EMR Databases – Which is Best?

Posted on December 26, 2005 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Which is the best database for your EMR to use is a very tough question. In fact, like most questions the best answer is it depends. Here’s a few things to think about when you choose an EMR vendor and their associated database.

My first suggestion is that you avoid any database that is proprietary. When I say proprietary I mean any database that doesn’t allow you to add tables and modify the way the database is designed. Sure, almost every vendor will have policies on which tables and which parts of the database you are allowed to modify in order to maintain the integrity of the database, but no database should forbid you from adding tables in order to get the most out of your EMR. I think this is espescially important for custom reports you may want to create.

Second, look at the cost of the database as part of the overall cost of the EMR. Many colleges are lucky to have a site license for Oracle and so if some EMR is based on oracle then the expense will be much less for those in College Health and have this advantage. However, if your institution doesn’t have this site license then Oracle would be a very costly alternative. SQL Server licenses are also quite costly even if you could the college health education discount. MySQL is open source and therefore could be downloaded for free. If you have some in house expertise then you also will be able to avoid most other costs related to your database, but just know that because the software is delivered free there are often unseen costs that show up in managing the database. That covers the top 3 alternatives I think.

Understanding the language and the server software(ie. Windows, Linux, etc) you will be using is another important consideration when choosing a database. It doesn’t make much sense to use VB and connect to MySQL. Likewise, I don’t think it is wise to run MySQL on a Windows machine. If you go open source stay open source. If you go with Windows stay with windows. If you choose oracle then look at your in house skills, but I believe linux is better.

One final suggestion has to do with vendors who support multiple databases. You should consider the above criteria, but more importantly you should have a conversation with the vendor to see what database was used for the original development and which database was the program meant for. You will be best served if you use the database that the vendor is most familiar with so they can support you if and when any problems occur.