*Result*: Examining database persistence of ISO/EN 13606 standardized electronic health record extracts: relational vs. NoSQL approaches.

Title:
Examining database persistence of ISO/EN 13606 standardized electronic health record extracts: relational vs. NoSQL approaches.
Authors:
Sánchez-de-Madariaga R; Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), c/Sinesio Delgado, 4 -, 28029, Madrid, Spain. ricardo.sanchez@isciii.es., Muñoz A; Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), c/Sinesio Delgado, 4 -, 28029, Madrid, Spain., Lozano-Rubí R; Medical Informatics, Hospital Clínic, Unit of Medical Informatics, University of Barcelona, Barcelona, Spain.; Department of Computer Science, Autonomous Univerity of Barcelona, Barcelona, Spain., Serrano-Balazote P; Doce de Octubre University Hospital, Madrid, Spain., Castro AL; Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), c/Sinesio Delgado, 4 -, 28029, Madrid, Spain., Moreno O; Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), c/Sinesio Delgado, 4 -, 28029, Madrid, Spain., Pascual M; Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), c/Sinesio Delgado, 4 -, 28029, Madrid, Spain.
Source:
BMC medical informatics and decision making [BMC Med Inform Decis Mak] 2017 Aug 18; Vol. 17 (1), pp. 123. Date of Electronic Publication: 2017 Aug 18.
Publication Type:
Comparative Study; Journal Article
Language:
English
Journal Info:
Publisher: BioMed Central Country of Publication: England NLM ID: 101088682 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6947 (Electronic) Linking ISSN: 14726947 NLM ISO Abbreviation: BMC Med Inform Decis Mak Subsets: MEDLINE
Imprint Name(s):
Original Publication: London : BioMed Central, [2001-
MeSH Terms:
Database Management Systems/*standards , Electronic Health Records/*standards , Information Storage and Retrieval/*standards, Algorithms ; Databases, Factual ; Reference Standards
References:
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Contributed Indexing:
Keywords: Algorithmic complexity; Clinical practice; Document-based task; Electronic health record extract; ISO/EN 13606 standard; NoSQL database; Normalized medical information; Primary use; Relational database; Secondary research use
Entry Date(s):
Date Created: 20170820 Date Completed: 20180403 Latest Revision: 20231112
Update Code:
20260130
PubMed Central ID:
PMC5563027
DOI:
10.1186/s12911-017-0515-4
PMID:
28821246
Database:
MEDLINE

*Further Information*

*Background: The objective of this research is to compare the relational and non-relational (NoSQL) database systems approaches in order to store, recover, query and persist standardized medical information in the form of ISO/EN 13606 normalized Electronic Health Record XML extracts, both in isolation and concurrently. NoSQL database systems have recently attracted much attention, but few studies in the literature address their direct comparison with relational databases when applied to build the persistence layer of a standardized medical information system.
Methods: One relational and two NoSQL databases (one document-based and one native XML database) of three different sizes have been created in order to evaluate and compare the response times (algorithmic complexity) of six different complexity growing queries, which have been performed on them. Similar appropriate results available in the literature have also been considered.
Results: Relational and non-relational NoSQL database systems show almost linear algorithmic complexity query execution. However, they show very different linear slopes, the former being much steeper than the two latter. Document-based NoSQL databases perform better in concurrency than in isolation, and also better than relational databases in concurrency.
Conclusion: Non-relational NoSQL databases seem to be more appropriate than standard relational SQL databases when database size is extremely high (secondary use, research applications). Document-based NoSQL databases perform in general better than native XML NoSQL databases. EHR extracts visualization and edition are also document-based tasks more appropriate to NoSQL database systems. However, the appropriate database solution much depends on each particular situation and specific problem.*