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    of the HIT Policy Committee Basch served as the chairman of the recently concluded Maryland Task Force on EHRs and served as an advisor on health IT to the Obama transition team Basch practices general internal medicine in Washington DC and is an early adopter of electronic health records and e prescribing He also serves as the Medical Director for Ambulatory EHR and Health IT Policy at MedStar Health providing the clinical and strategic leadership for its ambulatory EHR implementation Basch has collaborated with Markle and the Engelberg Center for Health Care Reform at Brookings on several events and joint comments on the meaningful use regulations Scott Kennedy Scott Kennedy was named Vice President Pay Benefits in 2010 He joined Target in 2005 and has held the positions of Vice President Assurance Vice President Controller and Vice President Finance at Target Financial Services He is currently responsible for strategic development and program implementation for team member health and financial well being benefits plans and Target s compensation programs Kennedy currently serves on the Board of Directors for the Greater Minneapolis Crisis Nursery Prior to joining Target he was a partner at KPMG LLP a global accounting and consulting firm providing various accounting and consulting services to multinational clients in the U S and abroad Kennedy born and raised in Australia graduated from the University of Canberra with a Finance and Accounting degree Pam Carpenter Pam Carpenter is the business development manager for all federal civilian programs within the Adobe public sector organization In this role she develops the overall program capture strategy in key areas including federal healthcare grants management mobile and cloud computing Over the past 25 years she has served in senior level business development roles with Lotus Development IBM webMethods and Macromedia Carpenter is a graduate of the University of Delaware Warwick Charlton MD Warwick Charlton MD serves as Vice President and Chief Medical Officer for Intuit Health a new Intuit business unit created by combining recently acquired Medfusion with the Quicken Health Group He plays a key role in the innovation and development of new products and services designed to make health care delivery more efficient and effective with a special interest in improving patients interaction with their physicians Charlton s perspective and expertise in health policy health IT and business provided the strategic guidance and leadership for new business and product development opportunities that helped make Medfusion the leading patient to provider communications company He was instrumental in the creation of a number of technology and service driven solutions including Web and telephony products Prior to joining Medfusion Charlton served as CMO and SVP Product Development at Accordant Health Services and was CMO for ThinkMed LLC He is a board certified family practitioner and received an MBA from the Anderson School of Business at the University of New Mexico Susannah Fox Susannah Fox is Associate Director at Pew Research Center s Internet American Life Project She studies the cultural shifts taking place at the intersection

    Original URL path: http://www.markle.org/solr-search?keyword=&page=30 (2016-02-10)
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  • Resources | Markle | Advancing America's Future
    of a compendium called The Markle Connecting for Health Common Framework for Networked Personal Health Information It is made available free of charge but subject to the terms of a License You may make copies of this work however by copying or exercising any other rights to the work you accept and agree to be bound by the terms of the License All copies of this work must reproduce this copyright information and notice Download CP1 Policy Overview Network Participants The average person s ability to access data and communicate electronically is proliferating exponentially Consumer adoption of digitally networked services has transformed the culture of many industries often in ways unimaginable barely a decade ago Consider these examples of rapid consumer adoption of web based technologies Communications E mail is now an indispensable tool of communication for hundreds of millions of people worldwide Instant messaging and Voice over Internet Protocol VoIP such as skype com are increasingly accepted alternatives to traditional telephones Search The indexing of online information places enormous research power in the hands of individuals People now Google or MapQuest without thinking of picking up a phone book or going to a library Search engines are exposing ever more granular information such as full text searches of vast libraries of books or the estimated value of your home or the presence of a registered sex offender next door Collective contributions by customers add value to search engine results as demonstrated by the niche layers that individuals can add to Google maps E commerce Websites such as Amazon eBay and Craigslist create ever expanding communities of buyers and sellers which in turn create ever expanding content inventory and transactions Opening up online access to previously proprietary networks such as real estate listings and flight schedules has precipitated dramatic new conveniences for consumers and efficiencies for industry Personal finance Consumers embrace ATMs debit cards personal finance and tax software and online banking and investment brokerage services Such online transactions and self management tools replace mail phone and retail encounters with financial institutions Entertainment The explosive popularity of Apple Computer s iPod represents a progression toward individual manipulation and portability of entertainment media and other data No longer passive consumers of radio program director decisions individuals increasingly create and share their own playlists and podcasts In another example fantasy sports create networks of enthusiasts more deeply engaged than mere spectators of events Content Perhaps the most interesting techno social trend is how newly networked consumers generate whole new bodies of content Bloggers who use software that makes it easy to self publish on the web are directly challenging political and journalistic institutions among others People are now pouring their innermost thoughts and images into the worldwide digital stream through online communities such as MySpace com and YouTube com Wikipedia represents a related and equally powerful trend online collaborative publishing that derives its authority through the self regulating nature of open communities MySpace and Wikipedia in particular illustrate a phenomenal expansiveness of online community content creation By most accounts 1 2 both have emerged in about 18 months to join the 20 most popular sites on the web Wikipedia is now the most frequently visited reference site on the Internet 3 This paper does not attempt a comprehensive analysis of such successful innovations in sectors other than health care but we observe that they share a few basic traits They are highly useful All of the examples cited above provide rapid utility and convenience by taking available digital data making it digestible and providing immediate value to consumers They are easy to use Web applications that have diffused broadly typically deliver not only high utility but also a simple user interface that does not limit or burden the consumer 4 They are free or inexpensive for consumers to use Whether supported through advertisements or not for profit foundations dramatic growth applications generally collect small or no fees from consumers They rapidly proliferate due to the power of networks Consumers connect to various networks via their credit cards cell phones e mail accounts affinity club memberships and so on Search engines point to information residing across a vast number of sources all tied together by the Internet which itself is a network of networks Point to point communication tools like e mail and cell phones work because they can slice across competing networks Credit cards work across competing banks because there are worldwide networks that tie them together People trust strangers on eBay because there is a trusted payment network PayPal as well as a network of buyers and sellers who provide accountability by collectively and publicly rating each other Sites like Wikipedia Craigslist and MySpace have created arrays of communities of people with similar interests A key ingredient to the successes cited above is a fresh openness toward consumer access to and contribution of information By contrast the health care industry has moved more slowly toward providing consumers with online access to health data and interactive services Personal health information is different often more complex scattered sensitive less structured than the other types of information cited above However electronic personal health records PHRs represent an emerging vehicle to increase consumer participation in the health sector Personal Health Records PHRs PHRs encompass a wide variety of applications that enable people to collect view manage or share copies of their health information or transactions electronically Many PHR applications in existence today facilitate the viewing of health information A new generation of PHRs promotes the development of multiple and diverse applications that act on personal health information to help users with specific tasks Although there are many variants PHRs are based on the fundamental concept of facilitating an individual s access to and creation of personal health information in a usable computer application that the individual or a designee controls We do not envision PHRs as a substitute for the professional and legal obligation for recordkeeping by health care professionals and entities However they do portend a beneficial trend toward greater engagement of consumers in their own health and health care Today s PHRs are generally un networked They typically require the consumer to enter data manually or get a view of information from a single entity such as one health plan one pharmacy or perhaps one health care provider s electronic health record EHR Yet most people have relationships with many different doctors and health care entities particularly those Americans with multiple chronic conditions more than 60 million today and estimated to reach 81 million by 20205 must coordinate their care across several providers and entities If the PHR is limited to one particular relationship it may not meet the long term needs of many whose information is dispersed across organizations Some people in a stable relationship with one integrated delivery system may today have their information adequately accessible through an application from that institution However for most people over time PHRs would be much more useful if they were networked to aggregate the consumer s health information across multiple sources e g the consumer s insurance eligibility and claims her records from all of her doctors her lab results her pharmacy services her diagnostic imaging etc Networked PHRs as Tools for Transformation The mere aggregation of the consumer s data however should not be an end in itself The true test is whether the network makes it easier for ordinary people to coordinate and engage more actively in their own health and health care We see a networked environment for PHRs as a foundation for Americans to improve the quality and safety of the care they receive to communicate better with their doctors to manage their own health and to take care of loved ones This paper argues that consumers can help accelerate transformative change particularly in a networked information environment However we emphasize that clinicians also have a critical role in realizing the full potential of networked PHRs Consumers continue to see doctors and other health professionals as the key agents of their care and the most trusted hosts of their personal health information To take advantage of networked personal health information both consumers and clinicians must be open to changes in their relationships responsibilities and workflows Network enabled efficiencies and safety improvements are more likely to occur if consumers and health care professionals act as partners who share access to and responsibility for updating personal health information The status quo in which most personal health information under the custodianship of providers payers and other entities is largely un networked makes it more difficult for consumers to gather their data from multiple sources more difficult to choose freely among providers and thus more difficult to manage their health The Rationale for Networking Consumers Entrenched problems in the American health care system are well documented Among the oft cited deficiencies Fragmentation that leads to inefficiency and duplication of efforts and costs 6 7 Disappointing levels of safety and quality that lead to high rates of medical errors 8 9 10 Frequent unavailability of vital information at point of care 11 High costs that are growing at an unsustainable rate 12 13 An overall lack of patient centeredness 14 Rapid consumer adoption of newly networked services has proven to be possible indeed phenomenal in other sectors Consumers can adapt to technology and culture transformation more rapidly than large health care institutions with long histories of business processes and legacy systems Furthermore even as the majority of clinicians continue to keep consumers data on paper other important personal health information namely claims pharmacy diagnostic images and lab data are available in digital form today We conclude that the immediate effort to catalyze health care transformation must include a strategy to create a networked environment for PHRs and related technologies that takes advantage of these currently available digital data streams Providers can gradually form and join networks as their systems increasingly interoperate In fact networked connections to PHRs could help accelerate the EHR adoption curve as clinicians see advantages to joining the network There are additional strong rationales for involving consumers in a much needed transformation toward greater information access and transparency First the health care consumer has the largest stake in the contents of such information The consumer s life is put at risk when preventable errors occur due to lack of information Second the consumer is the ultimate payer of health care services Consumers are being asked to pay directly for a larger proportion of their care 15 16 Third younger generations expect to use technology in almost all aspects of their lives Fourth as the number and complexity of diagnostic and treatment modalities grows at a rapid pace patients are increasingly required to share the responsibility of decision making with their health care providers Furthermore patients are often in the best position to gather and share information with providers 17 18 For example a physician might know that a medication has been prescribed for a patient But without asking the patient the doctor does not know whether the patient actually took the medication how well it worked what other remedies she is taking or whether she had side effects Empowering health care consumers by placing information directly in their hands has the potential to radically improve health care 19 20 PHRs are still in the early development stages and a great deal of study is needed to measure the benefits and risks of PHRs Consumers patients and their families vary widely in the responsibilities they each wish to maintain in their own health However as noted in Connecting for Health s 2004 report Connecting Americans to Their Health Care preliminary evidence suggests that PHRs have potential to Empower patients and their families 21 22 23 24 25 26 27 28 Improve the patient clinician relationship 29 30 31 32 33 Increase patient safety 34 35 36 37 Improve the quality of care 38 39 40 41 42 Improve efficiency and convenience 43 44 45 46 47 48 Improve privacy safeguards 49 50 Save money 51 52 53 54 55 56 57 Lastly there is general agreement among many stakeholders including those listed below that PHRs should be a key part of health care modernization and reform efforts Government bodies like the National Committee on Vital and Health Statistics58 and the American Health Information Community 59 Professional societies such as the American Medical Association60 and the American Health Information Management Association 61 Consumer groups such as AARP and the American Diabetes Association 62 Health insurance plan associations like America s Health Insurance Plans and the Blue Cross Blue Shield Association 63 Bipartisan political leaders 64 Addressing Key Policy Concerns Will Be Core to the Transformation Process Although a networked PHR would provide significant benefits to consumers the exchange of health data over an electronic network poses serious concerns Confidentiality of personal health information is a core American value 65 There is evidence that Americans support a network for health information exchange if security and confidentiality safeguards are sufficient 66 Thus before encouraging the ubiquitous networking of PHRs to other health information systems we must establish a common understanding and an adequate set of shared rules We need a technical approach that allows access controls to keep information flowing among people authorized to see it and protected from unauthorized access or use The selection and implementation of technical elements are themselves aids or obstacles to confidentiality and security If PHRs can be authorized to connect securely to multiple data streams on the network then the competition among PHRs will be based on service features and value to the consumer not mere custody of the consumer s data All of the participants within the networked environment including health care institutions and professionals insurance companies labs pharmacy services employers and consumers themselves must agree to basic principles for providing individuals the ability to obtain personal health information about them and security and confidentiality protections must be baked in to the network design We do not know what kinds of applications and functions will be most effective in encouraging the transformation we seek The mere presentation of health data to consumers is not as likely to be transformative as new applications to interpret and apply the data in innovative ways that provide specific benefit to specific people and connect them with their health team and caregivers Although the Common Framework for Networked Personal Health Information recommends a framework for enabling networked PHRs we purposely avoid recommendations on what those applications should be or do Development of a sufficiently flexible network will enable the use of a great variety of personal health technology applications including many that we cannot imagine today Connecting for Health thanks Josh Lemieux Markle Foundation Daren Nicholson MD an independent contractor and David Lansky PhD for drafting this paper parts of which were originally published by the Markle Foundation in December 2006 The Washington Post homepage on the Internet Washington The Washington Post Company c2006 cited 2006 May 8 Top Web Domains about 4 screens Boutin P A Grand Unified Theory of YouTube and MySpace Slate serial on the Internet 2006 April 28 cited 2006 May 2 about 5 screens Available at http www slate com id 2140635 Clarke G Wikipedia Eclipses CIA The Register serial on the Internet 2005 September 7 cited 2006 May 4 about 3 screens Available at http www theregister co uk 2005 09 07 wikipedia growth Boutin P A Grand Unified Theory of YouTube and MySpace Slate serial on the Internet 2006 April 28 cited 2006 May 2 about 5 screens Available at http www slate com id 2140635 Anderson G Partnership for Solutions slide presentation 2004 cited 2006 May 2 Available at http www partnershipforsolutions org DMS files anderson cdc ppt Shi L Singh D Essentials of the US Health Care System Sudbury MA Jones and Bartlett Publishers Inc 2004 Blendon RJ et al Common Concerns amid Diverse Systems Health Care Experiences in Five Countries Health Aff 2003 May Jun 22 3 106 21 Institute of Medicine To Err is Human Building a Safer Health System Washington National Academies Press 2000 McGlynn EA Asch SM Adams J Keesey J Hicks J DeCristofaro A Kerr EA The Quality of Health Care Delivered to Adults in the United States N Engl J Med 2003 June 26 348 26 2635 2645 Miller MR Zhan C Pediatric Patient Safety in Hospitals A National Picture in 2000 Pediatrics 2004 Sep 114 3 907 Connecting for Health Achieving Electronic Connectivity in Healthcare monograph on the Internet New York Markle Foundation 2004 cited 2006 August 1 Available at http www markle org publications 842 achieving electronic connectivity health care summary financial incentives recommen Connecting for Health Steering Group and Personal Health Technology Council Opportunities for CMS Action in Support of Personal Health Records monograph on the Internet New York Markle Foundation 2005 cited 2006 May 17 Available at http www markle org publications 1256 opportunities cms actions support personal health records OECD homepage on the Internet Paris OECD updated 2004 March 6 cited 2006 June 14 Health Spending in Most OECD Countries Rises with the U S far Outstripping all Others about 4 screens Institute of Medicine Crossing the Quality Chasm A New Health System for the 21st Century Washington National Academies Press 2001 Robinson J Health Savings Accounts The Ownership Society in Health Care N Engl J Med 2005 Sep 353 12 1199 1202 Maze J Consumerism Creeping into Health Plans The Post and Courier Charleston SC 2005 December 5 final ed E6 Tang P et al Personal Health Records Definitions Benefits and Strategies for Overcoming Barriers to Adoption J Am Med Inform Assoc 2006 Mar Apr 13 2 121 126 Denton IC Will Patients use Electronic Personal Health Records Responses From a Real Life Experience J of Healthc Inf Manag 2001 Fall 15 3 251 259 Tang P et al Personal Health Records Definitions Benefits and Strategies for Overcoming Barriers to Adoption J Am Med Inform Assoc 2006 Mar Apr 13 2 121 126 American Health Information Management Association homepage on the Internet Chicago American Health Information Management Association updated 2005 July 25 cited 2006 May 8 AHIMA press release Personal Health Records belong to the Patient about 1 screen Masys D Baker D Butros A Cowles KE Giving Patients Access to their Medical Records via the Internet The PCASSO Experience J Am Med Inform Assoc 2002 Mar Apr 9 2 181 91 Jimison HB Sher PP Advances in Health Information Technology for Patients J AHIMA 1998 Sep 69 8 42 6 Tang PC Newcomb C Informing Patients A Guide for Providing Patient Health Information J Am Med Inform Assoc 1998 Nov Dec 5 6 563 70 Winkelman WJ Leonard KJ Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records A Critical Review and Proposal for an Evaluation Framework J Am Med Inform Assoc 2004 Mar Apr 11 2 151 61 Bluml BM McKenney JM Cziraky MJ Pharmaceutical Care Services and Results in Project ImPACT Hyperlipidemia J Am Pharm Assoc Wash 2000 Mar Apr 40 2 157 65 Broder C Projects Tap Technology for Disease Management iHealthBeat serial on the Internet 2003 June 10 about 3 screens Neville R Greene A McLeod J Tracy A Surie J Mobile Phone Text Messaging Can Help Young People Manage Asthma BMJ 2002 Sep 14 325 7364 600 Billault B DeGoulet P Devries C Plouin P Chattellier G Menard J Use of a Standardized Personal Medical Record by Patients with Hypertension A Randomized Controlled Prospective Trial MD Comput 1995 Jan Feb 12 1 31 5 Tang PC Newcomb C Informing Patients A Guide for Providing Patient Health Information J Am Med Inform Assoc 1998 Nov Dec 5 6 563 70 Fierman A Rosen C Legano L Lim S Mendelsohn A Dreyer B Immunization Status as Determined by Patients Hand Held Cards vs Medical Records Arch Pediatr Adolesc Med 1996 Aug 150 8 863 6 MacDonald K Online Patient Provider Communication Tools An Overview monograph on the Internet San Francisco California Health Care Foundation 2003 November cited 2006 June 15 Available at http www chcf org topics view cfm itemid 21600 Dishman E Sherry J Changing Practices Computing Technology in the Shifting Landscape of American Healthcare Santa Clara Intel Corporation 1999 Von Knoop C Lovich D Silverstein MB Tutty M Vital Signs E Health in the United States monograph on the Internet Boston Boston Consulting Group 2003 cited 2006 June 15 Kaushal R Shojania KG Bates DW Effects of Computerized Physician Order Entry and Clinical Decision Support Systems on Medication Safety A Systematic Review Arch Intern Med 2003 Jun 23 163 12 1409 16 Potts AL Barr FE Gregory DF Wright L Patel NR Computerized Physician Order Entry and Medication Errors in a Pediatric Clinical Care Unit Pediatrics 2004 Jan 113 1 Pt 1 59 63 Bennett JW Glasziou PP Computerized Reminders and Feedback in Medication Management A Systematic Review of Randomized Controlled Trials Med J Aust 2003 Mar 3 178 5 217 22 Miller RH Sim I Newman J Electronic Medical Records Lessons from Small Physician Practices monograph on the Internet San Francisco California Health Care Foundation 2003 October cited 2006 June 15 Available at http www chcf org topics view cfm itemID 21521 Bluml BM McKenney JM Cziraky MJ Pharmaceutical Care Services and Results in Project ImPACT Hyperlipidemia J Am Pharm Assoc Wash 2000 Mar Apr 40 2 157 65 Tang PC Newcomb C Informing Patients A Guide for Providing Patient Health Information J Am Med Inform Assoc 1998 Nov Dec 5 6 563 70 Bennett JW Glasziou PP Computerized Reminders and Feedback in Medication Management A Systematic Review of Randomized Controlled Trials Med J Aust 2003 Mar 3 178 5 217 22 Neville R Greene A McLeod J Tracy A Surie J Mobile Phone Text Messaging Can Help Young People Manage Asthma BMJ 2002 Sep 14 325 7364 600 Winkelman WJ Leonard KJ Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records A Critical Review and Proposal for an Evaluation Framework J Am Med Inform Assoc 2004 Mar Apr 11 2 151 61 Huff C Medical Paperwork Pains Patients Seeking Records Sometimes Frustrated Arlington Star Telegram Forth Worth TX 1999 January 11 1B 5B Miller RH Sim I Newman J Electronic Medical Records Lessons from Small Physician Practices monograph on the Internet San Francisco California Health Care Foundation 2003 October cited 2006 June 15 Available at http www chcf org topics view cfm itemID 21521 Bluml BM McKenney JM Cziraky MJ Pharmaceutical Care Services and Results in Project ImPACT Hyperlipidemia J Am Pharm Assoc Wash 2000 Mar Apr 40 2 157 65 MacDonald K Online Patient Provider Communication Tools An Overview monograph on the Internet San Francisco California Health Care Foundation 2003 November cited 2006 June 15 Available at http www chcf org topics view cfm itemid 21600 RelayHealth The RelayHealth WebVisit Study Executive Summary monograph on the Internet Emeryville CA Relay Health 2002 cited 2006 June 15 Von Knoop C Lovich D Silverstein MB Tutty M Vital Signs E Health in the United States monograph on the Internet Boston Boston Consulting Group 2003 cited 2006 June 15 Masys D Baker D Butros A Cowles KE Giving Patients Access to their Medical Records via the Internet the PCASSO experience J Am Med Inform Assoc 2002 Mar Apr 9 2 181 91 Schoenberg R Safran C Internet Based Repository of Medical Records that Retains Patient Confidentiality BMJ 2000 Nov 11 321 7270 1199 203 Gawthorn E Introducing the Personal Health Record RACGP Health Record System Brochure South Melborne Australia Royal Australian College of General Practitioners 1982 Miller RH Sim I Newman J Electronic Medical Records Lessons from Small Physician Practices monograph on the Internet San Francisco California Health Care Foundation 2003 October cited 2006 June 15 Available at http www chcf org topics view cfm itemID 21521 Von Knoop C Lovich D Silverstein MB Tutty M Vital Signs E Health in the United States monograph on the Internet Boston Boston Consulting Group 2003 cited 2006 June 15 Bluml BM McKenney JM Cziraky MJ Pharmaceutical Care Services and Results in Project ImPACT Hyperlipidemia J Am Pharm Assoc Wash 2000 Mar Apr 40 2 157 65 Broder C Projects Tap Technology for Disease Management iHealthBeat serial on the Internet 2003 June 10 about 3 screens MacDonald K Online Patient Provider Communication Tools An Overview monograph on the Internet San Francisco California Health Care Foundation 2003 November cited 2006 June 15 Available at http www chcf org topics view cfm itemid 21600 RelayHealth The RelayHealth WebVisit Study Executive Summary monograph on the Internet Emeryville CA Relay Health 2002 cited 2006 June 15 National Committee on Vital and Health Statistics homepage on the Internet Washington Department of Health and Human Services updated 2005 September 9 cited 2006 May 8 September 9 2005 Letter to Secretary Leavitt on Personal Health Record PHR Systems about 16 screens Fromerly available at http www ncvhs hhs gov 050909lt htm United States Department of Health and Human Services homepage on the Internet Washington United States Department of Health and Human Services updated 2006 May 3 cited 2006 May 8 American Health Care Community Consumer Empowerment Workgroup about 2 screens Available at http www hhs gov healthit ahic ce main html American Medical Association homepage on the Internet Chicago American Medical Association c1995 2005 cited 2006 May 8 Policy H 185 979 allocation of health services about 1 sreen Available at http www ama assn org apps pf new pf online f n browse p p T s t st p nth 1 prev pol policyfiles HnE H 185 979 HTM nxt pol policyfiles HnE H 185 982 HTM American Health Information Management Association homepage on the Internet Chicago American Health Information Management Association updated 2005 July 25 cited 2006 May 8 AHIMA press release Personal Health Records belong to the Patient about 1 screen Formerly available at http www ahima org press press releases 05 0725 asp Cerner Corporation homepage on the Internet Kansas City Cerner Corporation c2006 updated 2004 October 12 cited 2006 June 20 Cerner press release Cerner Launches 25 Million 10 Year Initiative to Provide Personal Health Records to Kids with Diabetes about 3 screens Available at http www cerner com public NewsReleases asp id 257 cid 228 America s Health Insurance Plans homepage on the Internet Washington America s Health Insurance Plans updated 2006 January 31 cited 2006 May 8 AHIP Statement on the State of the Union Address about 3 screens Available at http www ahip org content pressrelease aspx docid 14738 California Healthline homepage on the Internet Washington Advisory Board Company updated 2005 May 10 cited 2006 May 8 Former House Speaker Newt Gingrich Calls for Increased Investment in Health Care Information Technology about 2 screens Connecting for Health The Architecture for Privacy in a Networked Health Information Environment monograph on the Internet New York Markle Foundation 2006 cited 2006 May 17 Available at http www markle org sites default files P1 CFH Architecture pdf Markle Foundation Markle Foundation Survey Fact Sheet monograph on the Internet New York Markle Foundation 2005 cited 2006 May 17 Available at http www markle org publications 951 attitudes americans regarding personal health records and nationwide electronic hea 2008 2011 Markle Foundation This work was originally published as part of a compendium called The Markle Connecting for Health Common Framework for Networked Personal Health Information It is made available free of charge but subject to the terms of a License You may make copies of this work however by copying or exercising any other rights to the work you accept and agree to be bound by the terms of the License All copies of this work must reproduce this copyright information and notice Overview Many policy and industry leaders now agree that empowerment of consumers enhanced by convenient access to networked health information services will help drive necessary changes to the health care sector The Markle Connecting for Health Common Framework for Networked Personal Health Information provides a foundation for maintaining trust among all participants business professional and consumer in electronic health information networks The objective is to give consumers the ability to compile electronic copies of their personal health information including their own contributions under a set of fair practices that respect personal preferences for how information may be collected and shared The term networked implies connectivity across entities Networking health information is critical given the fragmentation of most health related services in the United States Markle Connecting for Health a public private collaborative group engaging more than 100 organizations representing all major components of the health sector convened the Work Group on Consumer Access Policies1 to identify a set of practices to support the emergence of networked personal health records PHRs in the public interest PHRs include a wide variety of electronic applications designed to help consumers manage their health related information and transactions communicate better with clinicians or take better care of themselves and loved ones The Common Framework resources are intended to foster network relationships and ultimately to enhance trust among the following parties Consumers including patients their families and caregivers Our vision is that individual consumers will be able to compile and share electronic copies of their personal health information captured at various points including the home e g monitoring devices patient diaries Heath Data Sources meaning any institutional custodian of the individual s personal health information This may include health care providers and clinics hospitals and health care systems health insurance plans clearinghouses pharmacies and pharmacy benefit managers laboratory networks disease management companies and others that hold data related to the personal health of individuals Consumer Access Services an emerging set of services designed to help individuals make secure connections with Health Data Sources in an electronic environment Consumers may be offered such services by a variety of organizations ranging from existing health care entities e g providers payers self insured employers to new entrants to the health sector e g technology companies employer coalitions affinity groups health record banks etc Such services are likely to provide functions such as authentication as well as data hosting and management We distinguish Consumer Access Services from PHR applications although both could be supplied in one integrated product Consumers ideally will have a choice of services to enable PHR applications of their choosing to exchange data with multiple Health Data Sources across a secure network of networks 2 The diagram below illustrates this basic distinction The rationale for Consumer Access Services rests primarily on two points It is not practical for most individuals to connect separately and differently to every institution that holds their health data and In an open and innovative market individuals should choose applications that best meet their own needs rather than be solely reliant on the applications offered by the various institutional sources of their health information or services The Common Framework resources are designed to guide organizations participating in what we call consumer data streams the flow of personal health information into and out of consumer accessible applications such as PHRs See CT1 Technology Overview for a discussion of consumer data streams and how they contrast with business data streams There are many emerging consumer data streams today Hundreds of PHR applications now offer a variety of services to U S consumers including products sponsored by providers health plans employers technology companies non profits and others Several global brands have launched initiatives to act as Consumer Access Services There also is a growing number of patient community sites often described as Health 2 0 that take innovative approaches to health problems from outside traditional health care Public opinion surveys commissioned by the Markle Foundation3 and others have found that most Americans want to have electronic copies of their health records The research indicates that Americans understand that quality of care could improve when their health information is available over the Internet to them and those who care for them Markle also found that eight in 10 Americans are very concerned about identity theft or fraud and the possibility of their data being used by marketers without their permission This Common Framework provides a voluntary approach to meet the dual challenges of making personal health information more readily available to consumers while also protecting it from unfair or harmful practices Connecting for Health Core Principles Markle Connecting for Health has published a set of principles that provide the foundation for managing personal health information within consumer accessible data streams The consensus principles based on accepted international fair information practices are presented fully in The Architecture for Privacy in a Networked Health Information Environment 4 Taken together the nine principles form a comprehensive approach to privacy the hallmark for which is that personal information be handled according to the individual s understanding and consent In brief the principles and the corresponding papers in this Framework are as follows Connecting for Health Core Principles Practice Areas of this Common Framework for Networked Personal Health Information 1 Openness and transparency Consumers should be able to know what information has been collected about them the purpose of its use who can access and use it and where it resides They should also be informed about how they may obtain access to information collected about them and how they may control who has access to it CP2 Policy Notice to Consumers 2 Purpose specification The purposes for which personal data are collected should be specified at the time of collection and the subsequent use should be limited to those purposes or others that are specified on each occasion of change of purpose CP2 Policy Notice to Consumers CP3 Consumer Consent to Collections Uses and Disclosures of Information CT4 Limitations on Identifying Information 3 Collection limitation and data minimization Personal health information should only be collected for specified purposes and should be obtained by lawful and fair means The collection and storage of personal health data should be limited to that information necessary to carry out the specified purpose Where possible consumers should have the knowledge of or provide consent for collection of their personal health information CP2 Policy Notice to Consumers CP3 Consumer Consent to Collections Uses and Disclosures of Information CT4 Limitations on Identifying Information 4 Use limitation Personal data should not be disclosed made available or otherwise used for purposes other than those specified CP2 Policy Notice to Consumers CP3 Consumer Consent to Collections Uses and Disclosures of Information CP7 Discrimination and Compelled Disclosures CT3 Immutable Audit Trails CT4 Limitations on Identifying Information 5 Individual participation and control Consumers should be able to control access to their personal information They should know who is storing what information on them and how that information is being used They should also be able to review the way their information is being used or stored CP3 Consumer Consent to Collections Uses and Disclosures of Information CP5 Notification of Misuse or Breach CP7 Discrimination and Compelled Disclosures CP8 Consumer Obtainment and Control of Information CT3 Immutable Audit Trails CT5 Portability of Information 6 Data quality and integrity All personal data collected should be relevant to the purposes for which they are to be used and should be accurate complete and up to date CP6 Dispute Resolution CP8 Consumer Obtainment and Control of Information CT2 Authentication of Consumers CT3 Immutable Audit Trails 7 Security safeguards and controls Reasonable safeguards should protect personal data against such risks as loss or unauthorized access use destruction modification or disclosure CP5 Notification of Misuse or Breach CT2 Authentication of Consumers CT4 Limitations on Identifying Information CT6 Security and Systems Requirements CT7 An Architecture for Consumer Participation 8 Accountability and oversight Entities in control of personal health information must be held accountable for implementing these principles CP4 Chain of Trust Agreements CP5 Notification of Misuse or Breach CP6 Dispute Resolution CP9 Enforcement of Policies CT3 Immutable Audit Trails 9 Remedies Remedies must exist to address security breaches or privacy

    Original URL path: http://www.markle.org/resources/rework-america/video/about-markle/event/general-markle-financial-information/health/rework-america/video/economic/commentary-rework-america-members?term_node_tid_depth=All&tid_1=All&date_filter[value]=&page=31&tid=All (2016-02-10)
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  • Warwick Charlton, MD | Markle | Advancing America's Future
    Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos About Markle Page Sections About Markle A Message from Zoë Baird Our Principles Our Impact Board of Directors Senior Team Our History Quick Links Conference Space Events Markle in the News Media Releases Past Initiatives President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos Warwick Charlton MD Chief Medical Officer Intuit Health Member Markle Connecting for Health Steering Group Warwick Charlton MD serves as Vice President and Chief Medical Officer for Intuit Health a new Intuit business unit created by combining recently acquired Medfusion with the Quicken Health Group He plays a key role in the innovation and development of new products and services designed to make health care delivery more efficient and effective with a special interest in improving patients interaction with their physicians Charlton s perspective and expertise in health policy health IT and business provided the strategic guidance and leadership for new business and product development opportunities that helped make Medfusion the leading patient to provider communications

    Original URL path: http://www.markle.org/health/experts-impact/1196-warwick-charlton-md (2016-02-10)
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  • Susannah Fox | Markle | Advancing America's Future
    Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos About Markle Page Sections About Markle A Message from Zoë Baird Our Principles Our Impact Board of Directors Senior Team Our History Quick Links Conference Space Events Markle in the News Media Releases Past Initiatives President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos Susannah Fox Associate Director Pew Research Center s Internet American Life Project Member Markle Connecting for Health Work Group on Consumer Engagement Susannah Fox is Associate Director at Pew Research Center s Internet American Life Project She studies the cultural shifts taking place at the intersection of technology and health care Her survey research has documented The Social Life of Health Information as well as the role of the internet among people living with chronic disease Health professionals friends and family members remain central but Dr Google and online patient communities are gaining in influence particularly due to the power of mobile Patients and the people who love them are not

    Original URL path: http://www.markle.org/health/experts-impact/1194-susannah-fox (2016-02-10)
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  • Steven E. Waldren, MD, MS | Markle | Advancing America's Future
    Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos About Markle Page Sections About Markle A Message from Zoë Baird Our Principles Our Impact Board of Directors Senior Team Our History Quick Links Conference Space Events Markle in the News Media Releases Past Initiatives President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos Steven E Waldren MD MS Director Center for Health Information Technology at the American Academy of Family Physicians Member Markle Connecting for Health Work Group on Consumer Engagement Steven E Waldren MD MS is a family physician and informaticist and he has dedicated his career over the last decade to understand promote and innovate health information technology He joined the American Academy of Family Physicians in May 2004 and serves as director of the AAFP s Center for Health IT He is also a commissioner on the Medicaid and Children s Health Insurance Plan Access and Payment Commission Vice chair of the ASTM Committee E31 on Healthcare Informatics and Board Chair for the Center for Improving Medications Management Waldren received a

    Original URL path: http://www.markle.org/health/experts-impact/1193-steven-e-waldren-md-ms (2016-02-10)
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  • Stephen Lieber | Markle | Advancing America's Future
    President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos About Markle Page Sections About Markle A Message from Zoë Baird Our Principles Our Impact Board of Directors Senior Team Our History Quick Links Conference Space Events Markle in the News Media Releases Past Initiatives President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos Stephen Lieber HealthCare Information and Management Systems Society Our Mission Markle works to realize the potential of information technology to address previously intractable public problems for the economic security

    Original URL path: http://www.markle.org/health/experts-impact/1192-stephen-lieber (2016-02-10)
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  • Sean Nolan | Markle | Advancing America's Future
    Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos About Markle Page Sections About Markle A Message from Zoë Baird Our Principles Our Impact Board of Directors Senior Team Our History Quick Links Conference Space Events Markle in the News Media Releases Past Initiatives President s Letters Rework America Page Sections About Rework America A Message from Rework America Opportunity for All Our Impact Initiative Members Expert Advisors Quick Links Rework America Connected Our Book America s Moment Initiative Overview Latest News Letters to Members Member Commentary Personal Stories Rework America Library Health Page Sections About Health Our Impact Steering Group Consumer Work Group HIE Committee Quick Links Blue Button Common Framework Health IT Health Library National Security Page Sections About National Security Post 9 11 Legacy Our Impact Task Force Quick Links National Security Library Reports and Recommendations Sharing and Collaboration The Lawfare Blog Library Quick Links Our Book America s Moment Archive Media Releases Member Commentary President s Letters Videos Sean Nolan Distinguished Engineer and Chief Architect Microsoft Health Solutions Group Member Markle Connecting for Health Work Group on Consumer Engagement Sean Nolan is Distinguished Engineer and Chief Architect at Microsoft Health Solutions Group In his role at Microsoft he is responsible for product development and operations for the company s enterprise and consumer health care platforms Microsoft Amalga and Microsoft HealthVault He also speaks on health information technology policy and opportunities in the health IT market and is a regular contributor to public private initiatives that leverage technology to improve worldwide health Before rejoining Microsoft in 2006 to help create the Health Solutions Group Nolan served as Founder and President of Software Poetry Inc a software and management

    Original URL path: http://www.markle.org/health/experts-impact/1191-sean-nolan (2016-02-10)
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  • Search | Markle | Advancing America's Future
    Healtheon WebMD he held leadership positions in multiple departments including Product Management Account Management and Systems Integration Altinger has worked in the technology industry for almost 25 years concentrating on health care information technologies since 1995 He attended Stanford University where he earned a Bachelor of Science degree in Mechanical Engineering in 1985 and a Masters of Science degree in Engineering Management in 1987 Peter Levin PhD Peter L Levin PhD was appointed Senior Advisor and CTO in June 2009 His primary role is to identify opportunities and implement improvements of Veteran health and benefit services by promoting a deeper collaborative culture renovating business processes and leading the development of new technology platforms He is the executive sponsor of the Blue Button personal health record of the Fast Track electronic claims processing system and of the VA s Open Government initiatives especially its social media platform all of which have been institutionalized by the agency as part of its ongoing transformation Levin was a National Science Foundation Presidential Young Investigator G H W Bush a White House Fellow Clinton and an Alexander von Humboldt Fellow TU Darmstadt He is the co author of more than fifty articles ranging from global positioning and cybersecurity to high performance computer simulations He was also a co author the technology chapter of the 1997 Biennial Presidential Report to Congress on Science and Technology Just before joining the Obama administration he co founded and led an award winning semiconductor design software firm was a venture partner at Dusseldorf based venture firm Ventizz Capital Partners and was an executive director of Astaro A G Levin studied in Electrical and Computer Engineering at Carnegie Mellon University and he subsequently enjoyed post doctoral training at the Technical University of Munich His first academic appointment was at Worcester Polytechnic Institute and he was later the associate dean for research in the College of Engineering at Boston University Today he maintains his academic affiliation as Consulting Professor of Aeronautical and Astronautical Engineering at Stanford University As a federal employee he collaborates with Markle but does not endorse documents Peter A Andersen Michael Jackman Mark Segal PhD Mark Segal PhD is Vice President Government and Industry Affairs for GE Healthcare IT Working closely with GE Healthcare s Washington Office and Standards Team he directs participation in various government and industry groups helps define and drive advocacy agendas and coordinates responses to regulations and legislation He is also immediate past Vice Chair and current Executive Committee member of the HIMSS Electronic Health Record Association EHRA and Chair of the HIMSS Government Relations Roundtable Before taking this role Segal was a Senior Manager for Global Strategy at GE Healthcare IT Prior to joining GE Healthcare in 2006 he spent over 20 years in healthcare most recently as Vice President at both Medical Present Value Inc and the American Medical Association focusing on public policy advocacy and product management He has spoken and published on a variety of healthcare topics He was the first

    Original URL path: http://www.markle.org/solr-search?keyword=&page=31 (2016-02-10)
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