Addressing extensibility requirements for health informatics data

The electronic health record (EHR) is a key artifact that threads the workflow from medical encounters to resolution (treatments and claims disposition) - it aims to provide a longitudinal view into a patient's interaction with care providers within an institution to enable better and streamlined care. The EHR must front a variety of information sources which can vary and evolve over time, creating natural challenges for data representation, storage, retrieval, and information mutation. We argue that underlying data systems must store information in a flexible manner to allow EHR and other systems to insert and extract data without rigid constraints and strict or a priori defined schemas.