The main aim of any healthcare database system should be to facilitate quality patient care. To that end, these systems should exploit advantages related to medical records, particularly up-to-date patient histories and timely access. Consequently, these databases are invaluable in clinical environments, particularly with regard to managerial transactions. Health care organizations require these database systems for making the acquisition and usage of data related to health more efficient and accessible. Organizations are dependent on such systems in order to inform or notify or to make decisions, like managerial decisions, and also in order to improve processes in parts which are related to the planning of the public health. These health information systems (or HIS) have really advanced and improved as an important tool for public health.

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Information systems presently can provide direction and assistance in making decisions related to data pertaining to public health. HIS provides a great deal of support to the aims of public health care; these aims include medical health results or facility evaluations, as well as clinical administration and its research, evaluation of the planning of programs, scrutinizing the policies related to public health, program policy development and evaluation, and analysis of utilization and approximation related to demand, along with quality declarations and measurements related to performance. HIS faces challenges in developing and also managing in addressing those issues which are related to public health. Problems and effects in relation to the health management have been identified in five areas which include present-day ideas and the applications of HIS towards the public health, the architectures of the information systems, databases which are available, operational models, and security and confidentiality.

A number of DBMSs use a particular form of architecture which is known as the three-level architecture. These levels are internal, conceptual, and external. The internal one explains how the data could be stored in the database (space allocation and also encryption). It also interacts along with OS in order to manage the files in their physical storage. The conceptual concept defines what type of data is stored along with relationships between that data. The external concept relates to the viewpoint of the users, related to the data. There are three schemes which are represented by these three levels: one internal and the other one is a conceptual schema that is per DB. However, there could be a number of external sub-schemas.

Distributed relational database architecture (DRDA) explains architecture that is linked to the distributed data. In addition to this, it also describes the rules for assessment of the data which is distributed; however, it does not offer actual application programming interfaces (APIs) to achieve access. DRDA allows a number of database systems along with some application programs to work together. Any of the combinations linked to products of the relational database management which use DRDA can be associated in order to form a dispersed database management system. DRDA has subsequent constituents such as the application requester, along with application servers including database servers. The job of the application requester is to agree to the requests of SQL from these applications and then to send these to their proper application servers in order to start processing. These application programs could also provide access to remote data if a health organization makes use of such a function. The server of this application then obtains the requests from the requesters of application; it then processes them. The job of an application server is to act on those parts of the requests which could be processed further, then forward the ones left to database servers in order to process them further. Then the database server collects requests from the application server along with the database servers. An additional function of this server is to support the distributed requests and also to forward the parts of a request to the database server in order to accomplish the request.

The professional literature of healthcare reveals that there are a number of settings in which people hunt for and eventually obtain health services. The requirements of people who used these databases around health care see and also relate with the particular technologies related to health care and are totally uninformed about technologies which are related to the development of the infrastructure in the everyday providing of health care. Some of the attention should be provided to the eventual user, the individual needs to access the system in order to obtain information which has already been gathered, with an understanding of usage by the large along with the smaller institutions and private users.

Any addition which is suggested by a particular HIS project including the infrastructural tools, either those tools used at present or those which are still under development, should be encompassed. There are other areas which should if they could cover the effect of the proposal on any of the efforts, even if they are the existing ones or the ones under development. The issues that demand consideration are connected to the safety, confidentiality, also the secrecy, scalability, and performance along with the requirements of the system. The relevance of technology would be related to law-making and supervisory issues. The architectures of the system and the database which are used in commercial EHRs, as well as needs related to EHRs in order to exchange information with pharmacies, laboratories, and also other systems, should be carefully considered.

One of the other advantages of such a system is that NIH or any other type of a suitable system could enter into a gigantic database in order to see the cumulative health of Americans, permitting them to more clearly and quickly identify areas for research, involvement, and care.

The basic things which are required for such an effort would be a single system which is for all, consuming a number of opposing systems which will portion that information, which may result in the loss of certain benefits. It also should be federally funded, in order for all Americans to have their medical information encompassed and properly available everywhere.

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