Health Information Technology for Economic and
Clinical Health (HITECH)Knowledge Activity and
History of Electronic Health Records (EHRs)-
Baccalaureate
Student instructions
1. If you have questions about this activity, please contact your instructor for assistance.
2. You will review the chart of Anna Danielski to complete this activity. Your instructor has
provided you with a link to the HITECH and the History of EHRs (BS) activity. Click on 2:
Launch EHR to review the patient chart and begin this activity.
3. Refer to the patient chart and any suggested resources to complete this activity.
4. Document your answers directly on this activity document as you complete the activity.
When you are finished, you will save this activity document to your device and upload
this activity document with your answers to your Learning Management System (LMS).
Learning objectives
1. Compare diverse stakeholder perspectives through the delivery of health care services
(5)
The activity
A Brief History of EHRs
EHRs have their roots in the 1960s, when keyboards and video display terminals provided
significant technological advances. Prior to the 1960s, medical records were kept on paper and
manually filed. With this new technology, some innovative thinkers in the healthcare industry
began the quest to improve healthcare delivery with this new technology. One of the notable
early advancements was the creation of a clinical information system by Lockheed Corporation.
Soon, academic medical centers and universities were creating their own systems. The federal
government became involved with EHRs when the Department of Veteran Affairs implemented
VistA in the 1970s. VistA was used in VA centers across the United States and in many other
healthcare organizations worldwide. (Tripathi, 2012)
A report released by the Institute of Medicine in 1991 recognized implementation of EHRs “as
one of seven key recommendations for improving patient records, and to propose a means of
converting paper to electronic records.” (Marquez, 2017)
1
, Key Attributes of a Computer-Based Patient Record
The 1991 first edition of The Computer-Based Patient Record: An Essential Technology for
Healthcare, and its second edition from 1997, set the gold standard for features that should be
available in electronic health records. (Institute of Medicine, 1991). The 12 attributes outlined
by the book, listed below, are still valid and necessary today.
• Problem list and current status of each
• Systematic measurement and recording of patient's health status and functional level to
promote more precise and routine assessment of the outcomes of patient care
• Documents clinical rationale for diagnosis and management
• Life time clinical record (longitudinal)
• Addresses confidentiality
• Accessible in a timely way at any and all times by authorized individuals
• Allows selective retrieval and formaṄng of information by users
• Linked to local and remote knowledge to support decision making
• Decision analysis tools, clinical reminders, prognostic risk assessment, and other clinical
aids
• Supports structured data collection and stores information using a defined vocabulary.
Supports direct data entry by practitioners
• Helps individual practitioners and health care providers institutions manage and
evaluate the quality and costs of care
• Sufficiently flexible and expandable to support not only today's basic information needs
but also the evolving needs of each clinical specialty and subspecialty
(Institute of Medicine, 1997)
EHRs made huge strides in the 2000s after these attributes were established. In 2004, the Office
of the National Coordinator of Health Information Technology (ONC) was created, and, not long
after, the Health Information Technology for Economic and Clinical Health Act (HITECH) was
passed (HeathIT.gov). The ONC was renamed the “Assistant Secretary for Technology Policy and
Office of the National Coordinator for Health Information Technology (hereafter ASTP)”
effective July 2024. The ASTP is the lead federal office charged with coordination of nationwide
efforts to implement and use the most advanced health information technology and the
electronic exchange of health information (www.healthit.gov).
The HITECH Act
2
Clinical Health (HITECH)Knowledge Activity and
History of Electronic Health Records (EHRs)-
Baccalaureate
Student instructions
1. If you have questions about this activity, please contact your instructor for assistance.
2. You will review the chart of Anna Danielski to complete this activity. Your instructor has
provided you with a link to the HITECH and the History of EHRs (BS) activity. Click on 2:
Launch EHR to review the patient chart and begin this activity.
3. Refer to the patient chart and any suggested resources to complete this activity.
4. Document your answers directly on this activity document as you complete the activity.
When you are finished, you will save this activity document to your device and upload
this activity document with your answers to your Learning Management System (LMS).
Learning objectives
1. Compare diverse stakeholder perspectives through the delivery of health care services
(5)
The activity
A Brief History of EHRs
EHRs have their roots in the 1960s, when keyboards and video display terminals provided
significant technological advances. Prior to the 1960s, medical records were kept on paper and
manually filed. With this new technology, some innovative thinkers in the healthcare industry
began the quest to improve healthcare delivery with this new technology. One of the notable
early advancements was the creation of a clinical information system by Lockheed Corporation.
Soon, academic medical centers and universities were creating their own systems. The federal
government became involved with EHRs when the Department of Veteran Affairs implemented
VistA in the 1970s. VistA was used in VA centers across the United States and in many other
healthcare organizations worldwide. (Tripathi, 2012)
A report released by the Institute of Medicine in 1991 recognized implementation of EHRs “as
one of seven key recommendations for improving patient records, and to propose a means of
converting paper to electronic records.” (Marquez, 2017)
1
, Key Attributes of a Computer-Based Patient Record
The 1991 first edition of The Computer-Based Patient Record: An Essential Technology for
Healthcare, and its second edition from 1997, set the gold standard for features that should be
available in electronic health records. (Institute of Medicine, 1991). The 12 attributes outlined
by the book, listed below, are still valid and necessary today.
• Problem list and current status of each
• Systematic measurement and recording of patient's health status and functional level to
promote more precise and routine assessment of the outcomes of patient care
• Documents clinical rationale for diagnosis and management
• Life time clinical record (longitudinal)
• Addresses confidentiality
• Accessible in a timely way at any and all times by authorized individuals
• Allows selective retrieval and formaṄng of information by users
• Linked to local and remote knowledge to support decision making
• Decision analysis tools, clinical reminders, prognostic risk assessment, and other clinical
aids
• Supports structured data collection and stores information using a defined vocabulary.
Supports direct data entry by practitioners
• Helps individual practitioners and health care providers institutions manage and
evaluate the quality and costs of care
• Sufficiently flexible and expandable to support not only today's basic information needs
but also the evolving needs of each clinical specialty and subspecialty
(Institute of Medicine, 1997)
EHRs made huge strides in the 2000s after these attributes were established. In 2004, the Office
of the National Coordinator of Health Information Technology (ONC) was created, and, not long
after, the Health Information Technology for Economic and Clinical Health Act (HITECH) was
passed (HeathIT.gov). The ONC was renamed the “Assistant Secretary for Technology Policy and
Office of the National Coordinator for Health Information Technology (hereafter ASTP)”
effective July 2024. The ASTP is the lead federal office charged with coordination of nationwide
efforts to implement and use the most advanced health information technology and the
electronic exchange of health information (www.healthit.gov).
The HITECH Act
2
