Given the federal government's role in providing and paying for health care, the standards used by the federal government can significantly influence decisions on the standards used by health care providers and vendors. The Office of Management and Budget (OMB) identified the Consolidated Health Informatics (CHI) initiative as one of the 24 electronic government initiatives supporting the President's Management Agenda (http://www.jrfii.com/chi). To accelerate the adoption and use of information standards and technology, the CHI will endorse, for future use in federal healthcare programs (i.e., HHS, VA, and DoD), clinical vocabularies and messaging standards that have widespread support and use within the private US health care community. The commitment of federal programs to use agreed upon clinical vocabularies and messaging standards will enable federal agencies to build interoperable federal health data systems, and will encourage the private sector to adopt electronic health information systems that will be compatible with those that federal government will employ, and vice versa. This federal leadership will help inform the private healthcare community's investment decisions in electronic health information systems. In March 2003, the Departments of HHS, Defense, and Veterans Affairs announced the first set of uniform standards for electronic exchange of clinical health information to be adopted across the federal government. As part of new systems developments, these Departments will adopt HL7 messaging standards, laboratory terminology standards (LOINC), digital imaging standards (DIACOM), and other standards.