Evaluation of database software in a medical environment

During the last decade database technology has been many advances. The HELP hospital information system, designed and used at LDS hospital in Salt Lake City, Utah, was developed before many commercially designed databases became available. Due to the unique qualities associated with medical data, it was deemed appropriate to compare the HELP hospital database system with commercial database systems. A set of patient data was converted into the database format required by various database systems. Some of these systems were used with a personal computer while others were used with a larger, multi-user computer. Six queries were formulated to represent common interrogations of the database. The time required by each database system to execute each query was measured. The disk space required by each system to store the patient data was also measured. Additionally, four file structures proposed as alternatives to that currently used by HELP system were evaluated. When the quantity of information to be retrieved from the database was small, differences between the various systems were small. When the commercial databases were required to maintain a view of clinical data similar to that presented by the HELP database, the commercial database retrieval time were comparatively slow. Three of the four proposed file structures yield roughly the same performance as the present HELP file structure. The fourth yield unsatisfactory query performance. The database systems used with a personal computer performed well enough to demonstrate that a personal computer can perform adequately as a small database host. Query execution time is but one aspect of a database system. More complete simulations of daily database usage with a representative sample of patient data would be necessary to draw conclusion about the overall appropriateness of the database systems tested. Clinical information consists of a vast number of patient attributes and is largely historical. The HELP database systems addresses these issues specifically while the commercially developed databases to not. When considering only retrieval time and storage space, the HELP database system performs in a medial setting as well as or better any of the commercial database systems evaluated.