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Medical imaging lifecycle management

Tony Turner
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medical imaging lifecycle management“ILM” stands for information lifecycle management, but in healthcare, it could stand for image lifecycle management. It’s a data retention efficiency tool that’s used to manage an imaging study over its lifespan. ILM involves moving older imaging studies to a cheaper tier of storage to keep the cost of managing the studies as low as possible.

Information lifecycle management and policy-based deletion

When most imaging professionals hear “ILM,” they instantly think of policy-based deletion: the process of deleting older images according to policy. Policy-based deletion is actually just an option underneath ILM. Yes, deleting older studies can save infrastructure costs, but it isn’t necessarily the best practice these days, because data is now considered valuable to healthcare organizations.

Most imaging archives have policy-based deletion capabilities built into their software. The policy is typically a combination of age of study, modality type, and Digital Imaging and Communications in Medicine (DICOM) metadata tags, with safety nets built in to protect mammography and pediatrics studies. Imaging vendors often allow you to run policy-based deletion scenarios without actually executing the policy, so that you can preview what images will be deleted. A good practice would be to run policy-based deletions only on either the primary or secondary archive, and review the results before running them on the peer archive. This way, if any mistakes were made, images could be restored.

Although policy-based deletion has been available for over 10 years, healthcare organizations often don’t delete studies because of compliance and legal reasons. And even though there are ways of using policy-based deletions to avoid errors, nowadays customers are starting to view data as having value for analytics or AI training. So, another justification for keeping all your imaging data forever is that it might be useful to your organization someday.

Information lifecycle management and cost

In discussions of ILM, another question that often comes up is: What is the cheapest storage for that second tier? Historically, several different types of media have been used — for example, Linear Tape-Open (LTO), DVD, and Blu-ray jukeboxes. Healthcare organizations now have many options such as 7.2K spinning hard drives, object storage, or cloud-based storage. But with all these options, organizations need to consider whether the final tier for their medical images is suitable for their clinical image workflow. The images must be easily accessible within a reasonable amount of time.

Also, organizations need to consider whether there is a return on investment — either financially or clinically — in implementing an ILM policy, or if it’s just the next cool thing that their IT department has read about. More important, medical images need to be protected, stay secure, and remain unchanged. Most storage environments now offer data encryption either at the hardware or software level, or they lock images to prevent them from being altered. Sometimes, not complicating the environment is the best solution.

Planning a medical-imaging archive

To help you implement ILM techniques, +. When planning an archive for medical imaging, you have flexibility: You can use on-premises storage, private or public cloud, and hybrid cloud options.

The first consideration in building a medical imaging archive is to understand the image workflow clinically and the size of the environment. It’s easy to overcomplicate an image archiving environment, especially in smaller environments. Sometimes, keeping it simple is a better solution.

The next consideration is to fully understand what the imaging software can do and what capabilities it supports. Can it manage the data movement between multiple tiers of storage? Does the software have strong ILM capabilities to intelligently manage the data movement? How does the image software compress the images? Does the software support S3 connectors into cloud-connected storage environments?

FabricPool on premises or in the cloud

Depending on the capabilities of the image archive software and your desires, NetApp can recommend ways to make your imaging archive environment more efficient, keep your data secure, and improve patient outcomes — while lowering costs for your organization. For example, when an imaging vendor can’t provide robust ILM rules or can’t support S3 connectors to cloud-connected storage, NetApp recommends FabricPool. FabricPool looks at the data blocks and intelligently determines the last time they were accessed by the application. Based on policy, FabricPool moves the data blocks to an S3 bucket either on premises or in the cloud.

Cloud or hybrid cloud solutions are also viable if you want to use a public cloud service provider to move image storage out of your data center and use your operating budget to cover the costs. This approach isn’t always the cheapest option, especially if the organization doesn’t have a grasp on its imaging workflow clinically. Understanding the advantages and disadvantages of cloud is critical when considering this path.

Learn more

ILM techniques can be super-valuable to organizations that are struggling to manage mounds of medical imaging data, especially in very large environments. Understanding the technology and limitations of the imaging vendor, all aspects of the imaging department’s workflows, and business objectives are keys to success. So is careful planning and involvement of key stakeholders across the organization.

To learn more, read our white paper about medical image archiving.

Tony Turner

Tony has 29 years of medical imaging and healthcare IT experience. At NetApp, he manages several medical imaging vendors and provides industry thought leadership and education to NetApp’s healthcare business. His career began clinically as a registered radiology technologist (RT). He earned his bachelor of science degree in telecommunications with a minor in management while working nights as an RT. Over the years, he has served in several different roles designing, selling, and implementing multiple enterprise imaging solutions.

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