HealthAlliance Hospital, a member of UMass Memorial Health Care, serves the communities of north-central Massachusetts and southern New Hampshire with acute care facilities, a cancer center, outpatient physical therapy facilities and a remote home health agency. As an investment in continued high-quality patient care, the hospital has implemented a picture archiving and communication system (PACS) from Siemens Medical Solutions so that it can move toward digital health records while eliminating traditional paper and film.
HealthAlliance is now able to make all of their data, including PACS images, available instantly, using the IBM GMAS, a cross-IBM offering comprised of storage, software, servers and services. The GMAS solution provides hospitals, clinics, research institutions and pharmaceutical companies with an automated and resilient enterprise storage archive for delivering medical images, patient records and other critical healthcare reference information on demand.
"Fast, easy access to diagnostic images is a priority," said Rick Mohnk, Vice President and Chief Information Officer of HealthAlliance. "Being paperless not only helps our staff improve their productivity and the quality of patient care, but also lowers our costs and improves our competitiveness. The IBM GMAS has helped us stay competitive and offer the leading edge technology that attracts top physicians to our staff and keeps patients feeling comfortable and well cared for."
Normally when you read or hear the term "grid", you might think of supercomputers, but in this case we are talking about information that is accessible from different interconnected locations. I've mentioned GMAS before in my posts [Blocks, Files and Content Addressable Storage and What Happened to CAS?] but I thought I would provide more detail on the elements of the solution.
Medical imaging equipment are called "modalities", which is just fancy hospital talk for "method of treatment".These have Ethernet connections designed to write to any storage with a CIFS or NFS interface. For example, press the button on the "X-ray" machine, and the digitized version of the X-ray is stored as a file to whatever NAS storage on the other end.
[Picture Archiving and Communication System] refer to the application and the computer equipment to manage these medical images, often stored in a DICOM format and indexed with HL7 metadata headers. There are many PACS vendors, GE Medical Systems, Siemens Medical, Agfa, Fuji, Philips, Kodak, Stentor, Emageon, Brit Systems, Mckesson, Amicus, Cerner, Medweb and Teramedica, to name a few. Many PACS providers embedded specific storage as part of their solution, but now are starting to realize that they need to be part of a larger storage infrastructure.
IBM System Storage [Multi-Level Grid Access Manager] is softwareon IBM System x servers that manages access across the grid of inter-connected hospitals, clinics and imaging facilities. It provides the NFS and CIFS interfaces to the modalities, and places the data into a GPFS file system on DS4000 series disk.
- GPFS and DS4000 series disk
IBM [General Parallel File System] has all the Information Lifecycle Management (ILM) capabilities to move data from one disk storage level to another, automates deletion based on expiration date, and can provide concurrent access from multiple requesters.The IBM System Storage DS4000 series disk products can support both high-speed FC disk as well as low-cost SATA disk.For large medical images, the SATA disk is often a good fit. The advantage of GPFS is that you can have policies todecide which images are placed on FC disk, and which on SATA, and then later move these files based on access reference. Images that are accessed the most frequently can be on FC disk, and those that haven't been accessed in a while on SATA disk.
- TSM space management
IBM [Tivoli Storage Manager for Space Management] supports moving files out of the GPFS file system and onto tape, based on policies. For example,keep the most recent 18 months on disk, and anything older than that gets moved to tape. This is similar to themigrate/recall technology used in DFSMShsm on the mainframe.
- Tape Library automation
Before GMAS, paper and film images had to be retrieved manually from shelves and filing cabinets. The massive amountsof data being stored, and for such long periods of time, makes it impractical to store all of it on disk. With tape automation, any medical image more than 18 months old can be retrieved in minutes. Patients with an appointment can have all of their medical images retrieved in bulk the night before. Emergency room patients can have previous images retrieved while admission clerks check for insurance coverage and perform triage.
- Display Screen
Images archived on the IBM GMAS are accessible in numerous ways. For example, all clinicians can access GMAS through hospital record system, which provides complete paperless and filmless access to the patient record including medical images, lab results, radiology reports, and pharmacy records. Medical workers at any location can also access the grid using their Web browsers. This allows each employee to use the display systems they are already familiar with.
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