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'NoSQL' and Electronic Patient Record Systems: Opportunities and Challenges

Research into electronic health record systems can be traced back over four decades however the penetration of records which incorporate more than simply basic information into healthcare organizations is relatively limited. There is a great (and largely unsatisfied) demand for effective health record systems, such systems are very difficult to build with data generally stored in highly distributed states in a diverse range of formats as unstructured data with access and updating achieved over online systems. Internet application design must reflect three trends in the computing landscape: (1) growing numbers of users applications must support (along with growing user performance expectations), (2) growth in the volume and range and diversity in the data that developers accommodate, and (3) and the rise of Cloud Computing (which relies on a distributed three-tier Internet architecture). The traditional approach to data storage has generally employed Relational Database Systems however to address the evolving paradigm interest has been shown in alternative database systems including 'NoSQL' technologies which are gaining traction in Internet based enterprise systems. This paper considers the requirements of distributed health record systems in online applications and database systems. The analysis supports the conclusion that 'NoSQL' database systems provide a potentially useful approach to the implementation of HR systems in online applications.