Think Outside the PACS Enterprise Grid Solution for

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

Agenda • • Medical Imaging Enterprise Storage Requirements • Grid Medical Archive Solution • Customer Success Stories • 2 Introduction Q&A Grid Storage Management Systems

Transformation of Medicine accelerated by a combination of revolutionary technologies and evolutionary practices Automated Systems Information Correlation 1 st Generation Diagnosis Distributed High-Throughput Analytics Revolutionary Technology Personalized Health Care Lifetime Treatment Pre-symptomatic Treatment Cancer Diagnosis Translational Medicine Molecular Medicine Genetic Predisposition Testing Clinical Genomics Health Care Today Digital Imaging Episodic Treatment Non-specific (Treat Symptoms) Electronic Health Records Data and Systems Integration Organized (Error Reduction) Evolutionary Practices 3 Grid Storage Management Systems Artificial Expert Sys. Personalized (Disease Prevention & Targeted Treatment)

More Data Over the Last 3 Years Than Previous 40, 000 years Combined Digital Pathology Digital Radiology P e t a b y t e s E-Health Initiatives/Linkages 40, 000 BCE cave paintings bone tools Electronic Medical Record 3500 writing Digital Cardiology 0 C. E. paper 105 1450 printing 1870 electricity, telephone transistor 1947 computing 1950 Late 1960 s Internet 1993 The Web 1999 Source: UC Berkeley, School of Information Management and Systems. 4 Grid Storage Management Systems 2003

Introduction Why health administrators should care about infrastructure • Uniformity of care • Reliability of services • • • 5 Business Continuance Disaster Recovery Affordability of IT investment Grid Storage Management Systems

Introduction Why providers should care about infrastructure • Speed - Configurable and Reliable Performance • • • 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 • • 6 Smart Caching and Data Backups IT Support: Central Global Storage Dashboard for Dynamic System Administration No scheduled downtimes Automated data migration for hardware upgrades Grid Storage Management Systems

Introduction Grids enable three IT functions: • Computation (PC & Server Grids) Intra and Inter - organizational cycle sharing Access to computing resources On Demand Utilization, App Speed & Scalability Collaboration (Data Grids) • Data Virtualization, Federation & Sharing • Virtual Storage Pooling Data Access, Productivity & Storage Utilization • • Orchestration (Intelligent Provisioning) • • 7 Automated SLA management & provisioning Improved Quality of Service & IT Grid Storage Management Systems Operating & Mgmt Costs (TCO)

Introduction Why Grid Storage System? Before Grid Site 1 App 1 Site 3 Site 2 App 3 After Grid App 4 . . . Site 1 App 10 App 1 Site 3 Site 2 App 3 App 4 . . . App 10 Grid Storage Platform “Siloed” Traditional architecture: • Difficult & expensive to administer • Low utilization of hardware & storage • Vulnerable to failure and downtime • Bandwidth inefficient • Block level replication 8 Grid Storage Management Systems “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

Introduction PACS and Imaging Architecture PACS Application Study Demographics and Metadata Application Study Images Infrastructure Transactional Data Fixed Content Data Store Fixed Content Data has unique & specific requirements 9 Grid Storage Management Systems

Introduction Three Tier Solution Architecture APPLICATION LAYER e. g. Stentor, Mc. Kesson, Agfa Clinical Function Image Access IMAGE MGMT LAYER e. g. Stentor, Tera. Medica, Emageon, others Image Management Layer Aggregation & Interoperability STORAGE LAYER Grid Storage Management System 10 Grid Storage Management Systems Data Protection, ILM Replication, Resiliency & Speed

Medical Enterprise Storage Requirements • High Performance § § Reliable & Protected § § Secure and Scalable to other regions and disciplines Simple Administration § § Data outlives hardware and media Multi-Facility § § Very large, rapidly growing data sets Long Retention Times § § Support heterogeneous PACS environment Massively Scalable § § Continuous operation in the presence of faults Open and Interoperable § § Fast access to data Easy to manage & operate Cost Effective § Affordable today & tomorrow Address Requirements Today and Tomorrow 11 Grid Storage Management Systems

Grid Medical Archive Solution (GMAS) IBM’s GMAS is a fixed content Grid storage platform 12 Grid Storage Management Systems

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 13 Grid Storage Management Systems

Application Integration Vendor Applications Protocol Reference Sites Philips/Stentor Easy. Access XCelera i. Site NFS CIFS DICOM Gen. Plus, VCH PHSA FUJI Synapse CIFS Banner AGFA IMPAX DICOM/CIFS/NFS VCH GE Cardiolink Enterprise Archive CIFS UHCS Camtronics Vericis CIFS UHCS PACS Application Independence 14 Grid Storage Management Systems

Fast Performance • Performance Scalability • • • 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 • • Seamless scalability through Grid Architecture Scales by adding new CPU and faster storage resources 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 15 Grid Storage Management Systems

HIPAA Compliance • Audit • • Data Integrity • • • Real-time & historical audit records • Object insertion • Object access • Object deletion Consistency check report Audited object insertion Confidentiality • Encryption Ensuring integrity, confidentiality & traceability of patient data 16 Grid Storage Management Systems

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 17 Grid Storage Management Systems

Information Lifecycle Management Rules Local Sites Central Data Center DR Site ? Configurable to meet your requirements 18 Grid Storage Management Systems

Decreased Total Cost of Ownership • Consolidated Storage Infrastructure • • • Optimized Price Performance • • Eliminates storage silos Increases utilization 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 FTE’s Costs less to deploy, manage, and operate 19 Grid Storage Management Systems

Summary – Gap Analysis Medical Requirements Grid System Features High Performance Reliable and Protected ü Automated and Self Healing Open and Interoperable ü Heterogeneous storage and applications Massively Scalable ü Grow as you go Multi Facility ü Bandwidth efficient and WAN optimized Simple to Administer ü Centrally managed Cost Effective ü Eliminate Silos Long Retention Times 20 ü De-centralized Grid Architecture ü Seamless hardware refresh Grid Storage Management Systems

Compelling Benefits What this means to you • Performance • • Improved uptime and reliability • • Higher storage utilization & simplified management and administration Extensible and Scalable • • Real time business continuity Decreased Total Cost of Ownership • • Timely access to mission critical patient data Across all medical disciplines, applications and locations Empower Healthcare Networks • Storage Hardware and PACS application agnostic Affordable PACS Storage Infrastructure 21 Grid Storage Management Systems

Success Stories 22 Grid Storage Management Systems

Customer Success Stories New 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 e. Server x. Series and Total. Storage § Philips Easy. Access PACS Solution Business Benefits § Improved performance, uptime and scalability § Real time disaster recovery and automatic fail over § Improved storage utilization § Simplified administration § Consolidated storage for >300, 000 studies in Yr 1 60 TB configuration deployed in 4 sites in 30 days 23 Grid Storage Management Systems

Customer Success Stories Provincial Health Services Authority Challenge: § § Delivering Cancer and Pediatric care for Province of British Columbia (Population 4. 1 M) Seamless access to images across Province Integrate with existing multi-vendor PACS Geographically dispersed facilities Solution: § § § Provincial grid in production since 2002 Links 40+ hospitals with 1, 500+ users 60 TB at 5 Data Centers, distributed DR Less than 1 FTE to operate and maintain Stentor, Agfa, GE, Mc. Kesson, Siemens, … Solution Business Benefits § Timely access to patient data § Reduction of avoidable medical procedures § Increased resiliency and uptime § Images accessible via EHR § Enhanced clinical collaboration In full production for over three years with no downtime 24 Grid Storage Management Systems

Summary • Healthcare has unique and challenging storage requirements • Traditional approaches are not scalable and reliable Grid Storage is proven technology with proven results 25 Grid Storage Management Systems

Thank You ! Questions and Answers