I have daily status meetings with various groups in our technical teams, and these questions almost always flow to: “What is the challenge today?” Sometimes, this challenge can be: “We can’t print on one of our outpatient care facilities” or “Today, we can’t send diagnostic images to remote radiologists.” Meetings help us focus, and as the CTO of OU Health in Oklahoma City, my job is to eliminate the problems that arise at these meetings and work to reduce or eliminate these repetitive issues in the future.
To do this, we need to solve the root cause of the problem. This, along with our desire to replace our electronic health records and revenue cycle systems, led to OU Health’s decision to overhaul our IT infrastructure for our long-term organizational needs.
OU Health strives to bring innovation to our patients. As an academic health system, we operate one of the country’s 71 National Cancer Institute designated cancer centers, Oklahoma’s only Level I Trauma Center and the state’s highest-level NICU, providing high-quality patient care and conducting clinical trials to achieve exciting new treatments. In addition to addressing our daily headaches, our IT overhaul will fundamentally change how we manage infrastructure and manage the businesses and clinical systems we use to support healthcare professionals and patients.
The complete transformation of the IT infrastructure of the health system is a difficult task. To use stale clichés, it’s like trying to work on the engine of a mobile train. This process has taken the dedication and careful planning, the work of my team and the support of technology partners like Cisco to organize and launch solutions on OU Health’s website.
A new beginning, a green space network and some restrictions
I have been lucky enough to have been working in healthcare for over 13 years. My previous experience includes seven and two years as Vice President of Technical Architecture at CableVision and SVP of Enterprise Construction at Discovery, where I gained extensive knowledge in telecommunications and entertainment. After six months off, I had the opportunity to return to my previous role, but I decided to use my expertise to help others in a more influential way. Watching my wife struggle with her organization for years, as a family practice provider and educator, I realize the difficulties that can arise when dealing with healthcare IT systems. Thanks to friends I worked with earlier in my career, I joined a healthcare consulting firm and started my healthcare career to help doctors and patients achieve the best results of medical care.
OU Health officially launched in July 2021, following a historical merger that combines the University of Oklahoma School of Medicine practice and OU Medicine, Inc. (The sole member, a member of the University Hospital Trust) to create OU Health (Oklahoma’s first fully integrated academic health system). The merger aligns OU health clinical businesses with national best practices across the healthcare industry and enables hospitals and clinics to become a unified and cohesive organization.
I have worked closely with our IT leadership team since I arrived at OU Health in March 2022. The program transfers OU health to the new EHR system. To achieve this, we deployed the Greenfield solution, which involves building new networks, systems, data centers and applications while keeping our legacy systems running.
Unfortunately, our environment is not at its best. It uses outdated devices, overlapping solutions, outdated code, untouched devices, etc., which raises many challenges. Our network is also very slow, which means it took 15 to 30 minutes for radiologists to download X-rays and cat scans in our remote locations.
This hinders the workflow and frustrates our clinicians and hospital staff. Whenever something goes wrong, they have to call us and we can’t proactively monitor and restore our system. When the link drops, we don’t know how to repair it. Obviously, overhauls are necessary to ensure that our healthcare professionals can focus on caring for patients without having to worry about technical issues.
We want redundancy, resilience and performance – meaning Cisco
Medical organizations are somewhat conservative when purchasing. We won’t look for the latest solutions, nor do we look at the cheapest solutions. We won’t cut costs because the lives of patients are at risk. Instead, we look at state-of-the-art trials and real systems. We use this approach when selecting laboratory equipment, imaging and diagnostic systems, surgical supplies, etc.
At OU Health, we have a long-term relationship with Cisco, and our chief engineer holds CCIE Enterprise Infrastructure Certification. Our in-house project managers also bring decades of experience managing large Cisco deployments. We all know that Cisco can provide high-performance, redundant and resilient infrastructure. However, my job requires me to be objective, so I participated in events like Gartner Summits and the annual HIMSS Global Health Conference and Exhibition to see what’s going on there. I have a good understanding of the tech landscape, but I haven’t found a partner that can deliver on promises like Cisco.
Hospitals are 24/7 institutions and hospital infrastructure must fully support unlimited situations.
When we created specifications for new environments, we looked at three things: high redundancy, high elasticity, and high performance. Like most healthcare facilities, OU Health operates 24 hours a day, 7 days a week, and our infrastructure must fully support unlimited situations. When we set up our new environment, we didn’t ask, “Why do we need Cisco?” The real question is, “Why not Cisco?”
Redefine our network through a software-defined network
When it is necessary to launch our new infrastructure, the team works with Cisco’s network architects, external partners and our in-house leading architects. We filed a request for funding and submitted it to our board of directors. We expect our executives to approve less than budget requirements, but we get the green light to build everything we ask for – the most advanced network and system environment, with OU Health on a map of top medical centers.
We have built a new network about Cisco technology. Its core layer is a software-defined networking solution, Cisco ACI (application-centric infrastructure) to help segment our network. We establish redundant high-speed links throughout the WAN, as well as multiple paths to connect our core network to hospitals, clinics, and outpatient systems. Then we have multiple routers to handle our software-defined networking and segmentation. If the router or segment fails, we transfer traffic to an alternative path.
We use Cisco ACI to route traffic to specific destinations in our network. A good example is laboratory results. Our laboratory equipment does not communicate with the outside world, but our technicians must send the results to our EMR. So we have split the network to only transmit the results to a specific server and then upload them to our recording system.
Patient health includes their health care data, and we will prioritize the safety of patient protected health information (PHI). We use ACI to create a firewall area and other sensitive data for PHI and other HIPAA regulations. Only users can access the environment if they execute transactions that require this information.
We also use Cisco UCS servers for scalability efficiency and agility, Cisco Identity Services Engine (ISE) for endpoint management, and we do end-to-end on Cisco Wireless Solutions, consisting of Cisco Catalyst 9130ax and 9166 access points and 9800-80-80 controllers. Additionally, we have adopted Cisco VDI to integrate some of our traditional systems (running on ancient machines) into our new infrastructure. Virtualizing these allows us to keep them running until we can replace the system without breaking care.
Migrate our data centers to ensure their transparency
Our three new data centers take the load on our new network. Our two data centers are active/activity centers and mirror each other, dividing our workload into two with 50% capacity per facility. Our third data center is Disaster Recovery (DR) and has redundant connections with all our hospitals, clinics and outpatient systems. If it happens unthinkable and our primary data center fails, a third data center will ensure we stay running.
One of our biggest challenges is moving our systems and infrastructure to new, more sustainable data centers. Instead of building our own on-premises data centers, we decided to work with top co-seat facilities, we could host our data centers and drastically lower our footprint. We work with Tierpoint to be one of the first customers to build efficiency in its new factory. They built power, cooling, HVAC and building materials to reduce their carbon footprint. We benefit from strong redundancy and backup capabilities, and energy-saving technologies help reduce our operating expenses while protecting the environment. Taking our data centers out of nature is one of our best business and technology decisions.
On June 3, 2023, OU Health lives with Epic and our new infrastructure. We have moved to the new major network in March 2023, but this is the final test. We are already reaping the rewards of new Cisco infrastructure. We no longer raise complaints about slow Wi-Fi speeds, connection failures, network segments and VPN issues. OU Health has quick access to what they need, allowing patients to get what they need faster. I look forward to sitting down with our nursing team to find ways to expand, innovate and build on our new platform.
Cisco is helping OU health improve our organization
Soon, my IT team will be able to leverage our new Cisco network to enable and execute OU Health’s business vision. We can integrate new departments, locations and facilities into our network faster as we expect to need to build more WAN connections and have a comprehensive map of current and future state. In the past, every network addition was a one-time event. But now, we can expand our platform as needed to add powerful new applications such as data analytics and population health management (PHM) tools to aggregate patient information across multiple systems and technologies. Now that we have launched an epic epic foundation that can help us drive quality patient care and cutting-edge research.
The best ideas attract organizations to increase value by supporting a business vision rather than fixing things.
Our new Cisco infrastructure is a valuable retention and recruitment tool. Clinicians and researchers also want to work in high-tech environments. They want to use a user-friendly system instead of struggling in electronic form, drowning out endless emails or waiting for medical images, test results, and waiting times for trial and patient data. When they have the most effective tools and the results are perfect, they can focus on patients and research.
OU Health’s mission is to advance our organization and transform our organization into a top academic health system. Our leadership sees technology as key to achieving our vision and business strategy. We are expanding our services and research programs and will continue to engage in innovation in diabetes and cancer care, pediatrics and geriatrics. We want to make a difference in Oklahoma and beyond by bringing the best health care to the people we serve.
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