uccsc v6.pptx
TRANSCRIPT
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
XXX-ABCD- 0123XXX-ABCD-0123VIPRION XXX-ABCD- 0123XXX-ABCD-0123VIPRION
GTM1 GTM2
LTM1 LTM2
Viprion1 Viprion2
ParnassusData Center
Cisco UCSVirtual Infrastructure
Cisco UCSVirtual Infrastructure
parnos1
parnsvr1
parnsvr2
minnos1
minnsvr1
minnsvr2
Rad Parnassus Nameserver
Rad MB Nameserver
pacs.radiology.ucsf.edu128.218.152.197
dicom.radiology.ucsf.edu128.218.152.198
mwl.radiology.ucsf.edu128.218.152.200
pacs.radiology.ucsf.edu128.218.152.229
dicom.radiology.ucsf.edu128.218.152.230
mwl.radiology.ucsf.edu128.218.152.231
ModalitiesIP Based (Non-DNS)
NeApp 325011 Disk Shelves
NeApp 32509 Disk Shelves
Rad CB Nameserver
MC Nameserver1
MC Nameserver2
Minnesota St.Data Center
Clients & Other PACS Systems(DNS Based)
PACS DICOM64.54.152.254
PACS DICOM64.54.152.253PACS DICOM Alternate
64.54.152.254
PACS DICOM Alternate64.54.152.253
Clients & Other PACS Systems(DNS Based)
ModalitiesIP Based (Non-DNS)
MWL64.54.152.252
MWL64.54.152.251
Load Balancer Pair Load Balancer Pair
vSphere
T4-1 Servers
vSphere
T4-1 Servers
Drawn By
Unit
Jeff Block
RadiologyRadiology – IMPAX Dual Data Center Infrastructure Rev
A 3/21/14
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)
XXX-ABCD- 0123XXX-ABCD-0123VIPRION XXX-ABCD- 0123XXX-ABCD-0123VIPRION
GTM1 GTM2
LTM1 LTM2
Viprion1 Viprion2
ParnassusData Center
Cisco UCSVirtual Infrastructure
Cisco UCSVirtual Infrastructure
parnos1
parnsvr1
parnsvr2
minnos1
minnsvr1
minnsvr2
Rad Parnassus Nameserver
Rad MB Nameserver
pacs.radiology.ucsf.edu128.218.152.197
dicom.radiology.ucsf.edu128.218.152.198
mwl.radiology.ucsf.edu128.218.152.200
pacs.radiology.ucsf.edu128.218.152.229
dicom.radiology.ucsf.edu128.218.152.230
mwl.radiology.ucsf.edu128.218.152.231
ModalitiesIP Based (Non-DNS)
NeApp 325011 Disk Shelves
NeApp 32509 Disk Shelves
Rad CB Nameserver
MC Nameserver1
MC Nameserver2
Minnesota St.Data Center
Clients & Other PACS Systems(DNS Based)
PACS DICOM64.54.152.254
PACS DICOM64.54.152.253PACS DICOM Alternate
64.54.152.254
PACS DICOM Alternate64.54.152.253
Clients & Other PACS Systems(DNS Based)
ModalitiesIP Based (Non-DNS)
MWL64.54.152.252
MWL64.54.152.251
Drawn By
Unit
Jeff Block
RadiologyRadiology – 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
Collaboration - ITS � Datacenter Team
� Minnesota St. Datacenter
� Load Balancers (F5 Viprion and GTM)
� Network Team � Network Monitoring and Performance – Netscout
Probes
CB-R1
CB-R2
CB-Core-R1
CB-Core-R264.54.30.253GI 2/2
64.54.30.249
GI 2/1
GI 1/10MC64.54.30.241
GI 2/1
64.54.30.245GI 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
MCGI 2/5/2
MB-Core_R1
MTZ-Core2
CB China BasinLRI Lab for Radiologic InformaticsMB Mission BayMC Medical CenterMCB Mission Center BuildingR Router Rad Radiology AT&T
NGMAN
GI 2/564.54.1.53
GI 6/2064.54.1.54
MB-Core-R2
GI 3/1564.54.1.34
GI 2/564.54.1.33
GI 3/1564.54.1.57
GI 6/2064.54.1.58
MCB-Core3-R1
MCB-Core4-R1
GI 5/164.54.1.197
GI 5/164.54.1.198
GI 5/164.54.1.193
GI 3/164.54.1.194
MTZ-Core1
GI 1/964.54.1.137
GI 6/1864.54.1.138
GI 5/164.54.1.142
GI 3/464.54.1.141
GI 1/11
MTZ-R1MTZ-R2
Campus - PRN Core
2408-0c50-r05
Campus - PRN Core
2252-00f1-r05
TE 3/6128.218.217.85
TE 1/6/15128.218.217.86
TE 3/6128.218.217.89
TE 2/6/15128.218.217.90 Campus - 654M
3043-0109-r01
Campus - 654M
3043-0109-r02
TE 1/164.54.131.76
TE 1/164.54.131.74
Campus -MB Core
3002-s251-r05TE 1/2
169.230.251.35
TE 1/364.54.131.75
TE 1/2169.230.251.34 Campus - 654M
ISG FirewallCluster
Campus - 654M
3043-0109-r05
Campus - 654M
3043-0109-r05
Radiology
Rack 1Radiology
Rack2Rad
RadMC
RADRAD
MC
MCMC
RAD
MC
MC
TE 1/164.54.131.77
GI 1/164.54.2.154
GI 1/23
GI 1/264.54.2.158
GI 1/23
GI 1/264.54.2.190
GI 1/24
GI 1/164.54.2.186
GI 1/24
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
NetScout(Clinical VLAN)
NetScout (Clinical VLAN)
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
NetScout (Clinical VLAN)
Radiology
Rack 3Radiology
Rack4SNMP
Router Stats
SNMPRouter Stats
SNMPRouter Stats
SNMPRouter Stats
Collaboration – Netscouts for Network Performance Testing and Statistics
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
XXX-ABCD- 0123XXX-ABCD-0123VIPRION XXX-ABCD- 0123XXX-ABCD-0123VIPRION
GTM1 GTM2
LTM1 LTM2
Viprion1 Viprion2
ParnassusData Center
Cisco UCSVirtual Infrastructure
Cisco UCSVirtual Infrastructure
parnos1
parnsvr1
parnsvr2
minnos1
minnsvr1
minnsvr2
Rad Parnassus Nameserver
Rad MB Nameserver
pacs.radiology.ucsf.edu128.218.152.197
dicom.radiology.ucsf.edu128.218.152.198
mwl.radiology.ucsf.edu128.218.152.200
pacs.radiology.ucsf.edu128.218.152.229
dicom.radiology.ucsf.edu128.218.152.230
mwl.radiology.ucsf.edu128.218.152.231
ModalitiesIP Based (Non-DNS)
NeApp 325011 Disk Shelves
NeApp 32509 Disk Shelves
Rad CB Nameserver
MC Nameserver1
MC Nameserver2
Minnesota St.Data Center
Clients & Other PACS Systems(DNS Based)
PACS DICOM64.54.152.254
PACS DICOM64.54.152.253PACS DICOM Alternate
64.54.152.254
PACS DICOM Alternate64.54.152.253
Clients & Other PACS Systems(DNS Based)
ModalitiesIP Based (Non-DNS)
MWL64.54.152.252
MWL64.54.152.251
Drawn By
Unit
Jeff Block
RadiologyRadiology – 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
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
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
Acknowledgements
� Radiology IT Teams
� UCSF ITS Teams � Data Center � Network � Medical Center Identity and Access Management
� Vendors � AGFA � Nuance � NetApp � F5 � Philips � imorgon � TeraRecon