ner to address all the major questions in health care delivery—access, costs, quality, financing and organization, health resources and personnel, and research—facing the nation today and in the coming years. The chapter also details the narrower benefits that might accrue to a variety of potential users, including patients and their families, health care providers, purchasers and payers, employers, and many other possible clients in the public and private sectors.

In assembling the data that will go into products for all such users and uses, the committee had sobering concerns about the quality of those data. Thus, it recommends that HDOs take responsibility for assuring data quality on an ongoing basis, and in particular take affirmative steps to ensure: (1) the completeness and accuracy of the data in the databases for which they are responsible and (2) the validity of data for analytic purposes for which they are used [by HOOs] (Recommendation 2.1). The committee also recommends that HDOs support and contribute to the regional and national efforts to create CPRs and CPR systems (Recommendation 2.2).

Initially, HDOs will attempt to provide data for particular users and uses to answer particular kinds of questions. Nevertheless, advances in the creation and operation of computer-based databases, whether centralized or far-flung, can be expected in the coming years. The committee believes that thoughtful appreciation of their potential and anticipation of their potential limitations will hasten that progress. The development of HDOs—their structure, governance, and policies on disclosure as well as on protection of data—must be designed for the achievement of these long-term goals.

The next chapter takes up the major responsibilities of HDOs in carrying out a critical mission: furnishing information to the public on costs, quality, and other features of health care providers in a given region or community. The committee adopted two strong assumptions as it began to consider this topic. The first is that considerable benefits will accrue to interested consumers and to the public at large from having access to accurate and timely information on these aspects of the health care delivery system with which they deal; this has been the thrust of the present chapter. The other assumption is that HDOs supported by public funds ought to have a stated mission of making such information available, and this will be a core element of several committee recommendations. The committee also assumes, however, that harms can arise from some uses of the information in such databases. For this reason, in the next chapter the committee considers administrative and other protections that it believes HDOs should put in place.



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