Health IT offers promise for improving patient safety and reducing  inefficiencies. Given the level of the federal  government’s participation in providing health care, it has been  urged to take a leadership role in driving change to improve the  quality and effectiveness of medical care in the United States,  including an expanded adoption of IT. In an effort to leverage the federal government’s role in health care,  the President called for the Secretary of Health and Human Services  to appoint a National Coordinator for Health Information  Technology. The Secretary appointed the first National Coordinator  in May 2004. For example, in late 2005 the National  Coordinator’s Office awarded several contracts to address a range  of activities important for expanding the implementation of health  IT; these activities include  ●  defining criteria and a process for certifying the interoperability of  electronic health records to help increase the number of health care  providers adopting electronic health records,   ●  defining health information standards needed to ensure the  interoperability of electronic health records and health IT systems,   ●  defining requirements for exchanging health information throughout  a nationwide health information network, and   ●  defining privacy and security policies to ensure the protection of  electronic personal health information. In May 2005, we recommended that  HHS establish detailed plans and milestones for the development of  a national health IT strategy and take steps to ensure that its plans  are followed and milestones are met. HHS Is Pursuing Efforts to Advance the Nationwide Implementation of Health IT, but It Has Not Yet Completed a National Strategy

HHS and the Office of the National Coordinator have been pursuing  various efforts to implement health IT solutions. Among other  activities, the department has been relying on recommendations of   the American Health Information Community to assist the office’s  health IT initiatives in several key areas aimed at the expansion of  electronic health records, identification of health IT standards,  advancement of nationwide health information exchange, protection  of personal health information, and other related issues. Further, although HHS has initiated specific activities intended to  meet the goals of its framework for strategic action, and it is  continuing efforts to expand the nationwide implementation of  health IT, it is undertaking these activities without a comprehensive  national strategy that includes the detailed plans, milestones, and  performance measures needed to ensure that the outcomes of its  various initiatives are integrated and its goals are met. However, HHS has not  yet defined detailed plans and milestones for integrating the various  initiatives, nor has it developed performance measures for tracking  progress toward the President’s goal for widespread adoption of  interoperable electronic health records by 2014.
Why GAO Did This Study

Health information technology (IT) offers promise for improving patient safety and reducing inefficiencies. Given its role in providing health care in the United States, the federal government has been urged to take a leadership role to improve the quality and effectiveness of health care, including the adoption of IT. In April 2004, President Bush called for widespread adoption of interoperable electronic health records within 10 years and issued an executive order that established the position of the National Coordinator for Health Information Technology within the Department of Health and Human Services (HHS). The National Coordinator, appointed in May 2004, released a framework for strategic action two months later. In late 2005, HHS also awarded several contracts to address key areas of health IT. GAO has been reporting on the department's efforts toward nationwide implementation of health IT since 2005. In prior work, GAO recommended that HHS establish detailed plans and milestones for the development of a national health IT strategy and take steps to ensure that its plans are followed and milestones met. For this testimony, GAO was asked to describe HHS's efforts to advance the use of health IT. To do this, GAO reviewed prior reports and agency documents on the current status of relevant HHS activities.

What GAO Found

HHS and the Office of the National Coordinator have been pursuing various activities in key areas associated with the President's goal for nationwide implementation of health IT. In 2005, the department established the American Health Information Community, a federal advisory committee, to help define the future direction of a national strategy for health IT and to make recommendations to the Secretary of Health and Human Services for implementing interoperable health IT. The community has made recommendations directed toward key areas of health IT, including the expansion of electronic health records, the identification of standards, the advancement of nationwide health information exchange, the protection of personal health information, and other related issues. Even though HHS is undertaking these various activities, it has not yet developed a national strategy that defines plans, milestones, and performance measures for reaching the President's goal of interoperable electronic health records by 2014. In 2006, the National Coordinator for Health Information Technology agreed with GAO's recommendation that HHS define such a strategy; however, the department has not yet done so. Without an integrated national strategy, HHS will be challenged to ensure that the outcomes of its various health IT initiatives effectively support the President's goal for widespread adoption of interoperable electronic health records.