Markle plans health exchange

The Markle Foundation has plans for the first-ever electronic health record exchange between municipal governments nationwide.

Markle will manage and fund a pilot system that will link rural, low-income Mendocino County, Calif., with Boston and Indianapolis. The prototype system will use Internet-based open standards, said Zoe Baird, foundation president. She spoke June 1 at the E-Gov Institute's Web-Enabled Government conference.

Baird said the system, for example, could help an accident victim from Indianapolis being treated in a Mendocino clinic. The system could alert health officials that the person is fatally allergic to aspirin and prevent complications that might arise from use of a common painkiller, she said.

The experiment, also funded by the Robert Wood Johnson Foundation, is the result of a public/private collaboration through the Markle-funded Connecting for Health group over a year, which includes more than 100 participating organizations. The consortium has been working on a set of policies and technical specifications for electronically sharing medical information, while protecting privacy and securing personal information. Connecting for Health released a proposal for the framework following a request from Dr. David Brailer, head of the Office of the National Coordinator for Health Information Technology (ONCHIT) at the Department of Health and Human Services on January 19.

Federal officials must learn from past information-sharing errors before taking on health data exchanges, Baird said. Information sharing should be part of policy conversations from the very start, rather than being added as an afterthought, she said.

Information in the new system will not be stored in one central database, but instead reside on disparate software and hardware. "What we're trying to do in he healthcare field is to avoid the mistakes that we made earlier in the national security field," Baird said.

Information must flow in a distributed but coordinated manner throughout agencies. "Users at all levels must be connected at all levels," Baird said. "This doesn't mean that you shouldn't have critical centers of analysis but it does mean that you should not expect that information has to come into a centralized hub before it is redistributed. We think of this as a networked environment instead of a mainframe environment."

Baird encouraged the government to grant awards to agencies that distribute their technologies. "If you're DOD and you've got a great search tool, don't sit there and think you're better than everybody else," she said. "Let them compete with agencies to see which agencies get their tools adopted."

While officials may have good intentions in upholding individual agency missions, applying more effective risk management strategies to protect sensitive information can bridge the gap. "We spend so much time in government fighting the fight between ourselves as opposed to the fight with the real enemy," she said.


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