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HHS Launches New Efforts to Promote Paperless Health Care System


HHS Secretary Tommy G. Thompson today announced two new steps in building a national electronic health care system that will allow patients and their doctors to access their complete medical records anytime and anywhere they are needed, leading to reduced medical errors, improved patient care, and reduced health care costs.

First, the Secretary announced that the Department has signed an agreement with the College of American Pathologists (CAP) to license the College's standardized medical vocabulary system and make it available without charge throughout the U.S. This action opens the door to establishing a common medical language as a key element in building a unified electronic medical records system in the U.S.

Secondly, the Secretary announced that HHS has commissioned the Institute of Medicine to design a standardized model of an electronic health record. The health care standards development organization known as HL7 has been asked to evaluate the model once it has been designed. HHS will share the standardized model record at no cost with all components of the U.S. health care system. The Department expects to have a model record ready in 2004.

Today's announcements are part of the ongoing HHS effort to develop the National Health Information Infrastructure by encouraging and facilitating the widespread use of modern information technology to improve the nation's health care system.

"Banks and other financial institutions all across the country can talk to each other electronically, which has streamlined customer transactions and reduced errors," Secretary Thompson said. "We want to do the same thing for the American health care system. We want to build a standardized platform on which physicians' offices, insurance companies, hospitals and others can all communicate electronically, which will improve patient care while reducing the medical errors and the high costs plaguing our health care system."

With terms for more than 340,000 medical concepts, the College's standardized system has been recognized as the world's most comprehensive clinical terminology database available. The licensing agreement with the CAP will make it possible for health care providers, hospitals, insurance companies, public health departments, medical research facilities and others to easily incorporate this uniform terminology system into their information systems.

"This system will prove invaluable in facilitating the automated exchange of clinical information needed to protect patient safety, detect emerging public health threats, better coordinate patient care and compile research data for patients participating in clinical trials," Secretary Thompson said.

The CAP agreement announced today will be administered through the National Library of Medicine (NLM), a component of HHS' National Institutes of Health (NIH). NLM has issued a 5-year, $32.4 million contract to the College for a permanent license for their terminology, known as SNOMED (Systematized Nomenclature of Medicine) Clinical Terms. The licensing agreement includes the core database in both English and Spanish along with regular updates. The terms of the contract include a one-time payment-shared by the Department of Veterans Affairs, the Department of Defense, and many HHS agencies-with annual update fees to be borne by the NLM.

"Today we take a bold step by making SNOMED available, a critical step in adopting health information standards across the federal government," Secretary of Veterans Affairs Anthony J. Principi said. "Putting health information standards in the public domain and promptly adopting health information standards for the federal health partners, is the 'tipping point' for national standards that strengthen our electronic health record systems, help optimize our health care, and, most importantly, improve the health of veterans as well as all of the people of the U.S."

"The Department of Defense is pleased to have contributed to the government-wide effort to license SNOMED. This effort will enable us to better share health information within the Federal government and beyond. I am delighted with our Federal partnership in this important step toward improving health care for all Americans," said Dr. Winkenwerder, assistant secretary of defense for health affairs.

"This license validates the College's longstanding support for the development of medical standards like SNOMED to further improve the quality of health care. It ensures that government and the private sector entities in the U.S. will be able to use a common approach to clinical coding, making it easier to coordinate care and exchange needed information," said Paul A. Raslavicus, MD, president of the CAP.

The contract between NLM and the College of American Pathologists comes after three years of negotiations. The effort was supported by all the agencies participating in the Consolidated Health Informatics initiative (CHI), which is working to adopt government-wide standards for clinical health data. CHI is the health care component of President Bush's eGov Initiatives, created under the President's Management Agenda, to make it easier for citizens and businesses to interact with the government, save taxpayer dollars and streamline citizen-to-government transactions. More information on CHI and the President's eGov Initiatives may be found at

NLM will distribute SNOMED through its Unified Medical Language System, which incorporates, links, and distributes in a common format 100 different biomedical and health vocabularies and classifications. Details of the SNOMED license arrangement as well as information on obtaining access to the SNOMED database may be found at: