After four days of ravaging Jamaica, Cuba, and the Bahamas, Hurricane Sandy slammed into the New Jersey shoreline on October 29, 2012, resulting in losses of $30 billion to businesses in the affected area; damaging or destroying 346,000 homes; causing widespread power outages (some of which lasted for several weeks); and killing 37 people. Neither the popular seaside city of Cape May nor Cape Regional Medical Center (CRMC), a 240-bed community hospital in Cape May Courthouse, suffered damage from what turned out to be the deadliest, most destructive hurricane of the 2012 Atlantic hurricane season—and the second-costliest storm of its type in U.S. history.
The extent of Sandy (and the devastation that it wrought) significantly affected the medical center in another way, however. It propelled implementation of a comprehensive backup and disaster recovery solution to the top of the list of priorities, with Off-site Archiving/Disaster Recovery—a service offered by FUJIFILM Medical Systems USA, Inc, under its Synapse® Cloud Services umbrella—going live in August 2013.
CRMC serves a population of 100,000 year-round residents and several million visitors annually. Patients’ imaging needs are handled in-house and at Cape Radiology, a freestanding, hospital-owned imaging center located in nearby Rio Grande, New Jersey. Collectively, these entities perform 90,000 imaging procedures per year.
The hospital’s need for a new approach to disaster recovery had been a topic of discussion among its administrators and other constituents for approximately two or three years, until right before Sandy struck. Secondary copies of the hospital’s database, including images, had long been stored on a server in an off-site facility. The server was aging and had not been properly maintained; a loss of nodes frequently impeded access to necessary data.
Keith Babore, CRMC’s director of imaging services, says, “We knew we were on borrowed time with this solution, based on its age alone. It wasn’t even really a backup and disaster recovery solution, anyway. There had been no question that we were going to have to do something.”
That a new backup and disaster recovery plan was warranted, given the hospital’s coastal location, also did not escape notice. Bob Gates, technology manager, observes, “This area is very vulnerable to hurricanes. We weren’t confident in our ability to retrieve good copies of our images after any floodwaters receded.”
The Wake-up Call
Still, disaster recovery planning remained on the back burner—until Superstorm Sandy “put in a major wake-up call,” Babore states. “The eye of the storm passed right through an area near the hospital. Nearby towns were underwater; had we been in Seaside Heights or Long Beach Island, not that far to the north of Cape May—where the damage was unimaginable—we would have been in big trouble.” Approached shortly after the hurricane about the need for a viable backup and disaster recovery solution, CRMC’s senior leaders displayed what Babore and Gates describe as sticker shock.
To gain decision makers’ support, the hospital’s IT Steering Committee explained to them the consequences of not having a true backup and disaster recovery solution in place—especially in light of the area’s susceptibility to hurricanes, of predictions that changing weather patterns might lead to a higher incidence of storms, and of the unlikelihood of emerging from another storm after having suffered only a few minutes without power (as was the case during Hurricane Sandy). Potential consequences include interruptions in the provision and continuity of patient care, lack of access to prior studies for comparison with new images, and delays in (or the impossibility of) restoring electronic images following a disaster.
Once senior leaders were on board, a cross-functional group comprising radiologists, IT personnel, and imaging staff members convened to conduct roundtable discussions of what was needed in a backup and disaster recovery solution. Many of the same individuals had been involved in a previous effort to select a PACS; this resulted in the implementation of Fujifilm’s Synapse PACS. Radiologists, Gates says, emphasized that they wished the backup to be invisible to them—in other words, no different from the original format. He adds, “From the IT perspective, durability and ease of information access were important.” Other must-have features included rapid image turnaround and a high level