The webcast discussed the benefits of using an application service provider (ASP) for long-term storage and disaster recovery of medical imaging data. ASP provides redundant offsite storage at multiple data centers, ensuring images are securely backed up and accessible. Three medical centers described how ASP allowed uninterrupted access to images even after disasters like Hurricane Katrina, avoiding data loss or access issues. ASP is a cost-effective solution that removes the burden of local storage management and hardware updates.

1. Thank you for joining us.
The webcast will
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2. Questions ?
A live Q&A with the presenters
immediately follows the video
presentation. Submit your questions
in the “Ask A Question” box on the
bottom right of the console.

3. Application Service Provider: ASP
• Secure, scalable DICOM data archive with full
disaster recovery
• Turnkey offsite solution
• Price per procedure model
• Obsolescence protection from hardware and
software as an expendable cost
• Data are redundantly backed up at several remote
data centers
• Images are immediately available to radiologists,
specialists, and referring physicians

4. Diagnostic Imaging Services - New Orleans
• Survived Hurricane Katrina
• Due to ASP, PACS and offsite archive
were secure
• No electronic images were lost
• Five free-standing radiology facilities
• 115,000-120,000 imaging procedures
each year

5. University of Washington Medical Center - Seattle
• 450-bed hospital
• 9 neighborhood clinics
• 100 outpatient facilities
• 210,000 imaging procedures annually
• Top 10 medical centers in the U.S.
— U.S. News and World Report
• Teaching hospital for University of
Washington School of Medicine

6. Rush-Copley Medical Center – Aurora, Ill.
• 183-bed community hospital
• Implemented ASP when it went online
with PACS six years ago
• Member of Rush-System for Health
• 120,000 imaging procedures each year
• Physician base of 500

7. UW Medical Center:
Webcast Presenters
• William Shuman, MD, FACR
Professor and Vice Chairman of
Radiology, and Director of Radiology
• Gene Hoefling
Administrative Director, Radiology
• Andy Strickland
Director of Imaging Informatics

8. Rush-Copley Medical Center:
Webcast Presenters
• Dennis DeMasie
Vice President and CIO
• Tom Markuszewski
Director of Imaging
• Bob Bruecker
PACS Administrator

9. Diagnostic Imaging Services:
Webcast Presenters
• Anthony Gettys
CEO
• Kathy Rabalais
Director of Clinical Services and IT
• Andrew LeBlanc
IT Consultant
• Keith Robichaux
PACS Administrator

10. Q & A Session
Please submit your questions by
typing them in the “Ask A Question”
box in the right of your console.

11. UW Medical Center: Facility Overview
• Harborview Medical Center – trauma
and burn center
• Children’s Hospital & Regional Medical
Center
• Veteran’s Administration Puget Sound
Health System
• 13 primary care clinics around the city
• 2 specialty clinics

12. UW Medical Center: Technology Portfolio
• 64-Slice CT
• 1.5 and 3 Tesla MR
• Digital mammography
• 4D ultrasound
• Nuclear medicine
• PET/CT
• Interventional radiology
• PET/CT and CT in radiation therapy for IMRT
therapy planning

13. Reasons for Going with ASP
• Filmless for seven years
• Gradually extended PACS into the
enterprise and expanded network
• Required a better archiving solution
• Prior to ASP, used optical disc and
then migrated to content addressed
storage

14. UW Medical Center: ASP Benefits
• Cost-effective savings
• Factor of safety and disaster recovery
• Data are backed up at several offsite
locations
• UW located near:
- Volcano: Mt. Rainier
- Earthquake fault
- Tsunami zone
• Expense of having a safe backup system is a
fraction of what a minimal disaster would
cost

15. UW Medical Center: PACS Archive
• PACS archive = 30 Terabytes
• Expected to reach 50 TB in a couple years
• 25 TB online for short-term storage
• Previously used optical disc for disaster
recovery, but it was too limited for growth
• Went to spinning disc, RAID technology
• Needed a third tier storage strategy
• Looked into ASP solution

16. UW Medical Center: Disaster Recovery
• Three copies of every exam are sent at
acquisition time:
- One copy of images goes to short-term,
on-site storage
- Second copy goes to server that sends
images to ASP via VPN to Chicago where
stored in another spinning RAID device
- Third copy kept on other ASP site in
California

17. UW Medical Center: Benefits of ASP
• Ability to continue business even if the
entire hospital is destroyed in an
earthquake
• Archive is online
• Simple implementation – only need to
provide a network connection to ASP
center
• Can run 150 MB per second over the
internet through a VPN

18. UW Medical Center: Choosing ASP
• Decision driven by escalating data
sets – 64-slice CT
• Started looking at ASP two years ago
• Key as move into next-generation
imaging systems with larger data
volumes
• Outgrew local archive

19. Rush-Copley: Why ASP?
• Driver: Avoid capital expense
• ASP: Expense it as you use it
• Don’t need hospital technical staff to
manage storage – vendor provides
resources
• Frees up CIO to focus on hospital’s
business and clinical needs
• Certified disaster recovery

20. Rush-Copley: ASP Lessons Learned
• Maximize resources to focus on
strategic operations
• Do a site visit prior to implementing
ASP
• Be sure vendor is thorough
• No HIPAA or JCAHO issues
• No concern with upgrades
• Looking to add cardiology ASP next

21. Rush-Copley: ASP Lessons Learned
• Logical solution for disaster-recovery
• Three layers of backup with ASP
• Turnkey solution at 2 offsite locations
• Invisible solution to the organization
from a hardware cost and manpower
cost
• ASP vs. onsite storage – pick ASP

22. Rush-Copley: ASP Benefits
• RAID – 4TB
• Store 2-3 years of images in short-term
storage
• ASP: Long-term storage is infinite
• Never run out of space
• Pay only for storage that is used
• Issue of storage is invisible, concerns
and problems are in the background

23. Rush-Copley: User Experience
• No data migration issues
• No questions, because there are no
problems
• User feedback: Out of site, out of mind
– the system always works
• Images are always available under all
circumstances

24. Rush-Copley: User Experience
• ASP means images and problems are
out of sight, out of mind
• No hardware and software
obsolescence
• No change in platforms to worry about
• No data migration costs

25. DIS: Overview
• 110,000 imaging procedures a year
• 5 facilities located throughout the
metropolitan New Orleans area –
Metairie and Marerro, La.
• Women’s center performs 20,000-
25,000 mammography procedures per
year
• 100-150 open MRI procedures on a
monthly basis

26. DIS: Benefits of ASP
• Created numerous efficiencies from a
radiologist’s standpoint
• Improved radiologist workflow
• Better use of radiologists’ time
• Able to store images at an offsite
location for a minimal fee

27. DIS: Katrina and Beyond
• When Katrina hit, the storage of images was
not a concern because ASP safely stored
information offsite
• After the storm, opened each clinic
individually
• Able to retrieve images and operate as
normal, as if the storm had never
happened
• Within 6-7 months after reopening, DIS
was back to pre-Katrina imaging volume

28. DIS: Katrina and Beyond
• Once reopened, patients were happy to
get images they needed
• Continuity of care for patients
• Referring physicians were glad too

29. DIS: The Disaster Plan
• June 2005: Review disaster plan with personnel
• August 2005: Activated disaster plan
• Katrina was imminent, had to shut down
• Before closing, made sure all modality-specific
exams had gone to ASP
• Images were stored offsite in Chicago and California,
as well as in short-term storage in New Orleans
• Went smoothly
• Confident in double back-up
• Able to retrieve data when they returned or wherever
they set up a workstation to work from

30. DIS: After Katrina
• After setting up a workstation, they were
able to read digital mammography exams
quickly
• Patient data and reports were fully secure
and safe through ASP
• ASP allowed us ‘one less worry’

31. DIS: Factors to Consider for ASP
• Strategic advantage – allowed us to recover
quickly from a disaster
• Disaster Recovery – data are maintained no
matter what happens locally
• Got PACS back online 3 weeks after Katrina
• Gave referring physicians access via web
• Convenience – technologists don’t have to
retrieve tapes
• Instant access to images
• All data were maintained, nothing was lost

32. Webcast Presenters
• William Shuman, MD, FACR • Anthony Gettys
Professor and Vice Chairman CEO
of Radiology, and Director of • Kathy Rabalais
Radiology
• Gene Hoefling Director of Clinical Services
and IT
Administrative Director, • Andrew LeBlanc
Radiology
• Andy Strickland IT Consultant
Director of Imaging Informatics • Keith Robichaux
• Dennis DeMasie PACS Administrator
Vice President and CIO • Andy Vranesic
• Tom Markuszewski GE Healthcare
Director of Imaging • Vijay Tanjore
• Bob Bruecker GE Healthcare
PACS Administrator

33. Thank You
To view an archive of this
video webcast, please visit …
www.HealthImaging.com/Webcasts