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Hospitals sharpen X-ray vision with digital archiving

Shane O'Neill

In an effort to improve patient care while complying with Health Insurance Portability and Accountability Act (HIPAA) regulations, more hospitals are implementing PACS (picture archiving and communications system), along with archiving software, to store and manage medical images.

Brigham and Women's Hospital in Boston recently purchased GE Centricity PACS Enterprise Edition from GE Healthcare, a $14 billion unit of General Electric Company. The system uses GE's PACS software in conjunction with high-end Clariion arrays from EMC Corp. to store and manage images.

At the other end of the spectrum, Good Samaritan Community Healthcare, a small community hospital in Puyallup, Wash., passed on the Centricity PACS SE, a smaller version of the Enterprise Edition, and chose a PACS unit from Kodak and Permeon software from Permabit Inc., Cambridge, Mass., to handle archiving.

Both hospitals had their reasons for choosing their respective vendors, but both agreed that quicker access to medical images improves patient care.

The imaging department of Brigham and Women's has three hospitals feeding into its Centricity PACS system and stores 3 TB of data per month. Dr. Ranin Khorisani M.D., vice chairman of radiology, said that with the Centricity PACS software, "if surgeons are trying to make a decision, they can see digital X-ray images in an operating room. If family doctors want to pull up images of a CAT scan on their PCs, they can do so in seconds."

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The hospital uses a Centera from EMC for archiving and in the next year plans to have between 40 and 50 TB of raw data on this system. Khorisani noted that last month alone, 1 million images were looked at by doctors at Brigham and Women's, a far cry from the days when doctors would have to call the film library to see an X-ray. To comply with HIPAA, all the images live on EMC Clariion arrays for three years before being moved to the Centera for archiving.

Khorisani hopes that soon PACS will be integrated with other software applications used in the hospital so that "test schedules, patient notes and lab examinations as well as radiology images can be viewed with the same software."

Increasingly, this need to store such digital images as MRIs, CAT scans, ultrasounds and X-rays has trickled down to smaller hospitals. Two weeks ago, GE Healthcare announced the Centricity PACS SE, a system similar to the Enterprise Edition, but designed and priced for small community hospitals. It uses the EMC entry-level storage system Clariion AX100 and comes ready to plug and play with hardware and software.

Good Samaritan goes for Kodak/Permabit

Because the Centricity PACS SE is so new, early adopters were not yet ready to speak about its performance. However Good Samaritan Community Healthcare did check it out and passed on the product in favor of a PACS unit from Kodak in conjunction with Permabit's Permeon software for archiving.

When Eric Lowe, IT Technology and Operations Manager at Good Samaritan, set out to purchase a PACS for the nonprofit private hospital, the PACS vendors he spoke to -- including GE, Siemens and Kodak -- all pitched the use of EMC's Clariion and Centera. But Good Samaritan wasn't interested in purchasing EMC.

Lowe resisted EMC as part of the PACS purchase because he'd had negative experiences with Clariion arrays in the past. The main problem, he said, was a high rate of failure of hardware including drives, cache and processor boards. "We had one instance where three drives failed simultaneously, crashed two servers, and came within a sniff of losing all the data associated with those servers," said Lowe. "This had a direct impact on patient care." He replaced 10 Clariion arrays with two XioTech Magnitude arrays.

Medical images are streamed over a network and the Kodak PACS software stores them on a storage area network (SAN) workstation where they can be viewed by radiologists. When all changes are made to the images, Permeon moves them to archiving where they can be read, but not changed.

Lowe said that he chose Permeon because it splits data across different nodes in a server for speedier access and expandability.

Peter Gerr, senior analyst at Enterprise Strategy Group (ESG), Milford, Mass., points to PACS as the next wave of technology in health care, but that merely setting up a PACS system is not enough. "It's the long-term protection of the images that really matters because HIPAA states that data be secure and available on an easily accessible format for the life of the patient," said Gerr.


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