HITECH Act and electronic health records

In 2008 fewer than 10 percent of US non-federal acute care hospitals used an electronic health record that met even a basic definition, according to the Office of the National Coordinator for Health Information Technology (ONC). Among office-based physicians the share was under 20 percent.

On 17 February 2009 the American Recovery and Reinvestment Act became law. Within it, the Health Information Technology for Economic and Clinical Health (HITECH) Act gave the Department of Health and Human Services authority to build programs that would improve the quality, safety and efficiency of care through health information technology, including electronic health records and private, secure exchange of health information. A federal certification program for EHR products began in 2010. In 2011 the Medicare and Medicaid EHR Incentive Programs started paying eligible hospitals, critical access hospitals and professionals to adopt certified technology and use it meaningfully.

Adoption rose quickly once the payments started. By 2018, 99 percent of hospitals reported using a certified EHR, and the figure was 99.4 percent in 2024. In 2024, 95 percent of office-based physicians reported using some EHR and 91 percent used a certified one. ONC's analysts concluded that the combined efforts of HHS and the HITECH programs had moved nearly all non-federal acute care hospitals to certified EHR technology.

The programs were later reorganized. In 2015 the Medicare Access and CHIP Reauthorization Act closed the Medicare incentive program for individual clinicians and folded similar requirements into a performance category now called Promoting Interoperability, while the hospital program continued under that name. ONC went on to carry out the 21st Century Cures Act's provisions on interoperability and on prohibiting information blocking, rules that apply to these electronic records.