(IJCSIS) International Journal of Computer Science and Information Security,Vol. 8, No. 2, 2010
Performance Issues of Health Care System usingSQL server
Narendra Kohli
Electrical Engineering DepartmentIndian Institute of TechnologyKanpur, Indiankohli@iitk.ac.in
Nishchal K. Verma
Electrical Engineering DepartmentIndian Institute of TechnologyKanpur, Indianishchal@iitk.ac.in
Abstract
—
:
In this paper, a smart card based on line health caresystem and its performance issues using SQL server areproposed. To provide a good quality of treatment in the hospital,it is required to integrate all the hospitals of country via internet.A Smart Card with 10 digits unique registration no. with hissome personal information is issued to patient. After gettingregistration in any hospital of the hospital network, patient has togo for checkup with smart card only. All the patient informationi.e. personal, doctor prescriptions, test reports etc. will be storedin the database of the local server of the hospital and time to timeuploaded to the centralized server. On the basis of uniqueregistration no., all the patient information can be retrieved fromthe database of the centralized server. Smart card based onlinehealth care system application has been designed as front end.Net and back end in SQL server. The block size or page sizebeing used during the database creation is playing veryimportant role in performance tuning. It is very important todecide the proper block size before database design. You cannotchange the block size once you have created the database. Re-creating the database again is a very costly affair.
Keywords- hospital, patient, smart card, SQL server2005
I.
I
NTRODUCTION
Automation & networking of the hospitals are the necessityof the society. The purpose of the same is to provide the betterservices for patients and it will increase the working efficiencyof the hospital system. Main idea for health care system is toobtain, store, analysis or process and uses of patientinformation (patient, doctor, hospitals, laboratory tests etc.). Atregistration counter in a hospital, administrator will generate a10 digit unique patient-Id. Basic information’s i.e. name,address, phone no. etc. with unique patient id will be stored onthe smart card and issued to the patient. As per the patient id,patient related information i.e. doctor diagnosis, test reports,MRI, CT-scan images etc will be stored in the databases of thehospital server and time to time uploaded to the centralizedserver. In future this information will be useful for doctors todiagnose the illness and give the important suggestions to thepatients for their health. While visiting to the hospital fortreatment, patient has to carry only smart card [1] [2].Administrator of the hospital or doctor will
use the smart card
through card reader. Designing of the proper databases anduses of different indexing techniques in SQL server 2005 willhelp for fast retrieval of patient data.II. Literature reviewThe need for automation systems in hospitals gains moreimportance [4]. A patient may be registered in any hospital of the networking of the hospitals. As per the requirement it isimportant to share the patient information between differenthospitals without ignoring privacy constraints & other relatedinformation. [1] Proposed the use of smart card to store thebasic information of the patient. Nowadays different types of smart cards are exiting in market [2] [3]. These cards haveproven to be convenient tokens for identification andauthentication in day to day activities [5]. As per therequirement, different types of smart cards can be used to storethe patient information. [6] [7] explains about telemedicineand PACS. E-health is producing a great impact in the field of information distribution of the health services to the hospitalsand public [8] [9]. Query optimization of SQL server has beendiscussed in [10] [11].III.
P
ROBLEM FORMULATION
3.1 If a patient is registered in one hospital andintegration and retrieval of patient information is not possiblein the hospital system then while taking the consultation withdoctor, patient can easily forget to explain his previoustreatment. In case of which incorrect prescriptions may beapplied. Keeping in mind an intelligent system i.e. smart cardbased online health care system has been proposed. Theproposed system is given in Fig. 1. The servers for thehospitals with high technical configuration are required. Allthe servers of the hospitals are connected with one centralizedserver of the hospital through internet. A very high bandwidthdedicated internet lease line has been proposed to use for thesystem. A smart card reader / writer unit has been attached toeach computer of this hospital system network. The proposedhealth care system has been loaded to all the servers of all thehospitals. The patient smart card stores some important
279http://sites.google.com/site/ijcsis/ISSN 1947-5500
(IJCSIS) International Journal of Computer Science and Information Security,Vol. 8, No. 2, 2010
information like unique patient id, name, sex, date of birth,blood group etc. As per the patient-id, patient details liketreatment prescriptions, test reports, images like MRI, CT-scanetc. have been stored in the database of the hospital server. Onthe basis of stored details of the patient, doctor can prescribethe proper medicine. SQL server tuning has been used whiledesigning the application.
Fig. 1: Smart card based health care system
3.2
To increase the performance of the application of online health care system, the following issues &technical issues will be taken:3.2.1
Issues:
•
Design an application that can serve maximumnumber of hospital and provide a platform fortheir interaction.
•
A system generated patient id that is unique formaximum possible time interval.
•
Store patient information optimally.
•
Speed up the DML (insert, update, delete)operations.
•
Store patient information for maximum possibletime.
3.2.2 Technical issues
:
•
Normalization of tables.
•
Maximum utilization of memory.
•
Imposing necessary constraints on tables.
•
Selecting best possible structure for queries.
•
Tuning and optimizing queries.
•
Optimal selection of join order and joinalgorithm.IV MethodologyApproach for above issues:
1.
The patient will provide basic information through smartcard (having 10 digit patient id and personal information) atregistration counter where it will be uploaded to server.2.
In smart card we are storing patient id and personalinformation like name, address, DOB etc. of a person. As perthe size of smart card we can store the information of a person.3.
Patient’s files may be one of the two forms image or PDF.Images are stored separately in image tables and PDF in PDFtable .These tables contain an Image ID or PDF ID and theirdescription. Image ID and PDF ID are stored in theirrespective tables as foreign keys that may be in patient doctoror Patient Lab or in PatientRoom Tables.4.
Since we are storing all the patient related information’son a centralized database server. So movements of files is notrequired .The required files for a particular patient & their labtest report & images, prescriptions, scan document &diagnosis reports can be retrieved from centralized databaseserver. Accessing the information’s related to patient will becontrolled by various level of access control and it will help usto prevent the unauthorized access from the data base.5.
As we have normalized our database we have removes allpossible redundancies6.
We have covered optimization at application design level,database design level, memory utilization & optimization of queries for accessing the data base. Few points about theoptimization are as follows:
•
Application is studied well and requirements areidentified. These requirements are categorized onobject level and respective tables to store thatinformation are created. After that database isnormalized up to BCNF (Boyce Codd Normal Form)level and 14 tables are created.
•
Size of attributes (their respective data types) isfurther minimized in order to compact record size, Sothat maximum number of records can be stored in asingle data page. Select queries are designed tohandle all possible search criteria.
•
Indexes are created to speed up above read access.First data base ids well studied to find out whatpossible values different attributes will take and whatwill be the size of tables. Considering both the thingsHash, B-tree (clustered and non clustered) andBitmap indexes are proposed.
•
Order of attributes in composite indexes are studiedand justified.
•
Every hospital will have day to day patientinformation locally to improve the performance
280http://sites.google.com/site/ijcsis/ISSN 1947-5500
(IJCSIS) International Journal of Computer Science and Information Security,Vol. 8, No. 2, 2010
particularly in case of frequent insert, updateoperation.
•
In a multi table join queries, we have studied thenature of the table & depending on the characteristicof the table their order will be pre estimated. SQLqueries Hints can also be given to optimizer to followthat order to achieve the optimal performance.
•
Proper join algorithms are justified in respectivecases and hints are given to optimizer.
•
Selecting the most optimal execution path by theoptimizer is the time consuming process. By giventhe Hints we can reduce the time taken by theoptimizer up to some level
•
To improve the DML operation by the hospital we tryto keep the data initially at the local server. Thisscheme reduces load from centralized server.
•
Every day a particular time is selected to updatecentral server by collecting information from localservers automatically. The operation to refresh thecentralized server may be made more frequent if required.
•
Transaction log is permanently off at centralizedserver as we don’t need any log for recovery.Because the all information’s are at the local server &can be reproduced easily.
•
All primary key, foreign key constraints are removedfrom centralized server as those constraints arealready checked at local servers. So there is not needto revalidate the information which is validated. Itwill improve the data loading performance at thecentral server.
•
For updating centralized server we will recommendto use bulk copy and bulk insert schemesV. Findings5.1 Simulation of query optimization for performance tuning:
To identify the bottleneck and performance related issues wehave done the following case study using different methodsand analyze the query and their execution path. In ourdatabase out of 14 tables, 4 tables stores patient relatedinformation’s and every table has approximately 14 lacrecords in SQL server to simulate.
•
Patient Stores registration information of patient
•
PatientDoctor Stores Doctor related information likedisease and others
•
PatientLab stores test report of patients.
•
PatientRoom Stores Room id’s, Daily charges And otherattributes of room where Patient is admittedThe following analysis is based on query and storedprocedure given below:The query selects Patient details from four different tables byapplying inner joins.Query
:
SELECT Patient1.PatName, Patient1.Address,Patient1.ContactNo, Patient1.Sex, Patient1.Occupation,Patient1.Guardian, Patient1.RegNo,Patient1.ReferredBy,Patient1.BloodGroup, Patient1.PatientHistory,Patient1.Disease, Patient1.DiseaseCatageory,Patient1.EntryDate,PatientRoomIPD.Hospital_Id,PatientRoomIPD.Room_Id, PatientRoomIPD.StartDate,PatientRoomIPD.EndDate,PatientRoomIPD.Status,PatientRoomIPD.TotalCharge, PatientDoctor.DoctorId,PatientDoctor.DoctorName, PatientDoctor.StartDate ASTreatmentStartDate,PatientDoctor.EndDate ASTreatmentEndDate, PatientDoctor.No_Of_Visits,PatientDoctor.Charges AS TreatmentCharge,PatientLab.LabNo,PatientLab.TestNo,PatientLab.TestDate,PatientLab.UnitFROM Patient1INNER JOINPatientRoomIPD ON Patient1.PatId = PatientRoomIPD.PatIDINNER JOINPatientDoctor ON Patient1.PatId = PatientDoctor.PatIdINNER JOINPatientLab ON Patient1.PatId = PatientLab.PatIdwhere Patient1.PatId=@Id;On the hardware configuration: Intel® Duel Core 2.8GHz 512RAM
Table 1: results on front end and query analyzer
On Asp.net Search Page(Front-End)On Query AnalyzerIterationExecution time inms using StoredProcedureExecution timein msusingQueryExecutiontime in msusingStoredProcedureExecutiontime in msusingquery
1 .719 .771 .827 .7402 .750 .756 .827 .7043 .750 .722 .720 .7164 .813 .733 .766 .8435 .719 .781 .810 .7976 .844 .727 .784 .7677 .672 .697 .750 .8038 .765 .755 .780 .767
Mean
.754 .743 .783 .767
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Performance Issues of Health Care System using SQL server
In this paper, a smart card based on line health care system and its performance issues using SQL server are proposed. To provide a good quality of treatment in the hospital, it is required to integrate…
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