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Peter B. Lange
Executive IT-Architect
Office of the CTO, Public Sector, IBM Europe




VNA for indexing & storing DICOM & non-DICOM objects
- A point-of-view from a CTO


UK Imaging Informatics Group – Birmingham November 6, 2012




                                                             © 2012 IBM Corporation
Hospital Environment Today
                         Tomorrow

       Radiology                          Cardiology               ..ologies         Other
                                                                                   Applications



         Vendor Neutral Archive
         Archive          Archive                                   Storage            Backup
    • DICOM archive                    • DICOM or non-                             • Non-DICOM
                                                                  • Non-DICOM
    • 50MB-2GB files                     DICOM                                     • Backup and
                                                                  • Little or no
    • First generation                 • Little or no               archiving        archiving
      obsolete                           archiving (DVD)                           • Small to very
                                                                  • Small files
    • “Closed” archives                • 500MB-1GB files                             large files
                                                                  • Dedicated
    • Archive dedicated                • Dedicated archive          storage        • Dedicated
      to each PACS                                                                   storage


     ••VNADifferent vendors, isolatedmedical content repository
     •       provides centralized archives
       • VNA provides centralized medical content repository
             Different vendors, isolated archives
     •• ‘Anytotoany’ access (controlled)
     • ‘AnyNo sharing of infrastructure
       •     No sharing of infrastructure
                  any’ access (controlled)
     •• Ensures compliance with sites privacy regulations
     •
     •
            No sharing of information base
       • Ensuressharing of information baseprivacy regulations
             No compliance with data
            May be located at different
                                        data
     •• Simplifies maintenance and reduces storage cost
       • Simplifies maintenance and sites
             May be located at different reduces storage cost
                                                                                         © 2012 IBM Corporation
2
VNA – Not just a digital dump ground



                                       Open and standards based


                                       Managed and structured


                                       Leverage information


                                       Scalable and secure



                                                              © 2012 IBM Corporation
3
What to look for when indexing in VNA. Become and stay vendor neutral.
Avoid VNA vendor lock-in, unlock DICOM content and secure future interoperability



                                                                                            Objects


                                     DICOM
                                                  Indexing
                                     Header                                VNA




                                                                                            Meta Data


Indexing                                Objects                           Meta Data
•   Automated                           •   Strip to the native format    • Decompose most of the header
•   Manage vendor specific headers      •   Follow open standards         • Make as mush header
•   Customizable                        •   JPEG, JFIF, PDF, MPEG etc       information available as possible
•   Configurable                        •   Avoid properitary formats     • Don’t loose any information
•   Rules driven                        •   True vendor neutral format      stored in the DICOM header
                                        •   Make available as non-DICOM   • Preserve integrity of DICOM obj

                                                                                               © 2012 IBM Corporation
4
What to look for when storing in VNA. Manage cost of ownership.
Manage the cost when the tsunami hits


    Hirachical Storage Mgmt                         De-dublication
    • Combine fast on-line with slower              • Automated detection and
      and less expensive near-line                    removal of dublicates
      and off-line (tape) storage                   • Policy driven removal of
    • Policy driven migration based                   intermediate versions
      e.g. on DICOM header
      information or class of
      information



    Other means                                     Retention & Disposition
    • Compression, even most native                 • Rules-based event-driven
      object formats already are                      retention and disposition
      compressed                                    • Not just age of study, but e.g.
                                                      events like ”patient turns 18 yrs”
                                                    • Meet regulations and at the
                                                      same time manage TCO
                                         VNA



                                                                         © 2012 IBM Corporation
5
VNA for non-DICOM objects. Interfaces are kings.


    WebDAV                             Java Cnt Repository (JCR)          CMIS
    • Older W3C standard originated    • J2EE standard initiated as       • Content Management
      in 1996                            JSR170 in 2003                     Interoperability Services
    • Based on HTTP                    • JCR 2.0 in the works from 2010   • Recent (2010) OASIS standard
    • Support is fading                  as JSR283                          backed by major vendors like
                                                                            Microsoft, IBM, ECM, Adobe
                                                                            and others




    File System Exchange               XDS                                Vendor specific adaptors
    • Vendor specific interfaces       • VNA shall be XDS repository      • Most VNA vendors provides
    • Often based on file pairs of     • Better more scalable security      interfaces and API toolkits for
      object and XML descriptor file     model than native VNA              on-line synchronous application
    • Async and batch oriented         • XDS-SD for scanned documents       integration
    • Can include parsing of e.g.      • XDS for HL7 CDA docs
      PDFs                             • XDR, XDM?




                                                                                               © 2012 IBM Corporation
6
VNA = Vendor Neutral Architecture?


    RIS/PACS                                Server Platform
    • Support a broad set of                •   CPU
      RIS/PACS and other diagnostic         •   32/64 bit
      imaging systems                       •   Multi-core
    • Easy configuration and                •   Form factor
      customization of interface




    Software Platform                       Storage Platform
    •   Operating System                    • Tiered storage
    •   Database                            • Network attached storage
    •   Application server
    •   Identity management
    •   Systems management
    •   Reporting
                                      VNA



                                                              © 2012 IBM Corporation
7
Complexity from the many choices


Business Goals
Grow top and
bottom line by:                    IT Reality
• Driving business                 Getting Up and Running
  innovation                       Takes months:
                                   • Specify/Design • Integrate
• Make new markets                 • Procure        • Deploy
• Respond to competitive
  threats                          Development Operations
• Enhance the customer             Takes 30-90 days:
  experience                       • Provision       • Configure

                                   Ongoing Effort
                                   Takes months and requires
                                   downtime:
                                   • Customize/Tune • Maintain
                                   • Scale          • Upgrade
                                   • Manage


                                                      © 2012 IBM Corporation
8
Delivery models

                        RIS/PACS


                  EMR




                        Power



     Appliances                    Cloud



                                       © 2012 IBM Corporation
9
© 2012 IBM Corporation
10
Backup Slides




                © 2012 IBM Corporation
Unlocking the value of information




     VNA                   Analytics and optimization
                           •   Performance Monitoring
                           •   Ressource optimization
                           •   Clinical Analytics
                           •   Decision support
                           •   Research
                                                        © 2012 IBM Corporation
12
Capture as process trigger for cross-disiplinary pathways




     VNA                   Process Management
                           •   Image as pathway trigger
                           •   Modeling
                           •   Monitoring
                           •   Simulation
                           •   Optimization
                                                            © 2012 IBM Corporation
13

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VNA for indexing & storing DICOM & non-DICOM objects

  • 1. Peter B. Lange Executive IT-Architect Office of the CTO, Public Sector, IBM Europe VNA for indexing & storing DICOM & non-DICOM objects - A point-of-view from a CTO UK Imaging Informatics Group – Birmingham November 6, 2012 © 2012 IBM Corporation
  • 2. Hospital Environment Today Tomorrow Radiology Cardiology ..ologies Other Applications Vendor Neutral Archive Archive Archive Storage Backup • DICOM archive • DICOM or non- • Non-DICOM • Non-DICOM • 50MB-2GB files DICOM • Backup and • Little or no • First generation • Little or no archiving archiving obsolete archiving (DVD) • Small to very • Small files • “Closed” archives • 500MB-1GB files large files • Dedicated • Archive dedicated • Dedicated archive storage • Dedicated to each PACS storage ••VNADifferent vendors, isolatedmedical content repository • provides centralized archives • VNA provides centralized medical content repository Different vendors, isolated archives •• ‘Anytotoany’ access (controlled) • ‘AnyNo sharing of infrastructure • No sharing of infrastructure any’ access (controlled) •• Ensures compliance with sites privacy regulations • • No sharing of information base • Ensuressharing of information baseprivacy regulations No compliance with data May be located at different data •• Simplifies maintenance and reduces storage cost • Simplifies maintenance and sites May be located at different reduces storage cost © 2012 IBM Corporation 2
  • 3. VNA – Not just a digital dump ground Open and standards based Managed and structured Leverage information Scalable and secure © 2012 IBM Corporation 3
  • 4. What to look for when indexing in VNA. Become and stay vendor neutral. Avoid VNA vendor lock-in, unlock DICOM content and secure future interoperability Objects DICOM Indexing Header VNA Meta Data Indexing Objects Meta Data • Automated • Strip to the native format • Decompose most of the header • Manage vendor specific headers • Follow open standards • Make as mush header • Customizable • JPEG, JFIF, PDF, MPEG etc information available as possible • Configurable • Avoid properitary formats • Don’t loose any information • Rules driven • True vendor neutral format stored in the DICOM header • Make available as non-DICOM • Preserve integrity of DICOM obj © 2012 IBM Corporation 4
  • 5. What to look for when storing in VNA. Manage cost of ownership. Manage the cost when the tsunami hits Hirachical Storage Mgmt De-dublication • Combine fast on-line with slower • Automated detection and and less expensive near-line removal of dublicates and off-line (tape) storage • Policy driven removal of • Policy driven migration based intermediate versions e.g. on DICOM header information or class of information Other means Retention & Disposition • Compression, even most native • Rules-based event-driven object formats already are retention and disposition compressed • Not just age of study, but e.g. events like ”patient turns 18 yrs” • Meet regulations and at the same time manage TCO VNA © 2012 IBM Corporation 5
  • 6. VNA for non-DICOM objects. Interfaces are kings. WebDAV Java Cnt Repository (JCR) CMIS • Older W3C standard originated • J2EE standard initiated as • Content Management in 1996 JSR170 in 2003 Interoperability Services • Based on HTTP • JCR 2.0 in the works from 2010 • Recent (2010) OASIS standard • Support is fading as JSR283 backed by major vendors like Microsoft, IBM, ECM, Adobe and others File System Exchange XDS Vendor specific adaptors • Vendor specific interfaces • VNA shall be XDS repository • Most VNA vendors provides • Often based on file pairs of • Better more scalable security interfaces and API toolkits for object and XML descriptor file model than native VNA on-line synchronous application • Async and batch oriented • XDS-SD for scanned documents integration • Can include parsing of e.g. • XDS for HL7 CDA docs PDFs • XDR, XDM? © 2012 IBM Corporation 6
  • 7. VNA = Vendor Neutral Architecture? RIS/PACS Server Platform • Support a broad set of • CPU RIS/PACS and other diagnostic • 32/64 bit imaging systems • Multi-core • Easy configuration and • Form factor customization of interface Software Platform Storage Platform • Operating System • Tiered storage • Database • Network attached storage • Application server • Identity management • Systems management • Reporting VNA © 2012 IBM Corporation 7
  • 8. Complexity from the many choices Business Goals Grow top and bottom line by: IT Reality • Driving business Getting Up and Running innovation Takes months: • Specify/Design • Integrate • Make new markets • Procure • Deploy • Respond to competitive threats Development Operations • Enhance the customer Takes 30-90 days: experience • Provision • Configure Ongoing Effort Takes months and requires downtime: • Customize/Tune • Maintain • Scale • Upgrade • Manage © 2012 IBM Corporation 8
  • 9. Delivery models RIS/PACS EMR Power Appliances Cloud © 2012 IBM Corporation 9
  • 10. © 2012 IBM Corporation 10
  • 11. Backup Slides © 2012 IBM Corporation
  • 12. Unlocking the value of information VNA Analytics and optimization • Performance Monitoring • Ressource optimization • Clinical Analytics • Decision support • Research © 2012 IBM Corporation 12
  • 13. Capture as process trigger for cross-disiplinary pathways VNA Process Management • Image as pathway trigger • Modeling • Monitoring • Simulation • Optimization © 2012 IBM Corporation 13