Radiology PACS Department of Radiology and Biomedical Imaging UCSF - PowerPoint PPT Presentation

Radiology PACS Department of Radiology and Biomedical Imaging UCSF

Outline — PACS Impact — PACS Workflow — PACS Infrastructure — Collaborations — Implementation — Challenges

PACS Impact — Distribution of medical images (X-Ray, CT , MRI, Ultrasound images) for the purposes of: — Direct Patient Care — Research — Teaching — Presentations — Archive of about 4 million studies — Over 1500 studies arrive daily from imaging devices within UCSF and devices from other medical institutions — Integrated with RIS, APeX, and surgical navigation devices

Basic PACS Workflow

PACS Workflow Components Application Servers — Front End Application — Database Servers — Primary and Backup Oracle DB — Connectivity Manager Servers — Interface from Radiology Information System (RIS) — Modality Worklist Servers — Workflow Manager and Archive Servers — Image Cache and File Services (Short-term and Medium-Term) — UCSF Archive — Locally Developed Long Term Archive (~180TB / ~4 Million Studies) — IDC — Agfa Long Term Image Archive — Database and Image Server Components — Full Test Environment —

PACS Infrastructure GTM1 GTM2 X X X -A B C D -0 1 2 3 N IO R IP V XXX-ABCD - 0123 -A B X X X C D -0 1 2 3 IO N V R IP XXX-ABCD - 0123 Clients & Other Clients & Other PACS Systems PACS Systems (DNS Based) (DNS Based) Rad CB Rad MB MC Rad Parnassus MC Nameserver Nameserver Nameserver2 Nameserver1 Nameserver dicom.radiology.ucsf.edu pacs.radiology.ucsf.edu mwl.radiology.ucsf.edu dicom.radiology.ucsf.edu pacs.radiology.ucsf.edu mwl.radiology.ucsf.edu 128.218.152.229 128.218.152.230 128.218.152.231 128.218.152.198 128.218.152.197 128.218.152.200 Load Balancer Pair Load Balancer Pair Parnassus Minnesota St. LTM1 LTM2 Data Center PACS DICOM Data Center 64.54.152.254 PACS DICOM Alternate Cisco UCS Viprion1 Viprion2 64.54.152.253 Virtual Infrastructure MWL Cisco UCS 64.54.152.252 Virtual Infrastructure Modalities IP Based (Non-DNS) vSphere Modalities vSphere IP Based (Non-DNS) PACS DICOM PACS DICOM Alternate 64.54.152.253 parnos1 64.54.152.254 minnos1 MWL 64.54.152.251 T4-1 parnsvr1 minnsvr1 T4-1 Servers Servers parnsvr2 NeApp 3250 NeApp 3250 minnsvr2 9 Disk Shelves 11 Disk Shelves Drawn By Jeff Block Rev Radiology – IMPAX Dual Data Center Infrastructure 3/21/14 A Unit Radiology

PACS Infrastructure Dual Datacenter Design — Goal: Redundancy and Enhanced Performance — Minnesota Street — UCSF Campus Networks & Firewall — UCSF Campus Load Balancers — PACS Components — Parnassus — Radiology Networks and Firewall — PACS Components

Collaboration – Radiology IT — Radiology PACS Support Group — Configuration of ~150 Clinical Devices — Configuration / Build / Deployment of ~150 Clinical PACS Workstations — Customization of PACS GUI — Radiology Information Systems (RIS) Support Group — RIS Integration — Powerscribe 360 Voice Recognition Integration — Radiology Desktop Support Group — Deployment of PACS Workstations — Help Desk Support

Collaboration - ITS — Datacenter Team — Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM)

Collaboration – Global Traffic Managers and Load Balancers GTM1 GTM2 X -A B X X C D -0 2 3 1 V IP R IO N XXX-ABCD - 0123 X X X -A C D -0 1 2 B IO R V 3 IP N XXX-ABCD - 0123 Clients & Other Clients & Other PACS Systems PACS Systems (DNS Based) (DNS Based) Rad CB Rad MB MC MC Rad Parnassus Nameserver Nameserver Nameserver2 Nameserver Nameserver1 dicom.radiology.ucsf.edu pacs.radiology.ucsf.edu mwl.radiology.ucsf.edu dicom.radiology.ucsf.edu pacs.radiology.ucsf.edu mwl.radiology.ucsf.edu 128.218.152.230 128.218.152.229 128.218.152.231 128.218.152.198 128.218.152.197 128.218.152.200 Load Balancer Pair Load Balancer Pair Parnassus Minnesota St. LTM1 LTM2 Data Center PACS DICOM Data Center 64.54.152.254 PACS DICOM Alternate Cisco UCS Viprion1 Viprion2 64.54.152.253 Virtual Infrastructure MWL Cisco UCS 64.54.152.252 Virtual Infrastructure Modalities IP Based (Non-DNS) vSphere Modalities vSphere IP Based (Non-DNS) PACS DICOM PACS DICOM Alternate 64.54.152.253 parnos1 64.54.152.254 minnos1 MWL 64.54.152.251 T4-1 parnsvr1 minnsvr1 T4-1 Servers Servers parnsvr2 NeApp 3250 NeApp 3250 minnsvr2 9 Disk Shelves 11 Disk Shelves Drawn By Jeff Block Rev Radiology – IMPAX Dual Data Center Infrastructure 3/21/14 A Unit Radiology

Collaboration - ITS — Datacenter Team — Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM) — Network Team — Network Monitoring and Performance – Netscout Probes

Collaboration – Netscouts for Network Performance Testing and Statistics NetScout (Clinical VLAN) RAD RAD SNMP MTZ- R 2 MTZ- R 1 SNMP Router Stats Router Stats SNMP SNMP GI 1/2 GI 1/1 GI 1/1 GI 1/2 Router Stats Router Stats 64.54.2.190 64.54.2.186 64.54.2.154 64.54.2.158 TE 1/3 Campus -MB Core Campus - 654M 64.54.131.75 GI 1/23 GI 1/24 GI 1/24 GI 1/23 3002-s251-r05 3043-0109-r02 MC TE 1/1 MC 64.54.131.74 SNMP MTZ-Core 2 MTZ-Core 1 SNMP Router Stats Router Stats TE 1/2 169.230.251.35 SNMP Router Stats GI 5/1 GI 1/9 Radiology 64.54.1.142 64.54.1.137 Rack 1 Campus - 654M SNMP SNMP TE 1/2 SNMP 3043-0109-r05 SNMP GI 6/18 Router Stats SNMP Router Stats Router Stats 169.230.251.34 Campus - 654M Radiology Router Stats 64.54.1.138 Router Stats ISG Firewall Rack2 RAD MC TE 1/6/15 Rad MC MC Campus - PRN Core 128.218.217.86 64.54.30.241 GI 5/1 Cluster CB- R 1 GI 2/1 MCB-Core 4 -R 1 GI 6/4 2408-0c50-r05 Radiology GI 1/10 CB-Core- R 1 PRN-Core 3 TE 3/6 64.54.1.193 128.218.217.85 Rack 3 GI 6/20 Campus - 654M GI 3/15 GI 3/1 GI 1/5/2 64.54.1.57 64.54.1.58 64.54.30.245 3043-0109-r05 64.54.1.194 SNMP Radiology GI 2/2 GI 4/45 – 4/48 GI 1/11 Router Stats NetScout LRI- R 1 Rack4 (Clinical VLAN) NetScout (Clinical VLAN) GI 1/10 SNMP (VSS stack) 64.54.30.249 Router Stats GI 4/45 – 4/48 GI 2/1 MC Rad MC CB- R 2 CB-Core- R 2 MC TE 2/6/15 GI 3/4 PRN-Core 4 TE 1/1 64.54.30.253 GI 2/5/2 128.218.217.90 Campus - 654M Campus - PRN Core 64.54.1.141 64.54.131.77 MCB-Core 3- R 1 GI 2/2 GI 6/4 3043-0109-r01 2252-00f1-r05 TE 3/6 TE 1/1 GI 5/1 SNMP 64.54.131.76 SNMP 128.218.217.89 64.54.1.197 Router Stats Router Stats GI 6/20 GI 5/1 GI 3/15 64.54.1.54 64.54.1.198 SNMP SNMP SNMP GI 2/5 64.54.1.34 Router Stats Router Stats Router Stats 64.54.1.53 MC CB China Basin MB-Core_ R 1 SNMP LRI Lab for Radiologic Informatics Router Stats MB Mission Bay MC Medical Center MCB Mission Center Building R Router Rad Radiology AT&T MC GI 2/5 MB-Core- R 2 SNMP NGMAN 64.54.1.33 Router Stats

Collaboration - ITS — Datacenter Team — Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM) — Network Team — Network Monitoring and Performance – Netscout Probes — Firewall Policy Access — New Firewall Installation with 10G Uplinks — Load Balancers and /32 Routes

Collaboration – Load Balancers and Complex Routing GTM1 GTM2 X -A B X X C D -0 2 3 V 1 IP R IO N XXX-ABCD - 0123 X X X -A B C D -0 1 2 3 N IO R V IP XXX-ABCD - 0123 Clients & Other Clients & Other PACS Systems PACS Systems (DNS Based) (DNS Based) Rad CB Rad MB MC MC Rad Parnassus Nameserver Nameserver Nameserver2 Nameserver Nameserver1 dicom.radiology.ucsf.edu pacs.radiology.ucsf.edu mwl.radiology.ucsf.edu dicom.radiology.ucsf.edu mwl.radiology.ucsf.edu pacs.radiology.ucsf.edu 128.218.152.230 128.218.152.229 128.218.152.231 128.218.152.198 128.218.152.197 128.218.152.200 Load Balancer Pair Load Balancer Pair Parnassus Minnesota St. LTM1 LTM2 Data Center PACS DICOM Data Center 64.54.152.254 PACS DICOM Alternate Cisco UCS Viprion1 Viprion2 64.54.152.253 Virtual Infrastructure MWL Cisco UCS 64.54.152.252 Virtual Infrastructure Modalities IP Based (Non-DNS) vSphere Modalities vSphere IP Based (Non-DNS) PACS DICOM PACS DICOM Alternate 64.54.152.253 parnos1 64.54.152.254 minnos1 MWL 64.54.152.251 T4-1 parnsvr1 minnsvr1 T4-1 Servers Servers parnsvr2 NeApp 3250 NeApp 3250 minnsvr2 9 Disk Shelves 11 Disk Shelves Drawn By Jeff Block Rev Radiology – IMPAX Dual Data Center Infrastructure 3/21/14 A Unit Radiology

Collaboration - ITS — Datacenter Team — Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM) — Network Team — Network Monitoring and Performance – Netscout Probes — Firewall Policy Access — New Firewall Installation with 10G — Load Balancers and /32 Routes — Medical Center IT — Active Directory

Collaboration - Vendors — Clinical Software / Hardware Vendors — AGFA Healthcare – PACS Software — NetApp – Storage — F5 – Load Balancers — imorgon – Ultrasound — Nuance Powerscribe 360 – Voice Recognition — Philips – iSite — TeraRecon – 3D Image Processing

Implementation — 2 Year Process — Not an upgrade, a complete replacement — Phased Rollout — Required Zero Downtime — Patient care was unaffected during go-live