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Jul 22 2010   9:56AM GMT

Overcoming barriers to healthcare storage virtualization

Posted by: Jenny Laurello
healthcare storage virtualization, HSV, virtualization

Q&A with Tony Cotterill, founder and CEO, BridgeHead Software

Q. “What are the top five barriers in achieving health care storage virtualization and best practices for overcoming those constraints?”

1. Exploding volumes of health care data

Health care organizations worldwide are faced with growing volumes of digital data.  The adoption and expanded use of Electronic Health Records (EHR) is being spurred by forces such as the HITECH provision of the American Recovery and Reinvestment Act in the United States, Canada Health Infoway, and the European Institute for Health Records (EuroRec).  And while the amount of this digital data (and the storage needed to maintain it) is growing at an unprecedented rate, it pales in comparison to the new data created every day by PACS (Picture Archiving and Communication Systems).  Not only are traditional Radiology PACS creating larger digital files as imaging modalities improve, but as other clinical disciplines (such as Mammography, Cardiology, Pathology, Endoscopy, and Ophthalmology, to name but a few) adopt digital imaging technology, data growth is increasing exponentially.

As health care providers increasingly come to rely on computerized systems in the course of caring for patients, Healthcare IT is under increasing pressure to protect, retain, and make available 24/7 this vast amount of medical data.  In the event of a system outage, their response must be swift, enacted confidently and without hesitation so that the business of patient care can continue with minimal disruption.

2. Not all health care data is created equally

Not only do hospitals cope with exploding volumes of data, but they also must deal with three different types of data: structured data, unstructured data and semi-structured data. In order to successfully implement a Healthcare Storage Virtualization (HSV) architecture, hospitals must understand each data category and plan to adopt separate management policies for each type.

  • Structured Data — Applications that generated structured data are database driven.  The most common example is the HIS, which may store it data in databases such as MUMPS, Cache, MAGIC, Oracle, or SQL.  RIS (Radiology Information System), LIS (Laboratory Information System), EHR (Electronic Health Record) and accounting systems typically fall into this category as well.  The amount of data these systems generate typically falls in the hundreds of GB range, maybe approaching a few TB in larger facilities.
  • Unstructured Data — Applications that generate unstructured data produce discrete files that are not associated with a database.  Office productivity suites are a good example of this.  Word processing documents and spreadsheets are routinely created by hospital administrative staff, and these files are typically stored on files servers.  And often, different users may store individual copies of identical files.  Other file types such as presentations, audio and video files, and pictures are stored in this manner as well.  The file systems storing this data may be of modest size in a small facility but can grow quite large in a multi-facility organization.  Many TB of unstructured file data can be a challenge to backup and recover for any Health care IT organization.
  • Semi-structured Data – There is a third category of data common to hospitals that we shall call semi-structured.  The two best examples of semi-structured data are PACS (Picture Archiving and Communication Systems) and ECM (Enterprise Content Management System) systems.  Both maintain a database of information (structured data) that reference often large quantities of discrete files (unstructured data).  A PACS database may run on Oracle or SQL, and its size may be relatively small in relation to the many TB of DICOM images that database references.

3. Interoperability and sharing of data

One of the biggest and most frustrating challenges facing health care IT professionals today is the complexity of data sharing among IT systems, departments and hospitals. Today, clinicians cannot easily (if at all), view a patient’s records and medical images in one place. The negative impact of this can be as serious as depriving patients of the high quality of care upon which their life may depend.

Part of this problem is that many IT solutions operate in stand-alone silos, and therefore will not interoperate with other applications. In the picture archiving and communication system (PACS) world, for instance, systems may be implemented as end-to-end solutions, with an integrated application and storage layer working together. This often means that the medical images stored within the PACS such as those created via endoscopy, mammograms and digital radiography are either inaccessible by other applications, or are using proprietary technology that doesn’t communicate with other software.

In either case, the data in question is of no use outside of its primary function. As a result, a patient may have to undergo a repetition of the scans, leading to duplicated effort, increased costs and wasted time. In order to increase data interoperability and overcome content sharing issues, health care IT professionals are increasingly expected to devise ways and means to ensure data can be utilized for multiple applications, across departments and even across geographically dispersed hospitals.

4. Data migration headaches

In health care environments, data migrations mainly occur in the event of hardware or application failures, or of the hospital’s desire to implement new technologies. Given that the typical lifespan of a storage device is between three and five years, migrations are not uncommon, and they often create challenges to keeping the hospital up and running at optimal levels.

Because medical records are often stored for the duration of a patient’s lifetime and perhaps longer, data is often migrated several times throughout its existence from one storage facility to another, or across applications. Migrations require the time, resources and effort of health care IT professionals to ensure that hospital systems can continue to operate, providing the necessary service levels of care expected.

The increased digitization of health care-related information brings with it many opportunities to deliver better quality care while bringing hospital systems in line with the commercial world. The road is not necessarily an easy one, however, with many challenges afoot. Health care Storage Virtualization provides a strategic framework to assist health care IT organizations in addressing these challenges head-on, creating a highly functional data and storage management environment today while ensuring a future-proof solution for tomorrow.

5. Growing backup windows for health care storage

With acts of nature such as Hurricane Katrina (responsible for destroying a U.S. hospital and the majority of its patient data), as well as more common outages and disruptions always looming, health care organizations require a robust Disaster Recovery (DR) strategy. Ensuring continuity of service that minimizes potential downtime and speeds recovery time should disaster occur now lies firmly within the health care IT department. Managers and executives are clearly conscious of this as illustrated in a recent survey[1], in which the majority of professionals indicated that DR is high on their current agenda. Yet many hospitals don’t have a DR strategy in place. Likewise, many claim to have a workable DR system, but have never tested it.

Furthermore, hospitals often struggle to maintain a robust data back-up process. This is largely due to the sheer volume of information – many institutions can’t physically backup the vast amount of data within available time windows, even as an overnight process. We’ve already established that data volumes are continuously rising. Consequently, back-up processes (and their impact on DR) are only going to become more challenging in the future.



Tony Cotterill is founder and CEO of Healthcare Storage Virtualization (HSV) company BridgeHead Software, which offers a scalable, future-proof platform to overcome rising data volumes and increasing storage costs while delivering peace of mind around the access, availability and protection of critical electronic patient data.


[1] BridgeHead Software, Data Management Healthcheck Survey, 2010.

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Thunder121  |   Oct 18, 2010  3:25 PM (GMT)

and now EMR Vendors are selling and implementing systems based on Software as a Service with guaranteed uptime leading to larger DR concerns..


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