Statement on National Healthcare Information Infrastructure

Approved May 18, 2002

American Health Information Management Association (AHIMA)

AHIMA’s Position

AHIMA believes that for the United States’ healthcare industry to meet the current and future needs of the nation, a properly funded and maintained national healthcare information infrastructure should be established.  This infrastructure should advance the delivery of patient care and improve the health of the population, while protecting the rights of patients and providers.  The focus of the infrastructure should be to provide accurate and timely information to support decision-making at all levels.  It must provide access to and exchange of health information that can be used by patients, providers, payers, research entities, public health, oversight, and policy makers


The national health information infrastructure should:

·        Advance electronic capture, access, use, exchange, and storage of quality healthcare data;

·        Promulgate comprehensive, uniform, standards for transmission, content, and terminologies used;

·        Provide uniform and comprehensive privacy protection to all patient identifiable information; and

·        Support innovation in the advancement of information technology used in healthcare.


Health information managers, AHIMA’s members, are educated and certified to be an integral part of this healthcare information infrastructure and to fully participate in the building of our nation’s healthcare information infrastructure.


Current Situation


As the healthcare industry moves into the 21st Century, the urgency for a national healthcare information infrastructure continues to grow:

·        Reports from organizations such as the Institute of Medicine (IOM) and the Leapfrog Group, point out concerns regarding medical errors and patient safety.  They recommend a structured approach to clinical orders, pharmacy prescriptions, and uniform collection of data from active healthcare clinical documentation and transactions.  Information regarding care, quality, outcomes, cost, and so forth is demanded in order to eliminate errors and make appropriate purchasing decisions.

·        Bioterrorism events highlight the lack of a public health infrastructure and the critical need for the US to establish a much stronger, more effective and more efficient national healthcare data exchange system.    Discussions about such a system continually point to the need for a more robust healthcare information infrastructure for a variety of purposes beyond public health.

·        Numerous healthcare providers, plans, and vendors are developing independent electronic medical records systems for their use – no national standards currently exist for an electronic patient medical record, so data sharing is therefore questionable and potentially unreliable.

·        Healthcare use of the Internet expands, and the exchange of data and information has begun to actively include patients. 

·        The healthcare industry struggles to implement the administrative simplification requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  HIPAA is a federal law designed to provide structure for adoption of the nation’s first uniform standard for electronic transactions and code sets, and national regulations for healthcare information privacy and security.  The effort for administrative simplification and uniformity, however, still struggles for recognition of its efficiency and effectiveness factors versus other healthcare resource needs.  Department of health and Human Service (HHS) efforts to implement HIPAA are unfunded and decentralized.

·        The National Committee on Vital and Health Statistics (NCVHS), after years of study, now calls for “a comprehensive, knowledge-based system capable of providing [healthcare information] to all who need it to make sound decisions about healthcare.”  The NCVHS recommends the need for an infrastructure and federal funding for a central office in HHS to oversee such an infrastructure.

·        Coding, data, and electronic transaction standards affecting healthcare are scattered throughout the federal government and the private sector, even those which comprise HIPAA.  Inconsistencies on the use of such standards are permitted and sometimes encouraged, even within the government.  As yet, no central authority for harmonizing such components and achieving maximum efficiency and effectiveness of what could be a healthcare infrastructure exists.


A National Healthcare Information Infrastructure Will Be Achieved When:


·        The existing HIPAA administrative simplification requirements are fully implemented

·        The privacy and confidentiality of an individual’s health information are respected and protected in context with the public’s need to share certain healthcare information for the greater good, such as public health.

·        A national consensus for the development and use of appropriate individual identifiers exists permitting the appropriate exchange of data for purposes such as national public health administration.

·        There is national consensus and achievement of consistency of medical coding and nomenclature in addition to the adoption of complete coding systems/standards that meet national and international needs for uniform diagnostic and procedure coding systems and nomenclature.

·        There are clear, uniform, and consistent data definitions and transaction standards.

·        Security is developed and installed throughout the industry to foster data integrity, appropriate confidentiality, and proper authentication.

·        The healthcare industry has a working infrastructure to access information that provides for the efficient, effective, and safe provision of healthcare (a national uniform electronic medical record standard(s)) and knowledge for medical research, public health administration, healthcare policy, and healthcare education (and prevention) for all.

·        Individuals facilitating the system and infrastructure are appropriately educated, trained, and certified.

·        The industry and the country are educated to recognize and accept the humanitarian and economic value of working together to improve the healthcare system and the care and products it generates.

·        The infrastructure is based on reimbursement and technology-neutral systems, and facilitates the on-going data exchange necessary to maintain and advance patient care, and other activities mentioned above.

·        The federal government, with the full support of Congress and cooperation of the healthcare industry, provides a leadership mechanism, funding, and oversight to achieve harmony of existing standards and development of a public/private partnership for the nation’s healthcare infrastructure, including  funding to allow all stakeholders a place or link in the infrastructure.

The American Health Information Management Association is a dynamic organization of over 41,000 specially educated professionals – all working to ensure accurate and timely information within healthcare.