Four states are banding together to pilot-test a smart card program for storing health information.

By the end of this year Wyoming, Nevada, North Dakota, and Idaho will jointly issue a request for proposals to develop the system, called Health Passport. A pilot program with 50,000 cardholders is expected late in 1997.

The pilot test will build on the success of an ongoing Wyoming project for delivering women-infant-children (WIC) payments on smart cards. The pilot has been administered by National City Corp.'s Stored Value Systems.

Health Passport is "focused on eligibility and medical information in the public health arena," said Thomas Singer, director of research at Western Governors Association in Denver, which is facilitating the project.

Health Passport may encompass several programs, including WIC, Medicaid, Maternal Child Health, Immunization, Head Start, and Indian Health Services.

Tracking medical history and health information such as height, weight, and blood type, the system is expected to eliminate repetitive form filing, duplicate testing, and fraud. Terminals and smart card readers would be installed at health clinics, doctor's offices, and hospitals, as well as retail establishments.

Mr. Singer explained that while magnetic stripe technology works for routine electronic benefits transfer, Health Passport requires the expanded memory of smart cards to store more data.

"Wyoming has demonstrated the value of smart card-based EBT for WIC," which combines financial transactions and medical data, said Mr. Singer.

Julie Kresge, a program analyst for the U.S. Department of Agriculture, one of the program's funders, said rural beneficiaries may have to travel to get medical attention. Carrying health information on a smart card can speed delivery and efficiency.

For more than 20 years, said Ms. Kresge, the federal government has been trying to link the myriad public health services departments. "The advantage of smart cards is that you don't have to change management information systems and reconfigure computer systems."

She added that the recipient has control of the data with personal identification number protection. "It gets away from the Big Brother image and provides power to the client."

At a hearing in San Jose, Calif., this month, potential bidders were briefed on the project and asked for feedback. "We wanted to refine the RFP before letting it out," said Mr. Singer. The initial request is for software design and development. Another procurement contract will be awarded for implementation.

Wyoming introduced its smart card WIC program in the spring of 1995. Bids will be requested for the statewide rollout in 1997 to select an administrator. Food-stamp delivery will be added to the card.

Mr. Singer said the Health Passport pilots will cost about $5 million, of which $3 million has already been earmarked. Trials of Health Passport, including WIC payments, will run in Reno; Twin Falls, Idaho; and Cheyenne, Wyo. In Bismark, N.D., the pilot program will not include WIC payments.

John Bianco, Stored Value Systems' vice president, said his company is "pleased with results of the Wyoming project." Still, he said, EBT "isn't a business for the faint of heart." With extensive capital investments and lengthy roll out time, "you have to manage (a program) very well to make it a profitable venture."

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