Thursday, September 6, 2007
Over the last several months a number of posts have shown up on auntminnie.com and pacs-admin@yahoogroups.com asking readers opinions on some of the smaller PACS solutions in the market. I assume that most of these questions are being posed by members of small imaging operations performing less than 40,000 procedures per year who assume that they can only afford the relatively inexpensive PACS solutions offered by the small vendors. In the past, this was probably the case, but that is no longer the case.
Today, several of the biggest vendors in the PACS market, creators of the really big and fully featured PACS, have achieved a scaling feature that allows them to offer effectively the same fully featured PACS at a price point within reach of even the smaller imaging operation.
These vendors have achieved this scaling by reducing the number of servers in the cluster, without eliminating robustness or reliability. They have retained the basic display features, including hanging protocols, but made many of the more advanced display features (like 3D) line item extra-cost options, so they can be added for a modest license fee if needed. They have made many of the professional services that were automatically included in the big system, line item options in the scaled down package. The site that can follow directions and set up their own modality interfaces, complete their RIS interface on their own, and perform their own network testing can save some money.
Perhaps the best feature of this new generation of scaled down PACS is that their upside potential is not artificially limited. If the study volume suddenly jumps by 100%, the small system can be expanded to accommodate growth, without a wholesale exchange of hardware or a whole new tier of software licensing. The user truly pays for only what they need, and only as they need it.
In this scenario, there is no reason for the smaller imaging organization to risk an investment in a fragile company and purchase a bargain-basement PACS with limited features and limited support. It is now possible to afford the economical version of the same PACS being used by the big boys.
Posted on 4:29:51 PM comment []
Medical Data Purge Strategies
An interesting and pertinent subject was introduced on the pacs_admin@yahoogroups.com web site on September 5. The subject is purging data from a storage solution in order to recapture expensive disk space.
Thomas Chase is correct, most older generation PACS and a good number of current generation PACS do not have a purge strategy much less a more appropriate ILM solution. Data purging and the more sophisticated subject of Information Lifecycle Management are indeed becoming major subjects today. Even with the ever falling costs of disk space, space costs money, and the growing volume of data being produced by 64 slice CT and FFDM is eating up more an more space. Then there is the subject of data migration from old to new PACS. Given the range of $10-15K per TB for data migration projects, you wouldn't want to move any more data than you absolutely have to move.
According to a number of PACS vendors I have spoken with on this subject, the major problem appears to be the fear (and legal consequence) of what will happen when a user inadvertently deletes data that should not be deleted. And don't think for a moment that it won't happen.
It is also quite likely that the vendors have enough to work on without delving into the development of a sophisticated media migration and/or purge strategy that uses meta data stored in the study's DICOM tags to determine what study to move where, when to move it, and when to delete it.
It is true that some storage solutions include ILM strategies, but they are (in general) not any more sophisticated than using study date, or date last accessed to trigger the move. That is really not good enough, in my opinion. The ILM strategy should consider study type, result, patient age, etc. The media vendors would be hard pressed to develop a more sophisticated ILM strategy based on DICOM tags for their storage solutions, because there is still a good deal of non-conformity among the PACS vendors in their use of DICOM tags. Until there is consistent use of Public Tags and standard encoding of the data among PACS vendors, the storage vendors would have to develop a unique ILM software solution for each PACS solution. What a mess that would be!
Realistically, a consistent application of DICOM Tags across the industry is not going to happen any time soon, so the current solution is simply this; you purge your data with every data migration to the next PACS. Alternatively, you pay dearly for the professional services team that will do it on a schedule not unlike spring cleaning of the carpets.
Posted on 11:17:11 AM comment []
