ABSTRACT
In the United States in the early 1960s, a number of public and private initiatives began the exploration of EHRs (see Section 3.2 on the history of EHRs in 1960 to 1996 that led up to the HIPAA of 1996). The Veterans Administration in 1971, the largest medical provider in the United States, started developing an EHR and rolled out a working system worldwide in 1987, originally called the Veterans Health Information Systems and Technology Architecture (VistA) (https://www.ehealth. va.gov/VistA.asp) and currently renamed HealthVet, the next generation of VistA. This chapter focuses on initiatives that spurred the development of the EHRs in the United States: HIPAA [3], the Affordable Care Act (ACA) [1], and the stimulus bill. Government documents, many of which can be found at www.HHS.gov, are used to outline important provisions contained in these acts focusing on the evolution and implementation of EHRs. For a complete list of all provisions of HIPAA, ACA, and the stimulus bill, links are provided.
