Further thoughts on "How does MyOSCAR file its records"

I had written the principles behind the filing system for MyOSCAR previously. The current MyOSCAR database server is based on an Open Source product MySQL version 5.1.30. MyOSCAR v1 began its life as an unintentional "fork" of the Indivohealth project. The original Indivohealth project has now been replaced by the totally different Indivo X (or the Smart Indivo) which fully supports the SmartPlatform project. The original Indivo PHR was based on the Berkeley DB which is now owned by Oracle. Over time pressures from a number of research projects necessitated a switch to a relational database. We have been using MySQL for our other projects (OSCAR EMR) so MySQL was a natural choice. However, health documents are still stored as individual documents. MySQL provides some relational structure to facilitate database searches and improve overall database performance.

Now looking into the future, how can we provide storage for potentially very large number of documents, some of which can be very large documents (e.g. the file size of a 30X human genome sequencing file is estimated to be about 500GB). And how can we enable the possibility of an individual storing his health records across multiple databases, which may be physically separate? What do organizations like Google, Facebook, or Twitter teach us about this?

I have started looking at a couple of potential solutions:

NoSQL


SQLite

Will continue...