At 04:56 PM 6/7/2003 -0500, Tim Cook wrote:
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.

I took no offense. I understand the "feel better" reason. I don't want the DBMS
to be an obstacle for people. Our software is now being used at the City of Hope
for managing clinical trials and they are pleased so far with this "new" approach
to handing data. They have been dyed in the wool RDBMS folks. They "feel
better" that I'm using a RDBMS under the hood, but understand that it would work
as well or better with an ODBMS



> 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.

Can you point me to a good, scalable, adequately performing, open source OODBMS? It isn't clear to me that ZODB meets these requirements, and I don't have a Java API to it. I've used storedobjects but it has some problems with scalability.


> 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>

Actually I think this is a good reason for consolidation. And consolidated systems
can then be federated. The consolidation can do some data normalization and
actually help. This was the plan for the GCPR. The problem of federation is eased,
and remember federation doesn't mean a single level of federation. A multi-tiered
federated approach would meet your requirements.




> 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?

Could be one reason. I think there are many. Some data is not regarded
as important by another, but this might be regarded as a "schema" problem.
Some data isn't even collected electronically. All of the important ED data in ABQ, for example,
is collected only on paper. One of the teaching hospitals refuses to use an electronic
chart precisely because it is a teaching hospital and they don't want the interns to have
an electronic "crutch".



> 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.

I think it is still a dream to have it in one place. You can get your financial
data today, but it isn't in one place, and isn't necessary very accurate, either.
When the data gets "moved", information gets lost. It isn't the electronic
transfer itself that is the problem, it certainly may be in definition of terms.



Dave



Cheers,
Tim



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