SX Cluster as the storage backend for SANTEC medical imaging system Clinic Workbench Avellino (Italy), 15 February 2015
Introduction Santec develops a platform for managing and archiving medical exams called PACLO. PACLO is a PACS system based on dcm4chee which provides all the services required to manage the medical exams including the related documents and the full workflow of a radiology department of an healthcare institution. The system is entirely based on open-source components and integrates directly into Clinic Workbench with the RIS module using the HL7 protocol. The partnership allows to achieve high levels of security and performance through continuous updates.
Introduction The platform follows the protocols and standards defined by two internationally recognized institutions, NEMA and IHE, and implements the following modules: Access to Radiology Information Consistent Presentation of Images Evidence Documents Key Image Note Patient Information Reconciliation Simple Image and Numeric Report Scheduled Workflow Basic Security XDS (Cross Enterprise Document Sharing) e XDS-I Audit Trail and Node Authentication
MyPACLO The platform exposes an administration console to customize the back-end services in a way which is totally transparent to the end users. Available customizations include: archival of medical exams in a cloud-based storage infrastructure exams compression/decompression scheduled prefetching of the medical exams coordinated with the booking system and appointment scheduler The front-end uses a web based portal called MyPACLO which allows to share the medical exams among different entities, patients and doctors. This feature opens the possibility for patients to monitor their medical data and improves the flow of information. Medical personnel can use MyPACLO to view the schedules, exams and diagnosis through the WADO service. MyPACLO reduces the need to focus resources on the production of CD, DVD and films. With MyPACLO each patient receives unique credentials to securely view their own medical data from any device with a web browser, including mobiles. Depending on the internal policy, it's possible to restrict or enlarge the amount of information and results available to the patient..
System architecture Exams are archived on a multi-level storage designed to optimize costs while providing durability, reliability and performances. The first level of storage relies is local and used as a local cache for the exams currently being worked on, the second level of storage is used for long term archival and to share exams across the whole hospital in a fully distributed way. Santec adopted Skylable SX Cluster for their on premise object-storage needs. The factors that played a key role in the choice were the ability to scale the solution horizontally, without incurring in physical limits, the speed increase obtained by adding more nodes to the cluster and the fully distributed architecture of the solution. In order to interface SX Cluster with the PACS system based on dcm4che, Santec developed a S3 Module and integrated into Clinic Workbench.The S3 Module connects to a LibreS3 daemon running on localhost, which talks directly to the SX Cluster and provides: client side deduplication faster uploads and downloads, multiplexing connections across all nodes client side encryption
Santec customers The platform just described has been in production at the ASL of Avellino since January 2015. The system currently receives and safely stores more than 6000 new exams/month. The average size of each exam is around 100MB,. The size of the data stored in the SX Cluster currently exceeds 32TB, out of which 30TB come from the old PACS storage system which has been decommissioned after 5 years of usage. The raw capacity of the cluster is currently 100TB and the replica level is 2 which gives the hospital a total of 50TB of usable space. Space usage is distributed as follows: 7.5TB for exams expected in 2015 30TB for the historical archive, comprising exams from 2009 to 2013 12.5TB of free space, to cope with unexpected spikes of exams.
Santec customers The storage system is distributed geographically across 3 districts in different cities: Solofra, Sant Angelo dei Lombardi e Avellino. Every districts hosts one PACS node and one node of the SX Cluster as follows: 50TB for 2 S X nodes in Avellino 25TB for 1 S X node in Solofra 25TB for 1 S X node in Sant Angelo dei Lombardi
Santec customers Every node is running on Ubuntu Server 14.04.02 LTS 64-bit on Supermicro hardware. Specs: 2x CPU 8Core 16 GB RAM 50x 500GB 6Gb SAS 10K rpm The cluster on average generates 45GB of traffic per day, 20GB of which come from the inter-node and node-to-client traffic and 25GB come from the pre-fetching client built into MyPACLO. SX nodes are connected over WAN using the National Public Connectivity service (Servizio Pubblico di Connettività, SPC) with speeds which range from 30Mbps to 100Mbps. The replication between SX nodes has been working flawlessly and has showed to cope well with occasional network hiccups in the WAN. Internally each workstation in the ASL offices is connected to the PACS system over LAN at 1Gbps speed.
Why Skylable SX? The platform has been built bottom-up with the goal of using only widely tested and solid Open-Source software. The tools provided with SX Cluster allow an easy installation and integration with the Santec platform and were very easy to learn and adapt to our needs. With the help of SX Cluster, we have replaced all the multi-vendor storage appliances the ASL was previously using with a single software-defined storage solution which solves all scalability issues. The possibility to hot-add more nodes to the cluster to increase space availability is critical when dealing with traffic patterns which are difficult to predict, like in this case.
2015 Provisioning The increasing volume of exams received every day and the strict SLAs to which medical IT services are subject, pushed us to go further with the storage consolidation process that we began at the end of 2014. By the end of 2015, we expect to be storing 80TB of new medical data. By the end of June 2015, we plan to deploy 3 additional SX nodes to increase the local redundancy in each datacenter. The cluster will have a total of 7 nodes, each district will have 2 or 3 nodes. Santec is currently developing a SX Module which will replace the S3 Module and furtherly simplify the architecture of the solution by eliminating the need for the LibreS3 protocol translator. With the SX Module performances will be furtherly improved and the protocol overhead will decrease.
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