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A Consensus Action Agenda for Achieving the National Health Information Infrastructure

Affiliations of the authors: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC (WAY, JPF); National Library of Medicine, National Institutes of Health, Bethesda, MD (BLH); Regenstrief Institute, Indiana University School of Medicine, Indianapolis, IN (JMO); University of Virginia, Charlottesville, VA, and University of Cambridge, Cambridge, England (DED); University of Wisconsin–Madison, Madison, WI (PFB); National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (RWM); Partners HealthCare, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (BM, DWB)USA

Correspondence and reprints: William A. Yasnoff, MD, PhD, National Health Information Infrastructure, Department of Health & Human Services, Room 440D, Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201; e-mail: <william.yasnoff{at}hhs.gov>

Received for publication: 05/11/04; accepted for publication: 05/22/04.

Background: Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII).

Methods: To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003.

Results: Attendees favored a public–private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.