processor)

KB, MB, GB, TB, and beyond

MHz, GHz

ALU/registers

ROM

Booting

RAM

Caching

© 2017 American Health Information Management Association

Computer Categories

Supercomputer

Mainframe computer

Personal computer

Mobile devices: notebooks, laptops, tablets, smart phones

Network computers (thin clients)

© 2017 American Health Information Management Association

Communications and Network Architecture

Firewall

Two or more computers communicating makes a network

Client/server architecture:

Service-oriented architecture, including web services architecture

Cloud computing; virtualization

© 2017 American Health Information Management Association

Network Configuration

LAN

WAN

WLAN

VPN

Network Topology

Physical

Logical

© 2017 American Health Information Management Association

Network Components

Network Operating System

Windows, Unix, or other

Network Interface

NIC, LAN Adapters, wireless access card

Transmission Medium

Hardwire cable, infrared light, radio frequencies

Other devices

Hub

Bridge

Router switch

Gateway

Multiplexor

Modems

© 2017 American Health Information Management Association

Network Protocols

Rules of the road

OSI Model:

Seven layers

TCP/IP

FTP

HTTP

© 2017 American Health Information Management Association

Physical Plant

Data center: location that affords special protection (back-up and disaster recovery) for mission-critical equipment

HVAC

UPS

Console monitoring

Caged server racks

Back-up generators

© 2017 American Health Information Management Association

Software that Supports Health IT

Operating System (O/S)

Platform

Application software

Makes applications perform their functions

Source code

Application software (programs) written in a language computers can convert to electrical pulses. Provides instructions for processing.

Developer of software owns it, and generally licenses it to others, but others cannot alter the software.

Note: Configuration of software during implementation is enabled by the source code allowing

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