Objectives
The Working Group will focus on the organizational and business issues that need to be addressed to achieve an infrastructure that enables and sustains the sharing of health information for optimal patient care. The goal of the Working Group is to create a framework and a set of tools that will advance the realization of an interoperable health information infrastructure at the community level.

Background
In their most recent report, the Institute of Medicine asserts that the major way to reduce the high number of errors in the medical system is widespread adoption of information-technology systems, such as electronic medical records, that can collect and share essential health information on patients and their care, and be linked in a national network accessible by all health-care organizations. At the practical level, despite strong interest in community models, and a continued emphasis on the need for an electronic information infrastructure, numerous challenges prohibit success of these initiatives. These challenges were identified in the first phase of Connecting for Health: creating the governance models, agreements, implementing policies and practices for building these kinds of exchanges, and building a compelling and sustainable model for devoting ongoing funding, resources and commitment to these projects. These solutions have become increasingly urgent, however, as the connection between mobility of information and the reduction of medical errors and improvement in patient safety become clearer to policy-makers, physicians and health systems leaders. Very little work has been done to clarify this or to improve the either the organizational or financial sustainability of community-based health information exchange models.

Proposed Approach
The goal of the Working Group is to create a framework and a set of tools that will help advance the realization of an interoperable health information infrastructure at the community level. A related goal is to stimulate exploration and testing of various models in real-world settings. To that end, the groups work will be grounded in a set of real world use case scenarios and a highly detailed approach for modeling future environmental factors. The information that is produced by this Working Group will be published in a white paper that will be shared within the public and private sectors. The work will include a set of models that will be useful to a variety of stakeholders interested in health information sharing on the ground in community-based demonstration projects.