seminating it to the public should prove very helpful and may contribute greatly to the number of ADE reports that are submitted.

Another recent promising initiative in this area of linking the evidence base to care is MedBiquitous, a consortium of professional medical associations and related organizations that is creating an extensible markup language (XML) framework for professional medicine, with a focus on medical education and credentialing (MedBiquitous Consortium, 2003). The XML standards allow providers to search the literature more easily to locate specific types of content related to particular medical conditions and also permit professional societies to verify board certifications of providers automatically.

Reporting Standards

The health care sector also currently lacks standardized measurement and reporting mechanisms for routinely monitoring the extent to which health care is safe and effective. In designing and building information technology systems, it is helpful to know in advance the reporting specifications that must be satisfied. As noted earlier in this report, many safety and quality measurement and improvement efforts are sponsored by health care providers, public and private purchasers, federal and state agencies, and accreditors. Some focus on near misses or adverse events, while others assess compliance with best practices through medical care performance and outcome measures. However, as noted by a previous IOM committee, too many resources are spent on health care measures that are either duplicative or ineffective, and little comparative quality information is made available in the public domain for use by beneficiaries, health professionals, or other stakeholders (Institute of Medicine, 2002). In addition, users of the available measures are hindered by the lack of reporting standards and consistent methodologies (Eddy, 1998; Rhew et al., 2001).

Standardized measurement and reporting mechanisms not only will facilitate the building of effective information technology systems and reduce confusion over reporting requirements but also could drive quality improvement in other ways, such as assisting efforts to reward quality care through payment or other means. For example, the Centers for Medicare and Medicaid Services (CMS), in partnership with Premier, Inc., a private alliance of more than 200 hospitals and health care systems, is currently conducting a demonstration project to evaluate the linking of standard performance measurements to differential hospital reimbursement (McGinley, 2003; Premier, 2003). Over the course of this 3-year project, those hospitals identified as

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