I maintain day by day standing conferences with varied teams inside our know-how group, and the questions virtually at all times drifts to: “What’s right this moment’s problem?” Typically that problem is likely to be, “We are able to’t print at considered one of our ambulatory care services,” or “As we speak, 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 remove the problems that crop up on these conferences and work to reduce or remove 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 switch 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 an educational well being system, we function considered one of 71 Nationwide Most cancers Institute-designated most cancers facilities within the nation, Oklahoma’s solely Stage I trauma heart and the state’s highest stage 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 help our healthcare professionals and sufferers.
A whole 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 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 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 manner. 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 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 tutorial well being system. The merger aligned the OU Well being medical enterprise with nationwide finest practices throughout the healthcare business 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 carefully with our IT management group on the Epic migration venture. 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, techniques, information facilities and functions, whereas retaining our legacy techniques working.
Sadly, our surroundings was not in the perfect form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which brought on 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 brought on frustration amongst our clinicians and hospital employees. They needed to name us every time one thing went incorrect, and we had no solution to proactively monitor and restore our techniques. When a hyperlink went down, we didn’t know how you can restore it. It was clear that an overhaul was crucial 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 will we have a look at the most affordable. 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 techniques. We take this method when deciding on lab gear, imaging and diagnostic techniques, 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 venture 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 wonderful grasp of the know-how 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 absolutely help a never-down state of affairs.
After 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 per week, and our infrastructure should absolutely help a never-down state of affairs. When it got here time to construct our new surroundings, 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 group labored with Cisco’s community architects, exterior companions, and our inner 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 mild to construct all the pieces we had requested for – a state-of-the-art community and system surroundings that will put OU Well being on the map as a top-tier medical heart.
We constructed our new community on Cisco know-how. Its core layer is Cisco ACI (Utility Centric Infrastructure), a software-defined networking resolution, 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 now we 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 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 techniques.
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 rules. 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 historic machines) into our new infrastructure. Virtualizing these permits us to maintain them working till we’re capable of exchange the techniques 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 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 information facilities fail, the third information heart will guarantee we stay operational.
Certainly one of our largest challenges and alternatives was migrating our techniques and infrastructure to new, extra sustainable information facilities. As an alternative of constructing our personal on-prem information facilities, we determined to companion 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 shoppers at their new facility constructed with effectivity in thoughts. They architected the facility, cooling, HVAC, and constructing supplies to cut 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 surroundings. Shifting our information heart off-prem was considered one of our greatest enterprise and tech selections.
On June 3, 2023, OU Well being went dwell 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 gradual 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 sooner. I stay up for 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 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 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 broaden our platform as wanted so as to add highly effective new functions like information analytics and inhabitants well being administration (PHM) instruments to combination affected person info throughout a number of techniques 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.
One of the best minds gravitate to organizations that allow 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 instrument. Clinicians and researchers additionally wish to work in high-tech environments. They would favor user-friendly techniques over fighting digital varieties, drowning in countless 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 tutorial 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 wish to make a distinction in Oklahoma and past by bringing the perfect medical care to the populations we serve.
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