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The state of Washington spent $1.7 million to fund three pilot projects to prove the efficacy of health record banks. Two the projects used Microsoft's HealthVault as their foundation; the third, operated by Spokane-based Inland Northwest Health Services, chose to go with Google Health's online personal records storage service.

"We needed to get something up fast, and our tech guys felt that the application programming interface from Google Health provided the fastest way to interface with various EHRs and get the data flowing," says Jac Davies, director of Northwest Telehealth, a unit of Inland Northwest Health Services. INHS was formed in 1994 to develop data exchange services in the Northwest. It currently operates a health information exchange that links 34 hospitals via a centralized repository running on applications from Meditech.

But, like its sister project Community Choice Healthcare Network (see main story) the INHS project, called 1HealthRecord, has run into snags unrelated to the records storage service.

The vexing problems are pretty fundamental: how to find data and how to get it into a usable format. 1HealthRecord isn't shooting for the stars-right now it just wants to deliver medication and allergy information to records in the health bank.

How tough can that be? Davies provides a real-world example. Three practices in Spokane are linked up to the 1HealthRecord service, and they all use the GE Centricity EHR, from Waukesha, Wis.-based GE Healthcare. But physicians at each practice, even within a single practice, use the EHRs differently. Some docs use drop-down menus in the EHR to capture patient date; others write that same information into a note. The result is the data is scattered all over the electronic landscape.

"We are focusing on proving the concept of a personal health record, but this really is the 'iceberg' issue for all health information exchange," Davies says. "There is a large gap between having data in an EHR and being able to exchange it."