“HHS Secretary Burwell asked National Coordinator for Health IT Karen DeSalvo to serve as acting assistant secretary for health, effective immediately,” according to a statement from ONC spokesman Peter Ashkenaz. “In this role she will work with the secretary on pressing public health issues, including becoming a part of the department's team responding to Ebola.”
HHS Secretary Sylvia Mathews Burwell, in a notice to her staff, welcomed DeSalvo, saying, “As the acting assistant secretary for health, Karen's experience as a practicing physician, a senior member of the HHS team, and as a nationally recognized leader in public health, will be invaluable to the department and me.”
“She will bring her knowledge and real-world experience to bear on some of the most important issues confronting our department, especially our Ebola response efforts,” Burwell said.
Given her public health background, “the idea of her serving in this public health capacity (with Ebola) seems to be a good fit. She's been here and done that,” said Dr. John Halamka, chief information officer of Beth Israel Deaconess Medical Center, Boston. Halamka has worked as an adviser to DeSalvo as vice chairman of the federally chartered Health IT Standards Committee.
DeSalvo had previously served as New Orleans health commissioner and has roots in public health.
After Hurricane Katrina struck Louisiana in 2005, DeSalvo, then Tulane University's chief of internal medicine and geriatrics, set up a clinic to treat survivors, which grew into a network of more than 80 primary-care clinics, most with electronic health-record systems, as patient-centered medical homes.
DeSalvo, the nation's fifth full-time national coordinator for health IT, had, at just over 10 months, the shortest tenure since the position was created by President George W. Bush in 2004.
DeSalvo was appointed in December 2013 and started in mid-January 2014. She took over from Reider, who had been serving as acting national coordinator since Dr. Farzad Mostashari stepped down in Oct. 2013.
Lewis will serve as the acting national coordinator until a full-time replacement for DeSalvo can be named. DeSalvo will continue to support the work of ONC while she is at the office of the assistant secretary.
DeSalvo leaves as the federal EHR incentive payment program, run by the ONC and the CMS, is winding down, having spent $25.1 billion and seen EHR adoption rates above 92% for hospitals and 75% for office-based physicians.
DeSalvo also has had to contend with considerable provider pushback on the timing and scope of the incentive payment program as it moved to its more difficult Stage 2 for meaningful use this year.
“The industry has gone through Stage 1 and Stage 2 (of the federally funded EHR incentive payment program), with ONC serving as a catalyst, and that has bonded the industry together,” Halamka said.
DeSalvo has emphasized interoperability of health IT systems during her tenure. The federal program is beginning to shift focus toward a national health information exchange architecture based on Internet principles.
Dr. Charles Jaffe, CEO of standards development organization Health Level Seven, would like to see the ONC continue on that tack.
Dr. William Bria, president of the Association of Medical Directors of Information Systems, a professional association of physicians working in applied medical informatics, said “because of the state of meaningful use and all of the concerns that there are of putting it back on the right track, a reboot of ONC seems to be what's needed. With Dr. DeSalvo moving to a new position, there is an opportunity to do so. Taking a hard look at what needs to be done, that's what the country needs to do now.”
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