Hospital network infrastructures oversee the overlooked

Network infrastructures are among the first hospital resources to feel the load when healthcare enterprises incorporate digital cardiac imaging.

"Institutions look at storage requirements and clinical workstations in great detail but often forget the network," said Stephen Stoycos, a GE Healthcare IT product manager. "It's a common mistake."

To guard against this oversight, some vendors offer professional services in network design and implementation.

"Key parameters to consider are not only backbone bandwidth and utilization, but segmentation design, especially what the connectivity is to the desktop and source devices," Stoycos said.

New technologies have shifted the paradigm for how digital image archive solutions are designed. Hospitals can now add cardiology images to large enterprise PACS solutions. Clinicians can read on-demand from PACS and get a single patient jacket that includes all radiology and cardiology studies.

Previous technologies required hospitals to plan autoforwarding schemes to push images locally onto individual workstations to meet performance requirements.

"These autoforwarding schemes would often break down when the number of users and workstations increased," Stoycos said.

Understanding the clinical workflow for a particular institution is another consideration.

"Particular attention should be paid to electronic orders, which aren't always present for cardiology," Stoycos said.

If they are, then things like prefetching historical studies can greatly enhance the end user's experience, especially when the long-term storage is a slower technology, he said.

Nonquantifiable considerations also demand attention.

"Since digital cardiac images will generally be retained for a lengthy period, long-term technology road maps, migration strategies, and parts and service availability need to be considered," said Dave Dupont, vice president of Plasmon.

Main infrastructure issues to be considered relate to software.

"PACS vendors typically certify specific solutions to guarantee interoperability," Dupont said.

The market offers a variety of storage options. Depending on the hospital's existing infrastructure, technologies that can be added to archives include MOD (magnetic optical disk), DVD (digital versatile disk), and UDO (ultradensity optical), as well as spinning disk, NAS (network attached storage), and SAN (storage area network) solutions.

Being able to select from an extensive storage menu is a welcome relief.

"Customers were often locked into a particular library technology that had a physical limit to the amount of data that could be kept online," Stoycos said.

Today's solutions allow new virtual archives to be added using the latest media technology, he said.