Like most large hospitals in the U.S., University Health Care System (UHCS) in Augusta, Ga., is challenged with new regulations requiring it to archive thousands of medical records -- a job the company initially chose EMC Corp.'s Centera system for until performance, reliability and cost issues forced it to seek alternatives.
UHCS is recognized locally for its cardiovascular services -- it developed the area's first cardiac catheterization lab in 1974 and performed the region's first angioplasty in 1980 -- but like all hospitals, it must balance a limited IT budget against the ongoing requirement for a reliable, high-performance infrastructure.
"Our demands are high," said Bill Colbert, chief information officer at UHCS. The hospital serves a 25-county region in Georgia and South Carolina, and every year supports approximately 200,000 patients, delivers 3,000 babies and performs more than 5,000 cardiac interventional procedures, among many other services. The demands on its IT infrastructure, and more recently its storage systems, are daunting.
"We didn't realize how much we would be storing; we filled up our Centera very rapidly," said Ken Sweatman, lead systems programmer at UHCS. The hospital currently archives close to 15 terabytes of medical images on its Centera with no let up in data growth. However, "the scaling [of Centera] was not cost-effective long term, there's no built-in hierarchical capability that would allow us to move data off to tape," Sweatman said. "EMC's answer was to buy another Centera."
In addition to cost concerns, UHCS ran into technical issues with the product. To archive application data on Centera that does not support the product's proprietary application programming interface, Centera users must install a gateway that converts the archive into an NFS or CIFS so that the application can archive and retrieve data.
"We experienced performance problems with the gateway," Sweatman said. "There were gateway outages … it's not redundant, so we had a few hours outage at a time."
Roy Sanford, vice president of content-addressed storage at EMC, notes that users should buy a second gateway for redundancy purposes. "Hardware fails, that's why you should do protection," he said.
However, this wasn't the end of the issue for UHCS. The hospital had been using a tool from EMC to monitor the utilization of its Centera through a Web GUI. "They had a problem with [the information it was collecting] being accurate and removed the feature from the product," according to Sweatman. "Part of our support issue with EMC was that they weren't explaining why they were doing what they were doing … the feature went away and there was no process for putting it back … They didn't work with us on it."
Sanford explained that the tool UHCS is referring to is most likely a diagnostic product used by EMC's professional services arm. "It is not given to Centera users … the information it delivers is extremely difficult to read, it's a core dump …the equivalent of taking hex data off a mainframe and trying to read that … it's not a customer-friendly tool," he said.
Meanwhile, EMC is looking at ways to provide users with more information on what's going on inside the product. Centera Seek, launched in March, was a step in this direction.
Still, it was too little too late for UHCS, which seemingly experienced poor support from EMC. Sanford conceded that "some channel partners are more educated on [selling and supporting] Centera than others."
IBM GMAS replaces Centera
UHCS began looking for a replacement about a year ago, and with considerable investment in IBM technologies already, it decided to check out Big Blue's Grid Medical Archiving Solution (GMAS). This product was not available when UHCS bought Centera.
The GMAS package includes IBM x-Series servers, storage and grid-based, fixed content archiving software from Bycast Inc., a Canadian company. Bycast's software turns the storage into a network-mounted file system that performs three key functions when data is pumped into it: It generates a digital signature to ensure the integrity of the data throughout its life; it replicates the data according to defined business rules; and it caches a local copy of the data on a gateway node to boost performance.
UHCS chose IBM's DS4100 SATA array for the back-end archive, but Bycast's software actually works with any storage. Hewlett Packard Co. (HP) offers a similar bundle using HP servers and storage called HP Medical Archiving that's also powered by Bycast's software.
Sweatman argues that the benefits of GMAS over Centera are numerous. It uses industry-standard protocols that protect against high-priced, proprietary components, he said. It includes a native hierarchical storage management module for archiving to tape enabling UHCS to reduce its costs over time; and it can retrieve as many as 35,000 large (100 MB+) images per hour, through low latency streaming transport, and dynamic load balancing across storage, bandwidth and CPUs. "Stability and recoverability are No. 1 for us, and IBM has just been more responsible and reliable," UHCS' Bill Colbert concluded.
The hospital has been running GMAS in production for two months, and while it plans to maintain the Centera it has, it will not be purchasing any additional systems. "Our archival strategy going forward will be GMAS … There's not been a lot of noise around it, which generally indicates it's a sign of success," Colbert said.
Bycast has around 10 direct customers of its StorageGRID software, but many more through OEM partners. Most StorageGRID implementations span multiple sites. For example, one customer, BC Cancer Agency, ingests data from more than 30 hospitals and stores the data in a grid spanning five data centers.
Areas for improvement
UHCS said a lot of the "prep work" for the GMAS installation was done at Bycast and not on site. "In the second phase, we'd like more control," Sweatman said. He'd also like to see IBM support other applications with Bycast's software besides just medical systems. "We'd like to add our financial info to a system like this, not just healthcare data."
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