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On-premises-first hybrid workflows in healthcare. Why start with digital pathology?

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dukicn
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Nov 11, 2024

On-premises-first hybrid workflows in healthcare. Why start with digital pathology?

 

Disclaimer: The following post has been co-authored by our ISV, Tiger Technology.

 

Digital pathology includes acquisition, management, sharing and interpretation of pathology information, both slides and data in a digital environment. Digital slides are created when glass slides are captured with a scanning device to provide a high-resolution digital image that can be viewed on a computer screen or mobile device.

Healthcare systems and organizations are implementing digital pathology workflows to enhance clinical services and care due to benefits such as improved efficiency, remote consultations, and collaboration among pathologists. Digital pathology enables remote access of slides, facilitating faster diagnoses, knowledge sharing, and access to specialized expertise. The introduction of high-resolution whole-slide imaging (technology where glass slides are scanned to produce digital images), combined with AI/ML approaches, could significantly improve the pathology workflow and diagnostic accuracy, leading to more precise diagnoses and personalized treatment plans.

Implementing digital pathology solutions is a complex task that requires more than just purchasing scanners and an image viewer. It involves identifying a comprehensive solution that effectively utilizes these technologies to improve clinical services and care, while also delivering a strong return on investment. This necessitates prioritizing these activities within the healthcare organization. Many healthcare organizations with digital pathology implementations have chosen enterprise or radiology-focused solutions due to existing relationships for storage and visualization. However, the unique requirements of digital pathology calls for a different approach.

An additional challenge comes from the fact that pathology generates an enormous amount of data annually, with global data generation in pathology estimated to reach up to 10 exabytes (based on the US pathologist workforce, the number of slides viewed daily, and the US share of global cancer incidence).

Finally, a typical midsize hospital may require several PB of storage to handle daily diagnostic imaging, pathology slide scans, and the digitization of archives spanning several years, not to mention the need for data backup and retention times of usually 10-15 years.

 

Cloud adoption over migration in healthcare

To overcome these challenges, healthcare organizations need to carefully evaluate and select a digital pathology storage solution that addresses their unique requirements. This entails factors such as storage scalability, data security, compliance with privacy regulations, and cost-effectiveness.

One way to fulfil these requirements is through hybrid storage solutions, which combine on-premises infrastructure with cloud-based services and are based on open standards. They can offer a viable approach to managing the substantial volume of pathology data without requiring complete re-architecting of critical workflows.

In the context of on-premises-first hybrid workflows, cloud adoption also offers numerous benefits such as:

 

  • Cost optimization and data protection,
  • Multi-site collaboration to fuel clinical work and research,
  • Adoption of AI services for faster and more accurate diagnosis.

Tiger Technology offers this approach to healthcare organizations through Tiger Bridge, a reliable tool for seamlessly managing and organizing mission-critical information, including its cloud tiering and archiving. This data management software enables organizations with an on-premises-first mindset to adopt hybrid cloud based on open standards without re-architecting their existing workflows.

 

How Microsoft Azure and Tiger Bridge help customers realize outcomes through cloud adoption

To optimize and improve digital pathology workflows, an optimal solution should facilitate the smooth integration of nearline or archived data with Microsoft Azure services. Such integration offers various benefits, including cost optimization and enhanced availability by leveraging the customer's existing Azure hot, cool, cold, or archive tiers. Additionally, Azure provides access to cognitive services and artificial intelligence/machine learning (AI/ML) capabilities, further enhancing the overall workflow experience.

The Bridge technology, in particular, integrates at the level of the file system and/or network share so that healthcare organizations continue to use their existing local infrastructure and leverage the benefits of the cloud as their patient data requirements grow. During the team's operations, policies operate discreetly in the background, ensuring the replication of patient data to the cloud while seamlessly integrating with the existing PACS/DICOM data.
Tiger Bridge also enables collaboration on the same data across multiple locations and healthcare professional groups, seamlessly connecting local sites and the cloud. It ensures patient data privacy and meets regulatory requirements. Tiger Bridge uses HTTPS/SSL transfer protocols to connect data to the cloud and adheres to Active Directory permissions.

In addition, Tiger Bridge supports interoperability and standardization as DICOM conversion could be an additional feature. It is believed that DICOM will become the dominant format, since it not only defines an image format but also defines protocols for image exchange and maintenance that have been used for years in radiology. This is important for secure whole-slide imaging share when discussing patient cases and looking for a second clinical opinion.

Tiger Bridge could also connect data to any powerful cloud-based AI image analytics and leverage ML tools that effectively support clinical decisions. It enhances the workflow by connecting the images to any AI/ML (DICOM Labelling, Model Training and Experimentation, etc.), while metadata is presented locally to be used by the existing workflow. This is achieved without the need to re-engineer the infrastructure or the workflow.

 

Tiger Bridge plug-in for Image Management Systems

Tiger Bridge integrates with image management systems and Microsoft Azure services. This efficient combination creates a single namespace without any disruptions in existing workflows. It preserves the original file format and meets compliance and security requirements. When using Azure Archive Blob Storage tier, data can be stored in a WORM (Write Once Read Many) format and must be rehydrated before use. At the same time, Tiger Bridge is 100% transparent for the workflow, including search and queries, and does not introduce any changes for doctors using the image management system.

 

How Tiger Bridge helped a large German hospital in reducing storage and infrastructure costs

In the realm of digital pathology technology, one of the foremost challenges is the steep adoption cost, which encompasses storage and infrastructure expenses, workflow disruptions, and compliance concerns. However, Tiger Bridge has ushered in a transformative solution for a prominent German hospital, profoundly impacting its operations.

Previously, the hospital incurred significant expenses to accommodate its daily slide scans and digitization of decade-old archives, amounting to a considerable storage burden. Typically, local storage costs can vary depending on the vendor, falling within the range of $25 to $35 per TB per month, while the hospital currently generates over 1PB of data each year, with a minimum retention period of 15 years.

Through seamless integration into the hospital's digital pathology workflows, Tiger Bridge empowered the institution to seamlessly utilize its existing local infrastructure while harnessing the immense advantages of Microsoft Azure for its whole slide imaging (WSI) data requirements. Consequently, the hospital no longer needs to invest in additional local storage, resulting in a substantial cost reduction.

The implementation of Tiger Bridge, coupled with the utilization of Azure Archive Blob Storage tier, has additionally lowered the hospital's storage costs to below $10 per TB per month, or 2.5 times less than before.

Last but not least, by adopting the on-premises-first approach, the institution gained additional advantages, including the ability to enhance pathology data through cloud services such as artificial intelligence and machine learning (AI/ML).

The partnership between Microsoft and Tiger Technology enables healthcare organizations and other businesses handling critical data to embrace cloud technologies without significantly changing their existing infrastructure or workflows. This integration delivers cost optimization, improves data interoperability, and access to AI/ML capabilities, all while ensuring the privacy and regulatory compliance of health data.

On a broader scale, the on-premises-first approach to the cloud empowers healthcare institutions to start implementing digital pathology workflows and enhance clinical services and care.

 

About Tiger Technology

Tiger Technology helps organizations with mission-critical deployments optimize their on-premises storage and enhance their workflows through cloud services. The company is a validated ISV partner for Microsoft in three out of five Azure Storage categories: Primary and Secondary Storage; Archive, Backup, and BCDR and Data Governance, Management, and Migration. 

Tiger Bridge by Tiger Technology is an Azure benefit-eligible, data management software enabling seamless hybrid cloud infrastructure. Installed in the customer’s on-premises or cloud environment, Tiger Bridge intelligently connects file data across file and object storage anywhere for data lifecycle management, global file access, Disaster Recovery, data migration and access to insights. Tiger Bridge supports all Azure Blob Storage tiers, including cold and archive tiers for long-term archival of data.

Updated Nov 14, 2024
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