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

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

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Radiology PACS Department of Radiology and Biomedical Imaging UCSF Outline PACS Impact PACS Workflow PACS Infrastructure Collaborations Implementation Challenges PACS Impact Distribution of medical

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SLIDE 1

Radiology PACS

Department of Radiology and Biomedical Imaging UCSF

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SLIDE 2

Outline

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

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SLIDE 3

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

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SLIDE 4

Basic PACS Workflow

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SLIDE 5

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

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SLIDE 6

PACS Infrastructure

XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N

GTM1 GTM2 LTM1 LTM2 Viprion1 Viprion2

Parnassus Data Center

Cisco UCS Virtual Infrastructure Cisco UCS Virtual Infrastructure parnos1 parnsvr1 parnsvr2 minnos1 minnsvr1 minnsvr2 Rad Parnassus Nameserver Rad MB Nameserver

pacs.radiology.ucsf.edu 128.218.152.197 dicom.radiology.ucsf.edu 128.218.152.198 mwl.radiology.ucsf.edu 128.218.152.200 pacs.radiology.ucsf.edu 128.218.152.229 dicom.radiology.ucsf.edu 128.218.152.230 mwl.radiology.ucsf.edu 128.218.152.231

Modalities IP Based (Non-DNS) NeApp 3250 11 Disk Shelves NeApp 3250 9 Disk Shelves Rad CB Nameserver MC Nameserver1 MC Nameserver2

Minnesota St. Data Center

Clients & Other PACS Systems (DNS Based)

PACS DICOM 64.54.152.254 PACS DICOM 64.54.152.253 PACS DICOM Alternate 64.54.152.254 PACS DICOM Alternate 64.54.152.253

Clients & Other PACS Systems (DNS Based) Modalities IP Based (Non-DNS)

MWL 64.54.152.252 MWL 64.54.152.251

Load Balancer Pair Load Balancer Pair

vSphere T4-1 Servers vSphere T4-1 Servers

Drawn By Unit Jeff Block Radiology Radiology – IMPAX Dual Data Center Infrastructure Rev A 3/21/14
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SLIDE 7

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

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SLIDE 8

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

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SLIDE 9

Collaboration - ITS

— Datacenter Team

— Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM)

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SLIDE 10 XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N

GTM1 GTM2 LTM1 LTM2 Viprion1 Viprion2

Parnassus Data Center

Cisco UCS Virtual Infrastructure Cisco UCS Virtual Infrastructure parnos1 parnsvr1 parnsvr2 minnos1 minnsvr1 minnsvr2 Rad Parnassus Nameserver Rad MB Nameserver

pacs.radiology.ucsf.edu 128.218.152.197 dicom.radiology.ucsf.edu 128.218.152.198 mwl.radiology.ucsf.edu 128.218.152.200 pacs.radiology.ucsf.edu 128.218.152.229 dicom.radiology.ucsf.edu 128.218.152.230 mwl.radiology.ucsf.edu 128.218.152.231

Modalities IP Based (Non-DNS) NeApp 3250 11 Disk Shelves NeApp 3250 9 Disk Shelves Rad CB Nameserver MC Nameserver1 MC Nameserver2

Minnesota St. Data Center

Clients & Other PACS Systems (DNS Based)

PACS DICOM 64.54.152.254 PACS DICOM 64.54.152.253 PACS DICOM Alternate 64.54.152.254 PACS DICOM Alternate 64.54.152.253

Clients & Other PACS Systems (DNS Based) Modalities IP Based (Non-DNS)

MWL 64.54.152.252 MWL 64.54.152.251

Drawn By Unit Jeff Block Radiology Radiology – IMPAX Dual Data Center Infrastructure Rev A 3/21/14

Load Balancer Pair Load Balancer Pair

vSphere T4-1 Servers vSphere T4-1 Servers

Collaboration – Global Traffic Managers and Load Balancers

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SLIDE 11

Collaboration - ITS

— Datacenter Team

— Minnesota St. Datacenter — Load Balancers (F5 Viprion and GTM)

— Network Team

— Network Monitoring and Performance – Netscout

Probes

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SLIDE 12

CB-R1 CB-R2 CB-Core-R1 CB-Core-R2

64.54.30.253 GI 2/2 64.54.30.249 GI 2/1 GI 1/10 MC 64.54.30.241 GI 2/1 64.54.30.245 GI 2/2 GI 1/10 GI 4/45 – 4/48 GI 4/45 – 4/48 MC

PRN-Core3 LRI-R1

(VSS stack)

GI 6/4 GI 1/5/2 GI 6/4 MC

PRN-Core4

MC GI 2/5/2

MB-Core_R1 MTZ-Core2

CB China Basin LRI Lab for Radiologic Informatics MB Mission Bay MC Medical Center MCB Mission Center Building R Router Rad Radiology AT&T NGMAN GI 2/5 64.54.1.53 GI 6/20 64.54.1.54

MB-Core-R2

GI 3/15 64.54.1.34 GI 2/5 64.54.1.33 GI 3/15 64.54.1.57 GI 6/20 64.54.1.58

MCB-Core3-R1 MCB-Core4-R1

GI 5/1 64.54.1.197 GI 5/1 64.54.1.198 GI 5/1 64.54.1.193 GI 3/1 64.54.1.194

MTZ-Core1

GI 1/9 64.54.1.137 GI 6/18 64.54.1.138 GI 5/1 64.54.1.142 GI 3/4 64.54.1.141 GI 1/11

MTZ-R1 MTZ-R2

Campus - PRN Core

2408-0c50-r05

Campus - PRN Core

2252-00f1-r05

TE 3/6 128.218.217.85 TE 1/6/15 128.218.217.86 TE 3/6 128.218.217.89 TE 2/6/15 128.218.217.90 Campus - 654M

3043-0109-r01

Campus - 654M

3043-0109-r02

TE 1/1 64.54.131.76 TE 1/1 64.54.131.74 Campus -MB Core

3002-s251-r05

TE 1/2 169.230.251.35 TE 1/3 64.54.131.75 TE 1/2 169.230.251.34 Campus - 654M

ISG Firewall Cluster

Campus - 654M

3043-0109-r05

Campus - 654M

3043-0109-r05

Radiology

Rack 1

Radiology

Rack2

Rad Rad MC RAD RAD MC MC MC RAD MC MC TE 1/1 64.54.131.77 GI 1/1 64.54.2.154 GI 1/23 GI 1/2 64.54.2.158 GI 1/23 GI 1/2 64.54.2.190 GI 1/24 GI 1/1 64.54.2.186 GI 1/24 SNMP Router Stats SNMP Router Stats SNMP Router Stats NetScout (Clinical VLAN) NetScout (Clinical VLAN) SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats NetScout (Clinical VLAN) Radiology

Rack 3

Radiology

Rack4

SNMP Router Stats SNMP Router Stats SNMP Router Stats SNMP Router Stats

Collaboration – Netscouts for Network Performance Testing and Statistics

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SLIDE 13

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

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SLIDE 14 XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N XXX-ABCD
  • 0123
X X X
  • A
B C D
1 2 3 V IP R IO N

GTM1 GTM2 LTM1 LTM2 Viprion1 Viprion2

Parnassus Data Center

Cisco UCS Virtual Infrastructure Cisco UCS Virtual Infrastructure parnos1 parnsvr1 parnsvr2 minnos1 minnsvr1 minnsvr2 Rad Parnassus Nameserver Rad MB Nameserver

pacs.radiology.ucsf.edu 128.218.152.197 dicom.radiology.ucsf.edu 128.218.152.198 mwl.radiology.ucsf.edu 128.218.152.200 pacs.radiology.ucsf.edu 128.218.152.229 dicom.radiology.ucsf.edu 128.218.152.230 mwl.radiology.ucsf.edu 128.218.152.231

Modalities IP Based (Non-DNS) NeApp 3250 11 Disk Shelves NeApp 3250 9 Disk Shelves Rad CB Nameserver MC Nameserver1 MC Nameserver2

Minnesota St. Data Center

Clients & Other PACS Systems (DNS Based)

PACS DICOM 64.54.152.254 PACS DICOM 64.54.152.253 PACS DICOM Alternate 64.54.152.254 PACS DICOM Alternate 64.54.152.253

Clients & Other PACS Systems (DNS Based) Modalities IP Based (Non-DNS)

MWL 64.54.152.252 MWL 64.54.152.251

Drawn By Unit Jeff Block Radiology Radiology – IMPAX Dual Data Center Infrastructure Rev A 3/21/14

Load Balancer Pair Load Balancer Pair

vSphere T4-1 Servers vSphere T4-1 Servers

Collaboration – Load Balancers and Complex Routing

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SLIDE 15

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

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SLIDE 16

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

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SLIDE 17

Implementation

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

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SLIDE 18

Challenges

— Design — Running New and Old Systems Simultaneously — Load Balancers

— /32 VIPs and Complex Routing

— Data Migration — PACS Workstations

— System Imaging

— First Few Weeks:

— AD GPO changes — Firewall changes

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SLIDE 19

Acknowledgements

— Radiology IT Teams — UCSF ITS Teams

— Data Center — Network — Medical Center Identity and Access Management

— Vendors

— AGFA — Nuance — NetApp — F5 — Philips — imorgon — TeraRecon