With the growing volume and size of imaging studies, disaster recovery is a big job for most organizations to manage. Careful, thorough planning and good vendor relationships can go a long way in helping everyone involved sleep better at night.

Cindy Moeller, vice president of information services for Good Samaritan Hospital in Los Angeles, has worked with InSiteOne for about three years. First, the facility used the vendor for its radiology image storage and recently expanded the relationship to its cardiovascular department.

“We see a real value in having our images stored offsite,” she says. Being in the middle of downtown L.A. means that an earthquake is a real risk. “An earthquake would have a serious effect. We need the ability to recover data or create copies as necessary.”

The hospital implemented a new cardiology PACS from McKesson last summer, partly because the old PACS was not on the major hospital network and did not have a contingency backup plan. Since the change, cath lab volumes go to McKesson and InSiteOne. This month, the hospital is bringing up all of its echocardiograms and beginning to transmit them for offsite storage as well. About 6 terabytes of cath images and about 1 terabyte of EKGs will be moved from current systems. “We’re in the process of continually making that step towards an offsite storage environment,” says Moeller.


Redundancy and capacity

When Good Samaritan created its outpatient imaging center, the administration realized that “once you start putting everything into digital media, you need to make sure you have the redundancy that’s necessary.” Plus, having offsite storage means needing less onsite storage. As modalities are transitioned to new, digital systems, this storage strategy helps meet the demand for more storage of images from, for example, the two new 64-slice CT scanners recently installed.

Both radiologists and cardiologists participated in the presentation to administration for the capital investment and ongoing expenses. “They were able to explain very clearly why this would affect them and the benefits for patient care,” Moeller says. And she reports that everyone is pleased with the ease of set up and response time.


Focus on replication

In 2006, Norton Healthcare in Louisville, Ky., replaced its two main storage arrays with a Symmetrix DMX-3 storage array system from EMC Corporation, according to Sean O’Mahoney, manager of client/server information systems. Norton also has from EMC two Clariion CX700s (SAN), two Clariion CX300s (SAN) that are directly attached to servers at some of their hospitals and four Centera systems that provide content addresseable storage (CAS).

All HIS data are replicated at the facility’s remote site. The Centeras archive radiology and cardiology PACS data, which is a switch from an optical platform. “We’ve got our archive and we’re able to use Centera’s native replication to send offsite,” says O’Mahoney.

Norton uses an Agfa Impax Cardiovascular information system for its cardiac images. Cath and echo studies are archived. “It’s crucial for doctors to have access to good historical data and be able to pull priors in a reasonable manner,” says O’Mahoney. “It just so happens that we were able to move forward with Centera as our archive platform.”

About six to 12 months of studies are stored online, then pushed back as necessary. As part of its larger disaster recovery strategy, Norton began replicating offsite data as well. “Centera’s platform has been great for that.” Agfa did a good integration job as well, he reports.

With the current set-up, O’Mahoney is confident that the organization can manage data growth. “EMC has a growth plan for Centera. We’ve expanded that particular Centera three times since we put it in, and haven’t had a problem.”


New initiative

The next initiative for O’Mahoney is establishing a second full-service data center at which 70 percent of current capacity will be replicated. “We would drastically reduce, compared to our current capabilities, the time it would take to get [the CVIS] and McKesson—patient safety-critical applications—back online.”

In case Centera failed, “we can access the same data from our replicated offsite Centera,” he says. That replication occurs over an IP connection. The data center is essentially a data bunker, he says, and “we feel confident that we would be able to pull data from the remote site with no trouble.” Because the Agfa Impax Cardiovascular database tracks the location of all data and is on SAN, O’Mahoney would have the necessary information to rebuild. “The disaster recovery scenario for us would be going to that site, acquiring some servers from our hardware vendors and standing up those servers.”

Since bringing PACS on board for cardiology imaging purposes, “those applications have become very critical to how we care for patients,” he says. Norton has the luxury, however, of the ability to fall back to film for cardiology imaging. All EKG and cath studies go to the CVIS and CT and MR data goes to McKesson PACS, so doctors can still print film. “If we’re offline, it doesn’t necessarily endanger a patient’s life,” O’Mahoney says.

O’Mahoney says that creating the new data center is “probably the single most important change we can make to our disaster recovery plan right now.” He says he’ll feel more comfortable once the new center is ready to take over the load in the event of a catastrophic failure.


Data growth on the horizon

Despite noticing that more and more equipment and image and information vendors are offering storage capabilities, Moeller said that her experience with InSiteOne made it easy to decide to continue working with them. “Personally, I see that data are just going to continue to grow,” she says.

O’Mahoney agrees. “The amount of data that we deal with now that we’re talking about electronic records and huge image files is approaching that of other industries. Both in complexity and elegance, as well as the amount of data, I think healthcare will quickly surpass other industries.”