Cool Technology of the Week

I have an "-ology" problem.

Radiology, Cardiology, Pulmonology, Gastrology, Gynecology, and Endocrinology all have image management needs that require high bandwidth networks, short term high speed storage, and long term archival storage.

Radiology has a industrial strength GE Centricity PACS. The other "ologies" have heterogeneous applications from multiple vendors. As a CIO, I can no longer let 1000 wildflowers bloom in the world of image management. Why?

1. Each department would use its own image viewing software
2. Each department would need its own disaster recovery strategy
3. Each department would use its own records management/image retention rules
4. Each department would need its own capital budget for storage
5. Clinicians would not be able to have unified list of all imaging studies for patient or consolidate images across multiple institutions using different medical record numbers

How do I solve this problem? The answer is Long Term Archiving that is standards compatible and supports all the ologies. Teramedica's Evercore is one solution. IBM's Grid Medical Archive Solution is another. This concept is the cool technology of the week.

The idea behind these systems is simple. Each department can purchase the applications which interface to its imaging devices and support its workflow. The Departments own the "front end"

Each of these imaging systems supports a DICOM exchange to a long term archive. In the past, I've used content addressable storage with a proprietary API and DICOM broker for radiology, DVDs for echo, CDs for vascular, MODs for radiation oncology, etc.

All of this will be replaced with an enterprise image archiving approach which can

1. Provide one place for all images in the enterprise to be stored. IS can provide any storage hardware it wants - NAS, SATA disk, Data Domain archiving appliances etc.

2. Provide unified metadata for every image which can support a single application for consolidated image viewing of all studies from all the "ologies" at different institutions

3. Provide records management rules which enable deletion, information lifecycle management, and compression based on image type or department. For example, digital mammography needs to be kept 10 years, but we can move it from fast storage to slow storage when appropriate. CT images could be compressed after a year and deleted after 5 years.

Having unified storage, unified viewing, and unified management means that IS can now own the backend of image management and treat it as a utility, just as we do with other central file architectures.

The end result of this utility approach to long term image management is a win/win. Departments select the applications they need and the workflow they want. IS manages the security, integrity, and cost of storage centrally. The total cost of operating an enterprise image infrastructure is lower, the service levels are higher, and compliance with records retention policies are simplified.

I've been pursuing this concept for the past 5 years, but now the products are mature enough to make it a reality and I plan to do this as an FY09 project.