What really happened
Sectra had just successfully executed the first PACS delta migration in the United States of this size, requiring no downtime on the servers; UH required only 15 minutes to direct their users to the new system. Most users in the hospital network had no idea that their entire PACS had just been upgraded and migrated from physical Unix servers to virtual Windows servers. UH PACS Manager Beverly Rosipko commented, “If PACS ever experiences a blip, everyone notices.” But no one noticed. And this is the greatest compliment Sectra could receive.
Compelling reasons for change
The UH network annually processes around 800,000 image exams—averaging almost 2,200 per day—and is growing, having recently added two new hospitals with another round-the-clock facility scheduled to open in 2016. UH requires not only a reliable but also a scalable PACS. The virtual system makes it easy to assign more image storage when necessary without needing to own and maintain expensive physical servers that sit idle until brought into service. At the same time, the new system offers greater redundancy to ensure that it remains operable no matter what happens.
University Hospitals now enjoys streamlined PACS administration: all images, including those from 11 remote clinics, are centrally managed. Cutting the power to one of the hospitals during maintenance, for example, will not affect the PACS. And servers no longer need to be restarted weekly as before. The new system also incorporates valuable new functionality like automatic worklist refreshing and 3D-image processing, while providing faster access to images.
Here’s the catch
The benefits to changing from Unix to virtual Windows servers were compelling. But the task remained daunting, and not only because of the size of the project. Industry-standard downtime for such a migration has previously been around 12 hours. Yet with their scale of operations and round-the-clock services, UH required as little downtime as possible. Too much was as stake.
University Hospitals is one of the region’s largest hospital networks. 24,000 physicians and employees provide every segment of the community with targeted care through facilities that range from a first-rate cancer center to one of the nation’s best children’s hospitals. PACS is critical to their operations: “We have patients on the operating table at any time of day, twenty-four by seven, three-sixty-five, and we rely on those images for surgery…we do twenty-four by seven, three-sixty-five final readings for all the emergency departments throughout the organization…so the images are critical for patients’ treatment,” explained Rosipko.
Thinking outside the box
Sectra Development Engineer Pontus Noren noted, “You have to take an approach that works in your environment.” And when the environment called for no downtime at all, a creative solution was needed. Sectra answered with a delta migration—a novel concept for PACS. Noren offered a simplified explanation of the complex process: “Normally you take the live PACS offline in order to migrate data, but this time we migrated the system ‘on the fly’ without stopping the live environment. We basically migrate the entire database the day before, just keeping the triggers that store the changes, and finish moving these on the day of the changeover.” “Sectra really thought outside the box,” Rosipko reflected.
Unexpected hurdles always arise with a migration of this size and complexity, and this time was no different. But Sectra was prepared for them. Said Noren, “I had all the resources I could possibly need. Engineers and developers flew over from Sweden, and more waited on standby back home.” A U.S. contingent met them on site. “It was a team effort.” Rosipko summed up the achievement: “It was a huge success.” Every image was available when the doctors needed them. She continued, “Sectra is different. They care, they listen…and they realize that there’s a patient on the other end, not just a server. And that’s the key.”