The Next Frontier: Cloud Storage

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 - Cloud computing

Data are growing in size and scope. Radiology departments and imaging centers face unprecedented bandwidth challenges that stem from the need to store exponentially growing datasets. With bandwidth costs increasing and servers consuming valuable square footage, radiology is on the lookout for a new solution. Cloud storage may fit the bill.

One way to alleviate storage pain points and free up some servers is to shift storage to a cloud storage model where images can be virtually stored and pulled on an “as needed” basis. While only 2 percent of healthcare organizations now use some form of cloud computing, 73 percent say they are moving toward migrating applications to the cloud, according to a February report from Software as a Service (SaaS)-based enterprise management company Mimecast. Storage was adopted by 22 percent of total respondents who had already adopted cloud computing (all respondents including, but not limited to, healthcare organizations). No figures specific to radiology or oncology, however, are yet available.

Cloud storage could lessen multiple IT challenges. Taking archives offsite reduces bandwidth pressures, and it allows IT staff to focus on what’s going on in the hospital instead of in the cloud. Cloud storage offers safety and redundancy as an offsite storage solution. Radiologists and patients benefit from improved access to images. The economic advantages are slightly more subtle. Facilities can re-purpose space to make room for clinical beds. Additionally, because reports are easily retrievable, redundant testing can be diminished.

Early adoption pays

Some facilities are already reaping benefits from cloud storage. In 2001, the 926-bedin Washington, D.C., partnered with InDex (InSite One) to store image archives prior to implementing PACS, says Keith M. Horton, MD, director of informatics, department of radiology. Currently, the facility has a PACS, and the hospital, along with nine hospitals in its , stores and accesses images through a cloud archive service.

Originally, says Horton, the organization began using a per-click program for image retrieval where every image was housed and charged for. After buying the storage hardware, Horton realized that the cost of constant software upgrades took a mighty toll from the capital budget. In addition, the facility was contemplating expanding its server room and needed a mirrored server room as a failsafe. “The server room was taking up a lot of space where patients could be treated,” says Horton.

The switch to a fully-outsourced image archive allowed Washington Hospital Center to conserve existing clinical space and bypass expansive server farms. “We can use the hospital square footage for what it’s supposed to be used for: taking care of patients.”

About 275,000 exams are performed at the hospital center each year and sharing cloud storage access for image archiving across its MEDStar environment has reduced the number of redundant tests performed on patients about 10 percent, says Horton. “You never know where patients are going to show up. For us, we get patients who travel from one hospital to the other,” says Horton. “Those sister hospitals can obtain patient images [in the cloud]. If other hospitals come online and share images in a secure pattern, I think that would make medicine more efficient.”

The switch to outsourcing image archives also yielded an administrative benefit which allowed the facility to avoid hiring an additional FTE or two to maintain its image archive. Currently, Washington Hospital Center has two full-time administrators who are able to focus on the clinically relevant portion of PACS, while offsite technologists attend to the backend needs of managing the cloud storage architecture.

“It gives you some comfort [to not worry about the backend processes] and allows experts in those fields to concentrate on their areas of expertise,” Horton says.

Proof of concept

“Old [image retrieval] standards no longer suffice,” says David L. Siva, director, medical information systems & technology at Daughters of Charity Health System, a regional healthcare system of six hospitals headquartered in Los Altos Hills, Calif. Previously, a 24-hour retrieval time sufficed. “Now anything more than 30 to 60 seconds is considered absolutely unacceptable,” he says.

According to Siva, the clinical expectation for study retrieval has changed while, simultaneously, datasets continue to grow in size and number. “There’s a large spike every