ISO/TS. First edition. Health informatics — Electronic health record communication ISO’s member body in the country of the requester. ISO/TS (E). PDF disclaimer. This PDF file may contain embedded typefaces. In accordance with Adobe’s licensing policy, this file. SPECIFICATION. ISO/TS. First edition. Health informatics — Electronic health record communication —. Part 4: Security. Informatique de.

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Schema management for document stores. ORM implies the construction of many tables related through foreign keys representing the complex structure of iwo extract XML file and may damage performance.

ISO/TS 13606-4:2009

All authors read and approved the final manuscript. In the case of MongoDB implementing an extremely big database, its apparent flatter 13066-4 behaviour would favour it versus a relational approach, in which joins of ever growing relational tables would produce high-slope linear complexity.

In general, this NoSQL approach is adequate for a so-called document-based application. Table 6 Shows illustrative data from three relational database 1366-4 systems presented in [ 16 ]. Q1 achieves much higher throughput in the MongoDB setting than in the relational database.

ISO 13606 specifications

This approach has the advantage of a tabular relational structure with less tables and join operations, and the direct query of fine-grained 13606-44 using the paths extracted from archetypes.

Feasibility and usefulness of a repository for secundary use for breast cancer patients.

It seems that concurrent execution favours MongoDB, since these queries execute sio concurrently than in isolation. Non-relational NoSQL databases seem to be more appropriate than standard relational SQL databases when database size is extremely high secondary use, research applications.

RSM designed and wrote the manuscript. This figure also shows clearly the considerably steeper linear slope of the relational approach relative to its NoSQL counterpart.


International Classification for Standards ICS is an international classification system for technical standards. In the ARM process, a new relational database schema, different from the direct relational schema used in the ORM, is generated. If you need help with the purchase or have any queries please email enquiries standards. Monteagudo JL, Pascual M. However if the main task carried out by the DBMS is a document-based task, a non-relational database may be appropriate. Response times to queries were calculated in the relational database using MySQL 5.

Managing data in healthcare information systems: However, MongoDB emitted an error message stating that those indexes had already been constructed by the system.

This research showcases several experiments which have been carried out in order to directly compare the implementation of the persistence layer of an EHR system using three different DBMS: EN Archetype Definition Language files. We recommend that you check the website of the publishers of the international document before making a purchase.

This is the main reason why ARM has not been implemented in this research. International Journal of Medical Informatics 79 Conclusions This research work has three main conclusions: Kaur K, Rani R.

However the relational paradigm was recently questioned by NoSQL document-based database systems. From x to vectorwise: On the other hand queries Q2, Q5 and maybe Q6 relate to problems and characteristics of problems of all the patients of the whole database and are more appropriate for secondary use of information i. 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.

In relation to secondary or research use of medical databases, the existence of links between parts of the EHR XML documents should be transparent to the underlying database technology, be it relational or document-based. Queries of increasing complexity were performed on these databases, against the information contained in the problems list. The relational model for database persistence [ 1317 ] is a very well established and mature methodology, which is paradigmatic.


Find initial date, resolution date and severity of all problems of a single patient. The special nature of medical knowledge that requires the separation into two levels of the dual model can have a profound effect on the way information in EHR documents is structured and how it is stored logically and physically in a database management system.

ISO/PRF – Health informatics — Electronic health record communication — Part 4: Security

If their occurrence in the archetype is 1, or into standalone tables with two columns, if their occurrence is higher than 1: Extensible markup language xml 1.

Thereafter the most executed highest priority query average throughput and the average response times of the three queries were calculated. In the specific case of standardized medical information, our problem is not the lack of a schema. From this point of view, MongoDB stands as a very efficient, optimizable and effective database system.

Int J Adv Softw. Regarding primary use, a probable clinical practice scenario is that formed of several extracts from a single patient, with which the medical professional is working at any given time. Recently, alternative methodologies i.

This basic approach may be improved in two different ways: Footnotes Electronic supplementary material The online version of this article doi: Archetype relational mapping — a practical openEHR persistence solution. This model has a well-established theoretical background which has been well studied and understood, and has long guaranteed consistency and efficiency within database 13606-44.

Additional files 12 and 3: This hypothesis is confirmed in [ 51 ].