Storage & Archiving: Safe Keeping for Now and Later

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Behind every successful PACS is a carefully orchestrated storage strategy - and hardware and software storage vendors made this quite apparent at this year's annual Radiological Society of North America (RSNA) show. As vendors served up digital imaging storage components that meet a variety of imaging, preservation and budget requirements, smarter consumers roamed the RSNA floor in search of short- and long-term archiving solutions, as well as disaster recovery/business continuity technologies, that make affordable PACS a successful reality.

Storage vendors delivered, realizing that while many larger institutions may be gearing up for their second and third generation PACS, smaller healthcare providers are just beginning to develop a digital imaging plan. While the latter may require a mid-range storage system that is affordable, easy to install and manage, the larger healthcare provider may be looking to leverage existing IT infrastructures with sophisticated software and also, advance to a healthcare enterprise archive. All was possible with the hardware and software components storage vendors touted at RSNA this year.

(Note: companies appear in alphabetical order.)



Bycast highlighted at RSNA the newest features of its StorageGrid software which helps healthcare providers take a more scalable, unified approach to archiving.

"Healthcare providers are trying to deal with a tidal wave of fixed-content digital data such as medical images," said Deanne Farrar, senior vice president of Industry Solutions for Bycast. "Data are being produced by multiple disciplines, including radiology and cardiology, and used by multiple applications such as PACS. In addition to dealing with this tidal wave of data, healthcare providers must also deliver a disaster recovery plan to ensure data availability and meet the data integrity requirements of HIPAA."

Bycast StorageGrid delivers a high-performance, fixed-content storage system based on grid computing architecture. It enables hospitals and healthcare networks to securely store and transmit diagnostic images and documents within the enterprise and across multi-site facilities.

Bycast is now shipping a new version - StorageGrid 5.0 - that introduces the FileSystem Gateway which exposes the StorageGrid as a virtual CIFS or NFS file system. This allows any type of fixed content, such as lab results, doctors notes, audio, video and diagnostic images, to be stored on the StorageGrid with the same scalability, reliability and speed that has always been available for native DICOM files. Furthermore, the FileSystem Gateway is content-aware and will intelligently process DICOM and other standard file formats. Therefore, all PACS can seamlessly store and retrieve images on the StorageGrid without the use of proprietary APIs.
   


Communication Synergy Technologies Inc. (ComSynTech) demonstrated the integration of its proprietary preservation and archiving technology into its InFORM radiology information system (RIS) at RSNA this year. 

The archiving software, called the CDV1000 Document Vault, enables healthcare providers to preserve and archive vital documents. A major benefit for customers is that the system does not rely on a document's originating hardware or software to restore the document to a human-readable format, the company said.

According to Seth Borg, MD, CEO, the CDV1000 Document Vault is an affordable document preservation and archive management system that facilitates compliance with many healthcare regulations, and at the same time, is integrated with a practice information system.  

ComSynTech also highlighted InFORM RIS's recent integration with MedPay USA's billing verification software. The added functionality allows the InFORM' RIS to deliver a host of pre-billing functions, including eligibility verification, Medicare compliance, electronic claims processing, claims auditing, claims status, remittance posting, secondary billing, contract management, denial management and contract management, according to Borg.



EMC at RSNA showcased its range of information storage and enterprise content management systems that help healthcare organizations better meet their PACS archiving demands. The company put a particular focus on its new generation of mid-range storage that is geared toward first-time PACS user and touted as easy to install and manage.

"We are using the show to support one of our key partners, GE, in the introduction of a new product which brings PACS way down stream from larger healthcare institutions into smaller- and medium-sized hospitals," said Joel Schwartz, senior vice president, general manager, Midrange Systems Division. In early November, GE introduced a new PACS for a smaller healthcare facility that combines its Centricity PACS SE with EMC's CLARiiON AX100. Using an Intel-based server hardware and EMC's new generation of storage, images can be stored online. It is the first PACS to be bundled with the CLARiiON AX100.

The affordable networked storage system (that Schwartz said will primarily be bundled with multi-vendor PACS) supports Microsoft Windows, Linux and Novell NetWare server platforms. It also is easy to install and manage, said Schwartz. "Because we felt these products were going to be used by many first-time PACS users, we said our second most important goal was ease of use," explained Schwartz. "We define ease of use as the ability for someone who is not a storage administrator to be able to install it in a SAN in under an hour."

EMC also highlighted its DiskXtender software which allows healthcare providers to easily migrate inactive, digital images to more cost-effective storage, while maintaining transparent access. The EMC Documentum Enterprise Content Management platform effectively enables the management of millions of documents and images residing across a healthcare organization.

EMC also noted Memorial Hermann Healthcare System's implementation of its Centera content addressed storage for compliance with HIPAA and JCAHO regulations. Centera provides secure, long-term archiving of historical images and patient records to accelerate compliance while enabling instant retrieval of regulated digital assets.



Fujitsu Computer Products of America Inc., a developer of magneto optical storage products, demonstrated new ultrasound DICOM viewing technology and the latest in security and archival medium for the medical imaging community.

Fujitsu showcased a USB 2.0 bus-powered DynaMO 1300 Pocket with DICOM Viewer that allows users to transport DICOM files on 3.5-inch MODs (magneto optical disks) from ultrasound and other medical imaging systems to notebook PCs and workstations. Great for mobile use, the high speed USB 2.0 powered MO drive is compact and weighs only 15 ounces. Bundled with viewing software and durable 1.3 gigabytes (GB) MODs, Fujitsu said the system is compatible with earlier 3.5-inch MODs [640, 540, 230 and 128 megabytes (MB)].

The viewing software - Trillium Technology Inc.'s Trillium ShowCase Viewer - provides easy viewing of studies on PCs or workstations. Features include clip start/stop, speed controls and the ability to compare modes and display stress echos.

According to Daniel Dalton, director, optical products, the low-cost technology is geared for healthcare professionals that are just getting into digital imaging.

Fujitsu also previewed at RSNA security and archival software for MO. The Secure MO Folder allows MO users to easily drop files into encrypted folders which protect data from intrusion from unauthorized parties. For data archival, Disk Drive TuneUp Pro v4.2 for MS Windows, developed by Software Architects Inc., provides low-cost archiving by creating  "write-once, read many" (WORM) optical recording on standard re-writable MO media. When an MO disc is formatted with UDF WORM format, it cannot be altered or deleted. According to Dalton, the security software will be launched at this year's HIMSS (Healthcare Information and Management Systems Society) conference, Feb. 13-17, 2005 in Dallas.



GE Healthcare used RSNA to showcase its new Centricity Digital Hardcopy that burns and labels CDs or DVDs for image and report distribution in DICOM format.

Simplifying file room processes, the system prints a full label with patient and study demographics and facility, address and contact information. Each CD or DVD also includes a copy of the browser-based Centricity DICOM viewer, allowing the user to view the images and reports contained on the disk on most standard PCs with internet access.

Featuring integration capabilities with Centricity PACS, the system provides access to worklist views on the Centricity PACS database, allowing users to access images and reports on-demand from the PACS. Users can display and review images and reports on the workstation, select the studies to be published and automatically burn them on a CD or DVD with a content-specific label. 

GE said Centricity Digital Hardcopy's integration capabilities extend beyond Centricity PACS and include any DICOM-compliant imaging network. The system can be configured to receive or query/retrieve studies from any DICOM server, workstation or modality. These studies can be automatically published on CD or DVD based on predefined rules, providing a mechanism for modalities, departments or satellites not yet integrated into the digital imaging network. GE said Centricity Digital Hardcopy provides the flexibility to integrate external reports from many other sources such as PACS broker and RIS products, enabling the hospital to integrate and publish comprehensive patient images and data as needed.



HP highlighted new partnerships with Siemens Medical Solutions and Bycast, as well as showcased its myriad storage technologies at RSNA.

First, the company announced that it will integrate is ProLiant servers and services with Siemens' SIENET Cosmos image management system

Siemens SIENET Cosmos is an integrated RIS/PACS designed for radiological practices and community hospitals. Integrated with HP's mid-tier level storage technologies, the digital image management system will provide a cost-effective medical imaging platform for any size medical imaging practice, the companies said.  

The initial products produced from the partnership are expected to be available in early 2005, according to the companies.    

HP and Bycast announced an expansion to the pair's existing relationship to jointly develop distributed storage systems for the healthcare industry.

HP will integrate its storage hardware (ProLiant) with Bycast's StorageGrid software, offering a cost-effective storage platform for fixed-content data. The systems will be available in the first quarter of FY05, said Jeff Miller, vice president of HP's Worldwide Health Industry Vertical.



IBM came to RSNA with upgraded versions of its Medical Assessment Workstation and Medical Archive Server. The company also touted the capabilities of its SAN Volume Controller virtualization software that helps hospital IT staff better manage their storage infrastructure as data volumes inevitably expand.

IBM's Medical Archive Server II now supports all of IBM's new storage products, including the DS4000, DS6000 and DS8000 systems and IBM's LTO (linear tape open) Ultrium tape family, said Patrick Boyle, business unit executive for IBM Healthcare Solutions. In addition to AIX (IBM's Unix operating system), the archive system now supports Linux-based servers.

"Many of our healthcare customers have said that Linux is very much an important emerging operating system platform," added Boyle. "We have also enhanced the storage management capability of the Medical Archive Server with our Tivoli Storage Management Software." Tivoli is designed to protect from hardware failures with backup-and-archive copies in near-line and off-line storage

IBM featured its Medical Assessment Workstation II with the new ability to support multiple high-resolution monitors on a single workstation. This allows users to view, for instance, patient scans at the same time as laboratory or other data, said Boyle. "This can benefit the ER or OR where physicians have to see an x-ray of the skull, a CT of the skull a three dimensional image of the CT and additional lab information up on the screen at the same time," he said.

The IBM Dual Monitor Display Medical Assessment Workstation II helps enable radiology departments and remote clinics to enhance productivity with twice the viewing capacity, software navigation and a cinematic 16:10 aspect ratio and 204 pixels/inch, allowing close scrutiny with fine-line accuracy. The Medical Assessment Workstation II costs between $8,000 and $14,000, including the displays, depending on the configuration.



InSiteOne used RSNA to preview a new storage technology - InDex Recovery Plus - that backs up a healthcare provider's medical data, not just DICOM images.

According to InSiteOne, InDex Recovery Plus meets the recovery demands of all medical data, including the databases that drive PACS and HIS/RIS. The system is a secure, HIPAA-compliant disaster recovery option for medical data. The storage technology works on a wide range of platforms and offers the flexibility to support scalable configurations.

Like all InSiteOne InDex DICOM archive systems, InDex Recovery Plus is a hosted system. Customers may elect to have a redundant copy on site as well with InSiteOne's high-availability option.  

InSiteOne said the technology is still in beta testing and will not be released for a couple of months.



Network Appliance Inc. highlighted its third-generation NetApp NearStore R200, a disk-based nearline storage system that combines the Data ONTAP operating system with ATA disk drives.

According to Al Boulanger, healthcare industry partner manager, the system provides a footprint that allows healthcare providers to house thousands of digital medical images online, and at the same time, affordably expand the storage capacity as needed. The NearStore R200 system is a disc-based, secondary storage device for enterprise applications and complements existing tape backup, archiving and data protection schemes. Therefore, it serves as a key component of an HSM (hierarchical storage management) infrastructure by storing less-critical data on a device whose cost and performance stand between primary and tape storage.  

For healthcare providers, the low-cost, high performance system increases the retrieval rate of PACS images and is easy to use and manage, said Wayne White, technology consultant for NetApp. "These large medical images, which would normally go to lower cost media such as tape or optical, can now be kept online with the same number of features and functionalities as the [original] options. If you have your data on optical or tape, getting them back is much more cumbersome."

"This archive system is typically geared more toward the mid- to high-enterprise environments," added Boulanger. "It can also be positioned for a number of radiology centers, but that is if they have a consolidation approach to storage, such as a data center where the data is migrated to one central location. In a 2,500 bed hospital, we typically see 400,000 to 500,000 images which is about 8 to 10 terabytes (TB) a year. It's very easy [in that setting] for the hospital's archive to fill up very quickly."

Introducing the R200 does not make old storage systems obsolete, but provides a more flexible approach to setting up a scalable, lower cost architecture that can expand as the hospital's digital imaging demands grow.



Panasonic Vision Systems displayed its new LQ-MD800 DVD Recorder system at RSNA that is dubbed a plug-and-play replacement for videotape recorders.

The system provides the capability to record/playback DVD-RAM and DVD-R media in the MPEG-2 format, making it suitable for a wide range of medical-grade applications. Durable DVD-RAM cartridge-encased media are suitable for acquiring and storing patient data files, particularly in medical sonogram recording where gels, powders and solutions are commonly found.

Panasonic said the LQ-MD800 Video Recorder offers "data secure" recording. The DVD-RAM media incorporates Defect Management System (DMS), making data recovery possible if the disc is partially damaged. For added versatility, DVD-RAM discs may be removed from their cases if necessary for playback in conventional DVD units.

The LQ-MD800 records in either NTSC or PAL formats without regional coding, so users can view images on nearly any DVD device.



Plasmon introduced a new version of its standalone UDO (Ultra Density Optical) drive that is suited for long-term archiving, affordable for smaller sized healthcare providers and easy to manage.

"The new thing is an easier to use standalone version of the drive which is targeted to small- and medium-sized organizations," said Dave Dupont, vice president of marketing. "This would be an ideal archival storage medium for a small clinic because each one of the cartridges holds 30GB which is a reasonable amount of storage and cost effective."

The Plasmon UDO drive features drag-and-drop capabilities for greater ease of use and expanded operating system support, including Microsoft Windows 2000 Server and Professional, Windows Server 2003, and Windows XP. Dupont said the 30GB capacity will expand to 120GB over the next four years.     

Because it features blue lasers for recording rather than the red lasers, the UDO drive achieves greater data densities resulting in higher media capacities. With true Write Once authenticity and a media life of more than 50 years, UDO meets the demands for the secure, long-term storage of information, the company said.

Plasmon will distribute its new standalone UDO drive through value-added resellers (VARs), system integrators and OEMs. Additional configurations for the drive include integration into Plasmon G-series libraries as well as internal drives for integration in third party.



Rorke Data showcased at RSNA its Galaxy 16i Serial-ATA (SATA) RAID that is now shipping with Hitachi's high-capacity 400GB SATA drives. In a 16-bay 3U chassis, users can achieve a capacity of 6.4TB. The 16i also is now available with single- or dual- controllers and with expansion JBODs for even larger capacity requirements.

Rorke highlighted its Galaxy NAS technology, a cost-effective, Windows-based system with capacities ranging from 432GB to 4.8TB. Utilizing 400GB SATA drive, the system is now available with single or dual 2.4GHz Xeon processors.

In addition to Plasmon's UDO technology and libraries, Rorke now offers StorageTek's StreamLine SL500 Modular Library system. StorageTek's library is scalable from 30 to 577 LTO cartridge slots with capacities more than 100TBs. Base units contain 30 to 50 LTO cartridge slots, drive expansion module provides 90 additional slots and cartridge expansion module allows for 130 additional slots.

Making it a bundled HIPPA-compliant system, Rorke offers software with its NAS/RAID and tape technology and XenData's Archive Server Software. The software manages RAID and tape on a Windows server to create an archive suitable for medical images. The software provides a continuous backup of files to tape and delivers data protection without any requirements for a backup window. In addition, the system can provide hierarchical storage management and optionally supports unalterable WORM tape cartridges. The solution is available from below 1TB to 1.5PB.



Software Engineering Corp. (Sencor) announced at RSNA the integration of its Sencor Medical Archive (SMA) DICOM storage software with Sony Electronic Inc.'s PetaSite tape library.

With scalability from 10TB (uncompressed) to 1.5 petabytes (PB)  (uncompressed), the PetaSite libraries are suited for medical facilities that wish to add secure protection for their current level of storage capabilities, as well as maintain the ability to expand into enterprise-wide image storage as they implement a digital imaging plan and their storage needs increase.

"The introduction of new imaging technologies has greatly increased the need for digital storage," said John Paumen, vice president of sales and marketing for Sencor. "One of the biggest concerns for imaging facilities is how to implement a reliable, cost-effective and scalable storage system."

SMA supports concurrent use of multiple media types from different manufacturers, including Sony's Professional Disc Blue Laser, TDK Medical's DMC (DICOM Media Creator) and IBM's eServer and TotalStorage hardware, all of which were on display at the show.



Sony Electronics showcased the latest in its portfolio of storage and archiving technology at this year's RSNA. The company previewed its plans for a high capacity Network Attached Storage (NAS) system capable of storing and backing up large amounts of data on either optical discs or tape media. The system consists of a main server, a cache server and a tape library. Utilizing data management middleware to prioritize the file access process, Sony said the product has the ability to store files that are commonly accessed in the main server, while less frequently accessed data are relegated to the cache server, or ultimately, to the tape library. The system can be configured with an application server to facilitate remote access to data, Sony said.

Sony showcased its Professional Disc for DATA (ProDATA) media. The recording technology uses blue lasers instead of standard red lasers to write more data on a disc. Retaining the conventional advantages of disc media such as high-speed random access and rewriteable and WORM options, ProDATA offers 23.3GB storage capacity and a data transfer speed of 11 Mbps read/9 Mbps write.



StorageTek brought to RSNA its range of PACS storage hardware as well as its application storage management software (ASM) that intelligently manages medical imaging archives.

Included in the mix was StorageTek's Flexline family of online storage systems with a particular emphasis on its Flexline 600 series. The 600 series capacity-centric storage systems provide disc-based data protection and online storage at a low cost. Based on Serial ATA technology, the enterprise-class disk systems provide disk-to-disk backup, fixed-content storage and distribution, remote data replication and general secondary disk storage.

StorageTek highlighted its StreamLine SL500 modular library system that scales from 30 cartridge slots to more than 500 slots with a capacity of more than 100TB of uncompressed data. The system accommodates up to 18 tape drives with an uncompressed data throughput of more than 2TB per hour. With the inclusion of StorageTek's ASM application - which was also one of StorageTek's key features at the show - users can manage the library from any location.

Jitendra Urankar, PACS/Healthcare solution manager, ILM solutions marketing, said the storage software is now becoming the key part of the equation. The company's ASM software utilizes policy-based management practices to manage data and retrieval across a hierarchy of storage systems in a multi-tiered strategy. It provides performance and capacity while concurrently managing growth and access requirements. It runs on Solaris, Windows and IBM S/390 operating systems. StorageTek currently offers v4.2 of its ASM software, but Urankar said it will release v4.3 in the first quarter of 2005.



TDK Medical used RSNA to highlight its DMC-2000 DICOM Media Creator, a medical DVD and CD recording system that incorporates an integrated PC. Connected to any DICOM network, the DMC-2000 network appliance enables on-demand recording of patient studies to DVD or CD, reducing film costs and streamlining workflow, the company said.

TDK exhibited its medical grade DVD recording media featuring ultra-protective Armor Plated coating technology. The coating technology provides protection against the loss of important medical data. It strongly guards against scratches, which can easily render traditional DVDs useless, TDK said. In addition, it provides dirt resistance, making it easier to wipe off fingerprints, contaminants and even accidental food and beverage spills without damaging the disc. The coating has superior anti-static qualities to reduce dust accumulation, which can damage expensive optical library systems.



Medical informatics company TeraMedica showcased its new enterprise imaging and information vehicle called Evercore.

Evercore connects multi-vendor PACS and radiology/cardiology to any vendor's storage imaging devices. It captures the data from any imaging device, stores the digital images and makes them available at the point of patient care across the healthcare enterprise. The J2EE architecture is Wintel/Unix applicable.

TeraMedica said the product bridges the gap between storing and distributing both images and data making comprehensive electronic medical records possible.