Orthanc
A lightweight open-source DICOM server. It receives studies from modalities or an existing PACS, stores them on disk, and exposes a REST and DICOMweb interface. Its PostgreSQL plugin is recommended for larger archives.
Medical imaging storage in Kenya
Keep every scan and patient record off the clinic floor
X-ray, CT and ultrasound studies fill a modality workstation in months, and the EMR database often lives on one machine under a desk. A storage server gives your facility an encrypted, off-site archive for imaging and nightly database backups, under your own administration.
15 thousand studies
We suggest
Storage S2
KES 5,000/mo
Around 30,000 studies is about 3 TB of 4 TB. The 8 GB RAM comfortably runs Orthanc with a PostgreSQL index and a web viewer.
Order Storage S2Imaging archives outgrow the workstation
Many Kenyan clinics and imaging centres keep studies on the modality console or a single PC acting as a mini PACS. When that disk fills up, someone deletes older studies to make room, and the patient who returns for a comparison scan a year later has no prior images to compare against.
An off-site archive changes that. A DICOM server such as Orthanc runs on the storage plan, the modality or local PACS sends a copy of each completed study to it over an encrypted tunnel, and radiologists can pull priors back when needed. The same server can take nightly encrypted dumps of your EMR database, so a failed hard disk at the facility is an inconvenience rather than a loss of patient history.
Be realistic about the hardware. These plans use SATA disks chosen for capacity, which suits archiving and retrieving studies but is not meant to replace a primary PACS that radiologists read from all day. Keep the primary system on site, use this server as the long-term and disaster-recovery copy, and treat everything on it as sensitive health data that must be encrypted and tightly controlled.
The problem
Risks facilities face with imaging and records
Prior studies get deleted
Modality storage is small. When it fills, older studies are purged, and comparison reads become impossible. Patients are sometimes re-scanned, adding cost and, for CT and X-ray, extra radiation dose that a kept prior could have avoided.
The EMR lives on one disk
A KenyaEMR or private EMR database on a single server under the reception desk is one power surge away from loss. Without a recent off-site dump, rebuilding patient histories means going back to paper files, if they exist.
Sensitive data, weak controls
Health information carries extra protection under Kenyan data protection law. Shared logins, unencrypted USB copies and DICOM ports open to the internet are common findings, and each one is a breach waiting to happen.
Reporting from elsewhere
Visiting or remote radiologists need studies quickly. Burning CDs or emailing images is slow and insecure, while a properly secured web viewer lets an authorised reader open a study without anyone copying files around.
What runs on it
Imaging and backup software you can run
With full root access, your IT team or vendor installs and maintains the stack. These are established open-source options used by healthcare providers.
OHIF Viewer
A browser-based medical image viewer that connects to Orthanc through DICOMweb. Put it behind HTTPS and proper user authentication so authorised clinicians can review studies without installing workstation software.
dcm4chee-arc
A full-featured open-source archive with worklist and HL7 support. Heavier to run than Orthanc, so it suits the larger plans and teams with experience operating Java applications.
WireGuard
A modern VPN that links your facility network to the server. Send DICOM traffic only through the tunnel, never over an open port, so the archive is invisible to the public internet.
BorgBackup with database dumps
Schedule mysqldump or pg_dump of your EMR database at the facility, then send it to the server with BorgBackup, which encrypts and deduplicates each nightly copy before it leaves the building.
Sizing
Estimating imaging storage
Set the slider to the number of studies you want to keep. We assume a mixed average of about 100 MB per study, typical of a facility doing mostly X-ray and ultrasound with some CT, and keep about 25% free.
- 1–7 thousand studies Storage S1 About 7,000 studies at roughly 100 MB each is near 700 GB, within the 1 TB disk with room for EMR database backups. Suits a single clinic with digital X-ray.
- 8–30 thousand studies Storage S2 Around 30,000 studies is about 3 TB of 4 TB. The 8 GB RAM comfortably runs Orthanc with a PostgreSQL index and a web viewer.
- 31–60 thousand studies Storage S3 Roughly 60,000 studies comes to about 6 TB of 8 TB, a fit for an imaging centre keeping several years of mixed modality work.
- 61–90 thousand studies Storage S4 About 90,000 studies uses around 9 TB of 12 TB, leaving space for encrypted database backups and growth from new CT or MRI volume.
- 91+ thousand studies Storage S5 Up to about 120,000 mixed studies fits 16 TB with headroom. CT- and MRI-heavy hospitals reach this sooner and may need several servers.
This is an estimate: a thin-slice CT or MRI study can run to several hundred megabytes, while a plain X-ray is far smaller, so your modality mix and compression settings decide real usage.
Storage S1
KES 2,000/mo
- 1 core
- 2 GB RAM
- 1 TB SATA storage
- 2 TB transfer
Storage S2
KES 5,000/mo
- 2 cores
- 8 GB RAM
- 4 TB SATA storage
- 8 TB transfer
Storage S3
KES 7,000/mo
- 4 cores
- 16 GB RAM
- 8 TB SATA storage
- 16 TB transfer
Storage S4
KES 15,000/mo
- 6 cores
- 24 GB RAM
- 12 TB SATA storage
- 24 TB transfer
Storage S5
KES 20,000/mo
- 8 cores
- 32 GB RAM
- 16 TB SATA storage
- 32 TB transfer
Before you go live
Securing a medical imaging archive
0 of 8 done. Tick them off as you go.
Built for Kenya
Health data rules in Kenya
Health data is sensitive personal data
The Data Protection Act, 2019 classes health information as sensitive personal data with stricter processing conditions. Facilities should be registered with the Office of the Data Protection Commissioner and able to show encryption, access control and a lawful basis for keeping each record.
Check where data may be processed
The Data Protection (General) Regulations, 2021 require some processing done for public-good purposes, including public health, to happen within Kenya. Public and contracted facilities should confirm their obligations and ask any provider, including us, where a server is hosted before storing patient data.
Power and links fail; plan for it
Facilities outside major towns often run on generators and a single internet line. Queue studies locally and let the transfer to the server catch up when the link returns. Orthanc can forward studies automatically once connectivity is back.
Questions
Medical imaging: your questions, answered
Can this replace our main PACS?
We recommend it as an archive and disaster-recovery copy, not the primary reading system. The plans use SATA disks over an internet link, which is fine for storing studies and pulling back priors, but radiologists reading all day are better served by a PACS on the local network.
Is it legal to store patient images on a hosted server in Kenya?
It can be, provided you meet the Data Protection Act, 2019 conditions for health data: a lawful basis, security measures such as encryption, access control and, for some public-good processing, keeping data in Kenya. Your data protection officer or legal adviser should confirm your specific obligations before you migrate.
How do studies get from our X-ray machine to the server?
Most modalities send studies using DICOM to a configured destination. Point that destination at a local Orthanc or your existing PACS, then have it forward each study to the Orthanc instance on the storage server through a WireGuard tunnel. Your modality vendor can confirm the settings.
Can we back up KenyaEMR to this server?
Yes. KenyaEMR runs on MySQL, so schedule a mysqldump on the facility server, encrypt it with BorgBackup or a similar tool, and send it over the tunnel. Restore a dump to a test machine regularly to prove the backup works and that you know the steps.
Do you have access to our patient data?
You hold root access and the encryption keys. If you encrypt data before it reaches the server, as we recommend, the stored files cannot be read without your keys. Keep those keys in your facility, recorded in your security policy, and never send them by email or WhatsApp.
Which plan suits a small clinic?
A clinic with digital X-ray and ultrasound usually starts on Storage S1 or S2, depending on how many years of studies it wants to keep. If you also run Orthanc with a database index and a web viewer for remote reporting, the extra memory on Storage S2 helps.
Also on Storage Hosting
Backup storage for what you need to keep
Ready to host your medical imaging?
Plans from KES 2,000 a month, paid by M-Pesa or card.
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