c. The Veterans Health Administration (VHA), DOD TRICARE, and the Indian Health Service (IHS) should continue implementing clinical and administrative information systems that enable the retrieval of clinical information across their programs and can communicate directly with each other. Whenever possible, the software and intellectual property developed by these three government programs should rely on Web-based language and architecture and be made available in the public domain.

Although this report focuses on the federal government’s role, the committee believes private-sector purchasers should also contribute to building the country’s health information infrastructure by providing financial and other incentives.

Comparative quality data should be available in the public domain for use by many stakeholders. There are numerous potential uses of such data. Public- and private-sector oversight organizations might rely on performance measurement data to develop benchmarks for the clinical practice patterns of providers and goals for stimulating improvements in clinical care. The data would also be useful to states and communities as a way of monitoring the progress of community-based efforts in meeting public health goals (e.g., reducing obesity and use of tobacco). Professional groups, including board certification entities and others involved in continuing education, would be likely to use the data to provide ongoing feedback to providers and identify best practices. Group purchasers and consumers might use the quality data to assist in the selection of providers and health plans.

RECOMMENDATION 6: Starting in FY 2008, each government health care program should make comparative quality reports and data available in the public domain. The programs should provide for access to these reports and data in ways that meet the needs of various users, provided that patient privacy is protected.

Pooling of performance data across all six major government programs would enable more accurate performance assessment for those receiving services through multiple programs. It would also permit benchmarking of performance levels across programs.

RECOMMENDATION 7: The government health care programs, working with the Agency for Healthcare Research and Quality (AHRQ), should establish a mechanism for pooling performance measurement data across programs in a data repository. Contributions of data from private-sector insurance programs should be encouraged provided such data meet certain standards for validity and reliability. Consumers, health care professionals, planners, purchasers, regulators, public health officials, researchers, and others should be afforded access to the repository, provided that patient privacy is protected.

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