PACSRIS Replacement: Data Migration

1
PACS/RIS ReplacementData Migration
SIIM 2007 Hot Topic Session 3 Friday, June 8,
800-930am

• Fred M. Behlen, Ph.D.
• Homewood, IL USA

2
Disclosure

• Officer, Director Shareholder, Laboratory
  Automation Inc. (LAITEK), Homewood, IL, provider
  of MigratekSM Data Migration Services
• Co-Chair, HL7 Imaging Integration SIG and DICOM
  Working Group 20 (the DICOM/HL7 common working
  groups)

3
So youre getting a new PACS

• Do I need to migrate my data?
• Can I do it myself?
• How do I specify a data migration job?
• How do I get someone to do it?
• How can I make it easier next time?

4
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

OldPACS
NewPACS
Query
Retrieve
OldPACS
NewPACS
Migrate
OldPACS
NewPACS
LongTermArchive
5
Can I do the same with reports?
Lack of implemented query standards limitsyour
options

• Retain access to legacy RIS
• Migrate data to
• the new RIS
• an enterprise repository

OldRIS
NewRIS
HL7 Query
HL7 Send
OldRIS
NewRIS
Migrate
?
?
OldRIS
NewRIS
EHR / ReportRepository
6
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 getting thin
• Migration becoming the Standard of Practice

7
Isnt it easy?
OldPACS
NewPACS
DICOM
8
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
• Coercions/corrections of patient demographics
• Some data may need to be updated to current DICOM
  Standards

9
D. I. Y. Data Migration

• Use a DICOM workstation
• Fetch studies from source archive
• Store studies to target archive
• Repeat
• Write run your own command (script) files
• Download a DICOM C-MOVE client program
• e.g. OFFIS movescu.exe (http//dicom.offis.de/dcmt
  k.php.en)
• Get a listing of the Studies in the source
  archive
• Make a batch file with one line to move each
  study
• Run it

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Script it yourself
Source Study Listing
echo 1 movescu -S -key 0020,000D"1.3.6.1.4.1.
16592.2.668980.864771.802" -aem NEW_PACS -aec
PACS_ARCHIVE -aem 10.10.1.22 10222
gtgtmigr.log echo 2 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.942708.483380.311"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 3 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.589418.207412.90"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 4 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.898719.402885.89"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 5 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.767350.594702.411"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 6 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.682688.583102.135"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 7 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.702211.149338.976"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 8 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.563630.293819.257"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 9 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.161189.135527.222"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 10 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.807468.458742.901"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 11 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.301849.894730.106"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 12 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.532073.23518.750"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 13 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.265758.276689.629"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 14 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.66805.844604.191"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 15 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.720483.942452.266"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 16 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.626366.70276.934"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 17 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.774470.406700.278"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log echo 18 movescu -S -key
0020,000D"1.3.6.1.4.1.16592.2.863735.648125.965"
-aem NEW_PACS -aec PACS_ARCHIVE -aem 10.10.1.22
10222 gtgtmigr.log
Command File
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Each line of script file
echo 9 (Echoes line number to show progress)
movescu (Invokes movescu.exe program)
-S (Selects Study level move)
-key 0020,000D"1.3.6.1.4.1.16592.2.161189.135527.
222" (Specifies Study Instance UID)
-aem NEW_PACS (AE Title of New PACS archive)
-aec PACS_ARCHIVE 10.10.1.22 10222 (AE
Title, IP address port of Old PACS archive)
gtgtmigr.log (Sends output to log file)
echo 9 movescu -S -key 0020,000D"1.3.6.1.4.1.
16592.2.161189.135527.222" -aem NEW_PACS -aec
PACS_ARCHIVE -aem 10.10.1.22 10222 gtgtmigr.log
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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

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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

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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

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Dirty PACS data

• Misidentified data
• Patient demographic data
• Accession Number
• Junk data
• Test images
• Discarded images
• Bad data
• Unsupported old SOP classes (image types)
• Corrupted/invalid DICOM objects

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Patient-level reconciliation

• Image attributes
• Patient ID
• Patient Name
• Patient Sex
• Patient Birthdate

• Patient attributes
• ID
• Name
• Sex
• Birthdate

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Exam-level reconciliation

• Image attributes
• Patient ID
• Patient Name
• Patient Sex
• Patient Birthdate
• Accession Number
• Requested Procedure ID
• Modality
• Referring Physician
• Study
• Series DateTime
• Image

• Report attributes
• Patient ID
• Patient Name
• Patient Sex
• Patient Birthdate
• Order Number
• Procedure Schedule ID
• Procedure Code
• Referring Physician
• Exam DateTime
• Report DateTime
• Reporting Physician

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Working with vendors

• Who does data migration?
• 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

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Phases of a Migration project

• Assessment. Detailed post-award investigation
  and planning by the migration vendor.
• Installation. Migration equipment or software
  installed.
• Inventory. Taking stock of all studies/series to
  be moved, and (if required) HIS/RIS
  demographic/exam data for mapping.
• optional Mapping. Matching activities for data
  cleansing.
• Transfer. Transferring the data, applying
  cleanup/correction/remapping functions as needed.
  
• Verification. Checking the migrated data at the
  target archive for validity.
• Cleanup and removal. Cleanup of configurations
  (migration AE Titles, permissions, VPNs, etc.)
  and removal of migration equipment or software.

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Technical Approaches
Old PACS
New PACS
Noninvasive Migration
Schedule Info
Smart MigrationAppliance
Interfaces Application Logic
QUERY
Stat QUERY
Interfaces Application Logic
DICOM SCP
STORE
RETRIEVE
DICOM SCP
DBMS
DBMS
Rapid Migration
DumpFile
PACSdatabase
PACSdatabase
RapidMigrationAppliance
STORE
Image Storage
Image Storage
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Noninvasive vs. Rapid Migration

• Noninvasive Migration
• Advantages
• No inside knowledge of source PACS required
• A single design serves a broad range of source
  systems
• Low cost of migration equipment
• Disadvantages
• Lengthy period of migration
• Workflow delays when studies must be retrieved
  stat from the legacy system
• Customer management attention and staff training
  needed for operating during migration
• Not usable for old PACS that lack DICOM
  query/retrieve interface

• Rapid Migration
• Advantages
• Legacy PACS can be retired sooner
• Data can be migrated before go-live
• No delays fetching from old PACS
• Shorter length of project (saves money for both
  customer and vendor)
• Suitable for old PACS that lack DICOM
  query/retrieve interface
• Disadvantages
• Engineering investment for each type of source
  PACS
• Target PACS must be able to handle high DICOM
  input rates
• More intensive site presence may be required
  during migration

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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

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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

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Handout materials, Contact info

• Presentation and D.I.Y. script files
  http//www.laitek.com/SIIM2007
• Fred Behlen ltfbehlen_at_laitek.comgt