NAME: NGWA BELTINE BIHNWI. Year: 2021. Date: 02/20/2021.

Review Questions;
Chapter 7
1. Enumerate and describe features of a network system.
a. Communication speed: network provides you a fast and easy way to communicate
efficiently using network with a group of people. For instance; you can enjoy the
advantage of email messaging, IP telephony, video conference and more.
Networking is great for sharing ideas and knowledge.
b. File sharing: Here, file sharing is one of the major advantages of computers
networking that people share files with each other. Files can be stored on a central
file server which allows data to be shared and accessible to all organization.
c. Back up and Roll back is easy: Since the files are stored in the main server which is
centrally located. Therefore, it is easy to take the back up from the main server.
d. Software and Hardware sharing: We can install the applications on the main server;
therefore, the user can access the applications centrally. So, we do not need to
install the software on every machine. Similarly, hardware can also be shared.

e. Security: Network allows the security by ensuring that the user has the right to
access the certain files and applications.

f. Scalability: Scalability means that we can add the new components on the network.
Network must be scalable so that we can extend the network by adding new
devices. But, it decreases the speed of the connection and data of the transmission
speed also decreases, this increases the chances of error occurring. This problem can
be overcome by using the routing or switching devices.

g. Reliability: Computer network can use the alternative source for the data
communication in case of any hardware failure.

2. Illustrate the different network topologies and discuss its features

including advantages and disadvantages.
a. Bus Topology: Bus topology is the simplest kind of topology in which a common
bus or channel is used for communication in the network. The bus is connected to
various taps and drop lines. Taps are the connectors, while drop lines are the
cables connecting the bus with the computer. In other words, there is only a single
transmission line for all nodes.

Advantages

- Simple to use and install.

- If a node fails, it will not affect other nodes.
- Less cabling is required.
- Cost-efficient to implement.

Disadvantages

- Efficiency is less when nodes are more (strength of signal decreases).

- If the bus fails, the network will fail.
- A limited number of nodes can connect to the bus due to limited bus length.
- Security issues and risks are more as messages are broadcasted to all nodes.
- Congestion and traffic on the bus as it is the only source of communication.

b. Ring Topology: Ring topology is a topology in which each computer is connected to

exactly two other computers to form the ring. The message passing is
unidirectional and circular in nature. This network topology is deterministic in
nature, i.e., each computer is given access for transmission at a fixed time interval.
All the nodes are connected in a closed-loop. This topology mainly works on a
token-based system and the token travels in a loop in one specific direction.

Advantages

- Easy Installation.
- Less Cabling Required.
- Reduces chances of data collision (unidirectional).
- Easy to troubleshoot (the faulty node does not pass the token).
- Each node gets the same access time.

Disadvantages

- If a node fails, the whole network will fail.

- Slow data transmission speed (each message has to go through the ring path).
- Difficult to reconfigure (we have to break the ring).
c. Star Topology: Star topology is a computer network topology in which all the
nodes are connected to a centralized hub. The hub or switch acts as a middleware
between the nodes. Any node requesting for service or providing service, first
contact the hub for communication. In a star topology, hub and switch act as a
server, and the other connected devices act as clients. Only one input-output port
and one cable are required to connect a node to the central device. This topology
is better in terms of security because the data does not pass through every node.
 Advantages

- Centralized control.
- Less Expensive.
- Easy to troubleshoot (the faulty node does not give response).
- Good fault tolerance due to centralized control on nodes.
- Easy to scale (nodes can be added or removed to the network easily).
- If a node fails, it will not affect other nodes.
- Easy to reconfigure and upgrade (configured using a central device).

Disadvantages

- If the central device fails, the network will fail.

- The number of devices in the network is limited (due to limited input-output port
in a central device).
d. Mesh Topology: Mesh topology is a computer network topology in which nodes
are interconnected with each other. In other words, direct communication takes
place between the nodes in the network. There are mainly two types of Mesh.

- Full Mesh: Here each node is connected to every other node in the network.
- Partial Mesh: Here some nodes are not connected to every node in the network.

Advantages

- Dedicated links facilitate direct communication.

- No congestion or traffic problems on the channels.
- Good Fault tolerance due to the dedicated path for each node.
- Very fast communication.
- Maintains privacy and security due to a separate channel for communication.
- If a node fails, other alternatives are present in the network.

Disadvantages

- Very high cabling required.

- Cost inefficient to implement.
- Complex to implement and takes large space to install the network.
- Installation and maintenance are very difficult.
e. Tree Topology: Tree topology is a computer network topology in which all the
nodes are directly or indirectly connected to the main bus cable. Tree topology is a
combination of Bus and Star topology. In a tree topology, the whole network is
divided into segments, which can be easily managed and maintained. There is a
main hub and all the other sub-hubs are connected to each other in this topology.

Advantages

- Large distance network coverage.

- Fault finding is easy by checking each hierarchy.
- Least or no data loss.
- A Large number of nodes can be connected directly or indirectly.
- Other hierarchical networks are not affected if one of them fails.

Disadvantages

- Cabling and hardware cost is high.

- Complex to implement.
- Hub cabling is also required.
- A large network using tree topology is hard to manage.
- It requires very high maintenance.
- If the main bus fails, the network will fail.

f. Hybrid Topology: A Hybrid topology is a computer topology which is a combination

of two or more topologies. In practical use, they are the most widely used. In this
topology, all topologies are interconnected according to the needs to form a
hybrid. All the good features of each topology can be used to make an efficient
hybrid topology.

Advantages

- It can handle a large volume of nodes.

- It provides flexibility to modify the network according to our needs.
- Very reliable (if one node fails it will not affect the whole network).

Disadvantages

- Complex design.
- Expensive to implement.
 - Multi-Station Access Unit (MSAL) required.

Review Questions
Chapter 8
1. What is TCP/IP? What are its features and functions?
Transmission Control Protocol/Internet Protocol (TCP/IP) is a communication
architecture used for networking computers and to communicate across the
Internet. TCP and IP were originally developed by the Department of Defense (DOD) to
connect a number of different networks from various vendors into a network of
networks called the Internet.  Its success was based on providing services such as file
transfer, electronic mail, and remote logon across a large number of client and server
systems.

Features and functions of TCP/IP

a. Multi-Vendor Support: TCP/IP is implemented by many hardware and software vendors. It is

an industry standard and not limited to any specific vendor.
b. Interoperability: Today we can work in a heterogeneous network (consisting of devices,
Operating Systems, software from different vendors) because of TCP/IP. A network user who is
using a Windows Operating System based computer can download files from a Linux machine,
because both Operating Systems support TCP/IP. TCP/IP eliminates the cross-platform/multi-
vendor boundaries.

c. Logical Addressing. Every network adapter has a globally unique and permanent physical
address, which is known as MAC address (physical address or hardware address). The physical
address is burnt into the card while manufacturing. Low-lying hardware-conscious protocols on
a LAN deliver data packets using the adapter's physical address. The network adapter of each
computer listens to every transmission on the local network to determine whether a message is
addressed to its own physical address.

d. Routability: A router is a network infrastructure device which can read logical

addressing information and direct data across the network to its destination. TCP/IP is
a routable protocol, which means the TCP/IP data packets can be moved from one network
segment to another.

e. Name Resolution: IP addresses are designed for the computers and it is difficult for humans
to remember many IP addresses. TCP/IP allows us to use human-friendly names, which are very
easy to remember (Ex. www.omnisecu.com). Name Resolutions servers (DNS Servers) are used
to resolve a human readable name (also known as Fully Qualified Domain Names (FQDN)) to an
IP address and vice versa.
f. Error Control and Flow Control: The TCP/IP protocol has features that ensure the reliable
delivery of data from source computer to the destination computer. TCP (Transmission Control
Protocol) defines many of these error-checking, flow-control, and acknowledgement functions.

g. Multiplexing/De-multiplexing: Multiplexing means accepting data from different

applications and directing that data to different applications listening on different receiving
computers. On the receiving side the data need to be directed to the correct application, for
that data was meant for. This is called De-multiplexing. We can run many network applications
on the same computer, by using logical channels called ports. TCP/IP provides means for
delivering packets to the correct application based on port numbers. In TCP/IP, ports are
identified by using TCP or UDP port numbers.

2. Enumerate and describe services available in the Internet.

a. Communication Services: Communication is one of the most popular services of the

internet. We are using internet-based communication services every day to contact
family and friends. It is also known as Internet Telephony. Some of the internet
communication services are Instant Messaging, Internet Telephony, and VOIP, Email,
IRC, Videoconferencing and more.

b. Information Retrieval Services: One reason why a computer network such as the
Internet has been created was, to allow users to access remote computers and transfer
files from one machine to another. This internet service includes FTP, FTPS, SFTP (Simple
File Transfer Protocol), Telnet, SSH File Transfer Protocol, Trivial File Transfer Protocol
and more.

C. World Wide Web (WWW) Services: WWW is one of the main services of the
internet. Most of us think that the Internet and WWW are the same but actually not.
Internet is Infrastructure and the Web is just a service provided on the Internet. Internet
is a network of networks and Web is just information present in the network. The
inventor of the Web is Tim Berners Lee and Robert Caillia.

c. Web Services: There are lots of applications built in various programming languages.
Some built using .net, some in Java, some in python, angular, node js. There may
need some ways of communicating with each other. And web services solve this
problem. Web services provide a common platform that allows multiple applications
to communicate with each other whatever programming languages are used for
making applications. So it acts as a standard medium of a passing message (data)
between the client application( made by using android,vue, angular, react or any
frontend language in general) and a server application(java,.net, python and more in
general) in World Wide web.
d. Directory Services: Directory services map network resource names to network
addresses and create a network name structure. Let's look at network directory
 services like DNS and LDAP. DNS (Domain Name System): The task of the DNS is to
translate human-readable domain names like ourtechroom.com into IP addresses
(something like 192.168.10.12) so that the web browser can load the requested
resources from the server. If there is no DNS then you have to remember the IP and
have to hit accessing intended sites with IP instead of a domain name
like ourtechroom.com. LDAP (Lightweight Directory Access Protocol): It is a
lightweight client-server directory protocol for accessing directory services. If your
data do not change frequently then you can store your data in LDAP Services and
you can access it frequently as LDAP provides a ' write-once-read-multiple-times'
service, whereas in SQL database you can have high read and writes. So, we can say
LDAP is non-transactional.

e. Automatic Network Address Configuration: Giving a unique IP address to all the

systems in a network is done by Automatic Network Address Configuration devices
like DHCP (Dynamic Host Configuration Protocol) Server. DHCP server's main works
are to make sure that no two systems got the same IP address.
f. Network Management Services: Network management services are also one of the
important services of the internet which are helpful for network managers. Network
management services help in preventing, monitoring, diagnosing, and solving issues
related to the network. Some common network management tools are trace route
and ping. Ping tool mainly helps to check the availability of the host machine and
time is taken to respond to all Internet Control Message Protocol (ICMP)
packets. Trace route tool mainly helps to find and display all the possible routes
(pathway) from request to response and get time taken for responding on each
pathway.

g. Time Services: Network Time Protocol (NTP) is a popular time service on the
internet that helps to synchronize and set the computer clock with great precision.
Computer clocks are synced to either Greenwich Mean Time (GMT) or Co-ordinated
University Time (UTC).
h. Usenet: Usenet is known as the 'User's Network.' It is one of the oldest networks
where users can post files to news servers and other members can access it.
i. Newsgroup: It is an active Online Discussion Forum, which can easily be accessed
through the Usenet. Each newsgroup includes discussions on a particular subject
that are implied in the newsgroup name.
Users can view and follow the newsgroup and comment on the post through newsre
ader software. Accessing to these newsgroups also requires a Usenet Subscription w
hich may cost you a charge.

j. Ecommerce: E-commerce is Internet-based buying and sale of goods and services.

Today, almost anything that is available in the market can be purchased through e-
commerce.
3. Enumerate and define different types of internet connectivity.
4. DSL.  DSL stands for Digital Subscriber Line.  It is an internet connection that is always
“on”.  This uses 2 lines so your phone is not tied up when your computer is connected. 
There is also no need to dial a phone number to connect.  DSL uses a router to transport
data and the range of connection speed, depending on the service offered, is between
128K to 8 Mbps.

5. Cable.  Cable provides an internet connection through a cable modem and operates

over cable TV lines.  There are different speeds depending on if you are uploading data
transmissions or downloading.  Since the coax cable provides a much greater bandwidth
over dial-up or DSL telephone lines, you can get faster access.  Cable speeds range from
512K to 20 Mbps.

6. Wireless.   Wireless, or Wi-Fi, as the name suggests, does not use telephone lines or
cables to connect to the internet.   Instead, it uses radio frequency.  Wireless is also an
always on connection and it can be accessed from just about anywhere.  Wireless
networks are growing in coverage areas by the minute so when I mean access from just
about anywhere, I really mean it.  Speeds will vary, and the range is between 5 Mbps to
20 Mbps.

7. Satellite.  Satellite accesses the internet via a satellite in Earth’s orbit. The enormous
distance that a signal travels from earth to satellite and back again, provides a delayed
connection compared to cable and DSL.  Satellite connection speeds are around 512K to
2.0 Mbps.

8. Cellular.  Cellular technology provides wireless Internet access through cell phones.  The
speeds vary depending on the provider, but the most common are 3G and 4G speeds.  A
3G is a term that describes a 3rd generation cellular network obtaining mobile speeds of
around 2.0 Mbps.  4G is the fourth generation of cellular wireless standards. The goal of
4G is to achieve peak mobile speeds of 100 Mbps but the reality is about 21 Mbps
currently.

9. Enumerate different local health databases and describe each.

a. Electronic Health Records (EHR): An Electronic Health Record (EHR) is an electronic
version of a patient’s medical history, that is maintained by the provider over time,
and may include all of the key administrative clinical data relevant to that persons
care under a particular provider, including demographics, progress notes, problems,
medications, vital signs, past medical history, immunizations, laboratory data and
radiology reports   The EHR automates access to information and has the potential
to streamline the clinician's workflow.  The EHR also has the ability to support other
 care-related activities directly or indirectly through various interfaces, including
evidence-based decision support, quality management, and outcomes reporting.
b. Practice management system: A medical practice management system is a type of
healthcare software that manages the day-to-day operations of a clinic, such as
appointment scheduling, billing and other administrative tasks.
c. Ambulatory surgery: Ambulatory surgery or outpatient surgery is a planned
operation for which the patient is not expected to be admitted to the hospital.
d. Radiology: Radiology is a medical specialty that uses imaging technology to diagnose
and evaluate the treatment of diseases seen within the body.
e. Pathology: Pathology is a branch of medical science primarily concerning the
cause, origin and nature of disease. It involves the examination of tissues, organs,
bodily fluids and autopsies in order to study and diagnose disease.
f. HR system: The field of health human resources deals with issues such as planning,
development, performance, management, retention, information, and research
on human resources for the health care sector.
g. Financial system: This refers to the function of a health system concerned with the
mobilization, accumulation and allocation of money to cover the health needs of
the people, individually and collectively.

Review Questions
Chapter 9
1. Draw a schema of HIS.

2. Differentiate EMR from EHR.

Electronic medical records (EMRs) are a digital version of the paper charts in the
clinician’s office. An EMR contains the medical and treatment history of the patients in
one practice. EMRs have advantages over paper records. For example, EMRs allow
clinicians to: track data over time, easily identify which patients are due for preventive
screenings or checkups, check how their patients are doing on certain parameters, such
as blood pressure readings or vaccinations and monitor and improve overall quality of
care within the practice.
 Meanwhile, Electronic health records (EHRs) focus on the total health of the patient,
going beyond standard clinical data collected in the provider’s office and inclusive of a
broader view on a patient’s care. EHRs are designed to reach out beyond the health
organization that originally collects and compiles the information. They are built to
share information with other health care providers, such as laboratories and specialists,
so they contain information from all the clinicians involved in the patient’s care.
3. Enumerate the advantages of EMR.
1. Providing accurate, up-to-date, and complete information about patients at the
point of care.
2. Enabling quick access to patient records for more coordinated, efficient care.
3. Securely sharing electronic information with patients and other clinicians.
4. Helping providers more effectively diagnose patients, reduce medical errors, and
provide safer care.
5. Improving patient and provider interaction and communication, as well as health
care convenience.
6. Enabling safer, more reliable prescribing.
7. Helping promote legible, complete documentation and accurate, streamlined coding
and billing.
8. Enhancing privacy and security of patient data.
9. Helping providers improve productivity and work-life balance.
10. Enabling providers to improve efficiency and meet their business goals.
11. Reducing costs through decreased paperwork, improved safety, reduced duplication
of testing, and improved health.
12. Enumerate different HIS technologies and briefly describe each.
a. Electronic Medical Record (EMR) and Electronic Health Record (EHR): These
two terms are almost used interchangeably. The electronic medical record
replaces the paper version of a patient’s medical history. The electronic health
record includes more health data, test results, and treatments. It also is designed
to share data with other electronic health records so other healthcare providers
can access a patient’s healthcare data.
b. Practice Management Software: Practice management software helps
healthcare providers manage daily operations such as scheduling and billing.
Healthcare providers, from small practices to hospitals, use practice
management systems to automate many of the administrative tasks.
c. Master Patient Index (MPI): A master patient index connects separate patient
records across databases. The index has a record for each patient that is
registered at a healthcare organization and indexes all other records for that
patient. MPIs are used to reduce duplicate patient records and inaccurate
patient information that can lead to claim denials.
d. Patient Portals: Patient portals allow patients to access their personal health
data such as appointment information, medications and lab results over an
 internet connection. Some patient portals allow active communication with their
physicians, prescription refill requests, and the ability to schedule appointments.
e. Remote Patient Monitoring (RPM): Also known as telehealth, remote patient
monitoring allows medical sensors to send patient data to healthcare
professionals. It frequently monitors blood glucose levels and blood pressure for
patients with chronic conditions. The data is used to detect medical events that
require intervention and can possibly become part of a larger population health
study.
f. Clinical Decision Support (CDS): Clinical decision support systems analyze data
from various clinical and administrative systems to help healthcare providers
make clinical decisions. The data can help prepare diagnoses or predict medical
events; such as drug interactions. These tools filter data and information to help
clinicians care for individual patients.

Review Questions
Chapter 10
1. Enumerate and describe the different technologies used in
automated clinical information system.
 a. Electronic Medical Record (EMR) and Electronic Health Record (EHR): EMR and EHR
systems replace paper patient records. The medical information on each patient is
collected and stored electronically. These records include patient health information,
test results, doctor and specialist visits, and healthcare treatments. Many healthcare
facilities use cloud-based storage for sensitive data for increased security. However, this
may not be an option for Critical Access Hospitals who struggle with basic EHR systems.
b. Practice Management Software: Information systems assist healthcare facilities and
personnel with the management of daily operations of the facility. This includes
scheduling of patients and medical services billing. Regardless of their size from single
practice doctors to huge multi-center hospitals, all healthcare providers utilize practice
management systems. The goal is to automate administrative tasks carried out as part
of doing business in the facility.
c. Master Patient Index (MPI): The software of this healthcare information system
connects patient records to more than one database. The MPI contains records for any
patient registered at a healthcare organization. MPI creates an index on all the records
for that patient. MPIs reduce duplicate patient records and avoid inaccurate patient
information that could result in patient claim denials.
d. Patient Portals: This information system enables patients to peruse their health data.
They can access appointment information, medications they may be receiving, and their
lab results via the internet. Some patient portals also facilitate active communication
with healthcare professionals, including physicians, pharmacists regarding their
prescription refill requests, and scheduling of appointments.
e. Remote Patient Monitoring (RPM): Also known as telehealth, RPM provides medical
sensors that can transmit patient data to healthcare professionals. RPM can monitor
blood glucose levels and blood pressure. It is particularly helpful for patients with
chronic conditions such as type 2 diabetes, hypertension, or cardiac disease. Data
collected and transmitted via RPM can be used by a healthcare professional or a
healthcare team to detect medical events such as stroke or heart attack that require
immediate and aggressive medical intervention. Data collected may be used as part of a
research project or a health study. RPM is a life-saving system for patients in remote
areas who cannot access face-to-face health care.
f. Clinical Decision Support (CDS): CDS analyzes data from clinical and administrative
systems. The aim is to assist healthcare providers in making informed clinical decisions.
Data available can provide information to medical professions who are preparing
diagnoses or predicting medical conditions like drug interactions and reactions. CDS
tools filter information to assist healthcare professionals in caring for individual clients.
g. Laboratory Information System (LIS): LIS software allows doctors and lab technicians to
coordinate inpatient and outpatient tests for microbiology, hematology, chemistry, and
immunology to obtain clinical data. A standard information system for a lab manages
patient demographics, check-in information, specimen entry and processing, and
results.