Health IT Summit DC 2015 - Cloud Storage and Medical Image Management: Responding to the filesize increases of advanced imaging technologies
Todd Thomas
CIO
Austin Radiological Association
iHT2 case studies and presentations illustrate challenges, successes, and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Similar to Health IT Summit DC 2015 - Cloud Storage and Medical Image Management: Responding to the filesize increases of advanced imaging technologies
Similar to Health IT Summit DC 2015 - Cloud Storage and Medical Image Management: Responding to the filesize increases of advanced imaging technologies (20)
Health IT Summit DC 2015 - Cloud Storage and Medical Image Management: Responding to the filesize increases of advanced imaging technologies
1. Cloud Storage and Medical
Image Management
RESPONDING TO THE INCREASING FILESIZES OF ADVANCED
IMAGING TECHNOLOGIES
2. Speaker Bio
20+ years healthcare IT
Software development, network design, management, storage network design
Computerworld Honors Laureate for Visionary Use of Information Technology
in Medicine - 2002
Network World Enterprise All-Star Award for use of free space optics - 2005
Computerworld Best Practices in Storage - Finalist, Data Lifecycle Management
– 2006
ITIL Foundation Certified
3. ARA Diagnostic Imaging
17 outpatient imaging centers
20+ area hospitals
90+ radiologists
1.3 million exams read or performed annually
900,000 exams digitally stored annually
4. ARA – Department of Information Technology
Chief Information
Officer
Director, Service
Delivery
Manager, Service
Delivery
Service Delivery Group
Server/Network
Administration
Director, Imaging
Informatics
Application Managers
Software Engineering
Manager
Development Group
Security Administrator
ICT Group
Administrative
Assistant
5. ARA Image Management Through The Years
2001
ARA – Department of Information Technology
• 6 TB usable
• Growth rate was 3 TB annually
6. ARA Image Management Through The Years
2003
ARA – Department of Information Technology
• 24 TB usable
• Secondary datacenter for replication
7. ARA Image Management Through The Years
2004 – content addressable storage
ARA – Department of Information Technology
• 2006: 58 TB of usable space
8. ARA Image Management Through The Years
2010– clustered storage
ARA – Department of Information Technology
• 2011: 235 TB of usable space
9. ARA – Department of Information Technology
Image Management Today
10. As Image Quality Goes Up, So Do Filesizes
16 slice CT: 18MB
64 slice CT: 23MB
1.5T MRI: 29MB
3T MRI: 71MB
US: cine loops, color flow
11. Digital Mammography By The Numbers
Average file size for a standard mammography image: 19MB
Average file size for a 3D tomography image: 392MB
Average ingest rate: 25G/day
16. Software-defined Storage
Your hardware, their software
Multi-protocol support
SAN + NAS = Unified
Act as basis for scale-out storage architectures
Atlantis, SwiftStack, Elastifile, Datacore
17. Cloud Storage
Attractive
Let someone else worry about capacity planning
True pay-as-you-grow
Considerations
Data protection
Privacy laws
Compliance with Health Insurance Portability and Accountability Act of 1996
Pricing models
Performance
“The future for PACS is in the cloud,” - Steven Tolle, chief product officer for Merge
Healthcare, at the 2013 annual meeting of the Radiological Society of North
America (RSNA).
18. Nasuni – Storage-as-a-Service
Onsite cache married with cloud storage
Your hardware appliance or theirs.
Encryption in flight, encryption on disk
Business-associate under HIPAA
Simplified pricing: one vendor, one price, one check.
19. Performance Testing
Old-school: stopwatch
Time to first image <= 3 seconds
3 trials for each study, per modality, using different settings
Over 3,000 time trials
Compared to baseline established by incumbent
20. Performance Findings - On premise
Time to first image from the cache – on average – performed 21% faster.
For a complete study coming from the cache – on average – 7% faster than the
incumbent.
21. Performance Findings – Cloud Retrieval
80MB Internet link
No bandwidth restrictions
Time to first image from the cloud – on average – was 49% slower than the
3-second baseline
A complete study from the cloud downloaded 8.5% slower than local
storage
22. Nasuni Today
Upon implementation, all new mammography studies were written directly to
Nasuni.
Have migrated 98% of all historical mammography studies (2d,3d) to the cloud
Performance has not been a concern due to the radiologists’ workflow for
mammography images
23. We’re Not Done Yet
Deployment of a VNA bring some compelling image lifecycle tools to the
environment
Multi-protocol support and storage-agnostic
Reduces the need for high-speed links to cloud
24. DATACENTER 2
Imaging Storage Architecture v4.1
1
2
1. Images ingested into VNA
2. VNA writes two concurrent copies
3. Nasuni writes images to out to the
cloud
3
25. Cost Considerations
1. Primary array acquisition and maintenance
2. StAAS appliance
3. Cloud costs
4. Telecom
5. Port speed connection charge for a direct connection
6. VNA acquisition and maintenance
26. In Summary
Filesizes are continuing to increase as modalities provide higher resolutions.
Storage-as-a-service is a viable model for long-term study retention.
Hybrid deployments even more so
Choose your cloud partner carefully.
Ensure compliance with HIPAA/HITECH/Omnibus from your partner vendor
27. THANK YOU
R Todd Thomas
Chief Information Officer
Austin Radiological Association
Email: thomast@ausrad.com
LinkedIn: www.LinkedIn.com/in/rtoddthomas
www.ausrad.com