ONC programs have been created to ensure certain areas within healthcare, progress. A main issue plaguing American healthcare is the electronic health record transition. One ONC program, State HIE, was created to help solve this problem. This program enables the continued progression of health records into electronic health records, ensuring the full transition needed soon (Healthit, 2014). As an NP, this program will allow for a smoother conversion to electronic health records (EHR) especially in key areas like physician/NP documentation. Programs like this aim to improve a longstanding issue with health records. However, because evaluations and lack of resources cause ineffective implementation, potential setbacks occur.

State HIE finished their announcement in March 2010, of State Health Information Exchange Cooperative Agreement Program awardees (Healthit, 2014). These 56 states, qualified State Designated Entities, and eligible territories gained monetary-based awards to incentivize continuation of changeover to EHRs. The program does this by enabling the rapid build capacity of health care facilities like hospitals to exchange health information across and within states and across health care systems. In 2011, State HIE granted an extra $16 million via a new Challenge Grants program (Healthit, 2014).

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Such increases in resources allows for expansion and improvement of build capacity, therefore providing health care facilities like hospitals and clinics with the ability to transition completely to electronic health records. Working as an NP, there are some private clinics and public clinics that lack the means to transition to an electronic health record database. They still possess primarily paper health records. These health records that remain make it difficult to achieve the transition desired by the program. This leads to problems for programs like State HIE to carry out program objectives.

It can be a challenge to evaluate progress as these programs may not have the resources to tackle such issues even with the added increases. “The main challenges of evaluating health IT programs of the breadth and scale of the HITECH programs are the complexity and heterogeneity of the interventions, and the unpredictable nature of the innovative practices spurred by HITECH” (Jones, Swain, Patel, & Furukawa, 2014, p. 4). This can make the program have a potential negative impact on my practice for example, because there may not be enough incentive to transition leading to long-standing issues of effectiveness. Nevertheless, these kinds of programs are vital. They provide much needed resources to implement changes that otherwise would not be implemented.

One peer-reviewed article notes EHR products may not deliver the kind of patient satisfaction anticipated. “EHR products vary in their ability to support more advanced functionalities, such as patient engagement and population-based care management. Many barriers to interoperability persist, limiting electronic communication across a diverse set of largely private providers and care settings” (GOLD & McLAUGHLIN, 2016, p. 654). This can be due to limited electronic communication leading to frustration. While State HIE is designed to increase electronic communication between medical facilities, the evolution of EHR and the technology behind it is lacking.

In conclusion, ONC programs like State HIE are needed within the current health care landscape. They incentivize through monetary gain, the ability of medical facilities to connect electronically with each other. However, resources lack to assess the program’s efficacy and whether these medical facilities have the means to support the transition to EHRs effectively. This can lead to continue stalls regarding a full changeover from paper health records to electronic health records.



GOLD, M., & McLAUGHLIN, C. (2016). Assessing HITECH Implementation and Lessons: 5 Years Later. The Milbank Quarterly, 94(3), 654-687. doi:10.1111/1468-0009.12214

Healthit. (2014, March 14). State Health Information Exchange (State HIE) Resources | Policy Researchers & Implementers | HealthIT.gov. Retrieved from https://www.healthit.gov/policy-researchers-implementers/state-health-information-exchange

Jha, A. K. (2012). Sharing Clinical Data Electronically. JAMA, 307(16), 1695. doi:10.1001/jama.2012.525

Jones, E. B., Swain, M. J., Patel, V., & Furukawa, M. F. (2014). Supporting HITECH implementation and assessing lessons for the future: The role of program evaluation. Healthcare, 2(1), 4-8. doi:10.1016/j.hjdsi.2013.12.015