title: Puncture-proof picture archiving and communication system.
abstract: As we become increasingly dependent on our picture archiving and communications system (PACS) for the clinical practice of medicine, the demand for improved reliability becomes urgent. Borrowing principles from the discipline of Reliability Engineering, we have identified components of our system that constitute single points of failure and have endeavored to eliminate these through redundant components and manual work-around procedures. To assess the adequacy of our preparations, we have identified a set of plausible events that could interfere with the function of one or more of our PACS components. These events could be as simple as the loss of the network connection to a single component or as broad as the loss of our central data center. We have identified the need to continue to operate during adverse conditions, as well as the requirement to recover rapidly from major disruptions in service. This assessment led us to modify the physical locations of central PACS components within our physical plant. We are also taking advantage of actual disruptive events coincident with a major expansion of our facility to test our recovery procedures. Based on our recognition of the vital nature of our electronic images for patient care, we are now recording electronic images in two copies on disparate media. The image database is critical to both continued operations and recovery. Restoration of the database from periodic tape backups with a 24-hour cycle time may not support our clinical scenario: acquisition modalities have a limited local storage capacity, some of which will not contain the daily workload. Restoration of the database from the archived media is an exceedingly slow process, that will likely not meet our requirement to restore clinical operations without significant delay. Our PACS vendor is working on concurrent image databases that would be capable of nearly immediate switchover and recovery.
authors.affiliation: Department of Radiology, Baylor College of Medicine, Houston, TX, USA. cewillis@texaschildrenshospital.org
authors.forename: C E
authors.initials: CE
authors.lastname: Willis
authors.forename: C W
authors.initials: CW
authors.lastname: McCluggage
authors.forename: M R
authors.initials: MR
authors.lastname: Orand
authors.forename: B R
authors.initials: BR
authors.lastname: Parker
mesh_terms: D003199:Computer Systems; D006801:Humans; D011873:Radiology Information Systems / Q000458:organization & administration