The Utah Department of Health is leading an effort to streamline the exchange of medical records without creating a central database that puts security or privacy at risk.

Secure exchange of electronic medical records and other health information, called "eHealth," is touted as safer for patients while improving care and reducing costs. Utah is a national leader in the use of electronic medical information, says Barry Nangle, director of the health department's Center for Health Data.

"In Utah, we have a lot of health information exchanged electronically already," Nangle says. " We are way ahead of the rest of the country as far as electronic claims processing."

Each day, he says, Utah doctors see nearly 2,000 patients in hospital emergency departments. Lives are saved when there's a quick, simple way to get information on medications, allergies and disease history, but that happens only to the extent that those involved — the doctors, hospitals, insurance companies, pharmacies and others — can securely exchange information through their various systems. While it's happening more and more, there are still barriers and challenges.

Nangle says much of the automated process follows quite closely the old process of "sharing the chart." That also had privacy and security issues, including the need to authorize who accesses what. The approach works fairly well in the electronic world as well, what Nangle calls a sort of automated "common sense."

But the public views computers and the databases they contain with some fear, fed by stories of information hacked into or computers stolen.

That's one reason Utah has chosen to find ways to make systems work well together without dumping all of its medical information into one basket, Nangle says. The information would still be available and usable by anyone who had legitimate need, but it would not be pulled from a single central source. "We want to capture the advantages of electronic data in a way that doesn't create a database susceptible to hacking," Nangle says.

The department's effort is being funded by a $345,000 grant from a Research Triangle Institute-National Governors Association collaboration. Utah was one of 34 states to receive such a grant to find what the issues are and then ways to resolve them.

The health department, selected by Gov. Jon Huntsman Jr. to lead the state effort, is forming committees to look at different issues. The governor-appointed members of the Utah Digital Health Services Commission serve as the steering committee. HealthInsight, a nonprofit quality-improvement organization, leads stakeholder discussions.

Nangle says the department has broken much of the challenge down to issue-specific panels. A programming committee will decide on standards so different systems can share information. A variations work group is finding and documenting the variations in practices that now exist. There's also a solutions work group and a panel that will look at legal issues, among others.

They're supposed to wrap up work under the grant and have concrete ideas and suggestions for the nation by March 2007.

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E-mail: lois@desnews.com