Reaction to DeSalvo Nomination Upbeat despite ONC Departure

Confirmation by the U.S. Senate is all that stands between National Coordinator for Health IT Karen DeSalvo, M.D., and her new full-time job as Assistant Secretary for Health at HHS.  But, industry stakeholders appear to be taking her impending departure from ONC in stride.

The White House on May 6 announced President Obama’s nomination of DeSalvo for the position which generated reactions from associations and providers that have been generally positive. The one exception is the Medical Group Management Association, representing 33,000 medical practice administrators and executives in 18,000 healthcare organizations. Robert Tennant, director of HIT policy for MGMA, says DeSalvo’s leaving ONC “leaves a significant vacuum” in the health IT community at large.

According to Tennant, DeSalvo has “exhibited tremendous leadership and has put forth a vision for moving the healthcare industry toward effective and attainable interoperability.” However, at the same time, he argues “there is still considerable work left to do for ONC, not least of all crafting HIT certification requirements that will act as a catalyst for industry improvement while not creating unreasonable barriers for vendors and their provider clients.”

Also See: New Blood at ONC Not a Bad Thing

Nonetheless, Tennant adds that MGMA wishes DeSalvo well in her future endeavors and thanks her for her service at ONC, while adding that the association looks forward to working with DeSalvo’s successor.

Jeff Smith, senior policy advisor for the College of Healthcare Information Management Executives, asserts that the nomination of DeSalvo at this point in time “actually bodes pretty well for the industry as a whole.” By promoting her to a higher level position at HHS, Smith sees it as creating “an opportunity for the health IT community to have a voice” at the senior echelons of the department.

While DeSalvo has only been at ONC since January 2014, Smith credits her for helping to change the health IT landscape and modernizing the healthcare system. Still, he does not see DeSalvo’s leaving ONC as creating a “significant vacuum” as MGMA’s Tennant believes.   

In a written statement, HIMSS congratulates DeSalvo on her nomination as Assistant Secretary for Health and states that the association remains “committed to working with Secretary Burwell and HHS, as well as the Office of the National Coordinator for Health Information Technology  during the confirmation and eventual transition to ensure our nation stays focused on achieving interoperable and secure healthcare information exchange that supports care coordination and healthcare transformation.”  

Ironically, in November 2014, CHIME and HIMSS sent a letter to HHS Secretary Sylvia Burwell warning that their organizations would only support DeSalvo’s then-appointment as Acting Assistant Secretary for Health—she has served in that position in an acting capacity since October 2014 while also continuing to lead ONC—provided it was for a short duration with the proviso that DeSalvo would quickly return to full-time leadership of ONC. Smith explains that CHIME is now comfortable with DeSalvo’s departure from ONC given the significant progress that has been made with several high-priority health IT projects.

“At that point in time [October 2014], we didn’t have the Interoperability Roadmap or the five-year Federal Health IT Strategic Plan, and there was a whole host of senior leadership vacancies at ONC,” he points out. “So, there were a whole bunch of things that were very much in process and that caused quite a significant amount of anxiety within the industry. However, at this point in time, a lot of those things have been produced and a number of those senior positions have been filled again.”

When it comes to finding a successor for DeSalvo, Beth Israel Deaconess Medical Center’s Chief Information Officer John Halamka, M.D., believes the person selected does not need to be a physician but should be someone that “understands the clinical ecosystem” and has a “deep understanding of healthcare processes and workflow including the daily impact of regulations on patients, providers and payers.” Halamka also recommends that DeSalvo’s successor should have a “working knowledge of the technology”—though does not need to be an engineer—as well as “extensive experience working with large, complex organizations and diverse stakeholders.”

Likewise, Smith recommends that DeSalvo’s successor should be someone who has “implemented a heck of a lot of technology” over the course of their career and is “very much in touch with the private sector on the provider side.” Yet, he does not think the National Coordinator for Health IT needs to be a physician. “We could be very well served by a physician, but we could be very well served by a CIO.”  

Pamela McNutt, senior vice president and CIO of Dallas-based Methodist Health System, similarly says she hopes DeSalvo’s replacement is “someone who has real life experience with EMRs and interoperability.”

Smith opines that there are a “whole host of folks who would be qualified to do this job, and that wasn’t necessarily the case four or five years ago.” What’s changed in that time is that “the industry as a whole has undergone a maturation,” he adds.