After a couple of replies to an earlier topic on ILM, I thought I’d toss another round of ideas into the pool. Are we ready for forcing a vendor compliance on structuring how ILM works. I’m not sure it’s something we have that much control over but sounds like a good idea.  Here’s my response.

I absolutely think that VNA, although a cheaper alternative to the native storage of most of our legacy PACS systems, does not close the discussion on storage limits. It’s easy to say that 2 pentabytes of storage should take us into the next generation of archieving, it doesn’t discount the fact that what we really need is, as you mentioned, compliance. From what I’ve witnessed, and mentioned by Skip, Forever truly is a long time.

We as hospitals or as imaging system managers need to understand that by learning early on what it takes to purge exams, is the most important factor. You have got to have the fundamentals down. How does your vendor’s ILM work? What scripts are important? And the most important, at what compression rate will your radiologists be happy with after your final compression? You can set dates to begin scaling down your compression. At 7 years, for here in MS, we can purge general exams, not including infants and mammo. So, if we tell our rads that at the 7 year mark, we’re dropping you down to 80% compression rate, will they be happy? Then at 10 years, we make the big jump to 30%. We’ve just made a huge difference in our storage if we apply this across the board but have probably annoyed our radiologists. So, this is where an early conversation with radiologists, DI Managers, compliance officers, and hospital administrators pays off. Test early and often.

Although we’ve been through this process for years, we are still not purging. Why not you ask? Well, it could be as easy as a change in hospital management. A new Radiology Director. There are constantly changes that will nag us after a decade or more of use. The time has come for compliance. I believe it begins with understanding your systems, meeting with other like-minded customers, and have the tough talk with our mentors at SIIM, RSNA, or some other forum. This will not be as easy as coming up with, say DICOM compliance. That standard speaks for all vendors. This is more difficult, as each vendor has a different method.

I’d love to pick your brains and get your sides on this issue. Maybe we can start a grass-roots movement toward creating compliance or at least get the conversation started!