What he sees in IT lately leaves him in awe. "We're growing [data volumes] by 40 percent a year, and now we have over 400 terabytes—just unimaginable volumes of data from what we had just a few years ago," Chapman says. "We've seen exponential growth, and it keeps pressure on the storage platforms."

In fact, Chapman and other CIOs in health care face a vicious cycle of mandatory document retention. Government regulations such as the Health Insurance Portability and Accountability Act (HIPAA) force every organization and every person to save electronic medical records and e-mail for longer and longer periods of time. As a public company, Kindred has to maintain financial records in accordance with the Sarbanes-Oxley Act. And like every company, it is subject to new federal litigation procedures that require it to provide electronic documents during legal discovery if it is sued.

A survey by the Healthcare Information and Management Systems Society (HIMSS) published in February finds that government regulation and compliance issues are a growing concern among IT leaders. Thirty percent of CIOs cited regulation and compliance as a top business issue this year, compared with 20 percent in 2007.

Healthcare institutions also face pressure from their legal departments to be able to produce all documents that relate to malpractice, as well as to Medicare fraud and abuse cases. Such documents, including e-mail, are "subpoenable and discoverable in legal cases," says Chapman. "Saying that we deleted them is not a good reason anymore."

Kindred does not save literally every single e-mail; what must be kept and what can be deleted is determined by the company's records retention policy. Nevertheless, the policy dictates that "a greater portion of specific e-mail is kept forever," says Chapman. Patient records may need to be kept for 35 years, and financial records have a 10-year life.

The sum of all this storage could be overwhelming for many organizations. Back in 2004, a Frost & Sullivan "Healthcare Storage Report" predicted that by 2010, medical organizations would have to hold nearly 1 billion terabytes of data, which is roughly the equivalent of 2 trillion file cabinets' worth of data. Last December, IDC (a sister company to CIO's publisher) reported that storage capacity is growing at a rate of 60 percent a year.

All that storage gets expensive and resource-intensive. "It's mind-boggling and completely nonproductive," Chapman notes. "It's that hidden cost of health care that you don't see at times."

Tales of the Tape