I maintain every day standing conferences with varied teams inside our expertise crew, and the questions nearly all the time drifts to: “What’s as we speak’s problem?” Typically that problem could be, “We are able to’t print at one in all our ambulatory care amenities,” or “Right this moment, 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 eradicate the problems that crop up on these conferences and work to attenuate or eradicate these points repeating sooner or later.
To take action, we would have liked to sort out the basis of the issue. This, together with our want to switch our digital well being file and income cycle system, contributed to OU Well being’s choice 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 all 71 Nationwide Most cancers Institute-designated most cancers facilities within the nation, Oklahoma’s solely Stage I trauma heart 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 every day complications, our IT overhaul will essentially rework how we handle our infrastructure and administer the enterprise and medical techniques we use to help 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 making an attempt to work on the engine of a transferring practice. The method has taken dedication and cautious planning, the work of my crew and the help of expertise 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 data 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 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 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 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 turn 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 crew 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 organising new networks, techniques, knowledge facilities and functions, whereas retaining our legacy techniques working.
Sadly, our surroundings was not in the very 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 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 brought about frustration amongst our clinicians and hospital employees. They needed to name us each time one thing went mistaken, and we had no technique to proactively monitor and restore our techniques. When a hyperlink went down, we didn’t know restore it. It was clear that an overhaul was essential 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 latest answer, nor will we have a look at the most cost effective. We don’t lower 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 now have a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inside challenge 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. 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 expertise 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 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 every 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 crew 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 every thing 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 heart.
We constructed our new community on Cisco expertise. Its core layer is Cisco ACI (Application Centric Infrastructure), a software-defined networking answer, to assist section 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 now have a number of routers to deal with our software-defined community and segmentation. If a router or section fails, we divert site visitors to an alternate 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 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 rules. 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 Identity Services Engine (ISE) for endpoint administration, and we go end-to-end on Cisco wireless solutions, consisting of Cisco Catalyst 9130AX and 9166 access points 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 in a position to 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 working at 50% capability. Our third knowledge heart 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 heart will guarantee we stay operational.
Certainly one of our greatest 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 associate 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 expertise helps decrease our working bills whereas defending the setting. Shifting our knowledge heart off-prem was one in all 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 section 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 search out methods to broaden, 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 of 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 amenities 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. Previously, each community addition was a one-off occasion. However now, we will broaden 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 techniques and applied sciences. Now that we now have rolled out Epic, we now have a stable basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.
One of the best 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 worthwhile retention and recruitment device. Clinicians and researchers additionally wish to work in high-tech environments. They would favor user-friendly techniques over combating digital types, drowning in countless emails, or ready hours for medical pictures, 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 will 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 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 very best medical care to the populations we serve.
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