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As the volume of electronic medical information increases, particularly if federal stimulus efforts to boost health information technology are successful, the issue of who owns the electronic data must be clarified, according to an article published in the Journal of the American Medical Association.

Clarification of property rights is necessary before comprehensive medical information networks can emerge, the authors contend. Building a network would be expensive, so the "intermediary" that did this would need clear authority to "exercise the economic rights" of the multiple parties contributing data.

"With sufficient legal clarifications and protections, one can image a wide range of contractual agreements that license, bundle or transfer patients' rights of access and control, to various parties under various conditions for a variety of applications," according to the article. "An intermediary could compile a bundle of patients' authorizations to use their information for research or marketing purposes; the compiler could, with patient authorization, then market these databases to permitted users or could transfer the bundled rights to a third party aggregator and marketer. Some earnings could flow back to patients or compensate participating clinicians. In this way, placing bundled rights to medical information into a stream of commerce could direct them toward their highest and best use."

Report authors are Mark Hall, professor of law and public health sciences at Wake Forest University in Winston-Salem, N.C.; and Kevin Schulman, M.D., professor of medicine at Duke University School of Medicine in Durham, N.C.

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