Governments begin to take note of a new model for health information data sharing and exchange

Bill Crounse 2007 03 On July 22nd of last year I made a post on HealthBlog titled “A possible sea change in the way we share health data”.  I wrote  this entry while attending last year’s World Congress Leadership Summit in Boston.  Here’s part of what I said in that post:

“In 2004, George Bush proclaimed that most Americans would have an electronic health record by 2014.  So here we are 4 years later, and despite a lot of focus on establishing the Office of the National Coordinator for Health IT, promoting the concept of a National Health Information Network and seeding Regional Health Information Organizations with millions of dollars in federal and foundation grants, one could argue that we aren't much closer to getting where we need to be than we were four years ago.  However, in those four years something else has emerged that is proving to be truly disruptive.  It's the idea of aggregating health information around the consumer as perhaps a better and certainly less costly solution than trying to interconnect every hospital, clinic, doctor's office, imaging center, lab, payer and other player in our complex ecosystem of care.  And what is at the center of this change?  It is patients and healthcare consumers themselves and the emergence of new technology models such as HealthVault, Google Health, Medical Record Banks, Dossia, and other solutions that appear to be leapfrogging the need for NHIN, RHIO's, or other efforts to hard wire a connection between every health facility. This truly represents a "sea change" in our thinking on how to achieve a portable, always available, and interoperable "electronic record" for most Americans……..”

image In many of the keynotes I’ve been giving around the world, I’ve referenced the “Connecting for Health” project in the United Kingdom. The UK’s national electronic patient records program has been underway for several years now.  It is running 4 years late and isn’t expected to be completed until 2014 at a cost currently estimated at £12.4 billion (about $400 per citizen). Extrapolated to the US, it would suggest that a National Health Information Network here would cost somewhere north of $120 billion.  And, I’d be willing to bet that it would actually cost a whole lot more.


Now, keep in mind that the UK project was started long before there was such a thing as Microsoft HealthVault or Google Health.  None-the-less, just as I predicted last Summer, rational minds in the UK are now beginning to question the wisdom of a government owned and operated national system for electronic records.  That was the focus of an article published today in the Times of London by chief political correspondent, Sam Coates.  Apparently, members of the Tory government are questioning the wisdom of Connecting for Health’s present course and suggesting that maybe the private sector could do it better, faster, and at far less cost.  In the article, a senior official for the Tories is quoted as saying  “This is an agenda we are massively keen on. We’re thinking about how in government the architecture of technology needs to change, with people ‘owning’ their own data, including their health records.”

The article, and another related article, raises concerns about possible undue influence being exerted on certain government officials by the private sector; in this case Google.  Whether that’s true or not, I think the heart of the issue is how best to get the job done at a price society, any society, can afford.  Around the world, governments are looking at the new model for health information sharing and exchange and coming to the same conclusion.  A patient-centric (citizen-centric) model of health data aggregation in the cloud makes a whole lot of sense.  Keep in mind that it is the model that’s important, not whether it’s done by Google, Microsoft, a not-for-profit medical record bank, or some other private (or public) entity.

Bill Crounse, MD   Senior Director, Worldwide Health    Microsoft

Comments (3)

  1. Sam Heard says:

    The suitability of the model for use in health care generally is crucial. The openEHR Foundation and community have been working on just this in Europe for more than 10 years and have made a heap of progress. We hope that the US government might look past the message standards to what is really enabling – a shared model for health information that enables clinicians, citzens and other providers to achieve quality outcomes at lower cost. Microsoft have included this approach in the latest Connected Health Framework. It is certainly a leading candidate as the key enabler.

    Declared interests:

    Director, openEHR Foundation

    CEO, Ocean Informatics

  2. Bidwell Ely says:


    I am curious as to how Microsoft can incorporate the VHA’s Computerized Patient Record System (which is complete and functioning)into a usable national system for the private sector. I have worked for the VA for years training residents on CPRS before retiring.


    Bidwell Ely

  3. hlthblog says:

    Thanks for writing, Dr. Ely.  Microsoft’s approach in the health industry is to liberate health data, connect care, and empower people.  Therefore, we are rather agnostic when it comes to one EMR vs. another.  We favor open standards, interoperability between and among systems, and solutions that improve the quality and safety of care while facilitating clinical workflow and allowing consumers to securely access and manage their own health data.  There are lots of solutions on the market; some better than others.  We want customers to have the freedom to use the solutions that work best for them.

    Bill Crounse, MD

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