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1965: The First Hospital Information Systems
Lockheed's early HIS automated hospital administrative tasks like billing and scheduling, known as the Technicon Medical Information System. This started the wave of digitization in healthcare, improving efficiency. “Technicon Medical Information System (TMIS).” Clinfowiki. https://www.clinfowiki.org/wiki/index.php/Technicon_Medical_Information_System_(TMIS). -
1973: Health Maintenance Organization ACT (HMO)
The HMO Act of 1973 incentivized the creation of HMOs, requiring data systems for patient care, tracking, cost management, preventative care, healthcare access, cost control, and reporting to federal oversight. It drove early adoption of HIT in HMOs such as automated patient records. https://www.ssa.gov/policy/docs/ssb/v37n3/v37n3p35.pdf -
1987: HL7 Standards Organization Founded
Health Level Seven began developing standards for health data exchange. It enabled interoperability, connecting different systems, to "change, integrate, share, and retrieve electronic health information." “Health Level Seven—HL7.” ScienceDirect Topics in Biochemistry, Genetics and Molecular Biology. n.d. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/health-level-7. -
1991: IOM Report on Computer-Based Patient Records
The Institute of Medicine advocated for electronic patient records. It shaped HIT policy and promoted EHR adoption. There were challenges in costs and provider resistance, but solutions with increased HIT funding. Institute of Medicine. Computer-Based Patient Record: An Essential Technology for Health Care. Washington, DC: National Academies Press, 1991. https://doi.org/10.17226/18459. -
2004: Office of the National Coordinator for Health IT Established
This was created to coordinate HIT and promote EHRs. It was created in "developing a nationwide interoperability health information technology infrastructure...and to improve the healthcare experience for all Americans." U.S. Department of Health and Human Services, “Celebrating 20 Years of Transforming Health IT and Interoperability,” HealthIT.gov, November 4, 2024, https://www.healthit.gov/20years/. -
2009: HITECH Act
The HITECH Act provided $19.2 billion dollars for EHR adoption, with strict criteria for meaningful use. It boosted EHR adoption from in the single digits to 96%. It advanced HIT and had significant provisions that impacted it such as privacy and security. Alder, Steve. “What Is the HITECH Act?” HIPAA Journal, April 3, 2025. https://www.hipaajournal.com/what-is-the-hitech-act/. -
2011: FHIR Standards Introduced
Fast Healthcare Interoperability Resources simplified data exchange. They enabled modern HIEs and health apps. There was inconsistent adoption but there ended up being industry wide implementation. It provides "basic resources, frameworks...and a platform in which different solutions can be implemented." Carina Nina Vorisek et al. "Fast Healthcare Interoperability Resources (FHIR) for Interoperability in Health Research: Systematic Review," July 19 2022
e35724, https://doi.org/10.2196/35724. -
2020: Telehealth Surge During COVID-19
Many platforms drove Telehealth adoption due to the Covid-19 pandemic. This expanded care access, integrated with eHRs. There has been infrastructure and equity issues, as well as improved outcomes however it also lead to policy changes and a focus on accessibility. Shaver, Julia. 2022. "The State of Telehealth Before and After the COVID-19 Pandemic." Primary Care Reports 49, no. 4 (December 2022): 517–530. https://doi.org/10.1016/j.pop.2022.04.002.