3 regional health networks to link up

The Markle and Robert Wood Johnson foundations announced on June 1 that they will spend $1.9 million to launch an Internet-based prototype for a national health information network.

The foundations, which are seeking to accelerate the use of information technology in health care to improve quality and reduce costs, will connect three regional health information organizations, making their existing and developing networks compatible with each other.

Between this fall and the end of the year, the RHIOs -- MA-SHARE, Boston; Mendocino SHARE, Ukiah, Calif., and Indiana Health Information Exchange, Indianapolis -- will link so they may share identifiable and non-identifiable data about patients' medication, laboratory results and chronic disease. Patients, however, must give their consent before their data are shared with and viewed by outside clinicians.

"Ultimately, the patients own the record, and it is with the patients' consent that this is done," said John Halamka, MD, acting CEO of MA-SHARE and chief information officer of Boston-based CareGroup Health System, at a news conference in Washington, D.C.

Project organizers hope that their effort will serve as a national model for RHIOs, which are local, regional or statewide networks that link and enable hospitals, physicians and patients to exchange information with each other. RHIOs also are critical building blocks in President Bush's plan to implement a national health network within 10 years.

Although hospitals routinely share information within their organization or a community, the prototype networking project being managed by Connecting for Health -- a public-private collaborative of more than 100 organizations funded by the Markle and Robert Wood Johnson foundations -- marks the first large-scale effort to facilitate information exchange between different entities across multiple states, participants said.

A major goal of the project is to demonstrate that it's feasible to establish an interoperable national network if RHIOs and health care entities across the country adopt privacy, security and open technical standards flowing out a set of principles Connecting for Health developed in 2004.

"All of those networks should use a common framework," said David Lansky, PhD, director of Markle's health program. "One of the reasons for that is that nationally if the public isn't trusting ... that this entire set of national relationships is operating under some common practices -- around privacy in particular -- then the whole network may be jeopardized by a possible loss of trust," Dr. Lansky said.

"It is absolutely critical that before people start investing in and developing information technology solutions to share information, that the common values are established up-front, that policies and goals are clearly defined, and that technologies are deployed to achieve those objectives," added Zoë Baird, Markle Foundation president.

Laid out in a Connecting for Health report, the principles include:

• Storing patient data in offices of doctors and hospitals, not in a centralized, national or regional database.
• Using the Internet to exchange information rather than creating a new network for that purpose.
• Accommodating whatever software and hardware participants use.
• Guaranteeing that patients and their doctors jointly make decisions about sharing patients' information.