As any PACS administrator can attest, the cost of advanced imaging technology is higher than the price of a new CT or PET scanner. As the number of DICOM images attained per scan increases exponentially, software and hardware alike have a hard time keeping up with the load; no matter how powerful your PACS, without the back-end server power necessary to keep it running, you might as well be reading from a light box. That’s why tech-savvy hospitals are turning to a new solution that just might revolutionize the server room as we know it: virtualized server environments.
Scott Starkey, director of digital imaging for OhioHealth Information Services, Columbus, Ohio, is responsible for maintaining Synapse PACS (from Fujifilm Medical Systems USA Inc, Stamford, Conn) across five primary OhioHealth hospitals. “We’re about 2,000 beds, total,” he says. “We have more than 120 radiologists reading at all five sites. From OhioHealth facilities, the radiologists read remotely for a dozen other central Ohio hospitals.”
Starkey and his team began looking at the possibility of virtualizing as part of OhioHealth’s business-continuity and disaster-recovery strategy. “We had a stand-alone production system, and had the ability to recover from a disaster from both spinning disk and tape,” Starkey explains. “A few years ago, we had a human-error problem that led to extended downtime. A recovery time of zero wasn’t part of our initial strategy, so we worked with Fuji to implement a business-continuity solution. Working with a vendor to validate your strategy is critical.”
Just ask Reynold Yordy, business manager for Fujifilm’s Managed Services Division. Yordy was sold on virtualized server environments after hearing about a demonstration of virtualization software at a trade show. The software vendors demonstrated moving a server from one physical host to another while playing a video, showing how the video streamed continuously despite the shift. After that, Yordy and his team were sold.
There’s No Place Like Oz
It wasn’t quite as easy, though, as clicking their heels three times and landing in the virtualized environment of their dreams. Yordy and his team wanted to convert one of Fujifilm’s data centers—a remote image-archiving center for customers outsourcing storage—to a virtualized environment, but first they had to prove that the technology wouldn’t lead to server inefficiency and increased downtime.
"Moving into a virtual environment took considerable planning," Yordy notes. "We worked with each area of our organization to help them understand what virtualization was all about."
Now the remote-archiving data center runs on eight processing cores—but only four are physical processors. Virtualization cut Fujifilm's total cost of ownership by 50%. "At the end of the day, it was about the customer," Yordy says. "We could provide higher levels of service for our application at a competitive price."
Price was a key consideration for the team at OhioHealth as well. “It’s always an important initiative for anyone with a lot of hardware because of power requirements and physical environments,” Starkey says. “That’s germane to everybody. Servers cost a great deal of money, so there’s an economy of scale to virtualizing, but we’re looking more toward business continuity and disaster recovery. The perfect solution would be cost prohibitive, and that’s where virtualization really helps us.”
How does it work? Many of OhioHealth’s mission-critical servers—and 18 PACS servers—are now virtualized across a live remote second data center, where Starkey and his team replicated their SAN, redundant server farm, and redundant network infrastructure. “Now, if our data center suffers a major problem, we switch over to the remote data center,” he says. The physical servers are HP Blade units, virtualized using VMWare ESX; Starkey and the OhioHealth technical teams manage them using an ESX program called Virtual Center. “That allows us physically to move live operating servers between physical hardware, so if we start to see a hardware problem, we can move that virtual server,” Starkey explains.
OhioHealth is also beginning to virtualize the desktop end of its PACS, offering referring physicians the ability to read reports and view images via Synapse client. “We’re testing the use of VMWare and a virtual access suite to push out the client to referring physicians' workstations,” Starkey says. “Doing that for referring physicians will allow us