Data Center

[kenrav]

I have a customer that is undertaking a very ambitious project. They're a medical device manufacturer that receives (wired and wirelessly) data uploads from their patient's medical device each day. They plan to store this data in an Oracle or SQL Server database and provide a patient and physician portal that will allow authorized users the ability to view results, perform queries, generate reports, etc. As many of you know, this area of health informatics is becoming more and more popular.

However, I'm curious about the feasibility of such an undertaking. They currently have 5 million patients and add about 4 milion each year. As such, they'll start off adding 5 million records (rather small) EACH DAY! That's 1.8 Billion records each year! In five years, they'll be storing over 7 Billion data records. In addition to the extremely large number of records, users supposedly will be able to perform queries and do some data mining.

Their Project Manager told upper management that their solution is "scalable". In my mind, I'm thinking they'll need a data center somewhat along the lines of Google.

Theoretically, I realize this can be done. However, this is a mid-size company and have budgeted only a few million dollars for this project. I realize that this is a lot of money, but I'm also thinking that it won't cover the air conditioning bill at their data center. Seriously, in addition to the data center costs, how easy is it to perform queries accross several billion records?

What do you think?

Ken

[HansV]

Hi Ken,

I have forwarded your question to someone who is familiar with this field; I hope to get a reaction from him soon.

[HansV]

I got a reply from my contact.

InterSystems has an object-oriented database system (Caché) that can handle enormous amounts of data and is claimed to be much faster than a relational database system.
Kaiser Permanente, one of the larger health insurance companies in the USA, uses software from InterSystems to manage data (100 TB) of over 8 million patients.
Might be worth a look.

Disclaimer: neither my contact nor I use this software, nor are we in any other way involved with the companies mentioned.

[StuartR]

It's interesting that you mention Intersystems Caché.

When I worked for Digital Equipment Corporation in the 1980s we had a product called MUMPS which was a programming language and database for the healthcare industry. I believe that this evolved into Caché.

[kenrav]

Thanks guys. I've heard of cache' as well and will explore.

[JoeP]

IMO, your client should be looking at a cloud based solution. The initial investment will be much less than a data center already sized for a certain amount of expansion. With Windows Azure or Amazon Web Services you have virtually unlimited capacity in both storage and computers. You or they would have to make sure that the service is certified for whatever legal compliance is necessary.

Joe

[kenrav]

JoeP,

Thanks for your reply. I'm thinking cloud is the way to go as well. You're correct regarding legal compliance; being a healthcare provider, there appears to be a restriction with regard to HIPAA security on using a public cloud. However, private cloud is still an option,

Thanks.

Kenrav

[JoeP]

I know Microsoft is big on compliance certification in the US. I'm confident that they have either a Microsoft partner or in-house people who can explain what your options are with Azure.

Joe

[Timelord]

OK, this is a little biased. I recommend OnBase made by Hyland software (http://www.hyland.com" onclick="window.open(this.href);return false;). It is biased as I have worked for this company for 12+ years. We have a SaaS or Cloud solution and we work with many hospitals. We also have a premise based solution, which is where we started. I think you will find that our offerings are impressive.

[Timelord]

Hi again. I checked the rules and I know that I cannot post any more information about our company as that would be wrong, so is it ok if I just mention that we have a YouTube channel that will tell you tons about us? and if you want to contact me directly I would be most happy to discuss anything, and finally, I am not a salesperson and I am honest (gotten me in trouble on occasion)

[BobH]

I'm certainly no expert on HIPAA, but I do know for sure that if information can be associated with an individual, its disclosure to persons not authorized to see it is illegal and can result in very heavy fines for anyone not protecting that information. In the case of health care providers, it is even possible for them to lose their certification and eventually their licenses for violations (although I've not heard of any significant cases that have gone that far).

Laws can and do change, but I think the budget you mentioned might mostly be spent providing security and encryption and authentication controls adequate to protect themselves. A small company would be well advised to make haste slowly in this area.

One of the toughest lessons I ever learned as an IT manager - and the hardest to teach users - is that "Because you CAN does not mean you SHOULD!"

[Timelord]

BobH, I absolutely agree with you. Any company that has to work with compliance issues should be very careful in the product selected. Investigate any products that are placed in front of you. Put out an RFP to some of the many companies that do this type of work. Make sure that they have big name customers that like their service as well as smaller companies that are happy. That will mean the the product can start small but grow as needed. I know that in our business the sales cycle is long and part of that is due to the fact that there are a lot of choices, but also because there are vast differences in products.

[kenrav]

TimeLord - Thanks for the info. I'm glad you did post what you did because I need to be aware of solutions.

BobH - HIPAA is indeed very scary. There are a couple of "Rules" related to HIPAA (HIPAA Security RUle and HIPAA Privacy Rule) that are pretty intimidating and the consequences of non-compliance are strict. Unfortunately, they're not "hard and fast" rules and often open to interpretation. The good news is that every so often, Medicare, the Office of Inspector General and others come out with a clarification regarding what you can and cannot do. Long story short is like you said "be very careful."

FYI, I'm not doing this particular project for this customer - I'm sitting on the sidelines on this one. I'm just curious whether they can accomplish what they've set out to do. It just seems to me that a company like American Airlines processes 300 million or so reservation transactions each year and I bet they spend tens or hundreds of millions of dollars each year on their data center. I just find it intereresting that my client plans to manage a billion records a year without any real experience in data warehousing. (Again, it's not simply storage; it's data mining, transactions, etc.) Of course, I wish them the best of luck.

Although I'm not doing this project, I will be doing others (it's the next "killer app" in the healthcare informatics area.) Stay tuned...