Can CDMI emancipate an interoperable medical records cloud ecosystem?

PREFACE: This is just a thought, an idea. I am by no means an expert in this area. I have researched this to inspire a thought process of how we can bring together 2 disparate worlds of medical records and imaging with the emerging cloud services for healthcare.

Healthcare has been moving out of its archaic shell in the past few years, and digital healthcare technology and services are booming. And this movement is part of the digital transformation which could eventually lead to a secure and compliant distribution and collaboration of health data, medical imaging and electronic medical records (EMR).

It is a blessing that today’s medical imaging industry has been consolidated with the DICOM (Digital Imaging and Communications in Medicine) standard. DICOM dictates the how medical imaging information and pictures are used, stored, printed, transmitted and exchanged. It is also a communication protocol which runs over TCP/IP, and links up different service class providers (SCPs) and service class users (SCUs), and the backend systems such as PACS (Picture Archiving & Communications Systems) and RIS (Radiology Information Systems).

Another well accepted standard is HL7 (Health Level 7), a similar Layer 7, application-level communication protocol for transferring and exchanging clinical and administrative data.

The diagram below shows a self-contained ecosystem involving the front-end HIS (Hospital Information Systems), and the integration of healthcare, medical systems and other DICOM modalities.

Hospital Enterprise

(Picture courtesy of Meddiff Technologies)

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The dark ages of data is coming

A recent report intrigued me. Given the recent uprising of data, data and more data, things are getting a bit absurd about the voluminous data we are collecting and storing. The flip is that we might need all these data for analytics and getting more insight from the data.

The Veritas Darkberg report revealed that a very large percentage of the data collected and stored by organizations are useless data, unknown and unused. I captured a snapshot of the report below:

Screen Shot 2015-11-08 at 8.03.05 AM

From the screenshot above, it shows 54% of the landscape surveyed is dark data, unseen and clogging up the storage. And in an instance, the Darkberg (cross of “Dark” and “Iceberg”) report knocked a lot of sense into this whole data acquisition frenzy we are going through right now.

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Discovery of the 8th element – Element R

I am so blind. After more than 20 years in the industry, I have chosen to be blind to one of the most important elements of data protection and availability. Yet, I have been talking about it over and over, and over again but never really incorporated it into mantra.

Some readers will know that I frequently use these 7 points (or elements) in my approach to storage infrastructure and information management. These are:

  • Availability
  • Performance
  • Protection
  • Accessibility
  • Management
  • Security
  • Compliance

A few days ago, I had an epiphany. I woke up in the morning, feeling so enlightened and yet conflicted with the dumbfounded dumb feeling. It was so weird, and that moment continued to play in my mind like a broken record. I had to let it out and hence I am writing this down now.

Element RRecovery, Resiliency, Restorability, Resumption. That’s the element which I “discovered“. I was positively stunned that I never incorporated such an important element in my mantra, until now. Continue reading

Don’t get too drunk on Hyper Converged

I hate the fact that I am bursting the big bubble brewing about Hyper Convergence (HC). I urge all to look past the hot air and hype frenzy that are going on, because in the end, the HC platforms have to be aligned and congruent to the organization’s data architecture and business plans.

The announcement of Gartner’s latest Magic Quadrant on Integrated Systems (read hyper convergence) has put Nutanix as the leader of the pack as of August 2015. Clearly, many of us get caught up because it is the “greatest feeling in the world”. However, this faux feeling is not reality because there are many factors that made the pack leaders in the Magic Quadrant (MQ).

Gartner MQ Integrated Systems Aug 2015

First of all, the MQ is about market perception. There is no doubt that the pack leaders in the Leaders Quadrant have earned their right to be there. Each company’s revenue, market share, gross margin, company’s profitability have helped put each as leaders in the pack. However, it is also measured by branding, marketing, market perception and acceptance and other intangible factors.

Secondly, VMware EVO: Rail has split the market when EMC has 3 HC solutions in VCE, ScaleIO and EVO: Rail. Cisco wanted to do their own HC piece in Whiptail (between the 2014 MQ and 2015 MQ reports), and closed down Whiptail when their new CEO came on board. NetApp chose EVO: Rail and also has the ever popular FlexPod. That is why you see that in this latest MQ report, NetApp and Cisco are interpreted independently whereas in last year’s report, it was Cisco/NetApp. Market forces changed, and perception changed.  Continue reading

The transcendence of Data Fabric

The Register wrote a damning piece about NetApp a few days ago. I felt it was irresponsible because this is akin to kicking a man when he’s down. It is easy to do that. The writer is clearly missing the forest for the trees. He was targeting NetApp’s Clustered Data ONTAP (cDOT) and missing the entire philosophy of NetApp’s mission and vision in Data Fabric.

I have always been a strong believer that you must treat Data like water. Just like what Jeff Goldblum famously quoted in Jurassic Park, “Life finds a way“, data as it moves through its lifecycle, will find its way into the cloud and back.

And every storage vendor today has a cloud story to tell. It is exciting to listen to everyone sharing their cloud story. Cloud makes sense when it addresses different workloads such as the sharing of folders across multiple devices, backup and archiving data to the cloud, tiering to the cloud, and the different cloud service models of IaaS, PaaS, SaaS and XaaS.

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Oops, excuse me but your silo is showing

It is the morning that the SNIA Global Steering Committee reporting session is starting soon. I am in the office extremely early waiting for my turn to share the happenings in SNIA Malaysia.

And of late, I have been getting a lot of calls to catch up on hot technologies, notably All Flash Storage arrays and hyper-converged infrastructure. Even though I am now working for Interica, a company that focuses on Oil & Gas exploration and production software, my free coffee sessions with folks from the IT side have not diminished. And I recalled a week back in mid-March where I had coffee overdose!

Flash storage and hyperconvergence are HOT! Despite the hypes and frenzies of both flash storage and hyperconvergence, I still believe that integrating either or, or both, still have an effect that many IT managers overlook. The effect is a data silo.

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Why demote archived data access?

We are all familiar with the concept of data archiving. Passive data gets archived from production storage and are migrated to a slower and often, cheaper storage medium such tapes or SATA disks. Hence the terms nearline and offline data are created. With that, IT constantly reminds users that the archived data is infrequently accessed, and therefore, they have to accept the slower access to passive, archived data.

The business conditions have certainly changed, because the need for data to be 100% online is becoming more relevant. The new competitive nature of businesses dictates that data must be at the fingertips, because speed and agility are the new competitive advantage. Often the total amount of data, production and archived data, is into hundred of TBs, even into PetaBytes!

The industries I am familiar with – Oil & Gas, and Media & Entertainment – are facing this situation. These industries have a deluge of files, and unstructured data in its archive, and much of it dormant, inactive and sitting on old tapes of a bygone era. Yet, these files and unstructured data have the most potential to be explored, mined and analyzed to realize its value to the organization. In short, the archived data and files must be democratized!

The flip side is, when the archived files and unstructured data are coupled with a slow access interface or unreliable storage infrastructure, the value of archived data is downgraded because of the aggravated interaction between access and applications and business requirements. How would organizations value archived data more if the access path to the archived data is so damn hard???!!!

An interesting solution fell upon my lap some months ago, and putting A and B together (A + B), I believe the access path to archived data can be unbelievably of high performance, simple, transparent and most importantly, remove the BLOODY PAIN of FILE AND DATA MIGRATION!  For storage administrators and engineers familiar with data migration, especially if the size of the migration is into hundreds of TBs or even PBs, you know what I mean!

I have known this solution for some time now, because I have been avidly following its development after its founders left NetApp following their Spinnaker venture to start Avere Systems.

avere_220

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