ExecutiveOrdersEO
EO 13335Executive OrderG.W. Bush · R Quiet signal

Executive Order 13335

Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator

This executive order creates the position of National Health Information Technology Coordinator within HHS to lead development of a nationwide interoperable health IT infrastructure. It mandates multiple reports within 90 days on incentives for health IT adoption and directs the Coordinator to produce a strategic plan for reducing medical errors and improving care quality through technology.

Federal Register Open PDF 69 FR 24059

Impact dates

  1. National Coordinator begins operations

  2. HHS Secretary report on incentive options

  3. OPM report on FEHB incentives

  4. VA/DoD joint report on rural health IT collaboration

  5. First strategic plan progress report (due 90 days after operations begin, so ~180 days from signing if operations start at day 90)

Key directives

  • Establish National Health Information Technology Coordinator position reporting directly to HHS Secretary
  • National Coordinator begins operations within 90 days
  • Develop strategic plan for nationwide interoperable health IT with measurable outcome goals
  • Strategic plan must not assume additional federal spending
  • HHS Secretary report on incentive options within 90 days
  • OPM report on FEHB incentives within 90 days
  • VA and DoD joint report on rural/private sector collaboration within 90 days
  • First progress report within 90 days after operations begin

Who is ordered

Timeline

Immediate

  • National Coordinator position established within HHS Office of the Secretary

Near term (90d)

  • National Coordinator must begin operations
  • HHS Secretary report on incentive options
  • OPM report on FEHB incentives
  • VA/DoD joint report on rural health IT systems
  • First strategic plan progress report due after operations begin

Long term

  • Nationwide interoperable health IT infrastructure development
  • Ongoing strategic plan implementation and periodic reporting

Risks & tensions

  • No additional federal resources assumption creates tension with ambitious nationwide infrastructure goals
  • Privacy/security mandates (Sec. 2(f), 3(a)(iv)) conflict with interoperability objectives requiring data sharing
  • Coordination across HHS, VA, DoD, OPM requires interagency cooperation that may face bureaucratic friction
  • Vague 'periodically thereafter' reporting lacks enforcement mechanism
  • Subject to appropriations clause may limit implementation if Congress does not fund
Executive Order 13335: Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator · Executive Orders