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Healthcare providers face special challenges documenting care efficiently in settings such as nursing homes, private residences, and assisted living facilities. These challenges are amplified when the practitioner is affiliated with a large healthcare system, where centralized electronic medical record systems and/or the paper record are employed to collect and manage clinical data. Electronic tools to collect patient information outside the facility are largely absent in these centralized systems. Niche practitioners working in off-site care locations can meet their information management needs with economically viable database solutions.

Healthcare organizations across the country are searching for methods to address escalating healthcare costs. One strategy is to leverage resources across affiliated but independent organizations. This approach is common in other industries; yet, protecting confidential patient information is unique to the healthcare industry. Guaranteed protection of patient confidentiality is a critical step in any inter-organizational strategy. Because of the need to leverage resources, the University of Texas Southwestern Medical Center (UT Southwestern) and its affiliates initiated a cross-institutional effort to address information security and confidentiality issues.