Daniel from Improve Press
I maintain each day standing conferences with varied teams inside our know-how workforce, and the questions nearly all the time drifts to: “What’s at present’s problem?” Generally that problem is likely to be, “We will’t print at one among our ambulatory care services,” or “At this time, 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 attenuate or get rid of these points repeating sooner or later.
To take action, we would have liked to sort out the foundation of the issue. This, together with our need to switch our digital well being report and income cycle system, contributed to OU Well being’s determination 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 educational 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 stage NICU, providing high-quality affected person care and working medical trials resulting in thrilling new therapies. 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 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 workforce 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 Expertise 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 observe supplier and educator made me notice the difficulties that come up when coping with healthcare IT methods. Due to 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 observe and OU Drugs, Inc. (sole member, College Hospitals Belief) to create OU Well being — Oklahoma’s first totally 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 out to be one unified and cohesive group.
Since my arrival at OU Well being in March of 2022, I’ve labored carefully with our IT management workforce on the Epic migration undertaking. This initiative moved OU Well being to a brand new EHR system. To attain this, we deployed a greenfield resolution, which concerned establishing new networks, methods, knowledge facilities and purposes, whereas maintaining our legacy methods working.
Sadly, the environment was not in one of the best form. It featured outdated gear, overlapping options, outdated code, unpatched gear, and extra, which brought about 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 about frustration amongst our clinicians and hospital employees. They needed to name us at any time when one thing went flawed, and we had no approach to proactively monitor and restore our methods. When a hyperlink went down, we didn’t know how one can restore it. It was clear that an overhaul was essential to make sure that our healthcare professionals might give attention to 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 will we have a look at the most cost effective. We don’t reduce prices as a result of sufferers’ lives are at stake. As an alternative, we have 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, we’ve a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inside undertaking 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. 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 companion that may ship on its guarantees like Cisco.
Hospitals are 24/7 establishments, and hospital infrastructure should totally 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 per week, and our infrastructure should totally 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 workforce labored with Cisco’s community architects, exterior companions, and our inside 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 an alternative we got the inexperienced mild to construct all the pieces we had requested for – a state-of-the-art community and system atmosphere that will 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 (Utility Centric Infrastructure), a software-defined networking resolution, to assist phase our community. We constructed redundant high-speed hyperlinks all through our Large Space Community (WAN) and a number of paths connecting our core community to our hospitals, clinics, and ambulatory methods. Then we’ve a number of routers to deal with our software-defined community and segmentation. If a router or phase fails, we divert visitors to another path.
We use Cisco ACI to route 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 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 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 methods (working on historical machines) into our new infrastructure. Virtualizing these permits us to maintain them working 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 working 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 in all our greatest 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 companion 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 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 sturdy 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 phase 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 increase, innovate and construct on our new platform.
Cisco Is Serving to OU Well being Elevate Our Group
Earlier than lengthy, my IT workforce 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, areas, and services 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. Up to now, each community addition was a one-off occasion. However now, we will increase our platform as wanted so as to add highly effective new purposes like knowledge analytics and inhabitants well being administration (PHM) instruments to combination affected person info throughout a number of methods and applied sciences. Now that we’ve rolled out Epic, we’ve 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 permit them add worth by supporting a enterprise imaginative and prescient as an alternative of fixing issues.
Our new Cisco infrastructure is a precious retention and recruitment instrument. Clinicians and researchers additionally need to work in high-tech environments. They would like user-friendly methods over combating digital types, drowning in limitless emails, or ready hours for medical photographs, check outcomes, and trial and affected person knowledge. Once they have probably the most environment friendly instruments and IT works flawlessly, they will give attention to 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 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 one of the best medical care to the populations we serve.
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