How to Manage Medical Image Storage: Considerations and Best Practices

There is a good deal of unfamiliarity and/or apprehension on how to manage medical image storage. In fact, many organizations are not aware of all the factors that influence the development of successful strategies; such as the financial, legal, technical, and patient care considerations and best practices.


Health imaging studies take up a large amount of space on storage devices and those devices are expensive. An individual PET-CT scan, for example, can easily exceed 150MB. When processing thousands of studies a year, the amount of storage required to archive that data over the duration of its useful life can cost thousands of dollars a year. Organizations that do not employ rules-based purging and compression rules miss out on the cost savings made available to them by maximizing their storage space. In fact, their costs will continue to increase because more and more space must be purchased to maintain their archive as years go by.


Conversely, long-term storage can also be used as a revenue stream. Radiology groups reading for multiple facilities can offer long-term storage as a value-added service, thus alleviating their clients’ needs for maintaining storage and generating revenue for their business.

Whether looking to reduce costs or generate revenue, developing an effective medical image storage strategy will help you achieve your financial goals.


Laws for how long patient data needs to be maintained vary from country to country. Within the United States, those laws also vary from state to state. It’s important to educate yourself on the various laws and recommendations to ensure you are maintaining your patient data for the required amount of time. Once all the laws are understood, the criteria by which patient data is maintained, compressed or purged can be developed and deployed. Failure to fully understand the legal ramifications of storing, purging or compressing your old patient studies could leave you in violation of the law. Developing your strategy in consideration of the legal requirements will ensure your organization is in compliance and you will have all the necessary patient data available if it is ever requested.


Adding to the complexity of developing your medical image storage strategy are the technical aspects. While functionality varies between each vendor’s PACS and/or archive system, the concept of purging or compressing data that is no longer needed is universal. It is important to consider the integrity of your patient data before deploying your purge and compression rules. Failing to do so can be disastrous. By normalizing your data, you will be able to create rules to selectively purge or compress certain types of studies based on your specific requirements. It’s important to note that compression within acceptable ranges of lossy compression is a valuable option for improving use of available storage space, if totally deleting the studies is deemed inappropriate.


Ultimately, the decisions made to store your patients’ studies long term will affect patient care. Developing strategies that ride the bare minimum on federal and state retention policies may not fall in line with your organizations standard of care. It only makes sense to develop policies that satisfy government regulations and seek to improve your patients’ experience. Unfortunately, those making the policies may have inadequate qualifications for determining the policies in relation to patient care. It is important to keep your staff radiologist(s) involved in the decision-making process for how long old patient studies should be maintained. After all, they will be the ones using them. Whatever approach you take with your polices on image retention, don’t let patient care fall to the bottom of the list. Utilize polices that make sense for your organization.


Careful consideration of medical image storage strategies is critical to a successful health imaging operation. Educate yourself, and the rest of your organization, on all of the important aspects of image retention and continue to stay abreast with the changes in the industry.

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