I maintain day by day standing conferences with varied teams inside our expertise group, and the questions nearly at all times drifts to: “What’s at this time’s problem?” Typically that problem could be, “We are able to’t print at one among our ambulatory care services,” or “As we speak, 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 attenuate or get rid of these points repeating sooner or later.
To take action, we wanted to sort out the basis of the issue. This, together with our need to interchange our digital well being document and income cycle system, contributed to OU Well being’s determination to fully overhaul our IT infrastructure in assist 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 among 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 therapies. Greater than fixing our day by day complications, our IT overhaul will basically rework how we handle our infrastructure and administer the enterprise and medical techniques we use to assist our healthcare professionals and sufferers.
An entire revamp of a well being system’s IT infrastructure is a frightening job. To make use of a well-worn cliché, it’s like attempting to work on the engine of a transferring prepare. The method has taken dedication and cautious planning, the work of my group and the assist of expertise companions like Cisco to place collectively and roll out an answer throughout OU Well being’s websites.
A Contemporary 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 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 data 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 along with her group’s IT as a household apply supplier and educator made me notice the difficulties that come up when coping with healthcare IT techniques. Because of a buddy 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 School of Medication college apply and OU Medication, Inc. (sole member, College Hospitals Belief) to create OU Well being — Oklahoma’s first totally 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 group on the Epic migration challenge. This initiative moved OU Well being to a brand new EHR system. To attain this, we deployed a greenfield answer, which concerned establishing new networks, techniques, knowledge facilities and purposes, whereas holding our legacy techniques working.
Sadly, the environment was not in the most effective form. It featured outdated tools, overlapping options, outdated code, unpatched tools, 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 areas.
This hindered workflows and prompted frustration amongst our clinicians and hospital workers. They needed to name us at any time when one thing went fallacious, and we had no technique 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 obligatory to make sure that our healthcare professionals might 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 answer, nor will we have a look at the most affordable. We don’t reduce 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 techniques. We take this strategy when deciding on lab tools, imaging and diagnostic techniques, surgical provides, and extra.
At OU Well being, we’ve 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. 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 expertise panorama, and I’ve but to discover a companion that may ship on its guarantees like Cisco.
Hospitals are 24/7 establishments, and hospital infrastructure should totally assist a never-down situation.
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 every week, and our infrastructure should totally assist a never-down situation. 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 group 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 a substitute we got the inexperienced gentle to construct all the pieces we had requested for – a state-of-the-art community and system surroundings that might put OU Well being on the map as a top-tier medical middle.
We constructed our new community on Cisco expertise. 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 Vast Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory techniques. Then we’ve a number of routers to deal with our software-defined community and segmentation. If a router or phase fails, we divert site visitors to an alternate path.
We use Cisco ACI to route site visitors to particular locations inside our community. An amazing instance is lab outcomes. Our lab tools 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 techniques.
Affected person well being consists of 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 surroundings 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 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 (working on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them working till we’re capable of substitute 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 energetic/energetic and mirror one another, splitting our workloads in two and with every facility working 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 main knowledge facilities fail, the third knowledge middle will guarantee we stay operational.
One in every of our largest challenges and alternatives was migrating our techniques and infrastructure to new, extra sustainable knowledge facilities. As an alternative of constructing our personal on-prem knowledge facilities, we determined to companion with a top-tier co-location facility who might host our knowledge facilities and decrease our footprint dramatically. We partnered with TierPoint, and have 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 cut back their carbon footprint. We profit from sturdy redundancy and backup options, and the energy-efficient expertise helps decrease our working bills whereas defending the surroundings. Transferring our knowledge middle off-prem was one among 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 main 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 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 quicker. I sit up for sitting down with our care groups to search out methods to increase, innovate and construct on our new platform.
Cisco Is Serving to OU Well being Elevate Our Group
Earlier than lengthy, my IT group will have the ability 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, areas, 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 increase our platform as wanted so as to add highly effective new purposes like knowledge analytics and inhabitants well being administration (PHM) instruments to mixture affected person info throughout a number of techniques and applied sciences. Now that we’ve rolled out Epic, we’ve a stable basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.
The perfect minds gravitate to organizations that allow them add worth by supporting a enterprise imaginative and prescient as a substitute of fixing issues.
Our new Cisco infrastructure is a beneficial retention and recruitment device. Clinicians and researchers additionally wish to work in high-tech environments. They would favor user-friendly techniques over battling digital varieties, drowning in limitless emails, or ready hours for medical photographs, take a look at outcomes, and trial and affected person knowledge. After they have essentially the most environment friendly instruments and IT works flawlessly, they’ll give attention to 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 expertise 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 wish to make a distinction in Oklahoma and past by bringing the most effective medical care to the populations we serve.
Share:
