Clearing Technical Hurdles, Washington Tries Health Record Banks | [node:field-byline] | Healthcare Blogs Skip to content Skip to navigation

Clearing Technical Hurdles, Washington Tries Health Record Banks

June 18, 2009
by David Raths
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Earlier this week, I wrote about a health record bank project being planned in Oregon. But north or the border, there are four HRB pilots already under way in the state of Washington. Three are state-funded and one (Madigan Army Medical Center in Tacoma) is funded through a federal appropriation.

Last year, Juan Alaniz, manager of the Health Record Banking Project for the Washington State Health Care Authority, told me that the state wanted to try something different than the traditional efforts that involve building interfaces between provider data silos. "We think the real change will come from consumers having control over their healthcare information and sharing it with whomever they want to. The health record bank could be the disruptive technology to change the paradigm," he said last spring.

Alaniz recently updated me on the three regional state-funded efforts. He noted that the projects all experienced unexpected technical issues that caused launch delays. It turned out that some of the interfaces between the personal health record software and Microsoft Health Record Vault and Google Health (the platforms the pilots are using) were more challenging than anticipated to develop. Alaniz said that Microsoft dedicated full-time staff to work through issues with the pilots.

He added that the pilots are now working to enroll consumers and are expected to showcase their models at state meetings in July. They will propose next-phase options that may include hardening of the technical infrastructure, creating interfaces to more data silos, increasing enrollment, sharing infrastructure, and possibly a common account locator service or virtual master patient index (to assure that the records are accurately matched). They will also begin business model planning to work toward self-sufficiency.

The Washington State Health Care Authority also has created an organization,, to support the concept of online personal health records in the state. Its activities may grow to include playing an ombudsman role for consumers. It may also provide advice and recommendations to communities and the industry on best practices for engaging consumers and providers. Alaniz noted that engaging providers is a crucial part of the equation. After all, even if consumers access health information, it's of limited value if they don't use that information in conjunction with their providers.



Thanks David. What most concerns me about this situation is it seems no one is learning from the lessons of RHIOs (can I still use that term?) past. Are we not seeing the typical failed model here of getting a grant for HIE, spending money like water, then "beginning business model planning to work toward self-sufficiency." I believe any HIE grant, be it state, federal or inter-galactic, should require a sound business plan BEFORE those funds are disbursed. We have to stop throwing good money after bad.

Good point, Anthony. One problem may be that it's not clear to anyone yet how health information exchange fits with traditional revenue goals of any of the organizations involved. Instead, as ONCHIT's Dr. David Blumenthal has written, it may be a "public good" that will require ongoing public investment or some form of tax to sustain. Here's an analogy: Most people think public libraries are a good thing. But they probably would never have happened if they had to fit into the business goals of private book publishers. So when regional or state HIE organizations look at long-term sustainability, they may have to bite the bullet and push for some sort of tax, as unpopular as that concept is. For instance, the state of Vermont last year placed a small tax on health insurance policies to help pay for health IT initiatives. We'll follow their progress.