Choosing the Most Efficient Database for a Web-Based System to Store and Exchange Ophthalmologic Health Records

Response times are a critically important parameter when implementing any telematics application. Hence, it is important to evaluate those times to check the performance of the system. Different database will get different response times. This paper presents a response time comparative analysis of the Web system of Electronic Health Record (EHRs), TeleOftalWeb, with the four databases used: Oracle 10 g, dbXML 2.0, Xindice 1.2, and eXist 1.1.1. Final goal of the comparison is choosing the database providing lower response times in TeleOftalWeb. Results obtained using the four databases proposed give the native XML database eXist an edge which, added to other features such as being a free software and easy to set up, makes us opting for it. TeleOftalWeb is being used by 20 specialists from the Institute of Applied Ophthalmobiology (Instituto de Oftalmobiología Aplicada, IOBA) of the University of Valladolid, Spain. At this time, there are more than 1000 EHRs and over 2000 fundus photographs of diabetic patients stored in the system.

[1]  Seo-Young Noh,et al.  An XML-based methodology for parametric temporal database model implementation , 2008, J. Syst. Softw..

[2]  D. Lam,et al.  OphthWeb---cost-effective telemedicine for ophthalmology. , 1998, Hong Kong medical journal = Xianggang yi xue za zhi.

[3]  Astrid M. van Ginneken,et al.  Technical Brief: OpenSDE: Row Modeling Applied to Generic Structured Data Entry , 2004, J. Am. Medical Informatics Assoc..

[4]  David Smith,et al.  A physician's perspective: deploying the EMR. , 2002, Journal of healthcare information management : JHIM.

[5]  Paola Inverardi,et al.  Experimenting different software architectures performance techniques: a case study , 2004, WOSP '04.

[6]  E. Coleman,et al.  Using electronic health records to improve care: will "high tech" allow a return to "high touch" medicine? , 2005, Journal of the American Medical Directors Association.

[7]  Wolfgang Meier,et al.  eXist: An Open Source Native XML Database , 2002, Web, Web-Services, and Database Systems.

[8]  Charles Safran,et al.  CareWeb™, a web-based medical record for an integrated health care delivery system , 1999, Int. J. Medical Informatics.

[9]  I.B. Hansen.  CipherMe: Personal Electronic Health Records in the Hands of Patients-Owners , 2006, 1st Transdisciplinary Conference on Distributed Diagnosis and Home Healthcare, 2006. D2H2..

[10]  Jan-Henk Gerritsen.  Native XML databases , 2006 .

[11]  Donald W. Simborg,et al.  Viewpoint Paper: Promoting Electronic Health Record Adoption. Is It the Correct Focus? , 2008, J. Am. Medical Informatics Assoc..

[12]  D. Gans,et al.  Medical groups' adoption of electronic health records and information systems. , 2005, Health affairs.

[13]  Mark Ginsburg,et al.  Pediatric Electronic Health Record Interface Design: The PedOne System , 2007, 2007 40th Annual Hawaii International Conference on System Sciences (HICSS'07).

[14]  Arie Hasman,et al.  Development and implementation of an EPR: how to encourage the user , 2001, Int. J. Medical Informatics.

[15]  Charles Safran,et al.  Electronic patient records and the impact of the Internet , 2000, Int. J. Medical Informatics.

[16]  Y. Kim,et al.  Web-Based Personal-Centered Electronic Health Record for Elderly Population , 2006, 1st Transdisciplinary Conference on Distributed Diagnosis and Home Healthcare, 2006. D2H2..

[17]  Rong Chen,et al.  Julius – a template based supplementary electronic health record system , 2007, BMC Medical Informatics Decis. Mak..

[18]  Yuh-Shan Ho,et al.  Scientific production of electronic health record research, 1991-2005 , 2007, Comput. Methods Programs Biomed..

[19]  Karen C. Davis,et al.  An XML/XPath query language and XMark performance study , 2003, 2003 Symposium on Applications and the Internet, 2003. Proceedings..