IT On A Budget A Rural Approach

1
IT On A Budget A Rural Approach

• Chris Foster
• Powell County Medical Center
• Deer Lodge MT

2
IT Systems How To Do It Yourself

• Intranet/Extranet Sites
• Networked Video Surveillance
• PACS/Teleradiology
• Digital Dictation/Transcription
• Wireless PDA Physician Resources
• Outdate Monitoring and Prevention

3
Intranet

• Heres What You Will Need
• Microsoft Front Page Cost 98 Using Microsoft
  Office Upgrade
• Windows XP Professional (for Internet Information
  Services Web Hosting) OR
• Apache Web Server Free Download OR
• Microsoft Server 2003 This is the preferred
  option as you can expand ALL network services
  (Includes free Sharepoint Services) Cost
  1,100
• Web Hosting PC or Server Networked PC running
  XP Pro Cost 0 ORPC New Dell Dim. Refurb 400
  OR Server Cost Dell Poweredge refurbished Dual
  160GB SCSI Pentium 4 or Higher w tape backup,
  this is preferred as it will allow expansion on
  ALL network services 1,399

4
Heres How To Intranet

• Install Internet Information Services (IIS) to
  the pc/server of choice
• Install Microsoft FrontPage
• Default location for site is c\Inetpub\wwwroot\de
  fault.html
• In Front Page Open new site at address above.
• Make changes to content of the default home
  page- On toolbar click New and choose from
  existing templates or blank page- Type text or
  insert photos (Click Insert, Picture, From
  File and browse to the location on your hard
  drive where this is located.- Highlight text or
  photos and right click to add hyperlink (ie
  This might be a newsletter stored on your hard
  drive at C\newsletters\AugustNews.pdf)
• Create New Pages as above and save- Create text
  and insert pictures as before
• Create buttons- On toolbar click Insert,
  Interactive Button and choose a style- On the
  Link click Browse and locate the linked file
  (I.e. C\newsletters\AugustNews.pdf)
• Create new pages for each of the links on your
  home page
• Link to the Intranet Site from any networked PC
  by typing the name of the server followed by the
  path above (I.e. \\johnsmith\Inetpub\wwwroot\defau
  lt.html), bookmark this link or set as home.

5
Extranet

• Heres What You Will Need
• Hosted internally with Intranet Setup Static IP
  from ISP provider cost 20Domain name cost
  10/yrFirewall cost 400-1,400
• Hosted ExternallyWeb Space cost 120/yrDomain
  Name cost 10/yr

6
Heres How To Extranet

• Purchase a domain name online (I.e.
  http//www.mtpin.org). If you are going to host
  your site on a server externally the domain name
  can usually be purchased along with a web hosting
  plan. This is probably the easiest and safest
  method for hosting for most facilities (try going
  to http//bella.lunarpages.com for hosting plans)
• For hosting from an internal server- Set a pc
  or server aside for web hosting and use static IP
  addressing. To do this go to Start,
  Settings, Control Panel and click on Network
  Connections and right click properties on the
  Local Area Connection. You will need an
  available internal IP address (something like
  192.168.111.168). Download Angry IP Scan from
  http//www.angryziber.com/ipscan or similar
  software to scan for available addresses. -
  Click on Internet Protocol (TCP/IP), check Use
  the Following IP Address and enter the available
  address in the space provided. Subnet Mask is
  usually 255.255.255.0. Default gateway should be
  the internal address of the firewall (Note You
  probably already have a firewall in place if you
  have internet access). The DNS server addresses
  you will have to get from your Internet Service
  Provider (ISP).- Obtain a static external IP
  address from your ISP. - Firewall settings will
  have to be set up to route/translate the external
  address into the internal address set up above.
  You will likely need tech support for this if you
  are not the Firewall administrator. Dont be
  afraid to call one of the nearby Tertiary
  hospitals. They have great IT staff and usually
  dont mind helping out.

7
Extranet Cont.

• - Contact your domain name provider and notify
  them of the static external IP address for the
  site. They will set this address to correlate
  with your domain name (I.e. www.mtpin.org)
• So the quick and dirty is- Someone enters your
  domain name http//www.mtpin.org into a web
  browser from the World Wide Web- Your domain
  name host has set this address equal to the
  static external IP address given to you from your
  Internet Service Provider.- The firewall sees
  this external address request and translates it
  into the internal address that you set up
  earlier. - The request is handled by the local
  machine running Internet Information Services

8
Network Video Surveillance

• Heres What You Will Need
• Dell Refurbished PC 160 GB w Pentium 4 or
  better, cost 400
• Axis 206 Camera cost 390
• Axis Camera Station 10 User Software cost 953

9
Heres How To Video Surveillance

• Each camera comes with self discovery of IP
  addressing so that all you need to do is apply
  power and plug each camera into the network using
  Cat 5 cable (standard for networking).
• Running power to each camera can be avoided by
  using Power Over Ethernet (PoE) from Axis which
  plugs in back at the hub rather than running
  individual supplies in the ceiling.
• Install Axis Camera station software on the PC
  being used for the surveillance.
• Run the software and select File Administration
  and Camera Explorer. This will allow you to
  identify the IP address of each Axis camer.
• When done, close and select the camera from the
  list. Give this a recognizable name and make
  sure the enable camera check box is highlighted.
• Select the Record Tab and click I/O alarms and
  motion detection.
• Click on the motion detection setting button and
  adjust the grid and sensitivity as necessary.
• To view individual cameras open a web browser (IE
  Explorer) and type in the address of the camera
  (192.168.111.xxx) as noted from the Camera
  Explorer above OR
• Create links on your home page to each camera on
  the network.

10
PACS/Teleradiology

• Heres What You Will Need
• For Teleradiology Need KPACS to view,
  manipulate and transport images cost 499.
• For PACS Need both Web Based IQ-Web and KPACS
  viewer 1,500 499 (or similar system).- Web
  Server Dual 300 GB HD preferably SCSI w Dual 36GB
  for operating system RAID 5 configured with LTO2
  tape backup 4,500- Offsite server backup
  4,500- Backup Software 2,500- Additional
  modalities X-Ray digitizer Orex CR cost 32,000-
  3 Meg Viewstation (CR) 3,500

11
Heres How To PACS/Teleradiology

• Teleradiology- Install Kpacs viewer on
  standalone pc. You will be asked for an AE
  title. Give this a name something like
  (teleserver). This is the name other systems will
  use to validate send/receive of images. Make sure
  the Port is set to 104. You will also need to
  know the static IP of the machine you are setting
  this up on. See- Go to the DICOM configuration
  button and add entities that you will either be
  sending to or receiving from. Enter a logical
  name (recognizable), AE Title, IP address and
  port (usually 104). You will need to get the AE
  Title from the company you are sending to (ie
  Nighthawk). An alternative here is to use Capital
  Radiology [phone] as there arent any
  charges to the facility for image submission.-
  Select the images to transfer by checking the box
  and then clicking on the transfer button.- An
  alternative here is to purchase the Web based IQ
  Server and set up an automatic routing table to
  the receiving radiologist or group. This way all
  images are automatically forwarded based on a
  schedule that you set up.

12
PACS/Teleradiology Cont.

• PACS (General Guidelines)-The IQ Server is based
  on the following free software that will need to
  be downloaded and installed prior to
  installation MySQL, Apache Web Server and .NET
  Framework.- Set up the IQ Server on server 1.
  The second should be configured for backup
  utilizing the backup software. Software will kick
  over IP and utilize all data on server 2 in the
  event of failure on 1.- Log into Webserver -
  Set up AE titles, IP and port 104 for each of
  the routes images will be sent to under
  Application Entities- Set up auto routing as
  necessary based on radiology need under Auto
  Route- Complete daily backups of system on tape
  drive

13
Digital Dictation

• What You Will Need
• Dell Poweredge refurbished Dual 160 GB RAID
  configured w tape backup cost 1,399
• Windows 2000 or 2003 Server Software cost 1,100
• Philips DPM9400E Portable Dictation cost 445
• Philips ProTranscribe with foot control and
  headset cost 379
• Phillips SpeechMike II Classic with software
  license cost 459
• PC for each station cost 399

14
Heres How To Digital Dictation

• Configure the server with a shared network drive
  - Create a drive labeled transcription- Right
  click and change to a shared folder and add
  permissions as necessary
• Install USB dongle and Digital Pocket Memo.
• Map Network Drive- Browse My Network to the
  shared transcription directory- Right click
  and Map Network Drive
• Install Speech Exec software to PC
• Open Speech Exec software and right click on the
  Finished folder on the left hand side. Browse
  the folder until you locate the folder you
  previously mapped and select this.
• Repeat this process for both the Speech Mike II
  and the Transcriptionist station.

15
Outdate Monitoring and Prevention

• Heres What You Will Need
• My World Maintenance cost 499 for standalone or
  network 2 user 989
• MyWorld Maintenance can be set up for any
  supplies, maintenance tasks, rotating tasks or
  just about anything requiring monitoring.
• Once supplies are initially entered, an
  expiration date is easily attached and monitoring
  is then automatic.