Seamlessly and securely integrate on-premise medical image workflows into AWS

August 5, 2021 Nelson Lee

Because healthcare organizations depend on their medical images to help improve patient outcomes, being able to securely store and retrieve those images reliably and quickly is crucial. Organizations face an increasing challenge to support a durable storage solution as image stores grow into hundreds of terabytes, and in some cases, petabytes. With the increasing number of ransomware events, organizations are looking for better ways to protect their images, especially because the commonly used mounted volume architecture is susceptible to these attacks.

Potential solutions need to consider the impact on clinicians’ workflows. Clinicians and radiologists rely on Picture Archiving and Communication System (PACS) to view and analyze images. Any added inefficiency such as learning new tools will negate other functional benefits, and be a blocker to cloud adoption for this use case.

A Vendor Neutral Archive (VNA) is popular among healthcare organizations, which centralizes and manages their images without changing the existing PACS by providing a downstream path for image requests. While VNA workflows can vary by organization, VNA data access profiles tend to be similar amongst organizations where a majority of the data is rarely accessed after it ages past the threshold point, while still requiring retrieval times on par with frequently accessed images. Also, considering that images are rarely deleted due to compliance requirements and the growing adoption of machine learning to unlock information from these large datasets, CTOs are required to routinely plan high-performance storage refreshes and acquiring additional datacenter space to serve clinician needs.

In this post, we demonstrate how healthcare organizations can migrate their VNA onto the AWS Cloud to help address these scaling challenges securely, while providing cost optimized storage services that meet the demands of clinicians – enabling customers for in depth conversations with vendors to ensure all their needs are met.

Architecture

Seamlessly and securely integrate on-premise medical image workflows into AWS

Seamlessly and securely integrate on-premise medical image workflows onto AWS

At the core of a VNA architecture is a Digital Imaging and Communications in Medicine (DICOM) interface, database, and storage. The DICOM interface allows customer DICOM devices such as a PACS to submit store and retrieval requests. Customers can use Amazon Elastic Cloud Compute (Amazon EC2) instances to perform this role, including in an autoscaling group to meet the load and high availability demands.

The VNA database stores all of the image DICOM metadata and storage locations in a relational database. Amazon Relational Database Service (Amazon RDS) can be used to simplify the setup, operations, and scaling.

Lastly, the images need storage that is durable, high performing, cost effective, and can help meet compliance requirements. The Amazon S3 storage class options provides all this, while making it easy for customers to integrate into the application using the AWS SDK. With Amazon S3 Intelligent-Tiering, customers can optimize storage costs automatically when data access patterns change, without performance impact or operational overhead. By placing the images behind the Amazon S3 API interface, a security layer is added to fend off ransomware attacks, along with the ability to track each request for audit requirements and performance through AWS CloudTrail and Amazon CloudWatch.

Next steps

In this post, we introduced how vendors can deploy VNA solutions on AWS to help their customers manage medical imaging workflows. To learn more, reach out to your AWS solution architect or contact us to get started.

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