Information Infrastructure

Serves up Scalable, User-Friendly Archive that Boosts Clinical Productivity

More than 1,700 healthcare organizations have installed the EMC Centera content-addressed storage infrastructure from EMC Corporation with good reason. Healthcare organizations are moving from silos of records to consolidated views of all patient information for accelerated service delivery, faster and more accurate billing, and lower operating costs. EMC Centera is a proven archiving platform with online access and assured authenticity, self-management, protection from technology obsolescence, and much more. With so much available in one system from one vendor, healthcare organizations are assured of data integrity, regulatory compliance, the best overall cost of ownership, and business continuity.

With 21,000 employees and 2,200 physicians, Fraser Health Authority in British Columbia, Canada, is one of the country’s largest and fastest growing health authorities. Fraser provides care for 1.5 million people in its 12 acute-care hospitals as well as home health, mental health, and public health services. The authority operates with an annual budget of $1.9 billion.

An early adopter

The implementation of a new PACS five years ago led to the need for a more sophisticated, leading edge storage solution. Fraser elected to invest in EMC Centera content-addressed storage (CAS), becoming an early adopter of the EMC Centera archiving platform and replacing its tape library system. By implementing PACS, “we were going to a new application that would generate significant data to be archived that we couldn’t manage in a tape environment,” says James Pink, manager of technical support and operations.

EMC has been Fraser’s strategic partner for storage for many years. Five years ago EMC was the only vendor that had a content-addressed storage system. Pink says they are currently storing about 240 terabytes (TB) of data in two EMC Centera units. Their volume is growing at about 10 terabytes a year. But, “that’s only with our initial PACS implementation,” Pink says. “We’re looking at expanding our whole archiving infrastructure to other applications. It’s going to grow a lot more.”

Right now, the organization’s PACS implementation includes a range of basic imaging modalities, including CT scanners, but the volume is expanding at a phenomenal rate, he adds.

One EMC Centera is primary; the other is secondary, and both are housed in different data centers. “We’ve done testing to be able to flip over the applications from one to the other,” says Pink. He recently went through a refresh of the EMC Centera systems—moving the data from one to the other—which went fine, he reports. “I have a good comfort level that the data will be there when we ask for the data. We go through the validation process at least once a year to make sure that the data the application thinks are there exists and are retrievable.”

Self-healing and scalable

One of the benefits of EMC Centera is its self-healing capabilities. If archiving issues occur, EMC Centera detects and resolves them, which is a huge benefit for us, Pink says. He also appreciates the system’s ability to enforce regulatory requirements for retention policies which ensures that data are not accidentally deleted and being single instance storage dramatically reduces the amount of storage required to retain images. “If I wrote the same file to the EMC Centera, it only keeps one copy of it, but I have two pointers to it,” explains Pink.

At Fraser, cardiology patient information is retained on short-term storage for 90 days, and PACS information for six months. With EMC Centera, Pink has been able to eliminate many costs associated with information backup. Less short-term storage translates to reduced backup windows and less tape media to purchase. Plus, online archiving makes all PACS and cardiology information immediately accessible.

EMC Centera is easy to scale and manage. Pink can simply add more storage capacity as needed. “At some point, we will look at carving off from multiple units to one or two large units. We are working with EMC on where and when it makes sense to do that.”

Data protection

Data storage at Bloomington Hospital in Bloomington, Ind., is growing at 8.2 TB a year, which requires almost annual expansions, says Business Continuity/Disaster Recovery Network Engineer Brian Bourkland.

After deploying a new PACS, the hospital decided to implement EMC Centera as its archival storage solution. One of the best aspects of the EMC Centera, Bourkland says, is that archived information becomes immutable—it cannot be changed. EMC Centera fully protects the authenticity and security of archived information by applying a hash algorithm to every file. If someone were to change even one character, the system recognizes that change and saves it as a new object. “There’s no way to alter anything,” he says. “When you’re talking about a legal medical record that contains someone’s PACS images, that’s an excellent way to archive that information.”

Bourkland has heard of organizations creating homegrown solutions. However, he doesn’t believe those solutions approach the level of protection offered by EMC Centera. “I think the product is the best design for archiving data that is in a fixed state; that is, the data are in final form. You wouldn’t want to use an EMC Centera like you would a SAN, but if you need to archive fixed content, you need a solution that no one in the organization can circumvent. EMC Centera provides this level of protection.”

Another benefit of EMC Centera is that users can set up governance parameters to help comply with HIPAA and Sarbane-Oxley regulations.

Before implementing EMC Centera, Bloomington was using an optical platter-based archive solution. EMC Centera is comprised of a redundant array of independent disk-based nodes. Nodes contain a processor, memory, and four disk drives with a capacity of 750 GB each in the Gen4LP model. EMC Centera’s performance has effectively put an end to complaints about the length of time it takes to retrieve an archived medical record.

Bourkland says the EMC Centera is a more effective archive solution for today’s healthcare environment. Physicians can access patient data within the hospital or remotely through Bloomington’s SSL VPN, which they really appreciate.

Bourkland notes that EMC Centera is easy to manage and significantly lowers system management activities and costs. The systems can intelligently dial into EMC and call for onsite repair, if necessary. EMC also offers a console that will run analyses as desired, or the facility can run reports onsite. These features, along with source and target EMC Centera systems for disaster recovery, put Bloomington in a comfortable position for data integrity and business continuity. The source EMC Centera replicates to the target. Each system is located in a separate data center. “If we lost a data center with one of the EMC Centera systems, we can connect to the other and resume production. Once the one that was lost is restored, they will automatically synchronize with each other.”

Hungry technologies

Exempla Healthcare, a three-hospital healthcare system headquartered in Denver, has 7,000 employees and more than 2,100 physicians. The organization replaced six storage devices from another vendor with three EMC CLARiiONs and four EMC Centera systems. Exempla had reached its storage capacity with the previous devices.

“EMC helped us analyze our current storage consumption, growth, and growth needs,” says David Pecoraro, chief information officer. To upgrade the previous system to meet its needs would have cost Exempla 30 percent more than the EMC solution.

That made “the sell” to administration pretty easy, says Pecoraro. “This [solution] has much more potential. It was a complete financial sell. It was a no-brainer.”

The organization currently is storing 135 TB and has a growth curve of about 20 TB a year. However, “we’re growing at a growing rate,” says Lots Pook, chief technical officer. A growth consumption rate calculated in February 2007 already is out of date, he says. The plans were intended to get Exempla through 2010, but storage capacity will have to increase before that time.

“Medical technologies are pretty hungry for storage space,” says Pecoraro. New advances make storage capacity a moving target that forces changes in storage requirements. Plus, purchasing decisions are made that impact storage needs. For example, one Exempla hospital will be bringing on an additional MR machine this year. “In February, 2007, we had no idea they were going to do that,” says Pecoraro.

Those ongoing changes make scalability pretty important, Pook says. “The ability to respond to the unexpected is key.”

Like Fraser, EMC Centera’s self-healing capabilities have been helpful to Exempla, particularly to the patient financial team. Before EMC Centera, the group experienced outages that would increase accounts receivable times. Now, the organization’s controller has noticed that the patient financial information has been much more stable.

“Reliability is valuable and important,” says Pecoraro. “These are mission-critical applications we’re putting on these SANs that need to be up 24 hours a day, seven days a week. We have got to use equipment that is highly reliable.”

Before the implementation of EMC Centera, Pook was considering requesting an additional SAN administrator. “EMC has much better storage management. I no longer feel the need for an additional FTE.” The existing SAN administrator leads a more comfortable life now, he adds. EMC Centera is much more integrated than the past system and the administrator has one graphical user interface (GUI) he uses to manage the entire EMC environment. “It’s much more user-friendly.”

For its disaster recovery strategy, Exempla has three data centers—one at each hospital. Each hospital’s data are replicated at one of the other hospitals. “We’re comfortable with how we’ve set up that replication scheme,” says Pecoraro. A fourth EMC Centera replicates all three hospitals’ data. Exempla has plans in place to build a fourth data center this year.

Advice from the field

Managing information infrastructure in the healthcare industry has long been a challenge. “Healthcare has never been funded for disaster recovery or business continuity,” says Pink.

“We’re challenged with access to capital for medical technology which competes with the disaster recovery and redundancy that other industries have come to expect,” says Pecoraro. “We’re making good headway in healthcare with clinical information systems and the paradigm is shifting from paper and pencil to digital. As that occurs, the industry is going to have to address this issue of disaster recovery and redundancy and fail-safe technology. I think we are making progress.”

Addressing issues such as these are the reasons so many healthcare organizations have chosen EMC Centera. These organizations leverage EMC Centera to ensure the authenticity of their medical information, provide immediate access to the information, and implement all the protection and replication safeguards necessary to meet their challenging needs. As the archiving storage platform for their information infrastructure, EMC Centera has demonstrated a proven track record helping healthcare organizations to cost effectively support care decisions, improve operational efficiencies, and pinpoint best practice care patterns that improve healthcare outcomes.