Design and implementation of a clinical data management system

Increasing activity in the use of computers for acquisition, storage, and retrieval of medical information has been stimulated by the growing complexity of medical care, and the needs for standardization, quality control, and retrievability of clinical data. Criteria for the design of a clinical data management system include flexibility in its interface with its environment, the capability of handling variable length text string data, and of organizing it in tree-structured files, the availability of this data to a multi-user environment, and the existence of a high-level language facility for programming and development of the system. The scale and cost of the computer configuration required to meet these demands must nevertheless permit gradual expansion, modularity, and usually duplication of hardware. The MGH Utility Multi-Programming System (MUMPS) is a compact time-sharing system on a medium-scale computer dedicated to clinical data management applications. A novel system design based on a reentrant high-level language interpreter has permitted the implementation of a highly responsive, flexible system, both for research and development and for economical, reliable service operation.