IBM wants to help pave the way for the free exchange of electronic health-care records that today are trapped in hundreds of disparate hospital, physician, and health insurance systems.

By the end of the year, IBM will launch a pilot system, the Interoperable Health Information Infrastructure, that will link IBM sites in San Jose, Calif.; Rochester, Minn. (home of the Mayo Clinic); and Haifa, Israel, to demonstrate how electronic medical records based on open standards could move from one health-care provider to another and follow a patient around the world.

"Our test bed will model the world of the future. We'll have both real and simulated data for 200 million individuals, with the resulting message flow," said James Kaufman, research manager for health-care information at IBM's Almaden Research Center in San Jose. Kaufman was interviewed during a forum called Transforming Healthcare with Information this week at the San Jose facility.

Generating electronic medical records and moving them around while ensuring privacy remains a distant goal in the health-care industry. Experts on medical-care costs estimate that 10% or more of the $1.7 trillion spent on health care annually could be saved through the use of transferable, electronic records, Kaufman said.

Health care represented 5.7% of gross domestic product in 1965; it represented 15.6% last year, and it continues to grow at a rate 2.5% faster than the economy, said Henry Aaron, a senior fellow at the Brookings Institute and a speaker at the forum.

IBM is seeking to work through regional health information organizations to enlist health-care providers and insurers to participate on its planned Interoperable Health Information Infrastructure. Regional health organizations could establish medical-record banks that any health-care agency could refer to, suggested Kaufman.

But one of the recurring topics at the forum was who would lead the transformation. Doctors' offices are averse to new technology unless they have a compelling reason to adopt it, Kaufman noted. Hospitals are already committed to proprietary systems that do not generate records that are easily shared with other systems. And health-care insurers have been struggling to meet Health Insurance Portability and Accountability Act health-care data privacy standards that took effect in the fall of 2003.

The adoption of standardized electronic health-care records would allow health-care organizations to apply medical data to new applications. IBM, for example, has developed software that could examine medical records and track infectious diseases, providing an early warning of potential epidemics. Called Spatio-Temporal Epidemiological Modeler, or STEM, the system uses analysis of health-care records and mathematical models to track the origin and spread of a disease.

STEM is one of what could be many public-health tools that help contain disease, diagnose individuals, and even spot a terrorist biological attack in a major city, Kaufman says.

The first day of the forum featured a talk by David Brailer, who was appointed national health information technology coordinator by President Bush last year. In a talk delivered via video conferencing, he said his office is starting its second year of work on delivering technology standards and a framework for creating portable health records.

"Interoperability is by far the hardest element," he said. Consumer health information needs to be portable and private, he said, while acknowledging that those criteria can be contradictory. Brailer conceded that it also wasn't clear who would make the first investment in generating portable records if standards can be agreed upon.