The data explosion along the care cycle

NVKVV 16de Colloquim ICT en gezondheidszorg Dinsdag 8 mei 2012, De Montil Moortelstraat 8, Affligem Eric van ‘t Hoff, EMEA Healthcare ISV Alliance Manager

Note: updated with latest Dell Storage solutions, December 2013

Some data about data

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How many photos were uploaded to Facebook in the past minute?

How many YouTube videos were watched yesterday?

What is the % of text messages versus phone calls for an average student:

> over 70,000 photos!

> 98% text messages for 2% phone calls!

> over 2 billion videos!

The data universe exceeds today 13 ExaBytes and doubles every 18 months!

What is % of all digital capacity for medical content in 2014 ?

> over 30%

1 ExaByte = 1000 PetaByte = 1000 TeraByte = 1000 = GigaByte = 1000 MegaByte = 1000 KiloByte = 1000 Bytes

Making healthcare data tangible

Regional hospital with 500 beds - Average nbr of annual studies: 100.000 - Average study size: 100MB - Average annual storage need: 10TB

Standard business laptop: - Average hard disk capacity: 150 GB - Available storage capacity: 1.500 studies - Available storage study days: 5,4 days

67 laptop hard disks needed every single year for radiology only!

DICOM image

Agenda

• Dell Healthcare at a glance

• The data explosion across the care cycle

• Why is storage still so expensive?

• Redefining storage economics with Dell

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Radiology Oncology Cardiology Women’s

health Pathology

Medical Record

5 DELL Confidential Dell Healthcare

Dell Healthcare at a glance

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Dell Healthcare & Life Sciences

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• 13,000+ healthcare & life sciences professionals

• We support over 10,000 Healthcare providers, health plans, pharmaceutical, biotech, medical device, diagnostic and scientific instrumentation customers worldwide

• Leading Healthcare Information Technology Services provider1

• Dell Healthcare & Life Sciences is with $2.9 billion (FY13) the second largest Healthcare IT company2

• We provide OEM services to 70+ Healthcare and Life Sciences software, medical device and scientific instrument providers

• Our Clinical Archive Cloud manages more than 95 million

clinical studies and 6.7 billion diagnostic imaging objects on behalf of more than 800 clinical sites in North America3

1) Source Gartner 2012 [url] 2) Source Healthcare Informatics 2013 [url] 3) See real-time ticker

7 Dell Healthcare

Managing and sharing medical data with Dell Clinical Cloud Archive

Secondary Datacenter Phoenix, Arizona

Primary Datacenter Wallingford, Connecticut

Over 92 million clinical studies and 6,5 billion diagnostic images

Over 800 clinical sites in North America

Over 2,5 million new studies every month, 70TB of extra storage

Vendor neutrality, patient centric, one time fee per study pricing, security and data protection, offsite disaster recovery and more

8 DELL Confidential Dell Healthcare

The data explosion in healthcare along the care cycle

Patient data digitalization along the care cycle

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OK OK Accident

Pain

Wellness/ Prevention

First Aid

Diagnosis Treatment Therapy Nursing/

Elderly Care

Healthcare providers

Health insurance

Ministry of Health

Patient organizations

Academic Hospital

Mental Health

Revalidation center

Diagnostic Center

General Practitioner

Nursing Home Elderly Care

Pharmacy drugstore

Regional Hospital

Ambulance services

from storing, accessing, protecting and archiving paper files and films to storing, accessing, protecting and archiving digital records and images

More healthcare information is becoming digital

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Genomics (DNA sequence)

Proteomics (protein structure)

Digital Pathology (virtual microscopy)

Medical Images (radiology, cardiology, oncology, …)

Laboratory Medicine (microbiology/hematology/urinalysis

immunology/phlebotomy)

Medications

Results

Histories & Encounters

Procedures

Vital Signs

Diversity of diagnostic applications is expanding and study size is growing

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Radiology Dermatology

(skin and its diseases)

Cardiology (Cardiac Cath,

Echocardiology, Nuclear )

Endoscopy Ophthalmology (anatomy, physiology and

diseases of the eye)

Digital Pathology Endoscopic Surgery

Otolaryngology

(ear, nose and throat)

Neurosurgery Oncology

Increasing legal retention time of medical records

0 5 10 15 20 25 30 35

CJD Related

Clinical Psychology Records

Oncology Records

Paediatric, Vaccination and Community ..

Maternity Records

Dental, Ophthalmic, Auditory Records

All Other Records (including Photography)

Breast Screening Xrays

Xray/PACS (image only)

Legal Requirement (The Public Records Act - UK)

Years

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Healthcare digitization is creating new challenges and unforeseen needs needs

Clinicians are in data overload An incredible amount of data generated for each patient through-out the care-cycle.

Digitalisation is a challenge

Growing storage in silos with data

moving between multiple core

systems in all forms. IT also needs to

comply to patient safety regulations.

Demand for care is growing There are simply not enough nurses and doctors to cope with our demands. Aging populations stressing an already taxed system.

Digitise patient information so it can be readily shared. Fully enable easy access to data to aid in decision-making from anywhere across the care-cycle

Standardise the IT infrastructure to simplify information sharing and reduce management and scaling costs while maintaining availability, uptime and compliance requirements. Enable interoperability with the many medical information systems to ease information sharing.

Focus on streamlining workflow and

optimizing processes to reduce the

burden on caregivers. Connect

hospitals and primary care physicians

to coordinate patient care and

increase staff productivity.

Being overloaded, caregivers lack

the resources for integrating time-

saving patient care technologies

into daily workflow routines.

Critical patient data can be lost, misplaced, or even misread. Delays in information management can affect decision-making. IT and storage costs are exploding.

There is too much information to

process, which can slow decision-

making and thus, patient care. As a

result, access to information is

limited and errors are made.

The Consequences The Challenges The Needs

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Spent IT to address digitalization needs

Source: IT costs in healthcare sector, MI Partners 14 October 2009

OK OK Accident

Pain

Wellness/ Prevention

First Aid

Diagnosis Treatment Therapy Nursing/

Elderly Care

Healthcare providers

Academic Hospital

Mental Health

Revalidation center

Diagnostic Center

General Practitioner

Nursing Home Elderly Care

Pharmacy drugstore

Regional Hospital

Ambulance services

0%

5%

10%

15%

20%

25%

30%

35%

GeneralPractitioners

Ambulances Diagnosticcenters

Regionalhospitals

Academicalhospitals

Pharmacies Revalidationcenters

Mental healthcenters

Nursinghomes

More than 20 % of healthcare IT budget is used for storage

Healthcare systems driving 20% of IT budget to storage

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Electronic patient health records (EHR plus supporting clinical applications such as CPOE, clinical decision support, etc.) Clinical imaging (radiology, cardiology, pathology, etc.)

Non-clinical imaging (scanned documents such as bills, invoices, etc.) General unstructured data (non-EHR data such as office productivity files, media files, etc.)

E-mail

Administrative applications (financials, billing, human resources, etc.)

Research data (excluding clinical decision support information)

Healthcare data in North America, from 3M TB to 14M TB in 5 years!

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Clinical and non-clinical imaging makes up for 45% of total data volume

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Estimated total Healthcare data volume in 2012 (N.A.): 5.4 Exabytes, growing 35% per year

An

nu

al D

ata

Vo

lum

e (

Pe

taB

yte

s)

73 372 424

574 753

1.563

1.695 25%

23% 24%

61%

30% 28%

42%

0

200

400

600

800

1.000

1.200

1.400

1.600

1.800

Research Data E-Mail AdministrativeApplications

ElectronicHealth

Records

Non-ClinicalImaging

GeneralUnstructured

Data/FileServices

ClinicalImaging

Big Data Growth in Healthcare

2012 Data Volume (PB) 5 Year CAGR

Healthcare data current reality

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• 30% of all digital capacity by 2014 will be medical content • 35% of annual healthcare data growth • 20% of healthcare IT budget is used for storage • 45% of storage capacity is dedicated to medical imaging • 65% of providers retain images forever • 95% is unstructured data, rarely accessed after creation

OK OK Accident

Pain

Wellness/ Prevention

First Aid

Diagnosis Treatment Therapy Nursing/

Elderly Care

Healthcare providers

Academic Hospital

Mental Health

Revalidation center

Diagnostic Center

General Practitioner

Nursing Home Elderly Care

Pharmacy drugstore

Regional Hospital

Ambulance services

The explosion of healthcare data demands for new ways to manage storage cost-efficiently!

19 DELL Confidential Dell Healthcare

Why is storage still so expensive?

Hard Drive costs per GB has declined more than 50x over the last 10 years

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Source: history of storage costs Matthew Komorowski

Storage efficiency is not just about $/TB but even more about $/performance

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SSD

Pri

ce

ind

icati

on

pe

r T

B (

20

12)

IOPS performance indication

50 100 150 200 50.000 >

5,200 RPM

7.200 RPM

10.000 RPM

SSD: Solid State Drive

IOPS: Input/Output Per Sec

2.000$

50$

Today largest capacity

for 2,5 inch SSD: 512GB

Today largest capacity

for 3,5 inch HDD: 4TB

15.000 RPM

500$

Note: storage connection interfaces (FC/SAS/SATA …) are not considered in above estimations

power consumption

Why is storage still so expensive?

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Virtualization of Servers and Desktops drives even more data and demand for

even more performance

year 0 1 2 3 4 5

stale data >80%

aging data ±10%

active data 2%-4%

Inactive data adds significant unnecessary costs

Companies are only using 40~50% of their installed storage capacity (source: ESG)

Optimization of cost per GB versus cost per IO performance

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Need for optimal

blended Cost!

€ €

Need for storage that optimizes I/O and costs

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year 0 1 2 3 4 5

Tier 1 : active data • fast but expensive • e.g. SSD or FC 15K RPM / RAID 10

Tier 2: semi-active/aging data • cost-effective

• e.g. FC/SAS 10K RPM / RAID5

Tier 3: non-active/slate data • slower but economic

• e.g. SATA - 7,2K RPM - RAID6

2% - 4%

±10%

>80%

25 DELL Confidential Dell Healthcare

Redefining storage economics with Dell

26 Confidential

Dell innovation redefines storage economics

27 27 Confidential

The Dell Storage Portfolio Workload-optimized solutions for any size enterprise

MD, NX Series

SC, FS Series

Affordable, entry level

storage

High performance

storage

PS, FS Series

Easy-to-use virtualized

storage

PowerVault EqualLogic Compellent

PowerEdge Servers

Dell Networking

Dell Software

Dell Services

Powered by Fluid Data technologies

Price-performance optimized storage architectures

Storage Market Trends

I/O Intensive

High Value Workloads

• Greater performance needs • Server-side storage for

performance tier via flash and cache (vSAN)

Price-Performance Optimized

Traditional IT

• Continued virtualized growth • Focus on simplifying

deployment and management • Growth in virtualization • Continue to focus here with

new PS and FFS features in Q4

Cost Optimized

Dense, XaaS, Cloud

• Highly cost-optimized dense expansion enclosures

• Server-side internal storage (dDAS)

• Growth in OpenStack

Server Cache

Server Cache

Low Cost scale-out disk

Flash Drives

All flash arrays

15K SAS Drives

10K SAS Drives

7200 NL-SAS Drives

Compressed Tier

Co

st

Pe

rfo

rman

ce

Au

to T

ierin

g

I/O performance optimized storage architectures

Confidential 29

Storage Market Trends

I/O Intensive

High Value Workloads

• Greater performance needs • Server-side storage for

performance tier via flash and cache (vSAN)

Price-Performance Optimized

Traditional IT

• Continued virtualized growth • Focus on simplifying

deployment and management • Growth in virtualization • Continue to focus here with

new PS and FFS features in Q4

Cost Optimized

Dense, XaaS, Cloud

• Highly cost-optimized dense expansion enclosures

• Server-side internal storage (dDAS)

• Growth in OpenStack

Server Cache

Server Cache

Low Cost scale-out disk

Flash Drives

All flash arrays

15K SAS Drives

10K SAS Drives

7200 NL-SAS Drives

Compressed Tier

Co

st

Pe

rfo

rman

ce

Au

to T

ierin

g

Cost-optimized storage architectures

Confidential 30

Storage Market Trends

I/O Intensive

High Value Workloads

• Greater performance needs • Server-side storage for

performance tier via flash and cache (vSAN)

Price-Performance Optimized

Traditional IT

• Continued virtualized growth • Focus on simplifying

deployment and management • Growth in virtualization • Continue to focus here with

new PS and FFS features in Q4

Cost Optimized

Dense, XaaS, Cloud

• Highly cost-optimized dense expansion enclosures

• Server-side internal storage (dDAS)

• Growth in OpenStack

Server Cache

Server Cache

Low Cost scale-out disk

Flash Drives

All flash arrays

15K SAS Drives

10K SAS Drives

7200 NL-SAS Drives

Compressed Tier

Co

st

Pe

rfo

rman

ce

Au

to T

ierin

g

Let us help accelerate your healthcare journey to efficient storage

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Let’s identify storage project and the challenges to explore

in depth how Dell can help

Visit the Dell booth at the NVKVV

Schedule a Storage Simplification Workshop,

Leverage Dell storage consulting services

32

Thank You