Inside the Data Center
Image access and distribution can be particularly challenging for large, multi-site, multi-facility healthcare enterprises. Often, such sites must manage multiple, disparate PACS and other sources of imaging data. Consequently, image access for clinicians across the enterprise is less than streamlined. In addition, standard health IT challenges such as bandwidth limitations, myriad PC platforms, operating systems, version control and even locked down PCs exacerbate the situation. For many multi-site enterprises, the solution is clinical consolidation as well as integrated storage and management of clinical data from various departments and improved image access via an enterprise visualization strategy which can lead to better patient care.
In some ways, Ochsner Health System in New Orleans, La., represents the typical large enterprise. Ochsner Health System includes seven acute-care hospitals and 35 clinic sites. Its 650 physicians provide care for hundreds of thousands of patients annually. In addition, 2,000 community physicians share the hospital environment.
In other ways, the health system is unique. Repeatedly recognized as one of the most wired hospitals in the U.S., Ochsner Health System embraces an aggressive clinical consolidation and image and data management strategy. The goal, says Lynn Witherspoon, MD, system vice president and CIO, is to integrate all clinical and document images generated by enterprise imaging systems in the EMR for streamlined access. The ambitious plan includes images across the “ologies”—including DICOM and non-DICOM datasets generated in cardiology, dermatology, endoscopy, gastroenterology and pathology. It also includes EMR image sets such as imaged documents and digital photographs. In addition, Ochsner Health System’s vision includes a robust disaster recovery plan that provides near-immediate recovery of image data if the primary archive fails.
Early last year, Ochsner Health System deployed Agfa HealthCare’s IMPAX Data Center and IMPAX Mobility* as the cornerstone of their enterprise visualization strategy. This image and data management plan is integrated with EMC’s Information Infrastructure including EMC CLARiiON, Centera, and RecoverPoint for its virtualized environment. EMC RecoverPoint protects valuable data in heterogeneous VMware environments—with efficient and effective recovery to any point in time. The solution consolidates data from disparate multi-vendor PACS and a host of clinical imaging systems to provide a single point of access for radiologists, cardiologists, and of course, referring physicians. Early results are impressive with all clinical stakeholders gaining efficiencies and improving clinical decision-making because of more efficient access to multi-vendor, multi-department and multi-site images and reports.
As recently as last year, Ochsner Health System physicians worked in a fragmented environment with images and data housed in multiple disparate systems. The problem partially stems from rapid growth over the last few years.
In 2004, Ochsner Health System included a single hospital and clinic. All radiology images were stored in Agfa HealthCare IMPAX PACS, while the cardiology department used two separate cardiology image management systems from different vendors. The initial PACS deployments solved many first-generation digital image management challenges by providing radiologists and cardiologists with access to digital data.
More complex, second-generation challenges, however, arose when Ochsner Health System purchased three area hospitals in October 2006. The legacy 650-physician strong, closed staff Ochsner Clinic blossomed into a multi-hospital open staff system supporting 2,000 community physicians. Ochsner Health System scaled its core clinical IT systems—HIS, pharmacy, LIS, RIS and PACS—into the community hospitals. The enterprise also web-enabled the EMR and made all clinical information systems available to the new community physicians. None of the new hospitals had deployed PACS at the time of purchase, but each installed a separate digital image management system driven by its own RIS by 2007.
Despite the PACS deployments at the new sites, image management grew increasingly complex. In the new, larger enterprise, Ochsner Health System radiologists interpreted community hospital images, which required investing in community hospital PACS workstations in the main campus radiology department. Ochsner