1. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 Planning for Expansion Steve Nevermann Workflow Solutions Manager

2. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 2 How do you know when it is time to expand your solution? What Options Should I Consider and Why? Multi-Tier Storage Overview Planning Check List/Workflow Solution Design Agenda

3. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 3 How do you know when it is time to expand your solution? Are you adding additional sites? Are you expanding the procedure volume? Are you adding additional modalities? Are you adding additional employees to the workflow? (Techs, Radiologists, etc.) Are you expanding from a simple to more complex workflow (e.g. tele-radiology to complete PACS)? Are you integrating to a new/existing system?

4. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 4 Adding new Sites What functionality are you adding at the new site? RIS, PACS, RIS/PACS

5. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 5 Are you expanding the procedure volume? How is the volume expanding? Can you utilize compression, if so at what level? Will you be adding Additional modalities Additional procedures on existing modalities? What changes will occur in the everyday workflow?

6. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 6 Are you adding additional Modalities Are the modalities DICOM compliant, what capabilities do they have? Will they support at least DICOM Store and DICOM MWL? How large will the image sets be? How will this modality affect the radiologist workflow? Will there be a need for additional reading groups for the managing the radiologist reading? Is the modality mobile? (US, Mobile MRI, Mobile PET)

7. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 7 Are you expanding from a simple to more complex workflow? Maybe a current tele-radiology solution, expanding to complete PACS or RIS/PACS Maybe a PACS only scenario to a complete RIS/PACS or RIS completing a RIS/PACS Maybe adding additional 3 rd party software/hardware to the core system (Digital Dictation, Scheduling, Lab Results, etc) Are you adding new center or remote location?

8. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 8 Are you integrating to a new/existing system? Will there need to be any migration? (Legacy images, reports, core tables) Will there be any interfaces with existing dictation systems, EMR systems, Scheduling system, etc. Has the workflow been thought through and a firm understanding of the overall workflow change? Has a workflow design been created and agreed upon? (see associated document)

9. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 9 What Storage Options Should I Consider and Why? Direct Connect On-Line Storage with Media Backup –Pros: Most cost effective approach Backup data is written to media for secure shelf management –Cons: Scaling of On-Line RAID not as great as that of a Network Attached Storage (NAS) Solution Time consuming recovery of On- Line RAID should device fail

10. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 10 What Storage Options Should I Consider and Why? Single NAS for On-Line Storage with Media Backup –Pros: Increased Scalability Backup data is written to media for secure shelf management –Cons: Increased costs as compared to direct connect storage. Time consuming recovery of On-Line RAID should device fail

11. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 11 What Storage Options Should I Consider and Why? Replicated NAS for On-Line Storage, No Media Device –Pros: Minimal down time should a single On-Line Storage array fail –Cons: Increased cost as both NAS solutions require scaling Data, while duplicated, is vulnerable by virtue of the fact that is is sitting on spinning disk (no media backup)

12. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 12 What Storage Options Should I Consider and Why? Replicated NAS for On-Line Storage with Media Backup –Pros: Minimal down time should a single On-Line Storage array fail Backup data is written to media for secure shelf management –Cons: Cost

13. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 13 What Tools Are Available? Data Replication Compression Media Management Remote Data Storage N-Tier Support

14. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 14 N-Tier Storage Multi-Tier Storage –Allows for the identification of a tier of file systems. –Data is migrated to lower level tiers Age based, configurable per tier As required, to free up space on higher level tier –Data Mirroring independently supported on each tier

15. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 15 N-Tier Storage Example Fusion Servers Mirror Primary Migrate 90 Days Archive Mirror Copy

16. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 16 N-Tier Storage - Benefits Multi-Tier Storage –Low cost, entry level alternative to full Hierarchical Storage Management (HSM) –Enhanced storage growth path –Flexible configuration –Allows for better optimization of Cost/Performance –Sets you up to leverage newer/faster/less expensive technology as it becomes available

17. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 17 Planning Check List/Workflow Solution Design Don’t forget to contact the Merge eMed Workflow Solutions team to assist anytime a change in your workflow occurs! Steve Nevermann: Workflow Solutions Manager 414-977-4348, snevermann@merge-emed.com Mary Rose Kenwood: Workflow Solution Specialist 414-977-4315, mkenwood@merge-emed.com Lee Taylor: Workflow Solution Specialist 414-977-4046, ltaylor@merge-emed.com

18. www.merge-emed.com ©2006 Merge eMed. All Rights Reserved. Energize Your Workflow 2006 User Group Meeting May 7-9, 2006 18 Your Host: Steve Nevermann Steve Nevermann – Workflow Solutions Manager 414-977-4348 snevermann@merge-emed.com