Medical imaging helps drive healthcare cloud migrations

Cloud technology infrastructure is maturing, and that has both health systems and technology vendors making transitions to the cloud. Organizations often site stability, uptime, and scalability as their main motives for moving to the cloud. There’s another, often unmentioned factor: The influence of medical imaging.

It’s estimated that digital imaging in medicine—namely, the results of an X-ray, computed tomography (CT) scan, and magnetic resonance imaging (MRI) scan— account for between 80% and 90% of all clinical content.

One reason is volume, as health systems in the United States order an estimated 84 million CT scans and 40 million MRI scans each year. Another is file size, which has been expanding as imaging technology has grown more sophisticated. While a single X-ray is 15 MB, a 3-D breast tomosynthesis file is 300 MB and digital pathology images are up to 3 GB. (You’d have trouble storing two such files on the first-generation iPod, which had a capacity of 5 GB.)

Given these trends, organizations have seen the cloud as a viable medical imaging storage option for years, even as storage hardware costs have plummeted. As early as 2015, consultants recognized cloud storage for the connectivity, elasticity, and redundancy not available in picture archiving and communication systems (PACs) or vendor neutral archives (VNAs)—including PACS and VNAs located offsite. Meanwhile, experts in Europe touted the cloud as secure and cost-effective, especially compared to burning files onto CDs, shortly after the General Data Protection Regulation (GDPR) and its strict privacy requirements went into effect.

Recently, healthcare has started transitioning imaging workloads to the cloud. Signify Research has projected investment in on-premises imaging IT architecture is decreasing at a rate of 0.2% per year, while spending on cloud architecture is increasing at a rate of nearly 20% annually. A separate report from KLAS Research indicated 95% of organizations investing in cloud-based imaging were happy with their experience, though most organizations admittedly had a relatively small study volume.

Flexibility is a key consideration. The ability to not just store but process medical images in the cloud further reduces the cost of on-site infrastructure while improving availability, which is particularly valuable for business continuity purposes. Organizations increasingly view these investments as a long-term strategic bet as well. They may not be offering breast tomosynthesis or digital pathology services now, but they may want the infrastructure in place to support them in the future.

Cloud imaging options

Just as there are different cloud deployment models in healthcare, there are multiple options for cloud-based medical imaging.

• Cloud-native applications have been specifically built for the cloud, taking advantages of features such as continuous integration, containerization, and process automation.
• Cloud-enabled services were originally built as traditional, on-premises systems and migrated for the cloud.
• Cloud-based systems occupy a middle ground, using cloud infrastructure to run an application while maintaining onsite infrastructure for storage, backup, or other purposes.

Each option comes with pros and cons. Cloud-native is the most advanced, but KLAS noted that data migration can be a time-consuming process. Cloud-enabled products often come from familiar vendors, but they can be costly, as vendors must rearchitect legacy systems from the ground up. Cloud-based is a less bumpy transition, but organizations don’t realize the main benefits of the cloud on their on-premises infrastructure.