Weathering the Storm: Cloud Technology & Disaster Recovery

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 - Snowy Field

At 2:46 p.m., March 11, Shigeru Ehara, MD, heard his phone alarm unexpectedly go off. He was working in the radiology department at Iwate Medical University in Morioka, Japan, and discovered the alarm was part of an earthquake alarm service, indicating a strong quake had just occurred.

After the earthquake and tsunami, the hospital was left without electricity, and limited emergency power capacity had slowed normal imaging services. The PACS was disabled, interpretations were rendered orally and memos were left on requisition forms.

This disaster provides a stark reminder that all medical imaging providers need to have a comprehensive disaster recovery plan that accounts for data protection, as well as allowing operations to continue at the highest level allowed by the situation.

As far as protecting data, in recent years, more facilities have turned to virtualization and cloud data storage as part of that plan. A 2011 survey of 1,200 IT professionals conducted by CDW Healthcare showed that one-third of healthcare organizations are implementing or maintaining cloud-based systems. Thirty-seven percent said they are developing a written strategic plan for the adoption of cloud computing.

Virtualization of servers is on the rise as well, as 89 percent of hospitals with 50 beds or more surveyed by CDW had at least one form of virtualization in place.

Typically, the top reasons for healthcare enterprises to turn to the cloud, where patient images and other data are archived on outside servers, and other offsite data strategies, have been the potential benefits in cost reduction and the flexibility that comes with expanded access.

More IT staffs, however, are recognizing the benefits cloud technology can have in terms of protecting and recovering data in the event of a disaster. A survey conducted at the 2011 Healthcare Information Management and Systems Society (HIMSS) conference showed that more than half of respondents who are using or are considering plans to use a cloud vendor for medical images said one of their major concerns was disaster recovery.

James P. Borgstede, MD, chair of the American College of Radiology (ACR) Foundation's International Outreach Committee, who has recently been involved with the ACR's relief work in Haiti, following the devastating earthquake of 2010, says it is important for facilities to know the strengths and weaknesses of their local PACS or offsite data storage system. In the film era, in the event of a power outage, there were hard copies of images.

"In that sense, there was an advantage to the old way of doing things," says Borgstede. "However, the disadvantage is that there's no way to transport those data electronically. So, if your systems were up and running but you needed interpretive support, there was no way to get that. You had to bring people into the disaster area, where now you have the opportunity to send the films outside the disaster area."

From quakes to snowflakes

It doesn't take a devastating earthquake to disrupt normal workflow; sometimes it can be a more common occurrence like a heavy snowstorm. That's what Oklahoma City-based Eagle Imaging Partners had to deal with in February.

Eagle Imaging primarily serves the state of Oklahoma, but also some hospitals in Kansas and Texas. It is an onsite group, but it utilizes a teleradiology distribution model and sends images to a vendor-supported cloud. Images are then brought back to workstations where physicians can access them at all locations with the same platform and workflow.

Eric Slimmer, Eagle Imaging's CEO, says the rural practice serves a number of facilities that are a significant distance from the larger metro areas, which could have been a problem when the region was hit by a "crippling" blizzard.

Many highways and interstates were shut down, some for two days, but Eagle Imaging was able to continue to provide interpretations using the cloud-based system. Some physicians provided interpretations from their homes.

"Cloud technology enabled us to provide a continuum of care to the rural hospitals that we cover," says Slimmer, adding that a number of imaging centers were closed, but the hospitals remained open. "Our group was able to continue to provide care in the middle of this blizzard. In the past, we wouldn't have been able to do that and hospitals would have had to go on divert and cease radiology reading."

Tiptoeing into the cloud

Not every organization is ready to jump headfirst into the cloud. This