Storage: Deciding How Much is Right

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Storage, which is crucial to getting the most out of PACS, is often peripheral to the medical professionals accessing it. Their main concern is reliability and quick availability. IT achieves this by planning for, implementing and managing a scalable (and hopefully flexible) storage architecture. But when you factor in exploding data demands, declining storage costs, ever-changing technology and software, robust disaster recovery, business continuity plans and obsolescence the story gets a little more interesting.

Every PACS has a personal element because each archive is planned for, configured and built to meet the specific requirements of the healthcare provider's medical imaging needs. Storage approaches are as varied as the hospitals that implement them. What's certain is that each year brings forth a newer and more sophisticated storage technology with greater capacity and capabilities - especially with the advent of networked storage. The shift has peaked IT's interest in centrally managing storage architectures in order to allocate storage as needed, where needed.

Limited budgets in the past hindered this storage evolution for hospitals. But the good news for administration and IT is budgets for healthcare IT are growing, according to recent studies. Some 73 percent of hospital CFOs indicated plans to purchase digital radiology systems, while 62 percent (of the 460 surveyed) said they expect to buy IT systems over the next five years, according to a survey earlier this year from the Healthcare Financial Management Association.

Since IT is revered as raising clinical quality and operational productivity, hospitals are more concerned about when they are getting a PACS, not why. The archive is fundamental and patients have the propensity to accumulate a trillion bytes of data over a lifetime, so now more than ever it's critical for healthcare providers to create flexible storage solutions.

When it comes to flexible solutions, IT has learned it is not always about replacing the hardware, but about adding intelligent archive software. "The hardware component of the IT budget is not necessarily growing," says Patrick Boyle, business unit manager of IBM Healthcare & Life Sciences. "The growth has really been in the software and services side of the IT budget within hospitals, such as application software [PACS, laboratory information systems and cardiology information systems], middleware and system management tools."


The move toward new technology is more evolutionary than revolutionary and storage software is the next step in the process. Hospitals should first deploy an optimal archive that meets their PACS needs - which may include leveraging existing IT infrastructures - and then look at software technologies that help improve overall management.

AnMed Health, an integrated delivery system in Anderson, S.C., is looking at implementing storage virtualization software once long-term and short-term PACS storage is complete. "In 1998, we made a decision to put in major new clinical systems," says Darrell Hickman, CIO/director of IS. "Up to that point, we had a few, but mostly what we had was for administration. We used the computer to bill patients, now we were using the computer to treat patients." For the computer to be a routine part of clinical treatment processes, the hospital needed a storage infrastructure supported by an unfailing disaster recovery plan.

AnMed installed IBM's DS6000 and DS8000 [formerly code-named the Shark] mid-range to enterprise-class storage technology that replicates data. With clinical systems storing data on the Shark, disaster recovery decreased from 38 hours to less than 45 minutes, says Hickman. When it came to PACS, IT wanted something similar and selected IBM's DS4000 (formerly FAStT) for its long-term archive, an entry-level to mid-range storage technology similar to the Shark. Two units are installed for disaster recovery purposes - one unit at the main medical center and another at a remote outpatient clinic. Short-term storage is on directly attached RAID, but there are imminent plans to move the archive onto the DS4000. Nearly 6TB will be allocated for short-term storage.

"Concurrently with that, we want to move the PACS database from locally attached RAID onto the Shark," says Hickman. "That, too, will be replicated at both the main medical center and the outpatient health campus." Access time to clinical priors is anticipated to reduce significantly.