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Healthcare and storage: patient imagery has changed the dynamics of healthcare as we know it today.

In the healthcare industry, one of the largest growth areas for storage is as a result of the demand for digital imaging technology and the real time requirements by physicians for access to critical patient information. This demand originally came about as a means to lessen the expense burden of film and subsequent storage of the physical medium. To meet this demand, technologies such as digital imaging matured allowing for faster development and access to the data resulting in more rapid and accurate diagnosis and deeper analysis of a patient's imagery. With the significant growth of the required electronic data and with the advent of health care regulations as well as the associated costs of operational backup/recovery, archiving, and disaster recovery, is it possible that the costs of emerging technologies will exceed the costs associated with the previous method using physical film? Can cost accountability be achieved without loosing the benefits of superior service delivery?

Healthcare Goals and Objectives

The overarching goal to be obtained by moving from physical imagery to electronic imagery is to arrive at a diagnosis swiftly and accurately in order to begin a treatment as quickly as possible. This is to be accomplished with the least risk, affordably and economically.

The key objectives are to offer the highest quality patient care with the least risk by providing a more detailed diagnosis and thus improving time to recovery. Providing information quickly to doctors and other health professionals (i.e., faster access to patient imagery, improve timeliness of data access, and provide anywhere/anytime access to patient data to clinicians) will result in a faster diagnosis and improve turn around time of interpretation.

Risk mitigation in the healthcare industry is always a priority. Any technology that can explore the patient internally non-intrusively with less known risk than invasive surgery is certainly attractive. These dynamics create requirements for high availability of critical patient data, providing for secure storage and access to patient information, and meeting governmental compliance regulations.

Health care providers can also realize improved profitability through electronic collection interfaces to insurance companies. All of these goals are driving explosive data growth. In order to cost effectively meet these objectives providers must address the valuation of data, providing appropriate storage of patient data including long term archival. Even for the miracles of modern science, all these seem like a tall order.

The Four Dimensions of a Successful Storage Provider Model

Healthcare organizations walk a tight rope in order to achieve these goals and manage to limited budgets. The best way to navigate these tricky issues is to have a balance between the following four key dimensions

* Establish clear business requirements

* Deploy effective resources to meet requirements

* Ensure mature processes that succeed in making the resources effective

* Enable economic efficiencies through accountability

As a result, the organization becomes an efficiently and effectively managed distributed storage environment by providing for a balance between these four key dimensions.

The first dimension: Establish the business requirements

Establishing clearly defined business requirements and expectations is vital to the success of any IT infrastructure and management initiative. Clearly defined, documented, and understood business requirements provide a concrete framework for the alignment of business operations and IT initiatives. This will provide the foundation for cost effective solutions to solve business challenges.

Make sure that operational goals are reasonable and aligned to business objectives. Typically, the operational expectation are so high that attainment of the goals can be accomplished, but not with the resources available or within the fiscal budget available. Careful understanding and negotiations between business entities and IT are required to ensure the operational and financial success of the healthcare enterprise.

The second dimension: Deploy effective resources to meet the requirements

Resources are the physical items that can be utilized to accomplish a goal, such as technology and personnel. Effective resources are architected technology and trained personnel that are prepared for action. The definition of the word effective is 'to be ready for deployment and operation'.

Caution should be taken to not get over zealous with the technology. Technology can do many cool things, but is it necessary? It is amazing that that e-mail can be transmitted to a cell phone; but is that a requirement? Perhaps it should be a requirement. It is imperative that the resources allocated to meet a requirement be appropriate, to meet the requirement, not exceed it.

Architected technology is the overall design, structure, or organization of a storage or backup system. It includes the hardware and the software required to run it. The trained personnel are proficient and practiced at their required specialty. Ideally, these two resources should go hand in hand and compliment each other.

Change is rapid and sometimes overwhelming in today's healthcare environment. In an effort to facilitate these capabilities organizations should consider creative approaches to obtaining timely access to key resources (i.e. contract talent, partner talent).

The third dimension: Ensure mature processes that succeed in making the resources effective

Mature processes are documented and measured to support a desired competency level for the action. Developing mature management processes are critical to successful deployment, management, and operations of applications. Mature management processes are well-established documented tasks that are routinely reviewed for continuous improvement and measured to ensure adherence. Additionally, the processes should be tested as any updates are made.

It is essential to formalize the executive commitment of adherence to process. Measurements, goals, and objectives can be put in place to ensure the highest quality deliverable is accomplished with this commitment in place. Without executive commitment, the necessary support and direction is lacking to be successful as an organization.

The fourth dimension: Nothing is free

Institute cost accountability that provides efficiency. Cost accountability ensures that the appropriate economics are matched to the business value of the data.

In the first dimension the cost of requirements were mentioned. It is essential that the cost of the requirements do not out weigh the financial benefits provided by the solution. Frequently the selection of an application has been a disjointed process; where the operational costs have not been accurately captured. For this reason it is important that key cost factors be developed and documented. These cost factors need to inclusive of all components of "Total Cost of Ownership" (TCO). Based on business requirements these costs are variable and the financial exposures to the enterprise can be significant if the business objectives are not sufficiently aligned. Practices like implementation of a "Tiered Storage Model" and "Storage Service Provider Model (SSPM) focus on driving alignment of the business requirements and IT operational cost and measurement.

What Does All this Mean?

In the initial implementation of these technologies, the ability to maintain a lower cost was probably achieved. However, as image storage technologies gained acceptance, a new requirement emerged. That requirement was the ability for real time, anywhere access to critical data. The additional costs required to support this access can be attributed to the benefits of this capability. As these technologies become more pervasive, it is believed that other objectives may come to the forefront. It remains to be seen what the cost benefit justification will be. But, what this does bring to light is a sense of urgency to accomplish the goal of "ability to maintain cost accountability". In an effort to understand these costs health care providers are investigating Storage Resource Management (SRM) tools to adequately capture key metrics for accurate reporting.


Is it possible that the costs of emerging technologies will exceed the costs associated with the old ways of using film? Can cost accountability be achieved without loosing the benefits of superior service delivery? The ability to achieve the goals and objectives defined by healthcare companies are a difficult balancing act; to map the business "functional requirements" to the "nonfunctional requirements" of technology and accomplish this within the limits of a budget. On the road to providing superior service, additional, albeit sometimes unnecessary, technologies are applied, driving the cost of service skyward. Thus, it is certainly possible that costs for the fundamental need of generating and interpreting a patient's image can exceed the costs of the previous process of utilizing physical film media. However, if the additional benefits are accounted for, it is possible that their value can merit the additional expenditure. It is key to understand the requirements of the service; is it merely a cost reduction in the storage of patient's images, or is it a higher quality of patient care encompassing faster access time to records. By understanding the all the various aspects of service being provided, the costs of superior service delivery can be delineated.

John A. Haight ( and Keith Drummond ( focus on storage related corporate strategies for GlassHouse Technologies. With over 50 years of professional IT experience between them, they provide extensive storage management strategies, design, and integration solutions for some of the world's largest organizations facing today's complex issues.
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Title Annotation:Storage Management
Author:Drummond, Keith
Publication:Computer Technology Review
Date:Sep 1, 2006
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