AWS Case Study: Toshiba Medical

Please provide an overview of your company.

Toshiba Medical Systems Corporation provides solutions that support the entire workflow at healthcare facilities including screening for early disease detection from diagnosis to treatment and post-treatment follow-up in Japan. We are a global provider of manufacturing, sales and technical services for medical equipment (diagnostic X-ray, medical X-ray CT, magnetic resonance imaging, diagnostic ultrasound, radiation therapy, and diagnostic nuclear medicine systems, medical sample testing equipment, and information systems for healthcare institutions) and a leading Japanese manufacturer of diagnostic imaging systems. Under our management slogan, "Made for Life™" (Made for Patients. Made for You. Made for Partnership.), we strive to increase the quality of life and contribute to the success of our customers.

Please tell us your reasons for adopting AWS.

On April 1, 2012, Toshiba Medical Systems established a Cloud Promotion Office under the direct supervision of the president to promote our healthcare cloud service, “Healthcare@Cloud” (registered trademark pending as of April 2012). As a first step, we set up an external storage service for X-ray, CT and MRI image data recorded by healthcare institutions via the Amazon Simple Storage Service (Amazon S3) in the Tokyo Region offered by Amazon Web Services (AWS), combining the electronic storage and management technologies offered by Toshiba Medical Systems PACS (RapideyeCore™) and the ICT cloud technologies owned by Toshiba Corporation. Right now we only offer Healthcare@Cloud in Japan and do not have any plans to extend the solution to other countries.

Please provide background for the development of new services in the cloud, such as the implementation of legal reforms and efficient hospital management, as well as requests for a disaster recovery (DR) solution.

Following a partial amendment to "Medical Record Storage Locations" published by the Ministry of Health, Labor and Welfare in February 2010, business environments for medical imagery external storage services offered by the private sector were developed in compliance with the guidelines. In addition, the importance of backing up medical information has been reaffirmed since the Great East Japan Earthquake in March 2011.

Due to technological advances in medical diagnostic imaging equipment, however, the quantity of image data (including CT and MRI 3D images and cardiovascular dynamic image data) has increased drastically, and the need for external storage has increased accordingly.

Legal reforms, implementation of efficient hospital management practices and requests for disaster recovery (DR) are the three major factors in developing ideas for a clinical image data storage system in the cloud.

With this situation in mind, Toshiba Medical Systems developed a cloud concept and did some comparative research into physical specifications, operations and monthly costs at multiple data centers (including locations which implement hosting and cloud services).

When evaluating the cloud services offered by AWS, we needed to verify whether they complied with guidelines on safety management for medical information systems and on employees engaged in information processing who are entrusted with medical data. The guidelines included 200 compliance requirements, including compliance with the three principles of electronic storage and the protection of personal information. The three principles of electronic storage are 1) "ensuring authenticity" 2) "ensuring visibility" and 3) "ensuring preservability." "Ensuring authenticity" aims to prevent confusing, overwriting or deleting data. Additionally, it clarifies the responsibilities of data creators. "Ensuring visibility” means that data should be readable to the naked eye as needed. It also stipulates that data should be displayed immediately in written form. "Ensuring preservability" defines that data should be stored in a recoverable form during the retention period stipulated by law or ordinance.

During the year we spent storing medical data, including researching requirements and collecting evidence, we were able to confirm that combining AWS cloud services with Toshiba's key management technologies and service operation systems would be suitable.

Please explain what will be realized by the cloud services provided by AWS and the new service provided by Toshiba Medical Systems.

By storing clinical data (imagery) in safe locations, hospitals can immediately retrieve or refer to image data if disasters or system failures occur. This means that high-quality healthcare services can be provided to patients without interruption. In addition, we believe that the following outcomes can be achieved:

1. We will be able to implement environmentally friendly systems, since we can reduce the costs of setting up and running redundant storage equipment for the safe storage of medical imagery and can also reduce space and energy consumption.
2. We will be able to reduce the workloads of image administrators and engineers through labor-saving processes in imaging system maintenance and management.
3. Safety and security will be achieved through reciprocal checks, by using double cryptographic keys for stored data and by storing image data in three geographically distinct data centers utilizing the characteristics of the cloud services offered by AWS.
4. It can support healthcare institutions of various sizes by adopting scalable storage methods, providing variable capacity and flexible pricing structures.
5. Because the externally stored image data is in an encrypted Digital Imaging and Communications in Medicine (DICOM)-compatible format, there won’t be any need for conversion when updating imaging systems in healthcare facilities, leading to significant cost and time savings. (DICOM standards are developed by The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) to define medical image formats recorded with CT, MRI and CR machines and communication protocols for medical imaging equipment that use these images.)

While implementing AWS cloud services, we particularly focused on ensuring the safety, security and scalable handling of diagnostic image data in the cloud.

Please tell us about your company’s future development with AWS.

Beginning with the external storage service for medical imagery, we plan to use the external storage services from AWS for data from the medical information systems we sell. In addition, while complying with these guidelines, we are looking into using the cloud for remote image data reading services.

To learn more about how AWS can help support your Disaster Recovery needs, visit our Disaster Recovery details page: http://aws.amazon.com/disaster-recovery/ .

Added August 13, 2012