The U.S. Department of Health and Human Services (HHS) has initiated two new steps in building an electronic health care system that will allow patients and their physicians to access their complete medical records as needed, leading to reduced medical errors, improved patient care, and reduced health care costs.

HHS Secretary Tommy Thompson said HHS has signed an agreement with the College of American Pathologists (CAP) to license the college’s standardized medical vocabulary system and make it available without charge throughout the country.

He said this action opens the door to establishing a common medical language as a key element in building a unified electronic medical records system.

HHS also has commissioned the Institute of Medicine to design a standardized model of an electronic health record. The health care standards development organization, known as HL7, has been asked to evaluate the model once it has been designed.

HHS will share the standardized model record at no cost with all components of the U.S. health care system and expects to have a model record ready in 2004. It estimates that the free system will reduce medical errors and reduce health care costs by about $100 billion per year. However, many health care institutions will need to invest in computers and train staff.

With terms for more than 340,000 medical concepts, CAP’s standardized system has been recognized as the world’s most comprehensive clinical terminology database available, the agency said.

The licensing agreement with CAP will make it possible for health care providers, hospitals, insurance companies, public health departments, medical research facilities, and others to incorporate this uniform terminology system into their information systems.

The National Library of Medicine (NLM) at the National Institutes of Health will administer the CAP agreement under a five-year, $32.4 million contract to the organization for a permanent license for their terminology, known as SNOMED (Systematized Nomenclature of Medicine) Clinical Terms.

The contract includes a one-time payment shared by the Departments of Veterans Affairs, Defense, and several HHS agencies–with annual update fees paid by the NLM.