For health computing, judicious use is a term used to set minimum U.S. government standards for electronic medical records (EDAs), which describes how patient clinical data should be shared between health care providers, providers and insurers, as well as between providers and patients. These changes had been announced for several years. According to the ONC, useful use has shifted to the Merit Index Payment System (MIPS), in part because of the introduction of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA is one of four components of MIPS that combines existing CMS quality programs (including judicious use), physical quality reporting system and value-based payment modifiers. Consolidation is expected to improve the quality of supply. The overall intent of judicious use was to improve cooperation between clinical and public health care, improve patient-centered preventive care, and support the ongoing development of reliable and standardized data exchange. The Health Information Technology for Economic and Clinical Health Act (HITECH) Act 2009 encouraged the adoption of judicious use. According to the U.S.

Department of Health and Human Services, subtitle D of the HITECH Act addresses privacy and security issues related to the electronic transmission of health information, in part through several provisions strengthening the civil and criminal application of HIPAA rules. In an effort led by both the CMS and the Office of the National Coordinator for Health IT (ONC), judicious use has been phased into practice and divided into three phases, ranging from 2011 to 2015. In addition, CMS and THE ONC have developed incentive programs to encourage eligible professionals and hospitals to introduce, implement and update EHR-certified technologies (CEHRT) and demonstrate their use, in accordance with their criteria. While the right program of use in the United States was part of a successful attempt to launch EHRs, it was also unpopular with suppliers who had to meet a range of requirements to prove their judicious use. In 2018, the program was reviewed by the Centers for Medicare and Medicaid Services (CMS) and renamed Medicare and Medicaid Promoting Interoperability Programs. The notion of judicious use is now largely outdated. The PDMP action is designed to encourage hospitals and ADMs to consult the PDMP, as it is important to monitor prescribed controlled substances and improve prescribing practices. The objective of the opioid treatment measure is to determine whether there is an existing agreement on the treatment of opioids when they electronically prescribe a Chedule II opioid with CEHRT, if the total duration of schedule II patient opioid prescriptions is at least 30 days cumulative. Hitech Act7 has created 62 regional national outreos, including the Hawai`i Pacific Regional Extension Center (HPREC), to provide technical assistance, guides and best practice information to support and accelerate health care providers` efforts to become “useful users” of RSEs. The coordinated introduction and use of safe EHRs will ultimately improve the quality and value of health care across the country.

In September 2009, hawai`i HIE was recognized as a state-designated entity by a cooperation agreement under the ONC-funded health information exchange program.