the basics, staying healthy, getting better, living with illness, and changing needs (Foundation for Accountability, 1999). FACCT selected measures from multiple sources and is continuing to develop new measures to fill perceived gaps.

Despite all of these efforts, work on standardizing event reporting and performance measurement activities has been slow. In 2002, the IOM recommended that QuIC be given the statutory authority and adequate resources to coordinate and standardize the government’s activities in the area of quality performance reporting (Institute of Medicine, 2002). This committee endorses that recommendation and agrees with the previous IOM committee that QuIC should coordinate its efforts with private-sector groups—including NQF, NCQA, JCAHO, and FACCT—involved in the promulgation of standardized event reporting and performance and outcome measures.

CURRENT STANDARDS ACTIVITIES IN THE FEDERAL AND PRIVATE SECTORS

As noted earlier, the efforts of both the public and private sectors to invest in information technology are hampered by the lack of national standards for the collection, coding, classification, and exchange of clinical, administrative, and reporting and quality assurance data. The role of the federal government in the promulgation of standards is one that is well developed in other sectors of the economy. For example, the Securities and Exchange Commission has statutory authority to establish financial accounting and reporting standards for all publicly held companies under the Securities and Exchange Act of 1934 (University of Cincinnati College of Law, 2003). Despite some well-publicized recent failures, these standards are meant to require credible, transparent, and comparable financial information that can be used by investors, creditors, and auditors. The commission often authorizes private-sector entities, such as the Financial Accounting Standards Board, to conduct this work and then officially recognizes the standards these entities develop as authoritative. In the health care sector, however, there has been a historical lack of federal coordination in the establishment of national standards. With the exception of morbidity and mortality codes for public health reporting (i.e., ICD-9 codes) and code sets for reimbursement (i.e., ICD-9, CPT, and the Healthcare Financing Administration Common Procedure Coding System), each agency has determined any additional data interchange, reporting, and terminology standards for its own system.



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