A unique solution to a hospital's networking problem
What would you do? You need to provide realtime access to 4000 clients,
running OnLine Transaction Processing (OLTP) applications and batch jobs against
100 databases. The solution to this problem, at Brigham and Women's Hospital in
Boston, Massachusetts, will surprise you--and it might just give you some ideas.
This hospital uses the Massachusetts General Hospital Utility
Multi-Programming System (MUMPS) programming language to write applications.
MUMPS is a language specifically for health-care data processing needs, and
performs well. Because each MUMPS database is inherently distributed, the
applications don't care where the data resides.
Brigham and Women's used to run MUMPS on midrange computers, but their
limited architecture forced hospital staff to find a solution that offered room
to grow. The approach they took was not the obvious one.
Instead of installing a large mainframe, the hospital looked for a PC-based
solution and found InterSystems, an international provider of database
management systems (DBMSs) and related software. InterSystems installed its
product, Open M, on PCs to run the hospital's thousands of lines of
indispensable MUMPS code. Open M is a combination of a DBMS and an application
development environment based on the ANSI standard M language. The latest
version uses Windows 95 and Windows NT and supports standard development tools
such as Visual Basic (VB) to develop front-end, client applications.
If a set of midrange computers couldn't handle the hospital's needs, how
can PCs do it? Here's where the distributed nature of a MUMPS database comes in.
PCs don't lack power--they lack bandwidth. InterSystems increased bandwidth by
distributing the computing across several PCs, creating a cheaper, more
scaleable environment that performed as well as the old systems.
The InterSystems design consisted of PCs running--amazingly enough--DOS.
Database servers on the back end provided access to the hospital's enterprise
database. DOS client boxes on the front end ran MUMPS programs that accessed the
servers, as needed. And data switches provided access at the data level, moving
data from the servers to the clients. These switches were necessary because the
limitations of DOS didn't allow enough connections to the database servers to
handle all the requests.
The hospital liked this architecture because it made growth simple. As Jim
Marra, corporate director of technology planning for Partners HealthCare
Systems, explained: "When I need a new database server, I just go buy a 486
from anyone who has a good price."
Reliability was also a key factor. "Originally, we intended to provide
automatic switchover in case one machine failed, but we never implemented it
because it never became necessary," Marra said.
Saving lives and collecting money both require excellent system
availability. Open M fills this requirement by providing subsecond response
times for OLTP applications. As a rule in application design, response times
should not exceed three seconds--Jim Marra said the hospital never considered
waiting that long.
When DOS Is not Enough
As part of a merger with several major Boston-area health-care facilities,
Brigham and Women's became part of Partners HealthCare Systems. Merging meant
integrating several data processing facilities with more than 12,000 nodes.
Again, Brigham and Women's faced a growth problem.
InterSystems representatives, continuing to look for ways to improve Open
M, asked me to evaluate this project. They were replacing DOS with NT and about
100 servers. I thought they'd lost their minds. I couldn't understand why
InterSystems was testing NT.
Then came NT 3.51. Here was the product InterSystems needed to fit its
vision. It now had the next generation of Open M, and the hospital had the tools
to open its system to more growth.
Why NT?
InterSystems and Brigham and Women's chose NT for several reasons. Clearly,
NT had to offer technical merit because getting the job done was the highest
priority. InterSystems liked NT because it simplified the Open M application's
architecture. Although the data switches were a clever workaround, NT's superior
architecture let InterSystems create more than enough connections to eliminate
this additional layer of processing.
When I asked Jim Marra why Brigham and Women's chose NT over NetWare, he
told me something I didn't expect. The hospital's confidence in Novell's support
for a development project was low. In contrast, the MIS staff's experience with
Microsoft's support made them comfortable with NT.
Paul Grabshied of InterSystems told me the choice of NT was also customer
driven. "We make choices to match what our customers want (within reason),
and we saw a demand for NT even at version 3.1," he said.
InterSystems saw three major advantages to using NT as a successful
platform for Open M. First, NT's hardware demands are light, making boxes
running NT inexpensive--a crucial element in InterSystems' application
architecture. Second, NT provides quality integrated networking, which is also
crucial to link the distributed database. And InterSystems liked NT's
Symmetrical MultiProcessing (SMP) support; it offered high power at low cost. In
addition to NT, InterSystems will continue to support Open M on DEC platforms
with a version for Digital's Alpha RISC-based chip.
Not Just for Hospitals
Although InterSystems' Open M has its origins in the medical industry, all
OLTP systems share the same needs, regardless of the type of data they handle.
Any OLTP application can use Open M. InterSystems gets about 25% of its business
outside the medical market.
Open M is available for several mainframe and midrange systems; now, NT's
innovative, distributed architecture is promising. You can configure the Open M
for NT and Win95 architecture in several ways, from an inexpensive single-user
environment to a three-tier environment that separates the functions of data
presentation, application logic, and database services.
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