Archive for the ‘Healthcare’ Category

2D or 3D? Which do you prefer?

James Han

Sr. Business Development Manager-Healthcare at EMC²

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Digital Breast Tomosynthesis (DBT) is gaining traction as an ideal breast cancer screening tool.  Traditional mammography is a 2D image of the breast, and has been used as a standard screening tool for decades.  DBT improves on the 2D version by taking multiple images from different angles and creating a 3D representation of the breast.  The 3D representation allows physicians to view tissue from any angle and depth making it easier to identify lesions, giving the patient a more reliable diagnosis. Lesions can also be detected earlier, giving the patient an earlier start on treatment.  Recently, DBT received the support of the American College of Radiology and the FDA due to research showing its benefits over traditional mammography.

While this is great for patient care, IT staffs are going to be challenged with the explosive data growth.  Traditional mammograms are typically 30MB while a DBT is 350MB, representing over an eleven-fold increase.  In the US, there are about 39 million mammography procedures each year.  If just half of them were done using BDT, it would represent over 6,500 terabytes of data each year.  Overall healthcare data is growing at 48% a year (typically doubling their storage needs every two years); new technologies such as DBT are contributing to the growth.

EMC® Isilon® helps healthcare IT staffs cope with the growth due to its node based scale-out architecture and the simplicity of a single file system.  An IT staff can easily and quickly scale its storage infrastructure: simply plug in four cables, two power cords, and in about 60 seconds the resources of the new node are available.  There is no downtime or need to remap any application’s access to the storage. Seamless growth without downtime means no impact on patient care. That’s one of the reasons why seven out of the top ten US Best Hospitals for Gynecology use EMC Isilon.

Are you interested in hearing from our customers? Join us live on 2/23 with McKesson and Radiology Regional Center, as we discuss The Promises and Implications of Digital Breast Tomosyntheis and check out our Healthcare resource page.

Improving Healthcare Data Management with EMC Isilon – Think holistic, not in separated storage islands

The Data Growth Challenge in Healthcare

According to the EMC Digital Universe with Research & Analysis by IDC Healthcare[1] data growth is one of the fastest across many industries. A 48% annual growth rate will lead to 2,314 Exabytes of data in 2020.

Data Growth

Source: EMC Digital Universe with Research & Analysis by IDC

The reasons for this data growth rate are many and include new healthcare applications and regulatory / compliance challenges and continued introductions of new technology and equipment that incorporate data-intensive next generation diagnostics.

The growing data sets will enable healthcare providers to make quicker information-driven decisions, increase efficiency, support remote diagnostics, and provide better collaboration.

For Electronic Health Record (EHR), additional unstructured data such as voice, video, and text are now being stored. New diagnostic and other healthcare applications are also growing with increasing use of medical images and studies with larger images sizes. Or, the deployment of clinical next generation sequencing will contribute to the 48% annual growth rate in healthcare data.

All these data must comply with country and state regulations including long retention periods. Those regulatory compliance requirements are an additional key data growth driver.

Another challenge of data growth is finding the right data at the right time. Big Data analytics enables healthcare providers to focus in on data most useful for diagnostics, treatment, and discovery.

The Data Management Challenge in Healthcare

Factors that are forcing healthcare organizations to rethink their storage strategies include:

More data must be stored: Storage capacity requirements continue to grow significantly with the shift to data-intensive healthcare. As the number of storage devices increases, so too does the need of IT resources to maintain the infrastructure.

Inefficiency in storage capacity: In most healthcare organizations, storage is typically deployed and managed by diagnostic functions or departments and capacity is not shared between modalities. This may lead to spare capacity for one modality while others need to be upgraded continuously. With a siloed approach to storage, extra capacity cannot be shared, thus increasing CAPEX and OPEX cost.

Changing data retention requirements: Patient records, digital diagnostic images, and clinical study results are now stored for longer periods of time. Some data can move into a ‘cold archive’ while other healthcare data needs to be immediately accessible online

Merger and acquisitions are increasing. According to the latest analysis by Kaufmann Hall & Associates, LLC, the number of hospital transactions announced in 2015 grew 18 percent compared to 2014. Healthcare organizations now own multiple hospitals, clinics, long term care facilities, and physician practices across a large geography. It isn’t practical in all cases to maintain a central data center at all places and it makes sense to have smaller regional data stores that can tier to a centralized “data hub”.

Is there a better solution?

Over the last years, we’ve made a tremendous investment into a scale-out Network Attached Storage solution. EMC Isilon easily scales with a push of a button and with the same pace of the data growth. EMC Isilon can seamlessly scale on demand, enabling healthcare organizations to add Petabyte of storage or expand performance “on the fly”. Every Isilon cluster is a single pool of shared storage eliminating the need to deploy a storage silo for each modality or department. Last year we introduced the concept of a “Data Lake”, enabling healthcare organizations consolidate their data into a central data repository. Through the multi-access methods supporting different healthcare applications, organizations can store, access, share and even analyze the data stored in one location without the need to copy the data from one storage silo or infrastructure into another. If needed, different access zones and data encryption ensures data security and data separation without compromising the “Data Lake” concept.

Very recently EMC announced the “Data Lake 2.0” with the introduction of OneFS 8.0 providing capabilities to expand the “Data Lake” from the “edge” to the “core” (the centralized data repository) to the “cloud”.

IsilonSD Edge is a software-defined storage solution running on commodity hardware in a VMware environment. IsilonSD Edge expands the “Data Lake” into remote locations or departments with smaller data storage requirements. This capability provides great efficiency and cost advantages in particular for larger healthcare organizations owning multiple geographical distributed healthcare facilities.

EMC Isilon CloudPools enables healthcare organizations to tier data off their central (“core”) Isilon cluster to either a private in-house cloud based on EMC Elastic Cloud Storage (ECS) or another Isilon cluster or into a public cloud for archiving as older patient related data may need to be stored for the life of the patient. This cost effective extension of the “Data Lake” provides encryption capabilities for security purposes and compression to minimize storage capacity requirements and bandwidth usage.

The extended “Data Lake” is managed through one management interface and regardless where the data is stored the records are immediately accessible.

Better Healthcare Data Management

The combination of EMC Isilon hardware, OneFS 8.0, IsilonSD Edge, and Isilon CloudPools delivers the capabilities needed to meet the growing data challenges facing healthcare organizations today and tomorrow. Our aim is to provide healthcare organization a storage investment protection and reduced OPEX & CAPEX by providing a solution that scales on demand in line with the data growth rate across the organization.

[1] http://www.emc.com/analyst-report/digital-universe-healthcare-vertical-report-ar.pdf

Space Fury in a Med Rush for Information

Yasir Yousuff

Sr. Director, Global Geo Marketing at EMC Emerging Technologies Division

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7,000 to 8,000 patients a day. 1.89 million patients a year. All in a single 1,400-bed facility providing medical research, teaching and rehabilitation services. This is the Nanjing Children’s Hospital (NCH), the largest children’s medical facility in Jiangsu Province, China.

Doing the Right Thing Presents ChallengesHealthcare

If you caught Mad Max: Fury Road sometime in 2015, you could probably imagine what the situation would be like when desperate masses can’t get their immediate needs met. In the case of Mad Max, it was thousands of thirsty people deprived of water, a precious commodity held back by the evil cult leader, Immortan Joe, to control and keep them in constant disarray.

When someone enters with a medical emergency, the hospital has to find a way to treat the patient, even if the hospital can’t cope with the capacity. And for reason and one reason alone: because it’s the right, human thing to do. The good news is where human limitations await, technology opens doors.

Many hospitals like NCH rely heavily on a picture archiving and communication system (PACS) for x-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) scans. This system supports accurate and rapid diagnosis as well as treatment by radiologists and attending physicians.

One of the problems faced by NCH was how its existing storage, which supported both its PACS and Hospital Information System (HIS), could not keep up with the performance and capacity required to meet the demands associated with more advanced medical imaging technology.

A research paper titled Empowering Personalized Medicine with Big Data and Semantic Web Technology: Promises, Challenges, and Use Cases predicts by 2020, healthcare data will reach 25,000 petabytes, a 50-hold increase from 2012. As new medical devices are introduced to offer better treatment modalities to patients in hospitals, the demands of storing and accessing data will become more prevalent.

Making It Easier to Do the Right Thing

So what’s the solution? The flexibility of a single file system storage that makes it easy for physicians to search, archive and scale, when required.

In NCH’s context, EMC Isilon’s X200 Series scale-out storage was implemented as the platform for its PACS solution. It has not only enabled quick scalability, but maintains system performance as more users and files are added, speeding access to large numbers of recent and historical medical images and records.

Like how speed was critical to saving the lives of Max Rockatansky and Imperator Furiosa in Mad Max as they attempted to escape an entourage of villains, speedy access to information can also save the lives of patients. Every split second counts in medical treatment, sometimes making the difference between life and death.

“In the past, I didn’t want to add too many users to PACS because I knew it would affect the experience of the current users in the system,” says Sunnan Qian, IT Manager at NCH. “Now I can increase the number of PACS users as demand requires with the confidence that performance will be maintained, ensuring we provide our physicians with consistent, fast access to medical records.”

Read the Nanjing Children’s Hospital Case Study to learn more.

Silos Belong in the Scrapyard

Another hospital that has benefited from centralized storage is Tokushima University Hospital (TUH). As a university hospital responsible for providing health-care services to Japan’s Tokushima Prefecture, it has a legal requirement to store certain data and images for a period of time, meaning a greater need for long-term storage than a regular nonteaching hospital.

“Our Data volumes will continue to increase as we become more reliant on technology systems to support diagnosis and treatment,” says Ken’ichiro Shimai, Deputy Director, Medical IT Center, TUH. “New CT and MRI modalities mean huge volumes of image data, added to the images already produced by the cardiovascular, endoscopy, ultrasound, and surgery departments. There volumes of data are growing year-on-year.”

TUH’s IT infrastructure initially comprised between 70 to 100 silo systems, which made it difficult to access patient records easily.

Consider a car chase in Mad Max, and how the protagonists urgently need to reach for a weapon to shake the villains off their tail, but have no idea which car compartment it is in. Information, in the medical context, is a powerful weapon. The ease of accessing it greatly increases the chances of a patient’s survival.

After implementing a similar EMC Isilon X200 storage system, TUH has successfully moved away from its silo-based data systems onto one of centralized management and control, enabling all medical data to be digitized and stored centrally. This ensures patient records remain immediately accessible to medical personnel to assist them in prescribing the most appropriate treatment.

Read the Tokushima University Hospital to learn more.

Backup to the Future

In an article by Financial Times, it discusses how the ability to monitor health indicators constantly – through devices such as wearables – rather than periodically during check-ups can be considered new medicine. These constant data flows may yield insights that force physicians to rethink the way they treat their patients. It’s safe to say that the storage and interpretation of medical data will play an increasingly vital role over the next few years.

The Radiological Society of North America (RSNA) Annual Meeting 2015 — Summary Report

Sanjay Joshi

CTO, Healthcare & Life-Sciences at EMC
Sanjay Joshi is the Isilon CTO of Healthcare and Life Sciences at the EMC Emerging Technologies Division. Based in Seattle, Sanjay's 28+ year career has spanned the entire gamut of life-sciences and healthcare from clinical and biotechnology research to healthcare informatics to medical devices. His current focus is a systems view of Healthcare, Genomics and Proteomics for infrastructures and informatics. Recent experience has included information and instrument systems in Electronic Medical Records; Proteomics and Flow Cytometry; FDA and HIPAA validations; Lab Information Management Systems (LIMS); Translational Genomics research and Imaging. Sanjay holds a patent in multi-dimensional flow cytometry analytics. He began his career developing and building X-Ray machines. Sanjay was the recipient of a National Institutes of Health (NIH) Small Business Innovation Research (SBIR) grant and has been a consultant or co-Principal-Investigator on several NIH grants. He is actively involved in non-profit biotech networking and educational organizations in the Seattle area and beyond. Sanjay holds a Master of Biomedical Engineering from the University of New South Wales, Sydney and a Bachelor of Instrumentation Technology from Bangalore University. He has completed several medical school and PhD level courses.

Wilhelm Konrad Roentgen, Professor of Physics in Worzburg, Bavaria discovered X-Rays in 1895 by observing and deducing an accidental exposure of energy from his early design cathode ray tube onto a photographic plate. The first X-Ray was of his wife’s hand, shown below. X-Rays are one of the earliest great discoveries of the post-Renaissance age, even before E=mc2. Radiological Society of North America (RSNA) has been the definitive gathering place for the future of Radiology and Healthcare technology for as long as I can remember. X-Rays and its cousin spectra drive most of the new innovations in instrumentation, process and informatics.

XrayThe Western Roentgen Society, a predecessor of the RSNA, was founded in 1915 in St. Louis, Missouri. RSNA celebrated its centennial last year in Chicago (the anchor city for the conference for a long time). An interactive timeline of RSNA and Radiology events can be seen here.

I broke my almost 18-year attendance hiatus after my RSNA Associate membership acceptance this year; I started my career building X-Ray machines many, many moons ago and have worked in most Radiology modalities.

Technology Highlights:

The scale of the conference was impressive, as has always been. The Technical and Exhibition Hall was massive at the McCormick Place Conference Center in Chicago. With about 670 exhibitors (105 new exhibitors) and the “who’s who” anchors like Bayer, Canon, CareStream, FUJIFILM, GE, Hitachi, Hologic, McKesson, Philips, Samsung, Shimadzu, Siemens, Terarecon and Toshiba this year’s technology innovation highlights were:

  • GE 1.5 Tesla and 3 Tesla MRI (Magnetic Resonance Imaging) instrument with Total Digital Imaging (TDI) as well as CardioVascular Ultrasound systems with HDlive.
  • Siemens 3D Advanced Visualization software, Cloud-based imaging network and xSPECT (Single Proton Emission Computed Tomography) for bone scans along with the combination of MRI-PET and PET-CT modalities.
  • Virtual Reality (True3D), 3D printing, Human Connectome, Machine Learning and Deep Learning.
  • RSNA Image Share, a Provider and Patient service.
  • The maturing of Vendor Neutral Archives (VNA).

Plenary sessions:

On Monday November 30th, the “New Horizons Lecture: Redefining Innovation” was delivered by Jeffrey R. Immelt, Chairman and CEO of GE. Mr. Immelt made the point that GE was both in the instrumentation innovator (US$20B) and payor (US$2.5B) revenue streams in healthcare. He emphasized that improving the ecosystem (consumerism + access, chronic disease outcomes, lower cost and behavior changes) as well as sustaining innovation (neural MRI, decision support, image guided interventions, automated image analysis and productivity) were its guiding principles. Precision Medicine, integration of Radiology with Pathology, cell therapy using Bioprocessing, mobile technologies at global scale and analytics were the central innovation themes for GE.

On Tuesday, December 1st, Dr. James H. Thrall, Chairman Emeritus, Department of Radiology at Massachusetts General Hospital, delivered the “Annual Oration in Diagnostic Radiology: Trends and Developments Shaping the Future of Radiology”. He outlined three themes: imaging technologies, infrastructure and information/communications systems, and the application of the imaging correlates of precision medicine. Dr. Thrall presented a Venn diagram of all imaging modalities. The various inter-modal intersection sets were highlighted with specific mention of PET-CT-MRI and the work of Dr. Ge Wang and Omni-Tomography was highlighted as shown in the figure below:

Omni Tomography

Of particular note to me was the official entry of “Precision Medicine” into the RSNA lexicon. This is the first year I have heard of the term “RadioGenomics” and “RadiOmics” in a major conference (first mentioned by Andreassen et al in 2002). Dr. Thrall made it a point to mention shorter acquisition times and lower radiation dosage to the patient.

Dr. Ronald Arenson, RSNA President, introduced both plenary speakers.

Academic Sessions:

My focus for the 2015 Academic sessions was Informatics. Here are the condensed highlights:

Dr. Charles Kahn (U Penn) and Dr. Bradley Erickson (Mayo) led the inaugural “Year in Review” for Imaging Informatics. This session was jointly sponsored by RSNA, AMIA (American Medical Informatics Association) and SIIM (Society for Imaging Informatics in Medicine). The format was a dense, rapid-fire summary of key topics for 2015 as well as the seminal journal articles on various topics, which were the foci of other informatics sessions:

“The Text Information Extraction for Radiology Reporting” session presented techniques using NLP, Machine Learning and Deep Learning. A majority of radiologists would like to see structured reporting. The tools mentioned were OpenNLP, Mallet, cTAKES, eHOST, VINCI ChartReview and NCBO Annotator.

One of the more useful “hands-on” sessions that I attended was “Radio-Genomic Research: Accessing Clinical Imaging-Genomics-Pathology Data from Public Archives-The Cancer Imaging Archive” led by Dr. C. Carl Jaffe and Dr. Fred W. Prior. The Cancer Genome Atlas (TCGA) data portal is well known in the Genomics. The NIH has now created The Cancer Image Archive (TCIA) which has specific deidentified images for integrating Radiology with Genomics.

There was an entire morning session devoted to “Digital Information Security and Medical Imaging Equipment” which covered the instrumentation layers, protocols and regulations in some detail. It is interesting to note that Radiology Imaging client applications are still using OSx as the primary platform, with some “hands-on” sessions for DICOM not using other OSes at all. It is time for a web service based imaging application to come to the fore.

I strongly believe that integrating (and interoperating with) Radiology and Pathology phenotypic moieties into Genomics knowledge will be the real catalyst for the adoption of Genomics as an early clinical test (which is getting more complex by the month). Oh, and let’s not forget Proteomics. If multi-modal Radiology becomes reality soon (especially PET-CT-MRI), using biomarker-guided imaging, the data generated and the analytics required both grow exponentially. We are getting to that unified “Healthcare Data Lake” as shown below:

EMC Healthcare

RSNA is now one of the top two academic conferences in the United States (and maybe worldwide) with a 2014 attendance of about 57,000. The 2015 attendance dropped, with registered attendants numbering about 48,000 (as of this writing). Here is hoping for more radiologists, technologists, innovators and patient advocates for this year’s RSNA!

Stay warm and healthy!

 Author’s notes: The opinions expressed herein are my own and not necessarily those of EMC. Hyperlinks are embedded within specific words or phrases. Please contact me if you need details on any of the above topics.

 

Wal-Mart probably knows more about you than your doctor…

James Han

Sr. Business Development Manager-Healthcare at EMC²

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When you walk into a Wal-Mart, they likely know more about you than your local hospital. They know when and what you’ve purchased, your income, your family members, your political affiliation, and probably even the habitual route you take while walking through the store.  Like many other companies, Wal-Mart mines tons of big data to improve their marketing campaigns, sell more, and generally improve their bottom line.

Healthcare is behind in employing big data analytics tools. For example, when you go to the hospital or clinic, it is often treated as a single visit—you may even have to update all of your demographic information each time.  Your data is generally only important during your visit and is often archived immediately after your visit—essentially making it inaccessible for subsequent visits. What if healthcare could employ big data analytics to the level of commercial enterprises like Wal-Mart?

Let’s look at some statistics related to healthcare spending.  A 2012 report (of 2009 data) from the National Institute for Health Care Management (NIHCM) reveals that spending for healthcare services is extremely uneven—a small proportion of the population is responsible for a very high portion of spending. The study finds that the top 5% of spenders account for almost half of spending ($623 billion), and the top 1% of spenders account for over 20% of spending ($275 billion)[1] (See Figure).

Healthcare_1

It wouldn’t take much improvement in efficiency when dealing with that 1% of the population to make a substantial payoff. If trends could be identified, or procedures developed that would lower costs for those few utilizers to keep them healthier and lower their consumption the impact can be dramatic.

Unfortunately, many healthcare providers are still trying to figure out what data they need to perform the equivalent of Wal-Mart’s analytics. Or they have the data, but can’t figure out how to get it all in one place.

EMC Isilon can help. Isilon is in the business of big data—making big data analytics more cost-effective and—perhaps most importantly with respect to healthcare—easier to implement. Isilon provides the foundation for a scale-out data lake—a key capability that provides simplicity, agility, and efficiency to store and manage unstructured data. Starting with a scale-out data lake, healthcare organizations can:

  • Invest in the infrastructure they need today to get started today,
  • Realize the value of their data, store, process, and analyze it—in the most cost effective manner, and
  • Grow capabilities as needs grow in the future.

In short, EMC Isilon can help healthcare organizations get on the road to leveraging their data to improve patient comfort, lower costs, and streamline healthcare procedures.

 

 

Source: [1]“The Concentration of Healthcare Spending: NIHCM Foundation Data Brief July 2012” http://www.nihcm.org/component/content/article/326-publications-health-care-spending/679-the-concentration-of-health-care-spending

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