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During Phase 2 (2003–2004), the Markle Connecting for Health collaboration developed The Markle Connecting for Health Roadmap for Achieving Electronic Connectivity from Our Nations Health Care Leaders.
Markle Connecting for Health built a broad consensus on a "roadmap" for achieving electronic connectivity in health care. In 2004 Connecting for Health's diverse membership released the Roadmap Report, which has become a blueprint for policymakers and other national leaders engaged in enabling nationwide electronic health information exchange.
The Roadmap does not require building large centralized repositories of personal health information. Instead, it advocates achieving a health information sharing environment with a decentralized "network of networks" approach based on common open technical and policy standards, called the Markle Connecting for Health Common Framework. The technical design was premised on leaving clinical data in the hands of those who have a direct relationship with the patient, and leaving decisions about who should and should not see patient data in the hands of the patient and the physicians that are directly involved with his or her care.
The Common Framework approach to achieving a Nationwide Health Information Sharing Environment was put forth and further refined by a larger group of health care leaders and organizations in a joint response to the Request for Information promulgated in 2005 by the HHS Office of the National Coordinator.
During the construction of the Markle Connecting for Health Roadmap, several work groups, comprised of leaders in the fields of information technology and all major stakeholders in health care, developed many of the building blocks later integrated into the full Markle Connecting for Health Roadmap. These working groups published a series of independent papers that elaborate more fully some of the concepts delineated in the Roadmap: