Leading-Edge Technology: ASP and the Community Hospital

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Rush-Copley Medical Center in Aurora, Ill., epitomizes the busy community hospital committed to leading edge technology. Six years ago, the 183-bed hospital decided to deploy PACS. In addition to PACS, the hospital was in a massive acquisition phase, deploying or planning to deploy several other technologies including voice recognition, clinical documentation, advanced radiology and cardiology imaging, wireless applications and computerized physician order entry.

The hospital’s position as a technology leader made for a tight budget. PACS represented a major capital outlay, so the Rush-Copley leadership decided to think creatively and eventually decided to go with GE Healthcare’s Centricity PACS ASP model.

Under the ASP model, GE Healthcare assumes the burden of long-term image storage; the vendor also assumes responsibility for disaster recovery and redundancy and data migration. The Rush-Copley decision was driven by financial considerations, explains CIO Dennis DeMasie. “PACS is a significant capital expense, and a lot of our money was going into bricks and mortar. We needed a different funding model; ASP allows the hospital to pay for the capabilities on a monthly basis without owning the hardware or the product itself. We basically expense the system as we use it.”

In the six years since embracing ASP, Rush-Copley has discovered that financial necessity is a winning combination, with ASP delivering numerous benefits. In addition to eliminating the initial hefty outlay, ASP:

  • Removes long-term archive management duties from the local site;
  • Incorporates technology upgrades and data migration into PACS funding; and
  • Provides a robust disaster recovery strategy.

The ASP model under the microscope

The ASP model differs from the traditional buy-and-own image archive plan, but it is a model that works and enables efficient, cost-effective imaging operations.

When a technologist acquires an image at Rush-Copley, the image is stored in an onsite, short-term archive. Images are available for immediate review by radiologists. The radiology department utilizes a 4 terabyte (TB) RAID for short-term local storage. “The RAID holds two to three years worth of images,” says Tom Markuszewski, director of imaging. The other, equally important piece of the puzzle, is long-term storage.

The long-term image storage strategy means that PACS sends the image sets to two separate, offsite data centers in Chicago and California, which serve as the long-term archive and disaster recovery solution. The benefits of this model are significant, particularly when it comes to long-term storage.

Hospitals and imaging centers are required to retain radiology studies for a minimum of seven years. What’s more, file size continues to grow exponentially as sites deploy new systems such as 64-slice CT and digital mammography, both of which can produce very large data files. The upshot? Long-term digital image storage is a challenge on multiple fronts — including finances, planning, staffing and management. The ASP model shifts this burden to the vendor. “Our long-term storage is infinite, yet we pay only for the storage we use. We know that we will never run out of storage. The challenges associated with long-term storage remain invisible to us,” explains Markuszewski.

That flexible long-term archive associated with ASP has come in handy at Rush-Copley Medical Center, which has seen its image volume increase from 40,000 to 120,000 studies annually since deploying PACS in 2001. 

The disaster recovery bonus

Disaster recovery and PACS implementation travel hand in hand. Healthcare facilities are required to implement a redundant archive; a single long-term, on-site archive does not suffice. The challenge is immediate with a PACS deployment, says Markuszewski. “Hospitals don’t have the luxury of implementing a PACS one day and identifying a disaster recovery solution at a later date. The disaster recovery solution must be identified from day one.”

Developing an internal disaster recovery strategy represents a tremendous undertaking as the hospital must purchase, site and manage the storage solution and ensure that images can be recalled readily in the event of a disaster. “It is very difficult for hospitals to provide a level of service that matches that of a vendor,” explains DeMasie, “GE can put together economics and scale to handle disaster recovery for our system and several others. Our partners at GE handle disaster recovery much more effectively and