Industry · Healthcare

Storage Built for Patient Data and Clinical Workflows

TrueNAS delivers HIPAA-ready storage for PACS, DICOM archives, EHR systems, and clinical research — with FIPS 140 encryption, OpenZFS data integrity, and long-term retention at a fraction of proprietary SAN pricing.

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TrueNAS healthcare storage for PACS and EHR

The Challenge

Healthcare organizations face a storage problem unlike almost any other industry: data that must be retained for decades, accessed on-demand at any time, and protected with audit-grade integrity. A radiologist pulling a 10-year-old CT scan during a procedure cannot wait 30 seconds for a tape restore. And a single corrupted DICOM file that is not detected until it is needed in an emergency can have serious consequences.

TrueNAS addresses both. OpenZFS checksums every block at write time, catching corruption long before it becomes a clinical issue. Immutable ZFS snapshots create a point-in-time record that cannot be modified by ransomware or accidental deletion. FIPS 140 encryption protects PHI at rest and in flight. And TrueNAS scales from a single-site PACS archive to a multi-petabyte enterprise clinical repository — without per-TB licensing fees that scale with data growth.

How TrueNAS Supports Healthcare IT

From PACS archive to clinical research storage, a single platform for all healthcare data workloads.

Compliance and Security

TrueSecure — FIPS 140 Encryption and HIPAA-Ready Controls

TrueNAS TrueSecure delivers FIPS 140-2 validated encryption for data at rest using AES-256-GCM and supports in-flight encryption for all data transfers. KMIP key management integration enables external key management servers — a common requirement for HIPAA Business Associate Agreements. Per-dataset encryption with independent keys means a single compromised key never exposes the entire storage pool.

Active Directory and LDAP Integration

Join TrueNAS to your hospital or health system’s Active Directory domain. PACS administrators, radiology staff, and clinical researchers access only the datasets their AD group permits — no separate storage user management required.

Audit Logging

TrueNAS logs all dataset access, permission changes, and administrative actions with timestamps and source IP. Audit logs are exportable to SIEM platforms — supporting HIPAA audit trail requirements and forensic investigation after a security incident.

PACS, DICOM, and Clinical Data

PACS Archive Storage

TrueNAS serves as the primary or near-line archive for PACS systems from all major vendors. SMB and NFS shares are accessible directly from PACS gateways — no proprietary storage client required on the PACS server.

Long-Term DICOM Retention

TrueNAS M-Series scales to 30 PB raw on hybrid NVMe + HDD — large enough to retain decades of DICOM studies, mammography archives, and pathology images for a large hospital system on a single addressable namespace.

EHR and Clinical Application Storage

TrueNAS provides iSCSI and NFS storage for Epic, MEDITECH, Cerner, and other EHR platforms. VMware VAAI certified and Hyper-V compatible for virtualized EHR deployments with the performance clinical applications demand.

Clinical Research and Genomics

TrueNAS R60 with PCIe Gen5 NVMe and 400 GbE provides the throughput genomics pipelines and clinical research computing clusters require — with S3-compatible object storage for cloud-portable research datasets.

Business Continuity and Recovery

Dual-Controller High Availability

TrueNAS F-Series and M-Series ship with dual active-standby controllers. Controller failover completes in under 30 seconds with no data loss — ensuring PACS and EHR systems remain accessible during planned maintenance or an unexpected controller failure.

Ransomware-Resistant Snapshots

Immutable ZFS snapshots cannot be encrypted or deleted by ransomware processes that gain access to the network share. A healthcare system can roll back an entire PACS archive to a pre-infection state without paying a ransom or restoring from tape.

Automated Off-Site Replication

Replicate critical clinical datasets to a DR site TrueNAS or to HIPAA-eligible cloud storage on a defined RPO schedule. Encrypted replication over SSH ensures PHI is protected in transit to any remote destination.

OpenZFS Self-Healing Integrity

Every DICOM file, EHR record, and clinical dataset stored on TrueNAS is checksummed at block level. Silent data corruption — a real risk in long-term healthcare archives — is detected and repaired automatically from redundant copies before any clinical application reads the data.

Trusted by leading organizations

Recommended TrueNAS Systems for Healthcare & PACS

Models commonly chosen for this workload, with reasoning.

F-Series

TrueNAS F60

2U all-flash · 32-core · 9 PB

All-NVMe for PACS imaging and EHR low-latency workloads. Dual-controller HA, FIPS 140 encryption for HIPAA-aligned compliance.

View F60 →

F-Series

TrueNAS F100

2U all-flash · 48-core · 20 PB

Higher-density all-NVMe for hospital systems and imaging archives — 48-core, 20 PB effective, same HA and FIPS posture as F60.

View F100 →

M-Series

TrueNAS M40

4U · 10-core · 3 PB

Midrange HA hybrid when budget is tight but compliance and uptime requirements are still strict — NVMe cache + 25/100 GbE.

View M40 →

Authorized TrueNAS Reseller

Protect patient data the right way

Tell us your PACS vendor, EHR platform, data retention requirements, and compliance needs — we’ll size the right TrueNAS and stay on the order until it ships.

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Recommended Hardware for Healthcare

PACS Primary / EHR Storage

TrueNAS F-Series

All-flash dual-controller HA for active PACS, EHR, and clinical workloads. Sub-millisecond latency and up to 20 GB/s throughput with 9 PB effective capacity.

View F-Series

Long-Term DICOM Archive

TrueNAS M-Series

Dual-controller hybrid with NVMe caching and up to 30 PB raw HDD capacity. Designed for 10+ year DICOM retention with flash-tier retrieval performance for active studies.

View M-Series

Clinical Research / HPC

TrueNAS R60

PCIe Gen5 all-flash with 60 GB/s throughput and 400 GbE networking. Sized for genomics pipelines, clinical AI training, and high-performance research computing clusters.

View R60

Find Your Fit

Not sure which series fits your workload?

Four deployment paths. Pick the one that fits.

Home, Office & Remote Site

Quiet, compact ZFS storage for creators, home labs, and branch offices. ECC RAM, 10 GbE, and IPMI in a desktop or 1U chassis.

Mini X+ Mini R

Explore Mini Series

SMB & Mid-Market Rackmount

High-density hybrid and all-NVMe rackmount NAS. From 3.4 PB hybrid up to 60 GB/s NVMe.

R20 R50 R60

Explore R-Series

Enterprise HA & High-IOPS

Dual-controller failover with TrueCache NVDIMM, hybrid or all-flash, and 25/100 GbE. Built for VMware, SAP, and 24/7 business-critical workloads.

H-Series M-Series F-Series

Compare Enterprise

AI/ML & Petabyte Scale

Tri-mode SAS + Gen4 NVMe with 400 GbE fabric and 60 GB/s system bandwidth. MinIO AIStor object storage for GPU clusters and AI/ML pipelines.

V160

Explore V-Series