Patton-Fuller Community Hospital bhas been in business in the City of Kelsey since 1975. The hospital provides high quality medical care to the citizens of Kelsey and the surrounding area. Some of the services the hospital offers are x-rays, pharmacy, and emergency services for children and adults. “As one of the first hospitals in Kelsey, the staff is committed to providing a variety of programs that will support the health and welfare of the local community populations” (Apollo Group, 2010). The hospital’s backbone network structure for the entire hospital is 1000Base T. Some of the other individual sections of the departmental network use different standards such as 1000Base F. The areas that use the 1000Base T are responsible for the administrative side of things. These areas are: hospital executive management, human resources, operations, facilities, finance, and IT data center. The areas that use the 1000Base F are responsible for the clinical areas. They include: radiology, operating rooms, wards, ICU’s, emergency rooms, labs, and pharmacy. For a failsafe, the entire hospital has a complete power backup system that automatically cuts over to a large diesel motor generator set. The hospital uses a network bridge to interconnect its logical network. A network bridge connects multiple network segments at the data link layer, which is Layer 2 of the OSI model. The Data Link Layer enables data to be transferred between network entities and might provide the means to detect and possibly correct errors that may occur in the Physical Layer. The hospital’s network is an Ethernet network. The Ethernet network uses a protocol called CSMA/CD which stands for Carrier Sense, Multiple Access with Collision Detection. The computers that use 1000Base T are networked with Cat. 6 cable. This cable allows for backward compatibility with the Cat. 5 and Cat. 3 cable standards but offers an increase in performance of up to 250 MHZ. The computers that use the 1000Base F are networked with single mode fiber because it performs at high speeds without the need to be refreshed and have higher bandwidth than multimode fiber. In order to have access to the Internet, Patton-Fuller utilizes a Cisco Router model 7609. It is connected with an Optical Carrier 1 line that has speeds of up to 51. 84 m/bits. The hospital also utilizes a Cisco ASA 5510 Virtual Private Network which “enables organizations to securely provide network access to a broad array of users, including mobile and fixed endpoints, remote offices, contractors, and business partners” (Cisco, 2010). With combined use, network traffic will flow smoother. The hospital is using a Cisco 1250 series for wireless access. It supports the 802. 11standard. The access points offer combined data rates of up to 600 Mbps to provide users with mobile access to high-bandwidth data, voice, and video applications regardless of their location, use multiple-input multiple-output (MIMO) technology to provide reliable and predictable WLAN coverage, and improve user experience for both existing 802. 11a/b/g clients and new 802. 11n clients” (Cisco, 2010). The OSI layers that are directly involved in the networking system of Patton-Fuller are the physical layer, data link layer, network layer, transport layer, session layer and application layer. The physical layer is all of the hardware that the hospital uses. This includes such things as the Apple iMacs, servers, and routers. The data link layer is where the data transfer takes place. The network layer routes the messages using TCP/IP. The transport layer ensures that the data is properly sequenced and transferred without errors. It uses the TCP/UDP protocol. The session layer handles the processes between the client and the server. A common protocol used here is RPC. The application layer enables user applications to work with the network. Some common protocols here are HTTP, SMTP, and POP3. I would recommend that the hospital use the TCP/IP, and HTTP protocols as a standard. Both protocols are reliable and will meet the needs of the hospital. Patton-Fuller’s backbone network structure for the entire hospital is 1000Base T. Some of the other individual sections of the departmental network use different standards such as 1000Base F. The two networks are connected by a network bridge. The network bridge is used to inexpensively and easily connect local area network segments (Microsoft, 2010). The reason a network bridge is inexpensive is that there is no configuration required and you don’t have to purchase additional hardware such as routers and other bridges. The hospital’s administrative network consists of Apple iMACS and thin computers that use 1000Base T with CAT 6 cables. All work stations belonging to Executive Management has Apple iMAC computers with 24” monitors, 2. 4 GHz speed, 2 GB RAM, and a 500 MB hard drive. Human Resources, OPNS, and the Finance Senior Managers have Apple iMACS with 20” monitors, 2 GHz speed, and a 350 MB hard drive. All of the systems have OS virtualization and use the MAC Operating System X, Leopard, and Windows XP. OS virtualization allows separate, isolated virtual environments to be used on a single server. The MAC Operating System X is a UNIX system that is both simple and powerful. Leopard further enhanced the system by making it faster and more reliable. Windows XP is a product of Microsoft but it is able to be installed on any MAC using a native version of Microsoft Office. This way users are able to create documents using MS Word, make presentations using PowerPoint, and make spreadsheets with Excel, among other things. All personnel who are only involved in data entry in HR, OPNS, and Finance are only given thin computers made by HP that come with 17” flat monitors. Thin computers only provide access to a network. They don’t have a hard drive, fan, or any other moving parts. They are ideal for hospitals since they offer more secure storage of data than desktops or notebooks. This feature will help the hospital more effectively comply with HIPPA laws. These type of computers are also energy efficient and very reliable. The following are using 1000 BaseF single mode fiber: MRI, CT, X Ray, Mammograms, PET, Nuclear Medicine, and Sonography have their own viewing station. This department uses a UPS to protect the data sent and received here. They utilize an Apple MAC Pro with 2-3 GHz processors, 16 GB RAM, 4-750 hard drive in RAID, a FO network card, 30” cinema displays, imaging software, as well as the MAC Operating system with OS Virtualization. The emergency room has 1 workstation with a portable x-ray machine. It is a MAC Pro with 2 dual 3 GHz processors, 8 GB RAM, 2-750 GB HD RAID, Fiber Card, SuperDrive, 30” display, and the MAC OS with OS virtualization. The regular workstations use a 20” iMAC with a 2 GHz processor, 2 GB RAM, 350 GB hard drive, SuperDrive, and fiber card. They are operating with the same MAC Operating System with OS Virtualization as the rest of the hospital. The SuperDrive allows for the reading and writing of media stored on different storage devices, such as CD/DVD. The fiber card allows for the prioritization of network traffic which is very important in a hospital because of the nature of some of the emergencies that occur there. The labs and the pharmacy are basically running on the same system as the ER bays with the exception of a 2. GHz processor and 500 MB RAM. The RIS Data Center is also using 1000 BaseF single mode fiber. It is running Apple Cluster Servers with the MAC OS that has remote desktop access. This allows for files to be accessed from home or on the road with the correct credentials. There is 10 terabytes of storage with a 4 GB fiber link. The data workstations are consistent with those in radiology, the labs, and the pharmacy. The RIS Data Center has an UPS (uninterruptible power supply) to protect the performance of the server. The OR, ICU, and Ward floors are using 1000 Base F with single mode fiber technology. The nursing stations and OR stations are using Apple MAC machines with 20” monitors, 2 GHz processors, 2 GB RAM, 350 MB HD, fiber card, SuperDrive, and Wireless. They are using the same OS as the rest of the hospital, the MAC OS X. Each room in the ICS has one network connection per bed. There is a 24 port FO hub per ward for connection to the network. RIS Imaging is using an Apple MAC Pro with 4 GB RAM, 30” flat panel display that is wall mounted, 2-3 GHz dual processors, 750MB HD, and a video and fiber card. The entire hospital is using the same OS. The IT Data Center is using 1000 BaseT technology. The center is using the CISCO Router 7609 and CISCO ASA 5510 VPN Router. Both of these routers have built in redundancy for accessing the Internet. The HIS system computer is a IBM series mainframe that is using the Linux OS. It is using DB 2 and has 18 processors, as well as 32 GB RAM and AES security which is an intrusion prevention system. There is also a Windows Exchange Server, an Internet Server, and a RAS server. There is a UPS in the data center to protect the servers in case of a power surge. It seems that the only Wi-Fi access in the hospital is for the staff, patients, and maybe the patient’s guests. Since there is only one connection per bed, the access to Wi-Fi seems to be very limited. Perhaps, the hospital could consider using Broadband cellular wireless as an alternative in order to avoid interference with the network already in place which the staff uses and to lower the risk of data getting into the wrong hands. If the hospital does want to expand its use of Wi-Fi for the hospital, it may need to install many more access points. Hospitals have two major obstacles when it comes to Wi-Fi and that is their thick walls and interference caused by medical devices. This is why I would suggest using the broadband cellular technology instead. Something that may be missing from the hospital’s network architecture is a wireless Gateway security system. The hospital should also consider using 802. 1 x for access control to the network. It should also consider using audit controls and a NIDS. To enhance the signal of the Wi-Fi network, the hospital could use directional antennas. Patton-Fuller strives to effectively meet the needs of the patients it serves through the people that it employs. There are several positions available at Patton-Fuller from certified nursing aide to Chief Operations Officer. Each individual has his/her own set of unique responsibilities. The hospital has services such as emergency care, x-ray, Sonography, and pharmacy. Due to the different requirements of the people served at the hospital, the staff has to be diversified and specialized. This diversification may lead to communication problems if the right steps aren’t taken. To ensure the correct steps are taken to counter potential communication problems, the Chief Information Officer is in charge of overseeing the Compliance Program. The officer “functions as an independent and objective body that reviews Hospital policies and evaluates compliance issues/concerns within the organization. The position ensures that the Board of Directors, management and employees are in compliance with the rules and regulations of federal and state regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the company’s Standards of Conduct” (Apollo Group, 2010). Some of the responsibilities of the CIO is developing, implementing, and maintaining a system-wide Corporate Compliance program, overseeing the Security Officer, the Director of Medical Records and the Director of Q. A. / Risk Management (Apollo Group, 2010). An important part of the successful operation of any business is Customer Relationship Management or CRM. Because hospitals “utilize the services of doctors, nurses, technicians, and other related specialists in the treatment and management of illness, including efforts to preserve mental and physical wellness” (Salesboom, 2010), an effective CRM solution would be ideal. Costs have steadily increased in the medical field and there are ways to find better, more cost efficient services. One way is by purchasing CRM software from Salesboom. This software accommodates the activities of all stakeholders involved; including patients and doctors, pharmaceutical companies and druggists, hospitals and insurance providers. “Some of the common driving forces for undertaking a CRM solutions in the Healthcare Sector are: •Cost and spending constrains – The growing proportion of older people and the constant development of new treatments means demand for healthcare is rising. Hospitals can utilize CRM software applications to control costs and more effectively automate operations. •Patients and system users are educated – People access the Internet to research medical options, and as a result are better educated and more demanding of service levels in health care settings. •Desire to anticipate the needs and drivers in healthcare delivery to meet patient needs. •CRM solutions on market – Maturing CRM technologies can deliver cost efficient solutions” (Salesboom, 2010). Salesboom CRM software addresses and integrates enterprise requirements from the following three key areas; Operational, Analytical, and Collaborative. The degree of detail and integration is scalable, and can be modified by as needed by the users. There is customer service, support, training, and professional services offered as needed. Information within the system is secure and accessible based on a highly scalable permissions tree. When scaling the access to information on the site, resources are able to be appropriately protected and information resources are able to be opened up for sharing based on organizational need. Furthermore, there is an Audit Trail functionality built into every item into the system. “This assures system services that can identify any information changes, access and sharing activities (and the owners) on the system. You can access Audit information at any time for review and reporting purposes and to demonstrate due diligence in adherence to legal, financial and medical regulations common in the Healthcare Sector’ (Salesboom, 2010). Salesboom CRM software facilitates organizations in the Healthcare Sector to meet the changing and rigorous protocols from a variety of regulatory agencies that track activities within the sector. These include Environmental, Occupational Safety and Health Administration (OSHA) and the Food & Drug Administrations, and various protocols such as Emergency Protocol, Resuscitation Protocols, Research Protocols, and Services Protocols, Patient Rights, Organ and Tissue procurement, etc. Compliance with these protocols and regulations will help avoid errors and potential legal action. Salesboom CRM will deploy a solution that enhances services and processes so the hospital can achieve a positive ROI in as short a time as possible: •Software Solution – our team will help develop CRM plan, strategic placement and requirements development •Identify and automate business processes •Software and/or process customization •Integration of CRM Software (with existing software) •Cleanse/Import Data •Reporting on implementation/deployment •Professional Training Services and Support Services” (Salesboom, 2010). Through streamline production and distribution operations, Salesboom CRM implementation guarantees cost containment using front and back end tools as part of standard software offerings. The company guarantees visibility across all areas from finance to manufacturing and across the supply chain within exceedingly generous timeframes. To meet the long term goals of the hospital, Patton-Fuller definitely should implement this new system in order to stay ahead of the game. In today’s times, many businesses are starting to make a Web presence and hospitals are one such business. Some services that Patton-Fuller could make available through a Web Portal are: the ability to subscribe to electronic newsletters, viewing of peoples public information that are currently in the hospital, such as patients’ room numbers, and the ability to purchase hospital uniforms online. Some online services that are available at other hospitals include: the ability to pay bills online, research available positions and fill out applications, and transmit data to doctors from monitoring devices from the comfort of your own home. These services may be used at Patton-Fuller to make things more convenient for patients who owe bills and have mobility limitations, make applying for a job quicker and easier, and allow doctors to receive vital information without requiring a patient to drive all the way to the hospital. The Web Portal could also be expanded to provide outside vendor services such as, Just in Time pharmaceutical replenishment and inventory updates. Just in Time pharmaceutical replenishment will allow the hospital to automatically replenish stock and optimize inventory. These processes will be automated, meaning they are automatically system generated and will result in greater efficiency of handling the pharmacy’s stock. Another online tool that is being used today is social networking sites. The use of such sites may expand the hospital’s community base by exposing information to a multitude of people. Sites such as FaceBook, Twitter, and MySpace are very popular, with the average user having 100+ friends (UOP, 2010). That will result in a lot of exposure. On the other hand, if someone writes a bad review, it could hurt the reputation of the hospital. In conclusion, Patton-Fuller Community Hospital is a reliable place to seek medical treatment if you are in the area. It has a nice size, fairly up-to-date network in place, with the exception of needing more Wi-Fi access and greater security controls. The hospital has a very capable and caring staff onboard and with the adoption of a CRM plan, the limits are endless. Finally, if Patton-Fuller makes a Web portal available, it will be able to reach out to more people and attain a greater customer base. References Apollo Group, Inc. (2010). Patton-Fuller. Retrieved August 16, 2010 from https://ecampus. phoenix. edu/secure/aapd/CIST/VOP/Healthcare/PFCH/IT/ITNetDTop. tm Cisco. 2010. Retrieved August 16, 2010 from https://www. cisco. com/en/US/prod/collateral/vpndevc/ps6032/ps6094/ps6120/prod_brochure0900aecd80402e39. html Microsoft. (2010). Network Bridge. Retrieved August 23, 2010 from https://www. microsoft. com/resources/documentation/windows/xp/all/proddocs/en-us/hnw_understanding_bridge. mspx? mfr=true Salesboom. (2010). CRM for Hospitals. Retrieved August 30, 2010 from https://www. salesboom. com/products/Hospital-crm-software-solution. html University of Phoenix. (2010). Social Networking Sites. Retrieved September 6, 2010 from University of Phoenix, CMGT 554 website.
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