CPRI. In particular, because many of the barriers to implementation relate to lack of information, the interim effort should emphasize education and evaluation of the value of CPR systems. This effort should also focus on coordinating standards development and representing the health care field's interests in the emerging national high-speed computer network.

Ideally, the interim office should be run by a small professional staff headed by a recognized expert in CPR development. An advisory board with representation from both the private and public sectors should also be established. Program staff would support standards activities, conduct educational programs, serve as liaisons to professional organizations and commissions, represent the health care community in National Science Foundation network discussions, advise AHCPR and other extramural funders of research and demonstration projects, and plan for the second phase of CPR development and implementation.

This program should be funded initially by the DHHS agencies that have a fundamental interest in patient data; these include AHCPR and other Public Health Service agencies such as the Food and Drug Administration (FDA), the Centers for Disease Control (CDC), the Health Resources and Services Administration (HRSA), and the Health Care Financing Administration (HCFA). Approximately $2 million to $5 million per year would be required for the first two years; more substantial funding would be needed for the next three years. The program should be closely aligned with AHCPR, but consideration should be given to contracting with a private sector organization to run the program. (Private sector management would allow greater flexibility and facilitate the eventual anticipated transition to a public-private entity.)

The committee urges that the private sector actively support immediate CPR activities through participation and funding (e.g., of demonstration projects) and that it be prepared to support the CPRI financially within five years. Failure of the private sector to support CPR efforts adequately could result in federal government control or dominance of CPR development and implementation efforts.

RECOMMENDATION 3. Both the public and private sectors should expand support for the CPR and CPR system implementation through research, development, and demonstration projects. Specifically, the committee recommends that Congress authorize and appropriate funds to implement the research and development agenda outlined below. The committee further recommends that private foundations and vendors fund programs to support and facilitate this research and development agenda.

Over the past several decades, impressive technological innovations in computer-based information storage, retrieval, and communication have allowed U.S. industry and research organizations to revolutionize the management



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