Stakeholders at Odds Over DeSalvo's Departure and the Future of Health IT

Health IT stakeholders appear split on how former National Coordinator for Health IT Karen DeSalvo's departure will affect future health IT initiatives, FierceHealthIT reports (Bowman, FierceHealthIT, 10/24).

ONC's Staffing Changes

Last week, DeSalvo announced that she would leave her post to serve as acting HHS assistant secretary for health, effective immediately, where she will lead HHS' Ebola response team.

Lisa Lewis, ONC's COO, has become acting National Coordinator for Health IT, and DeSalvo will continue to support ONC's work in her new role.

Meanwhile, Deputy National Coordinator for Health IT Jacob Reider also announced he would be leaving ONC in late November, after three years at the office.

DeSalvo and Reider's departures add to a growing list of top ONC officials who have left the agency in recent months.

On Oct. 17, Judy Murphy stepped down from her role as chief nursing officer and director of ONC's Office of Clinical Quality and Safety to join IBM. Meanwhile, Doug Fridsma, chief scientist at ONC, will become president and CEO of the American Medical Informatics Association on Nov. 1.

In July, Joy Pritts left her post as chief privacy officer at ONC and Lygeia Ricciardi stepped down as director of ONC's Office of Consumer eHealth (iHealthBeat, 10/24).

Amid the staff transitions, ONC also:

  • Has faced critiques from industry stakeholders over the timeframe of Stage 2 of the meaningful use program and the criteria for Stage 3, which is expected to begin in 2017;
  • Is involved in helping U.S. health organizations to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures, with several insurers and providers behind schedule to complete the transition by Oct. 1, 2015; and
  • Leads an effort to alter the U.S. national health information exchange infrastructure to improve electronic health record interoperability.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

ONC spokesperson Peter Ashkenaz said that despite the staffing changes, "ONC's policy work is not stopping." He added, "The policy set by ... DeSalvo is unchanged. Lisa Lewis will implement the strategic direction that has been set," and "DeSalvo remains engaged in key initiatives like interoperability and other major policies" (Conn, Modern Healthcare , 10/24).

Industry Reaction

While some health care stakeholders said the transitions at ONC could jeopardize the future of health IT programs, others welcomed the changes as a new opportunity (FierceHealthIT, 10/24).

American Medical Association President Robert Wah in a release said, "DeSalvo's departure, in addition to those of several other senior staff ... leaves a significant leadership gap, which could jeopardize the growing momentum around interoperability." He added, "Without widespread interoperability, the value proposition of EHRs has not been realized and the adoption of new innovative models of care has been hindered" (Slabodkin, Health Data Management, 10/28).

Rep. Renee Ellmers (R-N.C.) also raised concerns about the effect DeSalvo's departure would have on health IT. She said, "Meaningful use participation is at an all-time low; the process for developing a national interoperability roadmap has only just begun; and Stage 3 rules are nearing completion." She added, "All of these challenges require strong and lasting leadership -- something ONC seems to be in short supply of when taking into consideration the number of top officials who have left or will soon be leaving ONC" (Allen/Pittman, Politico Pro, 10/24).

Several hospital CIOs, including Indranil Ganguly of the JFK Health System, also questioned DeSalvo's abrupt departure, saying the move could call into question the Obama administration's "view of the value of health IT."

However, Russell Branzell, president and CEO of the College of Healthcare Information Management Executives, noted that the shakeup at ONC could be a good opportunity. He said, "If they bring the right people in -- hopefully from the industry and not from their government service -- then we think there's some great opportunity to make some needed changes and big impact" (FierceHealthIT, 10/24).

In a release, the Healthcare Information and Management Systems Society congratulated DeSalvo on her new role and expressed an eagerness to work closely with Lewis to "address the many issues facing [ONC] and the health IT community," including the meaningful use program, the interoperability roadmap and the Health IT Strategy Plan (Health Data Management, 10/28).

Similarly, former National Coordinator for Health IT David Blumenthal said he has "a lot of confidence" in Lewis' "ability to keep [ONC] running while a permanent head is sought." He added, "When I was at ONC, I didn't know anything about technology, but I was able to find people who did" (Politico Pro, 10/24).

Source: iHealthBeat, Tuesday, October 28, 2014

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