The Texas Children’s Hospital is Undergoing a Healthcare Transformation¬†

Lily Simpson

The largest children’s hospital in the United States is leveraging the cloud’s potential to advance medical practice and improve patient care.¬†

Every day, I witness miracles at my workplace. It is my responsibility to provide the necessary technologies to the physicians, nurses, and other team members to assist in the performance of medical miracles. 

Texas Children’s Hospital, where I work, is the most comprehensive pediatric healthcare facility in the country. Texas Children’s Hospital is a non-profit hospital with nearly 1,000 beds. Its mission is to create a healthy future for children and women all over the world by being a leader in patient care, education, and research.¬†

It is a setting in which the pursuit of innovation to improve patient care and outcomes drives nearly every agenda item. We were the first to successfully implant a pacemaker into a child, separate conjoined twin sisters at the age of ten months, and perform the first bone marrow transplant from one identical twin child to another. These are just a few of our many accomplishments. 

We are perhaps best known in the field of technology for creating Epic Rover, a mobile software application that is now widely used. Epic Rover employs barcode technology to reduce the likelihood of medication errors and to improve the quality and safety of medication administration. 

The children of Texas’ journey through the clouds¬†

Because we began our journey to the cloud in 2016, we are considered early adopters in the healthcare industry. 

We began with a simple goal in mind: to use the public cloud to improve many of the services and technologies that we already provide to our health providers and staff, such as predictive analytics, artificial intelligence, and big data. However, as time passed, we realized that this goal was overly simplistic. 

However, as we’ve progressed, a broader agenda has emerged, which is to develop the flexibility and agility required to deliver the services we provide to our healthcare professionals in a significantly more rapid manner than our traditional capabilities can provide, as well as to assist our organization in its efforts to become more agile across the board in general.¬†

This proved crucial when the pandemic struck and we were effectively expected to switch to a telemedicine model overnight after previously doing patient visits in person. 

Here’s how we got there, what we’ve learned and what we’re still learning, as well as some cloud computing best practices that we’ve incorporated as our journey into the cloud continues.¬†

Striking a Balance Between Privacy and Risk 

Every healthcare system faces the challenge of balancing patient confidentiality and the risk of harm. We spent a lot of time and effort in the early years of our journey into the cloud overcoming this barrier. Our infrastructure and application teams wanted us to push for greater cloud capabilities at a faster pace. Our security and compliance teams, on the other hand, were viewed as holding us back because they worked to ensure that we were in compliance with all applicable government regulations and requirements. But the knowledge we gained from going through this process proved to be extremely beneficial. 

We concluded that we needed to start integrating these disparate teams into a single implementation group right away. After that, we discovered that we could move forward in a less difficult and more productive manner. Because of this model, we were better able to contribute to the definition of an overall approach to security that was compatible with the speed of cloud computing, reduced our risk of noncompliance, and increased our overall security competence. 

This is more of an organizational and cultural transition than a pure security or risk management concern. We made some changes to our organizational structure, which aided in the exchange of ideas and the implementation of best practices across our entire IT organization. 

Increased knowledge gained through proper administration 

It is critical to emphasize that any company embarking on a cloud journey will need to learn from its own unique set of challenges, just as we have. To establish the new capabilities required to successfully function with a cloud-first mindset, organizational structures must be changed, as well as new skill sets must be learned. 

We had a rocky start to our change on more than one occasion. We realized something was wrong with the way this was being done because of the discomfort we felt. We came to the conclusion that cloud computing necessitates a very different strategy, and we were finally able to achieve our goal when we established a cloud governance office with the assistance of our business partners at Hewlett Packard Enterprise. This office was tasked with managing and maintaining all activities related to our cloud transformation. 

We began to see progress after switching to the new model

As a result, the entire company was able to take advantage of already available technology in ways that were not previously possible. We were able to see areas where we could improve, learn from our mistakes, and move forward because the governance office provided us with a platform to comprehend, plan, and act. 

Consider my concerns about privacy and risk. Because we cannot violate patients’ right to privacy, our previous system made it difficult to respond quickly to changing conditions. We can now quickly deploy new services while ensuring that the highest levels of cybersecurity controls and compliance are in place. We felt as if we had discovered the Holy Grail when we were finally able to do this.¬†

We could see progress after [establishing a cloud governance office]. It enabled the entire organization to take advantage of available technology in ways that were previously not possible. 

Creating the infrastructure for data science 

The advancement of knowledge in the field of medicine is almost entirely dependent on collaborative efforts. This means that we must enable our researchers, as well as researchers from partners such as Baylor, to run sophisticated analytic models against a variety of clinical scenarios. 

Our goal is to create a self-service research platform that will provide researchers with access to the tools and resources they need, whenever and wherever they need them. This will help us achieve our goals. 

Because we are focusing on increasing the capabilities of our existing data centers, we now have a very strong presence in artificial intelligence and predictive analytics in the cloud. This is a direct result of our efforts. 

In terms of architecture, design, and execution, we are still in the process of separating our on-premises estate from our public cloud. We are doing this because we believe that our cloud investments are fundamentally different from those we have made on-premises, especially when viewed through the dual-lens microscope of technology and capabilities.

To put it another way, the public cloud is superior in some ways, while on-premises computing is superior in others. In light of this knowledge, we are currently working to determine the optimal distribution of platforms that will be required to adequately serve the various workloads. 

Rapid ideation and experimentation in the name of innovation 

We were able to develop a discipline for experimenting because of the low level of risk associated with the public cloud. Even if our efforts are futile, we can proceed with confidence that we will be able to reduce our financial commitment. We were able to appropriately size these investments from the start thanks to our hybrid strategy. If something reaches a certain level of significance, we will be able to run it locally using a cloud-based model. 

In addition, we are expanding our business and investing heavily in the development of custom software applications. Because of the agility provided by our cloud operating architecture and development tools, we can quickly spin up new apps to support and improve our business processes. 

For example, when it was decided that Texas Children’s would be in charge of distributing large amounts of the COVID-19 vaccine, we devised a solution within four business days of being notified of the problem. We were able to do so because we had the appropriate governance in place, as well as the appropriate competencies, technical team, and processes. Technology is significant in and of itself, but in the end, it is the people, processes, and technology that work together to make this possible for us.¬†

Why do we undergo changes? 

Our transformation is still ongoing, but we are already reaping many of the benefits that we anticipated when we started down this path. Consider how quickly we can develop and release software. That has significantly improved and become much more cost-effective. Another advantage is adaptability. The epidemic highlighted the importance of being able to rapidly scale up or down based on requirements. To summarize, given the exponential growth of our data, I anticipate huge leaps forward in terms of improving healthcare, many of which are currently unknown. Everything about this is exhilarating. 

When I get out of bed in the morning to go to work at Texas Children’s Hospital, I do so fully aware that beyond those doors are children who stand to benefit from the technological resources that we work so hard to make available. Knowing that what my team and I do is so important to our doctors and employees who are there to help those children in every way possible is an experience unlike any other.