Welcome to Today’s Web Seminar! July 28, 2011 2:00PM ETSponsored by: Hosted by:
Mike Perkowski is co-founder and partner of New Reality Media LLC. Mike hasnearly 30 years of experience following the computer industry as a reporter, editor,publisher and marketing executive. Before co-founding New Reality Media, he was co-founder and chief operating officer of Microcast Communications, a media companycovering the IT and municipal broadband marketplaces. Previously, he spent 10 yearsat Ziff Davis Media in a variety of executive roles, including VP and general manager ofZiff Davis‟ Market Experts Group; vice-president of corporate marketing; publishingdirector of Smart Partner, and associate publisher for marketing at PC Magazine. Mikealso spent 13 years at CMP Media in various editorial and publishing leadership roles,including editor-in-chief and publisher of Computer Systems News. He has directed thedevelopment and implementation of numerous integrated marketing programs for hisclients at Ziff Davis, CMP and as an independent marketing consultant specializing innew-product launches, and has led such disciplines as market research, customerevent programs and sales training.Mike also was a member of the Board of Directors for the Computing TechnologyIndustry Association (CompTIA), the high-tech industry‟s largest trade association. Hereceived a B.A. in Journalism from Rider University (Lawrenceville, New Jersey)..
As a member of Dell‟s Medical Archive Team, Tom Rose is involved inseveral large scale client IT transformation projects for Dell in the NorthEastern US. Throughout a 20 year career in Healthcare IT, Tom hasdeveloped deep experience in the planning for and execution of high impact,complex information technology engagements designed to virtualize patientinformation currently located underneath clinical applications. Tom has directexperience in deployment of application neutral archives. Dell‟s offering inthis area is the Dell Unified Clinical Archive which can be configured to allowmedical imaging studies to be integrated with EMRs and even HIEs in apatient centric manner.Tom‟s technical competencies include: Clinical Information Systems • IHETechnical Framework (XDS-I) • EMPI linking to Universal Clinical Archives •Large Scale Enterprise Radiology and Cardiology Solutions • ApplicationNeutral Archives • Radiology & Cardiology PACS Conversions • DigitalPathology Imaging • Endoscopy Imaging
Dr. Peter Aiken is Associate Professor of Information Systems/Founding Director DataBlueprint. He has been employed since 1975 and in information technology/managementrelated positions since 1980. Following a career in retailing, he began his current avocationduring the early 1980s when he managed the Information Center of a major researchuniversity, delivering consulting and end user support services to a large, diverse,distributed user population numbering in the thousands. Later he was promoted to theposition of Computer Systems Senior Engineer, responsible for the distributed onlineprogram development (CICS) and telecommunications systems (VTAM) for the Universitysmainframe operations.In addition to managing nationwide research and development projects, Dr. Aiken haslectured internationally – giving invited talks in 17 countries. More than a decade & a half ofuniversity level teaching and course/curricula development experience has resulted in hischairing both doctoral and masters committees.Many of these projects have also resulted in jointly authored refereed publications with thestudents. In 1999, VCU spun off a for-profit company called Data Blueprint. The companyhas developed an international reputation for expertise in the areas of data reverseengineering, business and systems reengineering, systems integration/systemsengineering, strategic planning, information engineering, software requirementsengineering, human-computer interaction, and decision support systems.He is the author/co-author of seven books on information technology. Dr. Aiken publicationshave appeared in the Communications of the ACM, IEEE Computer, IEEE Software, theIBM Systems Journal, Information Week and a number of others.
To Ask a Question:1. Click Q&A pane2. Type question in the Type a question for the presenter field3. Click the Ask buttonUse the scroll button to scrollto your answer if necessary
Transformingthe technology ofhealthcareDell‟s Application NeutralUnified Clinical Archive Tom Rose Dell Medical Archiving SME Dell Healthcare & Life Sciences
Application diversity Imaging Modality Radiology Dermatology - Cardiology – Endoscopy Ophthalmology Visible Light Imaging Cardiac Cath, Echocardiology, Nuclear Digital Endoscopic Otolaryngology Neurosurgery Oncology Pathology Surgery1GB per image Depiction courtesy of Dr Rasu Shrestha VP of Clinical Informatics Dell Healthcare & Life Sciences University of Pittsburgh Medical Center
Data Locked in Clinical Silos Radiology Oncology Cardiology Women’s health Pathology• Clinical Information bound to the application• Expensive and redundant procedures are performed• Diagnostic collaboration among departments is inefficient• EMR systems are incomplete and lack certain critical patient information• Painful application migrations Dell Healthcare & Life Sciences
Transformation of Clinical PathEvolutionary Practices Decision Support Systems Healthcare Information Exchange Information Correlation Translational Medicine Health Care Today Diagnosis Non-specific Reduce Duplicate Effort Patient Centric Episode by Episode View Systems Efficiency Dell Healthcare & Life Sciences
Begin at the file levelExample of the file/object relationship This file: Plus this image (+) = An object (Containing One person’s data grouped Object UUID: 12345.6789 File Name: CT SCAN J B SMITH File Type: .DCM (DICOM) together, in Patient Name: John B. Smith Created By: Technician 1 Created On: 01-15-2010 Patient ID: 5534-58-7892 context) Age at time of procedure: 52 File Type: .DCM (DICOM) Procedure Date: 01-15-2010 Physician Name: Dr. Cardiologist Plus all this metadata Physician Notes: .WAV File Retention Period: 10 years Data Type: 3D Reconstruction-rotatable Prior 1: CT Scan .DCM Custom Metadata Affinity: Cardiac Surgical Profile Dell Healthcare & Life Sciences
Object Storage Ecosystem Object/CAS Block/SAN File/NAS TapeHigh Scale & Exabyte scalability Limited to To the extent that 128-bit flat address database scale the databaseExtensibility space, RESTful and transactional scales Yes Protocol, HTTP data performance communication requirementManageability Self Managing & LUNS, RAID File System, Risk of readability Healing, Groups, Replicas, LUNS, RAID Manual handling Metadata-enabled Backup Groups, Replicas automation & Backup. Metadata Compliance Stored Separately included Migration simpleAccessibility Online, HTTP, Tied to physical File tied to Offsite, offline location- location physical location independentCost/GB X86 HW, Peer High Performance, File System Scale, Nearline High Cost Scaling cost, Yes pricing WORM? Dell Healthcare & Life Sciences
DX Performance – Medium to Large Objects Nodes Writes Nodes Reads 32 32 24 24 40 MB 16 5.6 MB 16 1.5 MB 8 350 KB 8 4 4 0 200 400 600 800 1000 1200 0 200 400 600 800 1000 1200 Throughput by Stream in MB/sec Throughput by Stream in MB/sec• Large stream performance sufficient for environments needing rapid access to content• 32-node cluster performs write speeds for 40MB files at over 1000MB per second and reads at approximately 900MB per second. Dell Healthcare & Life Sciences
Medical imaging integrationCurrent View CT ScannerClinicalApplications PACS Workflow Clinical Source Modalities ProprietaryStorageLayer Scaling by frame Dell Healthcare & Life Sciences
Cost of image communicationCD/film handling cost IDN # 1 IDN # 2 IDN # 3 IDN # 4 Total – 16 hospitals CDs imported annually 3,600 852 3,600 3,600 CDs imported - 7 years 25,200 5,964 25,200 25,200 CD - cost per imported CD $2.50 $18.00 $4.00 $4.00 CD - import cost 7 years $63,000 $107,352 $100,800 $100,800 CDs exported annually 9,600 1,260 6750 12,276 CDs exported - 7 years 67,200 8,820 47,250 85,932 CD- cost per exported CD $4.50 $19.00 $4.50 $12.00 CD - export cost 7 years $302,400 $167,580 $212,625 $1,031,184 Films imported annually 600 285 2,640 2,640 Films imported - 7 years 4,200 1,995 18,480 18,480 Films - cost per imported film $3.00 $15.00 $4.00 $4.00 Films - import cost 7 years $12,600 $29,925 $73,920 $73,920 Film exported annually 5,880 101 600 178 Film exported - 7 years 41,160 706 4116 1,247 Films - cost per exported film $16.50 $30.00 $16.50 $20.00 Films - export cost 7 years $679,140 $21,168 $67,914 $24,948Total CD/film handling cost $1,057,140 $326,025 $455,259 $1,230,852 $3,069,276 “ It is estimated that there are more than 785 million health care tests conducted each year in the United States. The lack of interoperable systems to effectively communicate the results among the various 785+ Million providers who need to review them Healthcare Tests/Year is consuming 1 billion hours of administrative processing time just to get the data in the right place, according to one estimate.”- Scott McCabe, “EMRs vs. Information Convergence”, April 2008 Dell Healthcare & Life Sciences
Universal Viewer EMR integration Dell Healthcare & Life Sciences
Universal Viewer EMR integration Dell Healthcare & Life Sciences
XDS for Imaging (XDS-I) Profile Patient Identity Source Patient Identity Feed Query Document Documents Document Registry Consumer Register Document Set Provide & Register Retrieve Document Set Manifest Image Document Document Source Repository (Image Manager/ Image Archive ) Retrieve Images Dell Healthcare & Life Sciences
XDS – Key Features • Document centric – Published clinical data is organized into “clinical documents” using agreed standard document types (HL7, PDF, DICOM) • Document is „application neutral‟ – Document content is processed only by source and consumer systems • Standardized registry attributes – Documents are described by a standardized set of attributes. – Standardized queries are used to discover the content Dell Healthcare & Life Sciences
IHE Infrastructure Profiles: XDS, PIX/PDQ, ATNA• Cross-Enterprise Document Sharing (XDS) – Standards based architecture for sharing of clinical documents among healthcare enterprises• Patient Identifier Cross-Referencing (PIX) – Standards based architecture for reconciling patient ids from different domains• Patient Demographic Query (PDQ) – Standards based architecture for searching based on patient demographics.• Audit Trail and Node Authentication (ATNA) – Securing of any communication between endpoints and auditing of systems that receive/send patient information. Dell Healthcare & Life Sciences
How does XDS-I work? • Publish a “document of pointers to images” to a PACS “repository” Think of these as hyperlinks to the actual study file • Register the location and meta-data for the document in a “registry” This is a DICOM Manifest, or a catalogue of patient data on hand.XDS document registry XDS Study repository PACS Dell Healthcare & Life Sciences
How does XDS-I work? • Query for correct patient name (PDQ) and MPI (PIX) • Query for available patient exams (DICOM Manifest) PACS • Click on „document‟ pointers from XDS registry • Pull images from the appropriate PACS repository XDS Document Registry XDS Study Repository PACSPatient Admits toEmergency Room-Anywhere Dell Healthcare & Life Sciences
Dell Unified Clinical ArchiveHelping Healthcare providers efficiently store, manage and share medical image data Medical Record Radiology Cardiology Neurosurgery Endoscopy Digital Pathology Unified Clinical Archive Clinical Data Management Data Consolidation and Information Life cycle Management Dell On-Premises Dell Cloud Clinical Archive Clinical Archive Object based storage platform Managed Enterprise Archive Dell Clinical Collaboration Portal Clinical Collaboration Portal Universal View withData Access and Distribution Cross Enterprise Data Access and Distribution Dell Healthcare & Life Sciences
Q&ALet‟s discuss your transformationFor more information contactSusmit Pal firstname.lastname@example.org://content.dell.com/us/en/healthcare/healthcare-medical-archiving-unified-clinical-archive.aspxThank you! Dell Healthcare & Life Sciences
A particular slide catching your eye?
Clipping is a handy way to collect important slides you want to go back to later.