Avoiding the

disaster" in disaster recovery"> NDMA now has a fraction of that, with approximately 75TB in each of its two locations, for a total of 1.5 million digital images in the archive. Danois projected that NDMA will grow that to about 10 million images by July or August.

The unanswered question is whether the project can scale. Thus far, Danois said, the architecture is doing "very well" in scaling. i3 plans to bring another 150TB of new storage online in or around June, bringing the total capacity to 250TB.

Because of the way NDMA was designed and its proven scalability and ability to handle medical imaging so well, i3 expanded breast imaging to handle MRIs and CT scans. Last year, the company also for the first time offered disaster recovery for hospital PACS (Picture Archiving Communication Systems).

Those systems are big business, Danois said. General Electric, Siemens and Eastman Kodak build around them, and hospitals make multimillion-dollar IT purchases to get them.

But what the disaster recovery means for hospitals is that, for the first time, they can look at disaster recovery as more than an insurance question. NDMA is a fully functioning medical imaging management system. By creating a complete copy of the PACS database on i3s system, rather than having lost data or trying to restore data from linear tape—which can take more than a year to recover all data—hospitals can have almost instantaneous access.

"That capability has never before been in the marketplace," Danois said.

Hallelujah to that, said Murray Hill Radiologys Vincente.

"GE, who we were going to buy [a new 4TB system] from, would have a [disaster recovery] service, but God forbid theres a fire or flood," Vincente said. "You live and die by having these images stored, and stored properly."

When it came to Murray Hill Radiologys attention that it could export images, on a daily basis, to a very secure database backed by IBM that had multiple disaster recovery sites, both in different locations, it came as a godsend, Vincente said.

Beyond being "as secure as you can get," Vincente said, the service meant that Murray Hill Radiology didnt have to worry about needing larger real estate—which, in New York City, is a serious matter.

"In New York City, every square foot of space is a priority," Vincente said.

In addition to disaster recovery and savings on real estate and hardware, the pressure to deal with serving up the digital images in a timely manner when a patient is in the office has been lifted from the backs of IT.

"We could tie to [our scheduling and medical records] system so it would pull the images on the schedule, so we didnt have to—when the patient was here—go retrieve them," Vincente said. "It would prefetch images, and wed have them ready, in queue, the night before."

The concept was clearly a winner. But i3 was brand-spanking new, an untested commodity. So what made Murray Hill take the chance on this newcomer?

"The people who are there [Danois and Diane Hockstein, president of MyNDMA] are really in touch with what needs to happen," Vincente said.

That means that whatever bugs needed to be worked out of the system, i3 and MyNDMA were on top of it, Vincente said. For example, a priority for Murray Hill Radiology was to take all the images on its old, full-up 4TB system and migrate them to the new service.

The biggest kinks so far have been aspects of migrating images. The service has to work well with vendor hardware to push images to the wall plug, Vincente said. As it is, GE and some of the other hardware vendors write proprietary software for their piece of equipment.

For example, Vincente said that she cant just take an optical disk from a GE MRI machine and plug it into one from Siemens. Thus, Murray Hill needed a patch from GE to decode the images so they would be readable in a common format that could be accepted by i3.

Fortunately, Vincente said that GE worked to help Murray Hill, and the clinic was able to get all the images off the old system, over the course of a few months, using magnetic tape. The images are now flowing over DSLs.

But these are all mere technology tidbits. Whats really important in this story is the diagnosis of breast cancer. For that, Vincente said, "information is always key."

"When a woman has access to her medical records and doesnt have a closet full of film jackets, because [digital images are] easily stored on a CD or on the Internet, it makes for better medicine," Vincente said. "When a radiologist sits down and has previous mammos, it is the best form of medicine. Its the future—youre allowing women to take control of their medical records. And thats always good. Information is key."

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