facilitate the exchange of data and information among health care providers, vendors, and others. However, much more remains to be done, and that is the focus of this committee’s work.

Recommendation 2. A national health information infrastructure—a foundation of systems, technology, applications, standards, and policies—is required to make patient safety a standard of care.

  • The federal government should facilitate deployment of the national health information infrastructure through the provision of targeted financial support and the ongoing promulgation and maintenance of standards for data that support patient safety.

  • Health care providers should invest in electronic health record systems that possess the key capabilities necessary to provide safe and effective care and to enable the continuous redesign of care processes to improve patient safety.


The development of standards for health care data in the United States often occurs as a series of independent, voluntary processes. Many of the important standards are developed by standards development organizations using a consensus process.

Despite efforts toward harmonization and cooperation among the various standards development organizations, the development of health data standards in the United States is essentially an entrepreneurial activity. As a result, standards development organizations sometimes create competing standards, and there is no guarantee that all the necessary standards will be developed. Indeed, the full range of needs for health care data standards have not yet been fulfilled. Currently, there is no oversight body in the United States tasked with reviewing the full portfolio of existing health care data standards, identifying gaps, and fostering efforts to fill those gaps. The committee believes that, as the largest purchaser of health care services and the most influential regulator, it is critical that the federal government assume a more active role in the establishment of the data standards necessary to protect patient safety (see Chapter 3).

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 govern-

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