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But others in healthcare IT argue that providing performance and availability is what IT departments are in the business of doing. "It's not up to the vendor to put you in a compliant mode. It's up to us," said Jim Touchstone, senior systems engineer at Mississippi Baptist Health Systems (MBHS) in Jackson. The hospital worked with its vendors to put together its own integrated data center stack. The infrastructure includes a primary IBM DS8300 SAN storage system shared among modalities and an IBM N5200 array for disk-based near-line archiving.
"This 8000 array . . . we've had it on our floor for four years and, knock on wood, never had one minute of downtime with it," Touchstone said. "We've had the N5200 for four years, and we've failed over before because we had a drive go out, but we never had any downtime. Our network is fully redundant; there are answers for the availability problem."
"As an industry we're not at odds with or opposing . . . what our users want to do," said Philips Healthcare's Valante. In addition to the Health Insurance Portability and Accountability Act (HIPAA), the American Recovery and Reinvestment Act (ARRA) and state requirements for retention of records, devices hosting PACS information are regulated by the Food and Drug Administration (FDA). Compliance with those regulations is also a risk PACS vendors assume for customers, Valante argues. "Once you start opening those doors, you're accountable to FDA filing," he said. "We do a
Some hospitals undaunted
"They must all go to the same school because I heard that same thing about it being a certified, FDA approved, blah blah blah. When push came to shove, I didn't listen and [my PACS vendor] supported it," said Michael Knocke, CIO at Kansas Spine Hospital in Wichita. The hospital has approximately 6 TB of capacity on primary, local secondary and remote secondary Compellent Technologies Inc. SANs, and runs PACS applications from a single vendor across the board. (Knocke declined to identify the vendor.)
Knocke acknowledges he had some advantages that larger facilities don't have, including a smaller data set and a single PACS vendor for all modalities. "But that didn't make it easy," he said. "At the time that I moved my images from where they were being stored originally to a Compellent SAN, the [PACS system] OEM vendor was not happy. They basically said, 'No you can't do that' and I said 'Well, I'm going to do it' and they begrudgingly continued to support me even though there were threats."
Micha Ronen, PACS administrator at Phoenix-based Sun Health Corp., which was acquired by Banner Health in 2008, is in the process of merging his NetApp Inc.-based PACS archiving systems into Banner Health's Bycast grid (Bycast Inc. was acquired by NetApp in 2010). "One of the beauties of Bycast is that for us, migration is not an issue," Ronen said, because it can layer over heterogeneous storage repositories without requiring data to be moved. At least, that's how Bycast has worked historically; NetApp has since said it will not support third-party storage systems going forward under its Bycast-based StorageGRID software unless they're fronted by its V-Series gateway and made to look like NetApp storage.
Ronen is unconcerned with this change. "For us, I don't foresee any problem. They would definitely like to get a bigger share of the storage we have and so will have to accommodate our environment."
This was first published in August 2010