Overview

The Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) was enacted to improve health care delivery and patient care through an investment in health information technology (health IT).  HITECH included provisions to promote adoption of certified electronic health records (EHR) through financial incentives.  This federal policy has been key in spurring digitization in health care.  Today, most health care providers use electronic data and analytics to improve quality outcomes.  To address challenges associated with EHRs and data interoperability, Congress passed the 21st Century Cures Act in December 2016, legislation that covers many aspects of health care. This includes enhancing interoperability by discouraging information blocking and creating a reporting system on EHR usability, functionality, and security.

EHR Vendor Landscape

The EHR vendor landscape has markedly changed since HITECH was enacted.  Over the last decade, there has been considerable concentration in the market in part due to EHR performance and health system consolidation.  Nationally, three vendors have a combined 70 percent market share for acute care hospitals; this includes Epic (28 percent), Oracle Cerner (26 percent), and Meditech (16 percent).  In Maryland, hospital mergers and acquisitions have contributed to shifts in vendor share.  Epic maintains the largest share (53 percent) among acute care hospitals, up from 19 percent in 2014. Oracle Cerner has the second largest share (33 percent), followed by Meditech (12 percent).*  

*As of 2023

Resources

The MHCC conducts environmental scans to assess health IT adoption and use in ways that improve quality and health equity and ensure privacy and security of electronic health information. For more information on  health IT reports and briefings, click here.  To access a variety of informational flyers, guidance, and other tools for health care providers, click here.

Additional Resources

• Health IT Playbook  
  Designed by The Office of the National Coordinator for Health Information Technology (ONC) to help practices in selecting and implementing health IT, including best practices for EHRs and other health IT-related topics. 


• Promoting Interoperability (PI) Programs
  Renamed by the Centers for Medicare and Medicaid Services (CMS) in April 2018 with new focus on improving health data exchange. 


• The Quality Payment Program (QPP)
  Puts into place key aspects of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) using a framework that rewards health care providers for quality, and combines previous quality reporting programs (i.e., PQRS, Value-Based Modifier, and Meaningful Use).


• Certified EHR Technology (CEHRT)
  EHR standards and other criteria established by CMS and ONC that are required for participation in the PI Programs and other quality reporting programs.


• Electronic Health Record Association (EHRA)
The Healthcare Information and Management Systems Society (HIMSS) EHRA address national efforts to create interoperable EHRs with the aim of improving quality of care and the productivity and sustainability of the health care system.