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Achievable Steps Toward Building a National Health Information Infrastructure in the United States

Affiliations of the authors: Department of Medicine and Biomedical Informatics, Vanderbilt University, Nashville, TN (WWS); Health and Life Science Division of Accenture, LLP, Chicago, IL (BJK); Veterans Health Administration, Department of Veterans Affairs, Washington, DC (RMK).

Correspondence and reprints: William W. Stead, MD, Informatics Center, 3401 West End Ave, Suite 290, Nashville, TN 37203-6866; e-mail: <bill.stead{at}vanderbilt.edu>.

Received for publication: 09/03/04; accepted for publication: 11/05/04.

Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have the intended beneficial national impacts and which are better left to smaller projects within the boundaries of health care organizations. This report provides a primer for use by informatics professionals as they explain aspects of that dividing line to policy makers and to health care leaders and front-line providers. It then identifies short-term, intermediate, and long-term steps that might be taken by the NHII initiative.

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