Data storage and management requirements for the multimedia computer-based patient medical record

The business of healthcare management is changing rapidly, heading in the direction of managed care, capitation, and integrated delivery systems. Information management is crucial to the success and competitiveness of these new care delivery systems. A major goal of medical systems designers is to develop a model for a multimedia, computer-based patient medical record (CPR). The fundamental function of a CPR system is to record, monitor, retrieve, and analyze all events associated with an encounter between the patient and the healthcare system. Data components of the CPR include all forms of multimedia information, gathered from various departments within the institution. Users of the data will be diverse and widely distributed. The amount of digital data generated will be approximately two terabytes (TB) of information per year for a medium-sized metropolitan medical institution. Most of the data (by volume) are diagnostic radiological images. This information must remain on-line or near-line for 7-10 years, or longer in many cases. Image and other data of the CPR will be stored as self-defining information objects in a data repository (DR). The DR will be comprised of distributed storage subsystems and a high-level communications interface. Mass storage subsystems and information management systems being developed now will be core technologies of the DR and the CPR.