Exclusive report from IBM Data Summit: Addresses healthcare data growth
The innovation model is changing, according to Mike Svinte, vice president of IBM global pharmaceutical and life sciences, who hosted the IBM Healthcare Data Summit 2007 in Cambridge, Mass., on Friday.

“We are entering into a new model of innovation with different characteristics,” he said. That includes innovation that is more open, whether via trade secrets or open standards; more collaborative, which includes more engineering entering into therapeutics; and more global. “It’s an exciting and dynamic time,” said Svinte.

Technological resources also are becoming more limitless rather than limited, in terms of computing power, for example. “It’s a sea change of what is available, how we apply it and how we take advantage of it.”

Two requisites for innovation, said Svinte, is the will to do the hard work, which we increasingly have, and the capabilities, which also are increasing.

There are huge pressures on healthcare systems, he said. The rapidly aging population means that by 2025, 1.2 billion people around the world will be more than 60 years old, and 2 billion by 2050.

The healthcare industry offers challenges IBM doesn’t see in other industries. The amount and the complexity of data in healthcare is driving innovation.

The various components of healthcare systems are interdependent, Svinte said. “There is more reliance and a desire to work together.” We are moving away from ‘one-size-fits-all’ medicine and toward more personalized, targeted medicine. “That’s a fundamental change. The scale of medicine has changed. Today, we are episodic and reactionary.  In the future, we will be predictive and preemptive medicine.”

Imaging is playing a big role in those changes. Medical imaging is creating wonderful, rich data, said Rich Bakalar, MD, chief medical officer for IBM. But, healthcare is laggard when it comes to IT because of the complexity of that data. The industry has been provider- and payor-centric and is shifting to becoming patient-centric, he said. That’s partly because, he said, each patient has more ability to influence their own health than all the other influences combined because of they alone can modify their own behavior and choose to comply with treatment.

Unfortunately, the United States spend more on healthcare than most other countries without good results. The U.S.’s healthcare system currently is ranked 37th according to the World Health Organization. “Forty percent of what we spend on healthcare is due to inefficient use of information,” said Bakalar.

That knowledge, as well as the following, are driving change:
  • Globalization. “We are exporting our chronic conditions to developing countries and developing countries are importing their acute conditions,” he said.
  • Consumerism.
  • Aging and overweight.
  • Diseases are more costly to treat.
  • New treatments and technologies.
Healthcare facilities have been very progressive when it comes to investing in imaging technologies, Bakalar said, and there has been less investment in IT. “Now, we are starting to see a more balanced approach between the two.”

Three changes must occur, he said, for success. They include shifting from cost basis to value basis; consumer responsibility; and transforming care delivery models. These three changes will result in a win-win transformation.

These changes also would hopefully change efforts to integrate technologies from “plug-and-pray” to true plug-and-play, he said.

“It’s time to get our arms around storage,” Bakalar said. In medical imaging, it’s all about the context of the image. An image is only useful if the person viewing it has the relevant information. “Medical context drives the value of the image.” Today, IBM is architecting systems that are future-centric, he said, and geared to larger volumes of imaging studies. “There is a higher demand for the services of radiologists so productivity is key.”

Storage for healthcare presents demands that are challenging to meet, including an always on archive, reliable integrity, easy management and administration, easy migration, affordable and scalable systems, and autorecovery.

“Healthcare represents interoperable and specific usage requirements that will drive further innovations,” said Clod Barrera, distinguished engineer for IBM.

The challenges presented by PACS are driving Barrera’s work. “PACS are isolated islands of data and applications,” he said. All the tasks associated with any system—recovery, growth, management—have to be done separately with a PACS. IBM’s GMAS can help manage content growth, support heterogenous storage hardware, eliminate information silos, and support disaster recovery. The system has an embedded ability to help facilities grow from terabyte to pedabyte status.

Harbin Clinic in Rome, Ga., operates 20 facilities in four northwest Georgia counties and is the region’s largest multispecialty practice. Tom Fricks, chief information officer, said the organization developed a five-year plan in December, 2001. A practice management system was already in place, an EMR came on board, a RIS came in 2002 and PACS in 2005. “We decided to be EMR-centric,” he said. “The physicians don’t want to have to log on to multiple systems for patient information—they won’t even click on an icon.”

The clinic scans one million documents a year and creates 500,000 electronic prescriptions annually. For all of its needs, Fricks migrated data off server attached storage to storage attached networks with attached blades, and he established disc to disc backup. The PACS purchase drove the purchase of the first SAN. The facility then created immediate care which extended the clinic’s hours and reduced the window in which Fricks and his team could work on systems without affecting users.

Fricks found that vendors primarily are offering turnkey systems and don’t support independent technology platforms. “There’s a learning curve for IT staff. They’re used to just fixing PCs.” The changes have resulted in better utilization of hardware resources, quicker recovery for hardware failures, and a decrease in offline times for backup.

Mark LaBelle, manager of servers and storage for Spectrum Health in Grand Rapids, Mich., joined the organization about a year ago. He installed the IBM DS8300 for its high reliability, self monitoring, and high performance. The organization also has, but hasn’t yet used, flash copy and metro mirror, an EMR, PACS, revenue cycle software and numerous other software applications.

“PACS is our biggest challenge,” said LaBelle. The organization performs 500,000 radiology studies a year which consumes two terabytes of additional storage a month. When PACS was installed, the plan was to flush studies more than two years old from disk and only maintain them on tape. As soon as two years passed, that plan became a problem. When radiologists saw a patient with priors, they wanted to see that patient’s entire history. That retrieval was taking 20 to 30 minutes.

LaBelle helped facilitate a short-term fix via IBM’s Tivoli storage manager, and leased enough disc to hold the 50TB PACS archive. It took about two weeks to migrate the PACS data.

Meanwhile, he made a commitment to never again create a solution where users had to read tapes to satisfy a mouse click. He moved the PACS to spinning disk ASAP. He also developed a longer-term strategy that uses IBM’s GMAS.