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ehr

electronic health records

Epic, FHIR

SystemTechniques · 18Primitives · 72 ehr Deterministic simulation testingdistributed · medium: Run the whole system in one thread under a seeded scheduler with simulated network, disk and clock, so every failure replays from its seed.›Primary-backup replicationdistributed · medium: One node orders all writes and ships them to standbys; the acknowledgement rule (none, one, all) sets what a crash loses, and an external arbiter decides who takes over.›Terminology code systemsnetworking · medium: Code systems, value sets and concept maps (SNOMED CT, LOINC, ICD) with subsumption queriesRecord linkagesearch-sort · medium: Probabilistic record matching (Fellegi-Sunter) with blocking for patient or entity indexesCoverage-guided fuzzingsecurity · medium: Mutate inputs, run an instrumented target, and keep any input that reaches a new code edge; feedback turns blind guessing into incremental search.›Envelope encryptionsecurity · medium: Encrypt each object with its own data key and wrap that key under a KMS-held key, so rotation re-wraps 60 bytes and deleting a key shreds data.›Tamper-evident audit logsecurity · medium: An append-only log whose Merkle root, signed per batch, lets anyone verify an entry is present and history was never rewritten, with log-size proofs.›Write-ahead logstorage · low: Append each change to a checksummed sequential log and fsync it before touching data pages; the basis of crash durability in nearly every database.›Fhir resource modelnetworking · low: FHIR resources, references, search parameters and REST interactions for health data exchangeFuzzy string matchingsearch-sort · low: Edit distance, Jaro-Winkler and trigram indexes for approximate name and address matchingHdr histogramdata-structures · low: Log-linear bucketed histograms with bounded relative error for latency percentilesIdempotency keysfinance · low: Client-chosen unique key per logical operation, stored with a request fingerprint and the final response, so retries replay the first result instead of acting twice.›Process supervisionhardware-os · low: A parent process starts services, reaps their exits and restarts them under a delay and burst-limit policy, then stops them with SIGTERM before SIGKILL.›Hl7v2 message parsingnetworking · low: HL7 v2 pipe-delimited segments, escaping, ACKs and MLLP framing for clinical interfacesAuthorization models (RBAC, ABAC, R…security · low: How to decide who may do what to which object; roles for coarse rules, relationships for sharing, and checks on every object.›Mutual TLSsecurity · low: TLS where the client also proves a certificate key, so every connection carries a verified, rotatable machine identity.›OAuth 2 and OpenID Connectsecurity · low: Delegated authorization (OAuth 2) and login on top of it (OIDC); use authorization code + PKCE for every user-facing client.›B+ treestorage · low: Balanced high-fanout search tree with all values in linked leaves; the default on-disk index for point lookups and range scans.›Optimistic concurrency controlstorage · low: Run transactions without locks, record what they read, and validate at commit that nothing changed; fastest when conflicts are rare.›Graceful drainingsystems · low: On a termination signal, stop taking new work, finish in-flight work until a deadline, tell clients to reconnect elsewhere, then exit; clients resume from a token.›Cooperative schedulingconcurrency · low: Green threads/coroutines yielding at await points on a user-space schedulerRecord replaydistributed · low: Record every nondeterministic input (time, randomness, I/O, model and tool outputs, per-tick player input) and re-execute deterministically for debugging, replays and state rebuildPRNGs (PCG, xoshiro)numerics · low: Small, fast, statistically strong non-cryptographic generators: PCG32 and xoshiro256**, with seeding, parallel streams and unbiased ranges.›+ 11 more techniques+ 56 more primitives

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In-house systems

Named systems of this kind at large companies, with their paper or write-up.

MHS GENESIS (US DoD, Leidos-led team)Leidos Holdings