People can access this information at www.sundhed.dk (Denmark’s e-Health portal) by using NemID, a national digital signature platform. The Shared Medication Record is in operation and was fully implemented at all hospitals and general practitioners in 2014.
Question: How do you make a SQL database scale and provide extremely high availability for critical health care data? Answer: You don’t. You use Riak
This was the challenge faced by the Danish National Board of eHealth and Trifork in 2011, when the nationwide roll-out of the Shared Medication Record gave rise to an architecture reality check.
Health care institutions such as hospitals, general practitioners and emergency services require fast, around the clock access to the Danish citizens’ medical data in order to provide the appropriate treatment.
The Board of eHealth enables patient centred cooperation across institutions by providing a shared view of each citizen’s medications. They do this by registering all medicine prescriptions in a database, which is accessible to the health organizations for online reads and updates. However, this database would begin to crumble under the load of the projected increase in activity.
The National Board of eHealth considered several options: The traditional database storage model as seen in popular relational databases like Oracle requires more units and duplicated set-ups – which make both implementing and keeping up with the need to scale a costly endeavour. Adding to that, the inflexibility of this model means that you must know well in advance how many data servers you’ll need, meaning that you often err on the side of caution, which further increases costs and complexity.
Steen Hernig, NSI “Migrating the prescription database to Riak’s decentralized model offered better scalability and availability.”
Riak solves these problems by automatically duplicating data to the desired redundancy level, and rearranging data to make use of the resources available. Scaling up is as simple as connecting a new machine to the cluster. Riak will then automatically make use of it by shifting responsibility to it.
The National Board of eHealth, which is a government institution under the Ministry of Health and Prevention, saw that Riak would provide the required scalability at an affordable price. But more importantly, they wanted to ensure very high availability of the Shared Medication Record. It is critical data in the sense that having it online can literately mean the difference between life and death. Riak enabled them to achieve this goal by putting the Medication Record service in the cloud.
The medicinal data service is hosted in a secure, private cloud, where datacentres are under Danish legislation, trusted and certified with handling sensitive data. Being a true multi-master solution, any datacentre can serve any client and any request at any time. Riak synchronization enables them to act as one big datacentre in the cloud.
Riak’s superior architecture and distributed cloud model has enabled the Shared Medication Record to scale up, and have unprecedented availability at an affordable price. Furthermore, the farsighted Board of eHealth has future plans for the Shared Medication Record. From the current enabling of information sharing, they seek to use the medicinal data to intelligently support healthcare personnel make the right medication decisions. With Riak the data is always there. The Shared Medication Record system won the 2011 Danish government digitization prize for significantly reducing medical errors and increasing patient safety.