17. The company owners basically want to franchise the operations. The headquarters will run database operations for all of the local clinics. Describe how you will configure the database to support this operational process. List any potential problems you might encounter.
Best to start with the main problems: Security and data transmission rates. From a security perspective, it is better to run the operations from a central location—most likely with a Web-based approach. The problem is that some facilities might be in locations with limited bandwidth. On the other hand, the target is major cities; close to primary work centers; so there should be some decent bandwidth available. For basic text and numeric data, the central approach should not be a major problem. If the company wants to include digitized photos and x-rays or even video, bandwidth would become a major problem. These items would most likely have to be stored locally. The other catch is the two ICD tables. Even with an LOV approach, it would be slow to search and repeatedly download those tables when selecting values. The best approach would be to put those directly on the local drives of the medical computers (perhaps even USB drives). Medical professionals would be able to get almost instantaneous searches and lookups through the codes. And the code lists are updated on regular schedules, so it would be relatively easy to download new versions (or incremental updates) over night or early in the morning.