6.1 Health Information Technology
Sections:
6.1.1 Background & Terminology
I. Background
Health information technology (HIT) has become an essential component of healthcare delivery and administration. Electronic health records (EHRs), clinical decision support systems, telehealth, remote patient monitoring, health information exchange, mobile applications, connected medical devices, and other digital technologies support clinical care, communication, administrative functions, patient engagement, and population health. As these technologies have expanded, healthcare organizations have increasingly focused not only on technology adoption but also on interoperability, usability, data quality, privacy, cybersecurity, workflow integration, and the effective use of health information.
Geographic location, healthcare workforce availability, infrastructure, broadband access, and other factors can affect access to healthcare services. Digital health technologies can help extend access to healthcare services and health information when distance or limited availability of healthcare professionals creates barriers to in-person care.
eHealth, mHealth, telehealth, and telemedicine are HIT-enabled approaches that support healthcare delivery, communication, patient monitoring, and access to health information. Telehealth technologies can extend healthcare services beyond traditional clinical settings and are particularly useful when distance, mobility, or healthcare workforce availability creates barriers to in-person care.
HIT systems can collect, process, store, and communicate health information for use by healthcare professionals, patients, and other authorized users. Data may come from EHRs, patient-entered information, laboratory and diagnostic systems, connected medical devices, and remote monitoring technologies. Depending on the system, these data can support patient self-management, clinical decision-making, communication, and care coordination. Electronic health records can support information sharing, medication management, clinical decision-making, and care coordination when the information they contain is accurate, complete, and available to authorized users (Adjerid et al., 2018; Hydari et al., 2019). When integrated with appropriate clinical decision support, EHR data can also assist healthcare professionals in evaluating patient information during care.
II. Terminology
Digital health. Digital health is a broad term that includes the use of digital technologies to support health, healthcare, and healthcare delivery. It includes areas such as eHealth, mHealth, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine. Examples include patient portals, mobile health apps, wearable activity trackers, remote monitoring devices, and software used to support healthcare professionals in caring for patients (U.S. Food and Drug Administration [FDA], n.d.-b).
eHealth (electronic health). eHealth broadly refers to the use of information and communication technologies to support health and healthcare services (da Fonseca et al., 2021). Examples include electronic health records, hospital information systems, patient portals, and other digital systems used to collect, process, store, exchange, or communicate health information.
mHealth (mobile health). mHealth is generally considered a component of eHealth and refers to health and public health practices supported by mobile and wireless technologies, including smartphones, mobile applications, patient-monitoring devices, and other connected technologies (WHO Global Observatory for eHealth, 2011). For example, a person might use a mobile app to track physical activity, nutrition, or exercise. Other applications may help patients record blood pressure or blood glucose readings, receive medication reminders, communicate with healthcare professionals, or access health information.
Mobile health applications may collect sensitive health information, creating important privacy and security considerations. Users should understand what information an application collects, how the information is used or shared, who can access it, and how it is protected. HIPAA protections apply when protected health information is created, received, maintained, or transmitted by HIPAA-regulated covered entities and business associates. Many consumer health applications, however, are not subject to HIPAA simply because they collect health-related information. Healthcare organizations should evaluate privacy, security, access controls, vendor responsibilities, and applicable legal requirements before integrating mobile applications into patient care (U.S. Department of Health and Human Services, 2026a).
Health information technology (HIT). HIT refers to electronic systems and technologies used to create, process, store, exchange, and use health information. Examples include electronic health records, electronic prescribing, clinical decision support, patient portals, health information exchange, and technologies supporting privacy and security. Effective HIT can support healthcare quality, safety, efficiency, communication, and access to information, but its benefits depend on system design, implementation, interoperability, data quality, usability, workflow integration, and appropriate use (U.S. Department of Health and Human Services, 2022).
6.1.2 General Categories of Health Information Technology Applications
Major categories of health information technology applications include electronic health records, telehealth and telemedicine, health information exchange and interoperability, clinical decision support, and internet-based and connected technologies.
I. Electronic Health Records
The electronic health record (EHR) is a digital patient record that provides authorized healthcare professionals access to information such as medical history, diagnoses, medications, immunizations, allergies, laboratory results, and treatment information. For example, a physician reviewing a patient’s EHR before prescribing a medication can see the patient’s current medications and documented allergies.Electronic health records can also include tools that support patient care and healthcare operations. Computerized provider order entry (CPOE) allows healthcare professionals to electronically enter orders for medications, laboratory tests, imaging, and other services. Clinical decision support (CDS) tools can provide reminders, warnings, or other information to assist with clinical decisions. For example, the EHR may alert a physician that a medication being ordered could interact with another medication the patient is taking. Patient portals allow patients to electronically access portions of their health information and communicate securely with healthcare professionals. The usefulness of an EHR depends on the accuracy and completeness of the information entered into it and the ability of different systems to exchange and use health information. Standards, health information exchange, and interoperability help make this exchange possible.
Standardization Overview
Healthcare information must be recorded and exchanged in a consistent way for different electronic systems to understand and use it. For example, a laboratory result sent electronically from a laboratory to a physician’s EHR must be identified and formatted in a way the receiving system can recognize. Healthcare organizations use standardized terminology, codes, and data formats to make this possible. Examples include SNOMED CT for clinical terminology and LOINC for laboratory and clinical observations. The United States Core Data for Interoperability (USCDI) identifies standardized health data that can be exchanged electronically. Health Level Seven Fast Healthcare Interoperability Resources (HL7 FHIR) provides standards that help different health information systems exchange information (Office of the National Coordinator for Health Information Technology [ONC], 2026a, 2026d).
Benefits
Electronic health records can improve access to patient information, communication, care coordination, clinical decision-making, and administrative processes. Having accurate patient information available at the point of care can help healthcare professionals make more informed decisions and reduce problems associated with incomplete or illegible paper records. Electronic exchange of EHR information can also reduce unnecessary duplication of services. For example, if a patient’s recent laboratory or imaging results are available electronically to another authorized healthcare organization, the healthcare professional may not need to order the same tests again. Electronic records can also support medication management, billing and reimbursement, communication among members of the care team, and patient access to health information.
Challenges
Electronic health records can also create challenges when systems are poorly designed, configured, or integrated into clinical workflows. Healthcare professionals may face complex screens, excessive documentation requirements, frequent software changes, or processes that require additional steps to complete routine tasks. Organizations therefore need to consider usability, workflow, system configuration, staff training, and ongoing evaluation when implementing and updating EHR systems. Electronic alerts illustrate both the benefits and challenges of health information technology. For example, an EHR may warn a physician that a medication being ordered could interact with another medication the patient is taking. However, if healthcare professionals receive too many unnecessary or low-value alerts, they may begin to overlook or routinely override them. This problem is known as alert fatigue. Electronic templates and CPOE systems must also allow healthcare professionals to document patient care accurately and completely. Poorly designed templates, default selections, or limited response options can contribute to documentation errors and may affect patient care, coding, and reimbursement. Healthcare organizations should continually evaluate these systems and modify them when problems are identified (Centers for Medicare & Medicaid Services, 2021).
Health Information Exchange
Health information exchange (HIE) refers to the electronic sharing of health information among healthcare professionals, organizations, patients, public health agencies, payers, and other authorized participants. For example, if a patient receives emergency care while traveling, HIE may allow the treating hospital to obtain health information from the patient’s regular healthcare organization rather than relying only on the patient’s recollection or unnecessarily repeating tests. Health information may be exchanged through local, regional, state, or nationwide networks. The Trusted Exchange Framework and Common Agreement (TEFCA) provides a nationwide framework intended to help separate health information networks securely exchange electronic health information (ONC, 2026e). Accurate patient matching is also important when information is exchanged. Healthcare organizations must make sure that information received from another system is connected to the correct patient. A matching error could cause information from two different patients to be combined or prevent healthcare professionals from finding information that belongs to the same patient. Both situations can create patient-safety risks.
II. Telemedicine and Telehealth Services
Descriptions
Telehealth broadly refers to the use of telecommunications technologies to provide or support healthcare when participants are in different locations. Telehealth can include clinical care, patient education, remote patient monitoring, provider consultation, and other health-related services. Telemedicine is often used more specifically to describe the delivery of clinical healthcare services at a distance. Terminology may vary among federal agencies, states, payers, and healthcare organizations (Health Resources and Services Administration [HRSA], 2022).
Although telemedicine/telehealth may seem to be an entirely new technology, it really is not. NASA pioneered telemetry and telemedical technologies in the space program to monitor the life signs of the astronauts. Telehealth technologies have evolved substantially and now support virtual visits, specialty consultation, behavioral healthcare, remote monitoring, and other services across many healthcare settings.
Telehealth use expanded rapidly during the COVID-19 public health emergency as federal and state policies temporarily increased flexibility related to reimbursement, technology, practitioner eligibility, and where telehealth services could be provided. Telehealth policy has continued to evolve since the public health emergency ended. As of 2026, federal legislation has extended many Medicare telehealth flexibilities through December 31, 2027, including the ability for many Medicare beneficiaries to receive nonbehavioral telehealth services in their homes without geographic restrictions. Coverage, reimbursement, professional licensing, prescribing requirements, eligible services, and permitted technologies can still vary by payer and state. Healthcare organizations must therefore monitor current federal and state requirements when providing telehealth services (HRSA, 2026).
Modalities
Telemedicine/telehealth can take the form of audio and video (synchronous), store-and-forward technologies (asynchronous), and remote patient monitoring (Rangachari et al., 2021).
1. Synchronous
This modality includes real-time telephone or live audio-video interaction, typically with a patient using a smartphone, tablet, or computer. In some cases, a nurse may use peripheral medical equipment (e.g., digital stethoscopes, otoscopes, ultrasounds) physically with the patient, while the consulting medical provider conducts a remote evaluation.
2. Asynchronous
This modality includes “store and forward” technology, where messages, images, or data are collected at one point in time and interpreted or responded to later. Patient portals can facilitate this type of communication between provider and patient through secure messaging.
3. Remote patient monitoring
Remote patient monitoring (RPM) uses connected medical devices to collect and electronically transmit patient health information from outside traditional healthcare settings for review by healthcare professionals. Depending on the technology and clinical need, monitoring may occur continuously or periodically. RPM can support the monitoring and management of acute and chronic conditions and may reduce the need for some in-person monitoring (Centers for Medicare & Medicaid Services [CMS], 2026b).
Zimmerman et al. (2021) compared satisfaction among patients receiving partial hospital treatment through telehealth during the COVID-19 pandemic with satisfaction among patients receiving in-person treatment before the pandemic. Satisfaction was high in both groups, suggesting that telehealth was an acceptable delivery approach for this patient population.
Remote monitoring technologies include devices such as continuous glucose monitors, connected blood pressure monitors, pulse oximeters, cardiac monitoring devices, digital scales, wearable activity or physiologic sensors, and other connected medical devices. Some FDA-authorized sensor-based digital health technologies are designed for wearable use and for monitoring patients outside clinical settings, including in the home (FDA, 2026d).
III. Health Information Networks and Interoperability
Health information networks connect healthcare organizations and other authorized participants so they can electronically exchange health information. However, simply connecting two systems is not enough. Interoperability means that different systems can exchange information and that the information can be understood and used after it is received. For example, a hospital may electronically receive a patient’s medication list from another healthcare organization. Interoperability means that the hospital’s information system can recognize and use the information rather than simply receive a document that cannot be incorporated into the patient’s record. Standards and initiatives such as USCDI, HL7 FHIR, and TEFCA help support electronic health information exchange across different systems and organizations (ONC, 2026a, 2026c, 2026d, 2026e).
Information blocking refers to practices that are likely to interfere with the access, exchange, or use of electronic health information. For example, a healthcare organization generally should not create unnecessary barriers that prevent a patient or another authorized healthcare organization from electronically accessing health information that is legally available to them. Federal requirements established under the 21st Century Cures Act address information blocking by healthcare providers, developers of certified health information technology, and health information exchanges or health information networks. Certain exceptions are permitted when specific requirements are met (ONC, 2026b).
IV. Decision Support Tools
Artificial intelligence (AI) refers to machine-based systems that can analyze information and generate outputs such as predictions, recommendations, or decisions based on defined objectives. In healthcare, AI may be used to analyze medical images, identify patients at increased risk for a condition, assist with clinical documentation, or support healthcare professionals in making decisions (National Institute of Standards and Technology [NIST], 2023).
Machine learning is a type of AI in which algorithms identify patterns in data and use those patterns to make predictions, classifications, or other outputs. For example, a machine-learning system may analyze large amounts of patient data to identify patterns associated with an increased risk of hospital readmission.
Clinical decision support (CDS) tools use patient information and other clinical knowledge to provide healthcare professionals with information that can assist with patient care. For example, a CDS tool within an EHR may remind a healthcare professional that a patient is due for a screening test or warn that a medication being ordered could interact with another medication the patient is taking. Some clinical decision support software may be regulated by the FDA as a medical device, depending on its function (Centers for Disease Control and Prevention, 2022a; FDA, 2026b).
V. Internet-Based Technologies and Services
The Internet of Things (IoT) includes physical devices that connect to networks and can collect, transmit, or exchange data. Examples include sensors, controllers, household devices, wearable technologies, and other connected equipment. Increased connectivity can improve access to data and enable communication among devices and systems, but it also creates important considerations related to privacy, cybersecurity, reliability, authentication, and device management (National Institute of Standards and Technology [NIST], n.d.-b).
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(NIST, 2018b)
