---
layout: clqms-post.njk
tags: clqms
title: "Database Design Review: Claude Sonnet"
date: 2025-12-05
order: 5
---

# Database Schema Design Review

**Prepared by:** Claude Sonnet
**Date:** December 12, 2025

## Executive Summary

**Overall Assessment:** ⚠️ **Over-Engineered**

The schema will technically work and can deliver the required functionality, but presents significant challenges.

| Aspect | Rating | Impact |
|--------|--------|--------|
| Functionality | ✅ Will work | Can deliver features |
| Maintainability | ⚠️ Poor | High developer friction |
| Performance | ❌ Problematic | Requires extensive optimization |
| Complexity | ❌ Excessive | Steep learning curve |
| Scalability | ⚠️ Questionable | Architecture limitations |

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## Critical Issues

### Issue #1: Excessive Normalization

**Severity:** 🟡 Medium

Single-field data has been separated into dedicated tables, creating unnecessary complexity.

### Issue #2: Problematic Unique Constraints

**Severity:** 🔴 Critical - Production Blocker

- `EmailAddress1` marked UNIQUE - will break for families sharing emails
- `InternalPID` unique in `patcom` - only allows ONE comment per patient EVER

### Issue #3: Audit Trail Overkill

**Severity:** 🟡 Medium

Every log table tracks 15+ fields per change, creating massive overhead with unclear benefit.

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## Recommendations

### 🔴 Critical Priority - Address Immediately

1. Remove problematic unique constraints (EmailAddress1, patcom.InternalPID)
2. Fix incomplete tables (add missing fields to `patrelation`)
3. Document temporal field logic (CreateDate, EndDate, ArchivedDate, DelDate)

### 🟡 High Priority - Plan for Refactoring

1. Simplify audit trails (reduce 15+ fields to 5-7 essential fields)
2. Consolidate patient data (consider moving to main `patient` table)

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## Expected Benefits

| Metric | Value |
|--------|-------|
| Total Complexity Reduction | **40-50%** |
| Developer Productivity Gain | **30-40%** |
| Performance Improvement | **2-5x** |

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*End of Report - Claude Sonnet, December 12, 2025*
