Protect Your Patient’s Imaging Data-PACS Security and Backup Solutions

Medical imaging has fully transitioned over to the digital realm. Many healthcare facilities now do not routinely print films or store them physically. Instead, all medical images are acquired in a digital format specific to medical imaging, called the DICOM standard. DICOM imaging files need their own form of electronic storage from which they can be retrieved and viewed when needed. This is where PACS comes in. Healthcare facilities that deal with medical images understand that they need a secure PACS server to ensure the safety of stored data. Two essential features of any reliable PACS system are data security and backup.

What exactly is a PACS? What type of data is stored in a PACS?

Healthcare facilities use a medical imaging technology system called PACS to store their DICOM files. PACS stands for Picture Archiving and Communications System. The technology replaces the need for hard copy films and film archives. PACS consists of a central server that houses all the imaging files. When images are acquired from the source, they can be directly saved to the PACS data storage system. Files can be retrieved from the PACS, modified as needed and stored again. The PACS stores not only the DICOM images, but also patient information, such as their name, age, and medical status. It may sometimes be integrated with the patient’s Electronic Medical Record (EMR). The PACS is usually installed as standalone software in the DICOM workstation, located mostly in the radiology department of a healthcare facility.

Recently, there has been an increase in cloud-based PACS servers. ‘Cloud’ refers to internet-based servers. Cloud PACS data storage systems are not physically located on the premises. Instead, they are located virtually on the internet and DICOM files are stored in the cloud. A cloud-based PACS has several advantages over traditional PACS. For example, you save on the cost and space requirements for hardware. You do not need to install specialized PACS software. Instead, you can just open your web browser and log on to the website that hosts the PACS server. This allows you to access DICOM imaging files from any device at any time.

Cloud based PACS allows you to conveniently increase or decrease your storage space as needed. For instance, with PostDICOM’s advanced cloud-based PACS solution, you can start with a basic 100 GB of secure cloud storage. From there, cloud storage can be expanded to 500 GB for $149.99 per month and as much as 2,000 GB for just $499.99 per month.

How do I keep patient data on PACS secure?

Storing medical images that belong to patients is an extremely sensitive process. Medical images come under the category of protected health information (PHI), which has to be kept confidential and protected from unauthorized access. With on-premises PACS servers, only authorized users are allowed to access the hardware that houses the PACS. Moreover, the user will need specific credentials to log on to the system and access medical images from the PACS.

It is often assumed that a cloud-based PACS would be less secure, considering that information is stored via the internet. This is, however, not the case. Firstly, both on-premises and cloud-based PACS are equally vulnerable to hacking and, therefore, have the same amount of security threat. Secondly, cloud-based applications generally offer more PACS security features than on-premises PACS. Some of the PACS security features available in cloud-based systems include

• Encryption: Encryption is a process by which data is encoded or ‘scrambled’, so that it is no longer readable when viewed by unauthorized individuals. Only users with proper credentials will be able to unlock the key and transfer the data back into a readable format. Encryption is done at random using complex algorithms, so it is not possible to decipher data merely by guessing. For instance, any medical data that is stored on PostDICOM’s cloud PACS is first encrypted by default using AES 256 encryption.

• Sessions and data transfer security: This is similar to the system used by online banking platforms. Your browser will not ‘remember’ data from a session and the session will automatically timeout if you forget to log out or do not use the system for a specific time period.

• Password protection: Most cloud-based PACS servers are password protected. Applications like PostDICOM’s cloud PACS require complex passwords, which must include lower case and upper case characters as well as special characters.

In addition to the above features, PostDICOM also offers the ability to anonymize patient imaging data prior to storage. This is useful if the imaging data is to be used in research, publications, or for teaching purposes, where it is imperative that the patient is not be identified.

Why is PACS backup needed?

Along with ensuring that PACS security features keep patient imaging data safe and confidential, it is important that the information stored in PACS is reliable and retrievable. When images are acquired from a patient, they become part of the clinic’s medical record, which has to be maintained by the hospital. Therefore, your healthcare facility is completely responsible for the medical imaging data that is stored in PACS. In case anything happens that results in data loss, important medical information related to the patient would be lost. Here are some of the threats that could result in losing all your imaging data from the PACS server:

• System failure: We’ve all experienced it—your computer can suddenly, inexplicably crash, and when it does, it takes all your data with it. If this system failure were to occur with the hardware housing the PACS server, your medical data would be lost.

• Natural disasters or catastrophes: Your healthcare facility may be located in an area prone to natural disasters, such as earthquakes, floods, or hurricanes. You could also be vulnerable to loss of data through catastrophes like fires. In such cases, if your PACS server is located on-site, it may be destroyed and you would lose all access to the data.

• Cybersecurity threats: Your healthcare facility might receive cybersecurity threats. There have been instances where hackers have infiltrated into the PACS server and have held medical data at ransom until the hospital agreed to pay up. If this were to occur and you had a decent backup, it would be practical to simply abandon your medical data (which should be encrypted), and move on to using the backup data.

Backup is like insurance—you may not always encounter a ‘worst case’ scenario, but it is worth your time and money to create a plan in case it does happen. If any of the above scenarios were to occur, it might become necessary to acquire new images. This would cost both time and money. It would also expose patients to unnecessary radiation. The worst case scenario would be that loss of imaging data compromises diagnosis and patient management, leading to adverse health outcomes. Needless to say, if imaging data from your PACS is lost, your practice could lose its reputation, and even be forced to shut down. That is why every healthcare facility must have a good, reliable backup of all the information stored in the PACS.

What are the options for PACS backup?

Just like the standalone PACS and the cloud PACS, there are two methods of PACS backup available—backing up to a physical disk space or backing up to the cloud. Backing up into another physical disk can be done using one of the following two options:

An external hard disk: Your external hard drive should ideally be located in a completely different location from your PACS. You will need to manually backup your medical imaging files if you use this method. Backup can be made once a month or more frequently, depending on the volume of medical images generated by the healthcare facility. There are two main challenges with this backup method. Firstly, you will need a responsible individual who will diligently perform the backup per schedule without fail. Secondly, if a disaster occurs between two backup schedules, there might still be images that have been acquired but not backed up, and these images will be lost.

Redundant Array of Independent Disks (RAID): RAID consists of a multiple number of disks or disk drives that are physically separate from each other, but can logically be integrated into a single unit. Basically, if data is distributed across multiple locations and then stored, it can be protected in case of a system failure. RAID backup can be set to happen automatically and does not need a person to do it. However, this also needs to be scheduled to fixed time points and is not in real time.

Cloud-based PACS backup: A great option for backing up your DICOM imaging data is to use a cloud-based PACS recovery system. If your primary PACS itself is on a cloud server, it is the most feasible option. Besides that, cloud-based PACS backup is also possible for on-premises PACS servers. Cloud backup is automatic and occurs as soon as a DICOM image is uploaded to the PACS server. Also, cloud PACS backup is literally done on a minute by minute basis, so there are no chances of data loss to occur in the time period between two backup schedules.

What is PACS recovery? How can it be achieved?

PACS backup is just one part of a comprehensive PACS disaster recovery plan. Just taking backups of all your patients’ medical imaging data is not sufficient. You must have a step-by-step plan in place so that if you do lose your medical imaging data, the backup is immediately available to your healthcare facility. This will allow you to switch to using backup data in a seamless manner.

Is your backup data accessible?

If your backup data is located on an external hard disk, you should probably store this offsite (away from the premises). Otherwise, in the event of a natural disaster, it is quite likely that your backups will be destroyed along with your original PACS. At the same time, the backup must be in a location that is convenient enough for you to access immediately, so that it can be integrated into the workflow almost immediately.

Is your backup data usable?

Backup data must ideally be stored in a format that is as easy to use as the original files. Data that has been compressed or encrypted in a way that needs complex retrieval may not be available in time for use by physicians.

Test your backup data periodically

Your PACS disaster recovery plan must include testing the backup data periodically. It would be (another) disaster to find out that after months or years of backing up your DICOM files, the backup does not work as expected. Sometimes backups can stop happening simply because the external hard disk or other similar storage devices run out of space. This problem does not occur with cloud-based backups as the storage space can be expanded according to requirements.

Cloud-based PACS-the best way to secure your medical imaging data!

An efficient cloud-based PACS system can help you store both primary and backup DICOM imaging files in a safe and secure manner. In the event of a system failure or a disaster, you do not need to be slowed down—cloud PACS backup can provide you immediate access to your imaging data with minimal downtime. All that a cloud PACS backup needs is a device that supports a web browser and a reliable internet connection. Even if the internet at your healthcare facility is down, DICOM files can be accessed using mobile data connections or from other locations that have internet access.

The best part of cloud-based PACS backup is the cost savings. With PostDICOM’s Cloud PACS, storage starts from $79.99 per month, which is so much cheaper than investing in physical storage for data backups. So if you are looking for an ideal way to secure you patients’ imaging data, consider PACS data migration to a cloud system today!