On April 27, 2004, President George Bush signed Executive Order 13335 establishing the position of the National Health Information Technology Coordinator. Six years, a recession, a change of administration, a couple of major legislations and a multitude of billions of dollars later, the Office of the National Coordinator for Health Information Technology (ONCHIT) is finally on the road to delivering on the original vision behind that executive order.
The stated mission of ONCHIT, as reiterated in the HITECH Act, was the creation of a nationwide interoperable health information technology infrastructure that makes pertinent information available at the point of care, improves health care quality and coordination, reduces health care costs and disparities and does all that while protecting privacy and security.
While the 2004 executive order did not go into much operational detail, the HITECH Act provided instruction on the structure and strategy for building the HIT infrastructure. It is interesting to note that the HITECH Act is comprised of two Titles; Title XIII in Division A which outlines the activities expected from ONCHIT and Title IV in Division B which creates the Medicare & Medicaid stimulus incentives to eligible providers. The notorious “Meaningful Use” term appears only in Title IV and only as a prerequisite for stimulus incentives from CMS and is loosely defined by certified technology, electronic prescribing, information exchange and reporting on clinical quality measures.
Additional guidance is provided on the selection of clinical quality measures to be in accordance with Section 1890(a) of the Social Security Act, which awards CMS $10 million every year for contracting development of such measures. Meaningful Use seems a rather benign litmus test for CMS to administer prior to dispersing any stimulus incentives. So why is it that “Meaningful Use” became the defining substance of the ONCHIT mission?
