I maintain each day standing conferences with varied teams inside our know-how workforce, and the questions virtually at all times drifts to: “What’s right now’s problem?” Generally that problem is likely to be, “We are able to’t print at considered one of our ambulatory care services,” or “Right this moment, we will’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 get rid of the problems that crop up on these conferences and work to reduce or get rid of these points repeating sooner or later.
To take action, we would have liked to sort out the foundation of the issue. This, together with our need to exchange our digital well being report and income cycle system, contributed to OU Well being’s determination to utterly overhaul our IT infrastructure in help of our long-term organizational wants.
OU Well being strives to convey innovation to our sufferers. As a tutorial well being system, we function considered one of 71 Nationwide Most cancers Institute-designated most cancers facilities within the nation, Oklahoma’s solely Degree I trauma middle and the state’s highest stage NICU, providing high-quality affected person care and operating scientific trials resulting in thrilling new therapies. Greater than fixing our each day complications, our IT overhaul will essentially remodel how we handle our infrastructure and administer the enterprise and scientific programs we use to help our healthcare professionals and sufferers.
An entire revamp of a well being system’s IT infrastructure is a frightening process. To make use of a well-worn cliché, it’s like making an attempt to work on the engine of a shifting prepare. The method has taken dedication and cautious planning, the work of my workforce and the help 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 Expertise 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 function, however I made a decision to make use of my experience to help others in a way more impactful means. Watching my spouse struggling for years together with her group’s IT as a household observe supplier and educator made me notice the difficulties that come up when coping with healthcare IT programs. Because of a good friend 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 Faculty of Drugs school observe and OU Drugs, Inc. (sole member, College Hospitals Belief) to create OU Well being — Oklahoma’s first absolutely built-in educational well being system. The merger aligned the OU Well being scientific enterprise with nationwide greatest practices throughout the healthcare business and enabled the hospitals and clinics to grow 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 workforce on the Epic migration undertaking. This initiative moved OU Well being to a brand new EHR system. To realize this, we deployed a greenfield answer, which concerned organising new networks, programs, knowledge facilities and functions, whereas protecting our legacy programs operating.
Sadly, our surroundings was not in one of the best form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which precipitated 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 precipitated frustration amongst our clinicians and hospital employees. They needed to name us each time one thing went fallacious, and we had no option to proactively monitor and restore our programs. When a hyperlink went down, we didn’t know how one can restore it. It was clear that an overhaul was mandatory to make sure that our healthcare professionals might deal with caring for his or her sufferers and never fear about technical points.
We Needed Redundancy, Resilience, and Efficiency—That Meant Cisco
Healthcare organizations are considerably conservative when procuring IT. We don’t search for the most recent answer, nor can we have a look at the most cost effective. We don’t minimize prices as a result of sufferers’ lives are at stake. As an alternative, we have a look at essentially the most superior tried and true programs. We take this method when deciding on lab gear, imaging and diagnostic programs, surgical provides, and extra.
At OU Well being, we have now a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inside undertaking supervisor additionally brings many years 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 superb 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 absolutely help a never-down state of affairs.
Once we created the specs for our new setting, 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 absolutely help a never-down state of affairs. When it got here time to construct our new setting, we didn’t ask, “Why Cisco?” The true query was, “Why not Cisco?”
Redefining Our Community with Software program-Outlined Networking
When it got here time to pitch our new infrastructure, the workforce labored with Cisco’s community architects, exterior companions, and our inside 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 gentle to construct every part we had requested for – a state-of-the-art community and system setting 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 (Software Centric Infrastructure), a software-defined networking answer, to assist phase our community. We constructed redundant high-speed hyperlinks all through our Large Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory programs. Then we have now 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 ideal instance is lab outcomes. Our lab gear doesn’t talk with the skin 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 information programs.
Affected person well being contains their healthcare knowledge, and we prioritize the safety round our sufferers’ protected well being info (PHI). We used ACI to create a firewalled zone for PHI and different delicate knowledge per HIPAA laws. Customers can solely entry that setting in the event that they’re performing a transaction requiring that info.
We additionally use Cisco UCS servers for scalable effectivity and agility, Cisco Identification Companies 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 programs (operating on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them operating till we’re in a position to substitute the programs with out disrupting care.
Migrating Our Information Facilities to Guarantee IT Transparency
Our three new knowledge facilities carry the load of our new community. Two of our knowledge facilities are energetic/energetic 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 programs. Ought to the unthinkable occur and our major knowledge facilities fail, the third knowledge middle will guarantee we stay operational.
Certainly one of our greatest challenges and alternatives was migrating our programs and infrastructure to new, extra sustainable knowledge facilities. As an alternative of constructing our personal on-prem knowledge facilities, we determined to accomplice with a top-tier co-location facility who might host our knowledge facilities and decrease our footprint dramatically. We partnered with TierPoint, and had been one of many first purchasers 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 setting. Shifting our knowledge middle off-prem was considered one 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 check. 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 rapidly, 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 workforce will be capable to leverage our new Cisco community to allow and execute OU Well being’s enterprise imaginative and prescient. We are able to 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. Prior to now, each community addition was a one-off occasion. However now, we will develop our platform as wanted so as to add highly effective new functions like knowledge analytics and inhabitants well being administration (PHM) instruments to mixture affected person info throughout a number of programs and applied sciences. Now that we have now rolled out Epic, we have now a stable basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.
The most effective 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 helpful retention and recruitment device. Clinicians and researchers additionally need to work in high-tech environments. They would favor user-friendly programs over combating digital kinds, drowning in limitless emails, or ready hours for medical photographs, check outcomes, and trial and affected person knowledge. After they have essentially the most environment friendly instruments and IT works flawlessly, they’ll deal with their sufferers and analysis.
OU Well being is on a mission to raise and remodel our group right into a top-tier educational well being system. Our management sees know-how as key to delivering on our imaginative and prescient and enterprise technique. We’re increasing our providers 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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