Diagnostic medical imaging is a crucial component of the overall healthcare delivery process. Ever since Wilhelm Röntgen discovered X-rays and began applying them to create medical images more than a century ago, science has provided dozens of modalities for medical imaging. Because such images enable doctors to noninvasively observe the normal and abnormal structure and function of a living organism, they deliver tremendous value in healthcare.
As with electronic health records (EHRs), it’s extremely useful to electronically archive patients’ medical images. Healthcare IT (HIT) applications such as PACS (picture archiving and communication system) have enabled doctors to easily archive, access, and share patients’ medical images.
Medical imaging technology can be expensive, however. Imaging devices—such as those for CT, MRI, or PET-CT scans—require a large capital investment, and the operating expenses to cover radiologists, trained staff, and electricity can be substantial. There’s also a potential cost to patient health: Unnecessary and repeated imaging examinations can expose patients to excessive ionizing radiation.
Image archiving is another cost to consider. Because medical images can be important evidence in malpractice investigations, various insurance payers and government regulations require long-duration archiving of patient information. Medical images can consume 70% of a hospital’s total data storage. Popular modalities such as CT and MRI generate data in the range of a few hundred megabytes per patient study. But newer imaging technologies such as digital pathology generate data that reaches gigabytes per whole-slide scan.
Traditionally, each imaging device manufacturer provided a PACS application to archive, access, review, and annotate DICOM (Digital Imaging and Communications in Medicine) format images that their own devices produced. This individual PACS approach led to the creation of information silos across a hospital or medical imaging facility. Different healthcare software can require different and incompatible combinations of database, OS, hardware, and communication protocols. For example, a PACS application might require a NAS protocol to serve files and a SAN protocol to serve a database workload. Unless a single storage system can natively cater to both protocols, IT administrators must manage separate storage systems for the NAS and SAN requirements.
These challenges can be compounded by frequent mergers and acquisitions (M&A) of healthcare organizations. In 2019, in the United States alone, 85 healthcare M&A transactions occurred. With such M&A, multiple instances of different medical imaging software can be inherited, requiring each imaging application to be maintained in its legacy architectural silo.
With siloed healthcare applications, the medical information is fragmented, and doctors can’t get a comprehensive view of a patient’s health. And if doctors aren’t aware of an existing imaging study from another department, they might unnecessarily repeat the imaging examination of the patient, incurring extra costs and radiation exposure. Therefore, hospitals are moving toward consolidation of medical images across all modalities, all departments, and DICOM and non-DICOM formats into an organization-wide vendor-neutral archive (VNA).
As with other Health Information Technology (HIT), medical images, too, increasingly face cybersecurity risks such as identity theft and ransomware. Therefore, IT administrators must protect medical imaging applications by using a hardware and software stack that complies with the latest security standards and regulations.
The FlexPod® converged infrastructure solutions from a partnership between NetApp and Cisco can help you mitigate these challenges. The FlexPod reference architecture consists of a scalable ensemble of rack or blade Cisco UCS Servers, Cisco Nexus or MDS switches, and NetApp® ONTAP® data management solutions. FlexPod is validated for various communication protocols such as NVMe, NAS, SAN, NVLink, Fibre Channel (FC), and FCoE, and for application workloads such as Oracle, SAP, and Microsoft SQL Server and Exchange. FlexPod is also validated for virtual desktop infrastructure (VDI) solutions such as Citrix Workspace or VMware Horizon, which healthcare organizations commonly require.
The FlexPod healthcare offerings are tailored to the storage requirements of your medical imaging applications. ONTAP storage performance has been validated under rigorous test loads like the real-life IT setup of a hospital or a medical imaging facility.
With FlexPod, your healthcare organization can consolidate multiple workloads by deploying all PACS and VNA applications on a common platform. And because FlexPod is validated for virtualization and container orchestration platforms, consolidation can also lower your costs by achieving multitenancy. The nondisruptive scalability of FlexPod enables you to deal with uncertain future data growth without incurring immediate extra capital expenditure for provisioning. Because of the extensive storage requirements and relatively incompressible nature of medical images, this benefit is especially important.
The ONTAP storage component of FlexPod maintains submillisecond latency when your end users access medical images. ONTAP natively offers NAS and SAN protocols, so a single FlexPod unit can meet all the storage requirements of your medical imaging application. With ONTAP, you get NetApp AFF storage for a performance tier that holds recently scanned medical images for faster access. The FAS capacity tier holds older medical images after they have been reported. And for long-term cost-effective archiving, FabricPool can automatically move old images to a capacity tier, to Amazon Simple Storage Service (Amazon S3), or to cloud storage.
FlexPod is validated for database applications such as SQL Server and Oracle that are essential for medical imaging. The FlexPod quality-of-service (QoS) and adaptive QoS features optimally provision your compute, networking, and storage resources to protect medical imaging applications from other (“bully”) workloads. With adequate IT resources, medical imaging applications can perform at a speed that your radiologists expect—and need.
The highly available architecture of FlexPod leaves no single point of failure and drastically reduces the risk of downtime for your mission-critical medical imaging applications. FlexPod validated NetApp MetroCluster and MetroCluster IP solutions enable disaster recovery with the zero recovery point objective (RPO) and a minimal recovery time objective (RTO) that are important for medical imaging applications. With NetApp SnapCenter® software, you have multiple options to meet your specific backup and restore requirements for imaging applications.
FlexPod also helps you comply with various security regulations, such as FIPS 140-2. And to protect medical images from unauthorized access, you can deploy add-on features such as Cisco Advanced Malware Protection (AMP) for Endpoints, Cisco Advanced Malware Protection for Email Security, and Cisco IPS (NGIPS).
FlexPod solutions have validated many technologies that greatly benefit the innovative trends in the medical imaging industry and make radiologists’ work easier and more efficient. By enabling radiologists and primary care providers to collaborate from anywhere in the world, FlexPod validated VDI solutions facilitate telemedicine. With VDI, your IT administrators can easily manage infrastructure resources and optimize resource utilization. VDI solutions also enable medical imaging applications to utilize virtual GPUs for better and faster rendering of 2D, 3D, and false-color images and videos on workstations. The validated artificial intelligence (AI), machine learning (ML), and deep learning (DL) FlexPod solutions easily handle the massive CPU, GPU, and storage speed requirements for medical imaging AI use cases.
Learn how FlexPod helps reduce deployment time and uncertainty for your IT infrastructure and helps lower TCO for your facility’s data center. For guidance on how to deploy medical imaging applications on FlexPod, read this technical report. You can also get directional sizing guidance to determine the compute, networking, and storage resources for your FlexPod unit, based on your organization’s expected patient footfall and annual number of imaging studies. You can confidently deploy and manage an appropriately sized FlexPod Datacenter to run your PACS and VNA applications.
The technical report we just mentioned is just one of many resources. Find out more about how FlexPod can help your organization improve imaging and EHR management to help reduce clinician burnout, increase patient safety, and enable doctors to deliver better care.
Dr. Nikhil Joshi is MBBS (degree for physicians in India) and M Tech in Biomedical engineering from Indian Institute of Technology, Bombay, India. Prior to joining NetApp, Nikhil has worked for solution management and development of multiple healthcare applications for over a decade, and observed how the EHRs and the underlying IT infrastructure can influence lives of physicians, clinicians and non-clinical staff as well as their ability to deliver care to patients.