Long-term storage can be a CIO’s worst nightmare. Worries begin on the cost front. As datasets grow, storage gobbles more and more of the IT budget. Then, there are labor issues and costs to contend with as storage management requires human resources. Finally, the specter of disaster haunts every CIO.

Disaster takes many forms. Consider, for example, Medical Imaging Northwest in Puyallup, Wash. The three-site imaging practice lost 10,000 studies when three hard drives failed during a planned migration in March 2006. “At that point, everyone realized we needed more security,” recalls Annette Simmons, IT manager/network administrator. Long-term storage became priority No. 1.

Whatever drives the decision, sites that invest in robust long-term storage report multiple benefits including reduced costs, better patient care and improved physician satisfaction. And the CIO gets a good night’s rest.

This month, Health Imaging & IT tours four very different facilities with one common denominator—an enterprise long-term storage strategy.

Best of both worlds

Scottsdale Medical Imaging CIO Jim Whitfill, MD, leaves little to chance. Last year, the 11-center, Phoenix, Ariz.-based practice implemented its third-generation archive, a two-tiered architecture combining Hewlett-Packard NAS spinning disk technology with a Plasmon UDO Archive Appliance. The NAS serves as onsite storage, and Plasmon UDO is housed in an offsite data center.

“We minimized our vulnerability to data loss through geographic diversity and a mix of storage technology,” explains Whitfill. The new configuration represents a considerable upgrade from previous architecture. Neither the first-generation tape library nor second-generation DVD archive provided secure durability or bulletproof, rapid access. Plasmon UDO Archive Appliance, on the other hand, demonstrated its durability after surviving a Hurricane Katrina-level soaking at New Orleans South Central Healthcare. After the water receded, the IT department recovered all patient data from the libraries.

Still, a mix of storage technology allows disparately located facilities to more securely cover various potential problems such as a batch of hard drives with an undetected glitch. “Data loss can occur with every type of media. In many cases, unpredictable events rather than major disasters cause data loss,” says Whitfill. By spreading and diversifying its storage infrastructure, Scottsdale Medical Imaging cuts its risk.

The small scale solution

After Medical Imaging Northwest lived the nightmare of hard-drive failures during a PACS migration in 2006, the imaging center honed in on storage, focusing on developing a secure, long-term solution. The primary challenges for small sites revolve around costs and resources. Medical Imaging Northwest completes 100,000 studies annually with a one man IT shop. “Onsite long-term storage requires additional staff, which raises its cost,” Simmons points out.

The practice turned to InSite One InDex Recovery for a secure disaster recovery solution. Images are archived to PACS and transmitted to two InSite One locations for redundancy. Medical Imaging Northwest achieves additional economies of scale, tapping into InDex Recovery for enterprise data and exchange backups. The solution eliminates tape costs and maintenance challenges, says Simmons. Plus, the practice retains control over its offsite data as InSite One uses a non-proprietary DICOM formula to store data, simplifying removal.

The enterprise archive

Johns Hopkins Medical Institutions (JHMI) in Baltimore, includes three hospitals and two outpatient centers. Its storage needs are tremendous. Less than three years ago, the system relied on a departmental, silo approach. Different departments used different vendors, and each system needed dedicated staff. Plus, images were not easily or universally available to all care stakeholders.

Fast forward three years. “JHMI has achieved significant cost and patient care benefits, images are visible on 12,000 workstations across the system, and referring physicians are delighted because they can see all of their patient images with access to 3D and fused datasets,” says James Philbin, senior director of enterprise medical imaging. The difference is an enterprise-wide, long-term storage strategy. The new strategy centers on a single replicated archive for all images from all ‘ologies.’ So far, radiology, radiation oncology, cardiology, orthopedic medicine and vascular surgery share a pair of NetApp FAS 6030 enterprise storage systems.

“Health systems can save money with an enterprise archive. It costs less to buy more storage, and it takes fewer people to maintain the system,” explains Philbin. Still, the configuration gets complex. JHMI deployed a mirrored archive in two different data centers with two networks, gaining high reliability and eliminating the labor associated with tape backup and MOD maintenance.

The health system continues to consider leading-edge solutions. For example, older data represents a challenge. Although the hospitals need to retain data for 10 years, only 5 percent of data are accessed after two years. “We want to secure the ability to spin disks down for older data,” says Philbin, “which reduces power and cooling requirements and costs.” Systems with a dense footprint such as content-addressed storage (CAS) could solve the issue. In addition, storage grid architecture offers a means to automate information lifecycle management and data replication to garner additional reductions in IT labor.  

Future-proofing

Six months after deploying PACS in 2004, St. Peter’s Healthcare, a 442-bed hospital in Albany, N.Y., realized it had nearly maxxed out its jukebox. “We were faced with three options,” recalls CIO Jonathan Goldberg, “expand the jukebox, purchase a tape archive or invest in disk storage.” The hospital tossed out the first two options. Growing the jukebox merely delayed the inevitable as imaging datasets continued to grow. A tape archive brings considerable IT labor requirements without delivering secure reliability.

“The hospital focused on enterprise needs and decided to future-proof ourselves as much as possible,” says Goldberg. “By looking at the whole environment, we could build a solution in a way that fit together.” Priorities included disaster recovery and long-term data center needs.

St. Peter’s Healthcare invested in an EMC Corporation Clariion storage area network (SAN) and two EMC Centera content-addressed storage (CAS) archives for storage of radiology and enterprise data. Centera archives are sited in separate locations to provide redundancy.

Everyone’s happy, says Goldberg. Radiologists have seen historical image access time drop from 90 seconds to less than 10 seconds, and IT staff appreciate the system’s manageability. Budgeting and planning is simpler because the hospital can see and analyze storage utilization to make decisions based on trends. “Long-term storage does take a large upfront investment, but the system pays for itself because data are secure and manageable,” sums Goldberg.

Guiding the storage decision

• Approach storage as an ongoing project. Technology that is valid today could be overwhelmed in two years.
• Calculate all of the infrastructure required to support each storage solution and use it to inform the final decision.
• Think big. Are there opportunities to achieve economies through an enterprise approach or replicated archive?

Long-term storage is a business essential with a wide variety of options on the market. A comprehensive, proactive approach that calculates all costs and reflects the possibility of technology failure serves as a solid starting point. The savvy CIO keeps storage in the forefront of operations as solutions and needs change rapidly. Diligence pays off via reduced costs, streamlined storage management, increased physician satisfaction and improved patient care.