Preparing for the Worst

Disaster recovery solutions keep hospitals
Maureen Leahy


November 17, 2006
A locally installed ImageGrid 1000 and a remote ImageGrid 1000DR work together to provide an image management and disaster recovery solution.

What doesn’t kill us, so the saying goes, makes us stronger. Those of us lucky enough to walk away from tragedy with our lives intact — for the most part — have undoubtedly learned important lessons not only about our own mortality but also the most basic human instinct: survival. And in today’s times of crises especially, we’ve learned the key to survival rests largely on preparedness and the recovery processes that follow.

The tragedies of 9/11 and Hurricane Katrina sounded emergency preparedness wake-up calls not only for big city and Gulf Coast hospitals, but healthcare facilities across the country. On the Coast, where hurricane season lasts from June 1 through Nov. 30, most, if not all, hospitals have comprehensive disaster recovery plans that are continually under review; yet some facilities were nearly paralyzed simply by the tremendous loss of communication Katrina caused. In order to avoid future interruption of critical processes and communication, facilities nationwide have since stepped up their procedures and are implementing new practices to ensure continuous patient care and access to vital patient information.

So how does a hospital embark upon — and succeed at — such an enormous undertaking?

Ideally, it starts with department representatives working together to determine the facility’s functional needs during a disaster, which in turn leads to the search for internal and external solutions that will support those needs. Unfortunately, the formation of an effective, enterprise-wide disaster recovery plan is not a one-stop shopping expedition — solutions from different vendors crossing several disciplines may be required. There are software, hardware, telecommunication, equipment, supplies, manpower requirements and more to consider. And with the push toward an electronic medical record, standards-based solutions designed to support a digital healthcare environment, as well as HIPAA regulations to satisfy, the task can be daunting; however, it is not insurmountable.

At least that’s been the case for Pacific Coast Cardiology (PCC) in Newport Beach, CA. At the backbone of the two-facility practice’s recovery plan is the ImageGrid 1000 from Candelis Inc., which adds additional layers of redundancy to the practice’s 15,000 annual studies. The server appliance provides automated, rule-based and secure routing of DICOM images as well as advanced replication features that meet HIPAA’s off-site patient record retention guidelines.

“We chose the ImageGrid 1000 for its archive durability, tremendous uptime and reliability and phenomenal PACS interface,” explained Josh Baker, director of IT. “We also wanted something that was easy to administer, cost effective, preferably Web based and had the automatic remote HIPAA-compliant off-site replications,” said Baker.

The facility produces enormous CT angio studies — sometimes up to 4,000 slices. The 6TB ImageGrid 1000 met PCC’s requirements for an expandable disc-based solution, high-performance back-up archive and DICOM interface that can interact with every modality and workstation.

In order for clinicians to provide the best healthcare possible, medical images must be readily available to them at all times.

“The ImageGrid 1000 appliance automatically replicates images to our Dynamic Imaging IntegradWeb product for real-time viewing anywhere an Internet connection exists. This allows our referring physicians to see their patient studies just moments after scanning is complete,” said Baker.

Facilities, such as the Oschner Clinic in New Orleans, are similarly pleased with the Remote Archive Solution from Heartlab, which, according to the company, can backup multiple types of large-scale storage systems, resulting in zero downtime. The solution was repeatedly put to the test during last year’s hurricane season and performed seamlessly, said Andreas Rubiano, director of Cardiology Informatics.

Remote Archive stores the HIPAA-compliant patient data backup on industry-standard, DICOM-compliant DVD-R media and goes a step further than standard recovery solutions by providing immediate access — even during a system outage — to the backup data, ensuring that physicians always have access to prior exams.

The road to a comprehensive disaster recovery plan may have its share of twists and turns, but when reminded of the alternatives, facilities soon realize the payoff is worthwhile. Thanks to the procedures and solutions involved, and the dedicated individuals who implement them, more and more facilities are equipped to weather the storms man or nature may dish out.


Disaster Management Resources
In order to execute an effective, enterprise-wide disaster recovery plan hospitals must do more than choose the right vendor solutions. The following federal agency and medical association Web sites offer important advice and resources for facilities that are serious about arming themselves with the latest in emergency preparedness/disaster recovery knowledge.
Society of Critical Care Medicine (SCCM) —
• Fundamentals of Disaster Management — originally published in 2003, this handbook is continuously updated to provide the latest guidance in strategizing treatment and flow of disaster victims, designating command centers, streamlining media communication, patient transport and more
• Hospital Mass-Casualty Disaster Management (HDM) — designed for those who may not have extensive experience handling critically injured patients, this course also addresses follow-up care
• Fundamentals of Disaster Management (FDM) — a standardized one-day course that helps equips healthcare professionals with the knowledge and expertise needed to manage large-scale disasters
• Critical Care Preparedness Workgroup — developed by SCCM in conjunction with the Center of Biosecurity of the University of Pittsburgh Medical Center, the Working Group on Emergency Mass Critical Care focuses on delivery of critical care services following a bioterrorist attack or large-scale epidemic
American Hospital Association (AHA) —
Members can log in and click on Issues » Emergency Readiness for the latest tips and recommendations
Centers for Disease Control and Prevention (CDC) —
Agency for Healthcare Research and Quality (AHRQ) —
U.S. Department of Health and Human Services —