Is Less Storage Space Needed for EHR Systems?

While EHR data volumes continue to grow, advancements in storage technology and data management practices suggest that less storage space may be needed in the future.

Electronic health records (EHRs) have become a cornerstone of modern healthcare. By digitizing patient data that was previously stored on paper, EHR systems aim to improve care coordination, reduce medical errors, and engage patients in their own health.

But this digital revolution has come with growing pains. Chief among them is the sheer volume of data generated by EHRs, which has caused storage needs to balloon. This raises an important question: with smart strategies and new technologies, can we curb the rapid growth in EHR storage requirements?

Is the Growing Volume of EHR Data a Myth?

There is no doubt that EHRs produce tremendous amounts of data. A single patient over their lifetime can generate thousands of notes, images, lab results, medications, and more. Multiply that across a large health system with millions of patients and many decades of operation, and you have a data tidal wave.

But the notion that EHR data volume is spiraling out of control may be somewhat exaggerated. While storage needs are undoubtedly increasing, improvements in data compression, deduplication, and infrastructure efficiency have prevented unchecked expansion.

Several factors contribute to EHR data growth:

• Imaging files from MRIs, CT scans, and x-rays are massive.
• Genomic data from lab testing adds billions of data points per patient.
• Patients now have longer, more complex health histories.

Yet advances in storage technology have paralleled the data explosion:

• Data compression reduces file sizes by 40% or more by eliminating redundancy.
• De-duplication detects identical data blocks and only stores one copy.
• Declining per-gigabyte storage costs offset volume increases.

So while EHR data is growing, it may not be the runaway storage crisis that some predicted.

Cloud vs. On-Premise Storage: Which is More Space-Efficient for EHRs?

For health systems, a key decision is whether to host EHR storage on-premise or in the cloud. Which model makes more efficient use of space?

On-premise storage requires sizable upfront investments in hardware and IT infrastructure. The benefits are complete control and the ability to scale up incrementally. The downside is overprovisioning capacity to accommodate future growth.

Cloud storage delivers unlimited capacity on-demand. It can scale seamlessly without capital investment. However, it is an operating expense, and providers pay for all allocated space. Unused capacity equals wasted budgets.

Cloud vs. On-Premise EHR Storage: Space Efficiency & Cost Comparison

Feature	On-Premise Storage	Cloud Storage
Space Efficiency	Less efficient due to overprovisioning to accommodate future growth	More efficient due to consumption-based model, no overprovisioning
Upfront Investment	High - hardware, infrastructure, IT staff	Low - minimal upfront costs
Scalability	Incremental, requires additional hardware investments	Seamless, unlimited on-demand capacity
Cost Model	Capital expenditure (CapEx)	Operating expenditure (OpEx)
Cost per GB (at scale)	Higher	Lower
Control	Complete control over infrastructure	Less control, reliance on cloud provider

Ultimately, cloud storage is inherently more space-efficient. Its consumption-based model discourages overprovisioning, whereas on-premise allotments tend to exceed actual needs. However, prudent management can optimize either approach.

There are also cost trade-offs between the models, with cloud storage becoming progressively more affordable per gigabyte stored as utilization scales.

Is "Big Data" Making EHRs Less Efficient, Not Just Bigger?

EHR adoption was intended to make healthcare more efficient through data-driven coordination and decision making. In a twist of irony, EHRs themselves have suffered efficiency declines as data overload grows. Is "big data" now hindering clinicians?

Bloated EHRs with volumes of redundent, disorganized, and outdated data slow caregivers down. Clinicians waste precious time searching records for the signal amidst the noise. Fragmented data entry compounds inefficiencies system-wide.

This data disorder then echoes downstream. Excessive "copy-paste" and outdated information must still be stored. Mistakes creep in when records are inaccurate or unclear.

There are incentives for healthcare providers to adopt superior data practices that could ultimately reduce EHR storage needs:

• Streamlining workflows and documentation requirements.
• Implementing single data entry to eliminate duplication.
• Applying intelligence tools to surface key insights more quickly.

In essence, storing less raw data may be possible by using what we store more thoughtfully and efficiently.

What Role Does Data Retention Policy Play in EHR Storage?

Data retention refers to how long information remains in an EHR system before it is deleted or archived. More expansive retention means more data needing active storage.

Healthcare organizations must balance legal requirements, clinical usefulness, and practical storage limits when crafting retention policies.

Federal and state laws mandate retaining certain records for set time periods – often a decade or longer. While essential for compliance, these policies are not tailored to what data has ongoing clinical value.

Ideally, EHR retention should be:

• Long enough to inform care, but not eternal.
• Distinguish utility of data elements, not just whole records.
• Flexible through technologies like data tiering and archiving.

Forward-looking retention policies paired with archival systems could significantly reduce active EHR storage needs.

Beyond Bytes: Are EHRs Becoming Smarter, Not Just Smaller?

As EHR adoption matures, the conversation is shifting from how these systems store data to how they leverage data. Emerging techniques like artificial intelligence and predictive analytics promise smarter EHRs.

If EHRs can surface insights more efficiently via these tools, the calculus around data storage changes. We may need less raw data persistence if we have technologies to interpret data more intelligently.

Of course, mining EHR data hinges on having extensive sets to analyze. This is the central paradox – the drive for efficiency competes against needs for rich data.

There are also ethical considerations around retaining certain data categories to train AI algorithms down the road, even if they exceed current utility.

EHRs are undoubtedly getting smarter. Whether they will keep getting smaller remains less clear. But technology will open new possibilities to strike this balance.

What Does the Future Hold for EHR Storage Needs?

EHR systems face intensifying data demands, but they also have expanding technological capabilities. Where this dynamic equilibrium settles will determine if less storage space becomes a reality.

While data volumes will keep rising, better data practices and scrutiny of what we choose to store can bend the curve. Cloud infrastructure and AI tools will complement this through scalability and insight extraction.

But broader healthcare trends around imaging, genomics, and longitudinal records will persist. And new data sources like wearables and social determinants may soon enter the fold.

In the end, the question is less about achieving a set storage target and more about using EHR data thoughtfully. With patient care as the north star, the industry can chart the right course on storage.