1. Data Migration : Plan Early and Sleep Better AKA PACS/RIS Replacement
SIIM U 2008 Section 6 Friday, May 16, 3:30-5:00pm
Data Migration : Plan Early and Sleep Better AKA PACS/RIS Replacement
Fred M. Behlen, Ph.D.
Homewood, IL USA

2. Disclosure
Officer, Director & Shareholder, LAITEK Inc. a.k.a. Migratek Data Migration Services
Co-Chair, HL7 Imaging Integration Work Group and DICOM Working Group 20 (the DICOM/HL7 common working groups)

3. So you’re getting a new PACS…
Data migration and its alternatives
D.I.Y. migration for small jobs
Anatomy of a migration project
Advance planning
Defining your requirements
Working with vendors

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
Old PACS
New PACS
Query
Retrieve
Old PACS
New PACS
Migrate
Old PACS
Long Term Archive
New PACS

5. 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 engineers getting senile
Migration becoming the Standard of Practice
Likability
You just don’t like that old PACS any more

6. Isn’t it easy?
Old PACS
New PACS
DICOM

7. Isn’t it easy? Old PACS New PACS DICOM C-STORE DICOM C-MOVE
Migration Controller

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
Proprietary image annotation and markup
Some data may need to be updated to current DICOM Standards

9. D. I. Y. Data Migration Use “send” utility on source PACS
Use “import” utility on target PACS
Use a DICOM workstation
Fetch studies from source archive
Store studies to target archive
Repeat
Write & run your own command (script) files using a (free) DICOM C-MOVE client program
e.g. OFFIS movescu.exe (Google for “OFFIS DICOM”)
Use a free migration utility (write to me and I’ll send you one)

10. … 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

11. 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

12. 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

13. “Dirty” PACS data Misidentified data Junk data Bad data
Patient demographic data
Accession Number
Junk data
Test images
Discarded images
Bad data
Corrupted/invalid DICOM objects
Repairable over-length fields are not uncomon
Unsupported old SOP classes (image types)

14. Patient-level reconciliation
Image attributes
Patient ID
Patient Name
Patient Sex
Patient Birthdate
Patient attributes ID
Name
Sex
Birthdate

15. Exam-level reconciliation
Image attributes
Patient ID
Patient Name
Patient Sex
Patient Birthdate
Accession Number
Modality
Study Date,Time
Image Date,Time
Order attributes
Patient ID
Patient Name
Patient Sex
Patient Birthdate
Order Number
Modality
Procedure Code
Check-in DateTime
Start DateTime
End DateTime

16. 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

17. Migration to today’s PACS
RIS
HL7
Orders
HL7
Results
New PACS
HL7
Legacy PACS
DICOM
Updates
Images
Most modern PACS rely heavily on RIS Orders & Results data
Orders and/or Results usually must be sent to the PACS before migrated images
 This can have a major impact on project schedules

18. Working with vendors Who does data migration? Business models
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

19. Technical Approaches Noninvasive Migration Rapid Migration Old PACS
Image Storage
PACS database
DBMS
Old PACS
Interfaces & Application Logic
Rapid Migration Appliance
Dump File
“Smart” Migration Appliance
QUERY
Schedule Info
RETRIEVE
STORE
New PACS
Rapid Migration
Noninvasive Migration
“Stat” QUERY
DICOM SCP

20. Plan Early Include migration early in your planning
Consider a Long Term or Enterprise Archive
Get HL7 interfaces to New PACS running ASAP
“Fourth party” consultants & project managers can earn their keep
Good policies & practices for your current system
Maintain your archive
Understand and maintain your data
Beware of dependencies on proprietary features

21. 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

22. Handout materials, Contact info
Presentation file:
Fred Behlen