I maintain day by day standing conferences with numerous teams inside our know-how staff, and the questions nearly all the time drifts to: “What’s at present’s problem?” Generally that problem may be, “We are able to’t print at one among our ambulatory care services,” or “Right now, we will’t ship diagnostic pictures 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 want to exchange our digital well being file and income cycle system, contributed to OU Well being’s resolution to utterly overhaul our IT infrastructure in assist of our long-term organizational wants.
OU Well being strives to convey innovation to our sufferers. As a tutorial 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 operating scientific trials resulting in thrilling new therapies. Greater than fixing our day by day complications, our IT overhaul will essentially rework how we handle our infrastructure and administer the enterprise and scientific methods 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 shifting practice. The method has taken dedication and cautious planning, the work of my staff and the assist of know-how 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 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 function, however I made a decision to make use of my experience to help others in a way more impactful method. 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 methods. 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 Faculty of Drugs school follow 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 finest practices throughout the healthcare business and enabled the hospitals and clinics to turn into one unified and cohesive group.
Since my arrival at OU Well being in March of 2022, I’ve labored carefully with our IT management staff on the Epic migration undertaking. This initiative moved OU Well being to a brand new EHR system. To realize this, we deployed a greenfield resolution, which concerned organising new networks, methods, knowledge facilities and functions, whereas maintaining our legacy methods operating.
Sadly, the environment was not in one of the best form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which prompted 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 areas.
This hindered workflows and prompted frustration amongst our clinicians and hospital workers. They needed to name us each time one thing went unsuitable, and we had no strategy to proactively monitor and restore our methods. When a hyperlink went down, we didn’t know the way to restore it. It was clear that an overhaul was vital to make sure that our healthcare professionals may concentrate on 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 latest resolution, nor will we take a look at the most affordable. We don’t reduce prices as a result of sufferers’ lives are at stake. As an alternative, we take a look at probably the most superior tried and true methods. We take this strategy when choosing lab gear, imaging and diagnostic methods, 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 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 associate that may ship on its guarantees like Cisco.
Hospitals are 24/7 establishments, and hospital infrastructure should absolutely assist a never-down state of affairs.
After we created the specs for our new atmosphere, 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 absolutely assist a never-down state of affairs. When it got here time to construct our new atmosphere, 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 staff labored with Cisco’s community architects, exterior companions, and our inner 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 gentle to construct every little thing we had requested for – a state-of-the-art community and system atmosphere 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 resolution, to assist section 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 methods. Then now we have a number of routers to deal with our software-defined community and segmentation. If a router or section fails, we divert visitors to another path.
We use Cisco ACI to route visitors to particular locations inside our community. An amazing 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 data methods.
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 atmosphere in the event that they’re performing a transaction requiring that data.
We additionally use Cisco UCS servers for scalable effectivity and agility, Cisco Id 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 methods (operating on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them operating till we’re in a position to exchange the methods 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 methods. Ought to the unthinkable occur and our major knowledge facilities fail, the third knowledge middle will guarantee we stay operational.
One among our largest challenges and alternatives was migrating our methods and infrastructure to new, extra sustainable knowledge facilities. As an alternative of constructing our personal on-prem knowledge facilities, we determined to associate 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 facility, cooling, HVAC, and constructing supplies to scale back their carbon footprint. We profit from strong redundancy and backup options, and the energy-efficient know-how helps decrease our working bills whereas defending the atmosphere. Shifting our knowledge middle off-prem was one among 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 not fielding complaints about gradual Wi-Fi speeds, connection failures, community section outages and VPN points. OU Well being can entry what they want rapidly, getting sufferers what they want sooner. I stay 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 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 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. 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 combination affected person data throughout a number of methods 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 allow 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 software. Clinicians and researchers additionally need to work in high-tech environments. They would like user-friendly methods over fighting digital varieties, drowning in countless emails, or ready hours for medical pictures, check outcomes, and trial and affected person knowledge. After they have probably the most environment friendly instruments and IT works flawlessly, they’ll concentrate on 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 one of the best medical care to the populations we serve.
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