Many medical professionals, including radiologists and surgeons, rely heavily upon medical imaging resources. That's because, as part of their role, they need a way to access images for diagnosis, archive these images within a picture archiving and communication system (PACS) and share them with patients, as well as other medical professionals.

While this functionality is essential for providing quality care, what many practices often don't realize are the time and costs associated with maintaining an onsite PACS as their facility's data grows. With increased data comes an increased need for additional hardware, security protocols, IT staff salaries and expenses on utilities, including electric and cooling to ensure the hardware continues to operate smoothly.

For a practice owner, as these costs start to build, and responsibilities for managing hardware become a more costly and time-intensive task, you might be asking yourself, "How did my medical practice morph into a data center?"

In case you missed it, this is probably what happened...

As File Sizes Grow, So Does Your Need for New Hardware

Traditionally, many practices dealing with imaging studies have installed an onsite PACS as a server to store medical imaging data. When these practices first purchased this hardware, they may have been told that it would meet all their storage needs for years to come only to find out that it filled up much faster than they anticipated.

One reason for this is that as medical imaging technology has developed over time, image files sizes have increased due to their improved quality. Our ability to create more detailed medical imaging by generating studies that include hundreds or even thousands of image slices means that file sizes have been increasing exponentially. This increase leads to a proportional need for additional storage capacity within an onsite PACS.

Whereas an x-ray is made up of a single image, more advanced medical imaging technologies such as magnetic resonance imaging (MRI), computed tomography (CT) or digital breast tomosynthesis (DBT) scans can be very large files, taking up gigabytes of data for a single study. This quickly eats up space on existing onsite hardware.

We recently had a client that installed a tomosynthesis breast imaging modality at one of their locations and found that some of the imaging studies being generated were 4 gigabytes in size! Compared to an x-ray that might only be 20 megabytes, you can start to see how if you are adopting new imaging technology into your practice that your existing onsite PACS solution might not be properly sized.

Unfortunately, many practices have fallen back on the same problem that got them into the mess and opted for buying additional hardware to accommodate the increased file sizes... and the transition into a data center begins.

Regulations Require You to Keep Data for a Long Time

On top of large file sizes, regulations in many parts of the world require that medical imaging studies be saved for some duration of time - usually about seven years after the acquisition of the image. In cases where imaging has been conducted for a minor, these studies may need to be held for even longer. In some states in the United States, regulations dictate that medical imaging must be retained for seven years after a minor turns 18, or until they are 25 years old. This means you could find yourself being the steward of a patient's data for over 20 years!

As time goes on, and you see more and more patients, your PACS will balloon due to your need to retain imaging studies. In many cases, we have seen that medical professionals are reluctant to delete the information even after the designated time period has passed. Instead they opt to buy additional hardware to manage new client information, growing their mini-data center.

As Business Grows, So Will Your Data

If your practice is just starting out, and you opt for an on-premises solution, you might start with a server that's small and easy to afford. As your business grows, and you begin generating more and more images, you'll likely need to purchase additional hardware to manage the additional volume created from serving new patients.

The challenge with this scenario, however, is that with hardware you don't have efficient scalability. You have to project your growth and then buy hardware and storage space ahead of when it's actually needed. For instance, say you have determined you generate about one terabyte of data per year and will need four terabytes of storage to account for the next four years of data. The most cost effective way to purchase this hardware is likely to buy a single four terabyte system that can handle the entire storage demand rather than multiple smaller units.

However, what this means is that you are paying in advance of your need as you really only require one and not four terabytes in the first year. You also run the risk that the hardware will reach end of life or crash before you even use all the space you purchased. Wouldn't you rather pay only for what you need when you need it instead of and growing your unintended data center?

Alternatives

As increasing file sizes, regulations and growing volumes all drive your need for additional storage; you will want to find a solution that can scale on-demand, in a manner that is both smooth and cost effective.

With a cloud PACS, this is automatic and seamless. Cloud PACS solutions scale based on your needs and actual usage. Pricing is typically based on how many actual studies you are sending to the cloud, thus avoiding purchasing expensive servers and hard drives potentially years ahead of when they are actually needed.

The best cloud vendors also only charge a one time fee for an imaging study to enter the cloud. These studies are then held for the duration of your contract or as long as you are a customer, allowing you to easily meet the regulatory requirements of image retention without having to house data from five years ago in your facility. Also, the cloud not only obviates your need for hardware, but for associated utilities and IT staff as well, while providing a solid disaster recovery backup.

Final Thought

If you're finding yourself having to store, manage and maintain more and more patient records and advanced medical imaging data on-premises, maybe you should reflect on the true goal of your practice: Is your goal to become a data center or to provide exceptional care to your patients?

By sticking with an on-premises solution, you're committing to future hardware costs misaligning with actual usage, as well as storing your images locally for however long your jurisdiction requires under the law. What's more, you will also have to deal with all the worries and concerns of operating a data center, including power outages, data loss and disaster recovery.

Conversely, if you find yourself frustrated by all the costs and maintenance involved in storing your medical images, it may be time to consider a new approach with your PACS strategy - the cloud. You owe it both to your practice and to your patients to spend less time worrying about hardware and more time focusing on how to provide the quality medical care your patients need.