The Committee envisions three major stages in the process. The first stage has five major tasks: creating the recommended senior position and lead office within HHS with sufficient authority and funds and building relationships with centers of leadership in HHS and other agencies; fleshing out the vision as a national health information policy and implementation plan; establishing incentives and requirements; launching a comprehensive standards acceleration process; and committing the resources implicit in each of these tasks. Taken together, these actions would demonstrate a strong governmental commitment to the development of the NHII.
The second stage centers on developing and expanding collaboration at national, State, and local levels and with the private sector to complete and confirm the implementation plan. This stage will involve the most extensive and substantive forms of collaboration.
The third stage involves carrying out the implementation plan in all relevant areas of the private sector and all levels and areas of government. This stage will include a feedback loop in which progress is monitored and issues requiring further action are identified.
NCVHS suggests that stage one be completed within 2 years, stage two within 5 years, and stage three within 10 years. Looking to its own role in this process, the Committee expects its responsibilities as HHS's primary external advisor on health information policy to grow more focused as HHS moves into its recommended leadership role. The Committee would welcome annual reports from the Department on its progress toward implementing the recommendations, beginning in 2002. The Committee also anticipates that it will continue to hold periodic hearings to assess NHII activities in the public and private sectors.
Before turning to the recommendations of the National Committee on Vital and Health Statistics, let us review the key messages of this report. The heart of the vision for the NHII is sharing information and knowledge appropriately so it is available to people when they need it to make the best possible health decisions. To serve the Nation's health needs, the NHII must make information available to individuals, healthcare providers, public health agencies, policymakers, and all others whose decisions shape health outcomes. It must serve all individuals and communities equitably; enhanced electronic capability must not be allowed to serve preferentially the segments of the population that are already most advantaged. Better safeguards for privacy, confidentiality, and security are hallmarks of the NHII. The evolution of the NHII is already under way, but so far progress is highly fragmented. Recent events underscore that an effective NHII is not a luxury, but a necessity; it is not a threat to our privacy, but a vital set of resources for preventing and addressing personal and collective health threats. Realizing the potential of the NHII will involve changes in personal, institutional, professional, civic, and governmental practices and in the relationships among these domains. Experts and industry representatives told the NCVHS that the Federal Government has a key role to play in these developments. But the Government cannot act alone; what is needed is a dynamic, nationwide collaborative venture for this purpose. The following recommendations outline a process for bringing that about.