Developing such a system would be a large undertaking. A good starting point would be to assemble data around the department’s goals and the key health challenges, described in Chapter 2. These are—by definition—the issues of most national concern, the issues about which Americans need to know most. Over a period of years, other necessary components of the data system could be added and existing data collection efforts updated and improved, through redirection, greater standardization, elimination of redundancies, and so on (NRC, 2001).

Starting with what is useful and available, much of the data for the information system could be drawn from existing public and private sources and assembled in creative, multidimensional ways. Although the amount of data already available is vast, it is scattered across agencies throughout government and in many private-sector databases and doesn’t necessarily produce actionable information for management.

An example of creatively combining data from different sources is a surveillance system called the Sentinel Initiative that captures information about Americans’ experience with drugs and medical devices.8 This system enables closer monitoring of product performance and gives rapid indication of any problems that arise, through analysis of existing national electronic claims and medical records data maintained by participating private-sector organizations and government entities, including VA [Department of Veterans Affairs], DoD [Department of Defense], and CMS [Centers for Medicare and Medicaid Services]. Thus the information the system produces is of high value for decision making (actionable) and is sharply focused on protecting the health of the public.

Some of the accountability data the department needs will undoubtedly come from the state and local levels. A relatively new branch of health services research called “public health systems research”—which examines the organization, financing, delivery, and impact of public health services (Ix, 2007)—may be especially helpful.


Creation of such a system was recommended in the 2006 IOM report, The Future of Drug Safety, and it was later codified in the Food and Drug Administration Amendments Act of 2007.

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