Kasier

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Think Outside the PACS Enterprise Grid Solution
for Medical Imaging
SURA Cyberinfrastructure Workshop Life Sciences
and the Grid
January 11, 2006
Richard S. Bakalar, M.D. Chief Medical
Officer IBM Healthcare Life Sciences
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Agenda

• Introduction
• Medical Imaging Enterprise Storage Requirements
• Grid Medical Archive Solution
• Customer Success Stories
• Q A

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Transformation of Medicine accelerated by a
combination of revolutionary technologies and
evolutionary practices
Personalized Health Care
Automated Systems
Lifetime Treatment
Pre-symptomatic Treatment
Cancer Diagnosis
Translational Medicine
Information Correlation
Revolutionary Technology
Molecular Medicine
Genetic Predisposition Testing
Clinical Genomics
Health Care Today
1st Generation Diagnosis
Digital Imaging
Episodic Treatment
Electronic Health Records
Artificial Expert Sys.
Non-specific (Treat Symptoms)
Organized (Error Reduction)
Personalized (Disease Prevention Targeted
Treatment)
Evolutionary Practices
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More Data Over the Last 3 Years Than Previous
40,000 years Combined
Digital Pathology
Digital Radiology
E-Health Initiatives/Linkages
Electronic Medical Record
40,000 BCEcave paintings bone tools
P e t a b y t e s
3500writing
Digital Cardiology
0 C.E.
paper 105
1450printing
1870 electricity, telephone
transistor 1947
computing 1950
Late 1960s Internet
1993 The Web
1999
Source UC Berkeley, School of Information
Management and Systems.
2003
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IntroductionWhy health administrators should
care about infrastructure

• Uniformity of care
• Reliability of services
• Business Continuance
• Disaster Recovery
• Affordability of IT investment

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Introduction Why providers should care about
infrastructure

• Speed - Configurable and Reliable Performance
• Smart Caching and Data Backups
• IT Support Central Global Storage Dashboard for
  Dynamic System Administration
• Collaboration - Flexible Scalability
• Up, Down and across medical specialties
• Respond to new data volumes changes in clinical
  practice (i.e. CT/MRI protocols)
• Diagnostics On Demand supporting Clinical Centers
  of Excellence
• High Availability and Data Integrity
• No scheduled downtimes
• Automated data migration for hardware upgrades

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Introduction
Grids enable three IT functions

• Computation (PC Server Grids)
• Intra and Inter - organizational cycle sharing
• Access to computing resources On Demand

• Collaboration (Data Grids)
• Data Virtualization, Federation Sharing
• Virtual Storage Pooling

• Orchestration (Intelligent Provisioning)
• Automated SLA management provisioning
• Improved Quality of Service IT

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Introduction Why Grid Storage System?
After Grid
Before Grid
Site 3
Site 3
Site 1
Site 2
Site 1
Site 2
...
...
App 1
App 2
App 3
App 4
App 10
App 1
App 2
App 3
App 4
App 10
Grid Storage Platform

• Virtualized Grid infrastructure
• Smaller, shared more cost effective storage
  environment
• Adaptive, self healing self managing
• High availability speed
• Enables infrastructure to be managed independent
  of the application

• Siloed Traditional architecture
• Difficult expensive to administer
• Low utilization of hardware storage
• Vulnerable to failure and downtime
• Bandwidth inefficient
• Block level replication

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IntroductionPACS and Imaging Architecture
PACS Application
Study Demographics and Metadata
Study Images
Application
Infrastructure
Transactional Data
Fixed Content Data
Data Store
Data Store
Fixed Content Data has unique specific
requirements
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IntroductionThree Tier Solution Architecture
APPLICATION LAYER
e.g. Stentor, McKesson, Agfa
Clinical Function Image Access
IMAGE MGMT LAYER
Aggregation Interoperability
Image Management Layer
e.g. Stentor, TeraMedica, Emageon, others
STORAGE LAYER
Data Protection, ILM Replication, Resiliency
Speed
Grid Storage Management System
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Medical Enterprise Storage Requirements

• High Performance
• Fast access to data
• Reliable Protected
• Continuous operation in the presence of faults
• Open and Interoperable
• Support heterogeneous PACS environment
• Massively Scalable
• Very large, rapidly growing data sets
• Long Retention Times
• Data outlives hardware and media
• Multi-Facility
• Secure and Scalable to other regions and
  disciplines
• Simple Administration
• Easy to manage operate
• Cost Effective
• Affordable today tomorrow

Address Requirements Today and Tomorrow
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Grid Medical Archive Solution (GMAS)
IBMs GMAS is a fixed content Grid storage
platform
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A Deeper Definition Grid Medical Archive
Solution (GMAS)

• Intelligently manages the interaction between a
  fixed content application and its storage
  resources
• Key Features
• Open Extensible
• Multi Facility
• Scalable
• Fast
• Reliable Resilient
• HIPAA Compliant
• Content, Resource and Location Aware
• Centralized Management
• Cost Effective

GMAS Multi facility, multi tier fixed content
storage
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Application Integration
PACS Application Independence
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Fast Performance

• Performance Scalability
• Seamless scalability through Grid Architecture
• Scales by adding new CPU and faster storage
  resources
• Real-time stream based transport
• Not store and forward? Low latency access
• Addresses both LAN and WAN environments
• Compression further boosts WAN performance
• Load Balancing to increase performance
• CPU resources
• Storage resources
• Network bandwidth
• Intelligent Caching
• Retains copies of recently stored/accessed data
  at right location

Improved Reliability and Access at Point of Care
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HIPAA Compliance

• Audit
• Real-time historical audit records
• Object insertion
• Object access
• Object deletion
• Data Integrity
• Consistency check report
• Audited object insertion
• Confidentiality
• Encryption

Ensuring integrity, confidentiality
traceability of patient data
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Centralized Management

• Web-based administration
• Proactive monitoring
• Fault detection alerts
• Real time and historical reports
• Multi-tier and multi-site mgmt
• Across all storage tiers
• Enterprise wide

Single operational dashboard for medical image
storage across the enterprise
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Information Lifecycle Management Rules
Local Sites
Central Data Center
DR Site ?
Configurable to meet your requirements
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Decreased Total Cost of Ownership

• Consolidated Storage Infrastructure
• Eliminates storage silos
• Increases utilization
• Optimized Price Performance
• Aligns cost of storage with relevance of data
• Flexible and dynamic
• Automated and self managing
• Simplified Administration
• Easy to operate
• Centrally managed
• Fault tolerant and self healing
• Reduced FTEs

Costs less to deploy, manage, and operate
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Summary Gap Analysis
Medical Requirements
Grid System Features
High Performance

• De-centralized Grid Architecture

Reliable and Protected

• Automated and Self Healing

Open and Interoperable

• Heterogeneous storage and applications

• Massively Scalable

• Grow as you go

Multi Facility

• Bandwidth efficient and WAN optimized

Simple to Administer

• Centrally managed

Cost Effective

• Eliminate Silos

Long Retention Times

• Seamless hardware refresh

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Compelling Benefits What this means to you

• Performance
• Timely access to mission critical patient data
• Improved uptime and reliability
• Real time business continuity
• Decreased Total Cost of Ownership
• Higher storage utilization simplified
  management and administration
• Extensible and Scalable
• Across all medical disciplines, applications and
  locations
• Empower Healthcare Networks
• Storage Hardware and PACS application agnostic

Affordable PACS Storage Infrastructure
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Success Stories
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Customer Success StoriesNew York Health
Hospitals Corp

• Challenge
• Improve access performance and uptime
• Increase resiliency and scalability
• Sharing of images across three NYC hospitals
• Integrate with existing Philips PACS

• Solution
• Link three major NYC hospitals plus Data Center
• The project included
• IBM Grid Medical Archive Solution
• eServer xSeries and TotalStorage
• Philips EasyAccess PACS

60TB configuration deployed in 4 sites in 30 days
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Customer Success StoriesProvincial Health
Services Authority

• Challenge
• Delivering Cancer and Pediatric care for Province
  of British Columbia (Population 4.1M)
• Seamless access to images across Province
• Integrate with existing multi-vendor PACS
• Geographically dispersed facilities

• Solution Business Benefits
• Timely access to patient data
• Reduction of avoidable medical procedures
• Increased resiliency and uptime
• Images accessible via EHR
• Enhanced clinical collaboration

• Solution
• Provincial grid in production since 2002
• Links 40 hospitals with 1,500 users
• 60TB at 5 Data Centers, distributed DR
• Less than 1 FTE to operate and maintain
• Stentor, Agfa, GE, McKesson, Siemens,

In full production for over three years with no
downtime
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Summary

• Healthcare has unique and challenging storage
  requirements
• Traditional approaches are not scalable and
  reliable

Grid Storage is proven technology with proven
results
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Thank You !Questions and Answers