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The HITECH Era and the Path Forward

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In 2004, President George W. Bush established the Office of the National Coordinator for Health Information Technology (ONC) to help bring the health care sector into the digital age. Then, in 2009, Congress passed the Health Information Technology for Economic and Clinical Health (HITECH) Act to spur greater action on digitizing health and moving away from the waste and errors associated with a paper-based health system.

In a New England Journal of Medicine “Perspective, four former ONC heads, including Commonwealth Fund President David Blumenthal, M.D., describe the progress made and identify areas that require additional effort and resources.

Moving Health Care into the Digital Era

Today, nearly all U.S. hospitals and about 80 percent of office practices use electronic health records (EHRs). A majority of providers can now share health information, while 87 percent of patients say they have access to their EHRs. What’s more, a review of 500 studies found 84 percent of them concluded that HIT improved care quality, safety, and efficiency.

But technology also has created challenges for the health sector — of usability and work flow, among others — and care providers have borne the brunt of the transformation. To ensure the seamless, secure flow of electronic information going forward, the authors propose the following changes:

  • establishing national standards for connecting EHRs with other health technologies
  • encouraging market innovations that will forge the way to a patient record that combines information from various sources with all current and past health data
  • making health data available to researchers, patients, and clinicians alike to maximize benefits, minimize risk, and generate health care improvements as well as scientific evidence.


The ONC continues to bring together stakeholders, including federal partners like the Veterans Health Administration and Department of Defense that can model new innovations. The private sector must complement this collaboration. Through their joint efforts, the country has an opportunity “to ensure that the burgeoning health IT infrastructure engenders an equitable learning health system that leads to high-quality care, lower costs, and a healthy and engaged population.”

Publication Details



Mary Mahon, Former Vice President, Public Information, The Commonwealth Fund

[email protected]


V. Washington, K. DeSalvo, F. Mostashari, and D. Blumenthal, “The HITECH Era and the Path Forward,” New England Journal of Medicine, Sept. 7, 2017 377(10):904–6.