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Networked Storage Systems for Imaging and Document Storage

ImageThe problem is simple: your practice is storing more and more digital documents every year. And documents -- especially images such as x-rays, MRIs, and PET scans captured by popular PACS (Picture Archive Communication Systems) are huge. A typical chest x-ray, consisting of two images, requires about 20 megabytes of storage space, for example.



So most practices will, sooner rather than later, require bigger storage systems for imaging and document storage, and as the number of computers in practices increases, the images and documents have to be accessible on a network. The simple problem seems to have an obvious solution: buy a network storage system, and buy it big.

But network storage comes in several different flavors. Small practices that don't deal directly with lots of image files can get by with a RAID array attached to their server, says Bob Burns, a managing partner of the Rosenberg, Texas-based 5th Quadrant Services, a national healthcare information technologies consulting firm.

And after that, says Burns, who has worked in the medical technology field for more than 30 years, "SAN vs. NAS is the big question."

While the acronyms can be confusing, knowing their general meaning can go a long way toward helping you make the best decision for your practice.

NAS
NAS stands for Network Attached Storage. Shahid N. Shah, an expert in health care tech for physicians offices who pens the Healthcare IT Guy blog, says it best: "A NAS is nothing more than a specialized Linux server with a bunch of hard drives in there. Because it's a regular server, it has USB ports, so you can go to Office Depot and buy a couple of USB disks and stick them in there. Then you can set up the NAS to back up first to one hard drive, which you take home, and then the next week you bring in the other backup that you had at home, and just swap it out. It's a painless, easy to use backup without going through hundreds of thousands or tens of thousands of dollars in backups. It works, and for small offices it's perfect. The backups are your disaster plan."

Shah likes the Buffalo TeraStation , which you can buy in configurations ranging from 1 to 4 terabytes, and comes with built-in software that enables you to easily configure your backup options (daily, weekly, etc.) The retail prices for a new TeraStation range from $600 to $2,000.

SAN
SAN stands for Storage Area Networking. Like a NAS, it is an array of drives, but unlike a NAS, the drives appear, to client computers on the network, to be local, which usually translates to speedier data transfer. SANs utilize very high speed throughput, and both Shah and Burns said they would typically recommend SANs for group practices with 10 or more physicians and more than 20 computers. According to Shah, a SAN is between five and 15 times faster than a typical NAS, but is very costly, starting, he says, "in the tens of thousands of dollars." A SAN can have great advantages, but is usually cost effective, says Shah, "if you're a radiologist and all you do is look at these gigantic documents all day long," because "a NAS will kill you."

NAS and SAN setups (along with standard RAIDs -- Redundant Arrays of Inexpensive Disks) are the most common primary network storage options for small group practices, but it is also crucial, when replacing or upgrading your network storage, to consider backup and emergency recovery storage plans. And these considerations relate directly to what your getting when you purchase your primary storage.

While very small practices, with between one and five physicians, can get away with buying off-the-shelf, consumer-grade drives. But for just a few hundred dollars more, in most cases, you can get "business grade" setups. Usually, the major difference between consumer- and business-grade offerings is in the level of support provided. “If you've got a business-grade setup, the storage server automatically sends an e-mail to the vendor if one of your drives goes down. A few days later, a technician will show up and replace that drive without you even knowing there was a problem. That's the level of support you'll pay a pretty penny for, maybe $200 or $300 extra on a NAS, that you wouldn't get with the consumer-grade drive that you buy from Office Depot."

Staying Safe
So buying business class helps ensure that when a drive goes down, your practice doesn't. While a drive failure is always a concern, the worst-case scenario -- a disaster on the scale of Katrina -- is also important to think about. For disaster recovery, both Shah and Burns recommend remote Internet storage. "That's the way to go because your data isn't at risk if there's a local emergency like a hurricane," explains Burns. Among the many Web-based storage backup services are Microsoft's Windows Live SkyDrive , Software Pursuits' SureSync , and AOL's Xdrive , which offer free online backups for consumers in addition to business plans.

For small practices, there are many choices for network storage systems. The good news is that storage technology continues to improve in both speed and efficiency, while overall prices per gigabyte of storage space continue to drop rapidly. Reputable vendors can provide reliable, fast, and safe solutions with good support at prices that won't break the budget. And even if you don't need to replace or upgrade your network storage today, backup and emergency solutions are always worth reviewing.

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