Catalyst Corner: March/April 2014

ONC and HITECH Anniversaries


2014 marks the anniversary of two profound industry-changing events: the establishment of the Office of the National Coordinator for Health Information Technology (ONC) in 2004 and the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 as part of the American Recovery and Revinvestment Act. 

ONC is the primary federal entity that coordinates the nation’s efforts to implement and use the most advanced health information technology (HIT) and the electronic exchange of health information. The position of national coordinator was created in 2004, through an executive order, and legislatively mandated in the HITECH Act. Physician and venture capitalist David Brailer served as the first national coordinator. In January 2014 the nation’s fifth national coordinator, Karen B. DeSalvo, M.D., M.P.H., M.Sc., was appointed. Other national coordinators have included Harvard Medical School professor David Blumenthal, psychiatrist Robert Kolodner, and physician and public health expert Farzad Mostashari. ONC is at the forefront of the administration’s health IT efforts and is a resource for the entire health system in supporting the adoption of health information technology and the promotion of nationwide health information exchanges to improve healthcare.

It will be interesting to see how the data-sharing agreement and consortium infrastructure develop and whether similar efforts will begin as a result. I’ll keep readers posted in my future columns.

ONC’s efforts received a great boost in 2009 with the passage of HITECH, when $49 billion was earmarked to expand the use of HIT. Money was set aside to promote adoption of electronic health records (EHRs) and their meaningful use, as well as for health information exchanges (HIEs). That investment has been successful in moving the nation’s HIT agenda forward, according to DeSalvo. In her recent blog post on HITECH’s anniversary (, she notes these figures:

  • Eighty-three percent of the nation’s eligible professionals and 94% of eligible hospitals have signed up for the Medicare and Medicaid Electronic Health Records Incentive Programs.

  • Slightly more than 435,000 professionals and 4,690 hospitals are registered for the programs.

  • Over 335,000 professionals and 4,400 hospitals have received incentive payments for adopting certified EHRs or demonstrating meaningful use.

In another recent blog post, DeSalvo highlighted key statistics from two recent surveys. They showed:

  • Almost 80% of office-based physicians used some type of EHR system, an increase of 60 percentage points since 2001 and nearly double the percent in 2008 (42%).

  • About half of office-based physicians surveyed said they use a system that qualifies as a “basic system,” up from just 11% in 2006.

  • Almost 70% of office-based physicians noted their intent to participate in the EHR incentive program.

HITECH also set aside nearly $600 million to establish HIEs. I had the opportunity to give an update on HIE status to participants at the annual conference of the American Society for Automation in Pharmacy (ASAP) this past January. Progress continues, and in February plans were announced by 16 state and regional HIEs to collaborate in an effort to build trust and remove barriers to patient data sharing. The effort moves forward a 10-year-old plan to create a national HIE network. The group’s hope is to ensure that important patient information is available at the point of care. The consortium’s next step is to elect leaders and hammer out a data-sharing agreement. Participants in the Mid-States Consortium of Health Information Organizations are listed in the box at right. 

It will be interesting to see how the data-sharing agreement and consortium infrastructure develop and whether similar efforts will begin as a result. I’ll keep readers posted in my future columns.

 Participants in the Mid-States Consortium of Health Information Organizations

 Colorado Regional Health Information Organization

Missouri Health Connection 

 Community Health Information Collaborative (Minnesota)

MyHealth Access Network, Inc. (Oklahoma)

 Coordinated Care Oklahoma

Nebraska Health Information Initiative

 Health Information Network of Arizona

North Dakota Health Information Network

 HealthShare Montana, Inc.

Quality Health Network (Colorado)

 Idaho Health Data Exchange

South Dakota Health Link at DOH

 Iowa Health Information Network

Southeast Texas Health System

 Kansas Health Information Network, Inc.

SMRTNET (Oklahoma)

Blue Button Support Grows 

In another HIT advance, ONC and the White House have announced that several community pharmacy chains and related associations have pledged their support of the Blue Button Initiative. The Blue Button Initiative is a public-private partnership between the healthcare industry and the federal government whose goal is to provide patients with access to their own electronic health information. Blue Button began with the Department of Veteran Affairs in 2010, with White House backing. Blue Button has expanded since that time, with an estimated 150 million people able to use Blue Button-enabled tools to access their health information from a variety of sources, such as healthcare providers, health insurance companies, medical labs, and HIEs. The Blue Button concept reflects the idea that patients should be able to securely access their health information and, if they choose, share it with healthcare providers and caregivers. Those announcing their support of Blue Button and committing to work over the next 12 months to standardize patient prescription information that will allow private-sector applications and services to grow include Walgreens, Kroger, CVS Caremark, Rite Aid, Safeway, the National Association of Chain Drug Stores, the National Alliance of State Pharmacy Associations, and the Pharmacy Health IT Collaborative. I provided details on the Blue Button initiative at ASAP’s midyear conference last June and will continue to brief ComputerTalk readers in future columns. In the meantime, system vendors may wish to review the Blue Button program to see if it can be adapted for use with their systems. CT

Marsha K. Millonig, R.Ph., M.B.A., is president of Catalyst Enterprises, LLC, in Eagan, Minn. The firm provides consulting, research, and writing services to help industry players provide services more efficiently and implement new services for future growth. The author can be reached at