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Health IT Strategic Framework

Addressing An Urgent Health Care Need

The U.S. health care system has a long and distinguished history of innovation.  Basic research results are translated into new understanding of disease, better diagnostic tools, disease prevention, and innovative treatments.  New therapies, procedures, and medications are the norm, and Americans have access to unparalleled standards of care and technologies that give them a continued stream of new treatment options, medications, and other therapies over their lifetimes.

At the same time, health care faces major challenges.  Health care spending and health insurance premiums continue to rise at rates much higher than the rate of general inflation.  Despite national health care spending of $1.7 trillion (Centers for Medicare and Medicaid Services, Office of the Actuary, 2004), concerns persist about preventable errors, uneven health care quality, and poor communication among physicians and hospitals.  The Institute of Medicine (IOM) estimates that between 44,000 and 98,000 Americans die each year from inpatient medical errors. (Corrigan et al., 2000).

These problems - high costs, medical errors, variable quality, administrative inefficiencies, and lack of coordination - are closely connected to inadequate use of HIT as an integral part of medical care.  The innovation that has made American medical care the world's best has not been applied to its health information systems.  With this in mind, President Bush has made transforming health care through HIT a top priority for the United States.  On April 27, 2004, the President announced his HIT initiative, setting a broad goal that most Americans should have electronic medical records within 10 years.  This vision for the development and implementation of a nationwide interoperable HIT infrastructure was further detailed in Executive Order 13335, which also directed the appointment of a National Coordinator for Health Information Technology.

The National Coordinator will lead the nation's effort to achieve the common goal of using information technology to improve the affordability, safety, and accessibility of health care in America.  The National Coordinator was directed to develop a nationwide strategic plan for HIT adoption.  The strategic plan will guide federal agencies and the private industry in their efforts to develop and implement programs that will promote the adoption of interoperable HIT.  A first step in preparing that strategic plan is the release of this framework.  The National Coordinator and this strategic framework will serve to move the nation from a long period of contemplation about HIT to a vigorous stage of action and progress in the public and private sectors on this issue.  The efforts described in this report are aimed at promoting a more effective marketplace, greater competition, and increased choice for consumers through wider availability of information on health care costs, quality, and safety.

This framework is intended to guide discussion, investigation, and experimentation so that progress can be made towards widespread adoption of HIT.  This report does not constitute a change in policy, rule, or law, and does not call for statutory changes in its own right.

Last revised: July 23, 2004

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