01
Client Profile & Background
A major private hospital group in Jakarta with over 500 beds and multiple outpatient clinics was experiencing rapid growth in medical imaging volumes. Their existing PACS storage, a mix of direct-attached storage and legacy NAS, could no longer keep up with the 2 TB of new imaging data generated daily. The IT team consisted of 12 engineers, but they lacked specialized storage expertise. The hospital needed a solution that could consolidate all imaging data, support up to 200 concurrent radiologists, and meet the 10-year retention requirement for medical records as mandated by Indonesian health regulations. They also required integration with their existing server and storage environment, which included a mix of HP and Dell servers.
The hospital had previously attempted to use a cloud-only PACS solution but faced high egress costs and latency issues due to Indonesia’s internet infrastructure. Therefore, they decided to invest in an on-premises enterprise-grade storage system with a hybrid cloud capability for disaster recovery. The goal was to achieve a unified storage pool that could handle both high-performance primary storage and cost-effective long-term archiving.
02
Technical Challenge
The hospital’s legacy storage system suffered from severe performance bottlenecks. During peak hours (8 AM to 11 AM), radiologists experienced load times of up to 45 seconds for a single MRI study, causing delays in diagnosis. The backup window for the 20 TB of daily changes exceeded 12 hours, often spilling into the next business day. Additionally, the system experienced two major outages in the past year, each lasting over 4 hours, due to controller failures in the old NAS units. The RPO (Recovery Point Objective) was 24 hours, meaning up to a day’s worth of imaging data could be lost in a disaster. The hospital also faced challenges with data migration from the old system to a new one without disrupting clinical operations.
Furthermore, the storage infrastructure lacked automated tiering, forcing manual movement of older studies to slower archive storage. This process was error-prone and often resulted in data being inaccessible when needed. The IT team spent 30% of their time managing storage instead of focusing on strategic initiatives. The hospital needed a solution that could provide sub-10 millisecond latency for active studies, support simultaneous streaming of 4K DICOM images, and ensure zero data loss with instant failover.
03
Implemented Solution
We designed and deployed a high-availability PACS storage architecture using Lenovo ThinkSystem SR650 servers as compute nodes and Synology SA3600 as the primary storage platform, configured in an active-active cluster. The Synology SA3600 provides 24 SAS SSDs for hot data and 12 NL-SAS HDDs for warm data, with automated tiering via Synology’s SSD cache technology. For long-term archiving, we integrated a QNAP TS-1685 with 16 large-capacity HDDs, connected via 25GbE iSCSI. Data protection is ensured by Veeam Backup & Replication, which performs snapshots every 15 minutes and replicates to a second site 30 km away. The entire solution is managed through a single pane of glass using VMware vCenter for virtualization and hyperconverged principles.
The implementation was carried out in phases to avoid downtime. First, we set up the new storage cluster and migrated historical data using Veeam’s backup copy jobs. Then, we reconfigured the PACS application servers to point to the new storage. The entire migration took 3 weeks, with zero downtime for clinical operations. We also deployed a backup and disaster recovery solution that meets the hospital’s RPO of 15 minutes and RTO of 1 hour. The solution includes a dedicated 10GbE network for storage traffic, isolated from the hospital’s general network.
04
Results & ROI
Post-implementation, the hospital achieved a 90% reduction in image load times, from 45 seconds to under 3 seconds for a typical MRI study. The backup window dropped from 12 hours to 45 minutes, and the RPO improved from 24 hours to 15 minutes. The system has maintained 100% uptime over 18 months, with no unplanned outages. The IT team now spends less than 5% of their time on storage management, freeing them to focus on digital transformation initiatives like AI-assisted diagnostics. The hospital also saved 40% on storage costs compared to their previous cloud-only approach, due to reduced egress fees and the use of cost-effective tiered storage.
The solution scaled seamlessly as the hospital added two new imaging centers, each generating an additional 500 GB of data daily. The automated tiering ensures that active studies remain on SSDs while older data moves to HDDs, optimizing performance and cost. The hospital now plans to extend this architecture to support their electronic medical record (EMR) system and other clinical applications. The ROI was realized within 14 months, driven by increased radiologist productivity, reduced downtime penalties, and lower operational costs. The hospital also achieved compliance with Indonesia’s data retention regulations, with all studies securely stored and protected.
