Implementing enterprisewide databases: a challenge that can be overcome

The evolving health care industry is placing new demands on its participants. Traditional institutional boundaries are being replaced by the need to cooperate, collaborate, and share increasingly scarce resources to provide high-quality care to patients. Information, which historically was coveted and protected, must now be shared by the multiple providers and organizations that together provide services. This need to share information has brought on the need for organizations to build common databases from which reports can be run, trends can be noted, and patient information can be drawn. Data warehouses and clinical data repositories are being recognized as solutions to issues of segregation of information. Both solutions are relatively new to health care, and there is acknowledgment that neither is simple to implement and that both represent new challenges to health care organizations. The article provides working definitions of the two solutions, describes at a high level some of the challenges associated with their implementation, and provides some of the key steps required to develop, implement, and realize the benefits of the clinical data repository or data warehouse.