The Personal Internetworked Notary and Guardian (PING): The Policy Implications of a Patient-Controlled Electronic Medical Record

There have been many attempts to create longitudinally-integrated, nation-wide electronic patient record systems ever since information technology has infiltrated the medical profession. This paper compares two recent attempts – a legislative attempt in the Universal Health Identifier (UHID) mandated by the Health Insurance Portability and Accountability Act (HIPAA) and a technical attempt under development at Children’s Hospital and MIT called the Personal Internetworked Notary and Guardian (PING). The paper uses these as a case study of two very different approaches to the medical records problem, and examines why UHID failed, and how PING is likely to succeed. PING’s technical architecture is examined in depth, and it is compared and contrasted to UHID’s stated objectives. Practical market, policy, and legal issues surrounding the national deployment of PING are examined.