Thursday, June 19, 2008

The Markle Foundations Connecting for Health Common Framework for Networked Personal Health Information

On Wednesday, June 25, the Markle Foundation's Connecting for Health Initiative will release a series of materials collectively entitled a "Common Framework for Networked Personal Health Information."
This work will be a follow-on to a much less detailed brief written in the context of the Connecting for Health Framework for Networked Personal Health Information. In this earlier phase, the attention was directed at providers and the means by which one assured trust was through contracts.

This very detailed and comprehensive set of documents will be based on a small set of common expectations; rules and protocols applicable to all exchange; the value of overcoming barriers to information sharing; and the improvement of the public trust. Without such an approach, many fear the policies will be monolithic and not sensitive to the variety of contexts in which health information is used. In lieu of a clear approach, piecmeal efforts may slow progress and innovation; implementation efforts may be disconnected from policies; and these approaches may place excessive reliance on consumer consent. Add to that, some approaches may simply not be practical.

What we are facing, many believe, is a "privacy gridlock" where too many parties are seeking the impossible perfect. The alternative is to show that extreme rhetoric is not necessary and that most efforts can rely on the enormous efforts that already have addressed some of the fundamental issues.

Three common expectations often articulated are:
  • Core privacy principles
  • Sound network design
  • Oversight and accountability
These are based on the broader set of guiding principles articulated in the Markle Comprehensive Framework. The three expectations have recently been discussed in Deven McGraw's June 4 testimony to the House Energey and Commerce Subcommittee, Health subcommittee.

The framework could be used as a set of guiding principles for a loose form of "certification" that defines attributes organizations, systems, or products must have to be included in federal health care initiatives, e-prescribing initiatives, health information exchanges, product development, consumer group activities, and other endeavors in which trusted use of health care information is necessary.

The new documents are impressive in scope. They are heavily-referenced and reflect the best thinking of some of the Nation's leaders. These are sound and comprehensive recommendations, but they are not necessarily prescriptive. They allow individuals and organizations to internalize and interpret recommendations in ways that seem most appropriate for their needs.


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