A multi-level approach for data description and management of a large hierarchical database supporting a hospital patient information system

  • K. Sauter
  • W. Weingarten
  • J. Klonk
  • P. L. Reichertz
Software Systems Development
Part of the Lecture Notes in Computer Science book series (LNCS, volume 65)


The paper describes a systematic approach to satisfy the various — and partly conflicting — data processing requirements occurring in a large operational hospital database.

The central patient data bank of the Medical System Hannover contains at the present time the data of about 124000 patients with a large number of medical and administrative data for accounting and reporting. This data is stored in several databases under the hierarchical database management system IMS and in standard OS-files. A number of parametric update and retrieval programs is in operation on this data bank and the main design criteria for the data structures had to be the support of the efficiency of these routine programs in addition to database administrator considerations such as storage space economy, security and stability.

In the recent years, the need for more flexible tools to describe and process this large amount of data has become apparent. Therefore, a data description system handling the various views of data has been designed and implemented in a first version.

The choice of the appropriate type of data processing language for a specific task depends on a number of criteria, such as efficiency, input/output requirements and the complexity of the database problem. Therefore, the following hierarchy of user-languages had to be developed:
  1. (1)

    The conventional PL/1-programming using the DBMS sublanguage DL/1

  2. (2)

    A procedural database language

  3. (3)

    A descriptive query language.


The main features of the languages (2) and (3) are described in the paper.


  1. (1).
    ANSI/X3/SPARC, Study Group on Data Base Management System, Interim Report, Washington DC: CBEMA, 1975Google Scholar
  2. (2).
    Chamberlin, D., Boyce, R.: SEQUEL — A Structured English Query Language. IBM Technical Report RJ 1394, IBM Research Lab., San Jose, California, 1974Google Scholar
  3. (3).
    Dubien, R.J., Corvey, H.D., Sevcik, K.C., Wigle, E.D.: A Data Base System Implementation Providing Data Independence for Medical Applications, Proceedings of the Second World Conference on Medical Informatics, Toronto, 1977Google Scholar
  4. (4).
    Frasson, C.: A System to Increase Data Independence in a Hierarchical Structure. In: G. Goos and J. Hartmanis (Eds.): Lecture Notes in Computer Science, Vol. 34, Springer-Verlag, Berlin, 235–246, 1975Google Scholar
  5. (5).
    Huits, M.H.H.: Requirements for Languages in Data Base Systems. In: Douque, B.C.M. and Nijssen, G.M. (Eds.): Data Base Description, North-Holland Publ. Co., Amsterdam, 1975Google Scholar
  6. (6).
    International Business Machines Corporation (IBM): Information Management System /360, V.2 — General Information Manual, Form No. GH20-0765-1, 1975Google Scholar
  7. (7).
    International Busines s Machines Corporation (IBM): Generalized Information System, V.2 (GIS/2) — Application Description, Form No. GN20-0360, 1970Google Scholar
  8. (8).
    Nie, N.H., et al.: Statistical Package for the Social Sciences (SPSS), Second Edition, McGRAW-HILL Book Co., ISBN No. 0-07-046531-2, 1975Google Scholar
  9. (9).
    Nijssen, G.M.: On the Gross Architecture for the Next Generation Database Management System, Information Proceedings 77. In: Gilchrist, B. (Ed.): IFIP Congress 77, North-Holland Publ. Co., Amsterdam, 1977, 327–335Google Scholar
  10. (10).
    Pocklington, P.R.: The Necessity for Requirements of and Basic Design of a General Data Interpretation and Evaluation System (DIES). In: Anderson, J. and Forsythe, J.M. (Eds.): MEDINFO'74, North-Holland Publ. Co., Amsterdam, 1974, 411–418Google Scholar
  11. (11).
    Reichertz, P.L.: The Medical System Hannover (MSH). In: Collen, M.F. (Ed.): Hospital Computer Systems, Wiley & Sons, New York, 1974, 598–661Google Scholar
  12. (12).
    Risch,T.: LIDAM — LISP Data Manager, Datalogilaboratoriet Report DLU 77/2, Uppsala University, 1977Google Scholar
  13. (13).
    Sauter, K.: Structure and Functions of the Patient Data Bank in the Medical System Hannover. In: Guenther, A. et al. (Eds.): International Computing Symposium 1973, Davos, North-Holland Publ. Co., Amsterdam, 1974, 585–589.Google Scholar
  14. (14).
    Sauter, K., Reichertz, P.L., Weingarten, W., Schwarz, B.: A System to Support High Level Data Description and Manipulation of an Operational Data Base System, Medical Informatics, Vol. 1, No. 1, 1976, 15–26Google Scholar
  15. (15).
    Stonebraker, M., Wong, E., Kreps, P., Held, G.: The Design and Implementation of INGRES, ACM Transactions on Database Systems, Vol. 1, No. 3, 1976, 189–222Google Scholar
  16. (16).
    Tsichritzis, D. (Chairman): Data Base Organization (Panel). IFIP Congress 77, Toronto, August 7–13, 1977Google Scholar
  17. (17).
    Weingarten, W., Klonk, J., Sauter, K., Reichertz, P.L.: Individual Data Retrieval by the Non-Programmer and System Supported Data Manipulation in a Complex Hierarchically Organized Data Base System, Proceedings of the Second World Conference on Medical Informatics, Toronto, 1977, 83–86Google Scholar
  18. (18).
    Wolters, E., Reichertz, P.L.: Problem-Directed Interactive Transaction Management in Medical Systems, Meth. Inform. Med. 15, 1976, 135–140Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1978

Authors and Affiliations

  • K. Sauter
    • 1
  • W. Weingarten
    • 1
  • J. Klonk
    • 1
  • P. L. Reichertz
    • 1
  1. 1.Department of Biometrics and Medical InformaticsMedical School HannoverHannoverFed. Rep. of Germany

Personalised recommendations