On Wednesday 20 September 2006 09:41, [EMAIL PROTECTED] wrote:
> The presupposition I read into your scenario is that all the data you
> describe is locked into a SINGLE document, like a database record locks up
> all patient info, where as under our model that would seem to be unlikely (
> but not impossible). The matter is the granularity of the forms system you
> develop for your context. If each one of those users are recording
> different info on different forms then there is no concurrency issues
> whatsoever. Each form is stored in the database as a document linked by
> the patient identifier, and when you as the doctor retrieve the practice
> nurse's form of test results you see it EXACTLY as she recorded it, as if
> it were a piece of paper.

I said I worry about concurrency *and* referential integrity.

If you break up the document into multiple sub-documents (basically mapping a 
document to a form in the simplest case?) you might run into situations where 
you have to record the same parameter in multiple documents - e.g. blood 
pressure in the context of an emergency visit, a diabetes visit, an antenatal 
visit, a practice nurse encounter etc. - possibly represented via different 
forms, possibly mapped onto several documents, but always the same entity - a 
blood pressure reading.

How to you handle it? If I refer in my own health record to the practice 
nurse's record and she realizes she actually entered it for the wrong patient 
the next day - how do you preserve referential integrity in such scenario 
with your document centric paradigm?

I am very interested in solutions for this problem - a more document centric 
storage would make my work a lot easier if I could overcome these problems 
myself.

Horst
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