Explosive growth in digital images
In 2009, in France alone, over 61 million x-ray examinations generated 5 Petabytes of data. The growing number of images taken in each x-ray, increasing use of new imaging technologies such as scanners and MRI, and new kinds of non x-ray images mean that data is increasing drastically. What’s more, in the space of just a few years medical imaging has moved on from being a collection of innovative techniques, to a separate department that supports both clinicians and patients. From storage via distribution to archiving, effective management of the entire medical imaging lifecycle has become a concern in its own right. Another major development is that the geographic way in which care is organized now means that clinical information needs to be shared outside the confines of the hospital.
Up to now, the PACS (Picture Archiving Communications System) has provided individual establishments with the imaging workflow functions they needed, including preserving and distributing images. But these days new possibilities are opening up, with the separation of functions into the production of x-ray images on the one hand and interactive archiving on the other.
The changing face of archiving at Nancy University Hospital: patient-centered image sharing, local image sharing and intelligent lifecycle management of content
In 2003, Nancy University Hospital (the Centre Hospitalier Universitaire de Nancy or Nancy CHU) implemented a PACS that is now somewhat obsolescent. The hospital was keen to improve the overall performance of its data storage and archiving, which is expected to grow to almost 24 Terabytes a year by 2014. So it decided to embark on a new approach, marking a further step in its progress, to introduce ‘neutral archiving’, independent of its PACS solution. This represents a significant functional development, setting the Hospital firmly on the road to full-scale information lifecycle management (ILM).
In real terms, storage functions for data coming out of the PACS are separated from archiving functions, which are often more costly and complex. This is an innovative concept, supported by a national deliberation process: all the archives are hosted on an independent platform, crossing all the Hospital’s activities, which can also incorporate the archives of other establishments in a spirit of pooling resources. The Alexis Vautrin Center for cancer diagnosis, treatment and research, is an integral part of the project, and in the future a number of the Hospital’s other partners are planning to connect to the system. Data archiving can extend to all kinds of applications and information that is already computerized or could be in the future (documents to be scanned, digitizing anapathology slides…). As a result, archiving becomes a universal, neutral resource that provides guaranteed access to data no matter what storage system is chosen or how it evolves.
So whereas it typically takes between 24 and 48 hours to put together all the information for a particular patient, the new platform will give clinicians real-time access to all the relevant images, with no need for technical help to do so. Files are put together more quickly, providing a richer wealth of information and avoiding the need for multiple repeated or unnecessary examinations… benefiting everyone concerned!
Bull and EMC join forces to deliver the first ‘neutral archiving’ project in the French hospital sector.
With its in-depth understanding of the hospital environment, technological expertise and knowledge of running large-scale integration projects Bull – along with its partner – was chosen to integrate the chosen functional solution EMC OSA, put in place the appropriate infrastructure and support the Hospital in its innovative approach.
The project is based around a solution developed by EMC: Open Systems Archive for HealthCare (OSA). It incorporates high-performance components including a Web-based multi-media visualizer featuring complete medical imaging functions. OSA has received IHE certification (DICOM, HL7 and XDS / XDS-i) and has been chosen by a number of major European hospitals, most notably in Belgium and the Netherlands. It consists of three modules:
- Health Care Connector, which connects the archiving system with PACS, radiology and hospital information systems
- Documentum, the content management system, which supports operational systems and can integrate all content management processes to ensure they meet data conservation, security, confidentiality and integrity regulations
- SMooTH PatientViewer, a web-based multi-media visualization module, used especially in this project for images and summary reports. It offers clinicians and radiographers a full range of search and interactive consultation functions.
OSA is based around state-of-the-art technologies, whilst also guaranteeing long-term stability, for example by using VMware for server virtualization and a pure HTML5 browser on the user workstation.
Rapid implementation, with a long-term outlook
Bull was able to bring together the right skills and create a highly structured project organization to ensure perfect collaboration between EMC, the publisher of OSA, and the business teams at Nancy CHU. “Our project is a pioneering one, with tough requirements in terms of performance, simplicity and scalability,” explains Pascale Bastien-Kere, Information Systems Director at CHU Nancy. “The combination of companies such as Bull and EMC creates real value for us. Under Bull’s auspices, their cutting edge expertise has been pooled to define an innovative and scalable solution that meets our clinicians’ needs. Such contributions are essential in meeting a challenge like this.” The first workgroups including representatives from the Hospital, met at the end of December 2010 and the project is due to go live before the end of 2011.
The scalability of the components being used is already opening up new possibilities for future developments, such as probative value archiving, archiving of non-radiological documents and the inclusion of new health sector partners in a spirit of resource sharing and in line with the logic of the French single electronic patient record initiative, the DMP. It is clearly positioning the Nancy University Hospital as a pioneering user of new technologies to enhance the performance of healthcare information systems.