With last week’s announcement that National Coordinator for Health IT Karen DeSalvo, M.D., has left ONC and Deputy National Coordinator for HIT Jacob Reider, M.D., will depart next month, the American Medical Association has expressed its concerns that their departures are creating a “leadership gap” which is putting at risk the agency’s progress in addressing critical challenges such as interoperability.  

On October 23, Health and Human Services Secretary Sylvia Burwell asked DeSalvo to serve as Acting Assistant Secretary for Health—effective immediately—to become part of the Obama administration’s Ebola response effort. In addition, Reider announced that he was leaving after three plus years at the agency. DeSalvo, who had only been on the job since January, and Reider are just the latest senior staff to leave ONC over the past few months.

“DeSalvo’s departure, in addition to those of several other senior staff including the Deputy Director of the Office of the National Coordinator for Health IT, Jacob Reider, which was also announced last week, leaves a significant leadership gap which could jeopardize the growing momentum around interoperability,” said Robert Wah, M.D., AMA president, in a written statement. “Without widespread interoperability, the value proposition of EHRs has not been realized and the adoption of new innovative models of care has been hindered.”

“The AMA has been calling on ONC to make the Meaningful Use certification requirements more flexible so that vendors have more freedom to innovate and tailor their products to meet physicians’ needs,” added Wah. “We recently released a Meaningful Use Blueprint to outline ways to improve Stages 1 and 2 of the program and provide suggestions for Stage 3, as well as a framework outlining eight priorities for more usable EHRs.”

However, the response from other organizations was more upbeat. HIMSS congratulated DeSalvo on her new role as the Acting Assistant Secretary of Health for HHS, and applauded her “decision to join the important national response to Ebola and other urgent public health crises.”

Carla Smith, executive vice president of HIMSS North America, in a written statement said that the organization welcomed the opportunity to work closely with Acting National Coordinator for HIT Lisa Lewis to “address the many issues facing the Office of the National Coordinator and the health IT community, particularly the challenges of the Meaningful Use program, the ongoing public effort on the Interoperability Roadmap, the Health IT Strategy Plan, and the continuous improvement of the EHR Certification Process.”

Health Level Seven International (HL7) also congratulated DeSalvo on her new role as the Acting Assistant Secretary of Health for HHS as well as thanked her and Reider for their public service in support of the advancement of health IT. “HL7 embraces the recent work of the ONC leadership on its Interoperability Roadmap and on the JASON Task Force recommendations,” said Charles Jaffe, M.D., HL7’s CEO. “The prioritization of standards-based interoperability and a commitment to long-term policymaking will enable healthcare to benefit from information technology in very tangible ways. HL7 welcomes the opportunity to collaborate with the new Acting National Coordinator, Lisa Lewis, and the diverse healthcare IT community, to overcome the barriers to interoperability.”

Lewis, who served as the Acting Principal Deputy National Coordinator for a five-month period in 2014 and had been serving as ONC’s chief operating officer, is considered an authority in the field of federal grants management.  As COO, she was responsible for providing executive oversight and setting the strategic direction for matters related to program integrity, budget formulation and execution, grants and contracts management, human capital, IT, and operational services. Lewis also currently serves as ONC’s chief information officer.

While Lewis will provide day to day leadership at ONC, DeSalvo will continue to work on high-level policy issues—remaining the chair of the Health IT Policy Committee—and she will continue to lead the development and finalization of the Interoperability Roadmap as well as remain involved in meaningful use policymaking, according to the agency.

DeSalvo will also continue to co-chair the HHS cross-departmental work on delivery system reform. At the same time, an Oct. 28 blog co-authored by DeSalvo and Lewis argues that “the team that is ONC is far more than one or two leaders.”

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