The storage arena is growing by leaps and bounds, according to exhibitors at this year's RSNA, thanks in great part to all those 64-slice scanner/image volume behemoths being sited. And as more and more healthcare facilities face the reality of thorough disaster recovery preparation and federal mandates for data retention, storage vendors served up a variety of solutions. They also cited the desire of small- and medium-sized organizations to have effective storage solutions that don't require substantial IT expertise in-house. They are meeting those needs by offering remote administration that can maintain the system through e-mail alerts and other internet-based communications. 

Several vendors said they recognize the increasing need for interoperability and compatability between different systems as well as access and interoperability among and between healthcare organizations.
Vendors also showcased their scalable storage solutions, allowing organizations of all sizes and financial flexibility to meet their short- and long-term storage needs, such as access to prior exams and storage of large studies and varying quantities. Although many larger facilities may have years of experience with PACS, vendors realize that smaller organizations are just beginning to plan their strategy to migrate to digital image archives.

7 Medical Systems/Evolving Solutions have worked together to meet the increasing need of healthcare organizations to achieve more storage both onsite and offsite. 7 Medical provides off-site storage in a managed hosted model, and Evolving Solutions is an IT storage architect providing data on demand and storage virtualization. Evolving Solutions is helping 7 Medical Systems to cost effectively host and manage offsite storage for healthcare providers, by architecting and implementing an IBM blade technology storage solution that includes fiber disk and tape.

This solution has enabled 7 Medical Systems to maintain system uptime 24/7 for mission-critical applications, lower cost of ownership due to virtualization and centralized computing operations, and lower up-front and ongoing costs for the care provider because of platform utilization & provisioning.

Acuo Technologies made its RSNA debut this year, showcasing its Acuo DICOM Assisted Migration (A.D.A.M.) software - a DICOM tool used in conjunction with AcuoMed Image Manager to migrate DICOM image data from one DICOM archive to another. A.D.A.M. provides for accurate rapid transfer of data from one archival storage system to another and from legacy PACS to new systems. It is one of the new Next Generation Archive products Acuo debuted this year.

A.D.A.M., Acuo's DICOM Assisted Migration software, automates the process of data migration from aging DICOM archives to more efficient and cost-effective storage devices. It provides a variety of options for data migration that makes the process invisible while efficiently cleaning patient records with "dirty data" requiring reconciliation. The storage virtualization software can work with any storage system, any PACS, and any hardware. Through its OEM and reseller agreements, Acuo distributes a full package to the end-user that's very scalable.

Acuo also introduced several new next-generation products that utilize Acuo's Intelligent Data Infrastructure that virtualize and extend storage, network and applications resources. These include a highly scalable and configurable DICOM Router, a Reconciliation Gateway for enterprise worklist synchronization, and an Archive/Image Manager that is highly scalable and efficient. 

Bycast said at RSNA it's found that radiology customers want PACS and storage to be fast and will not accept failure. Traditional systems have trouble delivering those requirements cost-effectively so Bycast has been developing storage management software. Through its partner-centric strategy, the company has made its software available to the market through partners such as Hewlett Packard and IBM.

Candelis introduced the ImageGrid 1000, a DICOM storage/router designed for imaging centers where IT expertise is scarce. It takes less than 15 minutes to install and provides remote maintenance through email alerts and proactive monitoring. Modifications can be made remotely. The system includes redundant components at all levels and it takes three hard drive failures for the system to go down. It can manage six terabytes in a single system and is expandable to 38 terabytes. The company is getting extremely good feedback and through word of mouth, plans to form OEM relationships in the first quarter of 2006.

CoActiv Medical Business Solutions announced that its EXAM-Vault Archive Service has been validated by Hologic Inc. as an approved archiving solution for the Hologic Selenia full-field digital mammography system. CoActiv EXAM-Vault Archive Service and the Hologic digital mammography system provide a complete image management system for hospitals and imaging centers specializing in breast cancer prevention, detection and treatment. EXAM-Vault is a cost-effective and efficient archive solution that is particularly suited to handle large data sets inherent in digital mammography exams.  Using a "Quad-Redundant" storage technique, CoActiv EXAM-Vault automatically and securely saves every exam in four locations, three of which are always on-line and immediately accessible. This on-line storage solution expedites the recall of prior digital mammography exams for comparisons and transmission to referring physicians.

CoActiv "Quad-Redundant" first stores online and onsite on a temporary basis an exam received from any DICOM compliant modality. Then the exam is instantly, and automatically, copied to the primary data center archive, which also is stored on-line and always available for instant recall. The exam is then simultaneously mirrored to a redundant CoActiv archive site where it is also stored on-line and immediately available. Finally, all exams are permanently archived to duplicate digital removable media (DVDs), with one copy stored at the data center and the other forwarded to the client.

EXAM-Vault is part of CoActiv's enterprise picture archiving and communication system, EXAM-PACS.

Data Distributing showcased its "D-Essentials" solutions line that imports, digitizes, archives, and distributes DICOM images, films, documents and data. The line is offered in simple modules or in phased, end-to-end deployment. Data Distributing's offerings are designed to make digital productivity accessible and tailored to even the smallest facilities, and solutions include all the application software, hardware, integration, training and installation. Data Distributing is also expanding its traditional mass storage line by including the Breecehill iStoRa Line, integrated Raid/Tape solution and Storagequest's NAS appliance for Optical Libraries.

DatCard showcased its PacsCube Express 100X and Express 200X. The 100X provides digital images in CD-R, an alternative to the costly static image output of laser film. It supports DICOM Send, DICOM Query/Retrieve (Q/R), remote DICOM Q/R and DICOM Print, and includes support of OEM DICOM viewers, auto-spanning of images across multiple CD-R/DVD-R, batch processing, teaching files, short-term down-time archive, and more. Optional DVD-R support is available for the writing and storage/retrieval of patient images.
The PacsCube Express 200X is geared for larger facilities as it supports both local and remote DICOM Query/Retrieve from PACS, Mitra Brokers, and DICOM send from imaging modality. A thin-client intranet application, iRecall, enables users from any computer web browser application to create a CD-R containing multiple studies and or patients on a single or multiple discs. The PacsCube database continually provides detailed audit trails of every disc created while maintaining pointers of the original study/patient information for the future reference. The thermally labeled discs contain facility and patient demographics including a unique identifier for audit trail purposes. The solution is configured with two recorders, is network capable, and has an input/output capacity of 300 discs. The Express 200X offers the added benefit of scalability.

EMC Corp. at RSNA announced its new reseller agreement with Siemens Medical Solutions enabling Siemens to offer EMC information lifecycle management (ILM) products and solutions to the healthcare market. To help healthcare providers store, manage, and protect a growing amount of increasingly complex patient information and clinical images, Siemens will offer EMC Symmetrix, EMC CLARiiON, and EMC Centera networked storage systems and platform software with its medical imaging solutions, Soarian health information solutions (HIS), and syngo Suite of RIS and PACS offerings.

Among the storage trends EMC was discussing at the meeting were a drop in the cost of storage coupled with a bump in IT budgets. The cost of storage is dropping by about 35 percent to 40 percent a year, while the amount of information to be stored doubles every year. And, IT budgets are up about 5 percent a year. But, most organizations don't spend very much on storage when they only need to archive.

Healthcare has become EMC's fastest growing vertical market and more than half of images generated in the United States are stored on EMC products, the company said. Storage is driven by PACS, but it's not a replacement business; rather a new business replacing film. It's a partner-driven market between health information systems and PACS suppliers. EMC has established strategic relationships with all the major suppliers in all tiers of the market. EMC is investing more in security as HIPAA and other laws mandate, and because customers are interested in business continuity and disaster recovery. To help meet those needs, EMC showcased the Next-Generation EMC CLARiiON Disk Library (CDL), a disk-based backup and recovery solution which allows healthcare providers outline a sound path for disaster recovery and business continuity planning.

EMC also highlighted the Centera Four-Node Configuration for Healthcare Providers, which provides small to mid-size hospitals with a lower-cost, lower-capacity enterprise archiving solution. EMC Centera content address storage (CAS) has been a popular choice among larger healthcare organizations for integrating with PACS applications and for email archiving. Now EMC's new Centera four-node configuration, which debuted in the spring, is a viable alternative for imaging centers and radiology clinics with tighter budgets and smaller capacity needs.

Next-Generation Documentum Enterprise Content Management (ECM) Platform Documentum's next-generation ECM platform allows healthcare providers to create a robust infrastructure foundation that manages the collaboration, creation, review, approval, archiving and ultimate disposal of information. This scalable ECM platform is an effective knowledge management solution that enables healthcare providers to meet R&D objectives and stay in compliance with current regulations.

EMC further highlighted new versions of its industry-leading EMC CLARiiON networked storage systems with native iSCSI (Internet small computer system interface) support, including the new CLARiiON AX100i, CLARiiON CX300i and CLARiiON CX500i models. These new low-cost storage area network (SAN) systems help healthcare provider reduce storage costs, consolidate IT infrastructures and deploy an information lifecycle management (ILM) strategy regardless of the size or type of environment. With the iSCSI systems, EMC is delivering the broadest set of fibre channel and native iSCSI storage networking solutions in the industry.

Fujitsu Computer Products of America showcased at RSNA its ultraportable removable storage drives, including the DynaMO 1300 pocket with DICOM viewer which allows clinicians to transport DICOM images and data on 3.5-inch magneto-optical disks to laptop and workstation PCs for convenient offline review. The system is bundled with Trillium Showcase Viewer software for DICOM imaging viewing. Clinicians also can update to PowerPoint for teaching purposes. The portable pocket drive allows clinicians to view images away from the ultrasound machine.

Hewlett-Packard showcased its Medical Archiving Solution which includes hardware, software, and services for multiple sites, PACS and imaging modalities. The system enables management of fixed content through grid storage architecture. It is also media aware and moves information from old to new media to avoid conversion needs and offer anti-obsolescence. The open standards base is geared for asset management, allowing organizations to stay current. Storage has been way too complex for many organizations, HP says, while it's driving spending. Customers tell the company that storage is the biggest challenge for IT directors. HP's portfolio offers solutions for large organizations but also smaller institutions that struggle with IT. They can buy as they go because the components will always be compatible and won't require extensive training.

The HP Medical Archiving Solution can be built to align with the physical facilities within a healthcare organization, available in three starter sizes: 5TB protected and compressed; 10TB; and 20TB. The solution comes with a rack 42u high, with multiple HP ProLiant servers and MSA20 storage shelves in the rack. Available in North America and Europe, the solution is a bundle of hardware, software and services, and will be sold for 2 cents to 4 cents per megabyte.

Hitachi Data Systems showcased the TagmaStore Adaptable Modular Storage systems models AMS200 and AMS500, and Workgroup Modular Storage model WMS100 that offer scalability, high-performance and high-availability. Leveraging many high-end features, such as logical cache partitioning and RAID-6, the AMS200, AMS500, and WMS100 are geared for small- and medium-sized businesses that are generating fast-growing amounts of data and need to meet application requirements for availability and performance in a small footprint.

Hitachi's TagmaStore Universal Storage Platform, TagmaStore Network Storage Controller, and HiCommand Tiered Storage Manager provide advanced, large-scale virtualization capabilities which enable intelligent tiered storage with software that can centrally manage the tiers and migrate data without disruption.

IBM Healthcare & Life Sciences designated information-based medicine as one of its six emerging business opportunities five years ago. And today, the topic is driving new innovation, ultimately leading to more personalized, predictive, and preventive medicine. Imaging is a critical data set, particularly when integrated with genetic and clinical information. To address the needs associated with managing the archiving necessary to analyze and store so much information, IBM introduced the new Grid Medical Archive Solution Entry Edition (GMAS EE), which reduces the entry price-point for small and medium facilities, providing a practical way to start to integrate grid technologies. It can expand to integrate with other fixed content in an organization. Access is very important to longitudinal studies and more and more organizations are integrated genetic information to make better treatment decisions.

For example, Mayo Clinic is integrating 4.5 million electronic medical records which allowed researchers to pull out patients for trials. They also are integrating 20 million lab notes and through text mining, can pull out key phrases. The goal is for physicians at the bedside to have access to information and decide on treatment based on similar patient experiences. The Cleveland Clinic has been conducting an abdominal aortic aneurysm study. The challenge is to avoid a rupture since 50 percent to 60 percent of those who experience even when already in the hospital do not survive. Researchers are studying whether there are biomarkers that can narrow down those patients who have a greater risk of a rupture. Once organizations integrate their information, researchers and providers can begin to find correlations between data sets to result in targeted treatment solutions.

InSiteOne at RSNA announced its new data migration service as part of its InDex services for data management and security. The service includes a partnership with DeJarnette Research Systems Inc., a world leader in medical imaging interface technology. The partnership brings new tools to the InDex services. InSiteOne's Capital Partners makes data migration an operational expense rather than a capital expense. Clients can finance over three years at 0 percent.

Clients have become much more concerned about disaster recovery, according to InSiteOne. For example, the company has received queries from hospitals in Florida concerned because of the frequency and fury of recent hurricanes. Although they have an intrastate disaster recovery system, healthcare facilities are now looking for out-of-state solutions as well. Facilities were copying their data but didn't understand the HIPAA requirements for data management. InSiteOne predicts that national efforts to digitize data will change data retention policies and wake organizations up to the costs of maintaining data forever. In fact, the company has gone from 50 to 300 customers without having to increase its staff size.

InSiteOne also announced an Authorized Dealer agreement with X-Ray Marketing Associates Inc., which allows members of the national association of independent medical imaging dealers to access InSiteOne's InDex line of integrated DICOM storage solutions, data migration services, and InDex Web tools for referring physicians.

The company also debuted its Rapid Retrieval Archiving, and recently opened a new state-of-the-art flagship data center in Wallingford, Conn., to facilities its new level of service. The new Tier 4 data center features state-of-the-art RAID2 spinning disk storage which offers increased capacity and higher performance.

Kodak's Health Group demonstrated at RSNA its new CARESTREAM solutions that deliver improved workflow and information sharing and include a storage solution. Kodak's CARESTREAM radiology solutions include PACS and RIS, which provide a comprehensive architecture that addresses the operational needs of clinics, imaging centers, hospitals and healthcare networks, including orthopaedic, mammography, and oncology facilities. They are designed to automate the diagnostic exam process and enable fast and efficient storage, distribution, and on-demand retrieval.

Kodak's CARESTREAM information management solutions are installed at more than 120 locations worldwide and go beyond conventional storage functions to provide efficient intelligent life cycle management of data, while enabling access to images and information stored in many platforms and locations across an enterprise or community. The CARESTREAM solutions can be easily integrated with third-party radiology, clinical, or hospital information systems and can be scaled to meet the needs of smaller smaller organizations.

KOM Networks' highlighted KOMworx, a Windows-based suite of products that offers storage management software solutions with extensive capabilities such as compliance, archiving, e-WORM (fixed content hard disk archiving), dynamic capacity management and information lifecycle management. KOMworx offers enterprise class solutions based on patented technology, extending and simplifying storage management, file retention and compliance to third-party products such as e-mail archiving, healthcare and financial applications.

KOM Networks provides an efficient, scalable and long-term solution addressing the requirements for secure and reliable fixed-content storage. By emulating optical media as hard disk, KOM archiving software offers seamless integration and native file system support for Windows, Unix and OpenVMS platforms. KOM software's Direct-Write ability to unalterable WORM media enables compliance and provides legal admissibility. OptiFile, OptiServer, and OptiStorm provide data archiving to optical jukeboxes and stand alone drives.

Network Appliance (NetApp) showcased at RSNA its newest disk-based solution -- FAS3020, positioned for the PACS market which complements short-term imaging and long-term archiving. The FAS3000 series (FAS3020 or FAS3050) delivers up to twice the price/performance of competing products in its class and supports more users per system for greater storage consolidation capability, according to the company. The hardware and software tools help with data permanence requirements. The company can provide software that allows for non-deletion and can encrypt that, providing peace of mind.

As part of the unified NetApp architecture, these systems support medical images in: FC SAN, IP SAN, and multiple network configurations, while offering scalability to higher performance systems with seamless, painless upgrades without requiring the "forklift" data migration needed by most other offerings currently on the market.

Additionally, the FAS3000 systems fully extend the value of the FlexVol capabilities built into Data ONTAP 7G by increasing disk performance even for small data volumes. FlexVol technology can reduce storage management costs and increase radiologists' storage utilization by up to 50 percent. Combined with the new SATA storage option, primary storage costs can be reduced by more than half.

ODS Medical announced its newly expanded line of CD/DVD DICOM Image Recording and Storage Systems including:
  • PACScomm Lite - an economical CD/DVD manual burn, print system;
  • PACScomm Plus - a combination CD/DVD Recording and Storage System with 400GB RAID  storage;
  • PACScomm Prime - a full compliment of both inkjet and Rimage thermal print options; and,
  • PACScomm Premier - a software option for those who want to install the PACScomm software on their existing Rimage burners.
The PACScomm inkjet hardware systems have been reconfigured to include an upgraded appearance, enclosed robotics and a locking mechanism for securing media.

Plasmon recently announced that its UDO libraries are now part of Agfa's IMPAX archive management system. GE Healthcare also has been shipping Plasmon's UDO Archive Appliance as a fully-integrated component of its Centricity PACS for about three months.

Plasmon's archive solution is built on compatability so that users do not have to move their legacy data-allowing for investment protection. The company has a roadmap to the fourth generation of UDO and each step will be backward compatible. That eliminates the need for disruptive technical changes every few years. Scalability goes from one to 19 terabytes, going to two to 38 terabytes next year.

The company also recently published a price comparison of UDO, tape and disk-based archival storage systems which found that UDO optical libraries are significantly more cost effective than disk-based Centera systems.

Rorke Data officially launched its Galaxy series of integrated storage servers and NAS products, with capacities ranging from 1 to 24TB and Linux or Microsoft embedded operating systems. Rorke featured its connectivity to Fujitsu's newly launched 10Gb Ethernet switch for superior performance and throughput as a bundled solution. Also featured was the Galaxy HDX 4Gb RAID series with 500GB SATA II drives, which is designed to exceed the high-bandwidth/high-capacity data storage requirements for today's imaging applications and NexSAN's secure and scalable Assureon storage appliance.

Sony Business Solutions and Systems highlighted its DVO-1000MD, a DVD recorder that features a built in hard drive. The recorder has two features-DVORECOVERY and DVOFAST-which provides the ability to re-capture lost video due to an accidental power outage and to remove a recorded disk in less than two minutes. Because it can stream to video and disk at the same time, it's very easy to make referral copies, the company says. Old controls are compatible and the front panel is designed to look like a VCR for easy use. The DVO-1000MD employs industry standard MPEG 2 video compression to capture images with exceptional clarity. The DVO-1000MD utilizes a 80 gigabyte hard drive to store up to 30 hours of video.

Sorna Corp. developed its LiteBox viewing and OpenLiteBox Administrator PACS-to-PACS image transfer software. The LiteBox viewer was designed for and by radiologists, and the FilmX LiteBox DICOM Viewer is optimized for rapid, efficient display and clinical review of diagnostic images. OpenLiteBox software is the licensable version of the LiteBox viewer that is embedded on every FilmX CD or DVD. Designed for use with a PC, it is available as an individual license for installation on a single computer, or as a concurrent user license, allowing the licensee to install OpenLiteBox on an unrestricted number of computers. OpenLiteBox is 100-percent DICOM, IHE PDI and HIPAA conformant. It is available in three software configurations: OpenLiteBox Viewer for viewing functionality only; OpenLiteBox Basic User for viewing and DICOM communication; and OpenLiteBox Administrator, which adds IHE PDI media importer profile functionality to Basic User. This capability simplifies and automates the process of importing the contents of a patient's CD/DVD into a PACS.

Sorna had requests for a common viewer since there are numerous DICOM viewers, and none are exactly the same. As more facilities migrate to digital, clinicians need to access web servers from a variety of PACS and to view DICOM CDs and DVDs from multiple sources that each have a different DICOM viewer. Sorna's solution enables referring physicians to simultaneously view prior exams on disk. The LiteBox DICOM viewer was recently approved by the FDA.

Sorna also showcased its new generation of FilmX recording systems, powered by eXpedo software. FilmX is a family of networked, highly automated CD, DVD and CD/DVD DICOM recorders that acquire and reproduce diagnostic images and reports of patients. The new generation uses site-configurable "workflow profiles" that streamline custom creation of patient records through programmed automation. 

Sun Microsystems bought StorageTek for $4.1 billion in June to make storage a more dominant component of its business, the company reiterated at RSNA. Its solution now revolves around information lifecycle management-the ability to get information at a reasonable cost and in a reasonable timeframe. HIPAA is a key component to the ILM strategy which is not a piece of equipment. Image is everything, the company says, so most of its customers want to manage their images themselves onsite. While most vendors end at disk-to-disk storage, Sun's solution lets user migrate information as it ages while always allowing access to it.

Sungard introduced at RSNA its new Service for Medical Images, a study management service to store and access digital radiological images from a secure SunGard archive. Using a managed service model, the service helps hospitals, imaging centers and physician group practices to avoid the high capital expenditure and technology obsolescence issues typically found with long-term study management of medical images. It also provides DICOM and PACS compatible medical image archiving and retrieval services.

SunGard's Service for Medical Images utilizes InSiteOne Inc.'s InDex Archive best-of-breed medical image storage and archiving software and architecture, which is compatible with most DICOM PACS solutions and DICOM modalities.

TDK Electronics Corp. showcased its DURABIS coating that the company says is 100 times more scratch resistant than standard DVD. Proprietary coding means DURABIS coating is good for long-term archiving as it means the CDs can last up to 100 years. The company also introduced a new entry to its DMC product line. The DMC-1000 is not as robust as the other components but offers a lower price point and the ability to upgrade to a burner with a printer.