ONC Staff:
 
As you know, I have told Secretary Sebelius that I will be returning to my academic home this spring, as was planned when I accepted the position of National Coordinator for Health Information Technology.  While we still have important work to do together, including the assurance of a productive transition for ONC, now is the time for me to express my deep gratitude to all of my ONC colleagues, and my admiration for all you have accomplished.
 
We have been privileged to be at the center of a great new enterprise at an historic moment in our health care system.  For years America’s health policy leaders have understood that information technology offered the opportunity for transformational improvement of the Nation’s health care system and the health of individual Americans.  Yet the obstacles are formidable: our fractured health care system, our dysfunctional payment methods, the lack of an infrastructure for exchanging health information, and more.
 
The enactment of the Health Information Technology Economic and Clinical Health Act of 2009 handed us a rare opportunity to transcend these obstacles and to create a foundation, a strategy, and a self-sustaining movement toward a future of HIT-assisted health care.  I believe we have effectively seized that opportunity, and you deserve the credit for this achievement.
 
Much attention has gone to the unprecedented resource commitment made by Congress and the President in HITECH – the allocation of as much as $27 billion in incentive payments to help support adoption of EHRs.  The money is indeed crucial, and the Center for Medicare and Medicaid Services is doing a great job of putting it to use.
 
But I believe the key factor for success has been, and will continue to be, the concept of “meaningful use.”  The HITECH Act recognized that EHR adoption alone would not bring about the transformative improvements that are possible with health information technology.   EHRs must be used to support a new kind of information-rich health care. Meaningful use provides, for the first time ever, a consensus goal on how information should be used to enhance care.  To realize its promise also  requires changes in the processes of care delivery.  HITECH gave ONC a major role in assisting health professionals and institutions to make these critical changes in the way care is delivered and we have begun this work in earnest.
 
We have successfully put in place the $2 billion support system created by HITECH, including:

• Sixty-two Regional Extension Centers (REC), providing assistance to providers nationwide, with special attention to smaller primary care practices and rural hospitals.
• Eight-four community college programs to provide HIT training and build a vitally-needed HIT workforce, including training for nurses, physician assistants and other in-place health care workers.
• Seventeen Beacon communities, demonstrating how HIT can help bring community resources together to tackle specific local health needs.
• State grants to support local solutions for health information exchange, consonant with broader national standards.
• A program of research and development to help us continually improve EHRs and move quickly to the next level in HIT.

It is the efforts of the ONC staff, working cooperatively with the health care professions, the states, and so many others that have brought these programs quickly into being. They are now up and running.  And we are already seeing  results that indicate that the national shift to EHRs and HIT-assisted care is finally underway:
 

• Adoption itself has turned up: from 2008 to 2010, the proportion of primary care physicians who had adopted a basic EHR increase by half, from 19.6 percent to 29.6 percent.
• A significant proportion of providers were already indicating in the latter part of 2010 that they plan to achieve meaningful use objectives and qualify for incentive payments:  81 percent of hospitals, and 41 percent of office-based physicians.
• A total of 291 EHR products have already been certified to support meaningful use objectives and qualify for use under the incentive payments program.
• Some 38,000 providers have enrolled in REC assistance programs.
• Community college programs will “graduate” an initial class of 3,400 HIT-trained students this spring, working toward a total capacity of 10,500 in each six-month session.
• We have achieved these accomplishments together, as a hard-working team with a unique opportunity to make a difference.

On a personal note, I have profoundly enjoyed getting to know you and work with you. It has been one of the highlights of my professional life. And I am confident that the progress will continue and even accelerate after I have settled back into academic life in Boston.
 
Best wishes to you all.
 
David

Click on the next page to read HHS Secretary Kathleen Sebelius' email to HHS Leadership and ONC staff.