The healthcare IT community was shocked by news last week that Karen DeSalvo, M.D., was leaving her post as head of the Office of the National Coordinator for Health Information Technology to assist the U.S. Department of Health and Human Services with public health issues, namely the department's Ebola response.
DeSalvo had only been with the ONC since January 2014, when she took over for Farzad Mostashari, M.D., a fellow physician and health IT evangelist who helped design and implement the ONC's programs following passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Not only was DeSalvo's switch to HHS effective immediately, it coincided with the departure of Deputy National Coordinator Jacob Reider, M.D., the ONC's second in command.
DeSalvo and Reider are leaving the ONC at a crucial juncture, when the U.S. healthcare system is struggling to move from mere adoption of electronic health records and other forms of health IT to meaningful use of those technologies in ways that improve care and lower costs. It's a long leap, as evidenced by a string of delays regarding when and how healthcare providers must demonstrate they are making the grade in order to receive federal incentive payments. Moreover, murmurings are growing louder that the billions of dollars spent on EHR meaningful use payments to date have not moved us closer to the Holy Grail of health IT: interoperability.
Just two days before the announcement that DeSalvo and Reider were leaving, the ONC released an updated draft of its 10-year plan to achieve a national, interoperable health IT platform. The self-described roadmap drew praise from key stakeholders, including the College of Healthcare Information Management Executives (CHIME) and Health Level Seven International, which develop standards and certification around health information exchange. Now, those same stakeholders are left wondering just how committed the federal government is to following through on its interoperability investment.
That's not to minimize the importance of a swift and coordinated U.S. response to the Ebola outbreak. In many respects, DeSalvo is an obvious choice to serve as acting assistant secretary for health. She has a heart for public health and rose to prominence as health commissioner for the city of New Orleans in the aftermath of Hurricane Katrina. I heard DeSalvo speak earlier this year at the Health Information and Management Systems Society annual conference in Orlando, where she pointed to the chaos that followed Katrina as evidence of the value of EHRs and robust health information exchange. Displaced residents relied on daily medications to control chronic conditions, but their prescriptions were lost to the floodwaters. Others were shuttled from hospital to hospital, only to have the same tests run over and over again.
At that same HIMSS conference, I also heard horror stories from advocates of healthcare transparency who fought for access to their loved ones. medical history records containing valuable information that could have been shared among caregivers to save time, money, suffering and even lives. These tragedies happen every day, only they are not on the scale of an epidemic or natural disaster.
Yes, the Ebola outbreak has the potential to become a national healthcare crisis, just as Hurricane Katrina was a crisis. The irony is that, nine years later, we are hardly better equipped with the health IT infrastructure that would allow providers to document, verify and share critical patient information on a real-time basis.
We have the momentum. We have the roadmap. Now it's time for someone to take the wheel.
Follow April Wortham Collins on Twitter at @aprilworthamDRG