University of MinnesotaInformation Technology in

Healthcare Medical Industry Leadership Institute

Course: MILI/PUBH 6562Fall Semester B, 2013

David L. Edgerton, Jr., BSEE, MBAInstructor

Health IT Hardware Overview

• Computer Components• Virtual Components Tour• Evolution of Health IT Processing • Network Fundamentals• Data Switches for the Health Internet

The Health IT Pyramid

Hardware

Decision Support Software

Life Support Software

Clinical & Financial Data

‘Hands On’ Components of Health Information Technology

Major Components of a Computer System

Input Output1. Arithmetic/Logic2. Control Unit3. Registers

Secondary Storage

Primary Storage

CPU

Information

Control

Central Processing Unit (CPU)

• Arithmetic/Logic Unit– e.g., if diagnosis=‘diabetes’ then count patient

• Control Unit– home of the machine code

• Registers– place-holders within the CPU as it processes data.

Primary Storage

• Core memory:– Read-only memory– Random-access memory– Cache memory

• Started off being very expensive• Extremely cheap today relatively to a few

years ago (32 MB, $1,280 in 1993; 32 MB, <$1 in 2012)

Secondary Storage

• Magnetic disks (e.g., Hard drives)• Magnetic tapes (e.g., Tape drives) • Optical disks– CD (700 MB)– DVD (4,300 or 4.3 GB)– Blu-Ray (25/50 GB)

• Smart cards• Solid state drives (e.g., SSD / USB drives)

Input Devices

• Keyboard• Pointing device– mouse– trackball– pointing stick

• Scanner• Handwriting recognition devices• Voice input

Output Devices

• Printer– Dot matrix– Laser– Inkjet

• Monitor• Speakers

MotionActivatedSecurity

QuadProcessorServers

SatelliteUplink

Welcome to Prof. Parente’s Enterprise Servers

Secondary StorageDual Mainframe Tape Drives

Secondary Storage: Mainframe Tape Drive

One of Eight Server Fans

I/O Peripheral Slots

Dual Processors & Heat Sinks

Basic PC Entrails

CPU

Connecting the Computer to Input & Output Devices

Keyboard

Serial Ports

SCSI Port

Speaker & MIC

Video Port

Network Port

Secondary Storage II

Floppy Drive

Hard Drive

Secondary Storage III

SCSI/SATAHard Drive

DVD

Primary Storage

RAM

PeripheralSlots

Power Supply Backup & Modem

Modem

UninterruptablePower Supply(UPS)

Central Mainframe

1970s - Setting the Stage for Bigger Things

• Hardware innovations opened up new opportunities:– On-line computer systems– Still used batch for big jobs (payroll)

• Minicomputers • Packaged systems

1970s - continued• Packages developed:

– accounts receivable– admissions– bed census– inventory control– medical records

• Turn-key packages: Vendor supplies hardware, software, installation support and training.

• Shared systems– use a ‘hub’– use terminals– forerunner of networks

1980s• Microcomputers make rapid advances• Institutions faced with more managers wanting

systems tailored to their needs.• Led to Balkanization of HMIS. Why?– Technology is cheap– Hospital departments start buying their own stuff– Although stuff was cheap, the new product cycle

rapidly accelerated.

1990s-Realizing integrated IS• Radical market change in health markets has

completed radical in IT change.– mergers– integrated delivery systems – Health reform’s promise, threat and debris– Health data standards– Internet/intranet capability– Privacy & security issues– Consumers enter the health care market informed with

MEDLINE data and clinical data from the web.

Intel processor mainstream purchase timeline: 1981-2000

• 1981: 8 bit XT 8086• 1987: 16 bit AT 80286• 1990: 16 bit 80386• 1993: 32 bit 80486• 1995: Pentium (80586)• 1997: Pentium MMX/Pentium Pro (80686)• 1998: Pentium II (80686 w/MMX)• 1999: Pentium III (80686 Slot 2)• 2000: Pentium IV above 1 Ghz.

Overview of Networks

• Central Mainframe Configuration• Client/Server Computing• File/Server Architecture• Distributed Data Processing

Central Mainframe

Client/Server

HSI Client-Server Platform

Cooling Fans

RAID Disk Array,6 Drive Bays

RAID Defined:

Redundant Array of

Inexpensive Disks

File Server

Distributed Data Processing

Network Topologies

• Bus topology

• Ring Topology

• Star Topology

Software Fundamentals

• Programming Languages• System Management Software– Operating systems– Utility programs

• Application Software– General office suite– Statistical analysis– Custom, visual programming design tools

Programming Language Evolution

Generation Characteristics

1 Machine Language (0,1)

2 Assembly Language

3 Procedural Language

4 Application Language

5 Natural Language

System Management Software

• Operating Systems– UNIX– LINUX–Microsoft (Windows XP, Vista, Server 7)

• Utility programs– File management– Anti-virus– Backup and security

Internet Networking 101

• LAN (local area network)• WAN (wide area network)• EDI (electronic data interchange)• TCP/IP (Internet protocol)• TCP (Transmission control protocol)

Circuit switching

The IS-way: Packet Switching

Multicasting