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![handle is hein.crs/govekxs0001 and id is 1 raw text is: Con gressionaI Research Sentk
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March 17, 2023
The Office of the National Coordinator for Health Information
Technology (ONC)
Information technology (IT), or the use of devices like
computers for the handling of electronic data, has existed
for decades, but has only recently become accessible to
many Americans in a health care context. The federal
government has tasked the Office of the National
Coordinator for Health Information Technology (ONC)
with developing a framework for and implementing
widespread adoption of information technology in health
care to create an interoperable, equitable, and accessible
system for all Americans. ONC's mission is to systemically
improve the American people's health through the access,
exchange, and use of data. ONC is a staff division within
the Office of the Secretary for the Department of Health
and Human Services (HHS).
Organization and Programs
All of ONC's organizational efforts are unified by two
objectives. First, ONC endeavors to [a]dvanc[e] the
development and use of health IT capabilities. Second,
ONC strives to [e]stablish ... expectations for data
sharing. ONC comprises four offices: the Immediate
Office of the National Coordinator (Immediate Office), the
Office of the Chief Operating Officer, the Office of Policy,
and the Office of Technology. The Immediate Office and
the Office of the Chief Operating Officer lead agency-wide
support through leadership, management, and advisory
activities. The Office of Policy is responsible for
developing policies in accordance with pertinent statutes
and executive orders. The Office of Technology provides
coordination, and technical and program support.
Focus Areas
ONC offices broadly conduct activities related to health IT
standards, certification, and exchange. Across these ONC
efforts, there are multiple ongoing key activities:
Interoperability. Advancing interoperability is at the core
of many of ONC's activities. According to the Healthcare
Information and Management Systems Society,
interoperability is defined as the ability of different
information systems, devices and applications (systems) to
access, exchange, integrate and cooperatively use data in a
coordinated manner, within and across organizational,
regional and national boundaries, to provide timely and
seamless portability of information and optimize the health
of individuals. Interoperability in health care presents
myriad potential benefits, including increasing clinical
safety, promoting health equity, and speeding public health
emergency responses. ONC organizes interoperability
efforts nationwide.
Trusted Exchange. In January 2022, ONC published the
first versions of its Trusted Exchange Framework and
Common Agreement (TEFCA), documents meant to
establish minimum acceptable interoperability standards.
Specifically, the Common Agreement delineates
infrastructure and governing approaches for basic
information sharing across all health networks. In turn, the
Trusted Exchange Framework enumerates aspirational
principles for trust policies and practices across health
information networks.
United States Core Data for Interoperability (USCDI).
The USCDI is a standardized set of health data classes and
constituent data elements for nationwide, interoperable
health information exchange. Required data include
clinical notes, allergies and intolerances, laboratory results,
and medications. Adhering to the USCDI is a mandatory
condition for health IT stakeholders seeking certification
under the ONC Health IT Certification Program. The third
version of the USCDI was released in January of 2022, with
a fourth version expected in July 2023.
ONC Health IT Certification Program (Certification
Program). Begun in 2010, the Certification Program is an
initiative under which health IT developers may voluntarily
obtain health IT certification. The Certification Program
incentivizes baseline conformity across electronic health
record (EHR) systems through a combination of evolving
standards, implementation specifications, and certification
criteria issued by the HHS Secretary. This conformity is
meant to promote interoperability through access,
exchange, and use of electronic health information (EHI),
especially through the use of open application programming
interfaces (APIs).
Information Blocking. The expectation in health care is
that EHI be shared amongst authorized parties. When an
actor engages in activities that interfere with, or are likely
to interfere with, the access, exchange, or use of EHI, this is
considered information blocking under the Final Rule
promulgated under the 21st Century Cures Act (Cures Act;
P.L. 114-255). Per this rule, actors, including health care
providers, health information networks or health
information exchanges, and health IT developers of
certified health IT, are forbidden from practices constituting
information blocking. ONC has, however, identified eight
exceptions to the information blocking prohibition.
Regulated actors who violate the information blocking rule
may be subject to civil monetary penalties.
Health Information Exchange (HIE). Through its
standards work, ONC promotes electronic HIE, allowing](ViewImageLocal?handle=hein.crs/govekxs0001&div=1&collection=&method=preview&ext=.png&size=3)