Maimonides Medical Center update from March 2006

As an early adopter of PACS (picture archiving communications systems), Maimonides Medical Center in Brooklyn, New York, was among the first medical establishments to reap benefits from the technology. It was also among the first to run into its archiving challenges.

PACS gear digitally stores cardiology and radiology tests, magnetic resonance imaging (MRI) results, and other large files. Mark Moroses, director of technical services at Maimonides, says his group began using PACS seven years ago, making it a pioneer, even in the New York area.

"We went over from film to PACS in one shot. One day we were cutting film, the next day that was it -- we were completely PACS," Moroses says. "The project paid for itself in a year. Film is expensive."

Seven years later, Moroses realized he needed a better system for archiving the huge files created by PACS. The hospital installed PACS before digital archiving or UDO optical technology was available. Moroses' group was storing images on a DVD jukebox. Last year, they realized the DVD jukebox had become slow and unreliable, and it lacked RAID capabilities to prevent files from getting corrupted.

"Because it's a jukebox and has mechanical parts, it had a high failure rate because we were using it for things it wasn't meant for," he says. "It had the highest failure rate of all our systems. We went looking for spinning disk. The time it takes to pull an image from spinning disk is quicker than a jukebox by 40 to 50 seconds in some cases."He settled on an Archivas Cluster fixed content appliance, which remedied the problems with DVD. The product also helped with another problem that came with hitting a magic number in archiving medical records -- seven years. (See Archivas Seeks Archiving Action.)

New York State law mandates health care organizations keep adult medical records for seven years. Maimonides can begin moving records it stored for seven years out of its archives. That's a good thing, because it frees up space and curbs data growth.

But it's not so easy to automate retention policies. Archiving software must read DICOM (digital imaging and communications in medicine), a standard that systems must support to view medical information. The software must read DICOM headers across all files, including emails, prescriptions, CT scans, and MRIs, to set retention periods.

"We hit the seven-year threshold before anybody else in New York, basically," Moroses says. "Archivas can set a retention policy [script] for anything it can write to its data store. I have separate retention policies for adult and pediatric images, which must be retained for 21 years."

Moroses won't say how much the Archivas system cost, but it was less than half of the $750,000 Maimonides allots to storage each year. "It will maybe pay for itself in two years," he remarks.Another option Moroses considered was a CAS (content addressable storage) system from Bycast aimed specifically at the medical industry and sold by Hewlett-Packard and IBM. (See IBM, Bycast Offer Grid Medical Archive.) Moroses says he preferred Archivas's interface and its ability to handle clusters. According to him, proprietary archiving systems such as EMC Centera and IBM DRR50 weren't options because they did not work with the DataCore SANsymphony software Maimonides uses to manage its SANs.

Overall, Maimonides maintains what Moroses calls "2.5 SANs," consisting of IBM Shark arrays to handle critical data, which includes emails, prescription records, CT scans, MRIs, and other medical information. There's a SAN in the main data center about 10 blocks from the hospital, which is mirrored by a SAN in the basement of an auxiliary data center at the hospital.

The "half SAN" resides at a cancer center opened a mile from the main hospital last year. The new SAN was built to handle PET/CT images, but it is not yet in production. PET/CF images fuse two technologies for three-dimensional pictures of active tumors to better pinpoint their locations. When the service becomes available, these images will be passed back to the PACS system via Sonet and eventually DWDM.

The hospital's SANs hold about 50 Tbytes now. The cancer center will add another 2 Tbytes when it goes online.

Dave Raffo, Senior Editor, Byte and SwitchOrganizations mentioned in this article: