I maintain each day standing conferences with varied teams inside our know-how crew, and the questions nearly all the time drifts to: “What’s at this time’s problem?” Generally that problem is perhaps, “We will’t print at one in every of our ambulatory care services,” or “At the moment, we are able to’t ship diagnostic photographs to our distant Radiologists.” The assembly helps us to focus our consideration, and because the CTO of OU Well being in Oklahoma Metropolis, my job is to remove the problems that crop up on these conferences and work to reduce or remove these points repeating sooner or later.
To take action, we would have liked to deal with the foundation of the issue. This, together with our need to switch our digital well being document and income cycle system, contributed to OU Well being’s resolution to fully overhaul our IT infrastructure in assist of our long-term organizational wants.
OU Well being strives to carry innovation to our sufferers. As an instructional well being system, we function one in every of 71 Nationwide Most cancers Institute-designated most cancers facilities within the nation, Oklahoma’s solely Stage I trauma middle and the state’s highest degree NICU, providing high-quality affected person care and operating scientific trials resulting in thrilling new remedies. Greater than fixing our each day complications, our IT overhaul will basically remodel how we handle our infrastructure and administer the enterprise and scientific techniques we use to assist our healthcare professionals and sufferers.
A whole revamp of a well being system’s IT infrastructure is a frightening process. To make use of a well-worn cliché, it’s like attempting to work on the engine of a shifting prepare. The method has taken dedication and cautious planning, the work of my crew and the assist of know-how companions like Cisco to place collectively and roll out an answer throughout OU Well being’s websites.
A Recent Begin, a Greenfield Community, and Some Limitations
I’ve had the privilege of working in healthcare IT for over 13 years. My earlier expertise contains serving because the VP of Know-how Structure at Cablevision for seven years and two years at Discovery because the SVP of Enterprise Structure, the place I gained a wealth of information in telecommunications and leisure. Following a six-month sabbatical, I had the chance to return to my earlier position, however I made a decision to make use of my experience to help others in a way more impactful approach. Watching my spouse struggling for years together with her group’s IT as a household follow supplier and educator made me understand the difficulties that come up when coping with healthcare IT techniques. Because of a pal I had labored with earlier in my profession, I joined a healthcare consulting firm launching my profession in healthcare IT to assist physicians and sufferers obtain the very best outcomes in medical care.
OU Well being formally launched in July 2021, following a historic merger that mixed the College of Oklahoma School of Medication college follow and OU Medication, Inc. (sole member, College Hospitals Belief) to create OU Well being — Oklahoma’s first totally built-in tutorial well being system. The merger aligned the OU Well being scientific enterprise with nationwide finest practices throughout the healthcare trade and enabled the hospitals and clinics to turn out to be one unified and cohesive group.
Since my arrival at OU Well being in March of 2022, I’ve labored carefully with our IT management crew on the Epic migration undertaking. This initiative moved OU Well being to a brand new EHR system. To attain this, we deployed a greenfield resolution, which concerned organising new networks, techniques, knowledge facilities and purposes, whereas maintaining our legacy techniques operating.
Sadly, the environment was not in one of the best form. It featured outdated tools, overlapping options, outdated code, unpatched tools, and extra, which brought about quite a few challenges. Our community was additionally very gradual, which meant that it took 15 to half-hour for a radiologist to obtain X-rays and CAT scans at our distant places.
This hindered workflows and brought about frustration amongst our clinicians and hospital employees. They needed to name us each time one thing went improper, and we had no option to proactively monitor and restore our techniques. When a hyperlink went down, we didn’t know the best way to restore it. It was clear that an overhaul was crucial to make sure that our healthcare professionals may give attention to caring for his or her sufferers and never fear about technical points.
We Wished Redundancy, Resilience, and Efficiency—That Meant Cisco
Healthcare organizations are considerably conservative when procuring IT. We don’t search for the most recent resolution, nor can we have a look at the most affordable. We don’t minimize prices as a result of sufferers’ lives are at stake. As a substitute, we have a look at probably the most superior tried and true techniques. We take this strategy when deciding on lab tools, imaging and diagnostic techniques, surgical provides, and extra.
At OU Well being, now we have a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inner undertaking supervisor additionally brings a long time of expertise in managing large-scale Cisco deployments. Everyone knows that Cisco can ship extremely performant, redundant and resilient infrastructure. Nevertheless, my job requires me to be goal, so I attend occasions like Gartner Summits and the annual HIMSS International Well being Convention & Exhibition to see what’s on the market. I’ve a wonderful grasp of the know-how panorama, and I’ve but to discover a accomplice that may ship on its guarantees like Cisco.
Hospitals are 24/7 establishments, and hospital infrastructure should totally assist a never-down state of affairs.
Once we created the specs for our new surroundings, we checked out three issues: excessive redundancy, excessive resilience, and excessive efficiency. OU Well being, like most healthcare organizations, runs 24 hours a day, seven days per week, and our infrastructure should totally assist a never-down state of affairs. When it got here time to construct our new surroundings, we didn’t ask, “Why Cisco?” The actual query was, “Why not Cisco?”
Redefining Our Community with Software program-Outlined Networking
When it got here time to pitch our new infrastructure, the crew labored with Cisco’s community architects, exterior companions, and our inner lead architects. We put collectively a funding request and offered it to our board. We anticipated our executives to approve lower than what our budgeted request was, however as an alternative we got the inexperienced mild to construct the whole lot we had requested for – a state-of-the-art community and system surroundings that may put OU Well being on the map as a top-tier medical middle.
We constructed our new community on Cisco know-how. Its core layer is Cisco ACI (Utility Centric Infrastructure), a software-defined networking resolution, to assist phase our community. We constructed redundant high-speed hyperlinks all through our Extensive Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory techniques. Then now we have a number of routers to deal with our software-defined community and segmentation. If a router or phase fails, we divert site visitors to another path.
We use Cisco ACI to route site visitors to particular locations inside our community. An awesome instance is lab outcomes. Our lab tools doesn’t talk with the surface world, however our technicians should ship outcomes to our EMR. So, we’ve segmented the community to switch outcomes solely to particular servers that then add them to our data techniques.
Affected person well being contains their healthcare knowledge, and we prioritize the safety round our sufferers’ protected well being data (PHI). We used ACI to create a firewalled zone for PHI and different delicate knowledge per HIPAA laws. Customers can solely entry that surroundings in the event that they’re performing a transaction requiring that data.
We additionally use Cisco UCS servers for scalable effectivity and agility, Cisco Identification Providers Engine (ISE) for endpoint administration, and we go end-to-end on Cisco wi-fi options, consisting of Cisco Catalyst 9130AX and 9166 entry factors and 9800-80 controllers. As well as, we adopted Cisco VDI to combine a few of our legacy techniques (operating on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them operating till we’re capable of change the techniques with out disrupting care.
Migrating Our Knowledge Facilities to Guarantee IT Transparency
Our three new knowledge facilities carry the load of our new community. Two of our knowledge facilities are lively/lively and mirror one another, splitting our workloads in two and with every facility operating at 50% capability. Our third knowledge middle is for catastrophe restoration (DR) and has redundant hyperlinks to all our hospitals, clinics, and ambulatory techniques. Ought to the unthinkable occur and our major knowledge facilities fail, the third knowledge middle will guarantee we stay operational.
Certainly one of our largest challenges and alternatives was migrating our techniques and infrastructure to new, extra sustainable knowledge facilities. As a substitute of constructing our personal on-prem knowledge facilities, we determined to accomplice with a top-tier co-location facility who may host our knowledge facilities and decrease our footprint dramatically. We partnered with TierPoint, and had been one of many first shoppers at their new facility constructed with effectivity in thoughts. They architected the ability, cooling, HVAC, and constructing supplies to scale back their carbon footprint. We profit from sturdy redundancy and backup options, and the energy-efficient know-how helps decrease our working bills whereas defending the surroundings. Transferring our knowledge middle off-prem was one in every of our greatest enterprise and tech selections.
On June 3, 2023, OU Well being went stay with Epic and our new infrastructure. We had already moved to our new major community in March 2023, however this was the ultimate take a look at. We’re already reaping the rewards of our new Cisco infrastructure. We’re now not fielding complaints about gradual Wi-Fi speeds, connection failures, community phase outages and VPN points. OU Well being can entry what they want shortly, getting sufferers what they want quicker. I look ahead to sitting down with our care groups to seek out methods to develop, innovate and construct on our new platform.
Cisco Is Serving to OU Well being Elevate Our Group
Earlier than lengthy, my IT crew will be capable to leverage our new Cisco community to allow and execute OU Well being’s enterprise imaginative and prescient. We will combine new departments, places, and services into our community quicker as a result of we anticipated the necessity to construct extra WAN connections and have a complete map of each present and future state. Up to now, each community addition was a one-off occasion. However now, we are able to develop our platform as wanted so as to add highly effective new purposes like knowledge analytics and inhabitants well being administration (PHM) instruments to combination affected person data throughout a number of techniques and applied sciences. Now that now we have rolled out Epic, now we have a strong basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.
The very best minds gravitate to organizations that permit them add worth by supporting a enterprise imaginative and prescient as an alternative of fixing issues.
Our new Cisco infrastructure is a useful retention and recruitment software. Clinicians and researchers additionally need to work in high-tech environments. They would like user-friendly techniques over fighting digital kinds, drowning in limitless emails, or ready hours for medical photographs, take a look at outcomes, and trial and affected person knowledge. Once they have probably the most environment friendly instruments and IT works flawlessly, they will give attention to their sufferers and analysis.
OU Well being is on a mission to raise and remodel our group right into a top-tier tutorial well being system. Our management sees know-how as key to delivering on our imaginative and prescient and enterprise technique. We’re increasing our companies and analysis initiatives and can proceed to innovate in diabetes and most cancers care, pediatrics, and geriatrics. We need to make a distinction in Oklahoma and past by bringing one of the best medical care to the populations we serve.
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