Program Description

As one of the original participating states in the Health Resources and Services Administration (HRSA) State Planning Grant (SPG) Program for grant period 2000–2001, the Arkansas team found a need to have access to existing data in a time frame that was conducive to policy decision-making discussions. To address this challenge, Arkansas utilized existing technologies and developed methods to incorporate existing data into a manageable format. The result of these efforts was the development of an Integrated Database as a data extraction tool.

During grantee meetings, the Arkansas team shared the challenges and resulting solutions with HRSA and the other funded states. After finding that other states did have some of the same challenges and an interest in the use of this data tool, Arkansas was approached by HRSA to develop the tools so that states funded in Rounds 1, 2, and 3 could have similar access to data to facilitate their policy discussions and strategy development.

Participating States

With HRSA's support and funding, the Arkansas team was able to develop a Multi-State Integrated Database (MSID) that provides access to data for all funded states. To date, 25 states from Rounds 1, 2, 3, and 4 of the HRSA SPG Program have received access to the database and several states have utilized the opportunity to incorporate their state-specific survey data into the database. One non-SPG state, New Mexico, has purchased access to the MSID using existing state funds.

Datasets

To provide access to the national database, the Arkansas team must acquire or capture data. This step includes performing integrity checks on the raw data captured from the data sources to ensure accuracy of raw data compared to nationally published data information available through traditional routes. The Arkansas team has obtained the national datasets listed below, completed all integrity checks of the data, and loaded data into the MSID system.

• Current Population Survey (CPS): This national survey is performed monthly by the US Census Bureau. Economic profiles include select health insurance questions once a year (March). CPS is the major source of household economic information nationally available that provides state-specific estimates.

• Behavioral Risk Factor Surveillance System (BRFSS): This state-level survey, supported by the Centers for Disease Control and Prevention, contains standardized questions fielded annually by all states. BRFSS is the major source of household information on health status and use of select services that provides state-specific estimates. Aggregation of results over the past 3 years facilitates small-area analyses of household information.

• County Business Patterns: Data available from the US Census Bureau provide information on existing businesses including industry type, employee number, and size of establishments based upon the number of employees. In the context of the MSID, these data will serve as the major source of information on business targets for health insurance expansion strategies.

Accessing the Databases

There are three typical types of users who access the MSID. The first is the "author-power user" who has intimate knowledge of the data and who is constructing complicated views to develop answers to earlier or complex questions. This user level is granted authority to publish views provided for other viewers. A second is the "power user" who has all of the functionality of the "author-power user" but cannot publish views. The remaining type is the "casual user" who is typically starting with a previously saved view of the data, and then performing some rudimentary real-time changes. Author-power and power users are best served by the desktop version of the software as it carries the full feature set; however, the causal user can be overwhelmed with this software and the more guided approach of the web version is often more successful.

To implement the MSID, both solutions (desktop and web based) are provided to each state. The web version requires no installation or setup at the state site because it will be installed, configured, and maintained at the host site (Arkansas). Users simply navigate to the web site (www.HealthDataNow.info), enter their username and password and are immediately able to begin viewing data. In addition, each participating state receives 3 licenses for the desktop software. This software connects to the data cubes in Arkansas via the Internet and data can either be viewed or copied to a laptop for use at a later time. In both scenarios, connection to the central MSID is via the Internet; however, when the desktop version of the software is being used, the data may be retrieved and stored for later "off-line" use (e.g., on a laptop for access and display during a meeting).

Training for Participating States/Users

The Arkansas team provides training and user support to all participating states via a user's conference and web-based training sessions. The conferences are scheduled with the Arkansas MSID team and the participating states in an agreed upon frequency, which is based upon availability. Individual training sessions via the web and teleconferences are available to any of the participating states upon request and based upon MSID staff availability. The option for an additional on-site conference is also available. The Arkansas team provides user support to all participants through a telephone Help Desk.