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PACS archiving

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Protecting and archiving healthcare data

Technological advances in medical imaging promise reliable and connected patient care in clinics and hospitals while causing exponentially increasing data volumes.


A large part of the data growth in healthcare is due to imaging procedures, which are generated, for example, in radiology, oncology, or pathology and stored in PACS applications. In addition, there are strict regulations and long retention periods for PACS data. What needs to be considered in PACS archiving and how can it be optimally implemented in hospitals and clinics?

What is a PACS?

PACS stands for "Picture Archiving and Communication System" and is a digital system for processing, managing, and archiving medical images and data - similar to a database and in which all medical images are stored. Every medical image taken within a hospital is automatically stored on a PACS server.

Images are captured and stored from diagnostic medical devices, such as X-ray, sonography, CT, MRI, or endoscopy. Meanwhile, PACS is growing into an application for the entire hospital. Other departments such as cardiology, neurology, radiotherapy, and also pathology want to take advantage of digital image data management and store their image data in PACS.

The data is stored in a short-term memory. Downstream, the data is stored long-term in a digital archive to ensure unchanged retention.

The long-term archive must meet high requirements. Legally-compliant archiving is a central function of the PACS archive. Due to retention periods of several decades, the data volumes in the long-term archive grow enormously. At the same time, this data must be accessible at all times by physicians at different locations and protected against changes or loss in keeping with legal regulations.

What does DICOM mean?

DICOM stands for "Digital Imaging and Communication in Medicine". It is an internationally recognized standard format for viewing, storing, retrieving, and sharing medical images.

A PACS server must have sufficient free storage capacity, because DICOM files, which are of high quality, generate large amounts of data.

Medical Images & Systems

The most important systems in a hospital include the hospital information system (HIS), the radiology information system (RIS), and the PACS. The digital images stored in the PACS are networked with HIS, RIS, or the electronic patient record to enable remote access at any time. Through the PACS, all radiological image data is stored centrally and can be made available for further treatment.

RIS controls all processes in the radiology department. A central task is the processing of X-ray requests and the optimal utilization of equipment, and is thus closely integrated with the PACS.

Digital Imaging and Communication in Medicine (DICOM) is a standardized format for the creation, exchange, and communication of medical images.

Whitepaper: Protect Healthcare Data in the Long-Term

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  • How can you manage the increasing data volumes from PACS and the like in a future-proof way?
  • What opportunities do a software-defined approach & managed services offer to reduce your TCO and time to manage?
  • How can data integrity and availability of health data be ensured?
  • What synergy effects can be achieved from consolidating archive, backup and Big Data storage?
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Growing data volumes from PACS & Co.

The technical advancement of imaging procedures simplifies diagnostics for physicians through high-quality images, but at the same time leads to large amounts of data and rapidly growing storage requirements.

Whereas a few years ago digital images were primarily created in radiology with the help of X-ray machines and CT scanners, the number of medical devices which send data to a long-term archive has now increased dramatically.

Due to technological advances, these devices are generating increasingly high-resolution images which allow for better reporting. As a result, the file sizes generated are also increasing. Whereas in the past only a few megabytes had to be archived per examination, today several gigabytes per examination are possible with high-resolution and moving image data. A modern multi-line computer tomograph, for example, produces up to 4000 individual images per examination.

These data volumes are due to medical image data such as CT scans, MRIs, ECG, ultrasound, and X-ray images and are generated in radiology, oncology, or pathology and stored in PACS applications.

This trend ensures that the storage requirements for PACS archiving of medical image data in many hospitals have suddenly exploded in recent years.

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Strict regulations and long retention periods

Not only is the amount of data which needs to be stored in healthcare growing exponentially, but the time periods over which the data must remain available are also increasing. At the same time, healthcare organizations must adhere to strict requirements and legal guidelines. Various laws require hospitals and clinics to retain data for decades.

Because retention periods of up to 30 years are possible (e.g., in radiation treatment and X-ray therapy), the entire data storage must also be replaced several times, because the systems used for storage today will no longer be state of the art in 30 years. In practice, systems are often changed much earlier because the solutions often do not meet actual needs, have lost efficiency, or were designed under-/over-sized. This leaves IT managers in hospitals struggling with uncertainties about which technologies and data volumes to expect in the future.

The result is expensive and time-consuming new acquisitions as well as complex migration processes which hinder everyday running of the hospital. The storage and archiving of PACS data as well as other medical data is therefore facing a paradigm shift towards more future-proofing and flexibility.

Case study: PACS archiving at KGU Frankfurt

The example of the Goethe University Hospital in Frankfurt (KGU) shows how the introduction of a PACS archive can provide more flexibility and future security.

For the university hospital, the smooth connection of the existing applications ECM, PACS, and further future systems was an important criterion for archiving the data from these sources in a long-term archive. Simple IT integration is fundamental here, because more than 80 applications/modalities from different manufacturers have to be taken into account in the radiology and cardiology departments of the KGU alone.

However, the PACS archive should not only be used in these areas, but should be available to the entire hospital as a central archive. For this reason, not only image data from the PACS, but also, for example, important SAP data, e-mails, and other administrative data are archived here.
The oncological focus of the clinic requires frequent access to older data, for example if a radiation therapy has to be performed again after a few years. Thus, patients and clinic staff also benefit from central PACS archiving. For this purpose, inventory data must be stored in an audit-proof manner for up to 30 years. In addition to this, KGU adds more than 12 TB of data annually, with a strong upward trend.

In the future, growing amounts of video data will also be archived, as these are increasingly used in teaching. Direct transmission to the lecture hall or teaching archives or storage registers for teaching and research purposes are being established, so this data can be used in studies. The archiving of video data is thus becoming ever more relevant in everyday clinical practice, making the topic of long-term archiving central to KGU from a legal perspective as well. Imaging evidence of operations, increasingly in video form, is an important legal safeguard for hospitals.

Because the KGU relies on a software-based approach to archiving, it is easy to expand the archive at any time, so that the hospital can look forward to further data growth without worry.

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