The Business Continuity Plan: Creating a Secure Imaging Infrastructure

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As imaging departments become increasingly digital, many are using different components of data storage, protection, migration and archiving to fit different pieces of the business continuity puzzle together to provide a seamless and continual flow of images and data across the enterprise while providing secure backups without impacting patient care. Having a plan is the first step.


Duplicate storage for peace of mind



An offsite location for duplicate storage takes away a lot of the headaches associated with disaster recovery, says Laurelynn Brey, radiology director and PACS administrator at Reedsburg Area Medical Center in Reedsburg, Wis. “It is like having an insurance policy.”

In November 2006, the 25-bed critical access medical center went live with Agfa Healthcare’s IMPAX PACS, and at the same time, decided to duplicate data on tape and send them to a storage center three blocks away to satisfy disaster recovery and HIPAA requirements.

“Three blocks just didn’t seem like enough,” says Brey, who felt backup tapes were not a sufficient level of protection for the hospital’s valuable data. After consulting with Agfa, Reedsburg chose InSite One’s InDex Recovery. In the event of a disaster, data can be accessed and viewed via the internet by any authorized hospital personnel.

Now, images are sent to an offsite facility in Phoenix for duplicate storage, providing Brey with the geographical distance she preferred for safeguarding data. “Things can happen that you certainly don’t anticipate—just three blocks away could have ruined everything,” she says.

Since InSite One is a preferred vendor through the Amerinet buying group, the hospital gained additional cost-savings on top of InSite’s fee-per-study pricing.

If the hospital ever has to use the system, Brey notes her confidence in how InSiteOne will recover imaging data. “Luckily, we really haven’t had to use it,” she concludes. “We just check to make sure it works.”


Data, server consolidation for faster recovery


Atlantic Health, a two hospital, 1,133-bed health system in Morristown, N.J., had reached the end of its HP storage lifecycle and began evaluating its entire information lifecycle management strategy to move critical data closer to its customers. With storage volume increasing, the backup window started to take a while to complete.

Consolidating critical data in a way that optimizes protection in large organizations typically means consolidating to a storage area network (SAN), however, “SAN is expensive,” according to Pat Zinno, director of infrastructure services and support.

“We wanted to be able to tier and scale vertically and horizontally across our data,” Zinno says. The health system has two EMC Centera systems and two EMC Symmetrix DMX3 SANs at the health center’s recovery data center. Atlantic already had an EMC Centera in house and when it contemplated integration, a one-vendor solution made sense for moving data from one platform to another.

He says that they took all of their applications and classified them into three different categories: mission critical, business critical and business important. “The category designation denotes how it gets connected to the SAN,” he notes.

Zinno concludes that by shifting approximately 70 percent of the health system’s data to the SAN, Atlantic Health has enhanced backup and disaster recovery capabilities by enabling disk-to-disk backups and real-time data replication and mirroring between our primary and backup data centers.


Seamless, continual data transmission


Like many regional medical centers using locum tenens coverage for diagnostic reads, the 220-bed Charlotte Regional Medical Center in Punta Gorda, Fla., found uninterrupted workflow and quick report turn-around times to challenging.

Additionally, proprietary communications blockages between different PACS and RIS applications at other HMA hospitals resulted in the inability to transmit images and patient information between sites for consults or workload balancing.

The medical center contracted with teleradiology provider E-Rad Solutions to tackle night-time reads, gaining the benefits of the MEDxConnect system from Compressus. According to Gail Hopkins, director of medical imaging at Charlotte Regional, they quickly realized the value of the Compressus system when the RIS they installed in March went down for more than 15 hours.

By kicking off orders to Compressus, radiologists offsite were able to dictate with voice recognition into a separate system. Once the RIS was operational again, all it took was copying and pasting cases from the Compressus server back into the RIS.

“Having a downtime plan is a wonderful thing,” she concludes. “But I did not have a RIS. The only way we maintained operations was because we were able to push images to the Compressus system.”


Avoiding downtime


Disaster recovery might be the nuts and bolts of business continuity within healthcare, however, it is really more about the effect disasters—both natural and human-induced—have on business operations.

“It is not just how you connect a server to your infrastructure, but what that means to your business,” says Chris Tomlinson, director of radiology at the Children’s Hospital of Philadelphia (CHOP).

For radiology, the hospital started calculating the cost of one hour of downtime and what was affected across the entire organization to make better decisions regarding the architecture of its systems and all permutations of different downtime scenarios.

CHOP has had fully redundant, geographically dispersed solutions both from the PACS itself and continuing through the tiered storage solution (ILM Strategy) from IBM called the MAS (Medical Archive Solution). More importantly, there is a fully integrated disaster recovery/continuity plan that exists for all the radiology systems.

Three months ago, CHOP contracted with Acuo Technologies to deploy its AcuoMed solution, which enables vendor-neutral archiving, transporting, tracking and retrieving digital images across an entire network, communicating with different DICOM storage devices throughout CHOP’s imaging environment, not just in radiology. Acuo’s system will act as middleware to the IBM Medical Archive Solution already deployed across the hospital’s imaging departments. CHOP also will upgrade its IBM MAS to the IBM GMAS or grid based MAS as part of the Acuo project for storage virtualization.

“We have designed the AcuoMed software to be fully redundant and geographically dispersed,” he adds. Additionally, the vendor-neutral solution will eliminate any future data migration costs for CHOP.

With IBM and Acuo, the hospital will have two data centers, running in tandem.

Many healthcare organizations have shifted data priorities, transitioning from thinking in terms of disaster recovery to the concept of business continuity as an essential part of day-to-day operations.