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Tuesday, December 12, 2023

The Know-how That’s Remaking OU Well being right into a High-Tier Medical Heart

I maintain day by day standing conferences with varied teams inside our expertise group, and the questions nearly all the time drifts to: “What’s at present’s problem?”  Typically that problem is likely to be, “We will’t print at one in every of our ambulatory care services,” or “At the moment, we are able to’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 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 would have liked to sort out the foundation of the issue. This, together with our want to interchange our digital well being report and income cycle system, contributed to OU Well being’s determination to fully overhaul our IT infrastructure in assist 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 every of 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 remedies. 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 programs we use to assist our healthcare professionals and sufferers.

A whole revamp of a well being system’s IT infrastructure is a frightening process. To make use of a well-worn cliché, it’s like making an attempt to work on the engine of a shifting prepare. The method has taken dedication and cautious planning, the work of my group and the assist 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 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 manner. Watching my spouse struggling for years along 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 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 very 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 educational well being system. The merger aligned the OU Well being medical enterprise with nationwide greatest 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 group on the Epic migration mission. This initiative moved OU Well being to a brand new EHR system. To attain this, we deployed a greenfield answer, which concerned establishing new networks, programs, knowledge facilities and functions, whereas holding our legacy programs working.

Sadly, our surroundings was not in the very best 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 sluggish, 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 brought on frustration amongst our clinicians and hospital employees. They needed to name us each time one thing went unsuitable, and we had no method to proactively monitor and restore our programs. When a hyperlink went down, we didn’t know the right way to restore it. It was clear that an overhaul was crucial to make sure that our healthcare professionals may 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 most recent answer, 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 essentially the most superior tried and true programs. We take this strategy when choosing lab gear, imaging and diagnostic programs, surgical provides, and extra.

At OU Well being, we have now a long-standing relationship with Cisco, and our lead engineer holds CCIE Enterprise Infrastructure certification. Our inner mission 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 associate that may ship on its guarantees like Cisco.

Hospitals are 24/7 establishments, and hospital infrastructure should totally assist 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 assist a never-down state of affairs. When it got here time to construct our new atmosphere, 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 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 every little thing 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 expertise. Its core layer is Cisco ACI (Software Centric Infrastructure), a software-defined networking answer, 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 programs. Then we have now 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 data programs.

Affected person well being consists of their healthcare knowledge, 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 knowledge 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 programs (working on historic machines) into our new infrastructure. Virtualizing these permits us to maintain them working till we’re in a position to change the programs 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 energetic/energetic 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 programs. Ought to the unthinkable occur and our major knowledge facilities fail, the third knowledge middle will guarantee we stay operational.

One in every of our largest challenges and alternatives was migrating our programs 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 may host our knowledge 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 expertise helps decrease our working bills whereas defending the atmosphere. Transferring our knowledge middle off-prem was one in every 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 major 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 phase 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 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 group 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 are able to increase 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 data throughout a number of programs and applied sciences. Now that we have now rolled out Epic, we have now a strong basis to assist us push the envelope of high quality affected person care and cutting-edge analysis.

The perfect 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 beneficial retention and recruitment software. Clinicians and researchers additionally need to work in high-tech environments. They would favor user-friendly programs over fighting digital varieties, drowning in infinite emails, or ready hours for medical photographs, 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 need to make a distinction in Oklahoma and past by bringing the very best medical care to the populations we serve.


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