Federal Healthcare Legislation that Promoted the Digitalization of Medicine and the Impact on Healthcare Delivery in 2025

Abstract

Background Federal healthcare legislation has played a central role in shaping the digital transformation of U.S. healthcare. Key legislative milestones–including the Health Security Act of 1993, the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Patient Protection and Affordable Care Act (ACA), and the 21st Century Cures Act–collectively accelerated the adoption of electronic health records (EHRs), promoted interoperability, and expanded access to digital health tools.

Objective This study aimed to examine how federal legislation across recent administrations has shaped the digitalization of healthcare delivery, and to evaluate the challenges and consequences associated with these policies.

Methods A targeted narrative review was conducted using primary legislative texts and federal policy documents from 1993 to 2016. Findings were organized chronologically and thematically to assess the intended objectives, observed impacts, and ongoing implementation challenges associated with major healthcare legislation.

Results Federal legislation significantly accelerated the adoption of EHR systems, expanded health information exchange, and enabled advances in patient safety, clinical quality, and population health analytics. Implementation has also introduced challenges, including high system costs, workflow disruption, documentation burden, and disparities in adoption amongst smaller practices. Emerging technologies, such as artificial intelligence, are further reshaping digital healthcare while raising new concerns regarding regulation, safety, and data governance.

Conclusion Federal policies have fundamentally transformed healthcare delivery by establishing the infrastructure for a digitally connected healthcare system. Despite measurable improvements in interoperability and data accessibility, persistent challenges remain. Future reforms should prioritize improved EHR design, enhanced clinician training frameworks, and policies that address adoption barriers to ensure that digital health innovations translate into safer, more effective, and equitable patient care.

Keywords

Clinical Information Systems - specific types - patient records - electronic health records and systems - clinical data management - standards - HIPAA - integrated information systems

Protection of Human and Animal Subjects

This study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Albert Einstein College of Medicine Institutional Review Board.

Contributors' Statement

K.M.: investigation, writing—original draft, writing—review and editing; S.N.: investigation, writing—original draft, writing—review and editing; T.S.: investigation, project administration, writing—original draft, writing—review and editing; M.V.: investigation, writing—original draft; K.T.: investigation, writing—original draft; B.G.: investigation, writing—original draft; S.J.: conceptualization, project administration, supervision, validation, writing—original draft, writing—review and editing.

Publication History

Received: 28 July 2025

Accepted after revision: 06 March 2026

Accepted Manuscript online:
09 March 2026

Article published online:
23 March 2026

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