Markle's health program aims to accelerate consumer use of information technologies in ways that improve the quality of health and health care based upon a consumer centric vision. The widespread diffusion of IT is essential to the realization of this vision because technology alone makes possible the high level of information distribution, access, control, and intelligence on which the vision depends. Among the strategies we have used to achieve this vision:

• Focusing the attention of thought leaders and the public on policy barriers to the development and use of consumer health/IT applications, and working to facilitate the collaboration of diverse groups in addressing these barriers.
• Building the case for the use of consumer health/IT applications by providing evidence of their positive impact.
• Facilitating the development of consumer health/IT applications with those characteristics that we believe have especially great potential to transform healthcare and consumers' relationship to it.
• Using a combination of new and old media to increase consumers' expectations about the extent to which they can actively participate in their own health care.

The flagship project that addresses most of these objectives is the Connecting for Health: a Public-Private Collaborative. Over the past year and a half, Markle has convened an extraordinary group of government, industry and healthcare leaders that has led the national debate on electronic clinical data standards. Early in its inception, the group drove consensus on the adoption of an initial set of standards, developed case studies on privacy and security and helped define the electronic personal health record (PHR).

Most recently, Markle announced the second phase of Connecting for Health: the creation of a Roadmap for achieving electronic connectivity in healthcare. For this phase, the Markle Foundation is pleased that the Robert Wood Johnson Foundation will also be supporting our effort. The collaborative will also be developing solutions for overcoming specific barriers to electronic connectivity and then setting up a demonstration project to test solutions under real-world conditions. (For more information on Connecting for Health please see www.connectingforhealth.org.)

Other projects that have contributed to our strategy include:

• Life on the Line, is a unique initiative combining the powers of TV and the Internet to inspire and enable women to take control of their health and health care. Life on the Line makes first-rate information and tools available to a mass audience and also serves as a model for the effective melding of different types of media to enhance the public's knowledge and attitudes-research indicates that most women exposed to it learn something and change the way they think about health. According to research carried out by the Foundation for Accountability (FACCT), women who saw the Life on the Line TV program and used the web site were significantly influenced by them: more than 80% learned something about health, while more than 60% changed their thinking about health and health care. (more)
  
  
• The Markle Telemedicine Clinic in Cambodia was a collaboration between American Assistance for Cambodia, Partners Telemedicine, and the Sihanouk Hospital Center of Hope and the Markle Foundation. The clinic uses the Internet to bring the expertise of some of the most highly trained and respected American doctors to a remote Cambodian province that suffers from a lack of access to health care services. The clinic provides an innovative model for remote care in the developing world. (more)
  
  
• The Patient Accessible Electronic Medical Records project, in partnerships with Partners Healthcare System and Foundation for Accountability (FACCT) is shedding light on the implications of linking patient and doctor via an innovative effort to access medical records online. The research team is also evaluating the potential benefits of patients' providing information about the health care services they receive to be used by the health profession in quality measurement. These inquiries help to establish a much-needed knowledge base to support the Markle Foundation's goal of empowering health consumers, and, ultimately, improving the quality of care.(more)
  
  
• The book Understanding Healthcare covers a wide array of health topics, including guidance on how to make effective use of the Internet and other high-tech tools to improve personal health. In supporting development of the book, the Markle Foundation furthered its goal of empowering consumers, through information technology-and through information generally-to become more active participants in their own care. Author Richard Saul Wurman, who developed Understanding Healthcare with support from the Markle Foundation, as well as Johnson & Johnson and the UnitedHealth Group, is a highly acclaimed information architect. (more)
  
  
• The Comprehensive Health Enhancement Support System (CHESS) was a study funded by the Markle Foundation and the National Cancer Institute (NCI) to evaluate the ways in which underserved women with breast cancer use and benefit from a computerized patient support system. CHESS provides users with up-to-date health information, software to help weigh treatment options, and 24-hour access to medical experts and other patients, all via an Internet connection from home. Findings show a significant positive value of CHESS for underserved patients, and indicate that CHESS participants could be recruited effectively on a large scale using NCI's Cancer Information Services (CIS) phone support network in combination with other outreach vehicles. The program has expanded from a pilot project at the University of Wisconsin to include a significant implementation in rural areas of Wisconsin and inner city neighborhoods of Detroit. (more)