CBET Study Course

Module 6: April 22, 2020

Healthcare Information
Technology

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 Session Rules &
Expectations
• All participant mics will be muted during each of the
sessions.
• Please use the ‘Questions’ tab within Go-To-Webinar
to ask the instructor questions.
– Questions will be collected, answered, and posted in
the AAMI Connect group that each participant has
access to.
• Each module will conclude with a practice exam that
will be administered via the Go-To-Webinar polling
feature. Be sure to select your answer within the 60
seconds of time given per question.
© 2020 Association for the Advancement of Medical Instrumentation www.aami.org/aci
 Learning Objectives
Participants who complete the Healthcare Information Technology module
should have a fundamental understanding and the ability to apply:

• Understand and apply protective standards and regulation for protected data
(HITECH, Medical Device Data Systems [MDDS], IEC 80001 – Application of Risk
Management for IT Networks, Health Insurance Portability and Accountability Act
[HIPAA], Manufacturer Disclosure Statement for Medical Device Security, Digital
Millennium Copyright Act [DMCA]).

• Identify and troubleshoot PC hardware and networking components (wired and

wireless) with use of appropriate diagnostic tools (e.g., cable tracers, cable testers,
PING).

• Understand the interrelatedness of computer applications.

• Understand and apply the fundamentals of network configuration.

© 2020 Association for the Advancement of Medical Instrumentation www.aami.org/aci

 Module Handouts
All handouts are available via the Go-To-
Webinar Handout function. For this module
you will have access to:

– IT & Networking Survival Guide

– Module 6 Practice Test
– Module 5 Practice Test Answers

© 2020 Association for the Advancement of Medical Instrumentation www.aami.org/aci

 Networks
• Networks are a collection of computers and
other hardware connected together.
• They provide communication between a
minimum of two devices.
• Networks come in various topologies.
• Each topology has advantages and
disadvantages when compared to each other.

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 Ring Topology

• All devices are connected to each in a virtual ring.

• Uses a token to communicate between the devices.
• Only the computer with the token can transmit to the
other devices.
• The system uses a Multi-Station Access Unit (MAU)
hub.
• The MAU sends the signal to each device in the
ring, until the computer with the token receives the
original message back.

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Ring Network

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 Star Topology
Most popular topology

• Offers greater flexibility over

other topologies.
• Each device has a dedicated
connection to the hub or
switch.
• The entire network can be
affected if the central hub or
switch fails.
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Star Network

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 Bus Topology

Also known as Daisy Chain

• Signals from each device travel on a bi-

directional bus.
• The Bus has two cable ends that must be
terminated.
• A faulty cable, terminated end or bad
connection will affect the entire network.
• A split in the network will cause signals to
become scrambled across the whole
network.
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 Bus Topology

• CSMA / CD

• Carrier Sensing - Multiple Access /

Collision Detection.
• Is software that senses when the line is
busy.

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Bus Network

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 Mesh Topology

• Each computer has a dedicated connection

to every other computer on the network.

• It is only practical for small sized networks.

• It is more tolerant to device and cable
failures than other topologies.

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Mesh Network

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 Hybrid Networks

• Are designed to take advantage of the

strengths of each combined network.
• Help minimize the weaknesses of the
combined networks.
• It can handle device and cable failures better
than the individual networks on their own.
• Star/Bus and Star/Ring are two examples of
Hybrid Networks.

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 TCP / IP

• A group of networking protocols used to

connect computers on the Internet.
• TCP provides transport functions while IP
provides the addressing and routing
mechanism.
• TCP/IP includes FTP, SMTP (Simple Mail
Transfer Protocol),Telnet and UDP (User
Datagram Protocol)

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 DHCP

• Dynamic Host Configuration Protocol

(DHCP).
• DHCP is used to dynamically assign IP
addresses on the network.
• DHCP is used to conserve IP addresses.
• When a device connects to the network,
DHCP will "lease" an IP address to it.
• When that device is not using the network,
DHCP can use the same IP address for
another device.

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 Network Communications

• Half Duplex is where a device is only

capable of one way communications.
Send or Receive.

• Full Duplex is where the device can

both send and receive signals at the
same time.

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Network Wiring

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Network Cables

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 Twisted Pair Cable

• Twisted Pair Cables are currently the most

commonly used network cables.
• Frequently used in Star Topology Networks.
• Available in shielded and non-shielded styles.
• It has eight individual wires twisted into four
pairs, enclosed inside a single sheath.
• The pairs are twisted at different rates to
reduce interference.

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RJ45

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 Twisted Pair Cable

• The Telecommunications Industry Association

(TIA) and Electronics Industry Association
(EIA) developed the TIA/EIA-568 standard.
• CAT-5 10BaseT (10 Mbps) or 100BaseT
(100Mbps) can be wired two different ways
and maintain conformance with T568A or
T568B standards.
• 10Base and 100Base ethernet networks
generally use only two of the four twisted wire
pairs.

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 Twisted Pair Cable

• Category 5 (CAT-5) cable is the most common

standard used today.
• CAT-5 is suitable for networks running at 100
Mbps or slower.
• CAT 5e cable is designed at a 100 MHz
frequency on cable segments of up to 100
meters.
• Depending on performance standards, CAT-5
can be used in 1000BaseT networks.

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 Twisted Pair Cable

• CAT-6 is suitable for networks running at 1000

Mbps up to 100 meter segments.
• CAT-6 cable can support 10 Gbps on cable
segments of up to 55 meters.

• CAT-6a will support 10 Gbps networks up to

100 meter segments.

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Twisted Pair Cable

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 Shielded Twisted Pair Cable

• Shielded Twisted Pair Cables come in two

types.
• Type 1A and Type 6A.
• It is used where additional shielding is
needed against electromagnetic interference.
• It only has two pairs of twisted wires with the
addition of foil or mesh shielding.
• Frequently used in Ring Topology Networks.

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 Network Media

Twisted Pair (TP)

• Two insulated copper wires
– Category 3: Traditional phone wires, 10
Mbps Ethernet
– Category 5 TP: 100 Mbps Ethernet

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RJ45 & RJ11

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 RJ45 vs RJ11

• RJ stands for Registered Jack.

• RJ45 is used with ethernet cables in computer
networking.
• RJ11 is used in connecting telephone units.
• RJ45 contains more wires,(8) than RJ11 (4).
• RJ45 is physically bigger than RJ11 to
accommodate the extra wires.

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Coaxial Cable

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 Coaxial Cable

• Two types of Coaxial cable are used for

computer networking.
• RG-8 (Thick ethernet) Is a 10Base5 format that
has a maximum cable length of 500 meters.
• RG-58 (Thin ethernet) Is a 10Base2 format that
has a maximum cable length of 200 meters.
• Both are limited to a speed of 10 Mbps & use
base-band transmissions.
• Frequently used in Bus Topology Networks.

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Coaxial Cable

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Coaxial Cable

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Fiber Optic

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 Fiber-optic Cable

• Fiber-optic cable carries light instead of

electrical signals.
• Normally has the light converted to electronic
impulses when connecting to the NIC .
• It is resistant to any electromagnetic
interference.
• It can span distances of 120km without signal
degradation.
• It offers a more secure form of transmission.

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Fiber Optic Connections

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 Fiber-optic Cable

• There are two types of fiber-optic cable,

single-mode and multimode.
• Single-mode uses a laser as a light source
and has a smaller core.
• Multimode uses a LED as a light source and
can process multiple wavelength signals.
• Two common connectors used in fiber-optics
include the Straight tip (ST) and the
Subscriber connector (SC).

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Plenum Rated Cable

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 Plenum Rated Cable

• The plenum is an open space found above a

building’s dropped ceilings.
• Plenum spaces often house telephone and
network communication cables.
• Plenum rated cables must comply with the
NEC specifications for flammability and
smoke density.
• Plenum rated cables need to be coated in
flame-retardant, low smoke materials such
as polyvinyl chloride (PVC).

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Network Hardware

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 Repeaters

• Repeaters are simple devices that act as a

signal amplifiers.
• Repeaters can remove noise from the
incoming signal,but cannot correct corrupted
messages.
• Repeaters can be used as media adapters,
such as converting signals from a fiber-optic
line over to a twisted pair line.
• The use of repeaters should be avoided on
network segments with high volumes of
traffic.
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Routers

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 Routers

• Routers are used to transfer information

between separate networks.
• Routers can analyze, and in some cases
correct corrupt packets of data.
• They use a routing table to direct information
to the correct network address.
• Routers must be directly connected to each
network and have an IP address in each
network.

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Network Hub

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 Network Hubs

• Hubs are simple devices used to connect

multiple computers together.
• They are available in active and passive
configurations.
• Hubs lack the ability to route incoming
messages and broadcast on all output lines.
• Hubs are used in Token Ring networks as a
Multi-station Access Unit (MAU).
• Hubs must operate in half-duplex mode.

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Network Switch

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 Network Switches

• Network switches act as a central connection

point for network devices.
• Frequently used in Star Topology Networks.
• Switches directly send received messages to
the destination address.
• This allows the switch to operate in full-duplex
mode.
• Switches help reduce network collisions and
as a result increase network bandwidth.

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Network Switch

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 Network Switches

• Switches improve network security by limiting

communication to specific ports.
• Switches can read and analyze the data they
are receiving.
• This makes them useful for troubleshooting
network problems.
• Switches can be configured to either
manually or auto negotiate half or full duplex
modes with other network devices.

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 Information Systems
What to Study? Topic Examples
• Binary! Hex!  Number conversions
• Computer Hardware  Architecture
• Computer Software  Operating Systems
• Security  HIPPA
• Network Hardware  Routers, switches
• Network Software  LANS, WANS
• Topologies  Connectivity

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Storage Hierarchy

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 Computer Hardware
Architecture • A+ Certification
• CPU
• RAM
• ROM
 Discs, DAT, CD ROM, USB
• Secondary Memory Memory, External Hard Drive
• I/O
 Modem, Keyboard, monitors
• Cable Types
• Connector Types

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 RAM

• Primary storage
• Cells individually addressable
• Each cell holds a single binary number
representing data or an instruction
• Most common size is 8 bits or a byte
• Cells combine to form a word. 32 bits is
most common

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Connectors

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Operating System

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 Operating System
• OS must load and execute • File management layer
a program translates logical file requests
• Must get program from from command shell into
storage location from I/O physical I/O requests
into memory which means • Resource management –
it has to provide and resolve conflicts among
allocate space programs
• Provide CPU time for • Memory management load
execution and schedule
• Monitor system arbitrator and
general management

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 Operating System
Software
• Acts as an interface for application programs
• I/O services, memory management
• Allocates resources
• Data communication services
• File management
• Program execution services
• Provides security

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 Application Software

• Accomplish user tasks

• Examples: Word
processing,
• Spreadsheet
• Data

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 Communications

• Communications channel
• Modem
• NIC
• Protocols

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 Physical Media
• Bit: Propagates between • Twisted Pair (TP): Two
transmitter/rcvr pairs insulated copper wires
• Physical Link: What lies – Category 3: Traditional phone
between transmitter & wires, 10 Mbps Ethernet
reciever – Category 5 TP: 100 Mbps
Ethernet
• Guided Media: Signals
propagate in solid media
– Copper, fiber, coax
• Unguided Media: Signals
propagate freely (e.g.,
Radio)

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 Connectivity!
Systems Integration!

Focus on how medical

instruments must interact with
computers and networks

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 Internet Protocol
Stack
• Application: Supporting network
applications
– ftp, smtp, http Application
• Transport: Host-host data transfer
Transport
– tcp, udp
• Network: Routing of datagrams from
Network
source to destination
– ip, routing protocols
Link
• Link: Data transfer between neighboring
network elements
Physical
– ppp, ethernet
• Physical: Bits ‘on the wire’.

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 IEEE 802.3

IEEE 802.3 is a collection of IEEE

standards defining the Physical Layer
and Data Link Layer's media access
control (MAC) sublayer of wired
Ethernet. This is generally a LAN
technology with some WAN
applications.
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 Network &
Communication Services
• TCP-IP protocol suite
– Locate and connect to other computers
– Access files, I/O devices, and programs from remote
systems
– Support distributed processing
• Network Applications
– Email, remote login, web services, streaming
multimedia, voice over IP telephony, VPN
• Interface between communication software and OS
I/O control system that provides network access
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 Network Structure
Devices recognize each other on a network
by their physical addresses and their
logical addresses

– Network Edge: Applications and hosts

– Network Core: Routers, Network of networks
– Access Networks, Physical Media: Communication
links

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Internet Network Layer

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 IP Addressing
• 32 Bit binary number which is divided into 4 octets. The
decimal range of an octet is 0-255 or 256 unique combos.
• The IP address consists of a Network ID and Host ID.
• The Network ID is shared and common to all on the same
physical network. Each physical segment has a unique
Network ID – (area code).
• Physical segment is the broadcast domain in which all
devices can communicate locally.
– Repeaters, Bridges, Switches, all forward broadcast packets.
Routers do not. Out a port of a router or between two routers.
• Host ID identifies a specific device (host) with a physical
segment (phone number).
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Binary! Hex!…..Why?
• Because of physical
concepts e.g. Resolution, IP
Addresses, and Subnets, we
need to be able to convert
between decimal, binary,
and hex.

• It all comes down to

bits & bytes

• Exercise your skills with

numbering systems!

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 IP Addressing

• Static/Assigned
– Routers and Servers
• Dynamic (Dynamic Host Configuration Protocol
(DHCP)): Server dynamically assigns IP addresses
according to its scope
– Range of IP addresses

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 IP Addressing
The unique device IP address is accompanied also by:
• Subnet Mask: This identifies which portion of IP address
is the Network ID and which portion is the Host ID.
Always accompanies IP address and are interrelated as
each only has meaning in the context of the other.
• Default Gateway: IP address of the router on the same
physical segment.
– Gives remote access to other networks.
EX.155.147.104.9 IP Address
255.255.0.0 Default Subnet Mask
155.147.104.1 Default Gateway

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 IP Addressing
Default Gateway:
• A default gateway serves as an access point or IP router
that a networked computer uses to send information to a
computer in another network or the internet. Default
simply means that this gateway is used by default, unless
an application specifies another gateway. The default
server does not even need to be a router; it may be a
computer with two network adapters, where one is
connected to the local subnet and the other is connected
to an outside network.

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 Subnet ID

• Subnets are created with custom subnet masks

• Subnetting is done to divide a large network into smaller
networks, sub-networks, or subnets. Class B would have
65,534 hosts on one physical segment.
• A subnet is a portion or subdivision of the IP addresses
that are associated with an assigned Network address.
The size and range is determined by subnet mask. Get it
by stealing bits from host’s address.

In binary, 1 represents which portion is the network and

0 represents which is host. 11111111.11111111.0.0
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 The Internet Structure &
ISP
Internet Service Providers (ISP) & Online Services

• Have permanent connections to the Internet

• Provide temporary connections to individuals and companies for a fee
• Local and national ISPs
• Online services offer members only areas (proprietary chats, research information,
specialized material)

Future – Many want more services from ISPs and Online

Services

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 Connecting to the Internet

• Plain Old Telephone Services (POTS)

• Cable
• Dedicated Line
– ISDN (Integrated Services Digital Network)
– DSL (Digital Subscriber Line)
– T Lines
• Satellite
• Wireless

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 Home Networks
Typical home network components:
– ADSL or cable modem
– Router/Firewall/NAT
– Ethernet
– Wireless Access Point

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 Local Area Networks
Company/University local area network (LAN) connects end
system to edge router
• Ethernet: Shared or dedicated link connects end system
and router. 10 Mbs, 100 Mbps, Gigabit Ethernet
• Deployment: Institutions, home LANs happening now

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 Wireless Area Networks

Shared wireless access network

connects end system to router via base
station (aka, access point)

• Wireless LANs: 802.1 lb (WiFi): 11 Mbps

• Wider-area Wireless Access: Provided by
telco operator
– 3G ~ 384 kbps
• 1885-2025 Mhz
– Wireless Application Protocol (WAP)/General
Packet Radio Serivce (GPRS) in Europe

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 Wireless Protocols

Various 802.11 Standards

Standard Transfer Rates
802.11 1 or 2 Mbps
802.11a Up to 54 Mbps
802.11b (WiFi) Up to 11 Mbps
802.11g Up to 54 Mbps

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 Network Security

Network security refers to activities designed to

protect the network. These activities protect the
usability, reliability, integrity, and safety of the
network and data. Effective network security
targets a variety of threats and stops them from
entering or spreading on the network.

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 Network Security
What Does Network Security Protect Against?

Many network security threats today are spread over the

Internet. The most common include:

– Viruses, worms, and Trojan horses

– Spyware and adware
– Zero-day attacks, also called zero-hour attacks
– Hacker attacks
– Denial of service attacks
– Data interception and theft
– Identity theft

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 Network Security

No single solution protects you from a variety of threats. You need

multiple layers of security. If one fails, others still stand.

Network security is accomplished through hardware and software.

The software must be constantly updated and managed to protect
you from emerging threats.

A network security system usually consists of many components.

Ideally, all components work together, which minimizes
maintenance and improves security.

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 Network Security
Components
Network Security Components often include:
• Anti-virus and anti-spyware
• Firewall, to block unauthorized access to the
network
• Intrusion prevention systems (IPS), to identify
fast-spreading threats, such as zero-day or
zero-hour attacks
• Virtual Private Networks (VPNs), to provide
secure remote access
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Repairs & Maintenance

• Reboot!
• Check connections!
• Test Equipment
– Cable Test Devices (Copper, Fiber)
– Network Test Devices
• Replace the toner cartridge!
• Reinstall the driver!
• Call the IS Dept.!
• Reestablish network connection!
• Vacuum!

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 Data Types
DATA TYPES STANDARDS
Alphanumeric Unicode, ASCII, EBCDIC
Image (bit map) GIF Graphical Image Format, JPEG
PCX (PC paintbrush)
TIFF (Tagged Image File Format)
BMP (Windows bitmap)
Image(Object) PICT, PostScript, SVG, SWF (Flash)
Outline graphic and fonts PostScript, True Type
Sound WAV, MP3, MIDI,WMA
Page Description PDF, HTML, XML
Video QuickTime, MPEG-2, REAL VIDEO, MPEG-4,WMV

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 Systems Integration
Concepts
MDI - Medical Device Integration is the process of taking the data
from electronic medical devices and integrating it to an EHR.
Proponents of MDI point out that electronic integration of data-
capturing devices and EMRs reduce inaccuracies when
transferring data from one to the other, and that healthcare
providers get more frequent updates while away from patients,
increasing their efficiency. These productivity and reliability
enhancements have driven a widespread push to adopt MDI
solutions in hospitals.

BMDI - Biomedical Device Integration is the approach to

automate the delivery of biomedical device data into the EMR
(Electronic Medical Record)

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 Regulatory & Safety

HIPAA - Health Insurance Portability and Accountability Act

protects the privacy of individually identifiable health information;
sets national standards for the security of electronic protected
health information.

MDDS - Medical Device Data Systems are hardware or software

products that transfer, store, convert formats, and display medical
device data.
In 2011, the FDA published a final rule reclassifying MDDS as
Class 1 medical devices exempt from 510(k) premarket notification
requirements.

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 Regulatory & Safety

IEC 80001 – Application of Risk Management for IT Networks

incorporating medical devices (international standard).

DMCA - Digital Millennium Copyright Act updated U.S. copyright

law (in 2000) to meet the demands of the Digital Age and to
conform U.S. law to the requirements of the World Intellectual
Property Organization.

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 Practice Questions

The presenter will be using the polling feature on

GoToWebinar to cover the practice exam
questions for this module.

You will have one minute to select your answer

and the instructor will reveal the correct answer
with an explanation.

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 Practice Question #1
What network topology uses a token to communicate with?
A. Bus Topology
B. Ring Topology
C. Star Topology
D. Mesh Topology

ANSWER:
B. Ring Topology
A Ring Topology, also known as a “Token” Ring
Network.

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 Practice Question #2
What function does this 15 pin cable perform?
A. HDMI Video
B. VGA Video
C. Composite Video
D. DVI Video

ANSWER:
B. VGA Video uses a 15 pin D shaped connector
Answer backing text.

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 Practice Question #3
What type of cable is used in the open space above a dropped
ceiling?
A. Twisted Pair
B. Coaxial Cable
C. Fiber Optic Cable
D. Plenum Rated Cat 5

ANSWER: D. Plenum rated Cat 5. Plenum is the

area above a dropped ceiling

Answer backing text.

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 Practice Question #4
What function does the” I/O” perform on a PC?
A. Data routing
B. Network Interfacing
C. Security Firewall
D. Interface between the computer and peripheral
devices

ANSWER:
D. Interface between the computer and peripheral
devices
Such as keyboard and mouse

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 Practice Question #5
What type of network topology is also referred to as a “Daisy
Chain”?
A. Bus Topology
B. Ring Topology
C. Star Topology
D. Mesh Topology

ANSWER:
A. Bus Topology
“Bus” network topology is also known as a “Daisy
Chain”.

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FIND US!

www.facebook.com/aamiconnect

search for AAMI in groups

aami.org/connect

twitter.com/

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95
 QUESTIONS??
Contact ACI at aci@aami.org

Martin McLaughlin
Director of Education Programming
mmclaughlin@aami.org
703-253-8275

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