[Weekly Compilation of Presidential Documents Volume 40, Number 18 (Monday, May 3, 2004)]
[Pages 702-704]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Executive Order 13335--Incentives for the Use of Health Information 
Technology and Establishing the Position of the National Health 
Information Technology Coordinator

April 27, 2004

    By the authority vested in me as President by the Constitution and 
the laws of the United States of America, and to provide leadership for 
the development and nationwide implementation of an interoperable health 
information technology infrastructure to improve the quality and 
efficiency of health care, it is hereby ordered as follows:
    Section 1. Establishment. (a) The Secretary of Health and Human 
Services (Secretary) shall establish within the Office of the Secretary 
the position of National Health Information Technology Coordinator.
    (b) The National Health Information Technology Coordinator (National 
Coordinator), appointed by the Secretary in consultation with the 
President or his designee, will report directly to the Secretary.
    (c) The Secretary shall provide the National Coordinator with 
appropriate staff, administrative support, and other resources to meet 
its responsibilities under this order.
    (d) The Secretary shall ensure that the National Coordinator begins 
operations within 90 days of the date of this order.

[[Page 703]]

    Sec. 2. Policy. In fulfilling its responsibilities, the work of the 
National Coordinator shall be consistent with a vision of developing a 
nationwide interoperable health information technology infrastructure 
that:
    (a) Ensures that appropriate information to guide medical decisions 
is available at the time and place of care;
    (b) Improves health care quality, reduces medical errors, and 
advances the delivery of appropriate, evidence-based medical care;
    (c) Reduces health care costs resulting from inefficiency, medical 
errors, inappropriate care, and incomplete information;
    (d) Promotes a more effective marketplace, greater competition, and 
increased choice through the wider availability of accurate information 
on health care costs, quality, and outcomes;
    (e) Improves the coordination of care and information among 
hospitals, laboratories, physician offices, and other ambulatory care 
providers through an effective infrastructure for the secure and 
authorized exchange of health care information; and
    (f) Ensures that patients' individually identifiable health 
information is secure and protected.
    Sec. 3. Responsibilities of the National Health Information 
Technology Coordinator. (a) The National Coordinator shall, to the 
extent permitted by law, develop, maintain, and direct the 
implementation of a strategic plan to guide the nationwide 
implementation of interoperable health information technology in both 
the public and private health care sectors that will reduce medical 
errors, improve quality, and produce greater value for health care 
expenditures. The National Coordinator shall report to the Secretary 
regarding progress on the development and implementation of the 
strategic plan within 90 days after the National Coordinator begins 
operations and periodically thereafter. The plan shall:
    (i) Advance the development, adoption, and implementation of health 
      care information technology standards nationally through 
      collaboration among public and private interests, and consistent 
      with current efforts to set health information technology 
      standards for use by the Federal Government;
    (ii) Ensure that key technical, scientific, economic, and other 
      issues affecting the public and private adoption of health 
      information technology are addressed;
    (iii) Evaluate evidence on the benefits and costs of interoperable 
      health information technology and assess to whom these benefits 
      and costs accrue;
    (iv) Address privacy and security issues related to interoperable 
      health information technology and recommend methods to ensure 
      appropriate authorization, authentication, and encryption of data 
      for transmission over the Internet;
    (v) Not assume or rely upon additional Federal resources or spending 
      to accomplish adoption of interoperable health information 
      technology; and
    (vi) Include measurable outcome goals.
    (b) The National Coordinator shall:
    (i) Serve as the Secretary's principal advisor on the development, 
      application, and use of health information technology, and direct 
      the Department of Health and Human Service's health information 
      technology programs;
    (ii) Ensure that health information technology policy and programs 
      of the Department of Health and Human Services (HHS) are 
      coordinated with those of relevant executive branch agencies 
      (including Federal commissions) with a goal of avoiding 
      duplication of efforts and of helping to ensure that each agency 
      undertakes activities primarily within the areas of its greatest 
      expertise and technical capability;
    (iii) To the extent permitted by law, coordinate outreach and 
      consultation by the relevant executive branch agencies (including 
      Federal commissions) with public and private parties of interest, 
      including consumers, providers, payers, and administrators; and
    (iv) At the request of the Office of Management and Budget, provide 
      comments and advice regarding specific Federal health information 
      technology programs.
    Sec. 4. Reports. To facilitate the development of interoperable 
health information technologies, the Secretary of Health and Human 
Services shall report to the President

[[Page 704]]

within 90 days of this order on options to provide incentives in HHS 
programs that will promote the adoption of interoperable health 
information technology. In addition, the following reports shall be 
submitted to the President through the Secretary:
    (a) The Director of the Office of Personnel Management shall report 
within 90 days of this order on options to provide incentives in the 
Federal Employee Health Benefit Program that will promote the adoption 
of interoperable health information technology; and
    (b) Within 90 days, the Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly report on the approaches the 
Departments could take to work more actively with the private sector to 
make their health information systems available as an affordable option 
for providers in rural and medically underserved communities.
    Sec. 5. Administration and Judicial Review. (a) The actions directed 
by this order shall be carried out subject to the availability of 
appropriations and to the extent permitted by law.
    (b) This order is not intended to, and does not, create any right or 
benefit, substantive or procedural, enforceable at law or in equity 
against the United States, its agencies, its entities or 
instrumentalities, its officers or employees, or any other person.
                                                George W. Bush
 The White House,
 April 27, 2004.

 [Filed with the Office of the Federal Register, 8:45 a.m., April 29, 
2004]

Note: This Executive order was published in the Federal Register on 
April 30.