Hitachi Clinical Repository supports digital imaging and communications in medicine (DICOM) and Health Level 7 (HL7) data access, consolidation, mining and distribution for healthcare providers.

1. W H I T E P A P E R : T E C H N I C A L
Hitachi Clinical Repository
Meet the Unique Challenges of DICOM/HL7 Data Access,
Data Consolidation, Data Mining and Data Distribution
By Hitachi Data Systems
October 2011

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Table of Contents
Executive Summary and Introduction 3
The Hitachi Clinical Repository Solution 4
Solution Architecture and Components 5
Hitachi Content Platform 5
Hitachi Data Discovery Suite 7
Hitachi Clinical Repository DICOM Connector 8
Hitachi Clinical Repository HL7 Connector 8
Conclusion 10

3. 3
Executive Summary and Introduction
This technical white paper profiles Hitachi Clinical Repository (HCR) and examines how it meets the
unique challenges of digital imaging and communications in medicine (DICOM) and Health Level 7
(HL7) data access, consolidation, mining and distribution. The paper delivers insight into the techni-
cal components of HCR. It details how these components interact and fit into the typical clinical
workflows of a healthcare provider. HCR is composed of Hitachi Content Platform (HCP) and Hitachi
Data Discovery Suite (HDDS). To extend the functionality of these systems and incorporate medi-
cal images and information, HCR is also delivered with a 3rd-party clinical connector (created by
Visbion). This connector provides DICOM and HL7 functionality, which is a unique requirement of
healthcare providers.

4. 4
The Hitachi Clinical Repository Solution
Today's modern healthcare facility is faced with an explosion of image and information related data
from multiple departments and domains across the enterprise. Data is generated in a variety of
formats and interoperability is lacking when outside the originating department. For the healthcare
organization, trying to manage data access, distribution and storage from these disparate data silos
often turns into a compatibility nightmare. And the significant ongoing expense of maintaining each
department's viewer, archive and storage islands must be considered.
Hitachi Clinical Repository is an interoperability framework and storage solution, purpose built for
managing the business and health data, fixed content, images and their associated metadata. HCR
enables a healthcare organization to establish a facility-wide central repository that allows multiple
business and clinical systems to utilize a central archive to deliver data storage in a vendor-neutral
format. HCR achieves this by abstracting the data from the source applications. This allows HCR
to deliver this data to consuming applications based on the metadata abstraction, regardless of the
source or format of the data.
Leverage Hitachi Clinical Repository
HCR is not a replacement for a PACS database or short-term cache. Providers can
choose to leverage the block storage with or without Hitachi Virtual Storage Platform
fronting.
HCR allows your administrators to get around the validation objection as its uses in-
dustry standard communication protocols (DICOM and HL7) to interface with the PACS
and IS systems. This eliminates the need for independent software vendors (ISVs) to
validate the Hitachi storage layer.
HCR is composed of a Hitachi storage layer (Hitachi Content Platform and Hitachi Data Discovery
Suite) integrated with an interoperability framework (that tightly integrates with a hospital's clinical IT
systems) (see Figure 1). This combination delivers a solution that meets the unique challenges sur-
rounding DICOM/HL7 data access, data consolidation, data mining and data distribution.
Key benefits of Hitachi Clinical Repository include:
■■Full clinical repository for all departments
■■Central image and data storage
■■Standards-based architecture DICOM/HL7/IHE/CIFS/NFS/REST/HTTP
■■Support for all image and data types
■■Open API for electronic patient record (EPR) and electronic medical record (EMR) Integration
■■Highly scalable storage systems
■■Vendor-neutral long-term clinical archive
■■High availability and business continuity

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Solution Architecture and Components
Figure 1. Hitachi Clinical Repository Architecture and Components
As mentioned above, HCR is made up of Hitachi Content Platform and Hitachi Data Discovery Suite
integrated with a 3rd-party ISV product developed by Visbion. Delivered as a solution, HCR seam-
lessly consolidates and presents all relevant health and business data in a single, longitudinal record.
This gives healthcare providers access to the most comprehensive view of their patients, enabling
them to be more efficient, cost-effective and innovative.
Hitachi Content Platform
Hitachi Content Platform is a distributed storage system designed to support large, growing ar-
chives of fixed-content data. HCP stores objects, including both data and metadata (the data that
describes the data). It distributes these objects across the storage space but still presents them as
files in a standard directory structure. HCP provides access to archive objects through a variety of
industry standard protocols, as well as through an integrated search facility.

6. 6
A combination of software and hardware, HCP provides an archival storage environment ideal for
storing all types of data, from simple text files to medical images to multigigabyte database images.
HCP provides easy access to the archive for adding, retrieving and, when allowed, deleting the
stored data. It uses write once, read many (WORM) storage technology and a variety of policies to
ensure the integrity of archived data.
HCP stores objects in an archive. Each object permanently associates data HCP receives (for
example, a file, an image or a database) with information about that data. HCP also allows client ac-
cess to the archive through the leading industry-standard protocols: HTTP, WebDAV, CIFS and NFS.
Using these protocols, actions such as adding objects to the archive, viewing and retrieving objects,
changing object metadata and deleting objects can be performed. These protocols can be used
interactively with a command-line tool or graphical user interface (GUI), or programmatically with ap-
plications written against the archive.
Extending the capabilities of HCP is the addition of the Hitachi Adaptable Modular Storage (AMS)
family of scalable storage systems designed to manage many of your extremely complex tasks
and give you operational efficiencies and performance you won't find anywhere else in a midrange
system. AMS includes enterprise storage capabilities that are typically found in high-end storage
systems, including dynamic provisioning to improve overall utilization rates and help simplify storage
management.
Nonclinical Information Workflow (CIFS, NFS, HTTP, etc.)
Figure 2 depicts the workflow for Hitachi Clinical Repository ingesting clinical information. HCR uses
standard protocols available in Hitachi Content Platform from information systems (IS) to archive and
index content into a single access point for consuming applications.
Figure 2. Hitachi Clinical Repository Workflow

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Hitachi Data Discovery Suite
Hitachi Data Discovery Suite provides indexing, search, file-tiering and proactive e-discovery ca-
pabilities for Hitachi Clinical Repository. HDDS simplifies e-discovery and improves the efficiency of
identifying, searching, retaining and managing unstructured data across online, nearline and archive
media. Users can search across multiple data silos, including all clinical data within HCR, regardless
of where that data originated. This all can be accomplished from a single interface according to user
access privileges via Microsoft Active Directory and LDAP integration (see Figure 3).
Figure 3. Hitachi Data Discovery Suite
Hitachi Data Discovery Suite and HTTPS Protocol
HDDS supports the Web Services non-GUI interface to perform HDDS operations and
to execute commands using the HTTPS protocol. Within this interface, method calls
are made over the network using HTTPS POST requests to the HDDS server, and
HDDS returns the results in XML format.
Since HDDS receives the request from client applications through HTTPS, the applica-
tion can be written with any program or script languages as long as the language can
send requests to HDDS by HTTPS protocol.

8. 8
Hitachi Clinical Repository DICOM Connector
Integrated within Hitachi Clinical Repository is a DICOM library supplied by Visbion, a leading medical
imaging software company. The HCR DICOM connector ingests a DICOM feed from the picture
archiving and communication system (PACS) over the TCP/IP network and receives the DICOM
images. It then parses the DICOM header into a custom XML file and stores the .dcm file, system
metadata and custom XML to HCP using its REST interface. The ability to create metadata about
the data object outside of the original application's database allows consuming applications (such as
electronic health record or portals) to discover and consume all clinical data, regardless of the source
of that data. It is this unique feature that sets HCR apart from other archiving solutions, such as
vendor-neutral archives and image archives.
Medical Imaging (DICOM Systems) Workflow
Figure 4 represents the components involved in Hitachi Content Repository ingesting DICOM images
from a PACS as its long-term archive.
Figure 4. Medical Imaging Workflow
Hitachi Clinical Repository HL7 Connector
The vast majority of hospital information systems speak HL7 (Health Level 7) to communicate patient,
study and report information between systems. HL7 messages are pipe delimited, text-based
messages that travel over the TCP/IP network. Hitachi Clinical Repository accepts a copy of the

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HL7 messages that the information systems [i.e., radiology information system (RIS), computer
information system (CIS), laboratory information system (LIS), hospital information system (HIS), etc.]
are already creating and sending out as part of the normal clinical workflow. In most cases, this is
accomplished by setting up a new destination on the hospitals' interface engine (i.e., Cloverleaf,
BizTalk, etc.) with HCR receiving a copy of all HL7 messages that are routed through the interface
engine. When HCR receives the HL7 message, it parses the content into a custom XML file and
stores the original HL7 message plus the custom XML to HCP using its REST interface. As a result,
HCR remains up to date with any patient and study updates as well as storing and indexing the
reports for consumption downstream.
By capturing this HL7 message, HCR reduces the need to be integrated with the originating ap-
plication. The originating application would consume the exact same HL7 message that HCR
consumes. The difference is that HCR is not using the originating application's database to store the
result; thus, the requirement to validate the ISV is removed.
Clinical Information Systems Workflow (HL7)
Figure 5 represents the component and workflow of Hitachi Clinical Repository when ingesting HL7
messages from information systems. HCR will parse the contents and aggregate the information
into a single access point for consuming applications.
Figure 5. Clinical Information Systems Workflow

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Example Electronic Health Record (EHR) Query in Hitachi Clinical Repository
In this example, the consuming application is querying for all records where the
patientName is Dave Wilson.
URL: https://hdds.hds.com:8443/hdds/api/cli
METHOD: POST
Parameter: #c=SearchFiles&-u=admin&-p=password&-y=advanced&-x=&-m=10000&
#u=xml:patient:patientInfo:patientName:string("Dave Wilson",
mode="phrase")
What the XML looks like:
<patient>
<patientInfo>
<patientId>1234</patientId>
<patientName>Dave Wilson</patientName>
...
</patientInfo>
<visitInfo>
...
</visitInfo>
...
</patient>
Conclusion
Hitachi Clinical Repository is an interoperability framework and storage solution for the health and
life sciences market. It is purpose built for managing the business and health data, fixed content,
images and their associated metadata. HCR enables a healthcare organization to establish a facility-
wide central repository that allows multiple business and clinical systems to utilize a central archive
that provides data storage in a vendor-neutral format. HCR assists our customers in addressing key
business problems, such as:
■■Providing a consolidated view of clinical data, including custom metadata, so that it may be
stored, accessed, distributed and utilized in an intelligent way
■■Delivering data ownership and ultimate control back to the facility, thereby facilitating a flexible IT
strategy that meets their needs today and future-proofs existing investments
■■Delivering performance and availability while simplifying IT management and reducing the grow-
ing expense for maintaining disparate systems
■■Enabling the provision of one longitudinal clinical record to a clinical portal to improve data quality
and informed decision making (competitive differentiation)

11. Corporate Headquarters Regional Contact Information
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www.HDS.com Asia Pacific: +852 3189 7900 or hds.marketing.apac@hds.com
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© Hitachi Data Systems Corporation 2011. All Rights Reserved. WP-415-A DG October 2011