The DeSalvo Appointment at ONC: A Year-End Directional Signal from HHS?

Dec. 26, 2013
With the appointment of Karen DeSalvo, M.D. as the new National Coordinator for Health Information Technology, is the Department of Health and Human Services sending an important signal to the field? Only time will tell, but the auguries seem positive.

The timing of the news on December 19 that Karen DeSalvo, M.D. had been appointed National Coordinator for Health Information Technology took most in healthcare by surprise, not least because it happened just days before the year-end holidays were set to begin, with the attention of most healthcare professionals focused elsewhere. But news it was, nonetheless, with important implications for the meaningful use process under the HITECH (Health Information Technology for Economic and Clinical Health) Act, the healthcare reform process under the Affordable Care Act (ACA), and other phenomena.

Dr. DeSalvo, who will begin her work as National Coordinator on January 13, will be the first female National Coordinator, and will, importantly, be coming from a particularly interesting corner of healthcare, having been the health commissioner of New Orleans, a community with a recent history of strong collaboration among healthcare stakeholders.

Importantly, some of those who know Dr. DeSalvo well are praising her appointment by HHS (the Department of Health and Human Services); among those is Anjum Khurshid, M.D., director of the Health Systems Division at the New Orleans-based Louisiana Public Health Institute (LPHI). The same days as the announcement, Dr. Khurshid told me that “We are delighted in New Orleans for Karen, and also for her organization… The work that she’s been able to accomplish in New Orleans over a short period of time has been tremendous, and the kind of leadership she’s brought here to the community is a model of efficient,  community-based, patient-centered focus,” Dr. Khurshid said. “And with her background as a primary care provider, in public health, and in academia, we could not imagine a better person.”

Dr. Khurshid is particularly well-positioned to comment, as he has known Dr. DeSalvo for several years. He is also well-positioned to comment in that his organization, LPHI, which for the past three years has been home to the Crescent City Beacon Community, has proven itself a leader in collaborative healthcare work; indeed, the work of Dr. Khurshid and his colleagues was honored by our team at Healthcare Informatics earlier this year, when they were named the co-second-place-winning team in the Healthcare Informatics Innovator Awards program, and we publicly recognized them at our Innovator Awards reception in New Orleans.

And that, in fact, is where I met Dr. DeSalvo, as she attended our reception in a show of support to Dr. Khurshid and the LPHI and CCBC folks. It was delightful to speak briefly with her and to have her be part of the group, as we honored teams of innovators in healthcare—including, coincidentally per the siting of the HIMSS Conference in New Orleans in 2013—a team from New Orleans itself.

Of course, Dr. Khurshid has been far from alone in expressing his strong support for the DeSalvo appointment. Many supportive tweets erupted when the news became public on the 19th. For example, Ruben Amarasingham, M.D., an internist and health researcher in Dallas, tweeted, “Karen DeSalvo MD is an awesome choice to be National Coordinator for Health IT. Bravo!” And Urmimala Sarkar, M.D., an internist at San Francisco General Hospital and an health IT researcher, tweeted, “Yes! Karen DeSalvo… good for primary care, public health patients.”

Also very significantly, the early word from CHIME (the College of Healthcare Information Management Executives) has been very positive. As Russ Branzell, CHIME’s president and CEO told me on December 19, “I attended a special presentation by the New Orleans Bio District that was held at the HIMSS Conference in New Orleans in February. I was very impressed with the work they’ve done in New Orleans, and of course, Dr. DeSalvo was part of that leadership group.” Russ definitely believes the DeSalvo appointment was a good choice.  “One of the things we at CHIME were asked about during this selection process was what we were looking for in the new National Coordinator,” Russ told me. “And one thing was that we wanted someone who comes from the field and knows the pains of doing this, knows the challenges of deploying healthcare IT in a real-world. I think she’s a logical fit with that experience. And the other intriguing thing is that she and her colleagues have been using HIT to drive population health.”

And ultimately, that gets to the heart of what might be particularly valuable in HHS’s choosing Dr. DeSalvo. She certainly has been on the ground as a leader in population health and transitions of care efforts, at the community level. Only time will tell how effective a leader she turns out to be, of course. But the signal that HHS is sending in choosing Dr. DeSalvo to succeed Farzad Mostashari, M.D. seems to be a clear one: community-based experience is valued, medical leadership is valued, a public health focus is valued. If all those elements translate into effective leadership at ONC, the coming months under Dr. DeSalvo’s management could prove to be very valuable ones at the agency. In any case, going into the New Year, there is good reason for optimism, as we plunge further into meaningful use and healthcare reform than ever before.

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