We are experiencing a revolution in the distribution of knowledge in the twenty-first century. Knowledge is no more centrifugally dispensed, means centrally produced and distributed in the periphery—today knowledge is produced everywhere and can be accessed instantaneously everywhere. Technological and methodological progress allows us now to evaluate the real world directly, by collecting information in unselected populations not accessible via randomized clinical trials. The term safetyness is suggested to mark that we have to appreciate that the world of randomized clinical trials and the real world are different in nature. In this context this chapter investigates patient registries, as a powerful tool for the future of health technology assessment in general and pharmacovigilance in particular.