National Public Health Informatics, United States

Chapter

Abstract

Informaticians looking at national public health information management in the US may ask, “Who designed it this way?” Most systems are not straightforward or easy to understand, in part due to their historical evolution in a decentralized federal structure that located most public health authority at the state level. Thus, many national systems have been built from the bottom-up in a heterogeneous fashion based on voluntary cooperation, sometimes induced through federal funding. In other cases, federal powers related to interstate commerce or national defense gave rise to centralized systems. More recently, federal agencies have played an important role in convening stakeholders, coordinating practice and information standards, and using funding to support implementation and induce conformance to standards. This chapter describes local, state and federal public health roles in the United States, points to collaborative products defining information requirements for various public health activities, outlines the evolution toward national information exchange standards, and describes health informatics roles (highlighting several important regulations) played by several federal and national agencies.

Keywords

Federal government Local health department State health department Police power Interstate commerce Taxing and spending authority National vital statistics Nationally notifiable conditions Department of Health and Human Services Public Health Service Centers for Disease Control and Prevention Food and Drug Administration World Health Organization International Health Regulations Health Insurance Portability and Accountability Act Centers for Medicare and Medicaid Services Core functions of public health Public health essential services Public Health Accreditation Board Business process Public health emergency preparedness Information supply chain Situational awareness Passive surveillance Electronic health record systems Clinical Laboratory Improvement Act Health Information Technology for Economic and Clinical Health (HITECH) Act Patient Protection and Affordable Care Act (PPACA, ACA) Electronic laboratory reporting Immunization information system National Electronic Disease Surveillance System Office of the National Coordinator for Health Information Technology (ONC) National Healthcare Safety Network BioSense Mini-Sentinel Cancer registry Environmental Health Tracking Network Standards and Interoperability Framework Health Information Technology Policy Committee (HITPC) and Standards Committee (HITSC) National Committee on Vital and Health Statistics National Center for Health Statistics Office of Surveillance, Epidemiology and Laboratory Services Public Health Information Network (PHIN) Nationwide Health Information Network National Academies Institute of Medicine Health Resources and Services Administration Agency for Healthcare Research and Quality National Institutes of Health National Library of Medicine Value Set Authority Center Veterans Administration Approved Testing and Certification Body Federal Health Architecture CONNECT Substance Abuse and Mental Health Services Administration Office of Civil Rights Office of Management and Budget Paperwork Reduction Act All payer claims database 

References

  1. 1.
    Hetzel AM. History and organization of the vital statistics system. National Center for Health Statistics, 1997. Appendix II of U.S. Vital statistics system: major Activities and Developments, 1950–95.Hyattsville, MD: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; February 1997.DHHS Publication Number (PHS) 97–1003.Available from: http://www.cdc.gov/nchs/data/misc/usvss.pdf. Cited 6 Feb 2013.
  2. 2.
    “History and background.” National Notifiable Disease Surveillance System. Centers for Disease Control and Prevention, updated 7 Dec 2012. Web. Cited 6 Feb 2013. http://www.cdc.gov/nndss/script/history.aspx.
  3. 3.
    List of Nationally Notifiable Conditions, 2012. Council of State and Territorial Epidemiologists. 2012. Web. Cited 6 Feb 2013. http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/PDFs/CSTENotifiableConditionListA.pdf.
  4. 4.
    ASTHO Profile of State Public Health. Volume two. Association of State and Territorial Health Officials. 2011. p. 58. Web. Cited 31 Mar 2013. http://www.astho.org/uploadedFiles/_Publications/Files/Survey_Research/ASTHO_State_Profiles_Single%5B1%5D%20lo%20res.pdf.
  5. 5.
    2010 National Profile of Local Health Departments. National Association of County and City Health Officials. 2011. p. 19. Web. Cited 31 Mar 2013. http://www.naccho.org/topics/infrastructure/profile/upload/2010_Profile_main_report-web.pdf.
  6. 6.
    Health Insurance Portability and Accountability Act. 1996. Web. Cited 14 Mar 2013. http://www.gpo.gov/fdsys/pkg/PLAW-104publ191/pdf/PLAW-104publ191.pdf.
  7. 7.
    For up-to-date HIPAA regulations and interpretations related to privacy and security see: “Health Information Privacy.” OCR home page. US Department of Health and Human Services, (not dated). Web. Cited 14 Mar 2013. http://www.hhs.gov/ocr/privacy/.
  8. 8.
    Baker MG, Fidler DP. Global public health surveillance under New International Health Regulations. Emerg Infect Dis. 2006;12(7):1058–65.PubMedCrossRefGoogle Scholar
  9. 9.
    Fidler DP, Gostin LO. The new international health regulations: an historic development for International law and public health. J Law Med Ethics. 2006 Spring;34(1):85–94.Google Scholar
  10. 10.
    Kohl KS, Arthur RR, O’Connor R, Fernandez J. Assessment of public health events through International Health Regulations, United States, 2007–2011. Emerg Infect Dis. 2012;18(7):1047–53.PubMedCrossRefGoogle Scholar
  11. 11.
    ASTHO Profile of State Public Health. Volume Two. Association of State and Territorial Health Officials.2011. p. 7–21. Web. Cited 31 Mar 2013. http://www.astho.org/uploadedFiles/_Publications/Files/Survey_Research/ASTHO_State_Profiles_Single%5B1%5D%20lo%20res.pdf.
  12. 12.
    2010 National Profile of Local Health Departments. National Association of County and City Health Officials. 2011. p. 52–60.Web. Cited 31 Mar 2013. http://www.naccho.org/topics/infrastructure/profile/upload/2010_Profile_main_report-web.pdf.
  13. 13.
    Institute of Medicine. The future of public health. Washington, DC: National Academies Press; 1988.Google Scholar
  14. 14.
    Public Health Functions Steering Committee. Public Health in America. 1995. Web. Cited 17 Feb 2013. http://www.health.gov/phfunctions/public.htm.
  15. 15.
    Operational Definition of a Functional Local Health Department. National Association of State and Territorial Health Departments. 2005. Web. Cited 17 Feb 2013. http://www.naccho.org/topics/infrastructure/accreditation/upload/OperationalDefinitionBrochure-2.pdf.
  16. 16.
    PHAB Standards and Measures Version 1.0. with errata December 2011. Web. Cited 17 Feb 2013. http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf.
  17. 17.
    Errata toPHAB Standards and Measures Version 1.0. Public Health Accreditation Board. 2011. Web. Cited 17 Feb 2013. http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0-Errata-December-2011.pdf5.
  18. 18.
    Common ground: public health preparedness toolkit: tools and methodology for business process analysis and redesign. Public Health Informatics Institute. 2011.Web. Cited 24 Feb. 2013 http://phii.org/sites/default/files/resource/pdfs/PrepToolKit_forwebsite.pdf.
  19. 19.
    For up-to-date information on CLIA see: “Clinical Laboratory Improvement Act (CLIA)”. CMS.GOV: regulations and guidance. Centers for Medicare and Medicaid Services. Revised 3 May 2012. Web. Cited 23 Feb 2013. http://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/index.html?redirect=/clia/.
  20. 20.
    VTrckS Homepage. Centers for Disease Control and Prevention. Updated 14 Mar 13. Web. Cited 31 Mar 2013. http://www.cdc.gov/vaccines/programs/vtrcks/.
  21. 21.
    Countermeasure Tracking System (CTS) Homepage. Centers for Disease Control and Prevention. Updated 1 Mar 2012. Web. Cited 31 Mar 2013. http://www.cdc.gov/osels/phsipo/diso/CTS.html.
  22. 22.
    Emery D, Engert E, D’Andrea G, Fawson C, Foldy S, Ziegler S, Blanco J, Mellin J. Health information exchange: from start-up to sustainability. Foundation for eHealth Initiative. 2007. p. 157–9. Web. Cited 31 Mar 2013. http://www.hci3.org/content/health-information-exchange-start-sustainability.
  23. 23.
    Centers for Disease Control and Prevention information technology strategic plan fiscal year 2012–2016: strengthening the public health information supply chain to better protect the health of people everywhere. Centers for Disease Control and Prevention. No date. Web. Cited 31 Mar 2013. http://www.cdc.gov/od/ocio/docs/CDC_IT_Strategic_Plan_2012_2016.pdf.
  24. 24.
    Public Health Information Technology: additional strategic planning needed to guide HHS’s efforts to establish electronic situational awareness capabilities (GAO 11–99). Government Accounting Office. 2010. Web. Cited 15 Feb 13. http://www.gao.gov/new.items/d1199.pdf.
  25. 25.
    Biosurveillance: nonfederal capabilities should be considered in creating a national biosurveillance strategy (GAO 12–55). Government Accounting Office. 2011.Web. Cited 15 Feb 2013. http://www.gao.gov/new.items/d1255.pdf.
  26. 26.
    Lenert L, Sundwall DN. Public health surveillance and meaningful use regulations: a crisis of opportunity. Am J Public Health. 2012;102(3):e1–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Platt R, Carnahan RM, Brown JS, Chrischilles E, Curtis LH, Hennessy S, Nelson JC, Racoosin JA, Robb M, Schneeweiss S, Toh S, Weiner MG. The U.S. Food and Drug Administration’s Mini-Sentinel program: status and direction. Pharmacoepidemiol Drug Saf. 2012;21 Suppl 1:1–8.PubMedGoogle Scholar
  28. 28.
    Current CBER mini-sentinel studies to further evaluate vaccine safety in large population databases. Food and Drug Administration. Last updated 25 Oct 2011. Web. Cited 22 Feb 2013. http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/ucm276981.htm.
  29. 29.
    Robb MA, Racoosin JA, Sherman RE, Gross TP, Ball R, Reichman ME, Midthun K, Woodcock J. The US Food and Drug Administration’s Sentinel Initiative: expanding the horizons of medical product safety. Pharmacoepidemiol Drug Saf. 2012;21 Suppl 1:9–11.PubMedCrossRefGoogle Scholar
  30. 30.
    Love D, Custer W, Miller P. All-payer claims databases: state initiatives to improve health care transparency. Commonwealth Fund, September, 2010.Publication 1439, vol. 99. 2010.Web. Cited 17 Feb 2013. http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/Sep/1439_Love_allpayer_claims_databases_ib_v2.pdf.
  31. 31.
    Chappel, A. Multi-Payer Claims Database Database (MPCD) for comparative effectiveness research. Presentation to the National Committee on Vital and Health Statistics. 2001.Web. Cited 23 Feb 2013. http://www.ncvhs.hhs.gov/110616p1.pdf.
  32. 32.
    “Research Data Assistance Center.” University of Minnesota. Web. Cited 14 Mar 2013. http://www.resdac.org/.
  33. 33.
    For example, see “Physician Quality Reporting System”.CMS.gov: Medicare. Centers for Medicare and Medicaid Services. Updated 23 Mar 2013. Web. Cited 31 March 2013. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html?redirect=/pqrs.
  34. 34.
    American Recovery and Renewal Act, Chapter 13. Health information technology for economic and clinical health. 2009. Web. Cited 14 Mar 2013. http://www.gpo.gov/fdsys/pkg/PLAW-111publ5/pdf/PLAW-111publ5.pdf.
  35. 35.
    Patient Protection and Affordable Care Act.2010. Web. Cited 14 Mar 2013. http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/html/PLAW-111publ148.htm.
  36. 36.
    Getz KA, Stergiopoulos S, Kaitin KI. Evaluating the completeness and accuracy of MedWatch data. Am J Ther. 2012; (Epub ahead of print). http://journals.lww.com/americantherapeutics/Abstract/publishahead/Evaluating_the_Completeness_and_Accuracy_of.99497.aspx.
  37. 37.
    National healthcare safety network. Centers for Disease Control and Prevention. Updated 15 Feb 2013. Web. Cited 31 Mar 2013. http://www.cdc.gov/nhsn/about.html.
  38. 38.
    NNDSS Home. Centers for Disease Control and Prevention. Updated 7 Dec 12. Web. Cited 31 Mar 2013. See http://www.cdc.gov/nndss/.
  39. 39.
    “Electric laboratory reporting.” Meaningful use. Centers for Disease Control and Prevention. Updated 20 Mar 2013. Web. Cited 31 Mar 2013. http://www.cdc.gov/ehrmeaningfuluse/elr.html.
  40. 40.
    Immunization information systems. Centers for Disease Control and Prevention. Updated 7 Mar 2013.Web. Cited 31 Mar 31 2013. http://www.cdc.gov/vaccines/programs/iis/index.html.
  41. 41.
    National Program of Cancer Registries (NPCR). Centers for Disease Control and Prevention. Updated 28 Mar 2013. Web. Cited 31 Mar 2013. http://www.cdc.gov/cancer/npcr/.
  42. 42.
    National Vital Statistics System. Centers for Disease Control and Prevention. Updated 14 Feb 2013. Web. Cited 31 Mar 2013. http://www.cdc.gov/nchs/nvss.htm.
  43. 43.
    “Syndromic surveillance.”Meaningful use. Centers for Disease Control and Prevention. Updated 3 Jan 2013. Web. Cited 31 Mar 2013. http://www.cdc.gov/ehrmeaningfuluse/syndromic.html.
  44. 44.
    National Environmental Public Health Tracking Network. Centers for Disease Control and Prevention. Updated 8 Jan 2013. Web. Cited 31 Mar 2013. See http://ephtracking.cdc.gov/showHome.action.
  45. 45.
    For information: “Division of Notifiable Diseases and Healthcare Information.” Public Health Surveillance and Informatics Program Office (PHSIPO). Centers for Disease Control and Prevention. Updated 21 Nov 2012. Web. Cited 31 Mar 2013. http://www.cdc.gov/osels/phsipo/dndhi/index.html
  46. 46.
    Smith P, Kriseman J. Evaluation of and recommendations for the National Notifiable Disease Surveillance System within the Federal Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. 2011. Web. Cited 16 Feb 13. http://www.cdc.gov/osels/phsipo/dndhi/docs/pdf/NNDSS-Evaluation-Report-FINAL.pdf.
  47. 47.
    Friede A, Blum HL, McDonald M. Public health informatics: how information age technology can strengthen public health. Annu Rev Public Health. 1995;16:239–52.PubMedCrossRefGoogle Scholar
  48. 48.
    Yasnoff WA, O’Carroll PW, Koo D, Linkins RW, Kilbourne E. Public health informatics: Improving and transforming public health in the information age. J Public Health Manag Pract. 2001;6(6):67–75.CrossRefGoogle Scholar
  49. 49.
    Information for health: a strategy for building the national health information infrastructure. National Committee on Vital and Health Statistics. 2001. Web. Cited 17 Feb 2013 http://www.ncvhs.hhs.gov/nhiilayo.pdf.
  50. 50.
    Loonsk JW, McGarvey SR, Conn LA, Johnson J. The Public Health Information Network (PHIN) preparedness initiative. J Am Med Inform Assoc. 2006;13(1):1–4.PubMedCrossRefGoogle Scholar
  51. 51.
    “The white house. Transforming health care: the President’s Health Information Technology Plan.” Promoting Innovation and Competitiveness: President Bush’s Technology Agenda.White House Archives. 20 Jan 2004. Web. Cited 31 Mar 2013. http://georgewbush-whitehouse.archives.gov/infocus/technology/economic_policy200404/chap3.html.
  52. 52.
    Department of Health and Human Services. Part III. 45 CFR Part 170: Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, Part C: Standards, Implementation Specifications and Certification Criteria Processes Before and After the HITECH Act. Fed Register. 2010; 75(8):2018–19. http://www.gpo.gov/fdsys/pkg/FR-2010-01-13/pdf/E9-31216.pdf.
  53. 53.
    Foldy S, Ross DA.“Public Health Opportunities in Health Information Exchange.”Public Health Informatics Institute Topics In Public Health Informatics. 2005. Web. Cited 22 Feb 2013. http://www.phii.org/sites/default/files/resource/pdfs/Opportunities_0605.pdf.
  54. 54.
    Blumenthal D. Stimulating the adoption of health information technology. N Engl J Med. 2009;360:1477–9.PubMedCrossRefGoogle Scholar
  55. 55.
    The HITECH Act was part of Public Law 111–5, the American Recovery and Renewal Act of 2009. Web. Cited 22 Feb 2013. http://www.gpo.gov/fdsys/pkg/PLAW-111publ5/pdf/PLAW-111publ5.pdf.
  56. 56.
    Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010;363:501–4.PubMedCrossRefGoogle Scholar
  57. 57.
    For regulations current as of this writing, see Fed. Register. 2012;77(171):53968–4162. Web. Cited 14 Mar 2013. http://www.gpo.gov/fdsys/pkg/FR-2012-09-04/pdf/2012-21050.pdf and Fed. Register Sept 4, 2012; 77(171):54163–541292. Web. (Cited March 14, 2013.) http://www.gpo.gov/fdsys/pkg/FR-2012-09-04/pdf/2012-21050.pdf acc.Google Scholar
  58. 58.
    Useful digests and tools related to the regulations are Available from:Meaningful use. Centers for Disease Control and Prevention. Updated 20 Mar 2013. Web. Cited 31 Mar 2013. www.cdc.gov/ehrmeaningfuluse.
  59. 59.
    Other useful information Available from: “EHR Incentive Programs.” CMS.gov. Centers for Medicare and Medicaid Services. Last modified 20 Feb 2013. Web. Cited 31 Mar 2013 http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html.
  60. 60.
    Other useful Available from: “Meaningful Use Resources.” Office of the National Coordinator for Health Information Technology. No date. Updated 25 Mar 13.Web. Cited 31 Mar 2013. http://www.healthit.gov/policy-researchers-implementers/meaningful-use-resources.
  61. 61.
    The standards and interoperability framework. Office of the National Coordinator for Health Information Technology. No date. Web.Cited 23 Feb 2013. http://www.healthit.gov/sites/default/files/pdf/fact-sheets/standards-and-interoperability-framework.pdf. Standards and Interoperability Framework wiki site. Office of the National Coordinator for Health Information Technology. No date. Web. Cited 23 Feb 2013.
  62. 62.
    S & I Framework Wiki Page. Office of the National Coordinator for Health Information Technology. 2013. Web. Cited 31 Mar 2013.http://wiki.siframework.org/.
  63. 63.
    Public Health Information Network (PHIN) strategic plan: strategies to facilitate standards-based public health information exchange (2011–2016). Centers for Disease Control and Prevention. 2011. Web. Cited 17 Feb 2013. http://www.cdc.gov/phin/library/documents/PHINStrategicPlan_v3_0.pdf.
  64. 64.
    Office of e-Government and Information Technology. Office of Management and Budget. Not dated. Web. Cited 14 Mar 2013. http://www.whitehouse.gov/omb/e-gov.
  65. 65.
    “Data.”Health Data. Gov. Department of Health and Human Services. Not dated. Web. Cited 23 Feb 2013. http://healthdata.gov/dataset/search.
  66. 66.
    Paperwork Reduction Act of 1995. Web. Cited 14 Mar 2013. http://www.gpo.gov/fdsys/pkg/PLAW-104publ13/html/PLAW-104publ13.htm.
  67. 67.
    Most federal health activities under the act are addressed by the Department of Health and Human Services.See “Information Collection/Paperwork Reduction Act.” OCIO website. Department of Health and Human Services. No date. Web. Cited 31 Mar 2013. http://www.hhs.gov/ocio/policy/collection/index.html.
  68. 68.
    Realizing the full potential of health information technology to improve healthcare for Americans: the path forward. Presidents Council of Advisors on Science and Technology. 2010. Web. Cited 16 Feb 2013. http://www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-health-it-report.pdf.
  69. 69.
    Howard A. “US CTO seeks to scale agile thinking and open data across federal government. Todd Park is looking for Presidential Innovation Fellows to help government work better.” O’Reilly Strata blog. 2012. Web. Cited 23 Feb 2013. http://strata.oreilly.com/2012/05/us-cto-seeks-to-scale-agile-te.html.
  70. 70.
    “Health Information Technology Research and Development Senior Steering Group” website. The Networking and Information Technology Research and Development Program. Not dated. Web. Cited 31 Mar 2013. http://www.nitrd.gov/nitrdgroups/index.php?title=Health_Information_Technology_Research_and_Development_Senior_Steering_Group_(Health_IT_R%26D_SSG)#title.
  71. 71.
    “Homeland Security Presidential Directive 21 (HSPD 21).” The White House. 2007. National Security Presidential Directives (NSPDs), Federation of American Scientists Intelligence Resource Program. Web. Cited 23 Feb 2013. http://www.fas.org/irp/offdocs/nspd/hspd-21.htm. This definition and HSPD 21 continue to be cited in more recent documents such as National Strategy for Countering Biological Threats. National Security Council. 2009. Web. Cited 23 Feb 2013. http://www.whitehouse.gov/sites/default/files/National_Strategy_for_Countering_BioThreats.pdf and Concept Plan for the Implementation of the National Biosurveillance Strategy for Human Health. Centers for Disease Control and Prevention. 2010. Web. Cited 23 Feb 2013. http://www.cdc.gov/osels/pdf/Concept_Plan_V1+5+final+for+print+KMD.PDF.
  72. 72.
    National Strategy for Bio Surveillance. Office of the President. 2012. Web. Cited 17 Feb 2013. http://www.whitehouse.gov/sites/default/files/National_Strategy_for_Biosurveillance_July_2012.pdf.
  73. 73.
    The National Biosurveillance Integration Center. Department of Homeland Security. No date. Web. Cited 31 Mar 2013. http://www.dhs.gov/national-biosurveillance-integration-center.
  74. 74.
    “Federal health architecture.” Standards and interoperability. Office of the National Coordinator for Health Information Technology. No date. Web. Cited 31 Mar 2013. http://www.healthit.gov/policy-researchers-implementers/federal-health-architecture-fha.
  75. 75.
    HHS organizational chart. Department of Health and Human Services. No Date. Web. Cited 31 Mar 2013. http://www.hhs.gov/about/orgchart/.
  76. 76.
    Federal health IT strategic plan 2011–2015. Office of the National Coordinator for Health Information Technology. 2011. Web. Cited 17 Feb 2013. http://www.healthit.gov/sites/default/files/utility/final-federal-health-it-strategic-plan-0911.pdf.
  77. 77.
    Office of the National Coordinator for Health Information Technology Justification of Estimates for Appropriations Committee. Fiscal Year 2010 .Department of Health and Human Services. No Date. Web. Cited 17 Feb 2013. http://www.healthit.gov/sites/default/files/onc_fy_2010_cj_final.pdf.
  78. 78.
    Office of the National Coordinator for Health Information Technology Justification of Estimates for Appropriations Committee. Fiscal Year 2013. Department of Health and Human Services. No Date. Web. Cited 17 Febr 2013. http://www.healthit.gov/sites/default/files/fy_2013_onc_cj_final.pdf.
  79. 79.
    CDC Organization. Centers for Disease Control and Prevention. Updated 14 Dec 2013. Web. Cited 24 Feb 2013. http://www.cdc.gov/about/organization/cio.htm.
  80. 80.
    Welcome to OSELS homepage. Centers for Disease Control and Prevention. 2013.Web. Cited 31 Mar 2013. http://www.cdc.gov/osels/.
  81. 81.
    Informatics R&D Laboratory: a resource for CDC and Its public health partners. Centers for Disease Control and Prevention. No date. Web. Cited 31 Mar 2013. http://www.phiresearchlab.org/.
  82. 82.
    Biotechnology Core Branch Facility. Centers for Disease Control and Prevention. 8 Apr 2011. Web. Cited 31 Mar 2013. http://www.cdc.gov/ncezid/dsr/biotechnology-core-facility-branch.html.
  83. 83.
    National Center for Health Statistics. Centers for Disease Control and Prevention. 28 Mar 13. Web. Cited 31 Mar 2013. http://www.cdc.gov/nchs/.
  84. 84.
    International classification of diseases, 10th Revision, Clinical modification (ICD-10-CM). Centers for Disease Control and Prevention. Updated 4 Oct 2012. Web. Cited 15 Mar 2013. http://www.cdc.gov/nchs/icd/icd10cm.htm.
  85. 85.
    Unified medical language system. National Library of Medicine. Updated 29 Mar 2013. Web. Cited 31 Mar 2013. http://www.nlm.nih.gov/research/umls/.
  86. 86.
    “RxNorm” Unified medical language system. National Library of Medicine.Updated 29 Mar 2013. Web. Cited 31 Mar 2013. http://www.nlm.nih.gov/research/umls/rxnorm/overview.html.
  87. 87.
    Value Set Authority Center. National Library of Medicine. Updated 25 Oct 2012. Web. Cited 31 Mar 2013. https://vsac.nlm.nih.gov/.
  88. 88.
    Partners in Information Access for the Public Health Workforce. National Library of Medicine.Updated 28 Mar 2013. Web. Cited 31 Mar 2013. http://phpartners.org/index.html.
  89. 89.
    Washington AE. The Patient-Centered Outcomes Research Institute — promoting better information, decisions, and health. N Engl J Med. 2011;365:e31.PubMedCrossRefGoogle Scholar
  90. 90.
    Test method for health information technology: initial set of standards, implementation specifications,and certification criteria for EHR Technology (45 CFR Part 170 Subpart C). National Institute for Standards and Technology. 7 Feb 11. Web. Cited 31 Mar 2013. http://healthcare.nist.gov/use_testing/index.html

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Family and Community MedicineMedical College of WisconsinMilwaukeeUSA

Personalised recommendations