Economical Software-Defned Storage

Just What the Doctor Ordered

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Economical Software-Defined Storage: Just What the Doctor Ordered
Decoupling hardware from software is the prescription for flexibility, scalability, and price performance
The eMed Consulting Group hosts data for medical practices that have implemented electronic
medical record (EMR) systems. By hosting their clients databases in secure data centers,
Louisville, Kentucky-based eMed allows medical practices to concentrate on caring for patients
rather than worrying about data safety and security. Originally established to help small- to
medium-sized doctors offices take advantage of federal incentive payments for implementing
EMRs, eMeds business challenge was to build a data-storage product with an economical price
tag. They met the challenge by selecting Silicon Mechanics zStax solution, based on the Intel
Xeonprocessor E5-2600 product family, which uses a software-defined storage model that
costs a fraction of legacy storage.
Hosting EMR data
The eMed Consulting Group was formed to help healthcare providers receive Medicare and
Medicaid incentive payments for adopting certified EMR technology. The company uses Aprima
Patient Relationship Manager (PRM) software to configure an EMR system appropriate for a
practices office. They then install the software, train employees on its use, and host their
database. This service is ideal for doctors in small- to medium-sized practices, who dont want to
incur the expense and worry of maintaining a server on their premises and paying for the staff to
maintain the server and database.
Outsourcing EMR data gives doctors access to the eMed Consulting Groups world-class
Payment Card Industry-compliant data centers, and also offers instant HIPAA compliance, as
well as physical redundancy to reduce exposure to natural disasters. Hourly backup and 24/7/365
systems monitoring gives doctors even more peace of mind. Connectivity to other laboratory
electronic services streamlines test ordering and recordkeeping processes.
According to the eMed Consulting Groups CEO Dave Vrona, eMeds business model is
designed to take away the complexity from doctors adopting EMRs. Doctors have enough to do
running their front office, explains Vrona. Most have neither the time nor the interest in
providing the IT support needed to host their data. They are looking for a lifeboat so they dont
have to be in the IT business.
He explains that doctors have to decide how to deploy their information technology, and the
choice must consider up-front equipment costs as well as significant ongoing maintenance costs.
Purchasing a high-quality server with adequate built-in redundancy and data backup can be
expensive, and to that must be added continual data monitoring and security. Vrona notes that
most offices balk at the expense of hiring the necessary IT resources, which tend to come with a
steep price.
These headaches are why outsourcing data is an attractive proposition. Knowing that the EMR
database is safe and secure gives doctors peace of mind, especially considering the critical and
private nature of the data collected. Because of the geographical redundancy of outsourced
database hosting, doctors know that if there is a disaster in their area, they have the ability to fail
over to another datacenter located in a remote area, so their database will be kept up and running.
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Hosting services enabled us to deliver a critical component of the EMR system to smaller
offices and clinics at a reasonable cost, says Vrona. We are providing them what is in effect a
private cloud.
The search for an affordable storage solution
According to Vrona, resiliency throughout the entire system, from compute, to backup, to
network, to storage, is absolutely essential for deploying a private cloud infrastructure. With
strong CIO backgrounds, the founders of eMed did a great deal of research before arriving at
their storage platform, and were early adopters of open-source storage, which can typically
deliver a product at a lower cost. The price of a solution from a traditional storage vendor would
not have been financially feasible when the company was originally launched, says Vrona. He
estimates that using a legacy storage hardware solution would have nearly quadrupled the
companys startup costs.
Instead, the company opted for a zStax ZFS unified storage appliance, to deliver a fully featured
NAS/SAN storage solution that provides enterprise storage features at mid-tier prices. The zStax
system was supplied by Silicon Mechanics, a Bothell, Washington-based provider of rackmount
servers, storage, and high-performance computing solutions. We were looking for cost-effective
storage that would support resilient information and multiple servers, and supported virtualized
environments so there could be shared storage, says Vrona. Silicon Mechanics delivers the
solution as a bundle and also provides an extremely high level of support during any
emergencies.
The ability of the zStax storage appliance to tolerate certain failures and keep on running is
something that Vrona values above all else. If a piece of hardware in the infrastructure fails, the
unit still keeps running. If we lose a single disk drive, we dont lose any data and the system
stays up and running. There are redundant power supplies, so there is no downtime if we lose a
power supply in one of the devices, and we can change power supplies on the fly. If we lose the
entire server, another server takes over.
zStax system details
Vrona explains that, while he knew conceptually what he wanted, he relied heavily on product
engineer Tommy Scherer of Silicon Mechanics to guide him in terms of what the eMed
Consulting Group should consider as they were making choices on the systems needed to get the
required resiliency.
Their current system, the zStax StorCore 104, is based on the IntelXeonprocessor E5-2600
product family with the IntelC602 chipset. Intel servers were the platform of choice for this
installation because of their breadth of features and the overall stability and consistency of the
platforms through various generations. Intel NICs (Ethernet controllers) offer excellent driver
support; in addition, different models and generations of Intel Ethernet and 10GbE controllers
work together seamlessly. This flexibility makes them ideal for solutions like the zStax, since
they are compatible with anything Silicon Mechanics might add to the setup. In addition, Intel
Advanced Encryption Standard New Instructions (IntelAES-NI) accelerate the encryption of
data for faster, more affordable data protection. Since the eMed Consulting Group deals with
medical records, a high degree of security was paramount, and using Intel processors and
chipsets made that goal much more efficiently achievable.
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IntelXeonprocessors and Intel NICs, combined with our AES-NI technology, provide the
performance, stability, and flexibility needed for a software-defined storage system, said Bev
Crair, general manager of the Storage Division at Intel. The zStax StorCore 104 combined with
NexentaStor on top of Intels technology provides an innovative, open, and efficient way to
store, manage, help secure and retrieve data as important as medical records.
The zStax StorCore 104 provides storage for database, virtual machines (VMs), and backup
functions with a single scalable storage appliance. The StorCore 104 provides two IntelXeon
head nodes, and a 4U disk shelf with wear-resistant SAS SSDs to accelerate performance, 15K
RPM hard drives to provide storage for database and VMs, and nearline SAS hard drives for
backup. Another key feature, snapshot-based replication, provides asynchronous, bi-directional
replication between the companys established location and storage at its new sites across the
country.
The use of hybrid storage pools harnessing RAM, SSDs, and hard drives of different spindle
speeds provides eMed the I/O performance they need for each storage tier without paying more
than necessary for performance or power, said Silicon Mechanics Scherer. Leveraging
software-defined storage architecture allowed eMed to grow its storage system from a simple
read-optimized hybrid storage platform to an enterprise-level, highly available appliance,
optimized for reads and writes. As their business needs grew, their architecture allowed them to
scale performance and capacity dynamically.
As Vrona notes, databases dont get smaller, so eMed expects to continually add storage as time
goes by. They currently have two zStax systems, one dedicated to virtual machines and one
dedicated to EMR databases. Slower and less expensive disk drives are used for backup, while
the database side uses the SSDs for hybrid storage pooling, enabling them to achieve flash
performance at the cost of spinning disks. We have been going through the process for the last
few years and continue to upgrade the system to take advantage of new options, says Vrona.
The company also has plans to use the architecture as it expands from hosting data for practices
that use Aprima PRM, into becoming a remote hosting resource for doctors and others using any
EMR system.

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