The New York effort demonstrates that the federal government's goal of making patient health information portable and accessible can be attained using existing technologies, said Jonathan Leviss, medical director of Sentillion Inc. , an Andover. Mass.-based vendor of identity management technologies.

Leviss had been involved in the early days of the project in his former job as chief medical information officer at New York City Health and Hospitals Corp. , the city's public hospital network.

He said the success of such projects and the proliferation of smart-card-based programs now depend mostly on resolving several process- and security-related issues.

Leviss said officials must answer several questions: What patient data can be put on smart cards? Who can access that data and for what purpose? When can the data be accessed? And how can it be protected from accidental or deliberate misuse?

"As we provide information outside of the primary health-care facility, we have to be assured that the patient data is secure," he said.