Organizations looking at deploying a Vendor Neutral Archive have some hard decisions to make. While there are several motivations for moving all of the enterprise image data, radiology, cardiology, endoscopy, etc. from disparate PACS archives to the consolidated VNA, the economic realities will make it a tough sell in many healthcare organizations. A properly configured VNA, one that provides reliable Disaster Recovery and Business Continuity, should have mirrored Primary and Secondary subsystems located in geographically separate data centers. That will make a VNA is at least twice as big as all of the organization’s PACS combined!
Furthermore the VNA application suite is considerably more sophisticated than that of the department PACS. Additional FTE resources, several with specialized expertise, will be required to administer the tag-mapping library, create and manage the retention policies, and monitor overall system performance, the security programs, and storage consumption.
All of which is to say, a properly configured VNA is going to be expensive to deploy and expensive to operate. Making the economic argument for the VNA is going to be very difficult, because the Total Cost of Ownership of a VNA will almost always be higher than the TCO of a Heterogeneous PACS environment, simply because most department PACS have a weak DR solution, and no Business Continuity solution. While the VNA will make a number of future data migrations unnecessary, the costs of those future data migrations avoided are typically not allowed in the cost models.
One possible solution to the economic challenge is to leverage Cloud Infrastructure and Software as a Service. Rather than capitalizing and self-managing the Secondary VNA subsystem in a second geographically remote data center (which most organizations do not now have), the entire Secondary subsystem is operationalized and hosted in a Public (multi-tenant) Cloud Infrastructure. Additional savings can be realized if the entire VNA, both the on-premise Primary and the off-premise Secondary subsystems, are managed under a Software as a Service contract. In this scenario, both the on-premise and off-premise storage is delivered and billed on an as-needed basis, and all of the management resources and off-premise hardware infrastructure are shared across multiple organizations.
The VNA configuration with the Primary subsystem on-premise and the Secondary subsystem off-premise in a Cloud is referred to as a Hybrid VNA. If the organization does not believe that it has the IT resources to manage the on-premise Primary subsystem, there are Hybrid VNA vendors that will manage both on-premise and off-premise subsystems under a Software as a Service contract. A Hybrid VNA managed entirely under a SaaS contract can have a 30% lower TCO than its capitalized, self-managed, on-premise counterpart. That 30% savings can be used to make a positive economic argument for deploying the VNA. For healthcare organizations with limited IT resources and no existing remote data center, the Hybrid VNA may be the only strategy that makes sense.