ITGS Presentation 2013

Conversations, Security Keys, and BYOD

Dull & Boring Stuff

Communication Protocols

• Transmission Control Protocolo Transport layer protocolo Breaks transmission into pieces (packets)o Supports resending of packetso Only supports one-to-one communication

http://www.dummies.com/how-to/content/the-tcpip-networking-protocol-suite.html

TCP

• Internet Protocolo Network layer protocolo Delivers packetso Uses logical addresses instead of MAC addresseso IP address is comprised of two parts

Network part Host part

o Allows for communication to another network

http://www.dummies.com/how-to/content/the-tcpip-networking-protocol-suite.html

IP

• URLo Uniform Resource Locationo More English-Like than TCP/IP addresso Domain Name Server (DNS)

Translates URL to TCP/IP addresso Lets you type www.hectic-dad.com and get to a real

website

http://computer.howstuffworks.com/dns1.htm

TCP/IP, URL, DNS blah blah blah

• Envelope Examplehttp://www.thegeekstuff.com/2011/11/tcp-ip-fundamentals/http://technet.microsoft.com/en-us/library/cc786128(v=ws.10).aspx

TCP/IP Protocol Architecture

• Internet Protocol addressingo IPv4

Address every device on the planet (hahahaha) 232 addresses (4,294,967,296) 4 octets (192.168.1.1)

o 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 evolutionhttp://en.wikipedia.org/wiki/IP_address

TCP/IP Addressing

• 2345

• MO-2345

• MO2-2345

• 620-662-2345

• 1-620-662-2345

• 0011-1-620-662-2345

Growth of Addressing

• Hypertext Transport Protocolo Request-Response protocol (ask & ye shall receive)o Not limited to world wide web (www) communicationo Can be used for other purposeso Runs on top of TCP networko Utilizes structured texto It’s a conversation

http://en.wikipedia.org/wiki/Hypertext_Transfer_Protocol

HTTP

• 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

HTTP Example

• File Transfer Protocolo Used to transfer entire fileso Request-Response protocol (ask & ye shall receive)o Client-server architectureo Runs on top of TCP-based connectiono Separate control and data connectionso It’s two conversations at once

http://www.webmonkey.com/2010/02/ftp_for_beginners/

FTP

• 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

FTP Example

Slightly More Interesting Stuff

EHR Security, Using EHRs, BYOD, VPN, Intranets, and

TANSTAAFL

Electronic Health Records

An alphabet soup and a can of worms

• Lots of nameso CPRo EMRo EHRo PHR

• Two varietieso Specialtyo Patient or Longitudinal

• Beware of data silos

Electronic Health Records

• Information accessibility

• Information transportability

• Improved Clinical Outcomeso Qualityo Reduced Medical errors

• Reduced Costso Individualo Societal

• Data mining

EHR Advantages

• 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 Disadvantages

• Information accessibility

• Information transportability

• Improved Clinical Outcomeso Qualityo Reduced Medical errors

• Reduced Costso Individualo Societal

• Data mining

EHR (DIS)Advantages

• Complicationso Interoperabilityo Transferabilityo Data siloageo Lexicon / Terminology

• Concernso Securityo Privacyo Patient Targeting

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270933/

EHR Complications & Concerns

• Authenticationo One stepo Two step

• Underlying computer security

• Underlying network security

• No holes allowed

EHR Security

• Computer/network steps

• EHR login

• Patient selection

• Patient viewo By encountero By diagnosiso By treatment

EHR Access Practicum

BYOD

It’s really easy until you have to actually support it

• 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

• 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 Advantages

• Heterogenous devices

• Lack of control over data

• Security

• Privacy

• Device control / Acceptable use

• Cost-sharing Complications

• Support nightmareshttp://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

BYOD Disadvantages

Virtual Private Networks

Playing hide-and-seek on the world wide web

• 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

Virtual Private Networks

Intranets

Playing in your own sandbox

• Collection of local network items

• Utilize standard network itemso Hardwareo Softwareo Ethernet, Wi-Fi, TCP/IPo Web browserso Web servers

• Local network using internet technologieshttp://compnetworking.about.com/cs/intranets/g/bldef_intranet.htm

http://medicalexecutivepost.com/2009/06/26/healthcare-intranets-and-extranets/

Intranets

• Lightning can be VPN

• Really *should be*http://www.skullbox.net/intranet.php

Intranets & Extranets

TAANSTAFL

Any guesses?

• There Ain’t No Such Thing As A Free Lunch

• Costs associated with technologieso TCP/IP - overheado HTTP - overhead, interpretation timeo FTP - overheado EHR Security - hassle, inaccuracy, not perfecto BYOD - support, heterogenous nature, securityo VPN - support, complexityo Intranet - support, complexity, overhead

TANSTAAFL

Project Simulation

Kill me now...this is too hard

• The Seven Questionso Whoo Whato Wheno Whyo Whereo Howo What aren’t you telling me?

Implementation Scenario

• The Seven Questionso Who - Dr. Hanna Schreibero What - Wired networko When - Yesterday (it’s always yesterday)o Why - To allow the practice to functiono Where - New Buildingo How - Computer networko What aren’t you telling me? - I dunno

Single Provider’s Office

• Wired workstations

• Limited connectivity

http://en.wikipedia.org/wiki/Computer_network_diagram

Single Provider’s Office

• The Seven Questionso Who - Dr. Hanna Schreiber & Dr. Maddie Pageo What - Wired + Wireless networko When - Yesterday (it’s always yesterday)o Why - To allow the practice to functiono What aren’t you telling me? - I dunno

Multiple Providers

http://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png

Drs. Schreiber & Page

• The Seven Questionso Who - Dr. Colton “I can do better” Harpero What - Wired + Wireless networko Why - Because I can provider better medical careo Where - Right next door in the same buildingo What aren’t you telling me? - I want to crush them

Dr. Colton “I can do better” Harper

• Two networks - one wireless airspacehttp://www.conceptdraw.com/samples/resource/images/solutions/network-diagram/Network-Diagram.png

Dr. Colton “I can do better” Harper

• The Seven Questionso What - Wired + Wireless + Patient Accesso Who - Dr. Josh “Rule the world” Pattersono Why - To provide one-stop medical careo Where - The entire floor above the other practiceso What aren’t you telling me? - Mwahahaha

Dr. Josh “Rule the world” Patterson

Even more complex

• Bandwidth

• Wireless cross-over

• Privacy

• Security

Inter-office Network Issues