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A medical facility that prides itself on staying on top of technology and providing superior service to the community, Memorial Hospital and Health System (MHHS) was ready to move on to a next-generation Picture Archiving and Communication System (PACS). At the same time, the organization knew that hand-in-hand with a new PACS implementation was the need for a faster, more secure and cost-effective storage infrastructure to handle short- and long-term storage of patients' medical images.
Today, the 526-bed nonprofit regional referral center based in South Bend, Ind., has implemented the Horizon Medical Imaging PACS from McKesson Corp. and a three-tier storage solution from IBM Corp.
The new McKesson technology coupled with the IBM storage replaces a first-generation PACS from Kodak and an accompanying storage solution from EMC.
Since the integrated system went live in November 2006, MHHS has already realized reduced maintenance costs and faster access to images, according to Steve Huffman, director of IT at MHHS.
As patient volumes at MHHS increased and the amount of data produced by imaging technology such as X-rays, CT scans and MRIs also grew, the medical facility saw the writing on the wall and knew it was time to move to a new PACS and, at the same time, replace its existing EMC storage.
"The EMC needed to be replaced because of limited size and scalability for our imaging needs," Huffman said. Newer imaging technology, he said, has exponentially increased the amount of data storage required. "In the past, a CT scanner only took a few slices, but today we get 64 slices, which results in much more digital data," he said.
Once MHHS selected its PACS vendor, it was time to select a storage partner. "McKesson wanted a storage infrastructure that we were interested in supplying. They were very flexible working with us," Huffman said.
The IT organization looked at storage products from both EMC and IBM to meet its criteria, which included scalability, robust disaster recovery and reliability. "We needed a storage solution that was nimble enough to accommodate a new modality if we added one without having to do a major forklift [upgrade]," Huffman said.
The hospital invited both vendors in to demonstrate their storage solutions and followed up with numerous discussions. At the end of the day, IBM made the better case, he said. According to the director of IT, IBM offered better support, better disaster recovery for business continuity, and better scalability.
The three-tier IBM storage solution consists of the IBM System Storage DS4800 with a 12.4-terabyte capacity for the first tier, for mission critical data. An IBM System Storage N5200 for the second tier provides scalability to keep pace with growth as well as availability and productivity, and the IBM System Storage 3584 Tape Library for the third tier addresses off-site storage and disaster recovery.
According to Huffman, images are fed to the IBM DS4800 and are written to the N5200, where they sit in archive and are accessible for quick access for up to a year. "So, for example, a patient gets an initial X-ray and three weeks later radiology wants to access the image. They get it off of the spinning disk on the N5200," Huffman said. In essence, the system writes to both places.
Up and Running
Both the IBM DS4500 and the N5200 are storage platforms for the McKesson PACS. McKesson, IBM and Memorial Hospital worked together to get the technology up and running. MHHS' IT department consists of 80 employees.
In addition to the integration of the PACS and IBM storage systems, the devices needed to integrate with other hospital systems as well. The software interfaces with other systems that allow images to follow patients while in the hospital, Huffman said. The integration work was done in-house by the hospital's IT team.
The PACS implementation began in September 2006 and the system went live in November. "We had to get the software up to speed and we had to get the different imaging modalities to write both to the old and new PACS," says Huffman.
The hospital needed to move a critical mass of images that resided on the Kodak system to the new system so medical personnel had access to the images they needed. The hospital is still converting images from its older Kodak PACS and expects the work to continue for another five months or so.
The hospital's IT staff is familiar with IBM storage since it uses other IBM products in various hospital departments. IT uses IBM Tivoli Storage Manager for backup and archive. It also runs an IBM Enterprise Storage Server and four IBM System p5 570 servers.