Sponsored by an educational grant from Siemens Medical Solutions and EMC Corporation
PACS is often a multi-faceted investment that requires healthcare enterprises to consider complementary solutions and develop comprehensive plans to maximize the initial investment. One of the key related solutions in the PACS decision-making process is information storage and management. Children’s Hospital of Alabama in Birmingham deployed Siemens PACS and syngo Workflow RIS four years ago, the issue of tiered storage was a key factor to consider. “PACS put us in the position where we needed to consider our entire image and information storage strategy,” recalls Senior Vice President and CIO Mike McDevitt.
The hospital embraced a proactive, long-range approach, solidifying a partnership with EMC Corporation and building on previous storage architecture. The approach paid off. Today, Children’s Hospital boasts a comprehensive information infrastructure that is meeting current needs and well-positioned for future initiatives.
The initial Children’s Hospital PACS deployment paired Siemens’ Magic Store archive with a tape library. “After a few months, we realized that the tape archive was very cumbersome and very time-consuming to maintain and support,” recalls PACS Administrator Lynn Odom. In some cases, it took six to seven minutes to retrieve prior images, causing an unacceptable level of inefficiency. The answer hinged on storing more intelligently, a smarter approach to storage that is effective, cost-efficient and easy to use.
So Children’s Hospital turned to its PACS vendor. Siemens, in turn, introduced the hospital to EMC, a developer and provider of information infrastructure technology and solutions. EMC met with the hospital and analyzed its information infrastructure and needs. EMC reviewed the hospital’s imaging modalities and considered its road map, which included digital radiography, CR and 64-slice CT. The hospital IT team, meanwhile, realized its image acquisition would continue to grow. “We knew our growth would continue not just at a straight line level, but at an exponential curve. And we wanted a scalable integrated solution,” McDevitt says.
The hospital had implemented an EMC CLARiiON storage area network (SAN) in conjunction with an earlier clinical information system deployment. After reviewing EMC’s solution set and considering its current and future needs, Children’s Hospital decided to leverage its SAN and deploy an additional EMC CLARiiON system and two EMC Centera active archiving systems to handle both short- and long-term storage needs. The decision was ideal on multiple levels, says McDevitt. “We could co-mingle solutions to integrate prior and future data, migrating from one system to the other as needed. In addition, the model provides an archive for the clinical information system.”
“The system is integrated, scalable, flexible and easily managed, which translates into savings,” McDevitt says. The previous approach consisted of isolated data servers that were difficult and expensive to manage. The EMC model of multiple tiers of storage systems, on the other hand, can be scaled in increments that allow the hospital to take advantage of adding capacity as needed. Thus, as the hospital adds 1.5 to 2 terabytes of data to its archive annually, it can make cost-effective purchases. Finally, the existing IT teams easily manage the entire EMC platform, which entails a comprehensive storage solution that provides a more robust architecture.
Image management & storage
The potential to improve efficiency and patient care drove the Children’s Hospital PACS deployment. The collaboration between Siemens and EMC magnified the benefits of integrated RIS/PACS. “The relationship between EMC and Siemens is critical to the long-term success of our PACS deployment. It provides the ability to take the archived information and make it available to the radiologists and the healthcare community,” says Chief of Radiology Stuart Royal, MD.
EMC Centera facilitates the rapid retrieval of images and patient information essential to an efficient enterprise. “If the information in the archive is not immediately available when the patient hits the emergency department and needs critical decision-making, then it does not meet the needs of the healthcare system,” Royal says. The EMC active archive solution facilitates rapid image retrieval and also provides the capacity to retrieve, display and manipulate images in three dimensions via the Web-based Viewer thin-client solution. EMC Centera also virtually eliminates down time; maintenance is a planned event. “With Centera, we know when we arrive in the morning systems are going to work, and we’re going to be able to take care of patients in an efficient fashion,” sums Royal.
Efficiency isn’t the only challenge in the pediatric imaging arena. Longevity is an important issue. “The storage life of children’s images is much longer than adults,” explains McDevitt. The State of Alabama requires healthcare providers hold onto images until seven years after the child reaches the age of majority, but Children’s Hospital often retains images much longer because many of its patients suffer from chronic illness such as cystic fibrosis or cardiovascular problems, in which prior images are essential to ongoing treatment decisions. This increases the storage load and also necessitates rapid retrieval of old priors; EMC Centera delivers the scalability and speed necessary to meet pediatric imaging requirements.
A future-oriented information infrastructure
When Children’s Hospital upgraded its storage architecture, it wanted to ensure that the information infrastructure technology and solutions could meet its current and future needs. The PACS is growing by leaps and bounds, says Pam Atkins, divisional director of IT, particularly since the hospital radiology group opened an outpatient imaging facility. Advanced imaging systems such as 64-slice CT also fuel storage demands, and the hospital may add reference images to its archive, which would bring its annual data burden to 2 terabytes. In addition, the hospital may invest in a document imaging system, which would increase storage demand.
Finally, Children’s Hospital plans to implement a more robust disaster recovery and business continuity plan to protect clinical and business information. Children’s Hospital plans to populate a hot site with EMC systems. The hot site will mirror the onsite platform and run in parallel to provide the necessary redundancy. If the main data center fails, the hot site will pick up instantly.
The final plus of the collaboration among Children’s Hospital, Siemens and EMC is commitment. “EMC is timely, responsive and committed to the information storage and management business. We feel strongly that our EMC storage platform will continue to support us well into the future. It can support multiple information system platforms and clinical and document images,” McDevitt says.