Installation and Maintenance of

Health IT Systems
Creating Fault-Tolerant Systems,
Backups, and Decommissioning
Lecture b
This material Comp8_Unit9b was developed by Duke University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.
Creating Fault-Tolerant Systems,
Backups, and Decommissioning
Learning Objectives
1. Define availability, reliability, redundancy, and fault
tolerance (Lecture a)
2. Explain areas and outline rules for implementing
fault tolerant systems (Lecture a)
3. Perform risk assessment (Lecture a)
4. Follow best practice guidelines for common
implementations (Lecture b)
5. Develop strategies for backup and restore of
operating systems, applications, configuration
settings, and databases (Lecture c)
6. Decommission systems and data (Lecture c)
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault Tolerance:
Computer Hardware
Redundant and fault tolerant hardware costs more
Computers are workstations and servers
Workstations need little fault tolerance
No critical data used interchangeably
Servers need redundancy and fault tolerance
Hot-swap hard drives
Hot-plug expansion cards
Error checking and correcting, hot-add memory
Redundant and hot-swap fans
Redundant power supply (PSU)
Multiple servers
Clustered systems are complex but highly available
Mirrored servers less complex but highly available
Hot spare simplest configuration but requires effort after failure

(Tulloch, 2005)
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault Tolerance:
Data Storage
Store data redundantly, so that single failures cause no loss
RAID (Redundant Array of Independent Disks) for hard drives
RAID 0 provides no fault tolerance! Speed increase only
RAID 1 (disk mirroring): Fast reading, simple, easy
RAID 5 (disk striping with distributed parity): increased
speed & reliability with relatively few disks, complex
Critical systems should include a hot spare
RAID 6 (disk striping with double distributed parity):
increased speed & additional reliability with relatively few
disks, similar to RAID 5 in complexity


(Tulloch, 2005; RAID, 2012)
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Example RAID Arrays
(en:User:Cburnett, 2006)
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault Tolerance:
Data Storage (contd)
Store data redundantly, so that single failures cause no loss
Distributed file system running over a network
Distributed File System (DFS) for Windows
Used with File Replication Service (FRS) to duplicate data
Others will depend on platform, can include ZFS (Solaris), AFS
(general UNIX), GFS (RedHat)
SAN (Storage Area Network), NAS (Network Attached Storage)
EMC
2
and NetApp are large vendors
Cloud or Hosted storage uses the Internet
Let someone else worry about drives!
Dropbox
iCloud
Amazon S3
Windows Azure Storage


(Tulloch, 2005)
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault Tolerance:
Virtualization
Types of Virtualization
Storage virtualization discussed previously
Server virtualization - virtual machines (VMs)
Virtual Machine = Software emulation of physical environment
Server running VMs called a VM host multiple VMs run on single host
Advantages
Easy upgrading and scalability
Simplified hardware management and fault tolerance
Easy to integrate existing systems and infrastructure
Disadvantage is a slight performance hit and more systems down with failure
Some services, e.g. Databases not perfectly suited for virtualization
Best practices for each service are available from the service vendor.
Infrastructure virtualization
Everything accessed through remote interfaces
Contracted level of service is important to specify
Simple devices + Internet access = Infrastructure as a Service (IaaS)


(Sanford, 2010)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b 7
Creating Fault Tolerance:
Off-Site Hosting and Access
Hosted servers are similar to hosted storage, but can maintain
an entire environment.
Web server hosting is early example
Virtual Servers in the cloud
System hardware extremely reliable and fault tolerant,
backed by service guarantees.
Ensure availability for servers with:
Redundancy & fault tolerance in network infrastructure:
Switches with Spanning Tree
Routers with secondary or backup links
Multiple Internet connections: Multihoming
Uninterruptible Power Supply (UPS) & backup power in
key areas, e.g. server rooms, wiring closets, critical PCs
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault Tolerance:
Software as a Service (SaaS)
SaaS, also known as Application Service Provider (ASP) or
Cloud provider
Benefits:
No local hardware admin costs (except network access)
Service contract guarantees very high fault tolerance
Accessible from PCs, tablets potentially anything with a
web browser
Drawbacks
Cost grows as usage grows not a fixed cost
Network access can fail whose fault is it?
Internet Access Provider
SaaS Host Provider
SaaS Company or software


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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault-Tolerant Systems,
Backups, and Decommissioning
Summary Lecture b
Best Practices for providing fault tolerant
computer hardware, data storage, virtualization,
remote hosting, and network access
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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Creating Fault-Tolerant Systems,
Backups, and Decommissioning
References Lecture b
References
RAID [cited 2012 January 31]. Retrieved from: http://en.wikipedia.org/wiki/RAID
Sanford, R. (April 2010) Electronic Health Records Need a Fail-Proof Foundation to Deliver on Quality, Economy
Promises. Health News Digest. Available from:
http://www.healthnewsdigest.com/news/Guest_Columnist_710/Electronic_Health_Records_Need_a_Fail-
Proof_Foundation_to_Deliver_on_Quality_Economy_Promises_2_printer.shtml
Tulloch, M. (April 2005) Implementing Fault Tolerance on Windows Networks. Available from:
http://www.windowsnetworking.com/articles_tutorials/Implementing-Fault-Tolerance-Windows-Networks.html

Acknowledgement: The following reference generally informed the unit
Shackhow, T. et al. (June 2008). EHR Meltdown: How to Protect Your Patient Data. Fam Pract Manag, 15(6), A3-
A8. Available from: http://www.aafp.org/fpm/2008/0600/pa3.html

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Health IT Workforce Curriculum
Version 3.0/Spring 2012
Installation and Maintenance of Health IT Systems
Creating Fault-Tolerant Systems, Backups, and Decommissioning
Lecture b
Images
Slide 5: RAID 0, RAID 1, RAID 5, RAID 6 [en:User:Cburnett]. c2006 [updated 2000 Jan 28; cited 2006 Feb 15].
Available from: http://commons.wikimedia.org/wiki/Redundant_array_of_independent_disks