More Than Imagery
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Regulations and more capable technology platforms increase demand for digital images and archiving and storage services.
A confluence of technology advancements and regulations are creating an ever-increasing demand for digital images at military and Veterans Administration health care facilities.
As a result, the community’s IT managers are expanding their systems’ storage capacities to handle the burgeoning amount of studies and accompanying which are part of patients’ health records. At the same technical community remains in security, reliable and long- and other requirements that will help provide access to digital image data and their supporting files, anytime and anywhere.
Digital Images Are Unique Data
Digital image archives provide health care facilities with centralized storage for radiology and other studies, along with greater access, reduced loss, and increased accountability of that data.
In the hierarchy of archived data, digital imagery has unique storage requirements that set it apart from archived emails and other products.
“E-mail is much more a transactional data—people want that information much more quickly. So you need higher-performance applications for e-mail as compared to medical images,” said Ravi Thota, director, product marketing and storage management, Network Appliance (NetApp). The company is a data storage provider for numerous DoD and other federal agencies, and their medical, intelligence and other communities.
“So, for medical images you don’t need a very high-performance system—performance is not the primary criteria,” pointed out Thota. “What’s more important are other issues: Is the data scalable? Can you keep it for a long time and still give the information to me quickly and reliably enough?” he emphasized.
The answers to those and other questions determine the effectiveness with which medical facilities manage their ever-increasing quantities of data.
More Data
The National Naval Medical Center (NMCC) Bethesda provided one perspective on the quantities of digital medical data which are entering archives.
The center archives about 135,000 radiology studies a year. “Due to the integration of new modalities to our picture archiving and communication systems (PACS), in the last two years we have seen an increase of about 30 percent of radiology studies that are stored to the centralized PACS archive instead of the traditional file room, or modality-specific ‘mini-PACS,’” said Hugh Scott, head, PACS services, Department of Radiology.
And it is not only current studies which are being sent to system archives. Paper files and legacy digital systems are being configured and sent to PACS data drives. NMCC migrated about 200,000 studies stored on optical disks its “jukebox” system to redundant array of inexpensive RAID), an array of harddisc interface drives which are configured as one common archive for its radiology PACS. “We are a success story and an example of how a digital imaging archive can be migrated to new media as such storage technology becomes available,” opined Hughes.
Pull of Technology
The military medical community’s expanding desire and ability to use data from its archives has been generated, in part, by the incredible speed at which medical image systems have evolved since the late 1980s. Health care providers to read studies not only on office PC workstations, but on PDAs and other portable devices as they are making rounds of their wards and in other venues served by a wireless environment.
One representative wireless device touted by health care information technology vendors for potential imaging reading applications is the Dell Axim X51v 624MHz handheld. The Axim displays images in the PACS environment. The handheld is enabled by integrated Bluetooth wireless technology and has a 64 megabyte synchronous dynamic random access memory and a 256 megabyte flash read-only memory.
Sony’s reader provides a second glimpse of another emerging platform with potential for use as a hand-held device for viewing medical imagery. The 0.5-inch thick device is smaller than many paperbacks and has the capacity for up to 80 average-size eBooks, according to the device’s product sheet. That same document notes the reader “also displays Adobe PDFs, personal documents, blogs, newsfeeds and JPEGs with the same amazing readability.”
Hardware advancements in resolution and screen size, and maturing technology applications, including data streaming, will allow practitioners to more effectively access archived images and supporting documents, and will continue to fuel the appetite for this data.
Access from Anyplace
NetApp’s storage architecture solutions go beyond traditional networks and provide insight into storage solution strategies.
“Some of the opportunities that we are involved in, in a general sense, would be when a doctor would look to pull up some imagery data and would collect it off of a medical device and traditionally put it into their network,” said Mark Weber, vice president and general manager, NetApp Federal Systems.
The company’s programs “allow a doctor to access the data from their home, in their office, or a handheld device. The bottom line is that they are putting the data in a data repository, or storage farm, which they can access from any place. We are doing these things in the current environment—we are treating the medical data as ‘data’—it’s much like we treat satellite imagery data. The storage is specialized and focused for one certain application, but it adjusts to these different requirements,” added Weber.
These requirements, in part, help meet government regulations concerning patient data.
Long-Term Storage
Government-mandated regulations, including the Health Insurance Portability and Accountability Act, requires health care facilities to keep medical records for their duration of the patients’ lives, plus seven years. This creates another requirement for infrastructure managers and maintainers.
“Basically we have to provide solutions that meet these customer requirements and will stand the test of time—not just this year and next year. Whatever solution we come up with must serve data to them decades from now,” pointed out Thota. Two storage system capabilities that help meet the requirement for long-term storage of information are scalability and standardized protocols.
The quest for scalability is forcing industry to migrate to ever-increasingly more capable storage platforms—with high-end capacities in the order of a petabyte of data (one petabyte contains one quadrillion bytes).
EMC, which specializes in designing and implementing information lifecycle management infrastructures in the health care industry, offers one such high-end networked storage system, the EMC Symmetrix DMX3. The system can store up to a petabyte, said Jay Lane, director of strategic programs, DoD Medical Division. By way of comparison, the company’s entry-level system, the EMC CLARiiON AX 150, has 750 gigabytes of capacity.
Cost-effective platforms also use standardized protocols which can store large amounts of imagery and other data for up to 20-or-30 years, or longer. This strategy enables IT providers to ensure the customer can read that information throughout the data’s lifespan.
“There is a lot of technology which goes around storing information in the native format, so you have the option to read that information even if the archival application goes away,” said Thota. “Some of the technologies that exist today absolutely require an archival application to read the information, because it is based on some proprietary protocols. We break that barrier and say that you have to use standard protocols for that information so that you can retrieve that information decades from now,” emphasized Thota.
Security
PACS and other archives are potential targets for intrusions. “It is just good sense to aggressively protect any data repository with state-of-the-art technology as it becomes available in the market place,” said Bethesda’s Scott.
Among the recently announced products to meet the community’s requirement is NetApp’s Information Server 1200. “The server tags sensitive information and identifies which of that information is very sensitive,” noted NetApp’s Thota. “This device will help you go through massive bits of information and pick out sensitive pieces of information and deliver the level of protection that that information needs” concluded Thota. ♦