Digital Pathology
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Digital Pathology How Digital Imaging is transforming Pathology. Clinical Image Storage Archives & Distribution Enterprise Solutions for Medical Imaging. 1 x. Digital Slides 100 x. October 27, 2008. Richard S. Bakalar, M.D. Chief Medical Officer IBM Healthcare & Life Sciences. 200 x.

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October 27 2008

Digital PathologyHow Digital Imaging is transforming Pathology

Clinical Image Storage Archives & DistributionEnterprise Solutions for Medical Imaging

1 x

Digital

Slides

100 x

October 27, 2008

Richard S. Bakalar, M.D.

Chief Medical Officer

IBM Healthcare & Life Sciences

200 x


Agenda

Agenda

  • Global Healthcare Trends

  • Business Drivers for Innovation

  • Lessons Learned from Radiology

  • Enterprise Medical Content Storage

  • Q & A


October 27 2008

Distributed High-Throughput Analytics

Data and Systems Integration

Transformation of Medicine accelerated by a combination of revolutionary technologies and evolutionary practices

Personalized Health Care

Automated Systems

Lifetime Treatment

Pre-symptomatic Treatment

Cancer Diagnosis

Translational Medicine

Information Correlation

Revolutionary Technology

Molecular Medicine

Genetic Predisposition Testing

Clinical Genomics

1st Generation Diagnosis

Health Care Today

Digital Imaging

Episodic Treatment

Electronic Health Records

Artificial Expert Sys.

Non-specific (Treat Symptoms)

Organized

(Error Reduction)

Personalized

(Disease Prevention &

Targeted Treatment)

Evolutionary Practices


October 27 2008

More Data Over the Last 3 Years Than Previous 40,000 years Combined

Digital Pathology

Digital Radiology

E-Health Initiatives/Linkages

Electronic Medical Record

40,000 BCEcave paintings

bone tools

P e t a b y t e s

3500writing

Digital Cardiology

0 C.E.

paper 105

1450printing

1870

electricity, telephone

transistor 1947

computing 1950

Late 1960s

Internet

1993

The Web

1999

Source: UC Berkeley, School of Information Management and Systems.

2003


Use cases for digital slides today

Use Cases for Digital Slides Today

  • Real-time Integrated Patient Care

  • Post-Interpretation – Digital Repository

  • Referred External Studies – Digital Archive


Lessons learned from radiology

Lessons Learned from Radiology

  • Enterprise Solutions

    • Workflow, Capture, Display, Distribution and Storage

    • Information Technology Support and Sustainment

  • What is “thought flow” ?

    • Enhanced Decision Support

  • Digital Diagnostics on demand

    • Data Analytics – Automated CAD, 3D, and Image Fusion

  • Importance Clinical & Technical Standards

    • Quality Image Display

    • System interoperability

    • Clinical Reimbursement


Introduction why providers should care about infrastructure

IntroductionWhy providers should care about infrastructure

  • Speed - Configurable and Reliable Performance

    • Smart Caching and Data Backups

    • IT Support: Central Global Storage Dashboard for Dynamic System Administration

  • Collaboration - Flexible Scalability

    • Up, Down and across medical specialties

    • Respond to new data volumes & changes in clinical practice (i.e. CT/MRI protocols)

    • Diagnostics On Demand supporting Clinical Centers of Excellence

  • High Availability & Data Integrity

    • No scheduled downtimes

    • Automated data migration for hardware upgrades


Introduction what keeps the cio up at night

IntroductionWhat keeps the CIO up at night !

  • Affordable system uptime

  • Eliminate data loss

  • Scalable without service disruption

  • Automated data migration for storage and server hardware refresh

  • Automated disaster recovery


Medical imaging storage challenge

Medical Imaging Storage Challenge

  • “Always-On” Archive

    • Mission Critical - Clinical Performance

  • Reliable Data Integrity

  • Easy to Manage and Administer

  • Easy Migration to new hardware

  • Automated Recovery

  • Affordable and Scalable

Digital Pathology Slide

Over 1 GB with compression


Introduction

Utilization,

App Speed &

Scalability

Data Access,

Productivity &

Storage Utilization

Operating &

Mgmt Costs (TCO)

Introduction

Grids enable three IT functions:

  • Computation (PC & Server Grids)

    • Intra and Inter - organizational cycle sharing

    • Access to computing resources On Demand

  • Collaboration (Data Grids)

    • Data Virtualization, Federation & Sharing

    • Virtual Storage Pooling

  • Orchestration (Intelligent Provisioning)

    • Automated SLA management & provisioning

    • Improved Quality of Service & IT


Introduction why grid storage system

IntroductionWhy Grid Storage System?

Before Grid

After Grid

Site 3

Site 3

Site 1

Site 2

Site 1

Site 2

...

...

App 1

App 2

App 3

App 4

App 10

App 1

App 2

App 3

App 4

App 10

Grid Storage Platform

  • “Virtualized” Grid infrastructure:

  • Smaller, shared & more cost effective storage environment

  • Adaptive, self healing & self managing

  • High availability & speed

  • Enables infrastructure to be managed independent of the application

  • “Siloed” Traditional architecture:

    • Difficult & expensive to administer

    • Low utilization of hardware & storage

    • Vulnerable to failure and downtime

    • Bandwidth inefficient

      • Block level replication


Introduction pacs and imaging architecture

IntroductionPACS and Imaging Architecture

PACS Application

Study

Demographics and Metadata

Study

Images

Application

Infrastructure

Transactional Data

Fixed Content Data

Data Store

Data Store

Fixed Content Data hasunique & specific requirements


Three tier medical imaging architecture

Three Tier Medical Imaging Architecture

CIS

APPLICATION LAYER

e.g. Aperio Spectrum Plus,

Apollo PACS

Clinical Function

Image Access

IMAGE MGMT LAYER

e.g. AcuoMed, Teramedica Evercore

Aggregation &

Interoperability

Image Management Layer

STORAGE LAYER

Data Protection,

ILM

Replication,

Resiliency &

Speed

Grid

Storage

Management

System


Centralized management

Centralized Management

  • Web-based administration

    • Proactive monitoring

    • Fault detection & alerts

    • Real time and historical reports

  • Multi-tier and multi-site mgmt

    • Across all storage tiers

    • Enterprise wide

Single operational dashboard for medical image storage across the enterprise


October 27 2008

IBM Grid Medical Archive Solution (GMAS) – An enterprise platform that optimizes enterprise storage resources by leveraging automation, grid and virtualization features across all storage brands, tiers and locations

Grid Access Manager (GAM)

Grid Access Manager

Value Proposition:

  • Protects Data for Life: Digital signatures, Proactive Checking, No Data Loss

  • Enterprise Solution: All sites (LAN/WAN), All applications, All Storage Tiers and Competitive Storage

  • Improves Availability and Uptime

  • Automates Storage Data

  • Real time failover, automated rebuild, self healing

  • Challenges:

  • Affordable system uptime

  • Eliminate data loss

  • Ensure data integrity

  • Scalable without service disruption

  • Automated data migration for storage and server hardware refresh

  • Automated disaster recovery


October 27 2008

Real World Case Studies


October 27 2008

Videoclip in Bob Thompson’s own words:

http://in.youtube.com/watch?v=p3k17RAs2OM


October 27 2008

Radiology

Digital Pathology

Cardiology

AcuoMed Image Manager

IBM GMAS Storage Manager

Configuration Architecture

Aperio Spectrum

Acuo Workflow

Cache

Other

Radiology

Fixed Content

Acuo DSG Server

PACS Server

Migration Server

Server

GMAS

Virtualized & Automated

Smart File System

HA Gateway

ControlNode

Administrative

Node

LAN

WAN

/

Tape

StorageNode

1

StorageNode

2

ArchiveNode

TSM Server

Library

Main Datacenter

Norristown Datacenter

The Children’s Hospital of Philadelphia


Ibm medical grid archive for digital pathology

IBM Medical GRID Archive for Digital Pathology

100101000110111000101010101001011010

100101000110111000101010101001011010

Transparent Actions Performed by the GRID

  • Each file is protected with digital fingerprint

  • Validated on access, replication and rebuild

  • Proactively verified in background

  • Corrupted files are quarantined and replaced with a known good file

  • Grid is both content-aware and resource-aware

Aperio Spectrum Application

Dual Read/Write

4 TB DAS

CIFS mount protocol

TCP/IP NAS attachment

2 TB Cache in GMAS Gateway Node

GMAS

Storage

Node #1

Storage

Node #2

SATA

Disk

SATA

Disk

19

The Children’s Hospital of Philadelphia


Summary

Summary

  • Healthcare has unique and challenging storage and information integration requirements

  • Traditional approaches are not scalable, affordable and reliable

Enterprise proven technology with proven results


Thank you questions and answers

Thank You !Questions and Answers


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