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Phase 4 (2003–2006) of the Markle Connecting for Health collaboration focused on the NHIN Prototype and personal health technology.
Markle Connecting for Health's Common Framework approach was selected by the U.S. Department of Health and Human Services (HHS) as a prototype for the nationwide exchange of health information. The three Markle Connecting for Health prototype communities (Boston, Massachusetts; Indianapolis, Indiana; and Mendocino, California) participated with Computer Sciences Corporation and several other partners in the award. Members of the Markle Connecting for Health collaborative and the Markle Foundation provided in-kind leadership and support to the federal prototype efforts.
The prototype presents an open-standards, distributed, "network of networks" approach to the Nationwide Health Information Network (NHIN). This "thin" NHIN approach is based on the Markle Connecting for Health Common Framework policy principles, guidelines, and technical specifications for electronically sharing health information, while protecting privacy and securing personal information. It uses a streamlined, cost-effective approach with low barriers to entry. The Office of the National Coordinator commissioned Gartner, Inc. to write a paper on all of the NHIN prototype efforts.
Any entity that implements the Markle Connecting for Health Common Framework standards and policies can participate in data sharing under this model. It therefore has no preferred service operators, is vendor-neutral, and can be implemented based on local needs and determinants. This network model does not require the centralization of clinical information. Instead, clinical information remains held by organizations at the edges of the network, where it is created, maintained, consumed and protected. Information is then shared based on the preferences of patients and their providers.
In December 2006, Markle Connecting for Health published Connecting Americans to Their Health Care: A Common Framework for Networked Personal Health Information describing a vision for a networked environment in which consumers can establish secure electronic connections with multiple entities that hold personal health information about them.
At its Connecting Americans to Their Health Care 2006 conference, Markle Connecting for Health released a national survey showing that Americans overwhelmingly want to have electronic copies of their medical records and believe that having greater access to their information will reduce medical mistakes and costly repeat procedures.