Digital Imaging and Communications in Medicine (DICOM)

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Chapter 15 Disaster PACS Planning and Management
post-Katrina Louisiana, we did not yet have fully supported DICOM network
security. But we had, in addition to many standard ones, a proprietary DICOM
compression algorithm that was never publicly published or disclosed. Setting
the system to this compression worked just like encryption: had anyone intercepted
our compressed transaction, he would not have been able to decipher it
with any known technique. Always know your options.
15.2.3
Archiving
Definitely, you need to secure your data archive. Creating another local copy
might solve this problem only partially. Another option would be archive outsourcing.
It would cut your local operational costs, it would save space, and it
would, most importantly, store your backup archive copy remotely to minimize
the chances of it being destroyed by the same disaster striking your building.
However, please keep in mind that storage outsourcing, especially on a large
scale is more expensive than storing data locally. It also makes you dependent
on your remote archiving company, so chose it carefully. Pay particular attention
to any contract termination issues so that the company won’t disappear
with all your data. The network (between local and remote archives) becomes
your major point of failure. Ensure that you plan carefully for other emergency
solutions, such as dispatching remote data back to you on hard drives.
By far, the best archiving solution is the solution that can be distributed
among several independent locations so that your PACS identifies the correct
location automatically. In other words, the best archive looks more like a datasaturated
network, where it really does not matter where the data resides as
long as it is known where it can currently be found. Most of us use this simple
approach all the time when we divide our DICOM data storage into teaching
archives, 3D cardiology cases, perfusion studies, and whatever else; it is
much faster to retrieve it from a small dedicated server than to pull everything
from a crowded and bottlenecked central archive. Centralized PACS archives
are dangerous and inefficient. If all cell phones worked from a single tower, we
wouldn’t have any cell phones.
15.2.4
Disaster-Proof PACS Design
Finally and most critically, your ability to survive any extreme event will depend
directly on your PACS granularity. What is the smallest subset of your
system that can function independently as a stable, self-sufficient PACS?
In the majority of cases, PACS are not granular at all. They are rigidly embedded
into hospitals, spread over several floors or even buildings, and stati-