“A Graph Database –transforms a–> RDBMS”
The Neo4j site seems to imply that whatever you can do in RDBMS, you can do in Neo4j.
Before choosing Neo4j as a replacement for an RDBMS, I need some doubts answered.
I am interested in Neo4j for
ability to do quickly modify data "schema"
ability to express entities naturally instead of relations and normalizations
...which leads to highly expressive code (better than ORM)
This is a NoSQL solution I am interested in for it's features, not high performance.
Question: Does Neo4j present any issues that may make it unsuitable as a RDBMS replacement?
I am particularly concerned about these:
is there any DB feature I must implement in application logic? (For example, you must implement joins at application layer for a few NoSQL DBs)
Are the fields "indexed" to allow a lookup faster than O(n)?
How do I handle hot backups and replication?
any issues with "altering" schema or letting entities with different versions of the schema living together?
This is an extremely broad topic covering everything from modeling and implementation to IT and support. It's impossible to really answer all those questions here, especially without details on your situation. However, you seem to be exploring options and avenues. So, I'll just pass on some general food for thought as someone that's implemented a number of systems.
Everybody seems to think their new database paradigm is a replacement for relational databases. So, take those claims with a grain of salt.
I like to think in terms of 3 fundamental models: Relational, Document, and Graphing. Depending on your problem space one or even more of these is the right answer. I would not do financial transactions in anything but relational (SQL Based). If you are building a CMS, then a Document DB is the way to go. If my application is modeling networks (roads, people, connections, networks etc.) I use Neo4J.
As far as production quality, there are solid options in each category. Relational has a bunch. For document databases I'd go MongoDB or a higher level JCR system like Apache Jackrabbit. For graphing, I only have experience with Neo4j and it is rock solid for me.
Whatever you do, don't buy into the hype that "We have the one technology that solves all your problems." It's not there and it narrows your thinking.
I 'm convinced Neo4j is a good replacement for relational databases by now.
It is ACID compliant
Though the community version lacks some features like hot backups, the enterprise edition has
You can get support for it
At first sight (and in the new releases where you don't need a START clause) its query language CYPHER can do almost anything SQL can
but
it's harder to find a CYPHER developer than a SQL one
and it does not have an equivalent optimizer: it matters more than with SQL how you write the query
Though it supports replication and Neo explicitly markets it as a big data product, I can't confirm it is scalable enough and I did not study security aspects.
In recent releases (younger that the question above), one can define indexes on labels, which work like indexes on tables in a relational DB, allowing for O(log(n)) lookups.
(fyi: Neo4j has no tables, but each node(~=row) can have different labels, comparable to gmail labels. This is more flexible: you don't have to chose whether you put cars and bicycles in one for vehicles table or not: a bicycle would have both a :vehicle and a :bicycle label.)
To answer the original question: Neo4j does hardly support for schema enforcement. Neo advices implementing automated consistency tests on your database, which you run on your acceptance test instance as part of your release cycle.
Using an enterprise db such as oracle will give you many, many features which may or may not be part of neo. These include:
ACID transactions
High availability / backups / standby
ability to use sql to get data in the most efficient way using a cost based optimizer - the db determines the best way to retrieve the data based on your latest statistics
Scalability, partitioning
support
security
If you are going to implement most of the functionality of your application in code by yourself and don't require the structure and advanced features offered by an rdbms or if your data structures are better suited to a graph based db then by all means trial neo. There is a reason that most corporate apps use a one of the traditional rdbms servers but this may not always be the case in the future
Related
I am looking at rewriting a VB based on-premise (locally installed) application (invoicing+inventory) as a web based Clojure application for small enterprise customers. I am intending this to be offered as a SaaS application for customers in similar trade.
I was looking at database options: My choice was an RDBMS: Postgresql/ MySQL. I might scale up to 400 users in the first year, with typically a 20-40 page views/ per day per user - mostly for transactions not static views. Each view will involve fetch data and update data. ACID compliance is necessary(or so I think). So the transaction volume is not huge.
It would have been a no-brainer to pick either of these based on my preference, but for this one requirement, which I believe is typical of a SaaS app: The Schema will be changing as I add more customers/users and for each customer's changing business requirement (I will be offering some limited flexibility only to start with). As I am not a DB expert, based on what I can think of and has read, I can handle that in a number of ways:
Have a traditional RDBMS schema design in MySQl/Postgresql with a single DB hosting multiple tenants. And add enough "free-floating" columns in each table to allow for future changes as I add more customers or changes for an existing customer. This might have a downside of propagating the changes to the DB every time a small change is made to the Schema. I remember reading that in Postgresql schema updates can be done real time without locking. But not sure, how painful or how practical is it in this use case. And also, as the schema changes might also introduce new/ minor SQL changes as well.
Have an RDBMS, but design the database schema in a flexible manner: with a close to entity-attribute-value or just as a key-value store. (Workday, FriendFeed for example)
Have the entire thing in-memory as objects and store them in log files periodically.(e.g., edval, lmax)
Go for a NoSQL DB like MongoDB or Redis. But based on what I can gather, they are not suitable for this use-case and not fully ACID compliant.
Go for some NewSQL Dbs like VoltDb or JustoneDb(cloud based) which retain the SQL and ACID compliant behaviour and are "new-gen" RDBMS.
I looked at neo4j(graphdb), but not sure if that will fit this use-case
In my use case, more than scalability or distributed computing, I am looking at a better way to achieve "Flexibility in Schema + ACID + some reasonable Performance". Most of the articles I could find on the net speak of flexibility in schema as a cause leading to performance(in the case of NoSQL DBs) and scalability while leaving out the ACID/Transactions side.
Is this an "either or" case of 'Schema flexibility vs ACID' transactions or Is there a better way out?
I think tarantool can help you. That solution have transactions, lua, msgpack, and etc. And also see that video
oracle has a good reputation for handling large-scale applications and it's also flexible to extend to cluster environment. Why everyone wants NOSQL?
because nosql db is much cheaper?
why not swith object-oriented db?
Firstly, not everyone does want NoSQL. Packaged software (eg ERP) is all pretty much mainstream RDBMS stuff. Don't confuse the amount of development effort with the usage.
What has happened is that NoSQL has opened up a whole range of applications that simply didn't suit relational technologies, and so there's been a rush of applications that CAN be developed. Most of the stuff that could be developed on RDBMS platforms already has been and is in more of a maintenance/upgrade phase. Probably with less upgrading than usual because of the whole global financial climate.
So in ten/fifteen years, as those NoSQL apps move into the same level of maturity, the frenzy will have died down and there's be less excitement.
Oracle also have NoSQL solution: http://www.oracle.com/technetwork/database/nosqldb/overview/index.html
A SQL solution isn't necessarily what you want regardless of scale.
There are situations where you can't easily predict the schema of your model, or worst still your data is schemaless. In those situations you want a data model which doesn't limit you but rather allows you the flexibilty you need to evolve your data while still maintaining core abilities such as fast indexes.
Another reason is that SQL doesn't represent the natural way in which you want to look at your data, predominantly graph DBs such as Neo4J or GraphDB allow developers or users to approach a linked graph model in a more intuitive way.
Of course there is a way to address all these issues in Oracle RDBMS, but it feels more like hacking the DB to fit your needs as opposed to using a DB that fits you. This sounds like a perk but it actually goes a long way into the ease of development and analysis of your application.
Now if we are talking about scale, Oracle can probably beat column based DBs such as HBase or Hypertable, but it is important to note that Oracle RDBMS isn't just more expensive it's way way more expensive. In today's world even small time startups have Terabytes of data they need to analyze daily. Even small companies can use clusters of 100 machines in the cloud to store their data, in such a company Oracle isn't a viable option the annual licensing cost and the hiring of DBAs will prevent startups from using it.
Finally the last reason why you would start off with NoSQL is speed, bringing up a MongoDB and starting development can be done in 5 minutes and sometimes you wanna handle problems as they come up and avoid premature optimization
If you are willing to let go consistency, there are no theorical limits to how mouch you can scale out some NoSQL solutions.
Some RDBMS can scale a lot, and Oracle is among the best of them, but no RDBMS let you cut in consistency, and therefor even the best has a pretty clear theorical limit to how much it can scale, not to mention the real world limits.
Some big names on the net just can't rely only on RDBMS anymore, and many others follows just to be like the big ones. Finally, some solutions are realy best fitted on a scheam-less structure, but those don't account for the most part of NoSQL users I would guess. The main point is to scale the web 2.0.
This is a very general question you are asking. Are you comparing the relational database to NOSQL database, or are you comparing commercial or open source database? We need to figure out as it seems we are comparing apples to oranges, and you will not get a straight answer.
Here are the breakdown from my perspective.
DB type: If you are comparing relational db vs NOSQL db, you should refer to this link
instead.
Cost: If you are comparing from a cost perspective, each has its own cost. Oracle will charge for the license, while the NOSQL db (using MongoDB as an example) are open source, and you don't have to pay the license. But you will need someone to have a good understanding of NOSQL to administer and maintain the site, which is a lot harder to find.
Application: What kind of application are you writing? You need to understand the database requirement for your application. If you need to store a lot of unstructured data as a key value entry, you are better off using NOSQL. On the other side of coin, you would prefer SQL db if you will join a lot of tables and execute complex SQL.
You mentioned Object Oriented DB, and that is another type of database from NoSQL or relational DB. At the end, it depends on your need. To expand the choice of horizon, some might heard of hierarchical database, which mainly live in mainframe environment. :-)
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I've been hearing things about NoSQL and that it may eventually become the replacement for SQL DB storage methods due to the fact that DB interaction is often a bottle neck for speed on the web.
So I just have a few questions:
What exactly is it?
How does it work?
Why would it be better than using a SQL Database? And how much better is it?
Is the technology too new to start implementing yet or is it worth taking a look into?
There is no such thing as NoSQL!
NoSQL is a buzzword.
For decades, when people were talking about databases, they meant relational databases. And when people were talking about relational databases, they meant those you control with Edgar F. Codd's Structured Query Language. Storing data in some other way? Madness! Anything else is just flatfiles.
But in the past few years, people started to question this dogma. People wondered if tables with rows and columns are really the only way to represent data. People started thinking and coding, and came up with many new concepts how data could be organized. And they started to create new database systems designed for these new ways of working with data.
The philosophies of all these databases were different. But one thing all these databases had in common, was that the Structured Query Language was no longer a good fit for using them. So each database replaced SQL with their own query languages. And so the term NoSQL was born, as a label for all database technologies which defy the classic relational database model.
So what do NoSQL databases have in common?
Actually, not much.
You often hear phrases like:
NoSQL is scalable!
NoSQL is for BigData!
NoSQL violates ACID!
NoSQL is a glorified key/value store!
Is that true? Well, some of these statements might be true for some databases commonly called NoSQL, but every single one is also false for at least one other. Actually, the only thing NoSQL databases have in common, is that they are databases which do not use SQL. That's it. The only thing that defines them is what sets them apart from each other.
So what sets NoSQL databases apart?
So we made clear that all those databases commonly referred to as NoSQL are too different to evaluate them together. Each of them needs to be evaluated separately to decide if they are a good fit to solve a specific problem. But where do we begin? Thankfully, NoSQL databases can be grouped into certain categories, which are suitable for different use-cases:
Document-oriented
Examples: MongoDB, CouchDB
Strengths: Heterogenous data, working object-oriented, agile development
Their advantage is that they do not require a consistent data structure. They are useful when your requirements and thus your database layout changes constantly, or when you are dealing with datasets which belong together but still look very differently. When you have a lot of tables with two columns called "key" and "value", then these might be worth looking into.
Graph databases
Examples: Neo4j, GiraffeDB.
Strengths: Data Mining
While most NoSQL databases abandon the concept of managing data relations, these databases embrace it even more than those so-called relational databases.
Their focus is at defining data by its relation to other data. When you have a lot of tables with primary keys which are the primary keys of two other tables (and maybe some data describing the relation between them), then these might be something for you.
Key-Value Stores
Examples: Redis, Cassandra, MemcacheDB
Strengths: Fast lookup of values by known keys
They are very simplistic, but that makes them fast and easy to use. When you have no need for stored procedures, constraints, triggers and all those advanced database features and you just want fast storage and retrieval of your data, then those are for you.
Unfortunately they assume that you know exactly what you are looking for. You need the profile of User157641? No problem, will only take microseconds. But what when you want the names of all users who are aged between 16 and 24, have "waffles" as their favorite food and logged in in the last 24 hours? Tough luck. When you don't have a definite and unique key for a specific result, you can't get it out of your K-V store that easily.
Is SQL obsolete?
Some NoSQL proponents claim that their favorite NoSQL database is the new way of doing things, and SQL is a thing of the past.
Are they right?
No, of course they aren't. While there are problems SQL isn't suitable for, it still got its strengths. Lots of data models are simply best represented as a collection of tables which reference each other. Especially because most database programmers were trained for decades to think of data in a relational way, and trying to press this mindset onto a new technology which wasn't made for it rarely ends well.
NoSQL databases aren't a replacement for SQL - they are an alternative.
Most software ecosystems around the different NoSQL databases aren't as mature yet. While there are advances, you still haven't got supplemental tools which are as mature and powerful as those available for popular SQL databases.
Also, there is much more know-how for SQL around. Generations of computer scientists have spent decades of their careers into research focusing on relational databases, and it shows: The literature written about SQL databases and relational data modelling, both practical and theoretical, could fill multiple libraries full of books. How to build a relational database for your data is a topic so well-researched it's hard to find a corner case where there isn't a generally accepted by-the-book best practice.
Most NoSQL databases, on the other hand, are still in their infancy. We are still figuring out the best way to use them.
What exactly is it?
On one hand, a specific system, but it has also become a generic word for a variety of new data storage backends that do not follow the relational DB model.
How does it work?
Each of the systems labelled with the generic name works differently, but the basic idea is to offer better scalability and performance by using DB models that don't support all the functionality of a generic RDBMS, but still enough functionality to be useful. In a way it's like MySQL, which at one time lacked support for transactions but, exactly because of that, managed to outperform other DB systems. If you could write your app in a way that didn't require transactions, it was great.
Why would it be better than using a SQL Database? And how much better is it?
It would be better when your site needs to scale so massively that the best RDBMS running on the best hardware you can afford and optimized as much as possible simply can't keep up with the load. How much better it is depends on the specific use case (lots of update activity combined with lots of joins is very hard on "traditional" RDBMSs) - could well be a factor of 1000 in extreme cases.
Is the technology too new to start implementing yet or is it worth taking a look into?
Depends mainly on what you're trying to achieve. It's certainly mature enough to use. But few applications really need to scale that massively. For most, a traditional RDBMS is sufficient. However, with internet usage becoming more ubiquitous all the time, it's quite likely that applications that do will become more common (though probably not dominant).
Since someone said that my previous post was off-topic, I'll try to compensate :-) NoSQL is not, and never was, intended to be a replacement for more mainstream SQL databases, but a couple of words are in order to get things in the right perspective.
At the very heart of the NoSQL philosophy lies the consideration that, possibly for commercial and portability reasons, SQL engines tend to disregard the tremendous power of the UNIX operating system and its derivatives.
With a filesystem-based database, you can take immediate advantage of the ever-increasing capabilities and power of the underlying operating system, which have been steadily increasing for many years now in accordance with Moore's law. With this approach, many operating-system commands become automatically also "database operators" (think of "ls" "sort", "find" and the other countless UNIX shell utilities).
With this in mind, and a bit of creativity, you can indeed devise a filesystem-based database that is able to overcome the limitations of many common SQL engines, at least for specific usage patterns, which is the whole point behind NoSQL's philosophy, the way I see it.
I run hundreds of web sites and they all use NoSQL to a greater or lesser extent. In fact, they do not host huge amounts of data, but even if some of them did I could probably think of a creative use of NoSQL and the filesystem to overcome any bottlenecks. Something that would likely be more difficult with traditional SQL "jails". I urge you to google for "unix", "manis" and "shaffer" to understand what I mean.
If I recall correctly, it refers to types of databases that don't necessarily follow the relational form. Document databases come to mind, databases without a specific structure, and which don't use SQL as a specific query language.
It's generally better suited to web applications that rely on performance of the database, and don't need more advanced features of Relation Database Engines. For example, a Key->Value store providing a simple query by id interface might be 10-100x faster than the corresponding SQL server implementation, with a lower developer maintenance cost.
One example is this paper for an OLTP Tuple Store, which sacrificed transactions for single threaded processing (no concurrency problem because no concurrency allowed), and kept all data in memory; achieving 10-100x better performance as compared to a similar RDBMS driven system. Basically, it's moving away from the 'One Size Fits All' view of SQL and database systems.
In practice, NoSQL is a database system which supports fast access to large binary objects (docs, jpgs etc) using a key based access strategy. This is a departure from the traditional SQL access which is only good enough for alphanumeric values. Not only the internal storage and access strategy but also the syntax and limitations on the display format restricts the traditional SQL. BLOB implementations of traditional relational databases too suffer from these restrictions.
Behind the scene it is an indirect admission of the failure of the SQL model to support any form of OLTP or support for new dataformats. "Support" means not just store but full access capabilities - programmatic and querywise using the standard model.
Relational enthusiasts were quick to modify the defnition of NoSQL from Not-SQL to Not-Only-SQL to keep SQL still in the picture! This is not good especially when we see that most Java programs today resort to ORM mapping of the underlying relational model. A new concept must have a clearcut definition. Else it will end up like SOA.
The basis of the NoSQL systems lies in the random key - value pair. But this is not new. Traditional database systems like IMS and IDMS did support hashed ramdom keys (without making use of any index) and they still do. In fact IDMS already has a keyword NONSQL where they support SQL access to their older network database which they termed as NONSQL.
It's like Jacuzzi: both a brand and a generic name. It's not just a specific technology, but rather a specific type of technology, in this case referring to large-scale (often sparse) "databases" like Google's BigTable or CouchDB.
NoSQL the actual program appears to be a relational database implemented in awk using flat files on the backend. Though they profess, "NoSQL essentially has no arbitrary limits, and can work where other products can't. For example there is no limit on data field size, the number of columns, or file size" , I don't think it is the large scale database of the future.
As Joel says, massively scalable databases like BigTable or HBase, are much more interesting. GQL is the query language associated with BigTable and App Engine. It's largely SQL tweaked to avoid features Google considers bottle-necks (like joins). However, I haven't heard this referred to as "NoSQL" before.
NoSQL is a database system which doesn't use string based SQL queries to fetch data.
Instead you build queries using an API they will provide, for example Amazon DynamoDB is a good example of a NoSQL database.
NoSQL databases are better for large applications where scalability is important.
Does NoSQL mean non-relational database?
Yes, NoSQL is different from RDBMS and OLAP. It uses looser consistency models than traditional relational databases.
Consistency models are used in distributed systems like distributed shared memory systems or distributed data store.
How it works internally?
NoSQL database systems are often highly optimized for retrieval and appending operations and often offer little functionality beyond record storage (e.g. key-value stores). The reduced run-time flexibility compared to full SQL systems is compensated by marked gains in scalability and performance for certain data models.
It can work on Structured and Unstructured Data. It uses Collections instead of Tables
How do you query such "database"?
Watch SQL vs NoSQL: Battle of the Backends; it explains it all.
What exactly is NoSQL? Is it database systems that only work with {key:value} pairs?
As far as I know MemCache is one of such database systems, am I right?
What other popular NoSQL databases are there and where exactly are they useful?
Thanks, Boda Cydo.
I'm not agree with the answers I'm seeing, although it's true that NoSQL solutions tends to break the ACID rules, not all are created from that approach.
I think first you should define what is a SQL Solution and then you can put the "Not Only" in front of it, that will be more accurate definition of what is a NoSQL solution.
With this approach in mind:
SQL databases are a way to group all the data stores that are accessible using Structured Query Language as the main (and most of the time only) way to communicate with them, this means it requires that the database support the structures that are common to those systems like "tables", "columns", "rows", "relationships", etc.
Now, put the "Not Only" in front of the last sentence and you will get a definition of what means "NoSQL". NoSQL groups all the stores created as an attempt to solve problems which cannot fit into the table/column/rows structures or even in SQL Statements, in most of the cases these databases will not support relationships, they're abandoning the well known structures just because the problems have changed since their conception.
If you have a text file, and you create an API to store/retrieve/organize this information, then you have a NoSQL database in your hands.
All of these means that there are several solutions to store the information in a way that traditional SQL systems will not allow to achieve better performance, flexibility, etc etc. Every NoSQL provider tries to solve a different problem and that's why you wont be able to compare two different solutions, for example:
djondb is a document store created to be used as
NoSQL enterprise solution supporting transactions, consistency, etc.
but sacrifice performance of its counterparts.
MongoDB is a document store (similar to
djondb) which accomplish great performance but trades some of the
ACID properties to achieve this.
CouchDB is another document store which
solves the queries slightly different providing views to retrieve the
information without doing a full query every time.
...
As you may have noticed I only talked about the document stores, that's because I wanted to show you that 3 different document stores implementations have different approach, therefore you should keep in mind the golden rule of NoSQL stores "Use the right tool for the right job".
I'm the creator of djondb and I've been doing a lot of research even before trying to start my own NoSQL implementation, but this is a field where the concepts will keep changing the way we see the information storage.
From wikipedia:
NoSQL is an umbrella term for a loosely defined class of non-relational data stores that break with a long history of relational databases and ACID guarantees. Data stores that fall under this term may not require fixed table schemas, and usually avoid join operations. The term was first popularised in early 2009.
The motivation for such an architecture was high scalability, to support sites such as Facebook, advertising.com, etc...
To quickly get a handle on NoSQL systems, see this blog post I wrote: Visual Guide to NoSQL Systems. Essentially, NoSQL systems sacrifice either consistency or availability in favor of tolerance to network partitions.
What is NoSQL ?
NoSQL is the acronym for Not Only SQL. The basic qualities of NoSQL databases are schemaless, distributed and horizontally scalable on commodity hardware. The NoSQL databases offers variety of functions to solve various problems with variety of data types, where “blob” used to be the only data type in RDBMS to store unstructured data.
1 Dynamic Schema
NoSQL databases allows schema to be flexible. New columns can be added anytime. Rows may or may not have values for those columns and no strict enforcement of data types for columns. This flexibility is handy for developers, especially when they expect frequent changes during the course of product life cycle.
2 Variety of Data
NoSQL databases support any type of data. It supports structured, semi-structured and unstructured data to be stored. Its supports logs, images files, videos, graphs, jpegs, JSON, XML to be stored and operated as it is without any pre-processing. So it reduces the need for ETL (Extract – Transform – Load).
3 High Availability Cluster
NoSQL databases support distributed storage using commodity hardware. It also supports high availability by horizontal scalability. This features enables NoSQL databases get the benefit of elastic nature of the Cloud infrastructure services.
4 Open Source
NoSQL databases are open source software. The usage of software is free and most of them are free to use in commercial products. The open sources codebase can be modified to solve the business needs. There are minor variations in the open source software licenses, users must be aware of license agreements.
5 NoSQL – Not Only SQL
NoSQL databases not only depend SQL to retrieve data. They provide rich API interfaces to perform DML and CRUD operations. These are APIs are move developer friendly and supported in variety of programming languages.
Take a look at these:
http://en.wikipedia.org/wiki/Nosql#List_of_NoSQL_open_source_projects
and this:
http://www.mongodb.org/display/DOCS/Comparing+Mongo+DB+and+Couch+DB
I used something called the Raima Data Manager more than a dozen years ago, that qualifies as NoSQL. It calls itself a "Set Oriented Database" Its not based on tables, and there is no query "language", just an C API for asking for subsets.
It's fast and easier to work with in C/C++ and SQL, there's no building up strings to pass to a query interpreter and the data comes back as an enumerable object rather than as an array. variable sized records are normal and don't waste space. I never saw the source code, but there were some hints at the interface that internally, the code used pointers a lot.
I'm not sure that the product I used is even sold anymore, but the company is still around.
MongoDB looks interesting, SourceForge is now using it.
I listened to a podcast with a team member. The idea with NoSQL isn't so much to replace SQL as it is to provide a solution for problems that aren't solved well with traditional RDBMS. As mentioned elsewhere, they are faster and scale better at the cost of reliability and atomicity (different solutions to different degrees). You wouldn't want to use one for a financial system, but a document based system would work great.
Here is a comprehensive list of NoSQL Databases: http://nosql-database.org/.
I'm glad that you have had success with RDM John! I work at Raima so it's great to hear feedback. For those looking for more information, here are a couple of resources:
Video Overview of RDM's General Architecture
Free Evaluation Download of RDM
I am trying to decide whether to use voldemort or couchdb for an upcoming healthcare project. I want a storage system that has high availability , fault tolerance, and can scale for the massive amounts of data being thrown at it.
What is the pros/cons of each?
Thanks
Project Voldemort looks nice, but I haven't looked deeply into it so far.
In it current state CouchDB might not be the right thing for "massive amounts of data". Distributing data between nodes and routing queries accordingly is on the roadmap but not implemented so far. The biggest known production setups of CouchDB use "tables" ("databases" in couch-speak) of about 200G.
HA is not natively supported by CouchDB but can build easily: All CouchDB nodes are replicating the database nodes between each other in a multi-master setup. We put two Varnish proxies in front of the CouchDB machines and the Varnish boxes are made redundant with CARP. CouchDBs "build from the Web" design makes such things very easy.
The most pressing issue in our setup is the fact that there are still issues with the replication of large (multi MB) attachments to CouchDB documents.
I suggest you also check the traditional RDBMS route. There are huge issues with available talent outside the RDBMS approach and there are very capable offerings available from Oracle & Co.
Not knowing enough from your question, I would nevertheless say Project Voldemort or distributed hash tables (DHTs) like CouchDB in general are a solution to your problem of HA.
Those DHTs are very nice for high availability but harder to write code for than traditional relational databases (RDBMS) concerning consistency.
They are quite good to store document type information, which may fit nicely with your healthcare project but make development harder for data.
The biggest limitation of most stores is that they are not transactionally safe (See Scalaris for an transactionally safe store) and you need to ensure data consistency by yourself - most use read time consistency by merging conflicting data). RDBMS are much easier to use for consistency of data (ACID)
Joining data is much harder too. In RDBMs you can easily query data over several tables, you need to write code in CouchDB to aggregate data. For other stores Hadoop may be a good choice for aggregating information.
Read about BASE and the CAP theorem on consistency vs. availability.
See
http://www.metabrew.com/article/anti-rdbms-a-list-of-distributed-key-value-stores/
http://queue.acm.org/detail.cfm?id=1394128
Is memcacheDB an option? I've heard that's how Digg handled HA issues.