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Agency overview | |
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Formed | April 27, 2004 |
Headquarters | Mary E. Switzer Memorial Building Washington, DC |
Agency executives |
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Parent department | Health and Human Services |
Website | healthit |
Footnotes | |
[1] [2] [3] [4] |
The Office of the National Coordinator for Health Information Technology (ONC) is a staff division of the Office of the Secretary, within the U.S. Department of Health and Human Services. ONC leads national health IT efforts. It is charged as the principal federal entity to coordinate nationwide efforts to implement the use of advanced health information technology and the electronic exchange of health information.
President George W. Bush created the position of National Coordinator on April 27, 2004 through Executive Order 13335. [1] [5] Congress later mandated ONC in the Health Information Technology for Economic and Clinical Health Act provisions of the American Recovery and Reinvestment Act of 2009, under the Obama Administration. [6]
With the passage of the HITECH Act, the Office of the National Coordinator for Health Information Technology (ONC) is charged with building an interoperable, private and secure nationwide health information system and supporting the widespread, meaningful use of health information technology.
ONC's mission is looking ahead as it begins its second decade in 2014.ONC is working to improve these five areas:
The concerted initiative on interoperability in 2014 seeks to achieve the ability of two or more systems to exchange health information and use the information once it is received.
The mission of ONC is to optimize the paths to reach these five health IT goals along with interoperability to support the Triple Aim.
Widely adopted by the healthcare sector, the Triple Aim was developed by the Institute for Healthcare Improvement to 1) improve patient experience of care, 2) improve the health of populations, and 3) reduce per capita costs of healthcare.
The Federal Health IT Strategic Plan from 2011-2015 had set these five goals
In its ongoing work, ONC is looking to address these priorities in 2014:
ONC's mission had previously been described as
The structure of the agency offers insight into its strategic goals, and the agency's continued interest in collaborative, transparent, experienced leadership. [7]
The Health Information Technology for Economic and Clinical Health (HITECH) Act seeks to improve American health care delivery and patient care through an unprecedented investment in health information technology. The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of Electronic Health Records (EHRs).
EHR Incentive Program Payments and Meaningful Use
The HITECH Act set meaningful use of interoperable EHR adoption in the health care system as a critical national goal and incentivized EHR adoption. The "goal is not adoption alone but 'meaningful use' of EHRs — that is, their use by providers to achieve significant improvements in care." The Centers for Medicare and Medicaid (CMS) managed and distributed these federal funds for the meaningful use of electronic health records in conjunction with state Medicaid departments with the cooperation and support of ONC and ONC programs.
As of March 2014, more than $22.5 billion in combined Medicare and Medicaid EHR Incentive Program payments have been made since 2011. More than $14.8 billion in Medicare EHR Incentive Program payments have been made between May 2011 and March 2014. More than $7.7 billion in Medicaid EHR Incentive Program payments have been made between January 2011 (when the first set of states launched their programs) and March 2014. More than 470,000 eligible professionals, eligible hospitals, and critical access hospitals are actively registered in the Medicare and Medicaid EHR Incentive Programs as of March 2014. [20] According to Modern Healthcare, payments have been made to 90.4% of the 5,011 estimated eligible hospitals; and 69.6% of the estimated 527,200 eligible professionals. [21]
ONC Programs
The following ONC programs [22] help to build the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery. Note: The list of programs below is in the process of being revised and updated.
*Combined Results of Community College and University-Based Training: In total the two programs trained 21,437 students from all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands at 91 academic institutions. [27] [28]
In January 2018, the Health Information Technology Advisory Committee (HITAC) was established as required under the 21st Century Cures Act.
Health Information Technology Advisory Committee (HITAC) | HealthIT.gov
Term: 2021-current
Co-Chair: Aaron Miri
Co-Chair: Denise Webb
Term: 2018-2020
Co-Chair: Robert Wah
Co-Chair: Carolyn Peterson
ONC also created two Federal Advisory Committees (FACAs), the Health IT Policy Committee, which the National Coordinator chairs, and the Health IT Standards Committee. Both of these committees were disbanded in 2018 due to new legal requirements within the 21st century cures act.
Health IT Policy Committee
The Health IT Policy Committee recommends a policy framework for the development and adoption of a nationwide health information technology infrastructure that permits the electronic exchange and use of health information. Vice-chair of this committee is Paul Tang, MD, MS, who is Vice President, Chief Innovation and Technology Officer at Palo Alto Medical Foundation. [29]
Health IT Standards Committee
The Health IT Standards Committee recommends to the National Coordinator standards, implementation specifications, and certification criteria. The Standards Committee also harmonizes, pilot tests, and ensures consistency with the Social Security Act. Vice-chair of this committee is John Halamka, MD, MS, who is Chief Information Officer of Beth Israel Deaconess Medical Center, Professor at Harvard Medical School, and a practicing Emergency Physician. [30]
Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.
David J. Brailer is known for founding and investing in leading health IT companies.
Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. Participants in data exchange are called in the aggregate Health Information Networks (HIN). In practice, the term HIE may also refer to the health information organization (HIO) that facilitates the exchange.
The eHealth Exchange, formerly known as the Nationwide Health Information Network, is an initiative for the exchange of healthcare information. It was developed under the auspices of the U.S. Office of the National Coordinator for Health Information Technology (ONC), and now managed by a non-profit industry coalition called Sequoia Project. The exchange is a web-services based series of specifications designed to securely exchange healthcare related data. The NwHIN is related to the Direct Project which uses a secure email-based approach. One of the latest goals is to increase the amount of onboarding information about the NwHIN to prospective vendors of health care systems.
The Certification Commission for Health Information Technology (CCHIT) was an independent, 501(c)(3) nonprofit organization with the public mission of accelerating adoption of robust, interoperable health information technology in the United States. The Commission certified electronic health record technology (EHR) from 2006 until 2014. It was approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB). The CCHIT Certified program is an independently developed certification that includes a rigorous inspection of an EHR's integrated functionality, interoperability and security using criteria developed by CCHIT's broadly representative, expert work groups. These products may also be certified in the ONC-ATCB certification program.
A health record trust provides a secure and protected place for individuals to create, use, and maintain their lifetime electronic health record (EHR). A health record trust takes personal health records one step further by combining an individual's electronic health record with their personal health record. It also protects patient privacy by establishing that the patient is the owner of their health care records. It gives patients the authority to access and review the entire document at any time. It allows healthcare professionals, facilities, and organizations to view all or a limited portion of the records.
Patient portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day and night. Some patient portal applications exist as stand-alone web sites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of a healthcare provider. Still others are modules added onto an existing electronic medical record (EMR) system. What all of these services share is the ability of patients to interact with their medical information via the Internet. Currently, the lines between an EMR, a personal health record, and a patient portal are blurring. For example, Intuit Health and Microsoft HealthVault describe themselves as personal health records (PHRs), but they can interface with EMRs and communicate through the Continuity of Care Record standard, displaying patient data on the Internet so it can be viewed through a patient portal.
Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on a 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands, the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system.
The Veterans Health Information Systems and Technology Architecture (VISTA) is the system of record for the clinical, administrative and financial operations of the Veterans Health Administration VISTA consists of over 180 clinical, financial, and administrative applications integrated within a single shared lifelong database (figure 1).
popHealth is an open-source reference implementation software tool that automates population health reporting.
The Electronic Healthcare Network Accreditation Commission (EHNAC) is a voluntary, self-governing standards development organization (SDO) in the United States established to develop standard criteria and accredit organizations that electronically exchange healthcare data. These entities include electronic health networks, payers, financial services firms, health information exchanges (HIEs), management service organizations and e-prescribing solution providers.
Informatics for Consumer Health (ICH) is a government initiative coordinated by the National Cancer Institute (NCI) within the National Institutes of Health (NIH). ICH focuses on a coordination of health information, technology, and health care delivery that empowers providers to manage care and increases the ability of consumers to gain mastery over their own health. The ICH online initiative involved stakeholders from various sectors—commercial IT, government, health care, education, research, and advocacy—exchanging ideas and resources to bridge information technology and health care with the goal of improving behavioral support for all consumers. The Informatics for Consumer Health field is related to health informatics, medical informatics, consumer health informatics, eHealth, and health information technology.
Sachin H. Jain is an American physician who held leadership positions in the Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC). From 2015 to 2020, he served as president and chief executive officer of the CareMore Health System. In June 2020, it was announced that he would join the SCAN Group and Health Plan as its new president and CEO. He is also adjunct professor of medicine at the Stanford University School of Medicine and a Contributor at Forbes. In 2018, he was named one of American healthcare's most 100 most influential leaders by Modern Healthcare magazine (#36).
The Blue Button is a system for patients to view online and download their own personal health records. Several Federal agencies, including the Departments of Defense, Health and Human Services, and Veterans Affairs, implemented this capability for their beneficiaries. In addition, Blue Button has pledges of support from numerous health plans and some vendors of personal health record vendors across the United States. Data from Blue Button-enabled sites can be used to create portable medical histories that facilitate dialog among health care providers, caregivers, and other trusted individuals or entities.
The Health Information Technology for Economic and Clinical Health Act, abbreviated the HITECH Act, was enacted under Title XIII of the American Recovery and Reinvestment Act of 2009. Under the HITECH Act, the United States Department of Health and Human Services resolved to spend $25.9 billion to promote and expand the adoption of health information technology. The Washington Post reported the inclusion of "as much as $36.5 billion in spending to create a nationwide network of electronic health records." At the time it was enacted, it was considered "the most important piece of health care legislation to be passed in the last 20 to 30 years" and the "foundation for health care reform."
Farzad Mostashari, MD, ScM, is the former national coordinator for health information technology at the U.S. Department of Health and Human Services.
The Fast Healthcare Interoperability Resources standard is a set of rules and specifications for exchanging electronic health care data. It is designed to be flexible and adaptable, so that it can be used in a wide range of settings and with different health care information systems. The goal of FHIR is to enable the seamless and secure exchange of health care information, so that patients can receive the best possible care. The standard describes data formats and elements and an application programming interface (API) for exchanging electronic health records (EHR). The standard was created by the Health Level Seven International (HL7) health-care standards organization.
David Blumenthal is an academic physician and health care policy expert, known as the National Coordinator for Health Information Technology from 2009 to 2011 during the early implementation of the Health Information Technology for Economic and Clinical Health Act provisions on "meaningful use".
Health care analytics is the health care analysis activities that can be undertaken as a result of data collected from four areas within healthcare; claims and cost data, pharmaceutical and research and development (R&D) data, clinical data, and patient behavior and sentiment data (patient behaviors and preferences,. Health care analytics is a growing industry in the United States, expected to grow to more than $31 billion by 2022. The industry focuses on the areas of clinical analysis, financial analysis, supply chain analysis, as well as marketing, fraud and HR analysis.
Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.