Fall Cleaning - Imaging Style (Part 2)

Welcome back to the Fall Cleaning series! Hope you found some helpful takeaways in part 1. As you might remember we explored several admin-level ideas for keeping your “imaging house” in top running order. If you missed Fall Cleaning – Imaging Style (Part 1) be sure to give it a read and make your 4th Quarter your most productive yet!

Today I’m going to share with you some of the more hands-on systems level tasks that I recommend tackling while you’re reaping the benefit of the Thanksgiving, RSNA and Christmas lull. So, without further ado, let’s dive in to some system’s work.

Disaster Recovery (DR) - When was the last time you did a DR failover … On purpose? With lower volume and some reduction of project-work this is the perfect time to schedule a failover and validate your procedures. Note: I don’t suggest you do this ON a holiday week, but before or after. Likely, there will be a few gremlins that need to be addressed and you will want to have some support staff around to help you sort these out.  This is also the perfect time to update your process documentation.

Configuration audit - If it ain’t broke, don’t fix it right? Well……. It could be “broke” but you just don’t know it yet. As systems become more and more complex you may have things misrouted, or misconfigured, but the redundancy in your system covers it up. This is an ideal time to dedicate some resources to giving system configurations a onceover to make sure all is as it should be. I would check routing, pre-fetch rules, storage locations, any prefixing or data manipulation (tag management), HL7 interfaces, compression, archive queues, unarchive counts, etc. As an example, a fast network may mask the fact that prefetching was turned off years ago, no biggie until you add in 5 tomo units and everything changes!

Storage storage storage - We all know that image sizes get bigger each year… tomo… but what about the system storage? Do you have cache storage where you need it? Are studies storing in the right location? How fast are you adding in data vs how much you have, ie. what is your run rate? If you are storing 5TB per year but only have 2 TB of storage you may want to look at this because, in addition to the new data, priors will be pulled back locally. Run your checks and make sure you have budgeted for storage both long term and short term!

Monitor backlight hours - If you’re not running an enterprise automated solution that preemptively alerts you it’s likely that you have little insight into the backlight hours of your diagnostic monitors. They do wear out! It makes an enormous difference in how your screensaver is setup, many times the backlight is running all night which reduces the monitor’s useful life because the monitor is still “on” when no one is reading. Take the time to run a good preventative check on your diagnostic monitors and order replacements if you need to.

QC issues - Data quality is a huge issue; in my experience I’ve found about 2% of studies didn’t match an order. Whether you are looking at PACS or VNA, there will be data sets that do not match. I have run into sites with thousands, and even hundreds of thousands, of studies flagged with QA issues that were left unresolved. You want the data to match as a prior and there is no benefit to leaving these issues to sit indefinitely. So, while it’s not necessarily the most fun of tasks, the 4th quarter tends to be a good time to dedicate 1-2 hours per day (possibly per person depending on your volume) to weed through and fix these data quality issues. 

Cable management – Most of us have been in a new server room, you start with good clean racks and tidy cable management then, as servers get moved in and out the whole space starts to resemble a consortium of octopi. Eventually, you have network cables tied to power cables tied to KVM cables strung between racks. Yes, it happens, but why not schedule a time to flip over to the DR system and clean up those racks? Anyone who has do to any work, ever, in your server room with thank you immensely!

Now that you’re armed with even more tips to a tidy and productive 4th quarter it’s time to get to work! As always, I greatly welcome your comments, thoughts and ideas so reach out on the blog, email or LinkedIn. And, if you’re going to be at RSNA this year and would like to connect in person let me know!