The most important development in the storage industry over the past 5 years has been its transition from developing and selling peripheral devices for computing platforms to becoming part of the network infrastructure. It used to be that when you bought a new server, you'd buy storage to go with it. Storage Area Networks (SANs) and Network Attached Storage (NAS) technologies let you add or subtract capacity independently of what you're doing on the server side. Many large and midsized organizations now manage storage independently.
But as once-new technologies such as NAS become commodity items, what comes next? Judging from large storage vendor attendance at the Radiological Society of North America (RSNA) conference in the fall, many of these vendors are confident about the emergence of application-specific storage. The RSNA, a nonprofit medical society whose mission is to promote and develop the highest standards for the application of radiology in healthcare, might not seem to be the most likely venue for a large gathering of storage vendors. Nevertheless, Procom Technology, Sony Electronics, and StorageTek representatives were present and walking the aisles at the RSNA conference. Why?
According to Mark Wagner, manager of medical solutions for Sony Electronics, the medical field is in transition, and consequently, medical institutions have a need for complete, customized storage solutions. Three factors are generating the need for healthcare-specific storage solutions: the explosion of data, specific use patterns of data within healthcare settings, and government regulations.
The explosion of data, of course, has been the sine qua non of storage growth for a long, long time. In the healthcare setting, the data explosion is more complicated—not only are transactional records (e.g., admissions, billing) becoming increasingly computerized, but medical data (e.g., medical charts, laboratory test results) are also being digitized. Radiology is at the forefront of the movement, which is why so many storage vendors were present at the RSNA conference.
For nearly a century, X-ray technology dominated radiology. Doctors no longer view poorly resolved film in dark rooms. Now, doctors use advanced digital technology to capture and analyze medical images to diagnose illness. In fact, medical images adhere to their own file format—the Picture Archival and Communication System (PACS). As such technology has become more sophisticated, the amount of data associated with each patient has grown substantially. Bob Koecheler, vice president of global partners at StorageTek, pointed out that in the past, CAT scans involved taking 15 to 20 "slices" to generate an image. Now, medical professionals use CAT scans to capture 200 to 300 slices, and doctors want even more slices as they attempt to create 3-D images. Images that were once megabytes of data now contain a gigabyte or more of information. But the data explosion is only one small piece of the puzzle. The use patterns for information in the medical setting are very different from the use patterns in a typical online transaction processing (OLTP) system, noted Reza Sadri, chief technologist at Procom.
First, the read-to-write ratio is very different in healthcare because many different medical professionals repeatedly access the same data. Second, the data lifecycle—the process by which you can move data from online storage, to near online, to tape, to archive—is specific to healthcare. Doctors often need to recall data that was captured years earlier, and they have to access that data very quickly. Finally, disparate data is generated, captured, and stored in different locations through many different applications. Radiologists have to link the images they produce in some way with the patient's chart, pharmacy records, billing information, and so on.
The final factor shaping storage solutions in the healthcare industry is government regulation, most notably the Health Insurance Portability and Accountability Act (HIPAA), which goes into effect on April 13, 2003. To comply with HIPAA regulations, healthcare providers must tackle two difficult problems: First, providers must be able to communicate information between different stakeholders in the system including doctors, hospitals, insurance companies, and the Federal government; and second, that information must be secure at every step in the process.
Although the healthcare industry might be the first to have application-specific storage requirements, it won't be the last sector to face such obstacles. Consequently, the next challenge that storage professionals and vendors face will be to create application- and industry-specific solutions.