As the ICD evolves, new codes might be added but the fundamental structure remains the same. A crude analogy would be a comparison between the Dewey decimal system and the ICD. Let's say you're with a patient and need to code in a ICD value for whatever malady he has. You have two forms of changes which can occur within your data model - (a) definition changes where your schema stays the same effectively and (b) paradigm changes. That being said - let's take a field which changes fairly rapidly, all things considered - medicine. I understand why Cassandra et al were required when generating dynamic live newsfeeds for each user in an ecosystem when the RDBMS query plan was pretty much designed in a naive non-uber-scalable-fashion.
Let me preface this with: I'm a huge proponent of SQL when appropriate.
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