It's been rolling in for a few years, and now an accumulation of clouds -- data clouds, that is -- has taken over the health care industry. In particular, at this year's RSNA technical exhibit, a number of health care IT companies brought out their newest fix for this off-site approach to data and image management.

What is cloud computing? The term means that end users no longer have to know where their data resides. It is all "up in the air" in a sense. No longer are hospitals, imaging centers and private physicians' offices tied to on-site hardware to access the data and imagery required to get through their daily caseload.

"The forecast at RSNA is that everything is about the cloud, because the cloud represents a new tier of data management," said InSite One's Mitchell Goldburgh, senior vice president of marketing and business development. "With the advent of the cloud, it's all virtual. It's like when you do a Google search for a restaurant. You don't care where that data is coming from as long as it is the data you need."

Off-Site Data Services

With the explosive growth of data being generated by the health care industry, off-site, scalable, and on-demand data services are gaining a lot of attention in the market. Goldburgh says physical storage continues to increase in capacity at a lower cost per unit, but after a relatively brief period of time, it costs more to cool and power the storage than it did to acquire it.

Other companies offering online data hosting include eRad, and Candelis, which recently branded the Candelis Cloud. Both provide universal, but HIPAA-friendly secured access to data via the web.

"We're taking a very revolutionary step forward in the way data is managed and communicated between radiologists and referring physicians," said Hossein Pourmand, vice-president of business development for Candelis.

"The cloud means the customer doesn't have to be burdened with all the hardware, both in terms of servers and archiving, and in terms of PCs and workstations," says Pourmand. "It helps hospitals at a very critical juncture to reduce their operating expenditures. When hospitals buy hardware, it also becomes obsolete very quickly."

Thin Clients

Other buzzwords hanging in the air this year at RSNA were the "zero" and "thin" clients, which basically are internet-based data portals. The "thinner" the client, the less front-end software is necessary to access the data. (For example, applications might be run online rather than loaded onto each computer.)

"In order to get into the cloud business you need to have perfected the thin client," said Pourmand.

Off-site data management also changes the game of data recovery in case of a disaster.

"People often have this idea that everything needs to be backed up. 'Oh my god, if it's not backed up...' but now technology has gotten to a point where back-up is no longer sufficient because the data is so vast that to recover the system would take them out of service for too long," says Goldburgh. "So disaster recovery has given way to business continuance."

Depending upon the level of service contracted, customers can have three copies of the data mirrored across the health care facility and InSite One's data centers in Phoenix, Ariz., and Wallingford, Conn. No matter what happens at the health care facility, that data is always available.

Most cloud computing services use common informatics standards like DICOM, HL7 and XDS and keep data in an "intelligent" digital format that can be registered, shared and analyzed, which is the direction the world of health care is going now that health information exchanges (HIE) and regional health information organizations (RHIO) are cropping up across the country with the help of federal government ARRA stimulus money.

InSite One just closed a deal to provide a universal image repository for the company's first integrated delivery network (IDN): Medstar Health, a network of nine hospitals in the Northeast; they also signed a contract to provide a standard image repository for U.S. military services.

The company has also partnered with Merge on the InDex Web and Cedara WebAccess technologies, which let physicians gain access to patient information via hand-held technology such as tablets, iPhones and Blackberry Bold phones.

Check back for more on premiering technologies from the 2009 RSNA Annual Meeting.