Tech Backs Standards for Online Health Records

With a majority of Americans supportive of electronic medical records but still wary of the privacy implications, the non-profit Markle Foundation moved June 25 to create a national framework of standards.

The effort drew the immediate praise and endorsement of Google, Microsoft and a host of other organizations, including insurers, WebMD and AARP.

The framework calls for all electronic health records to include an audit of who has access to the records, dispute resolution for consumers challenging the use of their records and prohibitions against using the records to discriminate in hiring practices. In all, the framework includes four overviews and 14 specific technology and policy approaches.

"We have achieved the first detailed, consensus-based approach to consumer access and privacy practices for important new Internet-based health information services," Dr. Carol Diamond, a Markle director and chairman of Connecting for Health, said in a statement. "A stable, common-sense set of principles and practices will foster innovation and improve consumer choice for these emerging services."

Diamond said work on the standards framework began more than a year ago as technology companies, health care delivery systems, health insurers and large employers began offering consumers options to keep their own copies of health information and connect to online health-related services such as Microsoft's HealthVault and Google's Personal Health tools.

According to the Markle Foundation, the new online health space was evolving without a common set of information practices and expectations.

"Consumer demand for electronic personal health records and online health services will take off when consumers trust that personal information will be protected," said Markle Foundation President Zoë Baird. "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."

Two years ago, the Markle Foundation released an outline of policy and technology resources to ensure privacy and security in electronic networks connecting medical professionals from different institutions and clinics.

"Some of the new services aren't covered under federal health information privacy laws, and there is uncertainty about privacy protections," said Steve Findlay, a health care analyst at the Consumers Union. "This collaboration lays out specific practices that all PHRs [personal health records] and related services can use, whether they are covered by federal privacy rules or not, so they can enhance public trust."

Microsoft noted it has been working with Markle since before the 2007 launch of HealthVault and that the online program is "largely aligned" with Markle's Connect for Health. Google said only "small changes" would be required in its Google Health offering to comply with the Markle framework.

Separately, the House Energy and Commerce's Health Subcommittee approved June 25 legislation designed to reduce medical errors and costs by encouraging the adoption of HIT (Health Information Technology) and to strengthen the privacy and security of health information in the electronic age.

"Your grocery store automatically knows what brand of chips you bought last year, but your cardiologist doesn't automatically know what prescriptions your family doctor prescribed for you yesterday," Rep. John Dingel, chairman of the Energy and Commerce Committee, said in a statement. "That's problematic for health care quality and costs."

The bill would authorize $575 million over five years for grants and loans to health providers to build health IT systems.