On Sat, 2003-06-07 at 13:43, David Forslund wrote: > >relational mapping that is sometimes done just so people 'feel' better > >about the data being stored in a RDBMS. <s> > > I don't do it so people "feel" better.
David, that comment was not meant for you personally and please note that I did say *sometimes*....we both know that is true. I have a GREAT deal of respect for the work you do as well as your knowledge and insight. > mapping can actually enhance those. If I had a good, high-performance, > scalable, open source ODBMS, I would use it. The ones I've used that > are good are not open source. Hhi performance is certainly an issue....and the big trade off. Scalable, I think you can find in opensource. > I don't think it is a 'whiz-bang' solution. I think it is the only > possible solution > with the exception that a single vendor owns everything. There are easy > solutions for replication of databases, caching and related issues so that > an given server doesn't have to be up 24/365. Federation and everyone up > 24/365 are really orthogonal. See my comments in the response to Richard Schilling. > Records today aren't available when they are needed even within a given > hospital. I don't know how to consolidate across international boundaries > let alone between two hospitals across the street from one another. They > don't want to do it. Consolidation in a region doesn't rule out > federation on > a larger scale. I think consolidation in a region makes good sense with the > caveat given below. The consolidation may take the form of a secondary > caching server to ensure the data has high availability. WOW! Are we ever in different worlds. I'll come back to this. <s> > But the data degrades as it is transmitted. Transmission doesn't cause it to degrade. Relational mapping causes it to degrade. If a document (in any standard format) is retained as a document it does not degrade. > This happens a lot in the US. > The change in an HMO which might occur every two years, results in significant > information being lost as the data is moved from one provider to > another. I have first hand information of this happening. And the cause is due to one system schema not mapping directly to the other....correct? > Also as a patient gets referred from > one provider to another, the information doesn't flow. It doesn't even flow > between two locations (offices) for the same physician. My point exactly. There is no concept of the master record. The politics of who owns the data is a prime driver for this problem. In the US, HIPAA should be a useful lever to solve that issue. Put all my healthcare data in one place where I can get to it and control it better as a patient. Cheers, Tim
