The passage of the HITECH Act and the introduction of the Medicare and Medicaid EHR incentive programs in 2011 (now known as the Medicare Promoting Interoperability Program and commonly referred to as "Meaningful Use") were pivotal events in the field of health information technology (IT). They launched the historic nationwide effort to rapidly move our health care system from paper to electronic health records (EHRs). With significant public and private financial investment, as well as massive “bridging capital” from vendor organizations and technology developers, more than 90% of hospitals and physician offices are now using EHR systems.

This radical change in what is arguably the most complex and fragmented sector of our economy is a gigantic achievement. However, the introduction of the EHR was only a first step towards realizing the promise of a modern digital health system. Process changes often lag technological changes, and the healthcare industry and interwoven regulations remain deeply imbued with workflows and mindsets born of a paper-based world. While we haven't completely ripped paper (and faxes!) out of healthcare yet, now is the time to put our firm focus on a paper-free 21st century healthcare system. Health system reform must be redesigned based on electronic data that can flow securely, appropriately, and easily anywhere, anytime to improve quality, safety, efficiency, affordability and equity of health care.

This year will be a year of transformation. The political and technical infrastructure necessary for the exchange of information on a national scale becomes a reality. This year, providers, patients, payers, public health practitioners, technology developers, researchers and other stakeholders will take decades of investment in health information technology to a higher level.

Our potential for innovation and the use of information to create value in healthcare has never been greater. Key provisions of the 21st Century Therapeutic Products Act (Remedies Act), passed in 2016 with overwhelming bipartisan support, will be implemented this year and will be key factors in significantly improving clinical interoperability. These include:

The continued implementation and enforcement of information blocking regulations will affect information sharing practices (c. , 130 Stat. 1176).
Application Programming Interface (API) standardization will provide a foundation for secure and standardized API functions to facilitate information sharing with certified EHR systems (45 CFR Sect. 170.315(g)(10)) .
Trusted Exchange Framework and Common Agreement (TEFCA) will create a national policy and backbone infrastructure to facilitate the exchange of information between electronic health record networks and other healthcare informatics systems (114-255, Sect. 4003, 130 State 1165 (2016).
Together, these guidelines will improve innovation in healthcare, public health and medical research. Rather than attempting to define or predict how the industry will evolve, the Office of the National Health Information Technology Coordinator (ONC) aims to establish and maintain the fundamental principles and building blocks of an ecosystem open health informatics that pushes the boundaries of what is possible. to improve health care.