Toward a National Health Information Infrastructure: A Key Strategy for Improving Quality in Long-Term Care. B. Health Information Standards for Interoperable Health Data


A major impediment to the development of the NHII is the lack of complete and comprehensive standards for electronic patient medical record information (PMRI). In its February 2002 letter to the Secretary of Health and Human Services the NCVHS wrote that "Standards for PMRI are important because they will facilitate significant improvements in the quality of patient care, promote patient safety, control rising healthcare costs, enhance the productivity of clinical research and strengthen the nation's ability to detect and respond to healthcare emergencies. They are critical to the creation of a National Health Information Infrastructure."2

Data interoperability, or the exchange of consistent and comparable data and information in electronic health information systems, can be accomplished only when developers and vendors adopt and use standards that allow one software program to communicate information to another and when the terms used mean the same thing. Compliance with standards assures that data and information are transmitted and received in a specific, structured form that enables data interoperability, comparability, and data quality. Congress demonstrated a commitment to this with the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), requiring standards in connection with electronic payment, and the NCVHS is actively promoting data standards in conjunction with the broader goal of a national health information infrastructure.

For health care information systems, several types of data standards are needed. The emphasis of this project is on terminology. However, a brief discussion of standards related to sending messages in electronic systems and standards related to clinical document architecture standards is provided to highlight the need for coordinated standards in several critical areas in order to ensure data interoperability.

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