Image Storage: When an Enterprise Strategy Works Best

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Forward-thinking healthcare providers are confronting the explosive growth and volume of digital information throughout the enterprise by consolidating electronic storage onto one unified platform. Ensuring that no storage sits idle, the approach also allows users to more dynamically and cost-effectively increase storage capacities. Factor in the advancements vendors have made to their storage hardware and software systems and hospital staff members are guaranteed real-time access to mission-critical digital information - thus improving the speed at which patient care is delivered.

Image storage in healthcare is clearly being consolidated into consolidated storage environments. The approach allows multiple data types from multiple clinical systems, such as PACS and electronic medical records, to be archived on one unified platform. Storage systems are therefore utilized and shared enterprise-wide, rather than restricted to use on a by-department basis.

While one healthcare provider's storage strategy, hardware and software differ from the next, successful implementations reap a common benefit - effective data management. Consolidating storage optimizes the IT support and also maximizes IT investments. Enterprise storage, once conquered, is easier to manage as it allows users to buy storage as needed and dynamically increase the archive's capacity.

In the driver's seat

Some healthcare providers that store different types of radiology, and sometimes cardiology, imaging studies on a unified storage platform are isolating different storage management solutions for different modalities. A critical factor that determines where the imaging study will reside is the age of the study.

Boston-based CareGroup, the healthcare system made up of Beth Israel Deaconess Medical Center, Beth Israel Deaconess Hospital-Needham, Mount Auburn Hospital and New England Baptist Hospital, is a large, multi-site healthcare system affiliated with Harvard Medical School. The healthcare system recently adopted an information lifecycle management (ILM) approach to enterprise-wide storage that augments its storage platform and efficiently manages online medical data, including PACS images.

"Enterprise-wide storage means to me that no longer do you store mission critical or clinical data on a machine under your desk," says John Halamka, CareGroup's CIO. "In fact what you are doing is putting storage, on a lifecycle managed fashion, in a centralized data center where it is available as a utility." CareGroup's 40-terabyte storage architecture allows mission-critical patient images to be kept on high performing, highly available storage for real-time access, while less critical data are stored on a lower costing, mid-tier level system.

The tiered storage supports CareGroup's PACS (GE Healthcare's Centricity PACS) that generates more than 5 terabytes of data each year. Radiology images migrate across multiple channels of storage throughout its lifetime. "With ILM, users can actually shuttle data over its lifetime between expensive, moderate, cheap - and even onto tape where it can be kept for 30 years," says Halamka. "Then if I need to shuttle it back, I can move it around different classes of storage as needed to for the optimized, cost-effective use of the infrastructure."

When medical imaging studies are first acquired, they go right onto EMC's Symmetrix DMX Series networked storage platform. Images stored here can be retrieved by radiologists and clinicians within seconds. After several months, images are moved to EMC's Centera content addressed storage (CAS) system. The last tier of storage is a tape archive, which houses older patient studies that are not as clinically useful.

"What is the value of an x-ray acquired today," poses Halamka. "It may be pretty high since the patient has a cough and a fever and the doctor is looking to rule out pneumonia. What is the value of the [same] x-ray in a year? Well, probably not a lot unless it is used as a comparison. What is the value of that x-ray in a decade? Probably none, but the state of Massachusetts requires us to keep all digital records on file for 30 years. So when I go out to buy storage, I am going to want to buy very fast reliable storage for the data that the doctors need to get to today. When the information gets older, then it can be moved to a less expensive class of storage."

Halamka advises that healthcare providers migrating to an online, enterprise-wide storage architecture carefully consider