ment 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 (1) provide administrative and technical support for the CHI and NCVHS efforts; (2) ensure the development of implementation guides, certification procedures, and conformance testing for all data standards; (3) provide financial support and oversight for developmental activities to fill gaps in data standards; and (4) coordinate activities and maintain a clearinghouse of information in support of national data standards and their implementation to improve patient safety.

  • The National Library of Medicine should be designated as the responsible entity for distributing all national clinical terminologies that relate to patient safety and for ensuring the quality of terminology mappings.


The committee’s recommendations address data standards that support patient safety. Data standards are formally accepted or endorsed definitions and rules regarding the format, meaning, and transmission of data elements. Data elements are individual pieces of data, such as age, medication, or diagnosis. This report is concerned specifically with standards for the following:

  • Data interchange formats—standard formats for electronically encoding the data elements (including sequencing and error handling). Interchange standards can also include document architectures for structuring

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