[UK comment] I recently read an article on The Register whereby a patient had requested a copy of an ultrasound image of his heart taken eight years ago. The Worcestershire Acute Hospitals NHS Trust said it would cost around £2,000 to retrieve the image from its data archive and questioned Andrew Brown, the patient, on the value in spending that figure. Andrew Brown believes it his right to have that information, but the Trust is of the assumption that the cost outweighs the importance of retrieving the data.
This raises a couple of interesting scenarios and debates:

Firstly, as patients, do we have a right to request information that a Trust holds on us? This point lends itself to a much wider political, social, economic and technological debate – so blogging about it now won’t do it justice.

Secondly, there is a huge misconception that archiving data means, by default, it is always available. In a statement, the Worcestershire Acute Hospitals NHS Trust said: “We do have the visual data on file, but the cost of generating an image from what is now obsolete technology is not a cost-effective use of public money.”

The article states the scan is stored in a DSR-TIFF format that is only readable by a specific build of Philips Xcelera software, which also requires a magneto-optical disc (MOD) drive. Philips UK no longer has that particular disc drive in stock because it is out of production, so it would have to buy one from the US.

This might well be the case, but it points to a lack of understanding of a robust data management strategy and vision – as I alluded to earlier, a misunderstanding on archiving.

Today, image archiving is most frequently handled by a technology, rather unfortunately named Vendor Neutral Archive (VNA). Why is it unfortunate naming? Simply, it has become a somewhat incomplete definition of medical image archiving that automatically assumes image availability – it implies it, but it does not guarantee it.  What is required to ensure image availability is an approach to VNA based upon a solid foundation of data protection – namely four interdependent ‘layers’: Physical Storage Layer, Abstraction Layer, File Layer and Content Layer.

It would seem that on this occasion, the focus has primarily been on the Content Layer, and in doing so has omitted those other aforementioned layers that are key to ensuring image availability.
Image availability is crucial to patient care. As a hospital, it is your responsibility to ensure that a strategic approach to data archiving is adopted across your entire organisation.

You can read more about BridgeHead’s views on archiving and data availability in our most recent whitepaper ‘VNA Does Not Equal Image Availability’ – What You Need to Know.’