--- Cameron Schlehuber <[EMAIL PROTECTED]> wrote:

> The key is to have a "unique key" that both systems use to identify
> each
> record uniquely.  The problem of duplicates arises when ambiguous
> identifying traits are all that are used.  Names, date of birth, etc,
> can
> all be entered with slight variations for the same person and can
> also be
> found to be the same for different persons.  That's why once a unique
> ID is
> assigned to a set of traits for a given person, using that ID (or
> "key" in
> table records) for solid identification becomes very important.  When
> you
> don't have such a "key", the process of matching up the data has to
> be done
> all over each time.
> 

That's not an insignificant problem because different organizations are
bound to use different identifiers. A Master Patient Index (MPI) is a
good solution when everyone uses the same index, but what if they don't
(or can't)? HL7 takes an interesting approach, allowing registry
identifiers to be part of the unique key. But how are registries
identified? Is there a body that assigns unique identifiers to VHA,
Kaiser, CHCW, and so forth? The problem is not at all unlike the use of
protocol numbers in TCP/IP (assigned centrally by the IANA) or domain
names (which are not centrally assigned or managed, but instead are
handled through a hierarchical series of registries). Ultimately, I
believe we will need some type of hierarchical designator and a set of
open standards describing how they should be managed.

===
Gregory Woodhouse  <[EMAIL PROTECTED]>
"All truth passes through three stages: First, it is ridiculed.
Second, it is violently opposed. Third, it is accepted as
being self-evident."
--Arthur Schopenhauer


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