The ability for mid-range and small-scale hospitals and clinics to play with the big boys when it comes to storage media is gaining ground. A range of more affordable storage choices is allowing storage area network (SAN) access for more than the academic-facility titans. And while network solutions and falling costs gain attention, don't expect to see tape and optical disk storage benched just yet. The media and cost choices abound, and every radiology department or enterprise can find something to meet its business and financial game plan.

Storage needs will continue to grow at a rapid pace. In 2004, the healthcare industry will spend approximately three times as much as in 2001 on storage, reaching $6 billion, according to Anderson Consulting Group Inc. (AC Group). In a White Paper that AC Group prepared for EMC Corp. on total cost of ownership (TCO), it is said that storage-related costs are expected to increase to 15 to 18 percent of an organization's annual IT budget by 2003-2004, based on the adoption of clinical applications that require extensive storage, such as PACS and Computerized Patient Order Entry (CPOE).

AC Group's findings also show that in relationship to server costs, storage-related costs will constitute 65 to 70 percent of server purchases through 2004. The average 330-bed hospital's storage requirement was estimated to increase from a mere 100 MB in 1960 to 4 terabytes by 2002-2003, according to the report.


DISK, TAPE OR OPTICAL

With all facilities keeping a watchful eye on expenditures and total cost of ownership for technology, spinning media prices continue to become more attractive. Fibre Channel and Small Computer System Interface (SCSI) disk storage price points (including the integrated storage systems) are about the same - anywhere from $50 to $80 per gigabyte, or five to eight cents per megabyte.

Serial ATA (SATA) disk - what some consider the eventual industry common standard drive - ranges anywhere from $5 to $30 per gigabyte, or half a cent to three cents per megabyte, according to Peter Gerr, analyst for Enterprise Storage Group. "Fibre Channel disk drives are probably three to four times the cost of comparable serial ATA drives," Gerr says. Fibre Channel and SCSI are able to transfer data at higher rates of speed than ATA.

Magneto Optical (MO) disks that store medical records run about $10 per gigabyte, comparable to Digital Linear Tape (DLT) or Linear Tape Open (LTO) tape. "But from a media perspective, it has a legacy of not necessarily being able to manage," Gerr says. "It's removable media in that you could store records onto an optical platter and take that platter off site somewhere. [But] it doesn't enjoy the same mainstream success that tape does."

Optical jukeboxes are typically standalone devices, which can be problematic in a networked world. "They're not networked and so in this age of storage area networks and attached storage, the lack of network-ability and lack of compatibility with mainstream management tools prevent optical from having more mainstream influence," Gerr says.

The next generation of optical that's been introduced is Ultradensity Optical (UDO) at about $2 a gigabyte. It's five times less expensive than MO and has a three and a half times higher density. The current generation of MO stores about 9 gigabytes per platter. The newly introduced UDO will store 30 gigabytes per platter.

"The $2 per gigabyte brings it into a range of ATA disk pricing," Gerr says. "So there may be a resurgence of opticalâ?¦a new ability for optical to compete against disk in [healthcare] environments because it enjoys resiliencyâ?¦"

Advanced Intelligent Tape (AIT), DLT and LTO are the three main types of magnetic tape. DLT is the most mature and most prominently sold media type. "It's proven to be very versatile, have good media lifetime, to be resilient to failure and is cost competitive with the other tape formats," Gerr says. "LTO is relatively newer technology and has only a fraction of the market share that DLT does. But the prognosis for LTO is good. It's a competitive format to DLT, but I think that gets to a religious discussion of which is better. Users have a preference either way, and cost may be one of the factors."

AIT is used less and is an older technology. The current AIT technology has a native capacity of a hundred gigabytes. "It's certainly dense in comparison to DLT and LTO, and the transfer rate is 12 megabytes a second," Gerr says. "So it's competitive as well. [However] it doesn't have the wide ranging vendor support that DLT has."

But overall, focus on a price tag can be a costly mistake when considering a purchase in the storage area. "Cost is just one ingredient in the discussion," Gerr says. "You also have to consider performance, scalability, how many systems can I manage at once and reliability. Not all data are created equal. Not all media are created equal, so thinking about the performance and cost reliability aspects really starts with knowing what kind of data you have. That's really going to drive users' decisions about what media and what systems they ultimately choose."


SPINNING OUT

Serial ATA drives will continue to catch the attention of vendors and users alike. "The major storage vendors like IBM and EMC are all lining up, giving the same advice to customers: Use SATA drives for large retained data systems and near line storage," says Craig Butler, IBM's brand manager for Midrange Storage. "It's not good for online transaction processing systems where you're frequently making small updates to your database," Butler says. "That's because these drives [have] an 8 [to] 5 duty cycle. Use SATA drivesâ?¦for long-term retained data and near-line storage, where you purposely copy a bunch of your rapidly changing data to a mid-range storage tier where again you would like less expensive drives. You take a snapshot of your data and do a backup from that tier and then move it perhaps to tape."

SATA drives will serve a role in updating or refreshing infrequently written data. Over time, the cost of SATA drives will decrease to the point where they are approximately one-third of fibre channel drives, as shipping volumes increase, probably by the end of 2004.

"So that's the promise," Butler says. "In large quantities, people are going to be able to use SATA storage to get their disks and the cost of maintaining this storage data down to about $10 a gigabyte, which is a penny per megabyte."

Butler cautions, however, that it takes larger capacities to benefit from the lower cost, because even with the lower cost of SATA drives, when you just buy a half a terabyte or one terabyte, the cost of the controllers and the drawers that the drives go into have to be factored into the equation. IBM's storage expansion unit (or drawer) to its mid-range disk storage product line offers from 750 gigabytes at the low end to 32 terabytes and beyond at its high end.

With disaster recovery on the minds of most healthcare institutions, Butler suggests SATA drives and near-line storage as a solution. "[It] is perfect for disaster recovery set up where you're near but maybe not in the same computer room, maybe on the same campus within 10 kilometers," Butler says. "You could take a snapshot of your data at regular intervals and send them across to another copy of your storage setup. If [facilities] are willing to do that once or twice a day, that's a good use of near-line storage and SATA drives."


HELP WITH HIPAA

The good news in all of this is that price per megabyte of storage will continue to drop along the current rate into the future. "That will help the radiology department," Butler says. "I think all the major competitors are working very hard on the software features that will help all industries with the data retention compliance issue that they're running into."

The Health Insurance Portability and Accountability Act (HIPAA) has driven home the need for backup copies of imaging exams. "The biggest impact that HIPAA has had is the awareness of the need for good disaster recovery procedures, good data management procedures," says John Galasso, Eastern regional health care specialist for Storage Technology Inc. "The bottom line is we're going to see the hospital storage enterprise more than we're going to see the departmental storage islands. The days of the information bucket are rapidly disappearing, and hospitals can't afford the hardware and software service contracts, but more importantly they can't afford the cost of additional HIPAA litigation."

Radiology departments and hospitals are still sorting out what is available, trying to find the best way to heed what has become the industry mantra: Information Lifecycle Management (ILM). "There are a number of tools out there to manage these data from various vendors," says Marti Baldwin, storage solution manager for Sun Microsystems. "There's overlap in those tools and software capabilities. There are gaps in the areas, and right now the whole industry is looking toward driving that business and trying to make it more simple for the radiologist to use the data and not have to manage them manually."

The hot thing today is to have your data online or near line on disk. "It's much faster, but tape is still the backup medium, and we still have to back up for business continuity and data continuity," Baldwin says. "There also has to be removable media capability. Not all hospitals have the telecommunications bandwidth to send everything through the network. No matter how much we as vendors support going to disk and writing our next-generation data archive and management to go to disk, there still has to be a tertiary or third level of data storage, and right now that's tape... It's still the cheapest and probably will be for quite some time."

And as holographic storage technology with its sights on increased data rates and sophisticated search capabilities looks for its chance to prove itself, the veterans still remain in the game.