Are Cloud-Based Vendor Neutral Archives (VNA) the Answer for the Healthcare Industry?

Healthcare providers are facing continually growing data storage requirements, a changing regulatory compliance environment and increasing numbers of data sources to manage.

The obvious culprit of rising healthcare storage requirements is diagnostic imaging systems. Currently, imaging systems are creating over 600 million images per year in the U.S. alone.

Diagnostic devices such as CT Scanners, MRI machines, and X-ray machines generate huge files and based on numerous regulatory requirements, must be retained for exceptionally long periods of time - 10, 30, 50 years. These images are usually stored and managed in standalone PACS (Picture Archive and Communication Systems) which house the images themselves as well as the associated metadata. The PACS secure, manage, and make the images available when needed while also providing high-resolution viewers and additional analytics capabilities.

Other types of healthcare data generated in hospitals include data from devices such as:

• Patient monitors
• Drug delivery systems
• In-room devices such as monitors and controls
• RFID readers
• Tracking devices and sensors for physiological measurements
• Video cameras

Much of this individual device data is stored in stand-alone storage silos making overall diagnostic capability almost impossible, while greatly complicating regulatory and legal actions response.

What is a vendor-neutral archive?

A recent technology trend that could help the healthcare storage issue is Vendor Neutral Archives (VNA). A VNA is an enterprise-wide unstructured data repository for patient medical images and associated unstructured patient data. The key to VNA usefulness is its ability to collect, consolidating and managing data from various PACS data silos. With all healthcare data consolidated in a single data management system, medical data can be used more effectively.

The main requirement for VNAs is its data neutrality. VNA data neutrality is achieved by integrating with the PACS so the VNA can collect, consolidate, and manage medical data from across several PACS.

Benefits from a centralized archive include not only medical image storage but also faster file retrieval due to a single repository to search, automatically linking patient-related files for faster access and overall content relevancy. A side benefit of a consolidated archive is faster backup and disaster recovery. In short, VNAs increase overall data control, security, and data availability while reducing complexity and cost.

In short, A VNA will increase the healthcare provider's control over medical data, ease PACS data migration complexity and cost, and decrease the healthcare provider's storage vendor lock-in risk. In the quickly changing healthcare technology landscape, VNAs make it possible to incorporate new diagnosis capability such as machine learning and data analytics across an entire patient data set.

Consolidation is the key

Healthcare provider VNA expectations include acting as the central repository for not only medical image content but also medical device data, as well as EHR content - thereby making all patient-related data more easily available for more precise diagnosis, reporting, regulatory compliance, and legal response.   

The current availability of vendor neutral archives is an issue because of the relatively limited number of platforms to choose from. Because of this, cost remains extremely high.

Also, some VNAs are not necessarily vendor neutral and raise the possibility of PACS-related storage vendor lock-in. Companies should first determine if the VNAs under consideration are truly vendor neutral and compatible with other medical device data they are using – both structured and unstructured.

Most VNAs are designed to utilize on premise storage resources versus public cloud storage. Utilizing on premise storage will, by its nature, cost more than a distributed public cloud. In fact, the fully loaded cost of on premise enterprise storage can cost $0.30 to $0.50 per GB per month – a huge cost when considering the amount of storage medical images consume and the amount of time they are retained.  Many proprietary PACS storage systems can cost even more – demanding a higher price due to making the PACS storage API available to a single storage vendor. The current crop of VNAs isn’t much better - requiring all data to be converted to fit their file format requirements.

The VNA cloud

A solution many healthcare organizations are exploring is public cloud-based VNAs. The public cloud can offer a much lower price cost over that of on premise storage – $0.005 to $0.05 per GB per month. Well-known public cloud solutions include Microsoft Azure, Amazon AWS, and Google Cloud.

In the not too distant past, healthcare organizations were cautious about adopting public cloud storage for patient records due to the belief that the public cloud was not secure enough. Another limiting factor was the fact that PACS did not allow for cloud storage from their proprietary systems.

Recently, healthcare management has realized that public clouds have become very secure, in fact, more secure than on premise storage. Because of that, Healthcare CIOs are much more accepting of exploring cloud solutions for their sensitive patient data. However, VNA availability in a public cloud platform remains an issue.

The obvious solution to the high cost of long-term medical data storage is for PACS to include open APIs so that cloud archiving vendors can create native archive solutions that can consolidate and manage the entire range of record format types.

VNA cloud best practices

Because of the expected life-span of medical data, cloud-based VNAs should be looked at as very long-term data archiving solutions. With that in mind, the following vendor neutral archive requirements should be considered:

1. The cloud platform and archiving application needs to be truly vendor (PACS) neutral
2. The cloud platform should be open versus proprietary to avoid vendor lock-in
3. The archiving application should store and manage all data types - in their native format, without the need for data conversion
4. The cloud platform should provide rigorous security
5. The cloud platform should include disaster recovery capability, including country-specific geo-replication
6. The cloud platform should be infinitely scalable
7. The VNA should provide strong “data at rest” encryption based on the provider’s own encryption keys
8. The VNA should communicate with the PACS for data movement, staging, and recall based on provider-defined policies
9. The VNA should provide “point in time” data review for more meaningful diagnosis
10. The VNA should capture and manage all file metadata
11. The VNA should provide for adding additional metadata to individual files for later analytics
12. The VNA should have extensive audit and reporting capability
13. The VNA should provide for data redaction, anonymization, and strong access controls
14. The VNA should include strong analytics that spans the entire archive
15. The VNA should be able to automatically link content-related data regardless of format
16. The VNA should include charge-back reporting so that data management costs can be distributed to each department based on usage
17. The VNA should provide strong search and culling capability for regulatory and eDiscovery response

The Azure Cloud and Vendor Neutral Archiving

Microsoft’s Azure Cloud is considered one of the top cloud platforms in the world due to its available services. Storage is only a piece of a viable cloud-based VNA. The ability to scale when needed, world-class security, built-in disaster recovery, a choice of price/performance storage tiering, powerful analytics, and AI/machine learning capability are all requirements of a future-proof public cloud VNA platform.

However, a great cloud platform is only a piece of a healthcare vendor neutral archive solution. The archiving and management solution is also a key component. Indexing, access controls, federated search, AI-based classification and culling, metadata tagging, built-in report rendering, retention/disposition policy management, data export, and the ability to successfully integrate with various PACS are also extremely important.

Archive2Azure plus Azure

Archive360 has partnered with Microsoft to offer an Azure Cloud-based VNA that meets all current medical information management requirements while providing a future-proof platform for long-term medical data archiving.

Archive2Azure is a native Azure solution, which utilizes the provider’s Azure tenancy (nullifying vendor lock-in issues), to store and manage the provider’s sensitive healthcare data. Archive2Azure takes advantage of the full range of the Azure platform services while providing the powerful information management functionality. The measurement all healthcare providers want to see is: does this new vendor neutral archive solution provide a positive return on investment (ROI) over that of your current on-premises storage solution(s)?

Contact Archive360 today to talk about Archive2Azure ROI in the healthcare industry and find out how we have helped many healthcare providers lower their overall costs.