Moving Toward a Unified National Health Care Database

In the United States, a push for a national, unified health care system is in the works now that the country has a new administration in the White House. To support a system of this nature, a huge national database will have to be built. And everyone’s medical records will have to be entered into a universal system that all doctors, hospitals and emergency personnel will have access to.

Right now, most health care organizations have their own database of patients or have their records still on paper. Over the course of the next few years, a lot of decisions are going to have to be made. Decisions like which database platform will be used, which security model will work best and what levels of access each user will have. It is going to be a huge project. There are many ideas floating around as to how to go about setting up a database of this size and control all the parts. Checks and balances will have to be put in place, as well as some top-notch security.

When choosing a database model, the logical thing to do is have a distributed system throughout the country. This will allow most of the data to reside locally with the patient, while also permitting the patient’s record to be accessed remotely if he or she were away on business. Further, it would cut down on the amount of data traveling over the Internet and thereby reduce the risk of someone maliciously accessing it.

Housing a database of this size would be a feat in itself, but all the major database companies involved could handle this type of system. IBM, Oracle, Microsoft and a few others all have a distributed model that can accommodate this amount of data in a usable fashion. The key to making this project successful is redundancy and accessibility. With a database this large — housing records for every American — downtime would be critical. Multiple instances would have to be created and updated to provide an extremely high level of redundancy.

Security for a database of this nature would have to be strong, too. Certain security standards would have to be met in order to gain access to the system. A security model would have to be developed to ensure anyone accessing the system has a high level of security on his or her own network. For example, if security is lacking in a primary care provider’s office, an upgrade would have to be implemented before the client is allowed to connect to the network. Let’s say a medical office has an open wireless hot spot that is connected to the same network as the national database. That office should not be allowed to connect until that security flaw is fixed. Further, even if the database is accessed securely via Web browser, what if the client saves data to his or her workstation? Once the data is localized — or worse, printed out — it is going to create a whole other set of problems. There likely will be a lot of back-end work at various primary care locations.

Then there’s the issue of money. The initial cost of a national health care database would be staggering. In the final version of the economic stimulus bill, both the House and Senate agreed to allocate $3 billion toward “the utilization of an electronic health record (EHR) for each person in the United States by 2014,” according to a CNSNews.com article. Primary care physicians who are still using paper records would have to redefine the way they do business. They would have to incur some costs to get their networks up to a certain level or even purchase new computers and hardware to access this new system. Training for the new system also would have to be sponsored.

However, it’s valid to argue that the money that a system like this will save in the long run would be worth the initial investment. And the breadth of a project like this would certainly create jobs and new opportunities in the marketplace.

Patrick Turner is president of Little Pond Consulting LLC, a certified provider of computer and network services. He has eight technical certifications and holds a master’s degree in computer science and information systems from Marist College. He can be reached at editor (at) certmag (dot) com.

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