NCVHS is also serving as the primary advisory body to the CHI initiative, established in October 2001 as the first of the 24 Office of Management and Budget eGOV initiatives to streamline and consolidate government programs among like sectors (Office of Management and Budget, 2003). DHHS was designated as the managing partner for the CHI initiative, with CMS in the lead. Other members of CHI include the VHA, the Department of Defense, the Indian Health Service, the U.S. Department of Agriculture, Environmental Protection Agency, and the FDA. CHI’s mission is to articulate and execute a coherent vision and strategy for the adoption of federal interoperability standards for health care information while providing technical support to selected projects. As noted earlier in this report, in March 2003 the secretary of DHHS announced that DHHS, the Department of Defense, and VHA would be adopting an initial set of clinical data interchange standards recommended to the secretary by NCVHS, including HL7, NCPDP, IEEE 1073, DICOM, and the Logical Observation Identifiers, Names, and Codes (LOINC) for laboratory tests and results (usually referred to as Laboratory LOINC). This announcement was based directly on the recommendations of CHI for standards that should be adopted government-wide. CHI is also continuing to identify standardized terminologies for the clinical domain areas associated with the EHR for use among federal agencies. The organizations are expected to announce their selection of the core group of standard terminologies in fall 2003. Given the sizable purchasing power (more than 40 percent of health care expenditures) and regulatory authority of the federal government, incorporation of these data standards into government programs is a powerful and effective approach to establishing national standards. However, CHI still lacks a clear mandate to establish standards that will be applied by all government programs. The CHI initiative also would benefit from greater participation of private-sector stakeholders and standards-setting bodies and from more clearly defined linkages with AHRQ’s evidence synthesis program and QuIC’s performance measurements standardization program.
In the public sector, in addition to CHI’s activities, an organization that is involved in the promotion of national data standards is the Public Health Data Standards Consortium, which is coordinated by the National Center for Health Statistics. It was developed to organize the public health and