We live in a world of increasing data access and use, recognising that exacting scientific analysis can spur insight, innovations and quality improvement in healthcare. How do we manage the conundrum that clinical analyses such as comparative effectiveness studies of therapeutics and outcomes studies are called research and must undergo lengthy and burdensome research regulatory processes while "Business Intelligence" solutions need not. Yet arguably the effectiveness and outcomes studies are more likely to produce clinically valid results leading to improvements in care than the plethora of 'operational' reports currently being generated.