ommended that the federal government assume a more active role in establishing national data standards (National Committee on Vital and Health Statistics, 2000). In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA, Public Law 104-191), which mandated standardization of administrative and financial transactions. In 2001, the Consolidated Health Informatics (CHI) initiative, an interagency effort, was established as part of the Office of Management and Budget’s eGOV initiative to streamline and consolidate government programs among like sectors (Office of Management and Budget, 2003). DHHS was designated the managing partner for the CHI initiative, with the Centers for Medicare and Medicaid Services taking the lead. The CHI initiative played a pivotal role in the recent decision by the federal government that programs of DHHS, the Veterans Administration, and the Department of Defense would incorporate certain data standards and terminologies (Department of Health and Human Services, 2003b).

The CHI initiative, although off to a very promising start, lacks a clear mandate to establish standards. In addition, the future of the initiative once initial standards and gaps have been identified is unclear. The initiative would also benefit from closer collaboration with NCVHS to ensure the active participation of private-sector stakeholders.

Recommendation 3. Congress should provide clear direction, enabling authority, and financial support for the establishment of national standards for data that support patient safety. Various government agencies will need to assume major new responsibilities, and additional support will be required. Specifically:

  • The Department of Health and Human Services (DHHS) should be given the lead role in establishing and maintaining a public–private partnership for the promulgation of standards for data that support patient safety.

  • The Consolidated Health Informatics (CHI) initiative, in collaboration with the National Committee on Vital and Health Statistics (NCVHS), should identify data standards appropriate for national adoption and gaps in existing standards that need to be addressed. The membership of NCVHS should continue to be broad and diverse, with adequate representation of all stakeholders, including consumers, state governments, professional groups, and standards-setting bodies.

  • The Agency for Healthcare Research and Quality (AHRQ) in collaboration with the National Library of Medicine and others should



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