The traditional approach to disaster recovery, where system architecture is configured to store a copy of imaging data on tape in an iron mountain, may have reached the tipping point - requiring considerable design modifications, propelled by exponential increases in data that must be maintained indefinitely. When an IT professional considers the quantity of information - including not only imaging data, but corporate email, electronic health records, and business continuity information for the entire healthcare enterprise - the magnitude of the challenge attains monumental significance.
Barry Runyon, research director for healthcare in the Gartner Group of Stamford, Conn., explains that with approximately 50 percent of all data now online, the sheer quantitative crush of that data necessitates careful consideration of a disaster recovery strategy. With industry estimates indicating that about 20 percent of health institutions have deployed picture archive and communications systems (PACS) to date, these issues will intensify over the next five years as PACS become an expected portion of the clinical suite and assume "standard of care" status.
Several evolving trends will force the issue of information lifecycle management activities where disaster recovery is only one component, and Runyon offers suggestions about how to meet the challenges looming just around the corner. The first step involves careful planning and assessment to prioritize the specifics of which data are critical to the enterprise, to determine what data must be recovered in what period of time, precisely what needs to be retained, on what media, and for how many years.
Because clinical data, including medical images and other components of the electronic medical records such as laboratory and pharmacy data, and corporate email communication between clinicians and patients are required from a legal perspective to be maintained for many years, the first trend involves integration of all data into a single stream. In other words, Runyon suggests that a PACS should not be isolated within its own disaster recovery plan.
Another concern arises in the eventuality of a disaster occurrence, the institution would not be able to wait several days for data to be restored - unless the entire healthcare facility were destroyed and could no longer function in any manner. Even then, many of the records maintained by the institution would be required by other area healthcare entities to properly manage patients with chronic and long-term health issues.
"Many large hospitals have established alternate data sites, to back up one another," says Runyon. For example, the cancer center across town will back up the primary IT data center and visa versa. This trend is designed to address a series of issues that include back up and recovery activities as well as off-site storage and archiving with a single architecture. "If it is a big enough enterprise, with a large IT budget and a high level of expertise, they will be doing their own disk-to-disk to tape architecture, which could be disk to near line storage or disk-to-a-remote mirroring storage area network [SAN]."
Gartner storage analysts expect that the use of tape archive copies will remain prevalent, despite the inherent costs and inefficiencies in retrieval of specific studies, and the problems with degradation of tape over the long-term, until the costs of other media storage options decline.
In the field
Scott Stewart, manager of information services at Rochelle Community Hospital in Rochelle, Ill., has designed a system for their small community, critical access hospital by employing Kodak Carestream Information Management Solution from the Kodak Health Group.
With one SAN in the hospital building and another at a clinic about 11/2 miles away, and fiber connectivity between the two locations, the system has designed to provide continual backup.
"We are keeping the two SANs in sync with one another," says Stewart. As the data are written, they are copied to the local PACS server, and then written to the SAN in one location and sent almost instantly to the other SAN located in an old bank building (where the server sets next to a circa 1920 bank vault). The two SANs are synchronized within about 10 seconds. "Within a minute of running the imaging study, it's stored in three locations, and then sometime during the day it's written to tape as the final backup."
This small IT staff of 2.8 FTEs wanted to insure ease