ONC Marks Its Eighteenth Anniversary

April 27, 2022
On the eighteenth anniversary of the creation of the ONC, Deputy National Coordinator Steven Posnack marked the occasion with a blog published to the ONC’s website

Eighteen years to the day after the Office of the National Coordinator for Health IT (ONC) was created, Steven Posnack, Deputy National Coordinator, commemorated the moment through a blog posted to the agency’s website, with the simple, straightforward title, “ONC Turns 18.”

The blog began thus: “On April 27, 2004, President [George W.] Bush signed Executive Order (EO) 13335 and created the Office of the National Coordinator for Health IT (ONC). Like tapping that first domino, this single action is a key moment in United States health IT history. Nearly two decades later, US policy and technology leadership in health IT is world-renowned.”

Posnack wrote that, “Throughout this time, ONC has remained true to the four original duties cast by EO 13335 (paraphrased):

serve as the Secretary’s principal advisor on the development, application, and use of health IT;

ensure that health information technology policy and programs of the Department of Health and Human Services (HHS) are coordinated with those of relevant executive branch agencies;

coordinate outreach and consultation with public and private parties; and

provide comments and advice on health IT at the request of the Office of Management and Budget.

The past 18 years has seen its share of remarkable, market-moving events, such as the passage of the HITECH Act (2009) and 21st Century Cures Act (2016) as well as major electronic health record (EHR) investments by HHS and the procurement of a commercial EHR system (ONC-certified, I might add) by the Departments of Defense and Veterans Affairs,” he wrote. “Add in large financial investments from the public and private sectors as well as a significant amount of “sweat equity” from provider organizations and technology developers and you can see why more than 90 percent of hospitals and nearly the same amount of physician practices now use EHR systems. This dramatic change in what is arguably the most complex sector of our economy is a mammoth achievement.”

Posnack went on to write that, “Amidst these and other marquee moments, a few hundred past and present staff have come through ONCs ranks with a simple purpose in mind – to make the nation’s health better through the use of health IT. And that’s what keeps us going. Having started at ONC shortly after its first birthday, there have certainly been months and years where the headwinds felt strong. But we persevered. While there is no shortage of work to be done, it’s also important to take stock of how far we’ve come. That’s a testament to all of the national coordinators (with whom I’ve had the privilege to serve) and the remarkable continuity they’ve offered across administrations.”

Under the heading “Health IT Trends Since ONC’s Launch,” Posnack noted that, “In 2004, most clinicians and hospitals documented patient records on paper. Large public and private financial investments, as well as enormous efforts from clinicians and technology developers began the historic, nationwide effort to rapidly digitize the healthcare delivery system.”

Posnack cited, among other accomplishments, the fact that, “Since ONC launched the Health IT Certification Program in 2010, almost all hospitals and approximately three-quarters of ambulatory providers now use certified EHRs”; the fact that 22 federal programs make use of ONC’s Health IT Certification Program, with hundreds of thousands of providers represented; the fact that, “[i]n the past ten years, the proportion of hospitals that let patients view their records has significantly increased”—from 24 percent in 2012 to 97 percent in 2019; and the fact that 70 percent of hospitals reported integrating data into their EHR from sources outside their health system, as of 2019.

Posnack concluded his blog by writing, “Thank you to everyone out there who has ever submitted a public comment, participated in an advisory committee, attended an ONC event, or supported an ONC project. We know if we invited you all, it would be one heck of a party! As we celebrate our 18th birthday, it’s with a continued sense of pride, patriotism, and optimism about the future of health.”

ONC has had eight National Coordinators and four Interim National Coordinators since its inception (Robert Kolodner, M.D., was both). They are:

Ø David Brailer, M.D. (2004-April 2006)

Ø  Karen Bell, M.D. (interim, April 2006-September 2006)

Ø  Robert Kolodner, M.D. (interim, September 2006; then permanent, April 2007-April 2009)

Ø  David Blumenthal, M.D. (April 2009-2011)

Ø  Farzad Mostashari, M.D. (2011-2013)

Ø  Jacob Reider, M.D. (interim, 2013-2014)

Ø  Karen DeSalvo, M.D. (2014-2016)

Ø  B. Vindell Washington, M.D. (2016-2017)

Ø  Jon White, M.D. (interim, January-April 2017)

Ø  Donald Rucker, M.D. (2017-2021)

Ø  Micky Tripathi, Ph.D. (January 2021-present)

Among the key turning points for the agency was when President Barack Obama signed the HITECH (Health Information Technology for Economic and Clinical Health) Act as part of the American Recovery and Reinvestment (ARRA) Act of 2009, with the HITECH Act giving the Department of Health and Human Services, ONC’s umbrella agency, $25.9 billion with which to promote the adoption of EHRs, and mandating, through the meaningful use process, the adoption of EHRs on the part of patient care organizations receiving Medicare reimbursement. The meaningful use program compelled EHR adoption and had a profound impact on the industry from 2009 until 2017.

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