Dr. med. Klaus Krüger

Make new from old: Data migration to a new PACS

The MVZ for Neurology and Psychiatry, with its own specialty-related imaging (CT, later MRI and ultrasound), was already practicing an in-house form of digital cross-sectional image archiving in the second half of the 1990s. By means of an Access database filled with patient data and path names of the studies, the data stock was transferred and stored in a DICOM-compatible solution in 2006/2007 by a service provider. When the warranty period for this system expired again at the end of 2021, the medical center needed to decide whether to update the software (including replacement of the hardware for the third time in a row since 2006/2007) or to completely change the archiving system.

The following considerations went into the decision-making process:

• An existing, large DICOM archive with the data sets of 25 years (including approx. 220,000 studies or 32 million old objects)
• Retrieval times for comparing large individual studies and inventories were already becoming longer and longer, resulting in waiting times that were no longer tolerable in the long term, neither from the workflow point of view nor economically.
• Previous service provider showed a lack of commitment regarding the future improvement of the retrieval times ("it should be better afterwards, but this can neither be guaranteed nor proved in advance", the provider's CTO stated).

New PACSibilities, please!

The decision was then made in favor of a new PACS solution from IMAGE Information Systems. The MVZ Hennef has already been using IMAGE's DICOM Viewer iQ-VIEW since 2007, furthermore DICOM Reader and iQ-ROBOT, and "as this business relationship has always and without exception been a pleasant one, we got in contact with the Rostock-based company, especially since they had implemented a large number of PACS solutions worldwide over the past 15 years and also had extensive experience with data migrations" said Dr. med. Klaus Krüger, neurologist and psychiatrist at the MVZ, Hennef.

With the help of a trial installation of IMAGE’s PACS, iQ-WEB, the MVZ team was able to test this system in a virtualized Windows environment on an SSD datastore over a period of three months in winter 2021/2022. Compared to their old solution, especially the much shorter retrieval times even of large studies convinced the physicians at the medical care center.

In spring 2022, a new virtualized host computer was added to the practice network – carefully set up by the on-site service provider in coordination with IMAGE.

After iQ-WEB had been installed on the two physically separated SSD datastores of the new host, the migration of the legacy data to iQ-WEB was carried out with the help of the iQ-MIGRATION tool. Given the huge volume of legacy data, the migration took a total of three weeks. During the migration, each study was examined individually and only transferred to the new archiving system after a check. Dr. med. Klaus Krüger reports: "Thanks to the very intuitive user interface of the migration tool, we were able to resolve occasional program stops by ourselves after a short briefing and avoided longer waiting times – especially on weekends and holidays. During this time, the responsible IMAGE staff were even available on weekends for short consultations (phone/SMS/email), but these were rarely necessary."

On March 31, the center’s imaging modalities were integrated into IMAGE Information Systems' DICOM Modality Worklist (iQ-WORKLIST), and on April 1, the system was finally put into operation.

First impressions of the new PACS?

Despite the parallel migration of the remaining legacy data during the first few days, there were no performance problems whatsoever noticed by the medical center’s personnel and the retrieval times of very extensive legacy studies turned out to be impressively short – not least because the hardware components had been perfectly matched.

The final purging of the legacy data and the fine-tuning of iQ-WORKLIST for the write-backs to the practice information system still took a few days and also ran in the background. According to Dr. med. Krüger, all components work flawlessly and to their complete satisfaction.

The six-year-old former PACS server was not taken out of service, but reconfigured to function as a backup system from now on. Dr. med. Krüger reports: "Thanks to the almost ingeniously simple file structure of iQ-WEB, setting up the backup functionalities was just as easy (daily database and system partition with Acronis, daily DICOM data with Robocopy as a time-controlled Windows task)". He concludes:

"I would like to emphasize that all work (except for the hardware installation by a local company) was performed remotely, thus reducing costly travel time. In retrospect, I can recommend this solution without any reservation to any PACS user who is considering or needs to change their system. I would like to advise everyone not to skimp on the hardware!"