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New York, NY - To help consumers, providers, insurers and other health data holders see how providing the ability for people to download their health records can improve health and health care, the Markle Foundation today released a new video showing the power of blue button technology. The four-and-a-half minute video debuted at a consumer health IT summit at the U.S. Department of Health & Human Services in Washington, D.C. Through the stories of three veterans, it illustrates how much this simple tool helps people keep track of their medical information and the value that the blue button offers to both patients and providers. Markle hopes the video can be an important educational tool to help data holders understand the value of the technology and appreciate its importance to patients. The Markle Connecting for Health public-private collaborative conceived the idea for the blue button download capability at a January 2010 meeting. The idea was then embraced and developed as an innovative tool by the Department of Veterans Affairs and Centers for Medicare & Medicaid Services. Today, over one million people, including veterans and non-veterans, use a blue button to download their personal health information. "Information access is a critical building block to helping patients make better decisions, improve their health, and get better care," says Laura Bailyn, Senior Director, Markle. The Markle Connecting for Health collaborative envisioned the blue button as a broadly available tool for patients and beneficiaries on the secure websites of medical practices, hospitals, insurers, pharmacies, laboratories and information services. To make the blue button technology reliable and trustworthy, the group also has developed a recommended set of privacy and security practices for its implementation. To learn more about the blue button technology, visit our website at www.markle.org or visit www.bluebuttondata.org. Contact Andrew Peters (301) 280-5728 or [email protected]
NEW YORK— Markle Connecting for Health today released a wide-ranging compendium of resources designed to further support the interoperable, private, and secure sharing of health information. The Markle Connecting for Health Common Framework Policies in Practice for Health Information Sharing—or Polices in Practice—address current critical implementation issues for electronic health information sharing, including informed individual consent, governance, individual access, and procurement. A diverse group of leaders with expertise in health information sharing, technology, privacy, and consumer engagement developed these Policies in Practice resources through a collaborative effort. Markle President Zoë Baird Budinger explains, “The Markle Connecting for Health collaborative produced these resources to address some of the key issues and concerns that we have heard expressed by those implementing health information sharing efforts at the local, state and regional levels. We hope this supplement to our 2006 Markle Common Framework helps guide such efforts to foster the secure and trusted sharing of health information.” Markle Connecting for Health is a public-private collaborative whose goal is to improve people’s health and advance the quality of health care in the United States through innovations in information technology. The Policies in Practice resources further specify the Markle Connecting for Health Common Framework for Private and Secure Health Information Exchange (Markle Common Framework), published in 2006. The Markle Common Framework offers a set of policy and technology guides based on Fair Information Practice Principles, which, when taken together, offer a comprehensive framework to support trusted health information sharing. Ted Kremer, Executive Director, Rochester RHIO, and committee member involved in the development process says, “The foundational aspects of the Markle Common Framework were instrumental to our regional health information exchange formation and continue to be valuable. However, we and others realized it would be helpful to build-on the Markle Common Framework and develop additional resources that apply directly to today’s environment. It was amazing to see the combined expertise that came together to address these issues and produce resources that are sure to be key to successful efforts going forward.” Today’s health IT environment has evolved significantly from the environment in which the Markle Common Framework was first issued. In addition to enactment of the HITECH Act, there is a greater level of federal leadership, new regulation, and investment in IT; and the use of health IT among providers is on the rise. A 2010 Markle Survey on Health in a Networked Life, comparing the core values of physicians and patients on deployment of IT in health care found that the majority of doctors prefer use of computers to paper and fax when sharing patient information with each other.1 “The landscape for health information sharing is changing,” noted Laura Bailyn, Senior Director, Health Initiatives, Markle. “As health information sharing needs and capabilities continue to evolve, it is critical to incorporate new knowledge and lessons learned. The Policies in Practice build on the foundational elements of the Markle Common Framework to provide additional support for implementers working in the field to make electronic health information sharing a reality.” Bailyn emphasized that the Policies in Practice are not intended to replace the original Markle Common Framework, but to supplement it. Each Policies in Practice resource aims to further specify the Markle Common Framework by addressing a targeted implementation need. The Policies in Practice are not toolkits or stand-alone solutions. They should be considered together and used in context, complying with all federal and state laws and regulations, and in light of individualized operations and objectives. The Policies in Practice address the following areas: Key Laws and Regulations: Changes Relevant to the Markle Common Framework. Highlights modifications to relevant privacy laws over the last five years and addresses them in the targeted policy areas of the Markle Common Framework. Consent: Implementing the Individual Participation and Control Principle. Provides context for implementing the privacy principle of “Individual Participation and Control” and suggests ways for health information sharing efforts to establish their own policies and best practices. Individual Access: Connecting Patients to Their Health Information. Identifies and specifies opportunities for addressing individual access and engagement in relation to health information sharing. Governance of Health Information Sharing Efforts: Achieving Trust and Interoperability with Meaningful Consumer Participation. Identifies and specifies opportunities for addressing individual access and engagement in relation to health information sharing. Policy Aware Procurement Strategies and Practices: Asking the Right Questions and Reaching the Right Answers. Details important elements to apply in technology procurement efforts, so that required policies are part of the acquisition and implementation of technology. For more information, please join us for a live webcast “New Markle Resources for Implementing Health Information Sharing” on Wednesday, May 9, 2012, 11:00 am – 12:30 pm ET. Authors of the Policies in Practice and other experts will describe these resources, including how they can be applied in today’s environment, and will answer viewer questions. Contact Andrew Peters (301) 280-5728 or [email protected] __________ Markle Foundation. The Public and Doctors Overwhelmingly Agree on Health IT Priorities to Improve Patient Care. January 2011: http://www.markle.org/publications/1461-public-and-doctors-overwhelmingly-agree-health-it-priorities-improve-patient-care.
NEW YORK, NY—The Markle Foundation announced today that Laura Bailyn has been named Senior Director of Health Initiatives. Bailyn, an attorney, will be working closely with Markle’s Managing Director of Health, Carol C. Diamond, MD, MPH, to help shape and drive the foundation’s work in health. “We are happy to welcome Laura back to Markle,” said Zoë Baird, the foundation’s President. “Her work as Program Manager on our Internet Governance Project in the early-2000s helped set the groundwork for our future involvement in technology-related health and national security policy. We look forward to her contributions to our ongoing efforts to accelerate the use of information technology to improve the quality and cost effectiveness of health care.” Bailyn has an extensive background in technology and a broad range of policy issues. Most recently, she worked as a business consultant for Apple, Inc., focusing on rights management, partnership development, and content clearances for Apple’s Marketing Communications Group. She also spent two years working for Two Trees Management Company where, among other things, she successfully obtained a rezoning for a $200 million mixed-use real estate development in an important neighborhood in Brooklyn, NY. Prior to that engagement, Bailyn practiced law in the intellectual property and technology group at Skadden, Arps, Slate, Meagher, & Flom, LLP for five years. “Laura’s breadth and depth of experience in strategically planning and executing complex initiatives will strengthen the ongoing impact of Markle’s work in health IT over the past decade to empower individuals to use their health information to improve their health and health care,” said Diamond. “Her expertise will enhance Markle’s capacity to continue to find needed policy and technology solutions to see that health IT can be implemented in ways that will improve health, and stimulate innovation while protecting privacy and maintaining consumer trust.” Bailyn holds a Bachelor’s degree from Washington University in St. Louis, and a Juris Doctor degree from the Benjamin Cardozo School of Law. She was a Coro Foundation Fellow in Public Affairs from 1993 to 1994.
NEW YORK—Doctors and patients overwhelmingly agree on key requirements for information technology (IT) to increase the quality, safety, and cost-efficiency of care, as well as core privacy protections, according to a national survey released today by the Markle Foundation. The Markle Survey of Health in a Networked Life is the first of its kind to compare the core values of physicians and the general public, referred to here also as patients based on their opinions as consumers of health care, on deployment of information technology in health care. It comes at the start of a new federal program to help doctors and hospitals upgrade from paper to electronic health records. "Doctors and patients agree on the importance of putting accurate information in their hands to improve the quality, safety, and efficiency of health care," Markle President Zoë Baird said. "A surprising 74 percent of doctors say they want to be able to share patient information with other professionals electronically. As medical professionals shift from paper records to electronic systems, this survey shows that the public and physicians overwhelmingly agree that we need to measure the payoff from investments in information technology in terms of better health and more cost-efficient care," Baird said. Agreement between doctors and the public was strongest on requirements to ensure that new federal health IT incentives will be well spent. The funding was included in the stimulus bill passed by Congress in 2009. "Roughly 80 percent majorities of both the public and doctors agreed that it’s important to require participating hospitals and doctors to share information to better coordinate care, cut unnecessary costs, and reduce medical errors," said Carol Diamond, MD, MPH, Managing Director at the New York-based nonprofit foundation. "By the same overwhelming margin, four in five doctors and patients expressed the importance of privacy protections for online medical records, an expectation we have repeatedly found on the part of the public in our previous surveys," Diamond said. "They also agree on the importance of measuring progress. This survey is a powerful indication that the public and physicians alike want investments in health IT to come with accountability." Survey Shows Many Doctors and Patients Believe Key Information is Lost in Their Health Care Conversations Of the doctors surveyed, 94 percent said their patients at least sometimes forget or lose track of potentially important things they are told during doctor visits, and 34 percent of the doctors said they themselves at least sometimes forget or lose track of potentially important things that their patients tell them. Among the patient group, 30 percent perceived that their doctors forget or lose track of potentially important information at least sometimes. According to the Markle Survey of Health in a Networked Life, we have found that: Among the doctors, 74 percent would prefer computer-based means of sharing patient information with each other. (Only 17 percent of doctors predominantly use such means today.) Nearly half (47 percent) of the doctors would prefer computer-based means of sharing records with their patients. (Only 5 percent do so today.) Yet 74 percent of doctors said patients should be able to share their information electronically with their doctors and other practitioners. Among the public, 10 percent reported currently having an electronic personal health record (PHR)—up from 3 percent who reported having one in Markle’s 2008 survey. Roughly 2 in 3 of both groups (70 percent of the public and 65 percent of the doctors) agreed that patients should be able to download their personal health information online. And 70 percent of the public said patients should get a written or online summary after each doctor visit, but only 36 percent of the doctors agreed. (Only 4 percent of doctors say that they currently provide all their patients a summary after every visit). "Our past surveys show that most US adults believe personal health records that include copies of their own medical information would help them improve their health and communicate better with health professionals," said Josh Lemieux, Director of Personal Health Technology at Markle. "With this survey, we find an increase in PHR use and learn that roughly two in three doctors agree that patients should have the option of online access to their personal health information. The survey also confirms that having modern information tools comes with expectations for privacy protections." Other findings from the Markle survey include: Majorities of 70 percent to 80 percent of both patients and doctors support privacy-protective practices, such as letting people see who has accessed their records, notifying people affected by information breaches, and giving people mechanisms to exercise choice and correct information. Majorities (65 percent of the public and 75 percent of doctors) agreed that it’s important to have a policy against the government collecting personally identifiable health information for health IT or health care quality-improvement programs. If there are safeguards to protect identity, however, at least 68 percent of the public and 75 percent of the doctors expressed willingness to allow composite information to be used to detect outbreaks, bioterror attacks, and fraud, and to conduct research and quality and service improvement programs. Large majorities of the public (75 percent) and the doctors (73 percent) said it will be important to measure progress on improving health care quality and safety to ensure the public health IT investments will be well spent. Both groups (each at 69 percent) agreed on the importance of specific requirements to improve the nation's health in areas like heart disease, obesity, diabetes, and asthma. Many are unaware of the health IT incentives: 85 percent of the public and 36 percent of doctors describe themselves as not very or not at all familiar with the health IT incentives program, which makes subsidies available for doctors and hospitals to increase use of information technology. "We all have a stake in making sure that information is protected and trusted so that it can be put to best use to improve our health," Diamond said. "This survey shows that doctors and their patients share many of the same hopes and expectations for advancing health in a connected world." Knowledge Networks (KN) conducted the surveys between August 10 and 26, 2010. The general population survey of 1,582 adults age 18 and older used KN’s KnowledgePanel®, a probability-based panel of 50,000 individuals designed to be representative of the US population. The survey of 779 physicians was conducted using KN’s Physicians Consulting Network (PCN), an invitation-only list of more than 45,000 practicing physicians. Results are available at www.markle.org. Large Majorities of the Public and Physicians Agree on Information-Sharing Priorities for Health IT Many Doctors and Patients Perceive Gaps in Their Communications3 in 4 Doctors Would Prefer Computerized Means To Share Patient Information with Each Other PHR Adoption on the Rise The Public and Doctors Largely Agree Patients Should Be Able To View, Download and Share Their Health InfoPublic and Doctors Alike Support Allowing Individuals to Download Their Own Health Information 70 Percent of Public Says Patients Should Get Summaries after Doctor Visits The Public and Doctors Agree on Importance of Specific Privacy Protections for Health IT The Public and Physicians Largely Unfamiliar with Details of Health IT Incentives Program Roughly Half of Doctors Say Pay Reform is Important The Public and Doctors Surveyed Use Social Media in Comparable Proportions Demographics of Public and Doctors Surveyed
New York, NY and Washington, DC—Thirteen major health and information technology organizations, in an unprecedented joint collaboration, today endorsed a "Common Framework" to support improved health information exchange in the United States while protecting patient privacy. The collaborating organizations have identified the vital design elements – of standards, policies, and methods—for creating a new information environment that would allow health care professionals, institutions, and individual Americans to exchange health information in order to improve patient care. These recommendations were developed in response to the Request for Information related to a "National Health Information Network" issued by the U.S. Office of the National Coordinator for Health Information Technology (ONCHIT) within the Department of Health and Human Services in November 2004. The collaborative foresees a new health information environment that would allow appropriate users to find, request and retrieve patient records rapidly and accurately, subject to patient authorization. This decentralized approach takes advantage of the significant investment already made in information technology in U.S. health care, protects the privacy of patient information, and allows rapid progress toward providing Americans with more reliable, higher quality care. The recommended approach does not require centralized national databases, replacement of existing information networks, or a unique national health identifier. The new health information environment should be based on: Open, consensus-driven and non-proprietary standards and common methods for their adoption Connectivity built on the Internet and other existing networks Uniform policies that protect privacy, assure security, and support existing trust relationships. The collaborative also recommends the use of financial incentives for the adoption of standards-based information technology in health care, citing opportunities to leverage this environment to produce value for patients, consumers, professionals, researchers, the public health community and, indeed, all sectors of our health care system. Finally, the recommendations describe the roles and structure of both the national and regional elements of this environment.
New York—Connecting for Health commends the recent announcement by the Department of Health and Human Services (HHS) on the adoption of the second group of standards for interoperable healthcare information and the appointment of Dr. David Brailer as the new National Health Information Technology Coordinator. At last week's HHS Health Information Technology Summit, Secretary Thompson announced the adoption of 15 additional standards agreed to by the Consolidated Health Informatics (CHI) initiative. The adoption of these standards is important to the development of interoperable health information systems in the public and private sectors. The new position of National Health Information Technology Coordinator was created as a part of the Health Information Technology Plan, which was announced late last month. Dr. Bailer is currently chair of the Markle Foundation's Connecting for Health working group on Legal, Financial and Organizational Issues of Health Information Exchange. "Electronic connectivity that enables patient information to be available privately and securely when patients and their doctors are making vital health decisions is essential if we are going to provide the best possible care to patients," said Dr. Carol Diamond, Managing Director of the Markle Foundation's Healthcare program and chair of Connecting for Health.Connecting for Health, a public private sector collaborative initiative funded by the Markle Foundation and receiving additional support from The Robert Wood Johnson Foundation, has been convening public and private sector stakeholders for the last year and a half to advance the goal of electronic connectivity within healthcare. "These announcements are important building blocks for this much needed transformation of healthcare which must be done with strong public and private sector partnership," said John Lumpkin, MD, MPH, senior vice president of The Robert Wood Johnson Foundation and executive vice chair of Connecting for Health. "The Summit on Health Information Technology was an exciting opportunity to see the government and the private sector come together ready to accomplish one goal: that of a fully leveraged information technology system to improve healthcare quality, safety and efficiency," said Dan Garrett, vice president and managing director of Computer Sciences Corporation's Global Health Solutions Practice and executive vice chair of Connecting for Health. "The call for someone to lead the nation's efforts to bring electronic connectivity to the healthcare industry is a two decade-old rallying cry," said Herbert Pardes, MD, president and CEO, New York-Presbyterian Hospital and executive vice chair of Connecting for Health. "We are most grateful for Secretary Thompson's leadership in this area and for his decision to appoint David Brailer to the post of National Health Information Technology Coordinator." "David Brailer is a pioneer and innovator in the field of health informatics and Connecting for Health has benefited tremendously from his leadership," added Dr. Diamond. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
New York—As momentum grows for bringing our outdated, paper-based healthcare system into the Information Age, Connecting for Health… A Public Private Collaborative today released a timely report that details specific actions the public and private sectors can take to accelerate the adoption of information technology in healthcare. Connecting for Health's Preliminary Roadmap for Achieving Electronic Connectivity in Healthcare calls for all stakeholders from across the healthcare industry to work together to build a health information infrastructure that would improve patient care, reduce medical error and lower costs while protecting patient privacy. The Preliminary Roadmap's key recommendations fall into three broad categories: Creating a Technical Framework for Connectivity: The creation of a non-proprietary "network of networks" is essential to support the rapid acceleration of electronic connectivity that will enable the flow of information to support patient care. The network should be based on a " Common Framework." The network should use a decentralized, federated architecture, that is based on standards, safeguards patient privacy and is built incrementally, without the use of a National Health ID or a centralized database of records. Addressing Financial Barriers: The development of financial and other incentives and related processes to promote improvements in healthcare quality through the adoption of clinical applications and information exchange based on standards. Engaging the American Public: Informing the public with a consistent set of messages to be used by government, healthcare, and consumer leaders to promote the benefits of electronic connectivity and to encourage patients and consumers to access their own health information. A full copy of Connecting for Health's Preliminary Roadmap for Achieving Electronic Connectivity in Healthcare can be found at www.connectingforhealth.org. In order to support implementation of its recommendations, Connecting for Health will release a final version of the Roadmap and detailed reports by individual Working Groups that contributed to it by September. The final Roadmap will provide additional detailed recommendations for action and commitments from Connecting for Health's Steering Group members, who include some of the foremost healthcare leaders in the public and private sectors. "The only way to overcome the barriers to electronic connectivity in healthcare is for the public and private sectors to work collaboratively to build an infrastructure that will improve healthcare for patients and their families," said Carol Diamond, MD, MPH, managing director at the Markle Foundation and chair of Connecting for Health. "Connecting for Health developed the Preliminary Roadmap to achieve broad agreement on a set of immediate actions that can be taken by all healthcare stakeholders over the next several years to help accelerate healthcare's transformation to the Information Age." "Connecting for Health is pulling together the right people, giving them an action plan in order to efficiently create a decentralized and standards-based network that's good for healthcare and patients," said John Lumpkin, MD, MPH, senior vice president of The Robert Wood Johnson Foundation, chair of the National Committee for Vital and Health Statistics and executive vice chair of Connecting for Health. A recent study from the Center for Information Technology Leadership estimates that the creation of a standards-based interoperable health information infrastructure could save the nation $86.8 billion annually after full implementation. Connecting for Health is an unprecedented collaborative of over 100 public and private stakeholders designed to address the barriers to electronic connectivity in healthcare. It is operated by the Markle Foundation and receives additional support from The Robert Wood Johnson Foundation. Since Connecting for Health began its work in 2002, momentum for electronic connectivity in heath care has accelerated rapidly, culminating in the president's recent call for electronic health records for all Americans within ten years. "There is a great amount of work being done throughout the country to support the development of electronic medical records, however, the healthcare system will remain highly fragmented and we will never fully realize the benefits that IT can bring to healthcare unless the systems and applications being developed can share information with each other," said Zoë Baird, president of the Markle Foundation. "To address this problem, Connecting for Health has come up with a set of groundbreaking recommendations that set the stage for development of an electronically connected, patient-centric healthcare information system." Connecting for Health's Preliminary Roadmap is being released at a critical time. In addition to President Bush's call for the creation of electronic health records for all Americans within ten years, leaders of both parties have highlighted the importance of IT in healthcare. Dr. David Brailer, the newly appointed National Health Information Technology Coordinator for the Department of Health and Human Services (HHS), is releasing a report on the Administration's strategic health IT plan next week at the HHS-sponsored National Health Information Infrastructure 2004: Cornerstones for Electronic Healthcare conference in Washington, D.C. "We have already begun to see the emergence of private sector activities conducted by Connecting for Health Steering Group members designed to turn our recommendations into reality," said Janet Marchibroda, chief executive officer of the eHealth Initiative and executive director of Connecting for Health. "We now have an excellent opportunity for the public and private sectors to work together and drive real change in healthcare." Creation of the "Network of Networks" "The most innovative aspect of Connecting for Health's Preliminary Roadmap is that its recommendations show how to develop a national health infrastructure through the creation of a "network of networks" which is based on open standards and which can be created without a central database of health records or a National Health ID--both long-time barriers that have prevented bringing the benefits of information technology to the field of healthcare," said Dan Garrett, vice president and managing director, Computer Sciences Corporation's Global Health Solutions Group, and executive vice chair of Connecting for Health. "Previous efforts to achieve the benefits of electronic connectivity in healthcare have been hampered by the fact there seemed to be no way of electronically linking medical records without jeopardizing privacy," said Jim Dempsey, executive director of the Center for Democracy and Technology and member of Connecting for Health's Working Group on Accurately Linking Information for Health Care Quality and Safety. "However, recent advances in technology offer solutions to this problem by providing the ability to deliver medical information when and where it is needed - whether by patients themselves or by the clinicians who care for them- without the need for central databases or national ID cards." In order to maximize trust in the system, Connecting for Health's Preliminary Roadmap recommends a decentralized and federated network approach that leaves decisions regarding the sharing of health information with patients and their healthcare providers. This approach creates a network of networks connected over the Internet, linked only by directories pointing to the sources of records. The directory system knows where records are kept, but not what information the records contain. The records are stored locally and can be shared electronically if authorized. The proposed network is designed to be flexible to accommodate the various electronic health record (EHR) and personal health record (PHR) models that are being developed. "Our recommendations limit the need for large scale disruption of services and huge up front capital investments because the network is designed to exploit current methods of institutional and provider record keeping while improving interoperability of existing systems," said J. Marc Overhage MD, PhD, associate professor of medicine, Indiana University School of Medicine; senior investigator, Regenstrief Institute and co-chair of the Connecting for Health Technical Panel. To support the incremental approach to development it advocates, the Preliminary Roadmap calls for the immediate creation of a "common framework"—a set of common standards, policies and methodologies to enable the secure transport of data to support electronic connectivity across the country. The Preliminary Roadmap calls for a public-private collaborative to test the "common framework" in a reference implementation to be completed with one year. "A common framework is a critical aspect of making sure that we are able to mobilize and effectively share health information on a large scale," said Wes Rishel, vice president, Gartner Research and co-chair of the Connecting for Health Technical Panel. "The reference implementation will help leverage interoperability on a broader scale." Alignment and Creation of Incentives to Overcome Financial and Legal RoadblocksConnecting for Health's Preliminary Roadmap includes recommendations designed to realign incentives and tackle the legal and financial risks that providers and hospitals face when making decisions regarding the adoption of IT applications and interoperable systems. The Preliminary Roadmap also includes a set of recommendations regarding data standards, focusing on a "ready set" of standards that are mature and proven. The Preliminary Roadmap recognizes that widespread adoption of interoperable, standards-based health records and the networks that enable electronic connectivity will not occur without the realignment of financial incentives and recommends a level of incentives that would encourage the adoption of electronic health records. The Connecting for Health Working Group on Financial, Organizational and Legal Sustainability will release later this summer an analysis of funding and other incentives designed to help healthcare leaders better understand the costs and benefits of accelerating the use of health IT systems. "Because the peer-reviewed research to date does not yet support a robust business case for the provider adoption of IT, having some qualitative models to help people to think through the business case can be a first step in understanding what it's going to take," said John Glaser PhD, vice president and chief information officer, Partners HealthCare System and chair of the Connecting for Health Working Group on Legal, Financial and Organizational Issues. "Due to the scarcity of capital, not a lack of interest, healthcare providers are hard pressed to make the investments in technology that would allow them to provide better quality, evidence-based care," said Herb Pardes, president and chief executive officer of New York Presbyterian Hospital and executive vice chair of Connecting for Health. "With an adequate set of investment and incentives, the healthcare industry will respond." Engaging the American Public Some of Connecting for Health's most far-reaching recommendations involve the patient's changing role regarding personal health and healthcare. Research done for Connecting for Health by the Foundation for Accountability (FACCT) has shown that few Americans understand how much today's inadequate information systems affect the quality of their healthcare. While Americans express high levels of interest in electronic health records, many believe that such systems are already in place. In fact more than half believe their own doctors are far more "wired" than is actually the case. Connecting for Health's Preliminary Roadmap addresses this problem by calling for an educational campaign about both the benefits and the current status of electronic connectivity in healthcare. "Educating patients would empower them to be more effective managers of their own health, better partners in care and more informed advocates of moving the health system towards greater connectivity," said David Lansky PhD president of FACCT and chair of Connecting for Health's Working Group on Policies for Electronic Information Sharing Between Doctors and Patients. The Working Group plans to release its final report at this year's National Health Information Infrastructure conference: Cornerstones for Electronic Healthcare on July 21. The report provides further details on the patient empowerment recommendations contained in the Preliminary Roadmap and will also include an analysis of research on the public's attitudes towards Personal Health Records and proposed themes that could be featured in an educational campaign. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
New York—Connecting for Health … A Public-Private Collaborative today released Financial, Legal and Organizational Approaches to Achieving Electronic Connectivity in Healthcare, a report which proposes a level of financial incentives necessary to significantly increase the adoption of electronic health records (EHR) by doctors. The report, undertaken by Connecting for Health's Working Group on Financial, Organization and Legal Sustainability of Health Information Exchange, proposes incentives at a rough level of $3-$6 per patient visit or $0.50 -$1.00 per patient per month. The report notes that small and medium sized practices, while likely to benefit more than larger ones from interoperability, will require greater attention and assistance due to their lack of resources, and suggests that financial and other types of support should be provided to local and regional electronic health record efforts and information sharing collaboratives. "The goal of this Working Group was to examine the barriers faced by ambulatory care providers in adopting health information technology and then to use any available empirical data to identify potential starting points and near-term opportunities for physician practices to adopt health care information technology," said John Glaser, PhD, Chief Information Officer at Partners HealthCare Systems Inc., and chair of the Working Group. "This report articulates a qualitative approach to examining the kinds of incentives needed to encourage the of adoption electronic health records." "Electronic health records have the potential to help reduce medical errors, lower costs and empower patients," said Carol Diamond, MD, managing director at the Markle Foundation and chair of Connecting for Health. "However, without the widespread adoption of electronic health records by small and medium physician practices - that represent more than half of the practices in this country - and the requirements for achieving the level of interconnectivity necessary to allow for the effective exchange of health related information, the benefits of information technology cannot be fully realized. We hope this report sparks a full and frank debate over the issue and that it can be a first step toward realizing the potential of electronic health records." The report concludes that the current business case for the adoption of health IT systems is not sufficient and that financial incentives are necessary to encourage health care providers to adopt IT systems that allow for interconnectivity to improve the quality of care. The report also finds that initial financial incentives for small and medium sized practices will need to cover most of the costs of adopting electronic health records, but that over time, these incentives will transition to performance-based incentives. The range of incentives is estimated to be $12,000 - $24,000 per full time physician per year. The analysis also shows that the business case for the incremental adoption of applications of health IT is sound, as long as the applications are interoperable, and suggests that e-prescribing and on-line tools for chronic disease management are good starting points. With an increased focus on health information exchange, and a significant influx in related funding available through government sources such as the US Department of Health and Human Services and its Agency for Healthcare Research and Quality, as well as organizations such as the eHealth Initiative, there is an urgency to provide early experimenters with as much knowledge as possible. To overcome the organizational barriers to the adoption of health IT systems, communities need to assess their readiness for data sharing, including an evaluation of their technical, clinical and organizational capabilities. Leadership will also play a crucial role because the report finds that communities will need a neutral convener to catalyze action and encourage participation in the system. "To fully realize the potential of electronic connectivity in health care, it is imperative that we have commonality in place - that is, some common approach to organizing information sharing activities at the local or regional level. ," said Nancy Lorenzi, Professor of Biomedical Informatics and Assistant Vice Chancellor for Health Affairs Vanderbilt University Medical Center Informatics Center, Eskind Biomedical Library and member of Connecting for Health's Working Group on Financial, Organization and Legal Sustainability of Health Information. "Without careful planning for the way regional efforts organize themselves and the standardization of some minimal information sharing practices, we will fail to achieve the ability to safely and effectively exchange information, leaving us no better off than we are now." The report concludes that most management and legal issues related to the establishment of a secure, confidential health information infrastructure can be addressed in the context of existing law and through the use of contracts. Organizationally, the report urges health care leaders to create regional technology support organizations to manage health information exchange infrastructures and diagnostic tools to assist communities in assessing readiness and to identify common features of successful information exchange infrastructures, and to disseminate their findings. The report is being released and discussed at today's Health Information Summit in Washington, D.C. A full copy of the report can be found here. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
NEW YORK—Dossia, Google, Intuit, Microsoft, and WebMD today joined prominent health care providers, health insurers, and consumer and privacy groups in endorsing a set of practices for new internet services that help consumers track and improve their health. The framework defines a set of practices that can help protect personal information and enhance consumer participation in online personal health records. "Consumer demand for electronic personal health records and online health services will take off when consumers trust that personal information will be protected," said Zoë Baird, president of the Markle Foundation, which organized the consensus framework. "We have broken the typical logjam in health care and reached consensus among health sectors and technology innovators, so internet health information products can flourish." The announcement comes as technology companies, health care delivery systems, health insurers, large employers, and others are proliferating options for consumers to keep their own copies of health information and connect to health-related services online. However, this emerging, innovative new space is evolving without a common set of information practices and expectations. "We have achieved the first detailed, consensus-based approach to consumer access and privacy practices for important new internet-based health information services," said Carol Diamond, MD, MPH, Markle managing director and chair of Connecting for Health. "A stable, common-sense set of principles and practices will foster innovation and improve consumer choice for these emerging services." The framework — developed by the Markle-operated Connecting for Health public-private collaboration — includes four overviews and 14 specific technology and policy approaches for consumers to access health services, to obtain and control copies of health information about them, to authorize the sharing of their information with others, and sound privacy and security practices. In 2006, Connecting for Health released a framework of policy and technology resources for privacy and security in internet-based networks connecting medical professionals from different institutions and clinics. The new framework deals with networks that include individual consumers as participants who can collect their information, store it in applications they control, and share it with whom they want. The following organizations today endorsed the framework: AARP • Aetna • American Academy of Family Physicians • Association of Online Cancer Resources (ACOR.org) • America's Health Insurance Plans • BlueCross BlueShield Association • CapMed • Center for Democracy and Technology • Center on Medical Record Rights and Privacy • Cisco Systems Inc. • Consumers Union • Dossia • FollowMe • Google • Geisinger Health System • Health Care For All • InterComponentWare Inc. • Intuit Inc. • MedicAlert • Microsoft Corp. • National Breast Cancer Coalition • National Partnership for Women and Families • NewYork-Presbyterian Hospital • Pacific Business Group on Health • Palo Alto Medical Foundation • Partners Healthcare System • RxHub • SureScripts • U.S. Department of Veterans Affairs • Vanderbilt Center for Better Health • WebMD "Some of the new services aren't covered under federal health information privacy laws, and there is uncertainty about privacy protections," said Steve Findlay, health care analyst, Consumers Union, publisher of Consumer Reports. "This collaboration lays out specific practices that all PHRs and related services can use, whether they are covered by federal privacy rules or not, so they can enhance public trust." Survey reveals overwhelming public support for privacy protective practices The Markle Foundation also released a survey today indicating that four in five U.S. adults believe that electronic personal health records (PHRs) would help people: Check for errors in their medical records (87 percent). Track health-related expenses (87 percent). Avoid duplicated tests and procedures (86 percent). Keep their doctors informed of their health status (86 percent). Move more easily from doctor to doctor (86 percent). Manage the health of loved ones (82 percent). Get treatments tailored to health needs. (81 percent). Manage their own health and lifestyle (79 percent). "This new survey indicates that an overwhelming majority of U.S. adults see the value of online personal health records. Nearly half express some interest in using one," said David Lansky, PhD, president and CEO of Pacific Business Group on Health and chair of the Connecting for Health work group that developed the new framework. "At the same time, the vast majority of respondents said having key privacy practices in place would be a factor in their decision to use such services. Nearly half called specific privacy practices ‘critical' in their decision to try one out," Lansky said. When asked about some of the practices contained in the new framework, consumers said: How important in decision to try a PHR service: Common Framework Practice Area It's critical __________ It's one factor in decision __________ Affected people would be notified if their information falls into unauthorized hands in a way that could compromise their identity or expose their health information. 60% 32% An individual would be able to review who has had access to their personal health information. 53% 37% Individuals would have a clear process to request corrections or dispute the way their information is handled. 53% 38% Individuals would NOT be denied care or penalized financially based on whether they decided to provide certain medical information to an internet-based service. 49% 40% The survey of 1,580 U.S adults – conducted by Knowledge Networks between May 13 and 22, 2008 – matched the demographic proportions of the general U.S. adult population (including online and offline households), and had a margin or error of plus or minus 2.5 percent. It was designed by Columbia University Professor Emeritus Alan F. Westin, a leading authority in privacy research. Among the other findings: A small percentage of Americans use PHRs today. Despite the expressed interest that consumers revealed when asked about electronic PHRs, only 2.7 percent of respondents (which equates to 6.1 million people) said they had one today. Of this small group, four in five described their PHR as "valuable." Consumers cite privacy concerns as a significant barrier to PHR adoption. Of the people who said they were not interested in having a PHR, more than half (57 percent) cited privacy concerns as a reason for not wanting one. "Regarding health privacy, we found that 24 percent of the public have high concerns; 49 percent to 56 percent have moderate concerns, and only 20 percent to 27 percent have low concerns," Westin said. "This pattern of health privacy intensity suggests that 73 percent to 80 percent of the public will want to be assured of robust privacy and security practices by online PHR services, if they are to join those offerings." Consumers see that several options can be effective in ensuring protections on the web. The survey asked consumers about their perceptions of effectiveness in four different ways of enforcing good practices on the web. Eighty percent said they thought each of these two options would be effective: Having an independent organization audit the PHR organization and provide a seal of approval to certify it is following good practices. The Federal Trade Commission or state attorneys general enforcing existing consumer protection laws, by finding any PHR that does not follow its own policies is engaging in false and misleading practices. Seventy-six percent said they thought each of these two options would be effective: Market forces - consumers choosing the products and brands they trust and not using others that do not follow good privacy practices. Congress passing a new health privacy law to cover the special features of online PHR services. "Enforcement is a crucial element of this framework," said James X. Dempsey, vice president for public policy of the Center for Democracy and Technology. "Moreover, the Connecting for Health approach makes it clear that it is not sufficient to rely on one single enforcement mechanism for the range of privacy principles. Rather, different enforcement mechanisms will likely be optimal for different aspects of the privacy framework, and comprehensive enforcement will probably require a mix of approaches. It was interesting to see from the survey that consumers believe that a range of enforcement tools may be effective." Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
NEW YORK—The simple, but rarely offered, ability for people to download their health records should be a priority in the nationwide push to upgrade health information technology, according to a policy paper released today by the Markle Foundation. Representing a wide array of providers, consumers, technology companies, insurers, and privacy advocates—50 organizations today declared their support for a specific set of privacy and security practices for the “blue button.” The public-private collaborative group envisions the blue button as a common offering among secure websites for patients and beneficiaries by medical practices, hospitals, insurers, pharmacies, laboratories, and information services. “By clicking the blue button, you could get your own health information electronically—things like summaries of doctor visits, medications you are currently taking, or test results. Being able to have your own electronic copies and share them as you need to with your doctors is a first step in truly enabling people to engage in their health care,” said Carol Diamond, MD, MPH, managing director at Markle. “This capability is not common today, but we have the opportunity to make it a basic expectation—especially now that billions of public dollars will be flowing to help subsidize health information technology,” Diamond said. The paper is being released as Medicare and the U.S. Veterans Administration (VA) prepare to implement a blue button this fall that will, for the first time, allow beneficiaries to electronically download their claims or medical information in a common format from the My Medicare.gov and My HealtheVet secure websites. President Obama announced the blue button for veterans in an August 3 address. “For the first time ever, veterans will be able to go to the VA website, click a simple blue button and download or print your personal health records so you have them when you need them, and can share them with your doctors outside of the VA,” the President said. The Markle collaboration’s recommendations are timely because the American Recovery and Reinvestment Act requires that individuals be able to receive electronic copies of their records from providers’ electronic health record systems. In addition, new federal economic stimulus rules require health care providers and hospitals to deliver electronic copies of things like lists of medications, after-visit summaries, and lab results if they choose to participate in federal subsidies for using health information technology. The Markle policy recommendations reflect consensus on one means by which this can be accomplished today, securely and efficiently. The group details privacy policies and practices for implementing the download capability with sound authentication and security safeguards and suggests practices to help individuals make informed choices about downloading their information. For example, it recommends specific language to remind individuals not to download or store their personal health information on shared computers. Christine Bechtel, vice president of the National Partnership for Women & Families, and a member of the federal Health IT Policy Committee, supported the Markle policy paper. “People see a lot of different health care providers over time, so giving them a convenient option to securely assemble their health information from multiple sources will help them better manage and coordinate their own care,” Bechtel said. “This capability is one of the simplest and most direct ways of helping patients and families see the benefits of the federal health IT investments that they, as taxpayers, have helped fund.” The proposed privacy policies build on the Markle Common Framework for Networked Personal Health Information, a set of recommended practices for individual access to information and privacy. The framework, first released in 2006, is widely supported by a range of technology companies, insurers, provider groups, and consumer and privacy advocates. “We recommend specific privacy policies to help individuals make informed choices about downloading their personal health information, and to emphasize sound authentication and security practices,” said Josh Lemieux, director of personal health technology at Markle. “By supporting this set of policies, a wide range of leaders commit to practices that encourage individual access to information in a way that respects privacy and security.” The following organizations declared their support for the policy paper, Markle Connecting for Health Policies in Practice: The Download Capability: AARP • Allscripts Healthcare Solutions • American Academy of Family Physicians • American College of Cardiology • American College of Emergency Physicians • American Health Information Management Association • American Medical Association • Anakam Inc. • Axolotl • BlueCross BlueShield Association • Center for Connected Health • The Children’s Partnership • Center for Democracy and Technology • Center for Medical Consumers • Children’s Health Fund • Chilmark Research • Computer Sciences Corporation • Consumers Union • Dossia Consortium • DrFirst • Google • Initiate, an IBM Company • The Institute for Family Health • Intel Corporation • Intuit Health • Keas, Inc. • LifeMasters-StayWell Health Management • Markle Foundation • McKesson Technology Solutions/RelayHealth • MedCommons • Medical Group Management Association • MedicAlert Foundation • Meditech • Microsoft Corporation • National Coalition for Cancer Survivorship • National Committee for Quality Assurance • National Partnership for Women & Families • National Quality Forum • NaviNet • Pacific Business Group on Health • PatientsLikeMe • Prematics, Inc. • Press Ganey • PricewaterhouseCoopers LLP • RTI International • Vanderbilt Center for Better Health • Visiting Nurse Service of New York • Wal-Mart Stores, Inc. • WebMD Health • Wellport Markle Foundation works to improve health and national security through the use of information and technology. Markle collaborates with innovators and thought leaders from the public and private sectors whose expertise lies in the areas of information technology, privacy, civil liberties, health, and national security. Learn more about Markle at www.markle.org. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
SAN FRANCISCO—Both the US public and doctors overwhelmingly agree that people should be able to go online to download copies of their medical information, according to a new survey released today by the Markle Foundation. Snapshots of the Markle Survey on Health in a Networked Life 2010—the first of its kind to compare public and doctor priorities for health information technology—will be previewed at the Health 2.0 conference this week in San Francisco. “Seventy percent of the public and 65 percent of the doctors agreed with the concept of a blue button that you can click to download your own health information,” said Carol Diamond, MD, MPH, Managing Director at the New York-based non-profit Markle Foundation. Medicare and the U.S. Department of Veterans Affairs (VA) are preparing this fall, for the first time ever, for beneficiaries and veterans to have a blue button to download their claims or medical information from the MyMedicare.gov and My HealtheVet secure Web sites. “With U.S. veterans now gaining access to a blue button, and Medicare beneficiaries soon to follow, these surveys indicate solid majorities of support among the public and doctors polled,” Diamond said. “This represents a remarkable agreement between the general population and doctors,” Diamond said. “In fact, only 7 percent of the public and only 15 percent of the doctors disagreed with a statement that patients should be able to download copies of their pertinent health information.” The new Markle survey offers a first-ever comparison of public and physician views on key issues surrounding health information technology, including their views on the new federal incentives to stimulate use of health IT. Different thematic elements of the findings will be released in coming months. The new federal rules require health care providers and hospitals to give patients electronic copies of their lists of medications, after-visit summaries, lab results, and other pertinent information in order to qualify for an estimated $27 billion in federal subsidies for using health information technology. The program, now being rolled out as required by the Recovery Act, is designed to make the sharing of patient information more efficient. Sixty-two percent of the public and 49 percent of the doctors surveyed said that for the billions in dollars of federal incentives to be well-spent, it’s important for the program to set requirements that participating doctors and hospitals supply patients with electronic copies of their personal health information. Only 8 percent of the public and 21 percent of the doctors felt that providing electronic copies to patients was not an important requirement for the program. But overwhelming majorities of the public and of doctors surveyed also want to make sure the money comes with privacy safeguards. “As with our past surveys, we found that privacy protections are a high priority,” Diamond said. “When asked about requirements necessary to make sure that federal incentive money for health IT would be well-spent, more than 80 percent of both the public and doctors said privacy safeguards were important.” Despite the strong support for the idea of downloading personal health information, 83 percent of the public said they never ask for their information in electronic format. The vast majority of the doctors said requests from patients for information in electronic format either rarely (24 percent) or never (67 percent) occurred. “The blue button can help raise awareness about the need to engage patients and their families through health IT,” said Josh Lemieux, director of personal health technology at Markle. “Providing secure, convenient access to their information is a building block to helping people improve their health and communicate better with nurses and doctors.” The Markle Connecting for Health collaborators recently published a set of privacy practices for the blue button download capability supported by 50 organizations representing technology companies, insurers, provider groups, and consumer and privacy advocates. Those practices are part of the Markle Common Framework for Networked Personal Health Information, which recommends policy and technology safeguards to encourage individual access to information and privacy. The surveys were conducted between August 10 and 26, 2010, by Knowledge Networks (KN). The general population survey of 1,582 adults age 18 and older was conducted using KN’s KnowledgePanel®, a probability-based panel of 50,000 individuals designed to be representative of the U.S. population. The survey of 779 physicians was conducted using KN’s Physicians Consulting Network (PCN), an invitation-only list of more than 45,000 practicing physicians. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.
SAN FRANCISCO—The Markle Foundation and the Robert Wood Johnson Foundation's Pioneer Portfolio today recognized a set of innovations that convert simple health data downloads into useful tools to help U.S. veterans improve their health. The foundations sponsored the Blue Button Developer Challenge to stimulate innovation and encourage doctors, hospitals, pharmacies, insurers, and personal health information services to let their customers securely download their medical information at the click of a blue button. The US Department of Veterans Affairs and Medicare have led the way by preparing to offer a blue button on their password-protected online portals to give veterans and beneficiaries the option of downloading copies of their medical or claims information. "Downloading your information is only the first step to making use of it," said Carol Diamond, MD, MPH, managing director at Markle. "The real winner of this challenge is the consumer because so many different approaches and ideas emerged to help patients put their information to good use." Adobe’s Blue Button Health Assistant received the top prize from a distinguished panel of judges: Craig Newmark, founder of craigslist.org; Steve Findlay, MPH, Senior Health Policy Analyst, Consumers Union; James Ralston, MD, MPH, Associate Investigator, Group Health Research Institute, and Steve Downs of RWJF. The foundations and the judges recognized the other finalists: Microsoft, MedCommons, and RememberItNow! "I was impressed that the challenge finalists took fairly unfriendly raw data and made it readable, usable, and easy to share in different ways," said Steve Downs, assistant vice president, Health Group, Robert Wood Johnson Foundation. "Within the very tight time frame of this contest, we are just scratching the surface of what is possible. I’m looking forward to tools that we haven’t even imagined." For the challenge, Markle and Robert Wood Johnson Foundation asked participants to develop a web-based tool that uses test blue button downloads from the VA or Medicare to help patients stay healthy and manage their care. "This competition was a great reminder that we each should be actively engaged in our own health, and that there’s great potential in online tools to help us make sense of our information," Newmark said. "As we have seen with other technology, a relatively simple step—like making your health information downloadable as the VA and Medicare are doing—can be revolutionary." Ralston, an internist and pioneer in using electronic personal health records (PHRs) to engage patients, said: "The contents of the blue button download provide a good foundation for tools that help patients share information with various providers. I was pleased to see many of the entries focus on communication of critical information between doctors and patients." Findlay, of Consumers Union, emphasized not only the criteria for usefulness and usability but also the privacy requirements of the challenge. "Many consumers want convenient, secure access to their personal health information and connections to their providers, but only when their privacy and security is protected," he said. Broad industry and consumer advocate support for the blue button emerged from a Markle Connecting for Health public-private collaboration. Fifty organizations from this collaboration—representing technology companies, insurers, provider groups, and consumer and privacy advocates—recently supported a set of privacy practices for the blue button. The privacy practices are part of the Markle Common Framework for Networked Personal Health Information, which recommends policy and technology safeguards to encourage individual access to information and privacy. Adobe demonstrated an application and a security-enabled PDF document for patients to store their downloads and share them with providers. MedCommons demonstrated how veterans could create online packets of radiology images when they go for second opinions. Microsoft showed how its online HealthVault platform could consume the VA data and allow it to be used in a variety of third-party applications that a patient might choose. RememberItNow focused on medication reminders for veterans. Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.markle.org/health.