Data Migration : Plan Early and Sleep Better AKA PACS/RIS Replacement SIIM U 2008 Section 6 Friday, May 16, 3:30-5:00pm Data Migration : Plan Early and Sleep Better AKA PACS/RIS Replacement Fred M. Behlen, Ph.D. Homewood, IL USA

Disclosure Officer, Director & Shareholder, LAITEK Inc. a.k.a. Migratek Data Migration Services Co-Chair, HL7 Imaging Integration Work Group and DICOM Working Group 20 (the DICOM/HL7 common working groups)

So you’re getting a new PACS… Data migration and its alternatives D.I.Y. migration for small jobs Anatomy of a migration project Advance planning Defining your requirements Working with vendors

Do I need to migrate my images? Methods for providing access to historical images: Retain access to legacy archive Migrate data to the new PACS an enterprise archive Old PACS New PACS Query Retrieve Old PACS New PACS Migrate Old PACS Long Term Archive New PACS

Why not keep the old PACS archive? Complexity Technical Administrative Economics Legacy system support costs Space, power and cooling Reliability Regulatory Compliance Legacy vendor support uncertain Hardware getting old, support engineers getting senile Migration becoming the Standard of Practice Likability You just don’t like that old PACS any more

Isn’t it easy? Old PACS New PACS DICOM

Isn’t it easy? Old PACS New PACS DICOM C-STORE DICOM C-MOVE Migration Controller

Not so easy It can take a long time Need to maintain clinical operations while migrating There will be errors that must be handled/mitigated DICOM interface may not export all desired information Gray scale window/level settings Key image selections Proprietary image annotation and markup Some data may need to be updated to current DICOM Standards

D. I. Y. Data Migration Use “send” utility on source PACS Use “import” utility on target PACS Use a DICOM workstation Fetch studies from source archive Store studies to target archive Repeat Write & run your own command (script) files using a (free) DICOM C-MOVE client program e.g. OFFIS movescu.exe (Google for “OFFIS DICOM”) Use a free migration utility (write to me and I’ll send you one)

… or Farm It Out Specify what you need Summary of your current state What you need moved Data matching/cleansing options Other options (gray scale window/level settings, key image, region of interest annotation, …) Engage a commercial solutions provider Who does data migration? Technical approaches Business models Protecting your interests

Specifying a migration project Summary of your current state Source system Type and version of system (include history of versions and upgrade dates) Number of Studies, Series, Images, Terabytes What modalities present Target system Type of system Configuration of hardware and storage system Sustained data input rate RIS/PACS relationship History of Modality Worklist Accession Number mapping – How are grouped procedures handled? What you need moved Reports Possible culling by retention requirements

Optional migration features Data enhancement options Capture proprietary gray scale settings? Usually inserted in individual images, or Included as Gray Scale Presentation State (GSPS) objects stored with the Image data. Capture proprietary key image selections? Key Image Selection (KO) objects, or GSPS objects including annotation. Data matching/cleansing options Patient Level mapping Study Level mapping

“Dirty” PACS data Misidentified data Junk data Bad data Patient demographic data Accession Number Junk data Test images Discarded images Bad data Corrupted/invalid DICOM objects Repairable over-length fields are not uncomon Unsupported old SOP classes (image types)

Patient-level reconciliation Image attributes Patient ID Patient Name Patient Sex Patient Birthdate Patient attributes ID Name Sex Birthdate

Exam-level reconciliation Image attributes Patient ID Patient Name Patient Sex Patient Birthdate Accession Number Modality Study Date,Time Image Date,Time Order attributes Patient ID Patient Name Patient Sex Patient Birthdate Order Number Modality Procedure Code Check-in DateTime Start DateTime End DateTime

Data Matching & Cleanup Methods Source data Study list from PACS Exam list from RIS Methods Rule-based Heuristic / probabilistic Timing Before moving images While migration in progress As part of migration exception handling Documentation

Migration to today’s PACS RIS HL7 Orders HL7 Results New PACS HL7 Legacy PACS DICOM Updates Images Most modern PACS rely heavily on RIS Orders & Results data Orders and/or Results usually must be sent to the PACS before migrated images  This can have a major impact on project schedules

Working with vendors Who does data migration? Business models Source (Old) PACS Vendors Target (New) PACS Vendors Independent migration contractors Business models Migration services (per a Statement of Work) Migration software (with training and support services) Technical approaches Noninvasive (DICOM C-MOVE) Migration Rapid Migration Protecting your interests Find the right amount of flexibility in requirements Schedule penalties/incentives Data confidentiality agreement

Technical Approaches Noninvasive Migration Rapid Migration Old PACS Image Storage PACS database DBMS Old PACS Interfaces & Application Logic Rapid Migration Appliance Dump File “Smart” Migration Appliance QUERY Schedule Info RETRIEVE STORE New PACS Rapid Migration Noninvasive Migration “Stat” QUERY DICOM SCP

Plan Early Include migration early in your planning Consider a Long Term or Enterprise Archive Get HL7 interfaces to New PACS running ASAP “Fourth party” consultants & project managers can earn their keep Good policies & practices for your current system Maintain your archive Understand and maintain your data Beware of dependencies on proprietary features

Make it easier next time Prepare now for the next PACS changeover: Require outbound migration specification from your new PACS vendor Speed Cost Maintain a separate long-term or enterprise archive Preferably one that stores its images in DICOM media file format

Handout materials, Contact info Presentation file: http://www.laitek.com/SIIM2008 Fred Behlen <fbehlen@laitek.com>