    [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.