🚀 go-pugleaf

> I'm developing a patient medical record system for a community-based hospital
> built around Unix workstations....
> ....The configuration requires a minimum of 30 nodes; the
> relational DBMS must support a least 12 different views of the medical
> database, which will have 68+ relations.

This may seem very silly.  It did to me when I was told but...  A close
friend of mine who does consulting work in the areas of communications,
networking and UNIX was once working with a hospital.  They ruled out
use of ethernet because it is expected to have failures (i.e.
collisions) and they were afraid that some clever lawyers might label
this as negligence.  Lawyer to jury:  "this institution installed a
system expected to have periodic failures which would delay critical
patient information.  Yet they tell you they care about their
patients".  Yes I know it's ridiculous but that was their concern.
You can bet the lawyer would carefully pick a technically naive jury.

Anyway the point is, before proceeding with your system you might
want to check up with the hospital administration and legal people.
I can refer you to my friend for more information if you like.
-- 
From the TARDIS of Mark Callow
msc@saber.uucp,  sun!saber!msc@decwrl.dec.com ...{ihnp4,sun}!saber!msc
"Boards are long and hard and made of wood"

> > I'm developing a patient medical record system for a community-based hospital
> > built around Unix workstations....
> > ....The configuration requires a minimum of 30 nodes; the
> > relational DBMS must support a least 12 different views of the medical
> > database, which will have 68+ relations.

	(I missed this first article, could some kind soul please mail
me a copy? We are doing very similar things, and it would be nice
to see what else is being done. We already have a patient medical
record system up and running, supporting a database of 2.1 million
patients. Thanks.)

> This may seem very silly.  It did to me when I was told but...  A close
> friend of mine who does consulting work in the areas of communications,
> networking and UNIX was once working with a hospital.  They ruled out
> use of ethernet because it is expected to have failures (i.e.
> collisions) and they were afraid that some clever lawyers might label
> this as negligence.  Lawyer to jury:  "this institution installed a
> system expected to have periodic failures which would delay critical
> patient information.  Yet they tell you they care about their
> patients".  Yes I know it's ridiculous but that was their concern.
> You can bet the lawyer would carefully pick a technically naive jury.
> 
> Anyway the point is, before proceeding with your system you might
> want to check up with the hospital administration and legal people.
> I can refer you to my friend for more information if you like.

	We (Johns Hopkins Hospital) have built and are building several
clinical information systems which are distributed across several machines
(supermini and workstation) connected using Ethernet. These projects will
even include order entry for tests, etc on patients. But there has been
no problem from the legal department about the use of ethernet. All systems
can break. Negligence is failing to provide a reasonable (electronic or
otherwise) backup for when the system does break.

	Now what we have been talking with the legal department about
is what consitutes an "electronic" signature. Given an environment of
unattended terminals, and users' typical inclinations to write down
passwords, just what is necessary and sufficient proof of identity when
ordering surgery?

-- 

					eric
					...!seismo!umcp-cs!aplvax!osiris!eric

++
> > This may seem very silly.  It did to me when I was told but...  A close
> > friend of mine who does consulting work in the areas of communications,
> > networking and UNIX was once working with a hospital.  They ruled out
> > use of ethernet because it is expected to have failures (i.e.
> > collisions) and they were afraid that some clever lawyers might label
> > this as negligence.  Lawyer to jury:  "this institution installed a
> > system expected to have periodic failures which would delay critical
> > patient information.  Yet they tell you they care about their
> > patients".  Yes I know it's ridiculous but that was their concern.
> > You can bet the lawyer would carefully pick a technically naive jury.

> But there has been
> no problem from the legal department about the use of ethernet. All systems
> can break. Negligence is failing to provide a reasonable (electronic or
> otherwise) backup for when the system does break.

Somehow I would expect that even a lawyer [:-)] could explain the
reliability of ethernet in layman's terms.  It is incorrect to
consider a collision to be a failure in any sense.  The transport
and network layer protocols must insure that colliding messages
are re-sent accurately.

The CSMA/CD (ethernet protocol) scheme can be compared to trying
to place a call on the phone.  Just because you sometimes get a
busy signal doesn't pmake the phone an unreliable system.  In
both cases there is an unbounded upper limit to the actual
time of connection.  But since the probability of not connecting
diminishes very rapidly with time (repeated trials), it is still
a useful and reliable system.

The system should also take care of real failures.  For instance,
if the cable is broken or the station you are talking to goes
down, your computer should not lead you to beleive that the
message was sent sucessfully.

-Mark Garrett