Many of the larger EMR or clinical research database vendors have realized this, but their designs are proprietary and not described in the literature. ![]() Appropriately designed metadata, and software designed to utilize it effectively, can provide significant insulation against change. ![]() In biomedical domains, new knowledge is being generated continually, and the databases that must support areas such as clinical care and research must also be able to evolve while requiring minimal or no logical / physical redesign. ![]() While the use of database technology is ubiquitous throughout IT (and health IT in particular), it is not generally appreciated that, as a database increases in scope, certain designs are far superior to others.
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