patient safety. Various government 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 standard-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 IOM also recommended that, after allowing a reasonable time for health care organizations to comply with national standards identified by the Consolidated Health Informatics initiative, the major government health care programs, including those operated by DHHS, the Veterans Administration, and the Department of Defense, should immediately incorporate these data standards into their contractual and regulatory requirements (e.g., Medicare conditions of participation).
Sharing patient data across providers and settings of care requires an interoperable infrastructure to provide clinicians with access to critical health care information at the time of care delivery. To meet this need, the strategic framework for the NHII calls for (1) fostering of regional collabo-