System Requirements

Requirements for a national electronic health records (EHR) information system include:

Privacy and Security Standards—Because of the extreme sensitivity of health information, personal information must be secure from attacks by Internet hackers and available only to those authorized to see it. This will require standards to encrypt information (translate it into secret code), to safeguard it from hackers and other illegitimate users, to authorize those entitled to see it, and to authenticate the identities of those seeking access. These standards will involve both hardware and software.

Interoperability Standards—The World Wide Web works for people and computers anywhere ("interoperability") because it is built on consensus standards that everyone can understand. Similarly, the National Health Information Infrastructure (NHII) initiative, led by Health and Human Services (HHS) Secretary Michael Leavitt, is managing the development of consensus standards to make EHRs work anywhere in the country. In fact, the National Health Information Network (NHIN) is being built on the Web. That means electronic health records will work across a broad range of different hardware and software.

Other Standard Functions—The NHII is also selecting standards for other functions that the EHR will perform-such as the type of information collected, stored, and displayed. Selections are made from standards proposed by Standards Development Organizations. In the past year, SAMHSA has participated in standards development sponsored by an international organization known as Health Level 7 (HL7).

Transparency—Health care consumers deserve to know about the quality and cost of their health care. Health care transparency provides consumers with the information necessary, and the incentive, to choose health care providers based on value. For more information, visit www.hhs.gov/transparency.

A Common Language—The medical terminology used by the various professionals who will enter information into each person's EHR must be uniform so that all can use it correctly and understand what others mean. The National Library of Medicine is the central coordinating body for clinical terminology standards within HHS. For more information on medical terminology, visit www.nlm.nih.gov/healthit.html.

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