I maintain each day standing conferences with varied teams inside our expertise staff, and the questions nearly at all times drifts to: “What’s right this moment’s problem?” Typically that problem is perhaps, “We are able to’t print at certainly one of our ambulatory care services,” or “Right now, we are able to’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 attenuate 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 interchange 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 certainly 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 remodel how we handle our infrastructure and administer the enterprise and medical programs 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 shifting prepare. The method has taken dedication and cautious planning, the work of my staff and the help 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 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 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 programs. 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 college follow and OU Drugs, Inc. (sole member, College Hospitals Belief) to create OU Well being — Oklahoma’s first totally built-in tutorial well being system. The merger aligned the OU Well being medical enterprise with nationwide finest practices throughout the healthcare trade and enabled the hospitals and clinics to grow to be one unified and cohesive group.
Since my arrival at OU Well being in March of 2022, I’ve labored intently 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 establishing new networks, programs, information facilities and functions, whereas conserving our legacy programs working.
Sadly, our surroundings was not in one of the best form. It featured outdated tools, overlapping options, outdated code, unpatched tools, 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 areas.
This hindered workflows and triggered frustration amongst our clinicians and hospital workers. They needed to name us each time one thing went unsuitable, and we had no option to proactively monitor and restore our programs. When a hyperlink went down, we didn’t know how you can restore it. It was clear that an overhaul was mandatory 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 most recent resolution, nor can we have a look at the most cost effective. 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 programs. We take this method when deciding on lab tools, imaging and diagnostic programs, surgical provides, and extra.
At OU Well being, we’ve got 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. 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 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 help 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 totally help 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 mild to construct all the pieces 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 expertise. Its core layer is Cisco ACI (Utility Centric Infrastructure), a software-defined networking resolution, to assist phase our community. We constructed redundant high-speed hyperlinks all through our Broad Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory programs. Then we’ve got a number of routers to deal with our software-defined community and segmentation. If a router or phase fails, we divert site visitors to another path.
We use Cisco ACI to route site visitors to particular locations inside our community. An ideal 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 information programs.
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 laws. Customers can solely entry that atmosphere in the event that they’re performing a transaction requiring that info.
We additionally use Cisco UCS servers for scalable effectivity and agility, Cisco Id 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 programs (working on historic machines) into our new infrastructure. Virtualizing these permits us to maintain them working till we’re in a position to substitute the programs with out disrupting care.
Migrating Our Information 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 programs. Ought to the unthinkable occur and our major information facilities fail, the third information heart will guarantee we stay operational.
One among our greatest challenges and alternatives was migrating our programs 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 may host our information facilities and decrease our footprint dramatically. We partnered with TierPoint, and have been one of many first purchasers 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 sturdy redundancy and backup options, and the energy-efficient expertise helps decrease our working bills whereas defending the atmosphere. Transferring our information heart off-prem was certainly one of our greatest enterprise and tech choices.
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 now not fielding complaints about gradual 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 sooner. I look ahead to sitting down with our care groups to seek 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 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. Previously, each community addition was a one-off occasion. However now, we are able to increase our platform as wanted so as to add highly effective new functions like information analytics and inhabitants well being administration (PHM) instruments to mixture affected person info throughout a number of programs and applied sciences. Now that we’ve got rolled out Epic, we’ve got 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 a substitute of fixing issues.
Our new Cisco infrastructure is a beneficial retention and recruitment instrument. Clinicians and researchers additionally wish to work in high-tech environments. They would like user-friendly programs over battling digital kinds, drowning in infinite emails, or ready hours for medical photos, check outcomes, and trial and affected person information. After they have essentially the most environment friendly instruments and IT works flawlessly, they will concentrate on their sufferers and analysis.
OU Well being is on a mission to raise and remodel our group right into a top-tier tutorial well being system. Our management sees expertise 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 wish 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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