Transcript presentation source

Internet/Intranet/Extranet
The Access Revolution
INDT 112, SETC 112, SECS 112
Wednesday, August 22, 2001
11:30 – 12:30
InSight Conference
San Diego, CA
August 18-22 , 2001
Fred Henning
Sr. Technology Analyst
Alexian Brothers Medical Center
Elk Grove, IL
8.17.2001
InSight 8.22, 2001
1
Alexian Brothers Health System
• Alexian Brothers Medical Center, Elk Grove, IL
• St Alexis Medical Center, Hoffman Estates, IL
• Alexian Brothers Behavioral Health Hospital, Hoffman
Estates, IL
• Retirement Communities & Nursing Homes
Milwaukee, WI -Signal Mountain & Chattanooga, TN - St Louis, MO
• Alexian Brothers Health Providers (managed care)
• Bonaventure Medical Foundation (phy. offices)
• ‘Alexian Field’, etc.
8.17.2001
InSight 8.22, 2001
2
Alexian Brothers Medical Center
The Alexian Brothers
700 year old worldwide religious congregation
ABMC Elk Grove
450 licensed beds
800 + physicians
3000 + employees
Elk Grove Village
Chicago suburb
western boundary of O’Hare airport
population 35,000
5000 + industrial occupancies
work force of 90,000
8.17.2001
InSight 8.22, 2001
3
This is NOT about www.alexian.org
the Alexian Brothers Home Page
8.17.2001
InSight 8.22, 2001
4
The Schedule said this is about:
• What is an
– Internet
– Intranet
– Extranet
•
•
•
•
Or- What Happened to my
LAN & WAN !
use them to expand access to ‘data’
methodologies for implementing
Retrieving data
Bonus - Internet Technology
8.17.2001
InSight 8.22, 2001
5
Alexian Brothers of Illinois - Intranet / Extranet:
North
Wimmer
Pavilion Bldg
Brock
Plaza
Niehoff
Pavilion
Woodlands
office complex
Bensenville
OH
BMF
Wood Dale
Hanover Park
BMF, OH, HH
Hospital
Elk Grove
ABHS
BMF, OH
St Alexis
ABMC
ABHP
BMF
Acct., PFA
Marketing
I.S. staff
Itasca
Hoffman Est
Data Center
ABBHH
BMF, MH/A
Schaumburg
OH
Digital/isdn
isp
other
Mt Prospect
Clinic
hbocvan
analog
Internet
8.17.2001
P.S.N
InSight 8.22, 2001
Business Partners
Physicians
6
Internet Connection:
AT&T Global
HBOCvan
Internet
user ID ALHS
56k telco line
DSU/CSU
Router
157.196.20.1
Focal
Network
Elron Internet Manager
157.196.253.70
Concentrator
Library Proxy Server
ISP
28115 Switch
Local COs
157.196.216.126
A
router
Cisco Router
209.172.185.25
209.172.185.26
157.196.229.14
:80 ABHS Intranet
SynQuest CBT
Fwd Advantage FAX Server
MS-SQL
157.196.229.12
alexian.smpt
SMTP Internet Mail Server
8.17.2001
Isolation
Firewall ver 6.7
157.196.20.2
T1 telco line
DHZA622375
DNS Servers
209.172.128.2
209.172.128.8
209.172.187.73
Dial up users
www.AlexianResults.net (Palm Project)
www.alexian.net (VPN access test page)
209.172.186.190
157.196.250.22
LINUX ftp & www Server
InSight 8.22, 2001
7
What Clouds are in your Sky?
Those direct connect circuits are not direct!
Ameritech Frame Relay
PSN
AT&T Frame Relay
56k
Business
partners
UUNet
Ameritech Networks
56k
T-3
AT&T - IBM Global
HBOCVAN
Old copper
DS3 Fiber
ISP
T-1
Alexian Brothers Data Center
8.17.2001
InSight 8.22, 2001
Saven
8
Internet Technology is the Key:
• understand an organizations’ use of Internet Technology
– e-mail
– WWW
– etc.
• various other technologies
– identify their potential
– identify HIPAA issues
• reality check - not just the hype
– resources
– costs
8.17.2001
InSight 8.22, 2001
9
From ArpaNet to Internet:
1970 ArpaNet a few Universities and
Government Installations with Large
Computers began to be interconnected.
1992 - 50 WWW sites
Today 10,000,000
8.17.2001
InSight 8.22, 2001
10
There must be a reason !
Today there are at least
5,000,000,000 pages - Yes, that’s
BILLION ! ! pages
4,400 new sites per day
Google is searching almost 1.5 Billion Pages !!
8.17.2001
InSight 8.22, 2001
11
‘The’ Internet is more then WWW
• We are really talking about the public
internet. (There are two Internets + 3rd?)
• Most of the time we are talking about a
portion of the internet that understands
HTML and can present graphics using
software known as a ‘browser’. This part
of the internet is known as the ‘world
wide web’. (www.somename.com)
8.17.2001
InSight 8.22, 2001
12
Vocabulary:
Internet:
A grouping of Resources and networkS
1970 > ArpaNet, US DOD, Telephone lines 56k
Original internet is what we are using
the original Universities and DOD are using a 100 megabit + network
tcp/ip:
transmission control protocol / internet protocol
r-login:
remote login
finger:
‘finger the suspect’, find out who is the person or personal information attached to a
userid (login name)
usenet:
Users Network, Discussion groups
Archie:
What ftp site has the file you want
Gopher:
Menu system to find text information
Veronica: search all menus on all gopher sites
Jughead: search specific menus on specific gopher sites
mosaic: Marc Andreessen (national center for supercomputer applications, university of illinois),
imbedded graphics, multimedia applications, color - links change when used webcrawler
search engine (Yahoo, etc.)
telnet:
port 23
e-mail:
SMTP (simple mail transfer protocol), MIME multipurpose internet mail extensions
ftp:
File Transfer Protocol
www:
port 80
URL:
www.fredhenning.com, [email protected]
domain name: .com, .gov, .org, .ie (Ireland) = top level domains
Hypertext: HTML, the code used to format text on the screen
Hyperlink: an imbedded path to a new location, in the document, another document or another
URL
8.17.2001
InSight 8.22, 2001
13
Internet Topics:
• Choosing an ISP
•
•
•
•
local phone numbers
multiple access to backbone
security
VPN experience
• why does it appear slow to users
• Security
• being a policeman
8.17.2001
InSight 8.22, 2001
14
What is the BIG Issue?
• In real estate it’s
– location, location, location !
• With the Internet it’s
– Bandwidth, bandwidth & more bandwidth !
8.17.2001
InSight 8.22, 2001
15
Bandwidth:
• analog telephone - 6000 bits/sec • in our tests with transcriptionists - 18,000 bps was
required for just one way on a digital line
• 56Kb = 56,000 bits/sec
• (56,000/8 = 7000 bytes (characters) sec)
• T1 = 1,540,000 bits/sec Max!!
• U.S. - 24, 56Kb voice channels
• NTSC Television - 5,000,000 bits/sec
• Resolution, color depth, audio quality
• compression, CODEC
8.17.2001
InSight 8.22, 2001
16
What about Internet speed!
Do you think you need more then a T-1?
Local
My PC Telco
ISP’s Internet
connection to
Backbone
Web page
ISP
My ISP
Local
Telco
On site Web
page server
8.17.2001
InSight 8.22, 2001
17
Our Portal:
8.17.2001
InSight 8.22, 2001
18
Issues:
Access to e-mail Pornography
unauthorized e-mail encryption
liability issues
breaches of confidentiality
productivity loss - personal e-mail and internet usage
large e-mail attachments - web graphics/downloads
Chat Rooms
Spam and spoof attacks (ping to death, etc.)
Virus, Trojan horse, worms
malicious Java and ActiveX code
archiving - long time because of music, graphics, etc
8.17.2001
InSight 8.22, 2001
19
The Hidden Costs:
•
•
•
•
=
•
•
•
Finding & saving music
watching streaming video
sending & receiving personal e-mail
sharing jokes, pictures via e-mail
Network Bandwidth
Storage & Backup
Security & PC Maintenance
8.17.2001
InSight 8.22, 2001
20
What does Internet Access Cost ?
June 2001 data:
Average time spent per employee – with Internet access.
22 hours 38 minutes per month.
If 500 PCs have Internet access and
disregarding the fact that there are 3 shifts
IF only 100 employees surfed at the National Average !
100 x 22.5 hours @ $21 per hour (wages) = $ 47,250 / month
@ $49 per hour (cost) = $110,250 / month ! ! ! !
8.17.2001
InSight 8.22, 2001
21
Who took over my PC?
Bill G said I
could !
What about ‘Smart Tags’ taking you to
ONLY Microsoft Sites ?????
I set up a Power Point on the Intranet site
I was viewing it and came to a slide with animation.
My PC went out over the internet to Microsoft and
downloaded an ActiveX component to allow me to
view the animation.
Using Microsoft Word and all of a sudden the PC
goes of to the Microsoft site for an update of the
functionality you are using
How is the Internet Security Set on user PCs?
8.17.2001
InSight 8.22, 2001
22
Where did all the disk space go?
When you use the internet you
accumulate all types of interesting
artifacts, pages, components,
beans,etc., etc.
8.17.2001
InSight 8.22, 2001
23
Internet Access Login:
8.17.2001
InSight 8.22, 2001
24
You Must Login:
8.17.2001
InSight 8.22, 2001
25
Policy Status !
• strictly enforced
• looking at one
• should have one
• lawsuits from offensive e-mail
• scandal - porn (chat rooms)
• costs - productivity, systems, resources
8.17.2001
InSight 8.22, 2001
26
Administrative Policy:
8.17.2001
InSight 8.22, 2001
27
How to get Administration involved!
So they won’t review your Internet policies!
Examples:
Medical Library
Materials Management
Human Resources
Division VPs
The
8.17.2001
gets out!
InSight 8.22, 2001
28
Internet Management System:
Switch
Concentrator
NT PC
Elron Internet Manager
firewall
LAN / Intranet
Router
ISP
Internet
8.17.2001
InSight 8.22, 2001
29
Looking for Bad Words !
8.17.2001
InSight 8.22, 2001
30
SEX!
8.17.2001
InSight 8.22, 2001
31
HTCIA:
The day of the Security Officer issuing
passwords and file access is over !
8.17.2001
InSight 8.22, 2001
32
The Firewall, Security's
First Line of Defense
Our FireWall - Isolation Systems (Shiva/Intel)
proprietary operating system
Individual circuit cards with their own CPUs and Memory for various functions
capable of 10,000 Internet users
VPN function occurs within the Firewall System
capable of 1024 VPN connections
3 levels of encryption complexity
Password, Certificate and/or Token security
8.17.2001
InSight 8.22, 2001
33
When is it Safe?
Basic Security Concept
physical security is primary
place the document in a safe
lock the safe
don’t share the password
don’t leave the password accessible
LOCK the Door!
8.17.2001
InSight 8.22, 2001
34
How does this apply?
a HIPAA issue
• Physical security is primary
• place the document in a safe
• lock the safe
• = Encrypt the data
– in your data base
– on the local PC
– in transmission across your network
• don’t share the password
• don’t leave the password accessible
– use a continually changing KEY
– control the Encryption KEY
8.17.2001
InSight 8.22, 2001
35
How do you Lock the Door?
Firewall
in bound - out bound
trusted sites
VPN
password, certificates, tokens
Frame Relay, ATM, Dedicated Circuits (fiber, copper)
part of the public network
Ameritech, Southwestern Bell
part of a private network
AT&T, IBM Global, HBOCVAN
Can I use the Internet ?
8.17.2001
InSight 8.22, 2001
36
VPN Users:
•
•
•
•
IR staff after hours access / support
Medical Center staff remote access
Physician View access
Business Partner Access
– collection agencies
• StoreCom PAX development
• Cortex upgrade support
• etc.
8.17.2001
InSight 8.22, 2001
37
VPN Access Diagram:
PSN
Internet
ISP’s
network
T1
Dial up networking,
Cable, DSL
MODEM
Router ?
encryption
Firewall
Http servers
LINUX, MS-iis
MS-SQL
VPN client
VPN key
8.17.2001
PC
ABMC LAN
Tunnel
InSight 8.22, 2001
38
If you can’t see the Firewall?
WWW.alexian.net
8.17.2001
InSight 8.22, 2001
39
Intranet, VPN Issues:
• What Browser
– what version, what plugins
• What applications
– is their a Browser view?
• Controlling the need for client side
software at the remote users site
• guests with their own VPN software
• Security !!!
8.17.2001
InSight 8.22, 2001
40
Virtual Private Network Client:
User PC looks as if is actually attached to the LAN Locally, any software requirements for a local PC
would apply
To view e-mail a GroupWise Client would need to
exist on the PC (if not using Novell Browser view)
To use Physician View the HBOC software would
need to be loaded on the PC
If an application can be accessed via a Browser then
NO Client Software is needed on the PC
to have an application Browser enabled normally
would require that a NEW module exist on a WEB
accessible server
8.17.2001
InSight 8.22, 2001
41
Encryption Theory:
theory
If 1000 cpus tried 1000 characters/sec
how long would it take to crack the code?
40 bit key
30.5 years
56 bit key
228 years
128 bit key
1.07 x 1024 years
8.17.2001
InSight 8.22, 2001
42
Encryption Reality:
40 bits = 40/8 (bits/byte) = 5 character
56 bits = 56/8
= 7 characters
128 bits = 128/8
= 16 characters
in competition, 128 bits encryption of
plain text has been broken in hours!!
Patters in plain text can be found!
Would you expect to find IBM in a document sent from IBM or Alexian in a
document from Alexian Brothers, (7 & 8 letter words following one another,
etc.?)
8.17.2001
InSight 8.22, 2001
43
Using Internet Technology Internally:
• You should be able to leverage your
internet and intranet
– webmaster
– data bases
– programming
• to produce actual cost savings processes
8.17.2001
InSight 8.22, 2001
44
E-Mail
• Using the first of the Internet ‘Killer Apps’
– ACD (Communication’s Reports)
– PFA Insurance Book (bad debt)
– payment & adjustment data (to vendors)
• is it Internet Accessible (can you send/receive
from home?)
• is it ‘Browser’ enabled mail ? (do you need a
client or just go to a ‘web page’)
8.17.2001
InSight 8.22, 2001
45
Do you need a Web Master?
• Marketing - yes
º someone that can produce nice graphics!
• Technology - someone!!
º understand how to get information to/from all
of the various systems and present it via a
browser
º fancy - may slow things down
8.17.2001
InSight 8.22, 2001
46
<HTML> Hypertext Markup Language
the Universal Language of the WWW
<html>
<title> test page </title>
<body>
<font style=“arial” size=+3 color=“blue”>
<p><center>
This is sample text!<br>
</font>
</p>
<p>
<font size=+5 color="red">
<img src=”yelhappy.gif"><br><br>
This is a sample image with motion!
</p></CENTER></font>
</body>
</html>
8.17.2001
InSight 8.22, 2001
47
View of test.htm
Http://www.SiteName.com/SomePath/face.htm
8.17.2001
InSight 8.22, 2001
48
Provide a Browser View of Your World:
• HBOC is not the only way to provide a
browser view of your information
• Other vendors
– on site solutions
– ASP solutions
• Roll your own
8.17.2001
InSight 8.22, 2001
49
An ASP solution
8.17.2001
InSight 8.22, 2001
50
Data Conversion & Interfaces, my
specialty since 1959:
When Tubes were used and a Drum was fast access
UNIVAC 1105
Analog
8.17.2001
Digital Conversion
InSight 8.22, 2001
IBM 7094
GEDA +/- 100 volt Analog
Computer
UNIVAC 51
1105
Accessible Data:
An original goal from 1990 & my ‘mantra’
• make data accessible to
°
°
°
°
all users
to / from all systems
in a user friendly format
and the data must be timely
8.17.2001
InSight 8.22, 2001
52
Taking Control of Your DATA:
Provide a UNIVERSAL view of Data to Users via Browser
Use HL7, SQL, Data Streams, etc.
to download, manipulate, upload
Re-format the Data into HTML
Use ASP and JAVA to give users control
8.17.2001
InSight 8.22, 2001
53
Where do I get the Data?
What if HL7 is not an option?
• Even Departmental Printers can be an answer!
• ADT Data Stream
• Lab, Rad, Pharmacy, etc. Orders Data Streams
• Lab Results Data Stream
• Bar Code & label printer streams
• ‘any systems’ audit/results output
8.17.2001
InSight 8.22, 2001
54
Screen Scraping / VB Example
Alexian Brothers Financial Account Revision Processor
Fri Aug 20, 1999 16:14
Account
Name
FC Type Admit
Disch
Balance Loc
A99162-00NNN ABCDEFG,FIRST
PO M/H 06/11/99 06/18/99
$349.99 AR
1 Total Charges
2 Total Adj
3 Total Payments
4 Refunds? 5 Exp?
$7,234.35
$3,734.35$3,150.01
No
No
6 Ins Liability
7 Ins Adj
8 Ins Payments
9 Pre-Collection
$0.00
$3,734.35$3,150.01
10 Pt Liability
11 Patient Adj
12 Pt Payments
13 Last Pt Payment
$349.99
$0.00
$0.00
14 Wkfl
15 Schd 16 Schd Type
17 Lst FU Dt Ty Sq 18 FU Hold
300
Custom
07/24/99 D 1
Yes
19 BD Pre-Listed
20 BD Date
21 Agency
22 BD Transfer Amount
23 Social Sec #
24 Birth Date
25 Bill Hld 26 Notes? 27 Adm By 28 Oth Accts
335-NN-NNNN
05/05/1977
No
Yes
BAM
Yes
29 COB Ins Carrier
#Clm LCS SubmitDt
Est Amt Due
Amt Pd Dsp Date
1 KVI
1
1
06/26/99
$7,234.35
$3,150.01 F 08/13/99
2 PPO 1500 PLAN
Press NL for Menu, enter code, or '-' for list--
8.17.2001
InSight 8.22, 2001
55
The Browser View of the Data
Link to Account SnapShot HTML Summary
Link to VB code
8.17.2001
InSight 8.22, 2001
56
A Browser View!
• What’s up front?
º the browser is the de facto standard
user interface - not Windows
• What’s behind?
automating the conversion of the present
screens, reports, etc.
to a browser compatible format
8.17.2001
InSight 8.22, 2001
57
Browser Terminal Emulators
aren't enough!
Heads down users should have all of the flexibility
a custom application environment provides.
users of information shouldn’t
need to know how to navigate
each application in order to get
the data they need
8.17.2001
InSight 8.22, 2001
58
Browser - Virtual User
html presentation:
tcp/ip
Browser request
middleware
conversions
Applications
any number on
any number of servers
8.17.2001
InSight 8.22, 2001
59
Active Web View Projects:
• integrated web view of data from 3 hospitals
• patient web access
– billing information, e-mail and electronic payments
•
•
•
•
•
operations shift notes
STAR HL7 queues
monitoring EBO scripting projects
Medical Library
On Line Station Census
8.17.2001
InSight 8.22, 2001
60
Live Census Data !
8.17.2001
InSight 8.22, 2001
61
HL7 Queues Monitor Web View:
8.17.2001
InSight 8.22, 2001
62
EBO Monitor:
EBO Process Monitor
Start Record
End Record
This Record
% Complete
200
400
250
25.00%
Account Number Financial Class Balance
99012300123
BO
500.12
Zero Bal Ct
Wrong FC Ct
In Follow up Ct Processed OK
1
2
1
46
Start Time
Now
Average/Min.
File Type
P
8:00:42 AM
8.17.2001
8:18:13 AM
2.77
InSight 8.22, 2001
63
Emergency Guidelines:
8.17.2001
InSight 8.22, 2001
64
Employee Handbook:
8.17.2001
InSight 8.22, 2001
65
Custom Documents:
8.17.2001
InSight 8.22, 2001
66
Education & Training:
8.17.2001
InSight 8.22, 2001
67
Synquest Main Menu:
CBT Produced in House !
8.17.2001
InSight 8.22, 2001
68
Who can have a Home Page (site) ?
departments,staff,MD
8.17.2001
InSight 8.22, 2001
69
Is the Internet the way to:
•
•
•
•
•
•
Place telephone calls ?
Teleconference ?
Video conference ?
Video surveillance ?
Monitor systems ?
Monitor alarms ?
8.17.2001
InSight 8.22, 2001
70
No Guarantees with the Internet!
• TCP/IP
– not true serial communications
• send
• receive
abcdefg
acdbgf
– no guaranteed delivery - collisions
• what do you do about them?
• applications must do the ‘hand shaking’
8.17.2001
InSight 8.22, 2001
71
IP Telephony:
• The buzz is IP Telephony
• The reality is - as always – bandwidth, quality, continuity of flow
• What is available
– Telephony cards in Routers
• 2 analog ports, FAX, voice
• T1/fractional T1 port(s)
– ATM vs.. Frame Relay - cloud
• PC to PC
• PC to PSN
• PSN to PSN via the Internet
• Private Voice & Data Networks (IP only)
8.17.2001
InSight 8.22, 2001
72
Video Vocabulary
• Words you need to understand
– Resolution
•
•
•
•
•
HDTV 1920 x 1080 (1200) 16:9 aspect ratio
1024 x 768 xvga 4:3 aspect ratio
800 x 600 svga
640 x 480 vga
320 x 240 or less
– frame rate
• 30 frames/sec (60 fields/sec)
• less than 30 frames/sec
• field sequential vs interlaced
– compression
8.17.2001
InSight 8.22, 2001
73
Is there a Standard?
Audio or Video
– compatibility ! ! ! !
•
•
•
•
•
•
•
8.17.2001
HDTV
NTSC
CU See Me
Real Audio - Video
Microsoft
IEEE
SoundBlaster
InSight 8.22, 2001
74
Sample of Video
link to a video
8.17.2001
InSight 8.22, 2001
75
Napster, et. al. :
• We freely give unlimited access to our PC and all of
it’s data
• NSA
• CIA
• FBI
– Carnivore - read e-mail
• SETI (shared computing)
– looking for intelligent life via radio signals
• Pratt & Whitney – United Technology
8.17.2001
InSight 8.22, 2001
76
Fred Henning
Sr. Technology Analyst
Alexian Brothers Medical Center
800 Biesterfield
Elk Grove Village, IL 60007
847-981-3667
847-956-5435 (FAX)
[email protected]
[email protected]
www.fredhenning.com
8.17.2001
InSight 8.22, 2001
77