Official Website of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT
Official Website of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT
The Office of the National Coordinator for Health IT was created by Executive Order 13335, signed by President George W. Bush in April 2004. ONC was established within the Department of Health and Human Services (HHS) and charged with, "fulfilling its responsibilities...consistent with a vision of developing a nationwide interoperable health information technology infrastructure..."
In keeping with its mission to improve the healthcare experience for all Americans, ONC awarded several multimillion- dollar contracts to organizations to accelerate the adoption of health IT. A hallmark of ONC’s approach, which continues today, has been bringing public-private groups together to foster effective collaboration between private entities and the government. Investments in 2005 led to new partnerships and funded standards development that furthered interoperable health IT.
The Federal Health IT Strategic Plan 2008-2012 served as a roadmap for federal agencies and stakeholders to collaborate on initiatives aimed at transforming the healthcare system through the strategic use of health information technology.
The Health Information Technology for Economic and Clinical Health HITECH Act sought to modernize the healthcare system through the widespread adoption and meaningful use of health information technology, to ultimately improve healthcare quality, reduce costs, and empower patients to take a more active role in their healthcare. The HITECH Act also, importantly, established ONC in law and provides HHS with the authority to improve healthcare through health IT.
Under the HITECH Act, ONC launched several programs aimed at supporting nationwide implementation of health IT from different angles. These include the State Health Information Exchange Cooperative Agreement program that established health information exchanges in each state, Regional Extension Centers that helped support small providers’ health IT adoption, Beacon Communities that demonstrated how health IT advanced healthcare, and the Workforce Development Program that provided health IT education to medical professionals. Notably, the Strategic Health IT Advanced Research Project (SHARP) program supported the discovery of breakthrough research that led to the creation of the Fast Healthcare Interoperability Resources (FHIR®) application programming interfaced focused standard that is enabling interoperability around the country.
Launched in 2010, the voluntary ONC Health IT Certification Program was established to provide for the certification of health IT and to support its availability for encouraged and required use under other federal, state, and private programs. The Centers for Medicare & Medicaid Services (CMS) Promoting Interoperability (PI) Programs (previously Medicare and Medicaid EHR Incentive Programs), as an example, required the use of health IT certified under the Certification Program. Throughout the evolution of the Certification Program, ONC has released multiple editions of certification criteria and regulations for new and expanded Certification Program requirements.
ONC launched the S&I Framework as a vehicle to convene the health IT community and rapidly prioritize health IT challenges and subsequently develop and harmonize standards, specifications and implementation guidance to solve those challenges. ONC was also responsible for curating the set of standards and specifications that supported interoperability and ensured that they can be assembled into solutions for a variety of health information exchange scenarios. The Framework worked to standardize vocabularies, structures, transport, security, and services with open APIs.
Provided a blueprint for enhancing the adoption and effective use of health IT in the United States, aiming to improve healthcare quality, efficiency, and accessibility through initiatives such as interoperability promotion, privacy and security enhancements, research support, and stakeholder collaboration.
The 2014 Edition Final Rule adopted important certification criteria that enhanced standards-based exchange, promoted EHR safety and security, enabled greater patient engagement, introduced greater transparency and reduced regulatory burden. Upon the 2014 Edition Final Rule effective date, it also created the program name change to the ONC Health IT Certification Program.
The ONC's 10-year vision for interoperable health IT infrastructure aimed to improve information exchange among healthcare providers, enhancing care coordination and patient outcomes. It provided a roadmap for stakeholders to work towards a more connected and efficient healthcare system, fostering innovation and collaboration in the industry.
A roadmap outlining steps to achieve nationwide interoperability of health IT systems. It proposed actions for stakeholders to collaborate on, focusing on standards, policies, and infrastructure development to improve health information exchange and patient care coordination.
A roadmap to promote the adoption and effective use of health IT. It focused on goals such as interoperability, healthcare quality improvement, privacy and security enhancement, and innovation in health IT.
The 2015 Report to Congress articulated the extent of health information blocking and provided a comprehensive strategy for addressing the roadblocks that interfered with making electronic health information more broadly available in healthcare. The report proposed a healthcare system that allowed electronic health information to be easily shared in a secure manner to support patient-centered care, and enhance healthcare quality while advancing research and improving public health.
The 21st Century Cures Act is a bi-partisan bill that was signed into law on December 13, 2016, by President Barack Obama. The bill provided funding for a multitude of healthcare efforts, including precision medicine, and sought to improve the interoperability of health IT and patient access to health information. The 21st Century Cures Act (Cures Act) established ONC’s authority regarding information blocking and made sharing electronic health information the expected norm by authorizing the HHS Secretary to identify "reasonable and necessary activities that do not constitute information blocking." The bill also provided ONC with the authority to begin work on a trusted exchange framework, including a common agreement.
The Cures Act Final Rule mandated standardized APIs, promoting interoperability and patient access to health information. Importantly, it aimed to reduce information blocking, enhancing care coordination and patient engagement while improving healthcare quality and efficiency.
TEFCA provided a standardized approach to health information exchange, aimed at facilitating secure and interoperable data sharing among different healthcare networks and systems. With TEFCA in place, organizations worked towards adopting common principles and technical standards for exchanging electronic health information, promoting better care coordination and patient access to their medical data. Additionally, TEFCA helped to establish trust among stakeholders and streamline data exchange processes, fostering collaboration and innovation in the healthcare industry.
The first set of designated Qualified Health Information Networks (QHINs) were approved to begin supporting the exchange of data governed by TEFCA. This marked a major milestone in the implementation of TEFCA and the promises envisioned in the 21st Century Cures Act. The designated QHINs were able to immediately begin supporting the exchange of data under the Common Agreement’s policies and technical requirements.
The HTI-1 Final Rule implements provisions of the 21st Century Cures Act and makes updates to the ONC Health IT Certification Program for algorithm transparency and information sharing. This rule furthers ONC’s continued work to build a stronger digital healthcare system that makes interoperability easier and supports patients’ access to electronic health information that makes a positive impact to their overall health and well-being.
This update to the Common Agreement includes enhancements and updates to require support for FHIR Application Programming Interface (API) based transactions. This capability allows TEFCA participants to more easily exchange information directly between themselves and will enable individuals to more easily access their own healthcare information using apps via TEFCA.
