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Odessa Medical moves to the dark (fiber network) side

A goal of 100% network availability and uptime is hard to meet. Odessa Medical moved to a dark fiber network to meet that need, IT director Brad Shook explains.

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After 15 years at Odessa Medical Health Center in Odessa, Texas, Brad Shook is seeing his long-term vision come into focus. Following a decision to move several business applications to the cloud, the center did a complete Wi-Fi upgrade, but the changes roll on. With its new design moving away from leased circuits to a dark fiber network for the 28-building healthcare operation, this director of IT operations has big plans for the West Texas Level II trauma center.

With a goal of 100% network uptime, Shook has researched how to tie in lighting and HVAC systems to increase internet of things building automation to make the medical complex more cost-effective and patient-friendly. Shook isn't all business, though. His serious hobby is maintaining a 243-gallon salt-water aquarium, where he concentrates on growing corals. We caught up with Shook early one morning to talk about how he got here and the future of the medical center on a dark fiber network.

Editor's note: This interview was edited for clarity and length.

What IT and networking projects are you working on at the moment?

Brad Shook, director of IT, Odessa Medical Health CenterBrad Shook

Brad Shook: My current projects have to do with achieving 100% uptime for everything in the health system. We have physicians' offices scattered throughout Odessa, not just in our hospital. We recently upgraded our electronic medical record system to Cerner, and it's hosted in the cloud. We moved our Office 365 to the cloud. Anything we can move to the cloud, we're moving that way fast.

Has moving to the cloud prompted your current projects?

Shook: Anytime something is cloud-based, you have to make sure your network is rock-solid. We've redesigned our entire network with lots of redundancy and failovers. We already did a full wireless network replacement. Now I'm changing the [wireline] network because we originally started out with the ISPs doing managed circuits from AT&T; Grande [Communications], a local company here; and Cable ONE. But we always seem to have issues with outages from the carriers.

Are your circuits supposed to have traditional 99.999% availability?

Shook: Well, the deal is that in healthcare, five nines isn't enough anymore. If you need an electronic medical record in the cloud, and you're down at that critical moment, you can't get to that information. You just can't afford that in healthcare. The big ISPs still tout five nines, but out here in West Texas, they typically never live up to that. Long story short, we've started looking at moving away from AT&T. The support has gotten so bad. Trying to get a hold of AT&T, we don't have any direct numbers anymore and no direct local reps to call. It can take you 24 hours just to get a ticket case open, and then sometimes two days before they're on site trying to fix something.

What's your alternative?

Shook: Well, in looking to bid at some other fiber companies in the area, I stumbled across going for a dark fiber network. I had just kind of figured it would be astronomically expensive. Turns out it was actually cheaper. We just recently signed a contract with Cable ONE, and we're going to be live on dark fiber to every single one of our remote buildings by October. Every building will have a redundant dark fiber path that goes out in different directions to terminate to different buildings, so if either one of those lines gets cut, we'll still be up. It's fiber pulled directly from one building to the next, so it's just like another floor in the hospital. It's a fiber run between buildings with no routers in between.

With our new network design, we're going to be able to use [Volume Shadow Copy Service-based backup] over our WAN, and it's to the switches and everything, so we don't have to add all these routing protocols. All of the equipment is ours because all [Cable ONE does] is terminate the fiber in the building, and then we go from there into our switches or main routers and use our own optics.

What kind of uptime will you expect with a dark fiber network and redundant paths?

Shook: We're the only Level II trauma center in our region. I'm going for 100% uptime; of course, you can't always have that. You could have a tractor come right next to the building and trench and cut fibers. Or we could have a major hailstorm that knocks power out to the point that our [uninterruptible power supply] in a clinic doesn't last long enough.

Will your network upgrades help you with the internet of things (IoT)?

Shook: One of the projects has to do with equipment tracking. We have [radio frequency ID], and we tag pumps, wheelchairs and beds. Now we'll start working on more automation. You've got a lot of money sitting in equipment that isn't being used all the time because our tracking system is very manual. I want to build workflows into equipment tracking. It's really fairly simple; it's just writing on the back end of the work flows to say 'When this, do this.'

Well, the deal is that in healthcare, five nines isn't enough anymore.
Brad Shookdirector of IT, Odessa Medical Health Center

We have a lot of loss of equipment because things go down the laundry chute. You can put exciters at chokepoints, like with a flashing light. So if a device gets into a laundry chute or into an ambulance bay, the exciter goes off and that's a visual for the staff to get that piece of equipment.

We're also looking at improving our infant security system. We're looking to use IoT there to add more warnings, more automated locking doors and more notifications to nursing.

And from there, I'm working with engineering and looking at building infrastructure and will tie more building automation into our new HVAC and LED lighting systems. Ultimately, if you design it right, it doesn't cost a whole lot of money. It just takes the proper planning and time.

Did you always plan on going into IT?

Shook: I didn't plan on going into IT. IT trapped me. I got a computer and was mesmerized by what I could do on it, so it was all downhill from there. My first degree was in business; then I moved to Odessa and went to the University of Texas of the Permian Basin (UTPB), which is where I started my computer science degree. But I also got a master's in business administration in 2008 at UTPB. I started out as a programmer at the hospital in the business office and from there moved into imaging. Being director of operations kind of brings me back to what I went to school for in business.

To close out with our discussion, what do you like to read?

Shook: The majority of my reading is on oceanography because I'm big into reef aquariums. I keep corals and saltwater fish, and there's a lot of chemistry involved in water parameters. So I do a lot of reading on that.

Next Steps

What is dark fiber? Learn more

The reality of super high availability

How IoT is shaking up healthcare

This was last published in August 2017

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What benefits would your organization see in moving to a dark fiber network?
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Brad, Does your hospital have plans for AI in 2018?
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We are focusing on IoT and Telecommunications in 2018. We will be AI ready in our Radiology arena by 2019. IBM Watson is proving some really great value in Radiology reads. I would be very interested in hearing of any AI projects in Health Care 
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Interesting AI in healthcare read on SearchHealthIT.com: http://searchhealthit.techtarget.com/tip/Benefits-of-artificial-intelligence-include-clinical-support

In what ways has AI matured enough to offer that imaging analysis benefit? What's making clinicians become more comfortable sharing their ability to evaluate patients with machines?
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They are training machines to use if then else statements. If this is true or false do this. or this etc. Deep Learning is also a part of it. From the looks of the article, the writer wanted to discuss avenues of AI that are built into population health systems for wearables and at home devices. Many CIO's, and Brad please Chime in would love this technology but have to prioritize budgets for infrastructure. Mr. Shook's article is a great example of getting a network to 100%, that's core, solid foundational work. 
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https://www.nanalyze.com/2017/02/artificial-intelligence-medical-imaging/

https://www.engadget.com/2017/10/27/for-a-dollar-an-ai-will-examine-your-medical-scan/

You mentioned 2019, that is a long time from now, what is the hesitation? Doctors, Patients, budget, Administration?  I have not seen that IBM has anything on the Market for sell except for a lot of it's coming, which is what they have been saying for the past 3 years at RSNA and each year they show something different. Nothing of which is a to market system. 
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Great question Kate. Dark Fiber removes all 3rd party entities from your traffic. Think of dark fiber like connecting two switches next to each other with a fiber jumper. When you do there's no middle man managing your traffic.
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Brad, Thank you for responding I would like to see an article on;

1) Security, how are you testing, preventing? Where you hit with the WantaCry Virus or were your vendors?

2) Interobaility, how are you sharing today and your plans for connectivity tomorrow. How closely are you working with your HIE to be ahead of the government's mandates?


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Great interview. I noted there is no mention of security aside from the 100% uptime. With the cloud and IoT, there are inherent risks that must be managed, especially in the medical domain. What was/is been my done to secure info, systems, etc?
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