398 
tion 3001(c)(5) as meeting standards adopted under 
section 3004 that are applicable to the type of 
record involved (as determined by the Secretary, 
such as an ambulatory electronic health record for 
office-based physicians or an inpatient hospital elec-
tronic health record for hospitals). 
‘‘(2) ENTERPRISE
INTEGRATION.—The term 
‘enterprise integration’ means the electronic linkage 
of health care providers, health plans, the govern-
ment, and other interested parties, to enable the 
electronic exchange and use of health information 
among all the components in the health care infra-
structure in accordance with applicable law, and 
such term includes related application protocols and 
other related standards. 
‘‘(3) HEALTH
CARE
PROVIDER.—The term 
‘health care provider’ means a hospital, skilled nurs-
ing facility, nursing facility, home health entity or 
other long term care facility, health care clinic, Fed-
erally qualified health center, group practice (as de-
fined in section 1877(h)(4) of the Social Security 
Act), a pharmacist, a pharmacy, a laboratory, a phy-
sician (as defined in section 1861(r) of the Social 
Security Act), a practitioner (as described in section 
1842(b)(18)(C) of the Social Security Act), a pro-
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vider operated by, or under contract with, the Indian 
Health Service or by an Indian tribe (as defined in 
the Indian Self-Determination and Education Assist-
ance Act), tribal organization, or urban Indian orga-
nization (as defined in section 4 of the Indian 
Health Care Improvement Act), a rural health clinic, 
a covered entity under section 340B, an ambulatory 
surgical center described in section 1833(i) of the 
Social Security Act, and any other category of facil-
ity or clinician determined appropriate by the Sec-
retary. 
‘‘(4) HEALTH INFORMATION.—The term ‘health 
information’ has the meaning given such term in 
section 1171(4) of the Social Security Act. 
‘‘(5) HEALTH
INFORMATION
TECHNOLOGY.— 
The term ‘health information technology’ means 
hardware, software, integrated technologies and re-
lated licenses, intellectual property, upgrades, and 
packaged solutions sold as services that are specifi-
cally designed for use by health care entities for the 
electronic creation, maintenance, or exchange of 
health information. 
‘‘(6) HEALTH PLAN.—The term ‘health plan’ 
has the meaning given such term in section 1171(5) 
of the Social Security Act. 
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‘‘(7) HIT POLICY COMMITTEE.—The term ‘HIT 
Policy Committee’ means such Committee estab-
lished under section 3002(a). 
‘‘(8) HIT STANDARDS COMMITTEE.—The term 
‘HIT Standards Committee’ means such Committee 
established under section 3003(a). 
‘‘(9) INDIVIDUALLY IDENTIFIABLE HEALTH IN-
FORMATION.—The term ‘individually identifiable 
health information’ has the meaning given such term 
in section 1171(6) of the Social Security Act. 
‘‘(10) LABORATORY.—The term ‘laboratory’ 
has the meaning given such term in section 353(a). 
‘‘(11) NATIONAL
COORDINATOR.—The term 
‘National Coordinator’ means the head of the Office 
of the National Coordinator for Health Information 
Technology established under section 3001(a). 
‘‘(12) PHARMACIST.—The term ‘pharmacist’ 
has the meaning given such term in section 804(2) 
of the Federal Food, Drug, and Cosmetic Act. 
‘‘(13) 
QUALIFIED
ELECTRONIC
HEALTH 
RECORD.—The term ‘qualified electronic health 
record’ means an electronic record of health-related 
information on an individual that— 
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‘‘(A) includes patient demographic and 
clinical health information, such as medical his-
tory and problem lists; and 
‘‘(B) has the capacity— 
‘‘(i) to provide clinical decision sup-
port; 
‘‘(ii) to support physician order entry; 
‘‘(iii) to capture and query informa-
tion relevant to health care quality; and 
‘‘(iv) to exchange electronic health in-
formation with, and integrate such infor-
mation from other sources. 
‘‘(14) STATE.—The term ‘State’ means each of 
the several States, the District of Columbia, Puerto 
Rico, the Virgin Islands, Guam, American Samoa, 
and the Northern Mariana Islands. 
‘‘Subtitle A—Promotion of Health 
Information Technology 
‘‘SEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR 
HEALTH INFORMATION TECHNOLOGY. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services an Office 
of the National Coordinator for Health Information Tech-
nology (referred to in this section as the ‘Office’). The Of-
fice shall be headed by a National Coordinator who shall 
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be appointed by the Secretary and shall report directly to 
the Secretary. 
‘‘(b) PURPOSE.—The National Coordinator shall per-
form the duties under subsection (c) in a manner con-
sistent with the development of a nationwide health infor-
mation technology infrastructure that allows for the elec-
tronic use and exchange of information and that— 
‘‘(1) ensures that each patient’s health informa-
tion is secure and protected, in accordance with ap-
plicable law; 
‘‘(2) improves health care quality, reduces med-
ical errors, reduces health disparities, and advances 
the delivery of patient-centered medical care; 
‘‘(3) reduces health care costs resulting from 
inefficiency, medical errors, inappropriate care, du-
plicative care, and incomplete information; 
‘‘(4) provides appropriate information to help 
guide medical decisions at the time and place of 
care; 
‘‘(5) ensures the inclusion of meaningful public 
input in such development of such infrastructure; 
‘‘(6) improves the coordination of care and in-
formation among hospitals, laboratories, physician 
offices, and other entities through an effective infra-
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structure for the secure and authorized exchange of 
health care information; 
‘‘(7) improves public health activities and facili-
tates the early identification and rapid response to 
public health threats and emergencies, including bio-
terror events and infectious disease outbreaks; 
‘‘(8) facilitates health and clinical research and 
health care quality; 
‘‘(9) promotes prevention of chronic diseases; 
‘‘(10) promotes a more effective marketplace, 
greater competition, greater systems analysis, in-
creased consumer choice, and improved outcomes in 
health care services; and 
‘‘(11) improves efforts to reduce health dispari-
ties. 
‘‘(c) DUTIES OF THE NATIONAL COORDINATOR.— 
‘‘(1) STANDARDS.—The National Coordinator 
shall review and determine whether to endorse each 
standard, implementation specification, and certifi-
cation criterion for the electronic exchange and use 
of health information that is recommended by the 
HIT Standards Committee under section 3003 for 
purposes of adoption under section 3004. The Coor-
dinator shall make such determination, and report to 
the Secretary such determination, not later than 45 
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days after the date the recommendation is received 
by the Coordinator. 
‘‘(2) HIT POLICY COORDINATION.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator shall coordinate health information tech-
nology policy and programs of the Department 
with those of other relevant executive branch 
agencies with a goal of avoiding duplication of 
efforts and of helping to ensure that each agen-
cy undertakes health information technology ac-
tivities primarily within the areas of its greatest 
expertise and technical capability and in a man-
ner towards a coordinated national goal. 
‘‘(B) HIT POLICY AND STANDARDS COM-
MITTEES.—The National Coordinator shall be a 
leading member in the establishment and oper-
ations of the HIT Policy Committee and the 
HIT Standards Committee and shall serve as a 
liaison among those two Committees and the 
Federal Government. 
‘‘(3) STRATEGIC PLAN.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator shall, in consultation with other appro-
priate Federal agencies (including the National 
Institute of Standards and Technology), update 
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the Federal Health IT Strategic Plan (devel-
oped as of June 3, 2008) to include specific ob-
jectives, milestones, and metrics with respect to 
the following: 
‘‘(i) The electronic exchange and use 
of health information and the enterprise 
integration of such information. 
‘‘(ii) The utilization of an electronic 
health record for each person in the United 
States by 2014. 
‘‘(iii) The incorporation of privacy and 
security protections for the electronic ex-
change of an individual’s individually iden-
tifiable health information. 
‘‘(iv) Ensuring security methods to 
ensure appropriate authorization and elec-
tronic authentication of health information 
and specifying technologies or methodolo-
gies for rendering health information unus-
able, unreadable, or indecipherable. 
‘‘(v) Specifying a framework for co-
ordination and flow of recommendations 
and policies under this subtitle among the 
Secretary, the National Coordinator, the 
HIT Policy Committee, the HIT Standards 
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Committee, and other health information 
exchanges and other relevant entities. 
‘‘(vi) Methods to foster the public un-
derstanding of health information tech-
nology. 
‘‘(vii) Strategies to enhance the use of 
health information technology in improving 
the quality of health care, reducing medical 
errors, reducing health disparities, improv-
ing public health, and improving the con-
tinuity of care among health care settings. 
‘‘(B) 
COLLABORATION.—The 
strategic 
plan shall be updated through collaboration of 
public and private entities. 
‘‘(C) MEASURABLE
OUTCOME
GOALS.— 
The strategic plan update shall include measur-
able outcome goals. 
‘‘(D) PUBLICATION.—The National Coor-
dinator shall republish the strategic plan, in-
cluding all updates. 
‘‘(4) WEBSITE.—The National Coordinator 
shall maintain and frequently update an Internet 
website on which there is posted information on the 
work, schedules, reports, recommendations, and 
other information to ensure transparency in pro-
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motion of a nationwide health information tech-
nology infrastructure. 
‘‘(5) CERTIFICATION.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator, in consultation with the Director of the 
National Institute of Standards and Tech-
nology, shall develop a program (either directly 
or by contract) for the voluntary certification of 
health information technology as being in com-
pliance with applicable certification criteria 
adopted under this subtitle. Such program shall 
include testing of the technology in accordance 
with section 4201(b) of the HITECH Act. 
‘‘(B) 
CERTIFICATION
CRITERIA
DE-
SCRIBED.—In this title, the term ‘certification 
criteria’ means, with respect to standards and 
implementation specifications for health infor-
mation technology, criteria to establish that the 
technology meets such standards and implemen-
tation specifications. 
‘‘(6) REPORTS AND PUBLICATIONS.— 
‘‘(A) REPORT
ON
ADDITIONAL
FUNDING 
OR AUTHORITY NEEDED.—Not later than 12 
months after the date of the enactment of this 
title, the National Coordinator shall submit to 
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the appropriate committees of jurisdiction of 
the House of Representatives and the Senate a 
report on any additional funding or authority 
the Coordinator or the HIT Policy Committee 
or HIT Standards Committee requires to evalu-
ate and develop standards, implementation 
specifications, and certification criteria, or to 
achieve full participation of stakeholders in the 
adoption of a nationwide health information 
technology infrastructure that allows for the 
electronic use and exchange of health informa-
tion. 
‘‘(B) 
IMPLEMENTATION
REPORT.—The 
National Coordinator shall prepare a report 
that identifies lessons learned from major pub-
lic and private health care systems in their im-
plementation of health information technology, 
including information on whether the tech-
nologies and practices developed by such sys-
tems may be applicable to and usable in whole 
or in part by other health care providers. 
‘‘(C) ASSESSMENT OF IMPACT OF HIT ON 
COMMUNITIES WITH HEALTH DISPARITIES AND 
UNINSURED, UNDERINSURED, AND MEDICALLY 
UNDERSERVED AREAS.—The National Coordi-
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nator shall assess and publish the impact of 
health information technology in communities 
with health disparities and in areas with a high 
proportion of individuals who are uninsured, 
underinsured, and medically underserved indi-
viduals (including urban and rural areas) and 
identify practices to increase the adoption of 
such technology by health care providers in 
such communities. 
‘‘(D) EVALUATION
OF
BENEFITS
AND 
COSTS
OF
THE
ELECTRONIC
USE
AND
EX-
CHANGE OF HEALTH INFORMATION.—The Na-
tional Coordinator shall evaluate and publish 
evidence on the benefits and costs of the elec-
tronic use and exchange of health information 
and assess to whom these benefits and costs ac-
crue. 
‘‘(E) 
RESOURCE
REQUIREMENTS.—The 
National Coordinator shall estimate and publish 
resources required annually to reach the goal of 
utilization of an electronic health record for 
each person in the United States by 2014, in-
cluding the required level of Federal funding, 
expectations for regional, State, and private in-
vestment, and the expected contributions by vol-
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unteers to activities for the utilization of such 
records. 
‘‘(7) ASSISTANCE.—The National Coordinator 
may provide financial assistance to consumer advo-
cacy groups and not-for-profit entities that work in 
the public interest for purposes of defraying the cost 
to such groups and entities to participate under, 
whether in whole or in part, the National Tech-
nology Transfer Act of 1995 (15 U.S.C. 272 note). 
‘‘(8) GOVERNANCE FOR NATIONWIDE HEALTH 
INFORMATION
NETWORK.—The National Coordi-
nator shall establish a governance mechanism for the 
nationwide health information network. 
‘‘(d) DETAIL OF FEDERAL EMPLOYEES.— 
‘‘(1) IN GENERAL.—Upon the request of the 
National Coordinator, the head of any Federal agen-
cy is authorized to detail, with or without reimburse-
ment from the Office, any of the personnel of such 
agency to the Office to assist it in carrying out its 
duties under this section. 
‘‘(2) EFFECT OF DETAIL.—Any detail of per-
sonnel under paragraph (1) shall— 
‘‘(A) not interrupt or otherwise affect the 
civil service status or privileges of the Federal 
employee; and 
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‘‘(B) be in addition to any other staff of 
the Department employed by the National Co-
ordinator. 
‘‘(3) ACCEPTANCE
OF
DETAILEES.—Notwith-
standing any other provision of law, the Office may 
accept detailed personnel from other Federal agen-
cies without regard to whether the agency described 
under paragraph (1) is reimbursed. 
‘‘(e) CHIEF PRIVACY OFFICER OF THE OFFICE OF 
THE
NATIONAL
COORDINATOR.—Not later than 12 
months after the date of the enactment of this title, the 
Secretary shall appoint a Chief Privacy Officer of the Of-
fice of the National Coordinator, whose duty it shall be 
to advise the National Coordinator on privacy, security, 
and data stewardship of electronic health information and 
to coordinate with other Federal agencies (and similar pri-
vacy officers in such agencies), with State and regional 
efforts, and with foreign countries with regard to the pri-
vacy, security, and data stewardship of electronic individ-
ually identifiable health information. 
‘‘SEC. 3002. HIT POLICY COMMITTEE. 
‘‘(a) ESTABLISHMENT.—There is established a HIT 
Policy Committee to make policy recommendations to the 
National Coordinator relating to the implementation of a 
nationwide health information technology infrastructure, 
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including implementation of the strategic plan described 
in section 3001(c)(3). 
‘‘(b) DUTIES.— 
‘‘(1) RECOMMENDATIONS ON HEALTH INFOR-
MATION TECHNOLOGY INFRASTRUCTURE.—The HIT 
Policy Committee shall recommend a policy frame-
work for the development and adoption of a nation-
wide health information technology infrastructure 
that permits the electronic exchange and use of 
health information as is consistent with the strategic 
plan under section 3001(c)(3) and that includes the 
recommendations under paragraph (2). The Com-
mittee shall update such recommendations and make 
new recommendations as appropriate. 
‘‘(2) SPECIFIC AREAS OF STANDARD DEVELOP-
MENT.— 
‘‘(A) IN GENERAL.—The HIT Policy Com-
mittee shall recommend the areas in which 
standards, implementation specifications, and 
certification criteria are needed for the elec-
tronic exchange and use of health information 
for purposes of adoption under section 3004 
and shall recommend an order of priority for 
the development, harmonization, and recogni-
tion of such standards, specifications, and cer-
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tification criteria among the areas so rec-
ommended. Such standards and implementation 
specifications shall include named standards, 
architectures, and software schemes for the au-
thentication and security of individually identifi-
able health information and other information 
as needed to ensure the reproducible develop-
ment of common solutions across disparate en-
tities. 
‘‘(B) AREAS
REQUIRED
FOR
CONSIDER-
ATION.—For purposes of subparagraph (A), the 
HIT Policy Committee shall make recommenda-
tions for at least the following areas: 
‘‘(i) Technologies that protect the pri-
vacy of health information and promote se-
curity in a qualified electronic health 
record, including for the segmentation and 
protection from disclosure of specific and 
sensitive individually identifiable health in-
formation with the goal of minimizing the 
reluctance of patients to seek care (or dis-
close information about a condition) be-
cause of privacy concerns, in accordance 
with applicable law, and for the use and 
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by improving population health, by reduc-
ing health disparities, and by advancing re-
search and education. 
‘‘(vi) Technologies that allow individ-
ually identifiable health information to be 
rendered unusable, unreadable, or indeci-
pherable to unauthorized individuals when 
such information is transmitted in the na-
tionwide health information network or 
physically transported outside of the se-
cured, physical perimeter of a health care 
provider, health plan, or health care clear-
inghouse. 
‘‘(C) 
OTHER
AREAS
FOR
CONSIDER-
ATION.—In making recommendations under 
subparagraph (A), the HIT Policy Committee 
may consider the following additional areas: 
‘‘(i) The appropriate uses of a nation-
wide health information infrastructure, in-
cluding for purposes of— 
‘‘(I) the collection of quality data 
and public reporting; 
‘‘(II) biosurveillance and public 
health; 
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