Orthanc Replication System
Orthanc Replication Ecosystem: 3-2-1 Backup Strategy
For the first two years of running Orthanc, the only backup method in place was Manual Copy of the Orthanc folder to a dedicated external hard drive, performed every 1-2 months. Over time, it became clear that this approach was not reliable enough — a single point of failure with long gaps between backups meant that weeks of imaging data could potentially be lost.
To address this, a proper Orthanc Replication Ecosystem was developed to ensure that DICOM data is always available and that backups are continuous and consistent across multiple platforms. KKBM now follows a comprehensive 3-2-1 backup strategy for all radiographic DICOM data — a recommended approach that provides multiple layers of protection against hardware failure, data corruption & disaster scenarios.
We are trying our best (with limited resources) to create a comprehensive and robust system to achieve this.
Replication Network Topology
Main Orthanc Server
Production PACS server in the Radiology Unit. Holds the master copy of all DICOM imaging studies.
Replication Sync Layer
Three independent mechanisms maintain synchronization between servers
Orthanc Peer Push
Triggered from Main Orthanc Server. Sends selected studies from main to backup server.
Main → Backup
Python Script Pull
Run from backup server. Compares instance UUID lists & pulls only missing DICOM from main to backup (daily operation)
Backup ← Main
Python Script Push
Run from backup server. Compares instance UUID lists & pushes only missing DICOM from backup to main
Backup → Main
Backup Orthanc Server
Dedicated backup server maintaining a synchronized copy of all DICOM data. Serves as the hub for monitoring and downstream backups.
Downstream Systems
Outputs from the backup server
Replication Dashboard
- Visual monitoring dashboard
- Static HTML dashboard showing backup process and history data points
Kopia Drive Backup
- Encrypted snapshot of backup Orthanc Storage
- Method: snapshot, deduplication backup
- Automated daily backup
Understanding 3-2-1 Backup
The 3-2-1 Rule Maintain at least 3 copies of data, stored on 2 different media types, with 1 copy stored off-site (or in separate physical location).
Implementation: Data Copies & Storage Layers
| Copy | System | Description | Backup Method |
|---|---|---|---|
| Data Copy-1 | Primary Orthanc Server | Production PACS server in the Radiology Unit, providing real-time access to all imaging studies | Live production data |
| Data Copy-2 | Secondary Orthanc Backup Server | Dedicated backup server maintaining a synchronized copy of all DICOM data via automated replication | Automated daily replication |
| Data Copy-3 | Fujifilm Vendor System | Local storage on the imaging equipment itself, retaining up to 5,000 recent DICOM files | Automatic (equipment-level) |
| Data Copy-4 | KOPIA & Veeam Backup | Additional local external backup for an extra layer of data protection | Scheduled external backup |
Two Different Media Types — Primary server storage + secondary backup server on separate hardware infrastructure
Physical Separation — **Details on physical location separation to be provided
Features of the Replication System
The Orthanc Replication System includes the following key features that ensure data integrity and operational visibility:
🔄 Automated Server-to-Server Replication
Data from the primary Orthanc server is automatically backed up to the secondary backup server on a daily schedule. This removes the need for manual intervention and ensures that backups are performed consistently without gaps.
📲 Telegram Notification System
A notification system is integrated with a designated Telegram group. After each daily backup cycle completes, assigned personnel receive a status message confirming whether the backup was successful or if any issues were encountered. This provides immediate visibility without needing to check the server directly.
🗓️ Automated Backup Task Schedule
In addition to the Orthanc-level replication, two further layers of scheduled backups run directly on the Backup Server PC to provide deeper data protection:
| Backup Tool | Frequency | Scope |
|---|---|---|
| Kopia (Deduplication Backup) | Daily | Exact copy of the Orthanc application folder and PostgreSQL database folder. |
| Veeam Backup | Weekly | Full PC Backup: whole pc system, Orthanc configuration (C: drive), Orthanc data storage & PostgreSQL database. |
📊 Replication Dashboard
A web-based dashboard provides a real-time view of the current replication progress as well as a history log of all previous replication processes. This allows staff to monitor backup health at a glance, verify that data is up to date, and quickly identify any failed or incomplete replication cycles.
Replication Ecosystem Backup Benefits
- Hardware failure resilience: Primary server failure does not result in data loss
- Corruption protection: Multiple independent copies guard against data corruption
- Disaster recovery: Rapid restoration possible from backup systems
- Business continuity: Operations can continue using backup server during primary system maintenance
- Compliance assurance: Meets healthcare data protection best practices and standards