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No unified, functioning system currently exists for the exchange of comprehensive health-care information across the wide spectrum of health-care networks. Regional health information organizations (RHIOs) and a national health information network (NHIN) have been proposed as vital building blocks in providing such a system, but these face many challenges, including delineation and implementation of accepted standards for health-care data, accurate patient identification and record matching, and the definition of incentives for accelerated deployment of health information technology. In response to these challenges, we present in this paper an alternative option, the Health Record Banking (HRB) system. Emulating commercial banking, this approach uses health-record banks to serve the need for immediately accessible and secure data for diverse stakeholders. It provides a means for financial independence for these banks and a mechanism for fostering medical research. We conclude with 10 critical issues associated with the development and implementation of an HRB system, which require public discussion.
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