Radiology in the Cloud: How to Store Petabytes of Medical Images

Brian T. Horowitz, Tech Journalist | 12/3/2012 | 6 comments

Brian T. Horowitz
Hospital CIOs and their staff are up to their ears in data, especially medical images like MRI and X-rays. We spoke with Geoff Duke, director of imaging information systems at Intermountain Healthcare, about just how to deal with all that data.

Intermountain, a nonprofit health system of 22 hospitals and more than 185 physician clinics in Salt Lake City, stores petabytes of data ranging from EHR to medical images. Making all those high resolution image files available in easily accessible storage is an expensive and challenging undertaking.

When hospitals have multiple picture archiving and communication systems (PACS), Duke noted, getting images off one system onto another can be a challenge. Hospitals with multiple facilities need to be able to take any type of radiology image and make it transportable and viewable for other clinicians in the organization.

Therefore, Intermountain uses a single PACS. "Having a single archive that's enterprise-wide, it makes it more transportable," said Duke. "You can put them in the hands of the clinicians anywhere they need to be viewed."

It is also important that the archive be vendor-neutral. Storing it over the long term, protecting it, and business continuity are all made easier in a vendor-neutral environment. Interoperability is a key, and if a company needs to add a new PACS system in three years, the images in the old system won't have to be moved, he suggested.

"We wanted to break down the silos that are generally created within imaging architectures," said Duke. "Right now we have a cardiology silo, we have a radiology silo, and we have other silos here and there. By aggregating them in one single archive, now I don't have to worry about it."

Duke advises that healthcare organizations consider a hybrid cloud, which is a combination of both storage onsite and in the cloud. There are advantages to security and compliance in a hybrid cloud, but they are more expensive. You have to know if it is a fit for your organization. Duke says:

If you were a smaller facility, it might not be cost effective for you to [use a hybrid cloud]. Healthcare and the word 'cloud' have not really gone together very well, but if the vendor can manage the security and privacy and manage the reliability, then it's certainly something to look into and evaluate as you're trying to figure out your own infrastructure.

Keeping copies of images in multiple locations is a key benefit of a hybrid cloud, Duke noted. Without this redundancy, CIOs would have to create thousands of tape backups that could take years to restore in the event of a disaster, he said. In a vendor-neutral archive, "we'd just switch to that other copy that's stored in a remote datacenter and start operating again."

When shopping for an archiving platform, make sure the company has experience with PACS systems. Duke said:

If you're talking to a vendor, make sure they've had some experience interacting with the PACS systems that are already in your environment. Make them show you how they operate in order for you to get some faith and trust that they're going to protect your data as well as you, if not better than how you would protect it.

If you can streamline your archiving and take advantage of the access and durability of the cloud, you'll likely get a good handle on your straining image archive. You can't eliminate the cost, but you can do a lot to keep it from getting out of control. What about you? How does your healthcare system approach archiving massive amounts of radiology data? Is a hybrid cloud the way to go? Would you choose a vendor-neutral archive? Comment below.

View Comments: Newest First | Oldest First | Threaded View
singlemud   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/28/2012 9:17:36 AM
Re: Hybrid solution makes sense
That is the ideal. Major healthcare providers are striking to make it happen
rdv   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/19/2012 2:26:54 PM
Hybrid solution makes sense
Having the radiology on cloud systems is a great thing to happen, this will help the doctors from the different places to exchange the patients case studies and help diagnose the problem.

  This will also help gather or add to the EHR or EMR of the patients.
Syerita Turner   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/4/2012 12:13:01 PM
Re: Ensuring interoperability
Interesting. I think that many would frown on sending any of the images to a cloud but as I sated in other feedback containing the cloud topic, it all goes into trust of the vendor servicing the cloud data. I believe that finding a vendor that will ensure the security of the information stored in the cloud is important. Knowing what the security measures are beforehand can aid in making the best decision. I think that using the cloud to cotrol the amount of information stored on site is brilliant. Now we just have to get the others on board.
Brian Horowitz   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/3/2012 8:18:49 PM
Re: Ensuring interoperability
@Ivan - Thanks for your insight. Hopefully a single PACS will be interoperable, but I like your idea of keeping other systems running as a backup. In the long run, though, the less silos the better.
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Ivan Schneider   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/3/2012 2:31:23 PM
Ensuring interoperability
It must be an immense data challenge -- ever-increasing file sizes with more and more scans, and you can't really throw anything away until someone passes away, and even then you may want to retain files as an archive or for research purposes.

Regarding the advice to use a single PACS, while also making sure that it's vendor-neutral: How can you be sure that it's vendor neutral if you're not really putting it to the test on a day-to-day basis? What if you consolidate on a single PACS and it turns out that it's not as neutral or interoperable as you had hoped? 

It might be worth considering an approach where you allow multiple PACS to exist within the same hospital network, so that the interoperability is tested on a day-to-day basis. That way, the hospital can develop core skills in making things work together, while keeping vendors' feet to the fire on truly being standards compliant.
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batye   Radiology in the Cloud: How to Store Petabytes of Medical Images   12/3/2012 11:12:04 AM
Size of the file...
I think hybrid cloud would be a best solution to deal with this problem... also old technology should not be forgoten... few years ago one of my Polish clients did show me KGB Archiver zip program where you could shrink the data from 1gb to 100mb or less...  myself for emailing photos I'm using Robosizer... 


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