Progression of the health data management lifecycle

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In 300-500 words compare bottom-up to top-down modeling. On the progression of the health data management lifecycle, what is the best approach to arrive at an effective data model?

There are two different viewpoints you can have regarding top-down versus bottom-up data modeling. The first is the movement from general to specific versus specific to general, and the second is the movement from functional to technical versus technical to functional. Needs assessment is the first step and the basis for all health care data based projects, followed by requirements, conceptual, logical and physical design. If top-down is viewed as the movement from functional to technical, how vital is this approach for effective data model design within the management lifecycle?

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