Office of the National Coordinator for Health Information Technology

Last updated
Office of the National Coordinator for Health Information Technology
Agency overview
FormedApril 27, 2004 (2004-04-27)
Headquarters Mary E. Switzer Memorial Building
Washington, DC
Agency executives
  • Don Rucker, M.D., National Coordinator for Health IT
  • Genevieve Morris, Principal Deputy National Coordinator for Health IT
Parent department Health and Human Services
Website healthit.gov
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, charged as the principal federal entity to coordinate nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information.

Contents

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]

George W. Bush 43rd president of the United States

George Walker Bush is an American politician and businessman who served as the 43rd president of the United States from 2001 to 2009. He had previously served as the 46th governor of Texas from 1995 to 2000.

The Health Information Technology for Economic and Clinical Health Act, abbreviated 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 is spending $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."

American Recovery and Reinvestment Act of 2009

The American Recovery and Reinvestment Act of 2009 (ARRA), nicknamed the Recovery Act, was a stimulus package enacted by the 111th U.S. Congress and signed into law by President Barack Obama in February 2009. Developed in response to the Great Recession, the ARRA's primary objective was to save existing jobs and create new ones as soon as possible. Other objectives were to provide temporary relief programs for those most affected by the recession and invest in infrastructure, education, health, and renewable energy.

Mission

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.

Health information technology is 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 an often-cited 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. According to a 2006 report by the Agency for Healthcare Research and Quality, broad and consistent utilization of HIT will:

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

Public health preventing disease, prolonging life and promoting health through organized efforts and informed choices of society and individuals

Public health has been defined as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological and social well-being. As such, according to the World Health Organization, it is not merely the absence of disease or infirmity.

Clinical research is a branch of healthcare science that determines the safety and effectiveness (efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treatment, diagnosis or for relieving symptoms of a disease. Clinical research is different from clinical practice. In clinical practice established treatments are used, while in clinical research evidence is collected to establish a treatment.

Leadership

The structure of the agency offers insight into its strategic goals, and the agency's continued interest in collaborative, transparent, experienced leadership. [7]

National Coordinators

Donald Rucker (April 2017 – Present)
Former Siemens Chief Medical Officer. Rucker was an emergency room doctor, internal medicine physician, a clinical informatics expert, an inventor, a designer and researcher and innovator and for the past four years, he was professor at Ohio State University, where he taught clinical Emergency Medicine and Biomedical Informatics. [8]
Jon White, MD (interim, January 2017 – April 2017)
White briefly served as acting National Coordinator prior to the appointment of Donald Rucker. [9] [10]
Vindell Washington (12 August 2016 – 19 January 2017)
Washington previously served as Principal Deputy National Coordinator. [11]
Karen DeSalvo (13 January 2014 – 12 August 2016)
DeSalvo became National Coordinator for Health Information Technology on January 13, 2014, [12] after serving as Health Commissioner for the City of New Orleans and Senior Health Policy Advisor to New Orleans Mayor Mitchell Landrieu. The role of National Coordinator is responsible for developing and executing the nation's Health Information Technology agenda. In New Orleans Dr. DeSalvo modernized and improved the effectiveness of the health department, and restored health care to devastated areas of the city, including leading the establishment of a public hospital. Prior to joining the Mayor's administration, DeSalvo was a professor of medicine and vice dean for community affairs and health policy at Tulane University School of Medicine. [13] DeSalvo left ONC on August 12, 2016 to focus on her work as Acting Assistant Secretary of Health. [11]
Jacob Reider (interim, 4 October 2013 – 13 January 2014)
Reider took the role of Acting National Coordinator for Health IT when Farzad Mostishari left ONC to become a visiting fellow at the Brookings Institution on October 4, 2013. [14] He returned to his earlier position as ONC's Chief Medical Officer when Karen DeSalvo became National Coordinator. [12]
Farzad Mostashari (2011 – 4 October 2013)
As National Coordinator Mostishari led ONC's major implementation phase after first joining ONC as its deputy national coordinator in July 2009. As deputy he developed a series of grant programs to promote electronic health record adoption, furthered the development of health information exchange, and helped construct the workforce development program. His vision has been instrumental in the formulation of the ONC’s Health IT Strategic Plan, the creation of ONC’s Authorized Testing and Certification Bodies, and influenced future stages of Meaningful Use.[ citation needed ]
David Blumenthal (20 April 2009 – 2011)
Physician and Harvard Medical School Professor David Blumenthal was appointed National Coordinator on March 20, 2009 and assumed the position on 20 April 2009. [15] [16] He set the inaugural tone and led the accelerated ramp up and development of the vastly expanded and fully funded role of ONC with the development of the many programs authorized by the HITECH Act, with the cooperation of the Centers for Medicare and Medicaid Services.[ citation needed ]
Robert Kolodner (interim, 18 September 2006; permanent, 18 April 2007 – 20 April 2009)
Psychiatrist Robert Kolodner became Acting National Coordinator on September 18, 2006, [17] and was formally appointed as National Coordinator of Health Information Technology on April 18, 2007. [18] He retired from the federal government on September 23, 2009. [19]
Karen Bell (interim, April 2006 – 18 September 2006)
Bell briefly served as Acting National Coordinator between Brailer's departure in April 2006 and Kolodner's appointment later that year. [17]
David Brailer (2004 – April 2006)
The first National Coordinator of Health Information Technology, physician and venture capitalist, David Brailer, laid critical groundwork for a vision of the role extensive use of electronic health records could play in the modernization of clinical paperwork and digitization of healthcare.[ citation needed ] Brailer resigned from the position on April 20, 2006. [20]

Programs

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. [21] 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. [22]

ONC Programs The following ONC programs [23] 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. [28] [29]

Advisory committees

ONC also created two Federal Advisory Committees (FACAs), the Health IT Policy Committee, which the National Coordinator chairs, and the Health IT Standards Committee.

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. [30]

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. [31]

Related Research Articles

Electronic health record a program used to document a patients medical history on a computer

An electronic health record (EHR), or electronic medical record (EMR), is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

David J. Brailer is known for his leadership and advocacy for health information technology specifically 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. In practice the term HIE may also refer to the organization that facilitates the exchange.

College of Healthcare Information Management Executives organization

The College of Healthcare Information Management Executives (CHIME) is a professional organization for chief information officers and other senior healthcare IT leaders. CHIME enables its members and business partners to collaborate; exchange ideas and technology; develop professionally; and advocate the effective use of information management to improve the health and healthcare in the communities they serve.

The eHealth Exchange, formerly known as the Nationwide Health Information Network often abbreviated as the NHIN or NwHIN, 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 the adoption of robust, interoperable health information technology. The Commission certified electronic health record technology 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.

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.

VistA electronic medical record system developed and used within the U.S. Veterans Health Administration

The Veterans Information Systems and Technology Architecture (VISTA) is the nationwide veterans clinical and business information system of the U.S. Department of Veterans Affairs. VISTA consists of 180 applications for clinical, financial, and administrative functions all integrated within a single database, providing single, authoritative source of data for all veteran-related care and services. The U.S. Congress mandates the VA keep the veterans health record in a single, authoritative, lifelong database, which is VISTA.

popHealth is an open-source reference implementation software tool that automates population health reporting.

Blue Button

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.

Farzad Mostashari U.S. government official

Farzad Mostashari, MD, ScM, is the former national coordinator for health information technology at the U.S. Department of Health and Human Services.

HL7® Fast Healthcare Interoperability Resources is a next generation standards framework that leverages the latest web standards and applies a tight focus on implementation and was developed by healthcare standards developing organization, Health Level Seven International® (HL7®). It describes data formats and elements and an application programming interface (API) for exchanging electronic health records. For patients and providers, its versatility can be applied to mobile devices, web-based applications, cloud communications and EHR data-sharing using modular components. FHIR is already widely used in hundreds of applications across the globe for the benefit of providers, patients and payers.

David Blumenthal Physician and health care policy expert

David Blumenthal is an academic physician and health care policy expert, best known as the National Coordinator for Health Information Technology in the period 2009-2011 during early implementation of the Health Information Technology for Economic and Clinical Health Act provisions on "meaningful use".

Jacob Reider is an American physician and expert in health information technology policy.

Health care analytics is the healthcare 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, fraud and HR analysis.

Medicare Access and CHIP Reauthorization Act of 2015

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), commonly called the Permanent Doc Fix, is a United States statute. It changes the payment system for doctors who treat Medicare patients. It revises the Balanced Budget Act of 1997. It was the largest scale change to the American health care system following the Affordable Care Act ("ObamaCare") in 2010.

Robert Kolodner is an American psychiatrist and medical informatician. In September 2006, he became the second U.S. National Coordinator for Health IT.

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.

References

  1. 1 2 69 FR 24059
  2. "Contact Us". HealthIT.gov. Office of the National Coordinator for Health Information Technology. 25 April 2016.
  3. "Leadership Bios". HealthIT.gov. Office of the National Coordinator for Health Information Technology. 13 September 2016. Retrieved 16 September 2016.
  4. "HHS Organizational Chart". U.S. Department of Health and Human Services. 25 May 2016. Retrieved 16 September 2016.
  5. "Office of the National Coordinator for Health Information Technology (ONC): Executive Summary". U.S. Department of Health and Human Services. 9 November 2004. Archived from the original on 29 September 2006.
  6. American Recovery and Reinvestment Act of 2009 at Congress.gov
  7. "About ONC". HealthIT.gov.
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  9. "Jon White, M.D." HealthIT.gov. 20 January 2017. Archived from the original on 2 February 2017.
  10. Monegain, Bernie (31 March 2017). "Donald Rucker named new national coordinator at ONC". Healthcare IT News. HIMSS Media. Retrieved 11 October 2017.
  11. 1 2 Sullivan, Tom (11 August 2016). "Karen DeSalvo stepping down as national coordinator to join HHS full-time". Healthcare IT News. HIMSS Media. Retrieved 16 September 2016.
  12. 1 2 McCann, Erin (19 December 2013). "HHS appoints new ONC chief". Healthcare IT News. HIMSS Media.
  13. "Karen B. DeSalvo, M.D., M.P.H., M.Sc". HealthIT.gov. 13 January 2016. Archived from the original on 28 June 2016.
  14. Brino, Anthony (10 November 2013). "Changing of the ONC guard". Healthcare IT News. HIMSS Media.
  15. "HHS Names David Blumenthal As National Coordinator for Health Information Technology" (Press release). 20 March 2009. Archived from the original on 4 March 2010.
  16. Manos, Diana. "Blumenthal to take over ONC on Monday". Healthcare IT News. HIMSS Media. Retrieved 12 October 2017.
  17. 1 2 Ferris, Nancy (20 September 2006). "Kolodner named interim national health IT coordinator". Healthcare IT News. HIMSS Media.
  18. Ferris, Nancy (18 April 2007). "Kolodner becomes permanent national coordinator of health IT". Healthcare IT News. HIMSS Media.
  19. Versel, Neil (23 September 2009). "Kolodner retires from federal government". Healthcare IT News. HIMSS Media.
  20. Leavitt, Mike. "Statement by Mike Leavitt Secretary of Health and Human Services On Resignation of David J. Brailer, National Coordinator for Health IT" (Press release). U.S. Department of Health and Human Services. Archived from the original on 29 October 2013.
  21. "Data and Program Reports - Centers for Medicare & Medicaid Services". Cms.gov. Retrieved 2016-01-10.
  22. "CMS Meaningful Use Incentive Payments Reach $22.9B". iHealthBeat. 2001-10-26. Retrieved 2016-01-10.
  23. "HITECH Programs". The Office of the National Coordinator for Health Information Technology. U.S. Department of Health & Human Services. 27 January 2011. Archived from the original on 19 February 2011.
  24. "Regional Extension Center Program Dashboard from HHS Office of the National Coordinator for Health IT". Dashboard.healthit.gov. Retrieved 2016-01-10.
  25. "Program Initiatives | Policy Researchers & Implementers". HealthIT.gov. 2014-01-21. Retrieved 2016-01-10.
  26. "State HIE Implementation Status | Policy Researchers & Implementers". HealthIT.gov. 2014-11-30. Retrieved 2016-01-10.
  27. "EVALUATION OF THE BEACON COMMUNITY COOPERATIVE AGREEMENT PROGRAM" (PDF). Healthit.gov. March 2013. Retrieved 2016-01-10.
  28. "HITECH Workforce Development Programs" (PDF). Dashboard.healthit.gov. 2013. Retrieved 2016-01-10.
  29. "Final Report : Evaluation of the Information Technology Professionals in Health Care ("Workforce") Program - Summative Report" (PDF). Healthit.gov. March 2014. Retrieved 2016-01-10.
  30. Kibbe, David; Klepper, Brian (2 February 2012). "Trusting Government: A Tale Of Two Federal Advisory Groups". Health Affairs Blog.
  31. Halamka, John (24 April 2014). "The April HIT Standards Committee meeting". Life as a Healthcare CIO.

Further reading