Mike Gray has an update on his attendance of SCAR in Austin. He touches on one of the hidden costs in PACS or CVIS systems - proprietary storage. Back in the early days of PACS many vendors used their own file management systems and stored data in proprietary formats. That's no big deal when you're just buying your PACS - but years down the road when you want to switch vendors, it becomes a very big deal. A non-standard file management system means that no one but that vendor knows where specific patients and exams are stored. Non-DICOM data means that only the vendor that wrote that non-DICOM data can read it.

A whole market has resulted from customers who need to extract their data from a proprietary system so that it can be used in a different vendor's system. Hot shot economists call this “erecting changing costs” and “lock-in.” You can read a previous post on this here. The later in the process you learn this, of course, the more shocking it is.

If you know what to look for, there are vendors out there who either allow you to avoid this problem or can be coerced convinced to make the appropriate accommodations when you first purchase their system (it's all about planning ahead). The bad news is that most storage vendors are playing the same games as some PACS/CVIS vendors.

Pictured right are some fancy RAID storage systems.