Private Health Information (PHI). In the United States, it is owned by the patient and health providers and vendors are custodians of it. It is handled much like government information of security classification: SECRET. Organizations that handle PHI must have policies in place to ensure that information is responsibly handled and all software must be accredited by the US government. All of this security consciousness of patient data comes at the expense of data portability between agencies who deliver care. The required protocols to move data from one institution to another are strict and laborious, requiring signatures from the patient each time data is moved, secure protocols to move it, and a record of who requested and what was requested. The current thinking (and spending) by the US Government is to create Health Information Exchanges (HIE). HIE’s are regional warehouses that store all data related to patient care. Each provider or other health related institution would upload all data to their assigned HIE.

So, what is the problem?

There are several: 1) Security- Each site is a potential target for data theft or abuse. 2) Expense- each HIE site is independently developed. Software is licensed multiple times, developers are paid multiple times to create the same platform in different locations. 3) Errors- With so many sites with independent implementations, the opportunity for errors and omissions in moving data from place to place multiply quickly.

What is the solution?

A medical record location service. Rather than storing data, metadata is stored. For any patient, identified by some unique identifier such as their social security number, a request for data is results in requests made to each vendor who houses the source data and those locations send the requested data to the requester. Almost identical to the well-designed Domain Name Service system that exists for all web sites, the service would direct and authenticate requestors to sources.

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