HIM 425 Module 4 Networks Short Paper Example

Two Paths to Every Clinic: Network Connectivity and Redundancy at Cedar Fork Community Health

[Student Name]

Southern New Hampshire University

HIM 425: Healthcare IT Infrastructure and Network Management

Module Four Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Two Paths to Every Clinic: Network Connectivity and Redundancy at Cedar Fork Community Health

Milestone One showed that two of Cedar Fork Community Health's five clinics reach the record through one shared wireless link that failed 14 times in a year, and that nearly a third of their video visits failed. If the health center moves its record to a hosted system, every clinic will depend on its internet connection even more. This paper explains how Cedar Fork's networks work, estimates how much capacity each site needs, compares connection options for rural clinics and proposes a design with redundancy and security built in.

Local and Wide Area Networks

Each clinic has a local area network, the wired and wireless connections inside the building. Switches connect workstations, printers and phones by cable; wireless access points let laptops and tablets connect without wires; and a router with a firewall sits at the edge, deciding what traffic can enter or leave. The wide area network connects the clinics to each other and to the main clinic where the record server sits today, using circuits leased from outside carriers. Three clinics have fiber connections. The two mountain clinics share a fixed wireless link: a radio on a ridge that beams signal to one clinic, which then relays it to the other over a second radio. Any interruption at the ridge, from ice to a power failure, cuts off both.

How Much Capacity Each Clinic Needs

Bandwidth is the amount of data a connection can carry each second, usually measured in megabits per second (Mbps). Latency, the delay before data arrive, matters as much for video and voice. Table 1 estimates peak demand for a typical mountain clinic with eight exam rooms. A high-definition video visit needs roughly 3 Mbps in each direction, so four simultaneous visits need about 12 Mbps up and down. The record itself, phones, scanned documents and occasional imaging add more. With a safety margin, each clinic needs about 50 Mbps in both directions, while the shared wireless link currently delivers about 25 Mbps down and 5 Mbps up, split between two clinics. The shortfall explains why video visits collapse to phone calls.

Table 1. Estimated Peak Bandwidth for One Eight-Room Clinic

Note. Estimates by the author; actual needs depend on vendor specifications and usage.

Why Connectivity Is a Care Issue

Bandwidth is not only a technical number. Wilcock et al. (2019) found that Medicare beneficiaries in counties with less broadband availability used telemedicine less, and Drake et al. (2019) reported a similar gap in rural America, concluding that poor broadband limits who can benefit from virtual care. Cedar Fork's patients face this gap at home, which the health center cannot fix alone, but its own clinics should not add to it. A patient who drives 40 minutes to a clinic for a video consult with a specialist should not have the call fail inside the building.

Connection Options for Rural Clinics

Rural sites have fewer choices than urban ones, and each option has trade-offs. Table 2 compares the options available or becoming available to the two mountain clinics.

Table 2. Connection Options for the Mountain Clinics

Note. Estimates from carrier quotes and public service maps gathered by the author.

Designing for Redundancy

No single rural connection is reliable enough to carry the record alone, so the design gives each mountain clinic two independent paths that fail for different reasons. The recommended pairing is low-orbit satellite as the primary link at both clinics now, with cellular service as the backup at the clinic that has coverage and a second satellite terminal on a separate power circuit at the other, until fiber arrives. A software-defined wide area network, a device and service that manages several connections as one, would watch both links, send traffic over the better one and switch automatically in seconds when one fails. It can also give video and voice priority over less urgent traffic, a practice called quality of service. The three fiber-connected clinics would add inexpensive cellular backup so that a cut cable no longer stops care.

Security Through Segmentation

Networks also carry risk. Kruse et al. (2017) found in a systematic review that health care organizations face growing cybersecurity threats while often lagging other industries in defenses. One of the most effective defenses for a small organization is segmentation, dividing each clinic's network into separate virtual networks: one for clinical workstations and the record, one for medical devices such as blood pressure monitors and the point-of-care testing machine, one for phones and one for guest Wi-Fi. Firewall rules then allow only the traffic each segment needs, so that malware on a guest phone or an unpatched device cannot reach the record. Connections to the hosted record would travel through encrypted tunnels.

Monitoring and Support

Redundancy only helps if someone knows when a link fails. The SD-WAN service includes monitoring that alerts the IT support provider when a connection drops or slows, and monthly reports would show each link's uptime and performance so that Cedar Fork can hold carriers to their commitments. The health information team would receive the same reports, since each outage may leave downtime documentation to reconcile.

Conclusion

Cedar Fork's network problem is a design problem: one shared path to two clinics, with too little capacity for the video care those communities need. Two independent connections per clinic, managed together, would keep the record and video visits available through most failures, while segmentation would protect the record from threats on the same network. This design becomes one component of the potential solution in Milestone Two.

References

Drake, C., Zhang, Y., Chaiyachati, K. H., & Polsky, D. (2019). The limitations of poor broadband internet access for telemedicine use in rural America: An observational study. Annals of Internal Medicine, 171(5), 382-384. https://doi.org/10.7326/M19-0283

Kruse, C. S., Frederick, B., Jacobson, T., & Monticone, D. K. (2017). Cybersecurity in healthcare: A systematic review of modern threats and trends. Technology and Health Care, 25(1), 1-10. https://doi.org/10.3233/THC-161263

Wilcock, A. D., Rose, S., Busch, A. B., Huskamp, H. A., Uscher-Pines, L., Landon, B., & Mehrotra, A. (2019). Association between broadband internet availability and telemedicine use. JAMA Internal Medicine, 179(11), 1580-1582. https://doi.org/10.1001/jamainternmed.2019.2234