Medical Databases and Patient Record Systems

Abstract

As computer-based electronic patients’ records replaced paper-based charts, hospital medical records departments gave way to computer centers that stored data on magnetic disks. As computer storage became cheaper and database designs became more efficient, medical databases grew in size and variety. Federated databases could store large volumes of aggregated data in multiple partitions, or as functionally oriented databases that were logically interconnected. Directly accessible from clinical applications, they allowed users to simultaneously access and query data for patient care, clinical research, and financial reimbursement. Extended central databases collected and managed data from different databases. Known as data warehouses, they could service ever-increasing volumes of data collected from ever-changing medical technologies. Larger warehouses developed partitions and data marts for subsets of data to serve users with specific needs. The need to store and query large collections of data led to the development of online analytical processing (OLAP), distributed database systems, distributed database management systems, and translational data processing between multiple data warehouses. With more powerful computers in the 1990s, physicians began to enter data directly into the patient’s electronic health record using the keyboard, mouse, and clinical workstation. Dedicated computers became database servers to store and integrate multiple databases. In the 2000s electronic health records became more common; in the 2010s federal funding produced more widespread diffusion of electronic health records, and advances in informatics resulted in more efficient data management of expanding, multi-media, patient care databases.