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EMR storage challenges
Richard Eshbach is assistant VP/CIO at Mountain States Health Alliance (MSHA), a network of 14 hospitals based in Johnson City, TN. He says converting to EMRs will be "a big challenge both technically and to the workflow of the clinical staff." His hospital network is in the midst of a $38 million EMR initiative (see "Hospital EMR storage preferences," below).
Hospital EMR storage preferences
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Most use the same networked storage they use for their primary systems
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Hospitals that use DAS are moving to SANs for better backup and disaster recovery
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Popular SAN storage choices include EMC Corp. Symmetrix 3000/Symmetrix DMX, Hewlett-Packard Co. EVA and IBM Corp. DS4800
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Smaller hospitals and clinics often use storage from Dell Inc. or assorted NAS vendors
An EMR is made up of many different systems that each collect and store data. "There's no one system, no one application you can call EMR. You're talking about 150 to 200 applications" that each store data in their own way, says Jacobs at Siemens Medical Solutions. In addition, existing paper records need to be scanned into the EMR and stored as PDFs or TIFF images.
Midland Memorial Hospital uses OpenV...
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ista from Medsphere Systems Corp. for its EMR. Core patient data is stored directly and is also integrated with the hospital's other primary systems. Medical images are kept in a separate picture archiving and communication system (PACS). Midland's efficient OpenVista core EMR database uses just 80GB for its 400,000 patients and stores links to medical images residing in other systems. The core EMR is growing by approximately 10GB a year, reports the hospital's Whiles, and he has allocated about 1.5TB of the hospital's Hewlett-Packard (HP) Co. SAN storage to the EMR.
A bigger storage challenge is medical diagnostic imagining, which forms an increasingly critical part of an EMR. Healthcare providers have to figure out how to accommodate PACS data within an EMR--data that can eat up gigabytes of capacity for a single patient. "A typical PACS image runs about 300MB," says SynSeer's Trotter. And compressing those images isn't always an option, as diagnosticians need the highest resolution possible; physicians, however, will usually accept a lower resolution reference image.
At 300MB a pop, medical imaging storage adds up fast. According to the IBM Global Technology Outlook for 2005, by 2010 medical images will take up 30% of the world's storage. An EMR usually includes only links to a patient's images. "Imaging alone could require a hospital to add 1TB a year," says Gartner's Runyon.
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