You are viewing a plain text version of this content. The canonical link for it is here.
Posted to user@couchdb.apache.org by Albin Stigö <al...@gmail.com> on 2014/03/24 15:07:36 UTC
healthcare projects running on couched?
Hi,
I'm an MD and developer. I've been using couchdb for a few years for
various projects.
I always thought couchdb would be a really good fit for various
patient record systems. Especially in remote areas with spotty
connection, or perhaps no connection at all, as you could run a local
version, then physically move it and sync later.
Anyways, I haven't really come across any so if you know about any
companies / projects I would be interested to hear about them!
Thanks,
Albin
Re: healthcare projects running on couched?
Posted by Jens Alfke <je...@couchbase.com>.
On Mar 24, 2014, at 7:07 AM, Albin Stigö <al...@gmail.com> wrote:
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
In general, yes. But in the US, HIPAA regulations seem to be pretty strict about the security of databases that store medical records, so one would need to ensure that the database is stored on an encrypted filesystem and the replication always runs over an SSL connection. (I remembered just in time to add “in the US”! :) I’m sure the EU has similar regulations.)
(Disclaimer: I don’t know anything first-hand about HIPAA, but I’ve talked with several developers of medical apps, especially mobile apps, who’ve shared these kinds of concerns.)
Another reason CouchDB is a good fit is that its ecosystem includes several mobile-ready implementations that can be used to sync records to/from phones and tablets. These include Couchbase Lite, PouchDB, and Cloudant’s mobile sync SDK.
—Jens
Re: healthcare projects running on couched?
Posted by Kevin Coombes <ke...@gmail.com>.
Check out 4medica. I'm not sure if they use CouchDB, but I know they are
aware of it. (My connection with them is indirect. The son of their CEO did
a summer internship with me and I had him work on a couchdb project. When I
met his father, he was perhaps more excited about the project than his son
was.)
Kevin
On Mar 24, 2014 10:08 AM, "Albin Stigö" <al...@gmail.com> wrote:
> Hi,
>
> I'm an MD and developer. I've been using couchdb for a few years for
> various projects.
>
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
>
> Anyways, I haven't really come across any so if you know about any
> companies / projects I would be interested to hear about them!
>
> Thanks,
> Albin
>
Re: healthcare projects running on couched?
Posted by Manokaran K <ma...@gmail.com>.
On Mon, Mar 24, 2014 at 10:02 PM, Jens Alfke <je...@couchbase.com> wrote:
>
>
> The replication model even supports peer-to-peer sync, which would allow users to share data in a situation like a disaster area or wilderness where there is no network infrastructure available. (I'm not making this up: I have heard of NGOs using CouchDB-based systems in refugee camps in Africa.)
"Lake Tanganyika Floating Health Clinic" here: https://iilab.org/
Re: healthcare projects running on couched?
Posted by Jens Alfke <je...@couchbase.com>.
On Mar 24, 2014, at 9:19 AM, אורן שני <or...@gmail.com> wrote:
> Id appreciate it if you could elaborate a little about why do you think
> couchDB is more fit for medinfo projects, comparing to SQL DB's.
The ease of data synchronization/replication, primarily. This is more robust: there’s no central point of failure, and the data can be stored near the people who need access to it. And as I just posted, there are several mobile implementations that allow the data to be stored literally in the user’s pocket where it can be accessed and updated even while offline.
The replication model even supports peer-to-peer sync, which would allow users to share data in a situation like a disaster area or wilderness where there is no network infrastructure available. (I’m not making this up: I have heard of NGOs using CouchDB-based systems in refugee camps in Africa.)
—Jens
Fwd: healthcare projects running on couched?
Posted by Garren Smith <ga...@apache.org>.
This is something that could be added to Couchdb weekly. Taken from the user@couchdb.apache.org
Begin forwarded message:
> From: Albin Stigö <al...@gmail.com>
> Subject: Re: healthcare projects running on couched?
> Date: 25 March 2014 at 11:54:33 AM SAST
> To: "user@couchdb.apache.org" <us...@couchdb.apache.org>
> Reply-To: user@couchdb.apache.org
>
> Thanks for all the replies, it seems couchdb is already used in many
> medical systems around the globe. I took the liberty to provide a
> summery.
>
> The reasons I think couchdb is an interesting fit are;
> from my developer point of view:
>
> 1. Relative ease of delpoyment, clean implementation, proven platform
> (erlang). Relativley simple configuration.
> 2. Easy synchronization let's you work without a single point of
> failure, spotty connections, in p2p configuration. Easy backups.
> 3. Ready for mobile (did I mention spotty connectinos in the hospital basement?)
> 4. Attachments (there are always scans, photos etc)
> 5. Changes streams provide easy notifications when something changed,
> new test results arrived etc. This is very convenient.
>
> Regarding conflict management, this is both and issue and a none
> issue. It has happened to me some times as a physician that I have
> experienced "conflicts" and that my changes were just overwritten by
> someone else (gasp). If there's a conflict both version always need to
> be saved. In medical records you never really delete or change
> anything, you make additions. Like a ledger.
>
> From my physician point of view (and what I know my colleagues think):
>
> 1. It should just work, right away. When I push the button it should
> be saved. Physicians are used to eventual consistency because we
> dictate a lot and it was previously transcribed my secretaries so it
> didn't appear right away anyway. But we could be sure it would. No
> locks. NO LOCKS!!!
>
> 2. Maximize uptime (by using a p2p you have a redundant system)
>
> 3. When new data arrives the screen should updated automatically.
>
> --Albin
>
> Links provided in earlier replies:
>
> http://www.4medica.com
> Are aware of couchdb but we don't know to what extent they use it.
>
> http://www.commcarehq.org/home/
> Their backend is couchdb.
>
> http://www.mobiusmed.com/
> Use it as a backing store for at least two products.
>
> http://neurofoundation.in
> Use it as their backend for their EMR system.
>
> https://iilab.org
> Not sure how they use couchdb.
>
> On Tue, Mar 25, 2014 at 12:47 AM, Jens Alfke <je...@couchbase.com> wrote:
>>
>> On Mar 24, 2014, at 10:10 AM, אורן שני <or...@gmail.com> wrote:
>>
>>> How abiut couchDB's conflict resoloution mechanism vs SQL DB's using locks.
>>> Do you think that is a major concideration?
>>
>> You can’t use locking in a widely-distributed system, or one client forgetting to release a lock would block everyone else (either forever or until the lease runs out.) It also makes offline updates impossible.
>>
>> I’ve heard of relational-db-based systems that do replication, but they don’t attempt to propagate locks. Instead they do conflict resolution during replication the same way CouchDB does.
>>
>> —Jens
Re: healthcare projects running on couched?
Posted by Albin Stigö <al...@gmail.com>.
Thanks for all the replies, it seems couchdb is already used in many
medical systems around the globe. I took the liberty to provide a
summery.
The reasons I think couchdb is an interesting fit are;
from my developer point of view:
1. Relative ease of delpoyment, clean implementation, proven platform
(erlang). Relativley simple configuration.
2. Easy synchronization let's you work without a single point of
failure, spotty connections, in p2p configuration. Easy backups.
3. Ready for mobile (did I mention spotty connectinos in the hospital basement?)
4. Attachments (there are always scans, photos etc)
5. Changes streams provide easy notifications when something changed,
new test results arrived etc. This is very convenient.
Regarding conflict management, this is both and issue and a none
issue. It has happened to me some times as a physician that I have
experienced "conflicts" and that my changes were just overwritten by
someone else (gasp). If there's a conflict both version always need to
be saved. In medical records you never really delete or change
anything, you make additions. Like a ledger.
>From my physician point of view (and what I know my colleagues think):
1. It should just work, right away. When I push the button it should
be saved. Physicians are used to eventual consistency because we
dictate a lot and it was previously transcribed my secretaries so it
didn't appear right away anyway. But we could be sure it would. No
locks. NO LOCKS!!!
2. Maximize uptime (by using a p2p you have a redundant system)
3. When new data arrives the screen should updated automatically.
--Albin
Links provided in earlier replies:
http://www.4medica.com
Are aware of couchdb but we don't know to what extent they use it.
http://www.commcarehq.org/home/
Their backend is couchdb.
http://www.mobiusmed.com/
Use it as a backing store for at least two products.
http://neurofoundation.in
Use it as their backend for their EMR system.
https://iilab.org
Not sure how they use couchdb.
On Tue, Mar 25, 2014 at 12:47 AM, Jens Alfke <je...@couchbase.com> wrote:
>
> On Mar 24, 2014, at 10:10 AM, אורן שני <or...@gmail.com> wrote:
>
>> How abiut couchDB's conflict resoloution mechanism vs SQL DB's using locks.
>> Do you think that is a major concideration?
>
> You can’t use locking in a widely-distributed system, or one client forgetting to release a lock would block everyone else (either forever or until the lease runs out.) It also makes offline updates impossible.
>
> I’ve heard of relational-db-based systems that do replication, but they don’t attempt to propagate locks. Instead they do conflict resolution during replication the same way CouchDB does.
>
> —Jens
Re: healthcare projects running on couched?
Posted by Jens Alfke <je...@couchbase.com>.
On Mar 24, 2014, at 10:10 AM, אורן שני <or...@gmail.com> wrote:
> How abiut couchDB's conflict resoloution mechanism vs SQL DB's using locks.
> Do you think that is a major concideration?
You can’t use locking in a widely-distributed system, or one client forgetting to release a lock would block everyone else (either forever or until the lease runs out.) It also makes offline updates impossible.
I’ve heard of relational-db-based systems that do replication, but they don’t attempt to propagate locks. Instead they do conflict resolution during replication the same way CouchDB does.
—Jens
Re: healthcare projects running on couched?
Posted by Manokaran K <ma...@gmail.com>.
On Mon, Mar 24, 2014 at 10:40 PM, אורן שני <or...@gmail.com> wrote:
> How abiut couchDB's conflict resoloution mechanism vs SQL DB's using locks.
> Do you think that is a major concideration?
>
If you make the documents sufficiently granular, the probability of
two or more users editing the same doc at the same time is negligible
in a hospital setup. So IMO conflict resolution is not important.
Regds,
mano
Re: healthcare projects running on couched?
Posted by אורן שני <or...@gmail.com>.
How abiut couchDB's conflict resoloution mechanism vs SQL DB's using locks.
Do you think that is a major concideration?
Oren
On Monday, March 24, 2014, Manokaran K <ma...@gmail.com> wrote:
> CouchDB replication and its availability on mobile devices will make
> it possible to provide a feature where a patient can sync her own
> medical history from her mobile device (after some form of
> authentication and authorization) with the hospital's EMR before and
> after treatment. This would be pretty difficult using relational
> databases.
>
> regds,
> mano
>
> On Mon, Mar 24, 2014 at 9:49 PM, אורן שני <orenshani7@gmail.com<javascript:;>>
> wrote:
> > Albin & all,
> >
> > Id appreciate it if you could elaborate a little about why do you think
> > couchDB is more fit for medinfo projects, comparing to SQL DB's.
> >
> > Many thanks,
> >
> > Oren
> >
> > On Monday, March 24, 2014, Albin Stigö <albin.stigo@gmail.com<javascript:;>>
> wrote:
> >
> >> Hi,
> >>
> >> I'm an MD and developer. I've been using couchdb for a few years for
> >> various projects.
> >>
> >> I always thought couchdb would be a really good fit for various
> >> patient record systems. Especially in remote areas with spotty
> >> connection, or perhaps no connection at all, as you could run a local
> >> version, then physically move it and sync later.
> >>
> >> Anyways, I haven't really come across any so if you know about any
> >> companies / projects I would be interested to hear about them!
> >>
> >> Thanks,
> >> Albin
> >>
>
>
>
> --
> Lord, give us the wisdom to utter words that are gentle and tender,
> for tomorrow we may have to eat them.
> -Sen. Morris Udall
>
Re: healthcare projects running on couched?
Posted by Manokaran K <ma...@gmail.com>.
CouchDB replication and its availability on mobile devices will make
it possible to provide a feature where a patient can sync her own
medical history from her mobile device (after some form of
authentication and authorization) with the hospital's EMR before and
after treatment. This would be pretty difficult using relational
databases.
regds,
mano
On Mon, Mar 24, 2014 at 9:49 PM, אורן שני <or...@gmail.com> wrote:
> Albin & all,
>
> Id appreciate it if you could elaborate a little about why do you think
> couchDB is more fit for medinfo projects, comparing to SQL DB's.
>
> Many thanks,
>
> Oren
>
> On Monday, March 24, 2014, Albin Stigö <al...@gmail.com> wrote:
>
>> Hi,
>>
>> I'm an MD and developer. I've been using couchdb for a few years for
>> various projects.
>>
>> I always thought couchdb would be a really good fit for various
>> patient record systems. Especially in remote areas with spotty
>> connection, or perhaps no connection at all, as you could run a local
>> version, then physically move it and sync later.
>>
>> Anyways, I haven't really come across any so if you know about any
>> companies / projects I would be interested to hear about them!
>>
>> Thanks,
>> Albin
>>
--
Lord, give us the wisdom to utter words that are gentle and tender,
for tomorrow we may have to eat them.
-Sen. Morris Udall
Re: healthcare projects running on couched?
Posted by Jens Alfke <je...@couchbase.com>.
On Mar 24, 2014, at 9:19 AM, אורן שני <or...@gmail.com> wrote:
> Id appreciate it if you could elaborate a little about why do you think
> couchDB is more fit for medinfo projects, comparing to SQL DB's.
The ease of data synchronization/replication, primarily. This is more robust: there’s no central point of failure, and the data can be stored near the people who need access to it. And as I just posted, there are several mobile implementations that allow the data to be stored literally in the user’s pocket where it can be accessed and updated even while offline.
The replication model even supports peer-to-peer sync, which would allow users to share data in a situation like a disaster area or wilderness where there is no network infrastructure available. (I’m not making this up: I have heard of NGOs using CouchDB-based systems in refugee camps in Africa.)
—Jens
Re: healthcare projects running on couched?
Posted by Manokaran K <ma...@gmail.com>.
Hi,
I have developed an EMR with CouchDB as the backend and
node.js/express.js/backbone.js, deployed in a small hospital in southern
India (neurofoundation.in). Its a small hospital (about 100 beds) so there
was no need for clustering or replicating across dbs.
Regds,
mano
On Mon, Mar 24, 2014 at 9:49 PM, אורן שני <or...@gmail.com> wrote:
> Albin & all,
>
> Id appreciate it if you could elaborate a little about why do you think
> couchDB is more fit for medinfo projects, comparing to SQL DB's.
>
> Many thanks,
>
> Oren
>
> On Monday, March 24, 2014, Albin Stigö <al...@gmail.com> wrote:
>
> > Hi,
> >
> > I'm an MD and developer. I've been using couchdb for a few years for
> > various projects.
> >
> > I always thought couchdb would be a really good fit for various
> > patient record systems. Especially in remote areas with spotty
> > connection, or perhaps no connection at all, as you could run a local
> > version, then physically move it and sync later.
> >
> > Anyways, I haven't really come across any so if you know about any
> > companies / projects I would be interested to hear about them!
> >
> > Thanks,
> > Albin
> >
>
--
Lord, give us the wisdom to utter words that are gentle and tender, for
tomorrow we may have to eat them.
-Sen. Morris Udall
Re: healthcare projects running on couched?
Posted by אורן שני <or...@gmail.com>.
Albin & all,
Id appreciate it if you could elaborate a little about why do you think
couchDB is more fit for medinfo projects, comparing to SQL DB's.
Many thanks,
Oren
On Monday, March 24, 2014, Albin Stigö <al...@gmail.com> wrote:
> Hi,
>
> I'm an MD and developer. I've been using couchdb for a few years for
> various projects.
>
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
>
> Anyways, I haven't really come across any so if you know about any
> companies / projects I would be interested to hear about them!
>
> Thanks,
> Albin
>
Re: healthcare projects running on couched?
Posted by אורן שני <or...@gmail.com>.
Albin & all,
Id appreciate it if you could elaborate a little about why do you think
couchDB is more fit for medinfo projects, comparing to SQL DB's.
Many thanks,
Oren
On Monday, March 24, 2014, Albin Stigö <al...@gmail.com> wrote:
> Hi,
>
> I'm an MD and developer. I've been using couchdb for a few years for
> various projects.
>
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
>
> Anyways, I haven't really come across any so if you know about any
> companies / projects I would be interested to hear about them!
>
> Thanks,
> Albin
>
Re: healthcare projects running on couched?
Posted by "Eli Stevens (Gmail)" <wi...@gmail.com>.
Mobius Medical Systems, LP uses CouchDB as the backing store for
Mobius3D and MobiusFX.
http://www.mobiusmed.com/
None of the CouchDB features are particularly visible to the end user
(ie. no from-the-field replication, etc.).
On Mon, Mar 24, 2014 at 7:07 AM, Albin Stigö <al...@gmail.com> wrote:
> Hi,
>
> I'm an MD and developer. I've been using couchdb for a few years for
> various projects.
>
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
>
> Anyways, I haven't really come across any so if you know about any
> companies / projects I would be interested to hear about them!
>
> Thanks,
> Albin
Re: healthcare projects running on couched?
Posted by Cory Zue <cz...@dimagi.com>.
CommCare's backend is built on couchdb: http://www.commcarehq.org/home/
On Mon, Mar 24, 2014 at 10:35 AM, Alexander Shorin <kx...@gmail.com> wrote:
> The one I know is http://medicmobile.org/2013/06/25/announcing-kujua/
>
> As for my experience: I developed LIS frontend system on CouchDB and
> could say that it's perfectly suited to this task and it would be fine
> for EMR systems too.
>
> Also check this thread for more information:
> http://www.mail-archive.com/user%40couchdb.apache.org/msg16346.html
>
> --
> ,,,^..^,,,
>
>
> On Mon, Mar 24, 2014 at 6:07 PM, Albin Stigö <al...@gmail.com>
> wrote:
> > Hi,
> >
> > I'm an MD and developer. I've been using couchdb for a few years for
> > various projects.
> >
> > I always thought couchdb would be a really good fit for various
> > patient record systems. Especially in remote areas with spotty
> > connection, or perhaps no connection at all, as you could run a local
> > version, then physically move it and sync later.
> >
> > Anyways, I haven't really come across any so if you know about any
> > companies / projects I would be interested to hear about them!
> >
> > Thanks,
> > Albin
>
Re: healthcare projects running on couched?
Posted by Alexander Shorin <kx...@gmail.com>.
The one I know is http://medicmobile.org/2013/06/25/announcing-kujua/
As for my experience: I developed LIS frontend system on CouchDB and
could say that it's perfectly suited to this task and it would be fine
for EMR systems too.
Also check this thread for more information:
http://www.mail-archive.com/user%40couchdb.apache.org/msg16346.html
--
,,,^..^,,,
On Mon, Mar 24, 2014 at 6:07 PM, Albin Stigö <al...@gmail.com> wrote:
> Hi,
>
> I'm an MD and developer. I've been using couchdb for a few years for
> various projects.
>
> I always thought couchdb would be a really good fit for various
> patient record systems. Especially in remote areas with spotty
> connection, or perhaps no connection at all, as you could run a local
> version, then physically move it and sync later.
>
> Anyways, I haven't really come across any so if you know about any
> companies / projects I would be interested to hear about them!
>
> Thanks,
> Albin