Innovation in imaging technology has led to startling increases in data-storage requirements at the Cleveland Clinic Foundation (CCF). A single-slice CT scan used to produce 50-megabyte studies; now they create 128 slices and produce studies larger than a gigabyte. Similar enhancements are occurring with ultrasound and MRI machines.
"Every new modality is creating more and more data," says Robert Cecil, M.D., network director of radiology and cardiology.
CCF's radiology and cardiology departments jumped from 30 terabytes of storage space in 2005 to more than 100 terabytes in 2006. In 2007, with digital mammography and other new imaging procedures coming online, they expect to far exceed the 2006 rate.
Cleveland Clinic's situation is hardly unique. As healthcare organizations move paper and film material to digital storage and adopt electronic medical records (EMRs), the growth in storage volume is exponential.
"On average, we're seeing a 70 percent growth in storage needs year to year," says Roberta Katz, director of the healthcare and life sciences solutions group at vendor EMC Corp. of Hopkinton, Mass.
The complexity and expense of data archiving and management systems contributes to the slow adoption rate of digital technology in healthcare, notes Miriam Nagel, a research analyst with global consulting firm Frost & Sullivan (San Antonio, Texas).
"Even large group practices are still using paper records and faxing documents," she says, adding that funding, IT staffing and interoperability issues all contribute to the inertia.
Take it in tiers
Among larger organizations that are moving ahead, many are adopting tiered network solutions that allow them to identify which data requires the highest-performance storage medium and automatically moves older material to a lower-cost medium.
For instance, Cleveland Clinic has turned to a tiered content infrastructure system from Sun Microsystems (Santa Clara, Calif.) that Cecil says provides plenty of room for growth and allows it to migrate data from disks to tapes automatically, following pre-established rules. He sees scalability and flexibility as keys to a successful data storage strategy.
"You have to be changing media every two to three years anyway," he notes. "Three years from now, you won't be able to buy a replacement for a disk you buy today, so you have to have a rolling strategy of copying from one medium to the next."
Looking for cost savings, some organizations are evolving from departmental solutions to a consolidated system-wide infrastructure. "You can gain efficiencies and eliminate redundant processes by standardizing on a few vendors," says EMC's Katz. Also, getting all that electronic health data — images and test results — in one place allows for more collaboration across the organization, she says.
Some medical centers find that an extensible storage infrastructure gives them the freedom to roll out new applications more quickly.
Last year, Roger Williams Medical Center, Providence, R.I., consolidated four racks of legacy servers down to two racks of blade servers and added a storage area network from Palo Alto, Calif.-based Hewlett-Packard. The 220-bed hospital is adding a digital PACS system to its EMR.
"Next year, we are adding a scanning and archiving application to put everything online that was not generated electronically," says Susan Cerrone Abely, vice president and CIO. She describes the introduction of the scalable data archiving as allowing for considerable cost avoidance. "We've been able to expand the applications we have and incorporate new technology with basically the same staffing we had two years ago," she says. "It has allowed us to have a more streamlined management than we had before."
Storage and disaster recovery
The painful example of Hurricane Katrina has forced healthcare groups to devote more resources to offsite data replication, and HIPAA regulations make it necessary to re-examine data retention and security issues. CIOs are weighing "who needs access, and finding a balance between availability and security," EMC's Katz says. "Physicians, IT people, quality and compliance people all need to be in on the discussion to determine how to deal with sensitive information."
To address those concerns, data classification is becoming a hot topic, says Terri Black, vice president of marketing for Plasmon, a Broomfield, Colo., archiving vendor. PACS archives already classify data well, she says, but that level of archiving sophistication must extend to the whole health system. For instance, e-mail and other hospital-related documents that are subject to litigation need to be classified for retrieval and moved to the appropriate tier of storage. "This is a big issue across the IT industry, and it is making its way into healthcare," Black says.
Most healthcare organizations don't consider their data storage strategy a selling point, but they should, argues Mark Anderson, a healthcare IT futurist with the AC Group Inc. of Montgomery, Texas. He says a robust data storage infrastructure has marketing value for hospitals. He recalls that a hospital client recently tried to offer local physicians access to advanced data services, but the physicians quickly stopped using it because they deemed it too slow. Hospital executives "have to understand the value of their information systems," Anderson says. "They should see total redundancy and data retrieval speed as a competitive advantage."
David Raths is a contributing writer based in Philadelphia.
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