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The establishment of a data council within DHHS and the realignment of the National Committee on Vital and Health Statistics into an advisory committee on health data, statistics, and national health information policy are positive steps that should be built upon. They have enabled DHHS to make significant strides in policy areas such as the development of regulations for protecting electronic health information. There are other roles for DHHS to play in this effort: (1) providing strategic leadership for Internet-related efforts within the department and its constituent agencies (this would include the use of the Internet in support of department and agency missions) and coordinating them with those of other federal agencies, (2) convening public and private bodies to identify, examine, and propose mechanisms for addressing issues related to the Internet and health care, (3) exploring cross-cutting issues that affect many health agencies and developing programs for addressing them (e.g., implementing a public key infrastructure that would support a range of federal health activities), (4) encouraging federal health agencies to share information and perspectives on their many responsibilities and interests, including the provision of care, payment for care, monitoring of care, health-related research, and public health, (5) advancing national debate about key information technology issues that affect health care, including the technical, organizational, and policy issues identified in this report, and (6) creating the organizational structures needed to ensure that issues at the nexus of health and information technology are identified and addressed promptly and efficiently. Although these activities will not by themselves resolve the issues, they will set in motion processes that can lead to a resolution.

Looking Forward

These recommendations are intended to help the nation move forward on technical, organizational, and policy fronts so that it can reap the benefits of the Internet for health applications. Additional work will be needed to identify other networking technologies of interest to the health community and to ensure that related information technology needs are met. This report prescribes the actions needed now to develop a truly healthy Internet in the future.


Kane, Beverley, and Daniel Z. Sands. 1998. ''Guidelines for the Clinical Use of Electronic Mail with Patients," Report for the AMIA Internet Working Group, Task Force on Guidelines for the Use of Clinic-Patient Electronic Mail, Journal of the American Medical Informatics Association 5(1). Available online at <>.break

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