Overwhelmed by millions of digital records and 30 isolated applications, Harbin Clinic asked IBM to make a house call.
Georgia's largest privately owned multi-specialty physician clinic, Harbin Clinic provides primary and specialty health services for 11 counties in Georgia and Alabama. In addition to its main campus in Rome, Georgia, the clinic operates more than 20 satellite offices in Rome and in the four surrounding counties. There are about 1,000 desktops in the clinics.
Since deploying a Picture Archiving and Communication System (PACS) and an Electronic Medical Records (EMR) system a couple years ago, Harbin has experienced exponential growth in data and an unprecedented demand for access to its digital data stores. The organization's growing IT infrastructure began to outstrip its ability to effectively store the massive amounts of data.
The good news is that Harbin is paperless. The bad news is that storage of all its digital data isn't up to par. In fact, the IT infrastructure has single points of failure that leave the healthcare provider extremely vulnerable in the event of a disaster.
Over the last few years, as Harbin Clinic sought out and installed advanced technology, CIO Tom Fricks knew his organization needed to find a better way to support the tremendous amount of data that was essential to the everyday work that went on at the clinic.
Two key applications raised awareness about the shortcomings of the clinic's data storage and security. The first was a PACS from Fujitsu. PACS let healthcare organizations scan, capture, store and disseminate images such as x-rays and scans digitally, eliminating paper and film images. The PACS has its own SAN. The second application was the EMR that was purchased in 2002 and fully deployed in 2005.
Today, Harbin scans one million documents into the EMR annually, enters 500,000 prescriptions into the system, and does 850,000 patient encounters a year. "All of our patient visits are recorded into the electronic system and without a paper record," said Fricks.
Purchased as a turnkey system, the EMR from Chicago-based Allscripts uses an EMC Clariion SAN for storage. Initially purchased with 4 terabytes of storage, the SAN has grown to 13 terabytes of capacity. "Every time we add an application to the SAN, we need to increase capacity," said Fricks. The EMR currently has five servers.
According to Fricks, many healthcare applications are sold and purchased as hardware/software turnkey systems, which results in an environment of individual applications with server-attached storage. In all, Harbin has about 70 servers and 30 applications.
Fricks' goal is to eliminate the server-attached storage and move it to IBM Blade servers. The challenge is to get the individual application vendors to work with Harbin's IT department to help make that happen. He's estimated that he can replace the 70 servers with 25 to 30 IBM Blade Servers. The organization also plans to look at virtual server technology.
The move will reduce the number of licenses and free up space in the data center. In the meantime, the current server/storage environment is a challenge to manage and it also doesn't allow the organization to balance storage across applications.
"In a nutshell, we need a more efficient way to handle data growth and maintenance, and we also want to migrate some of our data to archive," he said. "We want to put in a solution that's generic enough to help us with our other applications."
Toward a Solution
With the help of a local IBM channel partner, Harbin began to address storage management. The clinic uses IBM's Tivoli Storage Manager software for centralized, automated data protection. Harbin is also deploying IBM Blade Server technology.
IBM's Tivoli software helps Harbin reduce backup times. About a year ago, the organization found that it was running out of evening and weekend time to complete backups of its data stores.
It wasn't uncommon for backups to begin at 6 p.m. and run until as late as 10 a.m. the next morning. "Some vendors required that we back up to tape, so we weren't doing disk-to-disk backup," said Fricks.
Harbin realized a 70 percent reduction in the time it takes the organization to backup its data. Backups now start at 11:30 p.m. and finish at 5:30 a.m., a total of six hours. The healthcare facility uses Tivoli Storage Manager running on IBM System x386 servers and IBM System Storage DS4100 storage systems. Data is now backed up to an off-site location.
Harbin is also implementing an IBM Blade Server that is configured to help eliminate single point of failure issues with the server attached storage. The goal is to migrate the total server farm to blades. Harbin currently has four active blade servers, with five more planned for installation early next year.
The clinic is migrating its most critical applications, such as a laboratory information, radiology information and clinical research, to the blade servers first. It expects that it will take about two years to migrate all 30 applications.
Harbin also plans to expand the use of Tivoli for storage management. Today, for example, the EMC SAN is managed with EMC tools. "Rather than manage storage elements, we want to manage all storage with Tivoli," said Fricks.
Using Tivoli storage management will be more dynamic and effective by giving applications the amount of storage they need, he said.