Shaping a Vision for 21st Century Health Statistics. Birth of the visioning process


Aware of these limitations and of the tremendous information technology capacities now available -and feeling pressure to address critical information needs- Dr. Edward Sondik, Director of the Centers for Disease Control’s National Center for Health Statistics (NCHS), made a challenging request of the National Committee on Vital and Health Statistics (NCVHS) in 1998.

NCVHS is the public advisory committee on national health information policy to the HHS Secretary. Dr. Sondik, who is the Secretary’s senior health statistics advisor, asked the National Committee to help articulate a vision whereby health statistics in the United States could mobilize new capacities and fulfill the potential to promote and protect the country’s health in the 21st century.

The Committee rose to the challenge. In early 1999, NCVHS and NCHS joined with the HHS Data Council to launch a national consultation and visioning process that is still underway. The present interim report describes the learning that has emerged in the first year. The report will be used to elicit further input from more stakeholders about their perceptions of future health needs and the best mechanisms for addressing them.

The overarching goal of the visioning process is to provide the information needed to enable the American public to achieve and maintain the best possible health. To this end, the visioning process is addressing a multifaceted set of questions:

  • What health information will be needed in the 21st century?
  • What conceptual framework meaningfully organizes the information?
  • What approaches to collection, storage and communication will most efficiently get high-quality information where it can make a difference?
  • What privacy, confidentiality and security protections must be in place to ensure that information can safely be used to promote the public’s health?

This process calls for three kinds of vision: a good eye for detail, wide peripheral vision, and distance vision that can see far into the future without depending on outdated lenses. In other words, we need an understanding of what it is important to know, an appreciation of how best to find out, and a vision that can anticipate future needs.

The work to envision 21st century health statistics is closely related to another NCVHS project, that of envisioning and developing the National Health Information Infrastructure (NHII).(5) The NHII is not to be a unitary database. Rather, it is conceived of as a set of policies, practices, technologies, standards, and applications that support communication and the broad array of information needed to improve clinical care, monitor public health, and educate consumers and patients. Community, or population, health information¾the essence and focus of health statistics¾is one dimension of the NHII, overlapping and sharing data with the personal and provider dimensions.