Medical Imaging

Case Study - Platform Stability and Data Locality

Bioclinica achieves platform stability, data-locality and lowers TCO with CloudBasic database replication tools


MDDX (acquired by Bioclinica) uses a sophisticated cloud deployment model to employ fully accessible Geo-Read-Replicas for reporting; advanced database replication technology for improved system performance; and a cross-region Disaster Recovery solution. DevOps tools help automate DLM.

EXECUTIVE SUMMARY: MDDX (acquired by Bioclinica), a medical image management company, developed an advanced cloud-based platform that offers a 20-year image repository for clinical trials, providing numerous legal and technological benefits to the medical research industry. With zero tolerance for downtime, the company relied on CloudBasic’s robust RDS SQL Server replication technology to ensure uninterrupted platform availability in the cloud. It also used the fully accessible read-replicas, an integral part of CloudBasic’s solution (and unavailable in the standard AWS RDS Multi-AZ option for SQL Server), to power the performance analytics tools on the platform.

The Client

MDDX_LogoMDDX, a medical imaging company, developed an advanced web-based platform for medical research image management. Its primary goal is to eliminate some systematic difficulties related to clinical trial imaging. One of the primary features of the platform is an image depositary with a 20-year lifespan, with instant image retrieval. The company also developed image processing and data analytics tools to help researchers gain unprecedented insight into their medical data, even long after the clinical trials have been concluded.

The innovative technologies behind the platform, along with the included research site and lab performance metrics, provide an extremely valuable solution to the medical research institutions, positioning the company as a leader in the medical imaging field. MDDX clients include some of the most prominent names in the industry, such as GE Healthcare, as well as top tier research universities like Harvard and Cornell..

The Case

Medical images generated by CT and MRI scanners are stored in a special medical image format called DICOM (Digital Imaging and Communications in Medicine). Those files contain metadata, which facilitates the analysis of the images and the results from the clinical trials. However, the US Health Insurance Portability and Accountability Act (HIPAA), specifies several types of potentially identifying information (such as name, date of birth, gender, biometric data, and many more), which should be removed from the DICOM data.

The company image management software platform guarantees 100% de-identification of all DICOM images, which helps avoid any legal compliance issues related to improper image labeling. In addition to alleviating these legal concerns for the medical researchers, the company also guarantees protection against incompatible formats and data corruption. All that image data must be stored in a depositary for a long period of time. The vast amounts of accumulated data must remain accessible at all times for various research analyses and system performance metrics.

Both the legal and the technical aspects of this service require that the platform is powered by the most robust and reliable server technology. To ensure wide adoption of the platform at hundreds of medical research sites all over the world, it is even more critical that the data management technology behind the platform is rock solid, with no downtime or interruption of any kind.

The Solution

AWS RDS Multi-AZ vs. CloudBasic's RDS AlwaysOn

With CloudBasic’s RDS AlwaysOn you can deploy true Multi-Region server replication scenarios, even with MS SQL Server Web Edition, with full access to the Read-Replica, while still paying 1/2 less than the AWS Multi-AZ deployment. View sample replication scenarios to compare cost and benefits.

Considering the high importance of the medical image data, the stringent platform availability requirements, and the need to offer advance performance metrics to the users without burdening the main servers, the company chose CloudBasic’s RDS AlwaysOn/Geo-Replicate for SQL Server.

As a high-performance lightweight RDS SQL Server replication solution for AWS, RDS AlwaysOn provides fully accessible Geo-Read-Replicas for the analytics tools of the platform. All reporting tools use the replicas, rather than the primary server, which reduces the load on source databases and improves the overall stability of the platform. In addition to the load balancing and reporting function of replicas, they also provide seamless Disaster Recovery solution.

MDDX also leverages CloudBasic for DevOps DLM operations, integrating the tool into their DevOps tools (such as Jenkings), allowing them to achieve both continuous updating of data from production databases to staging/development instances and to clone production databases and create individual development instances on a regular basis.

The Results

Improved system performance, platform stability, and lower TCO!

The CloudBasic replication engine delivered more functionality than the classic AWS RDS Multi-AZ at a substantially lower cost.

The cross-region server replication set up of the read-replicas is a built-in Disaster Recover solution, where a Secondary replica can be promoted to Primary, should there be any cloud infrastructure disruption.

CloudBasic DevOps DLM tools enabled MDDX to move RDS SQL databases form dev to test to staging environments in an automated manner. Automating Database Lifecycle Management helps achieve true one-click deployments.

The sophisticated cloud deployment of this innovative platform, including the multiple Geo-Read-Replicas in different regions for data locality, ensured its continuous availability, and resulted in its wide adoption throughout the medical research industry. The company’s medical imaging tools are now used at over 150 research sites in more than 40 countries around the world, which are supported by customer service teams in multiple time zones.

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UPDATE, November 2017: Bioclinica®, the world-leading provider of scientific-enabled Medical Imaging, eHealth, and patient-centric solutions supporting clinical research, announced on 11/6/2017 that it has acquired Silicon Valley-based MDDX Research & Informatics, adding the industry’s most advanced cloud research image management and submission technologies to its extensive suite of eHealth solutions. To learn more about the aquistion read the announcement or visit