Point of Care Data Networking

1
Point of Care Data Networking

• by Kevin Breneman and Keith Ensor
• of
• Wellspan Networking and Telecommunications

Keith Ensor email kensor_at_wellspan.org Kevin
Breneman email kbreneman_at_wellspan.org
2
GOAL connectivity

• METER to HOST communications
• Paperless read and results reporting of patient
  testing
• A single source of truth that is reliably copied
  verbatim to whoever needs the data
• Populate other systems with the collected data
• Eliminate hand written transposing errors
• Improve efficiency of existing available staff
• Revenue recovery for services rendered

3
GOAL convenience for caregivers

• A good system will
• be preferred over a manual system
• return more info then a manual system
• simplify an otherwise tedious task
• Integrate easily with other hospital systems
• Allow moderate degrees of customization
• Patient id format matching and checking
• Inclusion of desired extra fields
• Elimination of unwanted field requests
• Include security controls and honor patient
  privacy

4
Wellspan Glucose System Components 1st Level

• Lifescan meter
• Lifescan IR docking station
• Lantronix mss100 terminal server
• House wiring / interconnect
• Catalyst 5500 Ethernet switch

decreasing user exposure
5
Other hidden components 2nd Level

• Core network components
• i.e. core or distribution router
• WAN links to annexs (wanwide area network i.e.
  across a phone company circuit)
• Lifescan Windows server, Lifescan Workstation
• QDXI / CLOVERLEAF interface engine
• Cerner interfaced Lab Info System
• Eclipsys interfaced registration / billing
  system
• Other systems

LOW user exposure
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Point of Care Data Networking Glucose Testing

• Docking Station Components

• The components youll see most around the
  hospital
• These are also the items with the highest human
  exposure and therefore will be the items
  requiring the most service and attention.

Tip -UPGRADE AC brick if you have Lantronix
REGALs -Tape power couplers
7
Wellspan Glucose System Components

• Lifescan meter

• Handheld, self powered, Lifescan glucose meter
  mini-computer
• Touch screen user interface Input/Output
• Strip sensor i/o port
• Bar code reader i/o port

• IR (infra red) communications i/o port
• Duplicate "earphone communications i/o port
• Battery powered

Tip turn off scanner decode of unused bar code
symbologies
8
Wellspan Glucose System Components

• Lifescan meter dock

IR port optical / infrared transceiver
rj11 presentation serial data communications
connector
Meter present trigger
FACT Only when docked is a meter available for
data upload download. -meter updates to flash
memory -meter programming changes
AC power adapter
Tip consider clamp locks for AC adaptors
9
Wellspan Glucose System Components

• Lantronix terminal server

Status LEDs
UTP rj45 Ethernet presentation
AC power adapter connect
RS232 standard db25 presentation serial data
communications connector with rj11 adapter
Tip ECHO test if its alive and on-line. from
your desktop pc issue the command ping
192.168.236.104
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Wellspan Glucose System Components

• House wiring / interconnect
• A reliable cable plant is key to a successful
  installation
• House wiring may be used for Ethernet, serial, or
  telephone connections
• Basically its nothing more then a quality
  extension cord for your wiring needs
• Learn your institutions wiring identification
  scheme. Itll may help you locate devices.
• Report problems by connection id information
• At Wellspan the first three digits indicate the
  central wiring closet where the cable terminates
  and the remaining digits are the sequence number
  or patch location for that cable.
• Consider custom length cords. Bundling can be
  done but exact length cables stay out of the way

Status LEDs
Tip
Structured house wiring. UTP Unshielded Twisted
Pair with rj45 jack presentation
UTP rj45 network cable
11
Wellspan Glucose System Components

• MID level network connectivity

Network switch with fiber uplink
telephoneports
Networkports
House wiring
Wellspan network closet 066 6th flr main bldg
12
Wellspan Glucose System Components
Tip check the path. from your desktop pc issue
the command tracert 192.168.236.104

• Top level network connectivity

CORE Router
Corelayer
Distribution Router 1
Hospital 6th flr idf 66meter location
Distribution layer
Distribution Router 2
Access layer
7th flr POC dept idf 79LIFESCAN Server
location
Hospital Data Center idf 159Cerner LIS location
13
Other hidden components 2nd Level

• Core network components
• i.e. core or distribution router
• WAN links to annexs
• Lifescan Windows NT server
• QDXI / CLOVERLEAF interface engine
• Cerner mainframe interfaced Lab Info System
• Eclipsys mainframe interfaced billing system

14
Point of Care Data Networking
A typical glucose meter to LIS (lab info system)
configuration

• Components
• Meter
• Docking station
• Ethernet / Terminal server
• Ethernet transport inter-network
• hub, switch, router
• Glucose System Server
• Lab Information System
• Other involved information systems

Glucose Meter B w/IR linking
POC dock
Ethernet Terminal Server
Ethernet Area Router
Ethernet Switch
Ethernet Hub
Glucose Server Data Collector
Lab Info System
SUPER DOOPER HOST
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Point of Care Data Networking
A typical glucose meter to LIS (lab info system)
configuration
Glucose Meter A w/IR linking
Host AAA

• Router interfaces 1,2,3,4 join FOUR tcp/ip
  networks.
• Without the router we can not segment traffic.
• With the router we can have local traffic stay
  local impart network access controls
• When a router is used each host must have
  knowledge that it needs to use the router for
  destinations not on its own subnet.

Ethernet Terminal Server 1
POC dock
Ethernet Hub
Ethernet Switch 1
Laser A
Glucose Meter B w/IR linking
Subnet 1
Ethernet Terminal Server 2
POC dock
1
Ethernet Area/Core Router
2
4
Subnet 2
3
Ethernet Switch 2
System to System Interface engine (Cloverleaf)
Subnet 4
Subnet 3
Ethernet Switch 4
Ethernet Switch 3
serial links
Lab Info System
Registration System
UTP links
Glucose Server Data Collector
Fiber links
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Wellspan Glucose System Components
Ethernet Area/Core Router
3
5
1
24
Ethernet Area/Core Router
6
7
Ethernet Switch 1
Ethernet Switch 3
Ethernet Terminal Server
Glucose Server Data Collector
Ethernet Switch
Glucose Meter B w/IR linking
POC dock
Ethernet Switch (2 4) w/ VIRTUAL capability
Ethernet Terminal Server
Interface engine (Cloverleaf)
Glucose Meter B w/IR linking
Lab Info System
Registration System
POC dock
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Point of Care Data NetworkingiSTAT Testing

• Wellspan Components iSTAT Reading
• iSTAT meter lifescan meter
• iSTAT IR docking station lifescan docking
  station
• COBOX terminal serverlantronix terminal server
• --------------------------------------------
• Cisco Catalyst Ethernet switch
• Cisco distribution router
• iSTAT Windows server
• CDS-Central Data Station Lifescan workstation

• Scripted CDS to Cerner interface
• Cloverleaf NOT used!!!! NON - HL7
• Likely Low Cost but LOW TECH.only works to
  Cerner. Un-expandable
• Looks like a user logged in on the system.
  Subject to Cerner changes!!
• uses a VT420 dumb terminal style of login and
  script to upload data
• NOT interfaced to Eclipsys interfaced
  billing/registration system

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Component FunctionsGlucose meter

• a limited function computer with i/o capabilities
  for
• display and keyboard / bar code reader input
• test strip subsystem and input
• Optical communications port to transfer data base
  field type data.
• Input
• operator lists / badges
• Database type field parameters
• Output
• Patient id
• Patient test number
• Time
• Patient test result value

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Docking Station

• IR (infra-red) linking to meter
• Physical and/or Optical connection to meter
• May be passive or may provide expanded
  communications features absent in the meter to
  offer serial RS-232 communications to existing
  hospital owned standards based Networking devices
  like a hospital owned Ethernet terminal server.
• The data stream from the meter/dock is like a
  single file row of marbles coming down a tube in
  sporadic pacing.
• References to the docks data port may include the
  terms serial, asynchronous, com port, rs232 port,
  rs485 port.

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Asynchronous Ethernet Terminal server

• A conversion device or communications converter
  to allow the connection of slow speed low cost
  devices to high speed Ethernet networks. (marbles
  to envelopes)
• Meter and dock speak asynchronously typically at
  only 9600 bits/second or about (9600/8) 1200
  characters per second.
• Serial communication is typically referenced by
  bits or single characters
• Ethernet by contrast speaks at 106 bits/second or
  about (106/8) 1,250,000 characters per second
  with typical modern networks NOW using fast
  Ethernet 107 and gigabit 108 bit rates.
• Ethernet communication is typically referenced by
  packets of data

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Ethernet terminal server (cont)

• The job of the terminal server is to package
  the async data into a larger package for
  efficient transport on a high speed network. i.e.
  Japanese subway stuffers.
• The data stream on the Ethernet side of the term
  server would be analogous to when a train comes
  by with open box cars and you fill each boxcar
  without the train stopping in a clocked loading
  fashion such that each boxcar represents a data
  packet from the terminal server. Many cars will
  leave only partially filled and sometime 2 or 3
  cars may be needed for one big packet that has to
  be split up because its too big or takes to long
  to get in the current passing boxcar!
• One box car or packet may contain multiple
  individual threads between several meters on a
  common terminal server origination or source to a
  common destination such as the LIS host offering
  multiple threads to accommodate communications
  with each connected meter.

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Cloverleaf (QDXI) interfacing and HL7

• An interfacing program executing on the LIS
  receives the inbound testing information but at
  Wellspan the meter actually first sends to the
  Lifescan server (Lifescan Workstation) which then
  sends to an interface engine which then sends to
  Cerner (the LIS) via HL7 data exchange protocol.
  HL7 health layer seven
• The advantage is that an enterprise hub and spoke
  interfacing plan can be adopted saving per host
  interface ports and resources.
• Consider this example 6 host hospital
  enterprise
• full mesh interfacing..interfacesn(n-1)/2
  or 6(5)/2 15
• hub-and-spoke interfacing..interfacesn(1)
  or 6(1) 6
• A hospital with only 20 hosts would take 180
  interfaces versus 20 interfaces

2
2
1
3
1
3
Hub and Spoke
Full Mesh
versus
QDXI
4
4
6
6
5
5
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LIS Laboratory Information System

• The LIS is the eventual receiver of the
  collected test data. The LIS (Cerner) receives
  the data via the HL7 data exchange protocol from
  Cloverleaf interface engine.
• A communications application module purchased for
  the LIS must be running and listening for this
  inbound data stream.
• The Cloverleaf and the LIS being Ethernet capable
  devices exchange packets (boxcars) filled with
  Lifescan transaction data that has been
  aggregated by the Lifescan Workstation.
• TCP / IP protocols job is to direct and route
  those data packets to the appropriate software
  communications endpoint on the LIS host.
• This endpoint is often called the listener, the
  interface socket, or host virtual port.

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that old black magic. DATA NETWORKING

• The part we just skipped is Networking's
  specialty and what puts bread on the table for
  Keith and Kevin !!!!!
• What really happens when my glucose meter begins
  to upload data to the network.
• How does the meter data actually make it to the
  LIS host?
• What keeps the data from getting all jumbled
  together when 5 meters all upload concurrently?

25
MAC and IP addressing MAC addressing

• Every Ethernet device EVER made has a globally
  unique MAC or media access control Ethernet
  address assignment. This assignment is burned
  into the chip set of each and EVERY Ethernet
  communications port of any device that can be
  Ethernet attached.
• In our example the terminal server would have one
  and the LIS host would have one.
• A MAC address is 48 bits long and is almost
  always written and represented in the computer
  world in hexadecimal.
• 281,474,976,710,656 possibilities
• example
• 08-00-2b-01-af-19 hex
• 0000 1000 0000 0000 0010 1011 0000 0001
  1010 1111 0001 1001 binary equiv
• 8,796,814,552,857 decimal equiv

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IP addressing

• Every Ethernet device added to a tcp/ip network
  needs to get an assigned IP address. This
  assignment is typically awarded by your
  institutions network guru or IP address
  administrator.
• In our example the terminal server would be
  assigned an ip address so it could talk to other
  tcp/ip systems on your network. An ip address is
  a 32 bit number typically expressed in decimal
  format. The left portion of the assignment
  reflects the network (think area code) that the
  host is enrolled in and the right portion of the
  assignment reflects the host number in that
  network. (think your 7 digit phone number)
• An IP address is 32 bits long and is represented
  in the computer world in decimal using what is
  called dotted decimal notation.
• Example 192.168.236.104
• Above in binary is 1100 0000 1010 1000 1110
  1100 0110 1000
• Full decimal value would be 3,232,296,040 but
  this reference is not used as the dotted decimal
  notation more easily shows network enrollment
• 32 bits 4,294,967,296 possibitlies
• Private REUSABLE addressing ranges
• 192.168.0.0 thru 192.168.255.255 first dot
  boundary (/24 bit)
• 172.16.0.0 thru 172.31.255.255 second dot
  boundary (/16 bit)
• 10.0.0.0 thru 10.255.255.255 (/8 bit)

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IP addressing/subnet masking

• Example 192.168.236.104
• Above in binary is 1100 0000 1010 1000
  1110 1100 0110 1000
• Mask 255.255.255.0 1111 1111 1111 1111
  1111 1111 0000 0000
• The above 32 bit mask allows 224 bits for
  network and 28 bits for host numbers
• MASK Value
• Typical masks are
• 255.255.255.0 - allows last byte to be all host
  numbers 28 255 (actually 256-1)
• 255.255.0.0 - allows last 2 bytes to be for host
  numbers 216 65,535
• 255.0.0.0 - allows last 3 bytes to be for host
  numbers 224 16,777,215
• BUT they can be on a NON-classful boundary
• 255.255.255.240 - CUSTOM mask example
• allows only the last HALF of last byte to be host
  numbers 24 15
• Every host in a tcp/ip network needs an ip
  address, a mask, and a gateway
• Mask indicates where the network / host boundary
  marker is.
• The mask is the masking tape that tapes over the
  COMMON NETWORK PART of the address that is not
  important when talking within your network.

28
IP addressing/gateway
Host portion
Network portion

• Example 192.168.236.104
• Above in binary is 1100 0000 1010 1000
  1110 1100 0110 1000
• Gateway 192.168.236.253
• Above in binary is 1100 0000 1010 1000
  1110 1100 1111 1101
• Mask 255.255.255.0 1111 1111 1111 1111 1111
  1111 0000 0000
• The gateway address will always be a similar ip
  address to yours in your local network.
• The gateway address you use will always be the ip
  address of a router interface.
• Your GATEWAY to the rest of the IP world.
• You talk to it. It talks to the next level on
  your behalf.
• The address you enter on your host for the
  GATEWAY will always be an address on YOUR
  network. It is who you DEFAULT to for getting
  beyond your network.
• long distance to another area code.
• Hence the name default gateway
• An ARP address resolution protocol table in your
  pc maps host ip addresses you talk to, to that
  devices MAC address. Devices really talk MAC to
  MAC!!!

Tip ECHO test the gateway. If its not alive
then that net will be unable to talk outside of
its own area code. from your desktop pc issue
the command ping 192.168.236.253
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IP addressing / dhcp or permanent (static)

• The ip address can also be awarded by machine
  from a pool of predefined available addresses.
  This technique is called DHCP or Dynamic Host
  Control Protocol. This works great for devices
  that join and leave networks and works well if no
  one needs to access your host. DHCP can be setup
  to award you a temporary ip address, your correct
  mask and your assigned gateway.
• A pc workstation works fine with a temporary
  dhcp address but a pc SERVER would almost always
  need to receive a permanently assigned address so
  other computers would know what to connect to.
• The addressing typically used by POC system
  component will likely always be static addressing
  because like a server the addressing is
  permanently awarded per device so that other
  systems can find the POC system components using
  the same address each time.
• Good static address example is www.google.com
  which really is 64.233.167.99
• Good dhcp example is your office pc which only
  makes OUTGOING connections so it doesnt really
  matter if you use a different address tomorrow.
  You could still for example get to google.com!

30
Wellspan Glucose System Networking
Glucose Server Data Collector IP
10.2.1.1 Gateway 10.16.9.1 Mask 255.0.0.0
Ethernet Terminal Server IP 192.168.236.104 Gate
way 192.168.236.1 Mask 255.255.255.0
Glucose Meter B w/IR linking
POC dock
31
Socket Communications

• Socket communications is how the I.T. world
  refers to endpoints.
• Two systems that are ETHERNET capable will use
  socket to socket communications for each flow
• Meter A on term server 1 to the Lifescan
  Workstation would use a socket pair.
• Meter B on term server 2 to the Lifescan
  Workstation would use a socket pair.
• At least one endpoint must use an exclusive ip
  address or socket number to differentiate between
  the two flows. (reference slide 15)
• Connect to your LIS host and then to an Internet
  sites on your work pc and then click start and
  run and in the dos window that opens type netstat
  a on your pc. It will show you an nice example
  of socket to socket communications
• example pc to google
• Example pc to CERNER via telnet

Tip
32
Sockets that receive connections

• are called Listeners because they are at the
  ready to receive an inbound connection.
• Are often called services or service sockets
  because they are typically tied via software to
  an application function like
• telnet, or ftp, or webserver
• Custom receiver application like Glucose meter
  data collection.

33
Application to Socket communications

• The application can however be coordinated with
  an initiating socket with the other endpoint
  being the listener. Printing is an example of
  such a reverse direction of socket communications
  because the printer is listening for a connection
  for its next print job.
• A listener may allow only ONE connection at a
  time or it may allow multiple concurrent
  connections.
• THE computer with the endpoint that INITIATES the
  communications is NOT the listener.
• Web server example of multithreaded listener
• If the terminal server is the listener end
  example of single thread listener.
• A busy listener will tell the end trying to
  connect to it that it is already busy or it may
  even allow a degree of queuing whereby it accepts
  a second, third or fourth connection but it may
  put that flow in a hold or stacking pattern till
  it can process the current on deck request.

34
Application to Socket communications
Click RUN, then click START then enter command
(win98) or cmd (winxp) and in the dos window
enter netstat a at the prompt to view all the
current socket connections on a pc. Heres a
partial clip from our Lifescan server.
Tip

• Active Connections
• Proto Local Address Foreign Address
  State
• TCP lfs_datalink135 0.0.0.00
  LISTENING
• TCP lfs_datalink135 0.0.0.00
  LISTENING
• TCP lfs_datalink1027 0.0.0.00
  LISTENING
• TCP lfs_datalink1029 0.0.0.00
  LISTENING
• ..
• .
• TCP lfs_datalink137 0.0.0.00
  LISTENING
• TCP lfs_datalink138 0.0.0.00
  LISTENING
• TCP lfs_datalinknbsession 0.0.0.00
  LISTENING
• .
• .
• .
• .
• TCP lfs_datalink4760 192.168.16.33001
  ESTABLISHED
• TCP lfs_datalink4762
  172.20.150.133001 ESTABLISHED
• .
• .

netstat a is a harmless command to view
connection status.It can be executed at any time
on any pc w/o impact.
35
Wireless adoption

• Current capabilities
• Wirelessly connect the terminal servers
• Future
• Direct real time or hot spot wireless linking
  for each meter
• Would help eliminate those times when no one
  remembers to dock and upload the days work from a
  meter.
• Wireless Meter tracking. Where did I lay meter
  icu01???
• Wireless daily audit of transactions w/o docking.
• Meter peds06 did not report for 24 hours so the
  server will look for it and potentially alarm
  /email a system manager if missing.
• Automated updates. All meters will be software
  upgraded to now accept an additional bar code
  format for the new to be adopted patient id
  system.
• Or all meters will be upgraded to Lifescan
  operating system version 6.12 from 5.83

36
What can POC users do to make for an optimal
Network deployment at their institution?

• Establish clear installation locations that are
  not overcrowded with other nursing functions.
• Name everything with a short, lower case,
  meaningful name during the design phase and stick
  with it.

• Too many devices here!! A horrid wire mess from
  msicu
• Wheres Waldo?
• Find the istat meter dock!!!!..????
• The lifescan doc is on the wall. Note its clean
  install helps keep it easiest to find but front
  clutter impacts its accessibility.

37
What might POC users be asking of POC vendors

• for future product considerations give thought
  from a Networking perspective.
• Does the vendors devices allow you to use
  existing network resources.
• You may already own terminal servers? Why buy
  more? We shouldnt have.
• Can they use DNS or dynamic DNS for naming
  simplification and connection destinations? A
  netstat will then show names instead of
  addresses!
• Can the peripheral devices be easily monitored
  for health status (SNMP, telnet and web access)?
• Does the system support test and training data
  collection while the production system is live?

38
Other BEST networking practices

• Neat cable work eliminates problems
• Label devices and document connections
• Give EVERYTHING an enterprise unique name
• Think like a hacker when planning the install.
• Hospitals have been lax on security for too long.
  
• If the area is already cluttered dont expect it
  to improve with the addition of another computing
  device. Something gotta go or new space must be
  allocated.
• If the installation looks permanent it will be
  permanent. If it is just splayed out on a counter
  itll be buried in charts and you can be assured
  of failures. If it didnt require tools to
  install it then it wont require tools to
  dismantle it and someone will.
• Consider a semi-annual or regular equipment
  inspection and be prepared to make repairs and
  corrections. Time the inspection with your annual
  review and tout how youve assured continued
  meter reliability. If it breaks youll get the
  blame so why not get the credit.

39
Point of Care Data Networking

• Thank-you
• Questions

Keith Ensor kensor_at_wellspan.org Kevin
Breneman kbreneman_at_wellspan.org
40
Point of Care Data Networking
EXTRA CREDIT
Keith Ensor kensor_at_wellspan.org Kevin
Breneman kbreneman_at_wellspan.org
41
BEST PRACTICES DNS Domain Name System

• Whats DNS have to do with POC networking???
• Forms a name to IP address relationship that is
  enterprise wide
• Enter every ethernet device in your DNS. You
  would submit to your DNS administrator the
  official hostname and its assigned ip address.
  They will add an A record to your enterprise
  DNS so the name can be resolved to an ip address
• Promotes good naming conventions
• Aids dramatically in troubleshooting
• Is the terminal server in ICU plugged in? The
  users say they cant upload?
• Lookup the ip address of the Lantronix in ICU and
  find it is 192.168.22.8
• So you do a ping to 192.16.22.8
• ---- OR -------
• Is the terminal server in ICU plugged in? The
  users say they cant upload?
• Ping the server by the enterprise naming
  convention for Lifescan terminal servers
• So you do ping ts-ls-icu01 (names should use
  only alpha and numerics and the special character
  for best practice.add 01,02 at the end for
  when you expand.)
• What would the name of the terminal server be in
  pediatrics
• Any traces or netstat reports will now present
  the DNS name of the device in the output instead
  of the IP address. Much more people friendly!!!

42
PING example - success

• Whats a ping display look like when it is
  successful?

43
PING example - failure

• Whats a ping display look like when it fails?

44
Trace route example (tracert)
Whats a tracert display look like?

• Note tracert (and ping) commands are case
  sensitive.
• Two techniques shown
• Standard trace with name lookup
• tracert 192.168.236.104

• Modified trace with resolve of names disabled
• tracert d 192.168.236.104

45
Futures

• IP version 6
• Huge address space
• 128 bits of addressing capacity
• 3.40 X 1038 available addresses
• 340,282,400,000,000,000,000,000,000,000,000,000,00
  0
• MAC layer addressing can be auto-extracted into
  an IP address and address awards can be made from
  the router w/o a dhcp server.
• Dynamic but always reserved for your MAC!
• Return to a net 5 years later and get the SAME
  address!
• Integrated encryption already included.
• Can be made to work with existing IP version 4
  networks

46
Wellspan Glucose System Components

• HL7
• Health Level Seven is a syntax standard
  specifically designed by. the healthcare industry
  to facilitate patient data exchange between
  computer applications .....
• Derived from the X12 EDI standard used for HIPPA
  compliant data transfer
• take a look at a typical HL7 ADT message. This
  message is sent when a new patient arrives at the
  hospital. The patient's demographics are entered
  into HIS (hospital information system) and then
  the information is communicated to all the other
  systems to avoid multiple entries of the
  patient's demographic information.
• MSH\EPICEPICADTSMSSMSADT199912271408CHAR
  RISADTA041817457D2.3 EVNA04199912271408
  CHARRIS PID04935752ID 1454721DOEJOHN
  DOEJOHN19480203MB254
  E238STEUCLIDOH44123USA(216)731-4359MNON
  4000034031129086999- NK1CONROYMARISPO
  [phone]EC
  PV1O168 219CPMA277ALLEN
  FADZLBONNIE 2688684
  199912271408002376853
• HL7 messages are ASCII messages and the standard
  requires that they be "human readable". The
  (pipe characters) are considered readable

47
Security Planning and Considerations

• Three As
• Authentication
• Multifactor
• Who you are username
• Something you know secret password
• Something you have key or token
• Authorization
• What is allowed now that your in?
• Not all users should have full access
• Accounting
• Who are you, what did you do, and when did you do
  it?
• Audit trail
• Intrusion analysis

48
Point of Care Data Networking

• THATs ALL FOLKS!!!!
• REALLY!!!!

Keith Ensor kensor_at_wellspan.org Kevin
Breneman kbreneman_at_wellspan.org
49
presentation needs

• What host will provide
• Screen and projector setup with VGA input
  capability
• Cable for VGA connect to laptop from projector
  that can reach presenters laptop location
• Table or stand for convenient nearby location of
  2 laptops to presenter with space for mouse
  navigation by presenter
• Extension cords / outlet for AC power for
  presenter laptop
• white board or flip chart w/markers of two colors
  
• Access to conference room 15 to 30 minutes prior
  to presentation for setup
• Hard copy of the presentation will be provided to
  each attendee.
• 3/15 POC mtg agenda for the day0830-0900
  registration0900-1000-  networking lecture
  (keith kev)1000-1015- break1015-1130 
  networking lecture questions (keith
  kev)1130-1330- lunch vendor fair1330-1430-
  barcoding lecture
• Conference chairperson/contactBeverly
  McAllister, MS, MT(ASCP)SCLaboratory Operations
  ManagerEphrata Community Hospital169 Martin
  AveEphrata, PA. 17522Phone [phone]Fax
  717-738-6533

• What presenter(s) will provide
• Final version of presentation emailed to Bev M.
  by 3/10/2006
• Laptop(s) and power point software and
  presentation file
• Laptop mouse and local cabling
• Spare laptop ready to be used to continue
  presentation in the event of equipment failure.