Scalable Storage and Disaster Recovery Infrastructure for Medical Images

Transcription

1 Scalable Storage and Disaster Recovery Infrastructure for Medical Images Session 265, March 8, 2018 Todd Thomas, CIO, Austin Radiological Association, MSO, LLC Paul Feilmeier, IT Director, Faith Regional Health Services 1

2 Conflict of Interest Todd Thomas- Customer Advisory Board (CAB) Member Nasuni Corporation Paul Feilmeier Has no real or apparent conflicts of interest to report 2

3 Agenda Challenges in unstructured data in A regional hospital environment A multi-site outpatient imaging provider Evaluating cloud and non-cloud Options Organizational requirements Organizational process ARA and Faith Regional strategy comparisons Suggestions and tips for formulating your strategy Q & A 3

4 Learning Objectives Classify unstructured data by type, importance to patient care, retention goals, and frequency of access requirements Evaluate multiple options including cloud-based and non-cloudbased, as part of putting together a comprehensive solution Compare approaches in terms of how they meet your organization's budget and service needs, and their ability to adapt to changing technology and unpredictable events 4

5 5 Disaster Threat 5

6 6 Ransomware Threat 6

7 TERABYTES CONSUMED 7 Unpredictable Growth D and 3D Image File Growth Predicted: 55 TB s Actual: 174 TB s Adding 304 Gigabytes per month 7 3, , , EXAM YEAR Source: Austin Radiological Association

8 HIPAA Contingency Planning Requirement Data backup plan Disaster recovery plan Emergency mode operation plan Testing and revision procedures Applications and data criticality analysis 8

9 Unstructured Data at Faith Regional Health Services Parts of patient health records are unstructured File shares Radiology (Dicom images) PAC system Types Media and video files (marketing) Cardiology images Pill cam shows pill being swallowed and processed through body 9 Sleep studies

10 Unstructured Data at Faith Regional Health Services Parts of patient health records are unstructured File shares Radiology (Dicom images) PAC system Importance to patient care Media and video files (marketing) Pill cam shows pill being swallowed and processed through body 10 Sleep studies Cardiology images

11 Unstructured Data at Faith Regional Health Services Parts of patient health records are unstructured RETENTION File shares STORAGE Radiology (Dicom images) PAC system MIGRATION COSTS Challenges Media and video files (marketing) GROWTH IN OUTREACH Pill cam shows pill being swallowed and processed through body VIDEO SIZE; RETENTION 11 Cardiology images PRACTICE GROWTH IMAGE GROWTH Sleep studies PRACTICE GROWTH STUDY SIZE

12 Unstructured Data at Austin Radiological Association 3X Projecti ons Ultrasound 3D Mammo Radiology PACS 2D Mammo MRI Database Backups Types Doppler studies CT Home Directories Archived Patient Records Marketing Media 12

13 Unstructured Data at Austin Radiological Association 3X Project ions Ultrasound 3D Mammo Radiology PACS 2D Mammo MRI Database Backups Importance to patient care Doppler studies CT Home Directories Archived Patient Records Marketing Media 13

14 Unstructured Data at Austin Radiological Association 3X Project ions Ultrasound 3D Mammo Radiology PACS GROWTH SLA S 2D Mammo MRI Database Backups SIZE Challenges Doppler studies CT Home Directories FREQUENT UPDATES Archived Patient Records RETENTION Marketing Media GROWTH 14

15 Shared Challenges Disaster Recovery Scalability and Manageability Unstructured Data Back up HIPAA Compliance Ransomware 15

16 Why ARA Explored Cloud Storage Requirements Traditional On-Prem Storage Pay as you grow capacity Problematic Good Perceived Cloud Benefits Hardware refreshes Expensive Eliminate Maintenance Costs Expensive Unknown Data Migrations Complex, expensive Complex, expensive 10 Month Migration Window Expensive Unknown 7-10 Year image retention Expensive Unknown Retrieval latency Good Possibly negative 16

17 Why Faith Regional Explored Cloud Storage Requirements Traditional On-Prem Storage 17 Perceived Cloud Benefits HIPAA Compliant Compliant Unknown Retrieval latency Good Possibly negative Multi-site access Good but expensive Unknown Scalable capacity Expensive Good Reliable back up Problematic Unknown File Recovery Time Problematic Unknown IT complexity Problematic Unknown Disaster Recovery Expensive Unknown

18 Strategy Formulation: Organizational Process Faith Regional Overall cloud first strategy ARA Acute capacity issue: Mammo Tornado raised concerns Survey of client cloud policies IT annual planning: storage options Consult with clinicians Consult with department heads 18 Solve acute capacity pain

19 Polling Question: Who is using cloud storage for patient imaging today? 19

20 Polling Question Why is your organization NOT using the cloud for patient imaging? 1) Data security concerns: HIPAA/encryption 2) Institutional policy 3) Latency concerns 4) Not sure where to start 5) Data migration concerns 20

21 Answer Slide: Audience Polling Results 21

22 Austin Radiological Association Cloud Strategy 3X Proje ctions Ultrasound 3D Mammo Radiology PACS GROWTH SLA S 2D Mammo MRI Database Backups SIZE Doppler Studies CT Home Directories FREQUENT UPDATES Archived Patient Records RETENTION Marketing Media GROWTH 22

23 Strategy Results: ARA Requirements Traditional On-Prem Storage Pay as you grow capacity Problematic Good 23 Actual Cloud Experience Hardware refreshes Expensive Eliminated Maintenance Costs Expensive Lower Data Migrations Complex, expensive Complex, expensive Migration Window Lengthy Not lengthy 7-10 Year image retention Expensive Cost-effective Retrieval latency Low Workflow dependent

24 ARA Projected Savings (Back in 2014) Projected Five Year Cumulative Spend On-premise vs Cloud in 2014 $4,500, Source of cloud savings: Lower cost/tb vs. projections Additional benefits: Time to implementation Quick to scale Eliminate capital approval cycles $4,000, $3,500, $3,000, $2,500, $2,000, $1,500, $1,000, $500, $- On-premise vendor Cloud 2020 $782, $545, $790, $545, $814, $545, $868, $545, $922, $545, Source: ARA

25 ARA Actual Costs as of 2018 (and projected out) Overall storage costs rising: On-prem will require significant expansion But This requires overbuying upfront (hockey stick) Focused cloud strategy is acting as a brake on exploding image storage costs (pay as you grow) 25 $600,000 $500,000 $400,000 $300,000 $200,000 $100,000 $0 Total Storage Spend Cloud+On Prem (projected) Source: ARA 2019 (projected) 2020 (projected) Total storage spend On-premise vendor Cloud

26 File shares Faith Regional Health Services Cloud Strategy Parts of patient health records are unstructured Media and video files (marketing) Radiology (Dicom images) PAC system Cardiology images Pill cam shows pill being swallowed and processed through body 26 Sleep studies

27 Strategy Results: Faith Regional Requirements Traditional On- Prem Storage HIPAA Compliant Compliant Compliant Retrieval latency Good Good 27 Actual Cloud Experience Multi-site access Good but expensive Cost effective Scalable capacity Expensive Very good Reliable back up Problematic Very good File Recovery Time Problematic Very good Reduce IT complexity Problematic Good Disaster Recovery Expensive Cost effective

28 100% Faith Regional Cost of Ownership Analysis 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Cloud as a % of Total Storage Costs Back up and DR costs Operational Cloud Storage Capital Storage Budget Source: Faith Regional IT Department Actual Cloud vs. Capital StorageCosts Back up and DR costs Operational Cloud Storage Capital Storage Budget Source of cloud savings: Lower cost/tb Additional benefits: Eliminated DR expense Eliminated Back up expense

29 Comparing Approaches Requirements Acute subset of PACS images (ARA) Budget Reduced overall costs by 40-50% Cloud First (Faith) Cost Effective Service/Responsiven ess Required tuning; Cloud latency (1s delay) inhibited broader deployment Met all requirements Disaster Tolerance Embedded in cloud solution - Very cost effective Adaptability to changing technology Limited by SLA s 29 Embedded in cloud solution Very cost effective Extremely versatile

30 Lessons Learned Paul Involve business leaders Understand costs both TCO and ROI Impact on future strategic decisions Ensure cloud partner meets all security requirements Todd Understand impact to your Internet link Not all files are created equally Account for delays inherent in pulling files from cloud 30

31 Learning Objectives Classify unstructured data by type, importance to patient care, retention goals, and frequency of access requirements Evaluate multiple options including cloud-based and non-cloudbased, as part of putting together a comprehensive solution Compare approaches in terms of how they meet your organization's budget and service needs, and their ability to adapt to changing technology and unpredictable events 31

32 Thank You Paul Feilmeier Information Technology Director Faith Regional Health Services LinkedIN: Todd Thomas Chief Information Officer Austin Radiological Association MSO, LLC LinkedIN: 32

33 Questions? 33