This is archived content, for historical reference only.

Efforts to digitize the nation’s health care system and make it possible to electronically exchange health information have been underway for more than a decade. Three major federal initiatives have shaped these efforts:

1. Executive Order 13335 established the position of National Coordinator for Health Information Technology (HIT).
2. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 created incentives for electronic health record (EHR) adoption and health information exchange (HIE).
3. The Patient Protection and Affordable Care Act of 2010 (ACA) established health care system payment reforms and is leading to new models of care delivery and payment that further encourage health care providers to engage in HIE.

This paper describes the HIE landscape as it stands today, nearly 10 years after the creation of the Office of the National Coordinator (ONC) and 5 years after the passage of the HITECH Act. It takes stock of the nation’s efforts to encourage HIE in three areas: (1) EHR adoption; (2) standards, certification, and incentives for HIE; and (3) governance. The paper also outlines current opportunities and challenges as described by nine experts in the fields of health care and HIT.