Bennett Davis, Hewlett Packard, reviews the issues involved with developing realistic storage architectures for the expanding requirements of medical image and record management. He explores the demands of long term file archival on limited IT budgets, and how to balance the demands for rapid access with constraints in IT spending. Davis outlines a multi-tier storage strategy to manage information effectively through its life cycle, and new archival technologies which overcome speed limitations and the high cost of enterprise storage systems. He provides pragmatic solutions in dealing with the explosive requirements of medical image and document management.