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Phase 3: Common Framework

During Phase 3 (2005–2006), the Markle Connecting for Health Common Framework model, the Markle Connecting for Health Common Framework prototype, and the Markle Foundation Personal Health Technology Initiative were developed.


The Markle Connecting for Health Common Framework Model

The Markle Connecting for Health Common Framework model does not require the development of large centralized repositories of personal health information. Instead, it achieves a health information sharing environment with a decentralized "network of networks" approach based on common, open, technical and policy standards and enforcement. The technical design was premised on leaving clinical data in the hands of those who have a direct relationship with the patient, and leaving decisions about who should and should not see patient data in the hands of the patient and the physicians who are directly involved with his or her care.

The Markle Connecting for Health Common Framework: Resources for Private and Secure Health Information Exchange provides the initial elements of a comprehensive approach for secure, authorized, and private health information sharing so that consumers and their authorized providers can have access to vital clinical data when and where they are needed. This capability is essential for providing high quality care and reducing medical errors. Our broad collaborative believes that such a Common Framework must be defined and maintained if we are to realize the goal of a health information sharing environment that makes vital information available for patients and their providers when and where it is needed, while protecting privacy and earning the trust of the American people.

The Markle Connecting for Health Common Framework elaborates a set of explicit privacy and technology principles and is comprised of specific technology standards, health information policies, and model contractual participation agreements. The policy and technology elements of the Common Framework were developed parallel to and in tandem with the three prototype communities over the course of a year. We convened both local stakeholders and the nation’s leading experts in privacy, law, health information technology, and health care delivery. The Common Framework is built on the assumption of local variation and innovation, and therefore specifies only the necessary common standards and policies for private and secure information sharing across communities of other non-geographic networks.


The Connecting for Health Common Framework Prototype:

Boston, Massachusetts; Indianapolis, Indiana; and Mendocino, California

The Connecting for Health Common Framework is specified in a set of 17 technical and policy guides developed by experts in information technology, health privacy law, health care delivery, and policy. These guides were developed and tested in a working prototype in three different community settings: Indianapolis, Boston, and Mendocino County, California. The Common Framework specifies the necessary polices and technical standards for these or any disparate health information networks to securely share information while protecting privacy and allowing for local autonomy and innovation.

In addition to the technical documentation, each of the three communities has made available its source code and testing interface.








The Markle Foundation Personal Health Technology Initiative

In parallel with its prototype work, Markle Connecting for Health convened the Personal Health Technology Council, comprised of 44 leaders and includes consumer and privacy advocates, medical professionals and informatics experts, payers, technologists, federal policymakers, bio-ethicists, researchers, and technology writers. The Council's charter was to guide the Markle Foundation and Markle Connecting for Health by identifying the next generation of policy challenges, anticipating issues that would emerge as personal health technologies become more widely available, and articulating policies that would lower barriers and accelerate the public’s successful use of these new technologies.

The Personal Health Technology Council established a set of Consumer Principles to guide the development and use of health information technology. The principles were released in October 2005 at the Connecting Americans to Their Health Care conference. The collaborative also released a public opinion survey at the conference showing broad consumer support for the concepts upon which the principles are based.