I maintain every day standing conferences with numerous teams inside our know-how staff, and the questions nearly all the time drifts to: “What’s right this moment’s problem?” Typically that problem could be, “We will’t print at one in every of our ambulatory care amenities,” or “At present, we will’t ship diagnostic photos 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 attenuate or get rid of 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 interchange our digital well being file 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 deliver innovation to our sufferers. As an educational 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 working medical trials resulting in thrilling new remedies. Greater than fixing our every day complications, our IT overhaul will essentially rework how we handle our infrastructure and administer the enterprise and medical methods we use to help 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 making an attempt to work on the engine of a shifting practice. The method has taken dedication and cautious planning, the work of my staff 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 consists of 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 means. Watching my spouse struggling for years along with her group’s IT as a household apply supplier and educator made me understand the difficulties that come up when coping with healthcare IT methods. Due to 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 absolute 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 apply 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 medical enterprise with nationwide greatest practices throughout the healthcare trade and enabled the hospitals and clinics to develop into one unified and cohesive group.
Since my arrival at OU Well being in March of 2022, I’ve labored intently with our IT management staff on the Epic migration challenge. 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, methods, information facilities and functions, whereas conserving our legacy methods working.
Sadly, our surroundings was not in the most effective form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which prompted quite a few challenges. Our community was additionally very sluggish, 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 prompted frustration amongst our clinicians and hospital employees. They needed to name us each time one thing went flawed, and we had no approach to proactively monitor and restore our methods. When a hyperlink went down, we didn’t know find out how to 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 Wished Redundancy, Resilience, and Efficiency—That Meant Cisco
Healthcare organizations are considerably conservative when procuring IT. We don’t search for the latest resolution, nor can we take a look at the most affordable. We don’t minimize prices as a result of sufferers’ lives are at stake. As an alternative, we take a look at essentially the most superior tried and true methods. We take this strategy when deciding on lab gear, imaging and diagnostic methods, surgical provides, and extra.
At OU Well being, we’ve got a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inside challenge 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. Nonetheless, my job requires me to be goal, so I attend occasions like Gartner Summits and the annual HIMSS World 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 situation.
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 situation. 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 staff labored with Cisco’s community architects, exterior companions, and our inside lead architects. We put collectively a funding request and introduced it to our board. We anticipated our executives to approve lower than what our budgeted request was, however as a substitute we got the inexperienced mild to construct the whole lot we had requested for – a state-of-the-art community and system setting that will 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 resolution, to assist phase our community. We constructed redundant high-speed hyperlinks all through our Vast Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory methods. Then we’ve got 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. A terrific instance is lab outcomes. Our lab gear 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 information methods.
Affected person well being consists of their healthcare information, 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 information 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 Id 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 methods (working on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them working till we’re capable of change the methods with out disrupting care.
Migrating Our Knowledge Facilities to Guarantee IT Transparency
Our three new information facilities carry the load of our new community. Two of our information facilities are lively/lively and mirror one another, splitting our workloads in two and with every facility working at 50% capability. Our third information middle is for catastrophe restoration (DR) and has redundant hyperlinks to all our hospitals, clinics, and ambulatory methods. Ought to the unthinkable occur and our major information facilities fail, the third information middle will guarantee we stay operational.
Considered one of our greatest challenges and alternatives was migrating our methods and infrastructure to new, extra sustainable information facilities. As an alternative of constructing our personal on-prem information facilities, we determined to accomplice with a top-tier co-location facility who might host our information facilities and decrease our footprint dramatically. We partnered with TierPoint, and have 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. Transferring our information middle off-prem was one in every of our greatest enterprise and tech choices.
On June 3, 2023, OU Well being went reside 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 sluggish 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 sooner. I sit up for sitting down with our care groups to search 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 staff will be capable of leverage our new Cisco community to allow and execute OU Well being’s enterprise imaginative and prescient. We will combine new departments, places, and amenities into our community sooner 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 will develop our platform as wanted so as to add highly effective new functions like information analytics and inhabitants well being administration (PHM) instruments to mixture affected person info throughout a number of methods and applied sciences. Now that we’ve got rolled out Epic, we’ve got a strong basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.
The perfect minds gravitate to organizations that permit them add worth by supporting a enterprise imaginative and prescient as a substitute of fixing issues.
Our new Cisco infrastructure is a useful retention and recruitment device. Clinicians and researchers additionally need to work in high-tech environments. They would like user-friendly methods over battling digital varieties, drowning in infinite emails, or ready hours for medical photos, take a look at outcomes, and trial and affected person information. Once 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 rework 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 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 the most effective medical care to the populations we serve.
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