The development of an electronic health information technology (IT) network is a priority for federal policymakers. Since the mid 1990s, the Executive Branch—under President’s Clinton and Bush—and Congress have started to put in place the infrastructure needed for sharing patient medical information. To this end, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996, which required HHS to create new privacy and security rules to protect patient information, transactions and code sets, and identifier standards. HHS has implemented these provisions.

The Bush Administration has also taken a number of actions to facilitate this process, including:

• Creating an advisory panel, the American Health Information Community (AHIC), to help in identifying changes needed to implement the network;
• Harmonizing interoperability standards by selecting three sets of “interoperability specifications,” including the LOINC standards;
• Directing federal departments and agencies that purchase and deliver health care services to only use health IT based on the interoperability standards recognized by HHS; and
• Modifing the self-referral prohibitions to so that hospitals and other health care entities can donate health IT and training services to providers;

AHIC has also created a number of workgroups to integrate key data into the network, including a Personalized Health Care subcommittee to standardize genomic test information and an Electronics Health Records workgroup to identify solutions for accessing and deploying laboratory test results and interpretations. The EHR recommendations are due shortly.

The Bush Administration has set 2014 as the year for when this process should be completed and an interoperable electronic health record should be available.

Federal Regulations

• Health Insurance Portability and Accountability Act (HIPAA) Privacy Rules
• August 8, 2006 Health and Human Services (HHS) Electronic Prescribing Rule

Government Health IT Sites

• Health and Human Services (HHS) Health IT Initiatives
• American Health Information Community (AHIC) Agency for Healthcare Research and Quality (AHRQ) national Resource Center for Health IT
• Government Accountability Office (GAO) Reports on Health IT

Legislative Proposals

• H.R.3800, the Promotion of Health Information Technology (HIT) Act (October 2007)
• S.1693, the Wired for Health Care Quality Act (June 2007)

Other IT Sites of Interest

• Institute of Medicine (IOM) Report: Key Capabilities of an Electronic Health Record System  
• Logical Observation Identifiers Names and Codes (LOINC) 
• EHR-Lab Interoperability and Connectivity Standards (ELINCS)
• American National Standards Institute (ANSI) Standards

AACC Position Statements