A recent survey found data storage to be one of the more pressing issues weighing on CIOs. And when one tries to pinpoint the culprit for most of that data, it's inevitably imaging. Just think of your inboxes — how easy is it to just delete the photo attachments from messages and shrink your footprint in seconds? For CIOs, multiple PACS and image redundancy are sure ways to exponentially increase storage costs. Recently, HCI Editor-in-Chief Anthony Guerra chatted with Jim B-Reay, vice president of business development at Healthia Consulting (an Ingenix) company, about how CIOs can get their imaging houses in order.

AG: Talk about the typical issues you're approached with; for example, is it CIOs that are coming to Healthia? What's a typical example of some problems they might need assistance with?

JB: What we're seeing right now is that to an extent, especially in the year 2008, PACS has grown. I would say that in 2002-2003, it was one of those strategic initiatives that CIOs were really putting a lot of their work into, much the same way the hospital CMOs and CEOs were getting involved in whether or not they should upgrade their modalities to digital. By this point, it's almost a foregone conclusion that if you're going to be doing imaging, you've got to have a PACS. And so almost all of the major institutions have got some form going, and almost all of the vendors have reached a level of parity.

Where we're getting engaged is on two levels. The first one is we've been brought in on a number of situations where the hospital is looking to almost start over with a digital hospital solution. They want to know, okay, if we were going to start with a blank piece of paper, how should we be pulling this all together. The other area that we're being brought in on is what I would call departmental expansions of PACS. What I mean by that is that now cardiology is asking for their own functionality, orthopedics is asking for functionality, and obviously mammography has always been in the picture, but they're starting to have greater demands for access to imagery. So what we're being asked to do is to question whether current PACS architecture can support this and if not, what is the solution?'

Unfortunately, what we're seeing is that PACS on a radiology level is relatively mature, but on almost every other level, it's still a bit ‘Wild West,’ and there is still a lot of replication of data. There continues to be a great deal of interoperability issues, and they're very specialized toolsets. And so, we're in a position where if somebody is saying, ‘We're an orthopedic specialty practice, I've got 15 terabytes of spine files out here; are you telling me that to work with this new PACS tool, I need to copy that data every time?’ Unfortunately, a lot of times, the answer is yes. Everybody wants to be strategic, but there are a number of cases where the vendors simply aren't there yet. Going way back, the blank piece of paper gigs are always the most fun, partially because they remind me of the early days of PACS because you really did get to look at all the options. Right now, it is such a mature market.

AG: I would imagine few organizations can take the ‘blank slate’ approach because most need to leverage their existing investments, correct?