Executive Order 13335 of April 27, 2004

 
                Incentives for the Use of Health Information 
                Technology and Establishing the Position of the 
                National Health Information Technology Coordinator

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, and to provide leadership for the development 
                and nationwide implementation of an interoperable 
                health information technology infrastructure to improve 
                the quality and efficiency of health care, it is hereby 
                ordered as follows:

                Section 1. Establishment. (a) The Secretary of Health 
                and Human Services (Secretary) shall establish within 
                the Office of the Secretary the position of National 
                Health Information Technology Coordinator.

                    (b) The National Health Information Technology 
                Coordinator (National Coordinator), appointed by the 
                Secretary in consultation with the President or his 
                designee, will report directly to the Secretary.
                    (c) The Secretary shall provide the National 
                Coordinator with appropriate staff, administrative 
                support, and other resources to meet its 
                responsibilities under this order.
                    (d) The Secretary shall ensure that the National 
                Coordinator begins operations within 90 days of the 
                date of this order.

                Sec. 2. Policy. In fulfilling its responsibilities, the 
                work of the National Coordinator shall be consistent 
                with a vision of developing a nationwide interoperable 
                health information technology infrastructure that:

                    (a) Ensures that appropriate information to guide 
                medical decisions is available at the time and place of 
                care;
                    (b) Improves health care quality, reduces medical 
                errors, and advances the delivery of appropriate, 
                evidence-based medical care;
                    (c) Reduces health care costs resulting from 
                inefficiency, medical errors, inappropriate care, and 
                incomplete information;
                    (d) Promotes a more effective marketplace, greater 
                competition, and increased choice through the wider 
                availability of accurate information on health care 
                costs, quality, and outcomes;
                    (e) Improves the coordination of care and 
                information among hospitals, laboratories, physician 
                offices, and other ambulatory care providers through an 
                effective infrastructure for the secure and authorized 
                exchange of health care information; and
                    (f) Ensures that patients' individually 
                identifiable health information is secure and 
                protected.

                Sec. 3. Responsibilities of the National Health 
                Information Technology Coordinator. (a) The National 
                Coordinator shall, to the extent permitted by law, 
                develop, maintain, and direct the implementation of a 
                strategic plan to guide the nationwide implementation 
                of interoperable health information technology in both 
                the public and private health care sectors that will 
                reduce medical errors, improve quality, and produce 
                greater value for health care expenditures. The 
                National Coordinator shall report to the Secretary 
                regarding progress on the development and 
                implementation of the strategic plan within 90 days 
                after the National Coordinator begins operations and 
                periodically thereafter. The plan shall:

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(i)

 Advance the development, adoption, and implementation of health care 
information technology standards nationally through collaboration among 
public and private interests, and consistent with current efforts to set 
health information technology standards for use by the Federal Government;

(ii)

 Ensure that key technical, scientific, economic, and other issues 
affecting the public and private adoption of health information technology 
are addressed;

(iii)

 Evaluate evidence on the benefits and costs of interoperable health 
information technology and assess to whom these benefits and costs accrue;

(iv)

 Address privacy and security issues related to interoperable health 
information technology and recommend methods to ensure appropriate 
authorization, authentication, and encryption of data for transmission over 
the Internet;

(v)

 Not assume or rely upon additional Federal resources or spending to 
accomplish adoption of interoperable health information technology; and

(vi)

 Include measurable outcome goals.

                    (b) The National Coordinator shall:

(i)

 Serve as the Secretary's principal advisor on the development, 
application, and use of health information technology, and direct the 
Department of Health and Human Service's health information technology 
programs;

(ii)

 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 (including Federal commissions) with a 
goal of avoiding duplication of efforts and of helping to ensure that each 
agency undertakes activities primarily within the areas of its greatest 
expertise and technical capability;

(iii)

 To the extent permitted by law, coordinate outreach and consultation by 
the relevant executive branch agencies (including Federal commissions) with 
public and private parties of interest, including consumers, providers, 
payers, and administrators; and

(iv)

 At the request of the Office of Management and Budget, provide comments 
and advice regarding specific Federal health information technology 
programs.

                Sec. 4. Reports. To facilitate the development of 
                interoperable health information technologies, the 
                Secretary of Health and Human Services shall report to 
                the President within 90 days of this order on options 
                to provide incentives in HHS programs that will promote 
                the adoption of interoperable health information 
                technology. In addition, the following reports shall be 
                submitted to the President through the Secretary:

                    (a) The Director of the Office of Personnel 
                Management shall report within 90 days of this order on 
                options to provide incentives in the Federal Employee 
                Health Benefit Program that will promote the adoption 
                of interoperable health information technology; and
                    (b) Within 90 days, the Secretary of Veterans 
                Affairs and the Secretary of Defense shall jointly 
                report on the approaches the Departments could take to 
                work more actively with the private sector to make 
                their health information systems available as an 
                affordable option for providers in rural and medically 
                underserved communities.

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                Sec. 5. Administration and Judicial Review. (a) The 
                actions directed by this order shall be carried out 
                subject to the availability of appropriations and to 
                the extent permitted by law.

                    (b) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity against the United 
                States, its agencies, its entities or 
                instrumentalities, its officers or employees, or any 
                other person.

                    (Presidential Sig.)B

                THE WHITE HOUSE,

                     April 27, 2004.