Webinar 2 - Additional Questions

We'd be interested in any training or best practices/practical advice or discussion with jurisdictions who are building or will be building a data warehouse. Also, is anyone building a Master Patient Index for their agency or part of their agency that is outside of a patient centric surveillance system? Also, while I believe that having access to an HIE is very useful for public health (if the HIE uses data standards), I don't think it would truly substitute for a data warehouse as the purpose of an HIE is different than what a PH data warehouse might be used for. Any advantages/disadvantages known about this?

Nancy, 

I *dream* of a MPI. :-) It would solve so many of our patient deduplication problems! Every business area in our agency works on deduplicating our patients and it's an issue faced by ELR and any time identified data is brought into the agency. 

I'd _love_ to see wide support for state MPIs, but off the top of my head, I think the legal and ethical challenges would be immense. As an aside - for disease and outbreak tracking reasons, USDA-APHIS has been trying to implement an animal tracking system similar to that deployed in most other countries (Canada is the one I'm most familiar with, but EU and others I'm sure have their version) for at least 10y in the US and haven't been able to due to producer (cattle, dairy, swine, etc) opposition. For public health and outbreak tracking reasons, it would be mighty useful to be able to track an animal from birth to table, even retrospectively (just an ID number, even without a centralized database of movements), but it's been violently opposed for privacy reasons. https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/SA_Traceability 

I was just talking with a co-worker about this - in STIs alone, it would save us _so_ much time! A solution in wide use that avoids the issue of using social security or other 'secret' numbers and has been in use since the 1970s is Sweden's PNumber: https://en.m.wikipedia.org/wiki/Personal_identity_number_(Sweden) A key point is that it's public and anyone can request it, for anyone, and their vital records office maintains the linkage between Pnumbers and other ID/identity. However, there are some key differences in our systems that make Pnumber theft (using someone's Pnumber at the Drs office) much less of an issue in Sweden than it would be here - namely, single payer healthcare. There's little benefit to using another Pnumber when everyone can get the same services with theirs, or request a temporary number easily. 

My .02 on a HIE is that it's just a big shared pipe... nothing rests there, so it's a great addition for public health to share/receive information from clinicians, pharmacists, etc, but it's no real help for a data repository. That's just my .02, and we don't have a data warehouse or a concrete plan to create one, so I'd love it if someone using a DW would correct my understanding if I'm wrong!

Crystal