Office of the National Coordinator for Health Information Technology (ONC)

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The Office of the National Coordinator for Health Information Technology (ONC) is an federal entity that promotes nationwide health information technology (HIT) efforts and electronic exchange of health information. It is part of the Office of the Secretary for the U.S. Department of Health and Human Services (HHS)[1].

The ONC is charged with implementing certain portions of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009[2].


Founded in 2004, the ONC oversees the implementation and development of HIT standards and a national health information technology infrastructure. The nationwide health information technology infrastructure would allow for electronic use and exchange of medical information. As of January of 2015, the ONC describes its charge to be the "coordination of nationwide efforts to implement and use the most advanced health information technology and the exchange of health information".[1]

Advisory Committees

The ONC is served by two Federal Advisory Committees, the Health IT Standards Committee (HITSC) and the Health IT Policy Committee (HITPC). As of January, 2015, the HITSC has a membership of 29 appointees forming 8 workgroups with the responsibility of mamking recommendations to the National Coordinator health IT standards for architecture and, content, semantics, transport, and security.[3] The HITPC has a membership of National Coordinator plus 25 appointees and serves the ONC with the development of policy recommendations for the development and adoption of a nationwide health information infrastructure. Work is predominantly the result of effort from 7 workgroups (as of January, 2015)[4]

Consolidated Health Informatics Initiative (CHI)

The goal of Consolidated Health Informatics Initiative (CHI) is to establish federal health information interoperability standards as the basis for electronic health data transfer in all activities and projects and among all agencies and departments. The first phase involved establishing a set of existing clinical vocabularies and messaging standards enabling federal agencies to build interoperable federal health data systems. [1]

Federal Health Architecture (FHA)

The Federal Health Architecture (FHA) program will define an overarching framework and methodology that allows initiatives throughout several federal agencies to proceed coherently, establishing the target and standards for interoperability and communication that will unify the federal health community. The FHA will establish a government-wide road map to achieve the federal health community's mission through optimal performance of its core business processes within an efficient IT environment.

Workforce Development Program: Program of Assistance for University Based Training

The Office of the National Coordinator (ONC) has awarded $84 million in funding for Health IT Workforce Development. There are four funded programs: (1) Community College Consortia: a non-degree program to be completed in six months or less. (2) Curriculum Development Centers: to develop educational materials for the Community College Consortia program (3) Competency Examination Program: to develop competency exams for health IT professionals and (4) University-Based training

It is anticipated that the widespread adoption of EHRs will create a demand beyond the current workforce capacity of professional expertise in Biomedical Informatics. The University-Based training grants will assist over 1,500 people to complete advanced training in HIT. There are six targeted workforce roles in University-Based training:

  1. Clinician/Public Health Leader
  2. Health Information Management and Exchange Specialist
  3. Health Information Privacy and Security Specialist
  4. Research and Development Scientist
  5. Programmers and Software Engineer
  6. Health IT Sub-specialist

In April 2010, nine Colleges and Universities were granted awards totaling 32 million dollars for University-Based Training: Columbia University ($3,786,677), University of Colorado Denver College of Nursing ($2,622,186), Duke University ($2,167,121), George Washington University ($4,612,313), Indiana University ($1,406,469), Johns Hopkins University ($3,752,512), University of Minnesota ($5,145,705), Oregon Health & Science University ($3,085,812), and Texas State University ($5,421,205).

Students who are funded through the ONC grants must complete the certificate program within one year, achieve a grade of B or higher in all courses, and commit 20 hours or more to the program each week. Courses in the programs cover a wide spectrum of information. For a required course in the OHSU program students need to post an entry on Clinfowiki. The grants vary between institutions in the per cent of tuition paid for. It is also possible for student to continue from the certificate program on to a Master’s degree.

Submitted by:Randy Berger

Promoting Interoperability and HIE: The Direct Project and Connect

One of the ONC's priorities is to promote the development of a national health IT infrastructure that allows for the exchange of health information in a secure and beneficial way. The ONC has sponsored two main projects that move towards that goal, Connect and The Direct Project. [5]


Connect is a software platform built by nationally-recognized standards and can be used to aid the development of a health information exchange (HIE) and the sharing of data. These standards are commonly called the Nationwide Health Information Network.

The Direct Project

Direct Secure Messaging is secure, encrypted email for healthcare.

The Direct Project launched in March 2012 and is an initiative that has brought a variety of stakeholders together to create a simple way for healthcare entities to send information securely. The project developed technology specifications for a service called Direct Secure Messaging and outlines it as a simple, secure, scalable, standards-based way to send health information over the Internet. Direct Secure Messaging is secure, encrypted transport specification that has the potential to create a ubiquitous transport messaging standard that can be accessed by a web portal or through an electronic health records (EHR) system.

Direct Secure Messaging is being provided by a variety of public and private vendors across the county. Many state HIE organizations are providing Direct Secure Messaging as a tool to facilitate the simple exchange of information. Direct is not robust HIE, but a simple solution that moves us in the right direction.

Additionally, in the final Stage 2 EHR certification rule released by the Department of Health and Human Services in August 2012, EHR vendors are required to adopt the Direct Transport Specifications for Stage 2 certification. This is a great step, but it will be a slow shift -- first vendors need to develop the Direct-enabled version of their EHR and then healthcare entities need to upgrade to that version, which can be a long process. However slow, the movement towards Direct will improve the ability to send protected health information electronically to all healthcare entities.

Related papers


  1. 1.0 1.1 Newsroom: About ONC. (2014, 11 Aug). From
  2. Health IT Legislation: Select Portions of the HITECH Act and Relationship to ONC Work. (2015, March 27). Retrieved December 6, 2015, from
  3. HITSC
  4. HITPC
  5. Direct Project