I maintain each day standing conferences with varied teams inside our know-how staff, and the questions nearly at all times drifts to: “What’s at present’s problem?” Typically that problem may be, “We will’t print at considered one of 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 reduce 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 exchange our digital well being file and income cycle system, contributed to OU Well being’s resolution to fully overhaul our IT infrastructure in help of our long-term organizational wants.
OU Well being strives to convey innovation to our sufferers. As an instructional 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 remedies. Greater than fixing our each 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 activity. 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 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 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 approach. Watching my spouse struggling for years together with her group’s IT as a household follow supplier and educator made me notice 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 School of Medication school follow and OU Medication, 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 change 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 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 preserving our legacy methods working.
Sadly, the environment was not in the most effective form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which triggered 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 places.
This hindered workflows and triggered frustration amongst our clinicians and hospital workers. They needed to name us at any time when one thing went fallacious, and we had no strategy to proactively monitor and restore our methods. When a hyperlink went down, we didn’t know the right way to restore it. It was clear that an overhaul was obligatory to make sure that our healthcare professionals may concentrate on 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 resolution, nor can we take a look at the most cost effective. We don’t minimize prices as a result of sufferers’ lives are at stake. As a substitute, we take a look at essentially the most superior tried and true methods. We take this method when choosing lab gear, imaging and diagnostic methods, 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 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 companion 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 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 help a never-down situation. 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 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 part 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 heart.
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 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. A terrific 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 information methods.
Affected person well being contains their healthcare information, 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 information per HIPAA rules. 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 Identification 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 substitute 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 heart is for catastrophe restoration (DR) and has redundant hyperlinks to all our hospitals, clinics, and ambulatory methods. Ought to the unthinkable occur and our main information facilities fail, the third information heart will guarantee we stay operational.
Considered one of our largest challenges and alternatives was migrating our methods and infrastructure to new, extra sustainable information facilities. As a substitute of constructing our personal on-prem information facilities, we determined to companion with a top-tier co-location facility who may host our information 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 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 atmosphere. Transferring our information heart off-prem was considered one of 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 main 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 sit up for sitting down with our care groups to seek 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 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. Previously, 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 combination affected person data throughout a number of methods 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.
The most effective 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 precious retention and recruitment device. Clinicians and researchers additionally need to work in high-tech environments. They would like user-friendly methods over combating digital varieties, drowning in infinite emails, or ready hours for medical photographs, check outcomes, and trial and affected person information. After they have essentially 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 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 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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