The First Affiliated Hospital Builds Medical Image Cloud

Overview

Challenge

• Maintain hospital’s data quality amid increasing amounts of data and equipment.

Solution

• Hitachi Data Ingestor, Hitachi Content Platform.

Outcomes

• Improved the daily reading speed for imaging by first-line doctors.
• Gained sufficient image data storage with elastic expansion capacity.
• Provided online access to the hospital’s historical image data.
• Delivered backup-free reliability for long-term protection of image data.

The First Affiliated Hospital uses data for internet healthcare and manages medical image files.

The Challenge: Store, Manage and Access Data, and Preserve Data Without Loss

The First Affiliated Hospital, Zhejiang University, is a large 3-A hospital (3-A hospitals are the top-tier hospitals in China based on their ability to provide care, medical education, and medical research). As the hospital increased its inventory of medical equipment and multiplied its medical images’ pixels, its PACS (picture archiving and communication system) data was growing at a rate in the range of 30% to 40% annually. Based on the existing 260 TB image data in 2018, the hospital's PACS image data is predicted to reach up to 1000TB by 2023.

Managing this near petabyte of image data had become one of biggest challenges for the hospital’s IT department. The hospital requires its IT department to permanently retain image data to meet future uses for patient information, or for such activities as consultation, research, statistics, etc. Therefore, they did not have the option of deleting stored images in order to free storage space. Another factor is that doctors need to quickly access recent images during their ward rounds and consultations. And for long-term, chronically ill patients, doctors need to quickly access historical images.

The hospital’s PACS system was also experiencing performance problems. Doctors said that image access was slow during the hospital-ward rounds every morning. In addition, the PACS space on the storage devices was insufficient. To save online space, the PACS software moves the data of a dozen of days earlier from FC hard disks to low-speed SATA hard disks every day. It is worth noting that the PACS software needs to read and write the offline hard disks every day, an operation managed by specialists from a PACS software company. In the past, the offline storage media for data consisted of compact discs (4.7 GB), with more than 10,000 discs in one room, very inconvenient to retrieve. Now, it is much more convenient to use a 2TB hard drive.

When data recall is required, it is not easy to use CD-ROM archives. It is very difficult to identify a normal and readable CD from a large pile of discs in a room and then to read data from it. Although offline hard disk archiving is slightly better, such archiving may fail due to errors in the software formats when the PACS software or the archiving software’s modules are upgraded.

The hospital encountered the following issues with PACS software.

• PACS software errors can lead to unsuccessful archiving, especially during software upgrades.
• The software has a relatively low efficiency for archiving, because the data needs to be read into the PACS server and then written to storage, rather than directly written from high-speed disks to low-speed ones, or when directly moving images to offline CDs or hard disks.
• Retrieval of offline data has high failure risk.

Many large hospitals have gradually abandoned this traditional storage method because it is not possible to completely solve its disadvantages simply by expanding storage or replacing storage devices with those that have larger capacity. Three major challenges continue to exist: 1) Low system performance, 2) Low cost performance of mass data storage, and 3) Massive data protection. What the PACS system needs is to adopt a new storage architecture to cope with these three challenges.

The Solution: Improved Access, Backup and Protection of Image Data

The hospital needs 2,000 report-reading clients and nearly 100 PACS devices in total, able to perform online read/write of PACS storage. It needs to deploy high-performance Hitachi Data Ingestor (HDI) file processors, configured with 70 TB flash storage capacity for nearly one year’s data. A 2000MB/s throughput online storage system can easily meet 50% of the concurrent read/write requirements. In addition, the flash space configured by Hitachi Vantara provides the fastest storage response speed. For example, for smaller CT-generated 512 KB files, the accessing time has been cut from one minute previously to a few seconds; and for larger radiography-generated 500 MB files, the accessing time has been cut from a half an hour to seconds (in a 10 gigabit network), ultimately improving the image-reading speeds for the hospital’s leaders and doctors.

By using the underlying storage replication function, the system can replicate the high-performance HDI flash storage to the massive image storage capacity of Hitachi Content Platform (HCP) every day. A set of 12 months of image data is stored in the online HDI and the online archive HCP. The strategy is that HDI will delete the originals of images older than 12 months, thus saving the online high-speed storage space. Only the image files’ pointers to HCP are retained for online callback of archived images. This enables efficient and automatic hardware archiving and online access to archived images.

HCP is a customized object storage platform for massive image files. This platform can be expanded online to nearly 800 PB available storage space. The images written to HCP are protected by WORM, automatic image data double-writing, file self-healing and other functions, avoiding damage to image files caused by accidental deletions or software errors. HCP has patented EC (erasure code) that allows simultaneous damage to six hard disks without losing data, thereby avoiding data loss caused by physical faults. HCP’s active-active and multiple-active features can easily be implemented for disaster protection. Massive image data thus can be archived and stored online in a cost-effective manner, and backup-free data protection can be realized for all physical and logical failure scenarios.

The Outcome: Enhanced Data Accessibility, Reduced Costs for Data Retention

After the upgrade and renovation of the PACS system, the hospital replaced its old-fashioned storage architecture with a new one that delivered the following benefits:

• Faster Access Speed: After storing the latest images in high-speed NAS storage, which can take advantage of more powerful file processing performance and be configured with a proper amount of flash hard disks, doctors improved their image-accessing speeds.
• Online Archiving: The images generated each day can be automatically replicated to the image archiving platform through the underlying storage, without the need for the archiving functions of the PACS software, thereby not affecting the performance of the PACS server nor requiring manual intervention for archiving. More importantly, now the archiving is operational 24x7 and can be accessed online at any time. This system architecture is what the hospital’s PACS system needed.
• Better Protection of PACS Images: The image archiving platforms does not use common SAN or NAS storage, but instead uses object storage specifically designed for massive amounts of unstructured data.

Partner

Jiangsu Zhenbang Smart City Information System Co., Ltd. is committed to information management for China's medical and health industry. Wholly owned by Huanya Medical Technology Group, it has R&D centers in Changzhou, Beijing, Guangzhou and Ningbo. The company provides advanced management consulting, solutions, information software and services for customers in the medical and health field. Engaged in overall planning, software R&D, system integration, operation/maintenance services and standard system establishment, it focuses on building smart regional medical and digital hospital information systems, and has become China's leading provider of comprehensive smart healthcare solutions.