Disaster Recovery Lessons from Radiology

When hospitals moved from film-based hardcopy systems to electronic images, they began to generate large amounts of data held on PACS – Picture Archiving and Communications Systems. Hospitals use various ‘modalities’ to scan patients, including Computer Tomography, Magnetic Resonance Imaging and Ultrasound systems. These modalities must regularly (and frequently) upload the scanned images to the PACS, where they can be stored, sequenced for retrieval and made available for remote diagnosis. However, a PACS is often a potential single point of failure with inevitable downtime – which is where the DR lessons start.

According to Fred Behlen of Laitek, a US data migration company, and Tony Jones, PACS administrator in Utah in the US, some of the main disaster recovery considerations are:

  • Calculate how much downtime is manageable and what that means in terms of alternative backup storage. To cope with 24 or 48 hours of PACS downtime for example, it may be necessary to store three to four weeks’ worth of patient images.
  • Plan the priority of medical data recovery. The highest priority is typically the images for patient scans made during the last 24 hours. Scans made a week ago or even past clinical records for patients can likely be recovered later.
  • Don’t assume that buying a DR system from a PACS vendor is the solution. The real solution is an effective, tested DR plan, together with appropriate resources (like the DR system).
  • While some hospitals consider PACS downtime to be inevitable (if only for testing an associated DR plan), it’s important to consider all potential causes of unavailability. Backup diesel generators that stop working when water gets into the fuel tank, or local network links being accidentally cut by construction workers are two examples.

Some PACS vendors provide cloud-based solutions for data backups, but these do not necessarily allow for telediagnosis. The next step may be to simply move the PACS (or equivalent) into the cloud and thus eliminate some of the current vulnerabilities.