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At One North Carolina Health System, Transforming the IT Infrastructure to Meet Future Needs

June 7, 2017
by Heather Landi
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This Healthcare Informatics Special Report as part of the May/June issue details one health system's data management strategy
courtsey: Wake Forest Baptist Medical Center

At forward-thinking healthcare organizations seek to support new technologies, applications and services, such as advanced analytics to support precision medicine or population health initiatives, many are finding that their existing, older IT infrastructure may be an impediment to driving innovation forward. The volume of data that hospitals create and manage is growing exponentially, many health IT experts say, driven by the use of electronic health records (EHRs), diagnostic imaging systems, and mobile applications as well as federal regulations mandating the ongoing digitization of healthcare.

This unprecedented data growth, and the need to effectively leverage data to its potential, is proving to be a significant challenge for healthcare IT leaders. Effective data management and strategic data governance can be critical in order to move forward with operational improvements and to provide a high level of service and performance to clinician end users. To this end, many healthcare provider organizations have undertaken modernizing their IT infrastructure to meet future technology needs.

When Chad Eckes, executive vice president and chief financial officer, joined the Winston-Salem, N.C.-based Wake Forest Baptist Medical Center in March 2014 as CIO, he encountered significant legacy IT infrastructure challenges, and these challenges were impacting the organization’s ability to focus on its strategic priority of enhancing patient care versus maintenance and support. The aging IT infrastructure was difficult to support, there were sprawling data centers running out of space and critical projects were being delayed due to infrastructure constraints, he says.

“The prior CIO had chosen to direct investments in the IT organization toward two very large-scale IT software projects, an Epic EHR implementation and an Oracle PeopleSoft implementation, and had stopped putting proper investment into the data center, the networks and the core infrastructure there. There was no master architectural blueprint for the infrastructure, as a result, it grew haphazardly, and it was an aging and failing infrastructure,” he says.

Wake Forest Baptist Medical Center is an academic medical center and health system comprised of Wake Forest School of Medicine and an integrated clinical system with three hospitals and nearly 300 clinics serving 2.5 million residents in a 24-county area in northwestern North Carolina. The health system conducts 1.3 million patient clinic visits, 44,000 inpatient stays, 50,000 surgeries and 162,000 emergency department visits per year. The system also includes Wake Forest Innovations, a commercialization business. All told, the organization has 14,000 employees comprised of 1,200 physician faculty, 1,000 affiliated physicians and 1,900 students. In addition, the health system’s network also includes over 18 affiliated community hospitals, more than 100 clinics, physician practices and outpatient services serving one million patients annually.

As then-CIO, Eckes’ first order of a business in 2014 was conducting an assessment of the IT environment. “There were many applications issues that had to be addressed. One of the things that we uncovered was a mounting infrastructure risk that was impacting the organization, and the second was a severe issue with analytics and reporting.”

Chad Eckes

The assessment demonstrated that 64 percent of the IT infrastructure was over seven years old, Eckes says, and 12 percent was more than 11 years old, and he adds, “How that was manifesting itself on the operations of the company was that there were significant downtimes on a regular basis. We were showing an uptime percentage of 84 percent out of that infrastructure.“

The IT infrastructure at the time required 1,500 servers and multiple storage area networks. “All the servers were your legacy racked and stacked,” Eckes says. Further, the organization had made limited progress on server virtualization.  “We were about 22 percent virtualized,” he says. And, Eckes adds, “We did not have a business continuity plan and disaster recovery plan for the systems, so that was core to our issues—when we were down, we were hard down, and that led to a lot of manually processing when taking care of patients.”

On the network side, the organization had many end-of-life products in the medical centers. “As an example, on our main campus we have 798 different networks, and 131 networks that had not received patch updates since 2010; not because we didn’t desire to, but because the products were so far end-of-life that we couldn’t patch them anymore,” he says.

For Wake Forest Baptist Medical Center’s executive leaders, modernizing the IT infrastructure was an imperative, and Eckes says organizational leaders considered two options. The first option for modernizing the IT infrastructure was what Eckes refers to as “the old-school way,” or traditional technology, and the second option was to implement a converged infrastructure.

“From a cost, risk and a speed-to-value perspective, all signs pointed to doing this with converged infrastructure,” he says.

After reviewing technology solutions providers, executive leaders decided to adopt a converged infrastructure approach, which is a data center management approach to consolidate computer, networking and virtualization silos into a single solution to support all of the organization’s applications. The health system worked with Dell EMC to develop a strategic plan for a new infrastructure and application platform, which resulted in the deployment of Dell EMC’s Vblock Systems to provide the infrastructure for the organization’s new software-defined data center, Wake Cloud.


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