Commemorating the 20th anniversary of the Office of the National Coordinator for Health Information Technology (ONC). The episode revisits key milestones and initiatives from the ONC's inception in 2004 by executive order of President George W. Bush to its recent accomplishments. Topics include the High Tech Act, the evolution of health IT infrastructure, the significance of electronic health records, and the challenges faced in achieving interoperability. Bill reflects on what worked, what didn’t, and the lessons learned for the future, particularly in the context of AI and healthcare technology. The episode also highlights various strategic plans and legislation, such as the 21st Century Cures Act, which have shaped the healthcare IT landscape.

00:00 Introduction and Overview

00:59 The Birth of ONC

03:03 Early Challenges and Investments

04:01 The High-Tech Act and Its Impact

05:28 Advancements and Unintended Consequences

10:48 Strategic Plans and Final Rules

12:11 Recent Developments and Future Directions

13:14 Conclusion and Reflections