The data explosion along the care cycle Healthcare data is growing exponentially due to increased digitization of patient records, medical images, lab results, and other clinical information. This data deluge is creating new challenges for healthcare organizations. Specifically: - Clinicians are overwhelmed by the huge amount of data generated for each patient. Too much information can slow decision making. - Growing storage in silos makes it difficult to share critical patient data across different systems, which can affect care. Storage and IT costs are rising dramatically. - Caregivers lack resources to integrate technologies due to being overloaded by growing patient demands. Dell aims to address these challenges by optimizing healthcare storage architectures. Dell's portfolio includes high performance

1. 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

2. Some data about data
How many photos were uploaded to Facebook in the past minute?
> over 70,000 photos!
What is the % of text messages versus
phone calls for an average student:
> 98% text messages for 2% phone calls!
How many YouTube videos were watched yesterday?
> over 2 billion videos!
What is % of all digital capacity for medical content in 2014 ?
> over 30%
The data universe exceeds today 13 ExaBytes and doubles every 18 months!
1 ExaByte = 1000 PetaByte = 1000 TeraByte = 1000 = GigaByte = 1000 MegaByte = 1000 KiloByte = 1000 Bytes
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3. Making healthcare data tangible
DICOM image
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!

4. Agenda
• Dell Healthcare at a glance
• The data explosion across the care cycle
• Why is storage still so expensive?
• Redefining storage economics with Dell
Radiology
4
Oncology
Cardiology
Women’s
health
Pathology
Medical
Record

5. Dell Healthcare
at a glance
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DELL Confidential
Dell Healthcare

6. Dell Healthcare & Life Sciences
• 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
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7. Managing and sharing medical data
with Dell Clinical Cloud Archive
Over 800 clinical sites
in North America
Over 2,5 million new
studies every month,
70TB of extra storage
Over 92 million clinical
studies and 6,5 billion
diagnostic images
Secondary Datacenter
Phoenix, Arizona
Primary Datacenter
Wallingford, Connecticut
Vendor neutrality, patient centric, one time fee per study pricing, security and data
protection, offsite disaster recovery and more
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Dell Healthcare

8. The data
explosion in
healthcare along
the care cycle
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DELL Confidential
Dell Healthcare

9. Patient data digitalization along
the care cycle
Ministry of Health
Health insurance
Patient organizations
Healthcare providers
General
Practitioner
Ambulance
services
Wellness/
Prevention
Accident
Pain
Diagnostic
Center
First
Aid
Regional
Hospital
OK
Academic
Hospital
Diagnosis
Pharmacy
drugstore
Treatment
Revalidation
center
Therapy
Mental
Health
OK
Nursing Home
Elderly Care
Nursing/
Elderly Care
from storing, accessing, protecting and archiving paper files and films
to storing, accessing, protecting and archiving digital records and images
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10. More healthcare information is
becoming digital
Laboratory Medicine
(microbiology/hematology/urinalysis
immunology/phlebotomy)
Medical Images
(radiology, cardiology, oncology, …)
Medications
Genomics
(DNA sequence)
Results
Proteomics
Histories &
Encounters
(protein structure)
Digital Pathology
(virtual microscopy)
Procedures
Vital Signs
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11. Diversity of diagnostic applications is
expanding and study size is growing
Radiology
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Cardiology
(skin and its diseases)
Digital Pathology
Dermatology
(Cardiac Cath,
Echocardiology, Nuclear )
Endoscopic
Surgery
Otolaryngology
(ear, nose and throat)
Endoscopy
Ophthalmology
(anatomy, physiology and
diseases of the eye)
Neurosurgery
Oncology

12. Increasing legal retention time of
medical records
Legal Requirement (The Public Records Act - UK)
Xray/PACS (image only)
Breast Screening Xrays
All Other Records (including Photography)
Dental, Ophthalmic, Auditory Records
Maternity Records
Paediatric, Vaccination and Community ..
Oncology Records
Clinical Psychology Records
Years
CJD Related
0
5
10
15
20
25
30
35

13. Healthcare digitization is creating
new challenges and unforeseen needs
needs
The Challenges
The Consequences
The Needs
Clinicians are in data overload
An incredible amount of data
generated for each patient throughout the care-cycle.
There is too much information to
process, which can slow decisionmaking and thus, patient care. As a
result, access to information is
limited and errors are made.
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
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.
Critical patient data can be lost,
misplaced, or even misread. Delays
in information management can
affect decision-making. IT and
storage costs are exploding.
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.
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.
Being overloaded, caregivers lack
the resources for integrating timesaving patient care technologies
into daily workflow routines.
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.
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14. Spent IT to address digitalization needs
Healthcare providers
General
Practitioner
Ambulance
services
Wellness/
Prevention
Diagnostic
Center
Accident
Pain
First
Aid
Regional
Hospital
OK
Academic
Hospital
Diagnosis
Pharmacy
drugstore
Treatment
Revalidation
center
Therapy
Mental
Health
OK
Nursing Home
Elderly Care
Nursing/
Elderly Care
35%
Source: IT costs in healthcare sector, MI Partners 14 October 2009
30%
25%
20%
15%
10%
5%
0%
General
Ambulances
Practitioners
Diagnostic
centers
Regional
hospitals
Academical
hospitals
Pharmacies Revalidation Mental health
centers
centers
More than 20 % of healthcare IT budget is used for storage
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Nursing
homes

15. Healthcare systems driving 20% of
IT budget to storage
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)
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16. Healthcare data in North America,
from 3M TB to 14M TB in 5 years!
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17. Clinical and non-clinical imaging
makes up for 45% of total data volume
Big Data Growth in Healthcare
Annual Data Volume (PetaBytes)
1.800
1.600
61%
1.400
1.200
42%
1.000
800
25%
600
30%
23%
0
1.695
24%
1.563
400
200
28%
73
Research Data
372
424
E-Mail
Administrative
Applications
574
Electronic
Health
Records
2012 Data Volume (PB)
753
Non-Clinical
General
Imaging
Unstructured
Data/File
Services
Clinical
Imaging
5 Year CAGR
Estimated total Healthcare data volume in 2012 (N.A.): 5.4 Exabytes, growing 35% per year
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18. Healthcare data current reality
Healthcare providers
General
Practitioner
Ambulance
services
Wellness/
Prevention
•
•
•
•
•
•
Diagnostic
Center
Accident
Pain
First
Aid
Regional
Hospital
OK
Academic
Hospital
Diagnosis
Pharmacy
drugstore
Treatment
Revalidation
center
Therapy
Mental
Health
OK
Nursing Home
Elderly Care
Nursing/
Elderly Care
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
The explosion of healthcare data demands for new ways to manage storage cost-efficiently!
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19. Why is storage
still so
expensive?
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DELL Confidential
Dell Healthcare

20. Hard Drive costs per GB has declined
more than 50x over the last 10 years
Source: history of storage costs Matthew Komorowski
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21. Storage efficiency is not just about $/TB
but even more about $/performance
Price indication per TB (2012)
2.000$
power consumption
SSD
Today largest capacity
for 2,5 inch SSD: 512GB
500$
15.000 RPM
10.000 RPM
7.200 RPM
50$
5,200 RPM
50
Today largest capacity
for 3,5 inch HDD: 4TB
100
150
200
IOPS performance indication
50.000 >
SSD: Solid State Drive
IOPS: Input/Output Per Sec
Note: storage connection interfaces (FC/SAS/SATA …) are not considered in above estimations
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22. Why is storage still so expensive?
Companies are only using
40~50% of their installed
storage capacity (source: ESG)
Virtualization of Servers and Desktops
drives even more data and demand for
even more performance
stale data >80%
aging data ±10%
active data 2%-4%
year 0
1
2
3
4
5
Inactive data adds significant unnecessary costs
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23. Optimization of cost per GB versus
cost per IO performance
€€
23
Need for optimal
blended Cost!

24. Need for storage that
optimizes I/O and costs
2% - 4%
Tier 1 : active data
• fast but expensive
• e.g. SSD or FC 15K RPM / RAID 10
Tier 2: semi-active/aging data
±10%
• cost-effective
• e.g. FC/SAS 10K RPM / RAID5
Tier 3: non-active/slate data
>80%
year 0
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1
2
3
4
5
• slower but economic
• e.g. SATA - 7,2K RPM - RAID6

25. Redefining
storage
economics with
Dell
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DELL Confidential
Dell Healthcare

26. Dell innovation redefines storage economics
26
Confidential

27. The Dell Storage Portfolio
Workload-optimized solutions for any size enterprise
SC, FS
Series
PS, FS
Series
MD, NX
Series
PowerEdge
Servers
Dell
Networking
Compellent
EqualLogic
PowerVault
High
performance
storage
Easy-to-use
virtualized
storage
Affordable,
entry level
storage
Powered by Fluid Data technologies
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27
Confidential
Dell
Software
Dell
Services

28. Price-performance optimized storage architectures
Performance
Server
Cache
Server
Cache
Storage Market
All flash
arrays
Flash
Drives
10K SAS
Drives
7200 NL-SAS Drives
Compressed Tier
Low Cost scale-out disk
Auto Tiering
15K SAS
Drives
Cost
I/O Intensive
High Value
Workloads
PricePerformance
Optimized
Traditional IT
Cost Optimized
Dense, XaaS,
Cloud
Trends
• Greater performance needs
• Server-side storage for
performance tier via flash and
cache (vSAN)
• Continued virtualized growth
• Focus on simplifying
deployment and management
• Growth in virtualization
• Continue to focus here with
new PS and FFS features in Q4
• Highly cost-optimized dense
expansion enclosures
• Server-side internal storage
(dDAS)
• Growth in OpenStack

29. I/O performance optimized storage architectures
Server
Cache
Server
Cache
Performance
Storage Market
All flash
arrays
Flash
Drives
10K SAS
Drives
7200 NL-SAS Drives
Cost
Compressed Tier
Low Cost scale-out disk
Confidential
Auto Tiering
15K SAS
Drives
29
I/O Intensive
High Value
Workloads
PricePerformance
Optimized
Traditional IT
Cost Optimized
Dense, XaaS,
Cloud
Trends
• Greater performance needs
• Server-side storage for
performance tier via flash and
cache (vSAN)
• Continued virtualized growth
• Focus on simplifying
deployment and management
• Growth in virtualization
• Continue to focus here with
new PS and FFS features in Q4
• Highly cost-optimized dense
expansion enclosures
• Server-side internal storage
(dDAS)
• Growth in OpenStack

30. Cost-optimized storage architectures
Server
Cache
Server
Cache
Performance
Storage Market
All flash
arrays
Flash
Drives
10K SAS
Drives
7200 NL-SAS Drives
Cost
Compressed Tier
Low Cost scale-out disk
Confidential
Auto Tiering
15K SAS
Drives
30
I/O Intensive
High Value
Workloads
PricePerformance
Optimized
Traditional IT
Cost Optimized
Dense, XaaS,
Cloud
Trends
• Greater performance needs
• Server-side storage for
performance tier via flash and
cache (vSAN)
• Continued virtualized growth
• Focus on simplifying
deployment and management
• Growth in virtualization
• Continue to focus here with
new PS and FFS features in Q4
• Highly cost-optimized dense
expansion enclosures
• Server-side internal storage
(dDAS)
• Growth in OpenStack

31. Let us help accelerate your healthcare
journey to efficient storage
Let’s identify storage project and the challenges to explore
in depth how Dell can help
Schedule a Storage Simplification Workshop,
Leverage Dell storage consulting services
Visit the Dell booth at the NVKVV
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32. Thank You
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