Leveraging the Cloud in Radiology

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Health-care providers today have a heightened interest in streamlining operations and reducing capital outlays to maintain or improve margins. In an increasing number of cases, cloud-based solutions and software as a service are being embraced by the radiology sector to meet these challenges—but not before a careful analysis that goes beyond cost considerations has been performed.

For some radiology players, a move to leverage the cloud stems from a desire to manage an increasing volume of imaging data more effectively, while simultaneously grappling with tight capital and operating budgets. Orlando Health in Florida—a 1,780-bed, not-for-profit private health network with 14,000 employees, multiple inpatient and outpatient facilities located across Central Florida, and 2,000 affiliated physicians—ranks among them.

Approximately two years ago, Orlando Health’s IT department acknowledged that shared cloud storage might, based on perceived total cost of ownership (TCO), constitute a more viable means of addressing multiple data-storage challenges than a traditional product would. Brian Comp, MBA, PMP, is Orlando Health’s chief technology officer, information services. In calculating TCO, Comp and his team took into consideration not only the anticipated initial capital outlay, but maintenance costs and the very real possibility of the need to upgrade Orlando Health’s data-storage technology down the road.

The health network currently maintains two self-hosted data centers in Orlando that handle more than 200 terabytes of data. About 25% of total data storage is needed for PACS and for a separate cardiology PACS. Comp says, “Besides these demands, our data rate had been growing by 50% annually and continues to do so. Storage growth allocations in the IT capital budget range from approximately $1 million to $1.5 million per year—a tight squeeze—and changes in reimbursement mean that capital is harder to find.”

Comp and his team also looked at potential power savings in weighing whether Orlando Health would be better served by a cloud-storage solution or by an installed hardware/software configuration. He deems power and cooling for the data center significant issues in Florida, noting that these expenditures are likely to be three or four times higher than those incurred by providers in many other locations. “We figured that by reclaiming electricity that would otherwise be needed to power the systems and cool the equipment, we could do 25% better than now,” Comp reports. “That was a strong justification.”

The department, however, wasn’t willing to base its decision entirely on economics; other concerns came into play. Orlando Health wanted reasonable assurance that only authorized parties would have access to data stored in the cloud, that cloud-storage performance levels would rival those provided by its own data centers, and that the vendor would, as Comp put it, be around for the long haul.

“We are still in the midst of figuring out the best cloud-storage model for us and discussing these issues with potential vendor partners, but the analysis definitely pushed us in that direction,” Comp states. “In our long-range plan for the next five to 10 years, our first step is to move our long-term storage to the data center of the cloud provider. We reduce the requirement for capital investment, we should be able to reclaim some electric power, our data-center floor space will be freed, we are hoping that our technical-support needs will be at least somewhat reduced, and we will be able to maintain our failover capability. If we have a loss at a primary data center, we want to be able to continue to provide service to our clinicians.”

He notes that Orlando Health’s planned transition to the cloud probably would not be possible if less-expensive, higher-bandwidth cloud-based solutions had not been introduced in recent years. “The original higher-bandwidth options were cost prohibitive—and thus, out of our reach,” he explains. “No analysis would have supported adopting them.”

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Alta Vista Radiology (Phoenix, Arizona) also saw the cloud as a panacea for its image-management and -storage ills. The provider offers teleradiology services to 80 hospitals in the Southwestern, Southeastern, and Midwestern regions of the United States, as well as along the East Coast. Alta Vista uses a PACS vendor’s software as a service to access a hosted version of the vendor’s PACS. The service is available on a