CCTOS Common : Synchronizations

• Objective:
• The goal is to have access to the latest version of any item at any time.  However it would not be realistic to concentrate all information in one unique server.
• Management of integrated health networks.  Automated synchronization between local systems and servers in the scope of regional servers, as soon as possible, nearly in real time or after some delay in case the connection would have been temporarily broken.
• To allow end users to work on both local and/or remote databases.
• Summary:
• Synchronization between:
• "Local systems":
• Personal computer of independent doctors or internal systems of hospitals. These local systems cannot be continuously on-line, particularly in the case of small independent practices and care at the home of the patient.
• Local systems are not required to share always the complete information about patients, but are invited to share the information useful for the continuation of the care of the patient.  What is not shared could be seen as "private notes".
• The author keeps control on what he agree to share.  This can be made easy by means of default rules.
• The data marked as to be shared are replicated as soon as possible to a common server, immediately if on-line or at the time of the next connection.
• "Shared common servers":
• Shared data bases on servers available 24/24 hours.  This may be a regional server, or the server of a "group's practice", in one or more levels of common servers.
• Management of notifications.
• Option allowing to subscribe to selected patients, in order to synchronize a duplication of the server on a local system.
• Options allowing an automatic declaration to national or regional indexes.
• Considered tools : 
• Softwares similar to "rsync" software in Open Source, http://samba.org/rsync/documentation.html .
• see also the DTNRG, Delay Tolerant Networking Research Group.
• National index:
• If available, national indexes are useful in order to find where medical information is available about a patient.  For example by a GP recorded as the referent GP and in 3 different hospitals.
• Of particular importance is to find where a central list of Health Issues is maintained, by the GP and/or sometimes by a general internist (see below the chapter about Health Issues).
• The interface to such an index allows:
• To retrieve a list of links to servers containing relevant information about a patient.
• To declare the existence of new documents.
• See a proposed schema:
  
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