Managing the Flow in Radiology

Enhanced Storage Improves Collaboration
Partnering: Digital Planning for Orthopedics

Enhanced Storage Improves Collaboration

When the University of Virginia Health System, Charlottesville, went live with its first PACS system in 2000, none of the commercially available storage solutions seemed robust enough for the system’s demands, which included powerful redundancy and failover systems. So rather than contract with the PACS provider, the team at UVA turned to EMC Corp, Hopkinton, Mass, to develop a customized, integrated storage solution for fast image retrieval with a tape backup for long-term storage.

Health care providers appreciate the flexibility and performance of the CARESTREAM RIS/PACS. With the addition of CARESTREAM Enterprise Information Management, facilities can efficiently archive a variety of imaging applications including cardiology, pathology, and others.

“We’ve been up on this solution for 8 years, and to date we haven’t lost a single image,” said Matthew J. Bassignani, MD, associate professor of radiology at UVA. “A couple of years ago, we heard another vendor’s PACS lost several thousand images. We haven’t been printing film for a long time, so that’s something we weren’t willing to tolerate.”

Today, UVA’s radiology department runs on a PACS from Carestream Health Inc, Rochester, NY, which is integrated with an updated version of the original EMC storage solution. “About a year ago or so, we upgraded to the new Symmetrix line,” said Sean Moynihan, Radiology IS Director at UVA. “Now we have around 14 TB of storage, eight of which are for PACS. We’re committed to multitiered storage. We currently have 6 months of very fast storage on the Symmetrix for images.”

The multitiered system is designed to spare clinicians the painful process of retrieving priors from tape, Moynihan explains. For business continuity purposes, images are stored on their respective modalities for a few days, in case of a short-term problem. Symmetrix holds the past 6 months’ studies and copies to tape daily for long-term storage; after a month, data is copied to a Centera ATA drive, from which it can be retrieved much more quickly than from tape. “Nothing is eliminated from the primary archive until it’s stored both on tape and on Centera,” said Moynihan. “And Carestream’s PACS has that intelligence built into it—each time a patient comes in and an image is retrieved from storage, the system looks at it, and if it’s not on Centera yet, copies it to Centera.”

Retrieving an image from Symmetrix takes just a few seconds, according to Moynihan, while loading from Centera takes place in 10 to 14 seconds. “The comparison loads while clinicians are working on the primary data set,” Moynihan noted. “It’s very efficient.”

Equally efficient is the disaster recovery system, which ensures that access to UVA’s estimated 425,000 studies a year is unaffected even when the primary data center has crashed. Moynihan runs the PACS on two identical data centers connected by dark fiber; whenever a study comes in, Carestream’s PACS automatically copies it to both Symmetrix storage arrays. When one server fails, the PACS transfers operations to the other server automatically. “The radiologists have no idea which data center they’re running from,” said Moynihan. “Nor should they. When they know the difference, I have a problem.”

Now the team at UVA is looking to improve interdepartmental collaboration by bringing other “ologies” onto the PACS. “They’re tough nuts to crack because they’re not all DICOM,” said Moynihan, “but the latest version of Carestream’s PACS has the ability to store other types of images, not just DICOM. Today, a lot of the other ologies aren’t in an electronic format or in DICOM. That makes them invisible. We want to bring them all together to provide the best possible care for our patients by giving clinicians the data they need when they need it.”

Partnering: Digital Planning for Orthopedics

On July 14, Agfa HealthCare, Greenville, SC, announced a new partnership with Meridian Technique Ltd, Southampton, UK. According to the terms of the deal, Meridian’s orthopedic digital planning solution, OrthoView, will be integrated into Agfa’s IMPAX for Orthopedics platform. Axis Imaging News spoke with Chris Pinner, vice president of sales and marketing for OrthoView, and Jeremy Hoover, accounts manager at Agfa, for more details on the integration.

Meridian’s OrthoView will be integrated into Agfa’s IMPAX for Orthopedics platform.

IE: How will OrthoView enhance the functionality of IMPAX; what features will it add, and what do they all do?

Hoover: As they transition from analog to digital imaging, orthopedic surgeons are challenged to perform presurgical planning on a PACS system rather than using film. By integrating OrthoView with Agfa’s IMPAX solution, a suite of preoperative planning tools is made available to the surgeon. OrthoView includes modules for joint replacement, fracture management, trauma planning, limb deformity assessment and correction, spine measurement tools, and pediatrics. By reducing the number of “mouse clicks” required by the surgeon to create a presurgical plan, their workflow is improved and efficiency is increased.

IE: Conversely, what will IMPAX contribute to OrthoView—faster processing speeds, integration with complementary software, or functionalities?

Hoover: Using OrthoView in conjunction with IMPAX means a surgeon has the power of the PACS viewer to find, select, and view images and then invoke the OrthoView tools to plan the procedure. The results of the planning session are stored in the PACS for viewing on any IMPAX workstation in the operating room or consulting rooms.

IE: Was the integration a response to customer requests? If so, what were they looking for, and how does the integration address their needs?

Pinner: A group of customers voiced the need to use OrthoView and IMPAX together. OrthoView is the world leader in orthopedic planning and IMPAX has a strong reputation as a Web-deployed PACS system. Together, the two systems provide a comprehensive solution to a surgeon’s needs. The Cleveland Clinic in the United States is one such user.

IE: Will OrthoView still be sold separately?

Pinner: Yes, OrthoView will continue to be sold separately or as an optional component to a complete IMPAX system from Agfa HealthCare.

IE: How is the integration being made available to IMPAX users—as an optional upgrade or as a standard part of the package?

Hoover: OrthoView is an option for all new Agfa customers and as an optional upgrade for existing IMPAX users.