Stanford Health Care has implemented a new network technology for its remote radiologists, addressing long-standing issues with slow medical image downloads and improving the efficiency of remote work. The solution has decreased the time to download large images by up to 90 percent.
For years, Stanford Health Care remote radiologists, some located as far as the East Coast and Hawaii, experienced significant delays when accessing large imaging files from Stanford’s Palo Alto data center. A single radiology image can be up to 5 gigabytes in size, and the delays were hampering productivity.
“The TDS Network team explored an out-of-the-box approach by extending Wide Area Network optimization — traditionally used only between data centers — to remote users,” explained Ramesh Powar, Director for Network Services. “While WAN optimization techniques are well established, their effectiveness for encrypted and compressed imaging data had not been conclusively proven. Despite this uncertainty, the team decided to proceed,” he added.
Initial assessments pointed to the existing Virtual Private Network as the source of the slowdown. However, a deeper analysis by the Network team revealed that the true bottleneck was network latency — the time delay inherent in sending data over long physical distances.
“This latency significantly impacted image download performance and, in some cases, made certain workflows impractical or impossible for radiologists working remotely. Understandably, this led to frustration and reduced productivity,” said Powar.
The recently deployed technology uses compression, de-duplication to eliminate redundant data, and a technique called TCP Window Scaling to send larger data packets at once. The implementation proved successful.
Approximately 110 remote radiologists are now using the new Aruba VPN solution. Each clinician was sent a small device for their home office, which they can install by simply swapping a single cable from their old equipment. Two redundant central devices are located at the Palo Alto data center to manage the network traffic.
Here are some examples of the positive feedback the Networking team has received:
“Overall, I am very satisfied with the upgrade and I really appreciate the efforts you and your team put in to make the transition possible.” — Dr. Hong
“I am cardiovascular and have definitely noticed a difference when looking specifically at functional cardiac CT images which tend to have ~4000 images. The lines now play very smoothly. – Dr. Malik
“With the [previous device] Meraki I would need to constantly manage it with power cycles and calls to your team re: connectivity outages and similar. In contrast, the Aruba has been rock solid ... I feel it's been a success, no jinx!” — Dr. Raag
“PACS images definitely loading MUCH faster ... It is amazing to be able to do this from East Coast.” — Dr. Fleischmann
“Overall, my home workstation speed is now comparable to onsite stations, despite a slower internet access speed than at 500P, which enables a 10-20 percent improvement in efficiency at home than the previous Meraki ... It’s like getting a Tesla after tooling around in a ‘90s Toyota Avalon.” — Dr. Guo
Building on this success, Stanford Health Care is now extending the solution to its network of Stanford Medicine Partners clinics. The technology has already been deployed to 10 clinics, with a total of approximately 35 clinics upgraded by the end of January.
