Now there are five

Karen DeSalvo becomes fifth ONC chief over a decade, and first woman in the post
By Bernie Monegain
12:00 AM

Perhaps the ONC chiefs can be like former presidents, getting together every now and then to trade stories about the trials and tribulations that come with the job.

With the appointment Dec. 19 of New Orleans Health Commissioner Karen DeSalvo as national coordinator for health information technology, the country can now count five ONC chiefs over 10 years, since President George W. Bush mentioned health IT in his State of the Union speech, and later made good on a big piece of the promise by establishing the Office of National Coordinator for Healthcare Information Technology. In the early years it was known as ONCHIT. In more recent years, it was shortened to ONC.

It was also Bush who named the first ONCHIT chief: David Brailer, MD.

Karen DeSalvo, MD

It was HHS Secretary Kathleen Sebelius who appointed DeSalvo.

"DeSalvo has advocated increasing the use of health information technology to improve access to care, the quality of care and overall population health outcomes – including efforts post-Katrina to redesign the health system with HIT as a foundational element," Sebelius wrote in a Dec. 19 letter to HHS staff.
DeSalvo’s first day on the job will be Jan. 13.

As New Orleans Health Commissioner, DeSalvo is known for working hard to restore healthcare to the city, especially in the wake of Hurricane Katrina, which destroyed parts of city in 2005.

“We devised a four-pronged blueprint for healthcare reform,” DeSalvo told Healthcare IT News in an interview last February. “We wanted to redesign the delivery system to focus on primary care, with a special emphasis on neighborhood-based care. We say down here that New Orleans is a preeminent laboratory for innovation and change, and it has been since we lifted ourselves up after Hurricane Katrina.”

DeSalvo has served as president of the Louisiana Health Care Quality Forum and as a member of the Steering Committee for the Crescent City Beacon Community grant. She is the first woman appointed to head the ONC.

Farzad Mostashari, MD

Farzad Mostashari, MD, joined ONC in July 2009 and was appointed national coordinator in April 2011. In August 2013 he announced his resignation and officially stepped down from his role in October 2013.

Immediately upon arrival at ONC, he became known for his passion, exuberance and trademark bow ties.

Today he is at Brookings Institution's Engelberg Center for Health Care Reform as a visiting fellow, where he is focused on topics related to helping clinicians improve care and patient health by using health information technology.

"He is a passionate visionary who never took his eye off the prize, while keeping his feet at least close to the ground," Paul Tang, MD, vice president, chief innovation and technology officer at the Palo Alto Medical Foundation, said when Mostashari announced he would be leaving his post. As vice chair of the federal Health IT Policy Committee, Tang worked closely with Mostashari, an experience he described as “fabulous.”

Tang’s comments were representative of comments from dozens of others who worked with Mostashari.

"His focus on public health and patient/family engagement has had an enormous impact,” said John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston. “My greatest lesson learned from Farzad is to choose policy goals first, then implement IT to support them, rather than implement technology for technology's sake."

David Blumenthal, MD

President Obama appointed David Blumenthal, MD, national coordinator on March 20, 2009. Blumenthal came onboard at ONC just two weeks prior to HIMSS09. He stepped down in the spring of 2011. In a memo to his staff, he said he would return to Harvard. Prior to his role at the ONC he was a practicing primary care physician and Harvard Medical school professor. He taught medicine and healthcare policy and served as director of Massachusetts General Hospital's Institute for Health Policy. In 2012, he became president of the Commonwealth Fund.

Industry insiders credit (or criticize) Blumenthal for developing the Meaningful Use EHR Incentive Program. Blumenthal once called the program “brilliant” in a public speech. Someone in the audience whispered, “Of course. It’s his program.”

In a letter to his staff announcing his departure from ONC, Blumenthal wrote:

“We have been privileged to be at the center of a great new enterprise at an historic moment in our health care system. For years America’s health policy leaders have understood that information technology offered the opportunity for transformational improvement of the nation’s health care system and the health of individual Americans. Yet the obstacles are formidable: our fractured health care system, our dysfunctional payment methods, the lack of an infrastructure for exchanging health information, and more.”

“I believe the key factor for success has been, and will continue to be, the concept of meaningful use.”

Robert Kolodner, MD

HHS appointed Robert Kolodner, MD, to head the Office of the National Coordinator for Health Information Technology on April 18, 2007. Kolodner had served as the Interim National Coordinator since September 2006. He left the post in 2009 and went to work at Open Health Tools, a multinational nonprofit organization. Last May, he joined telehealth company ViTel Net as vice president and chief medical officer.

Industry insiders and government leaders heaped praise on Kolodner, saying he provided the vision for what the healthcare system could be.

As former chief health informatics officer for the Department of Veterans Affairs, Kolodner led the development of the VA’s VistA program and its healthcare information system.

“Privacy and security are at the heart of everything we do,” Kolodner said in a 2006 speech. “We have to build that in. We have to have policy linking to standards and the architecture. Let’s not wait for perfection, but let’s make sure it is good enough.”

David Brailer, MD

Secretary Tommy G. Thompson announced the appointment of David Brailer to the newly created position of National Health Information Technology Coordinator on May 6, 2004, at a healthcare IT summit in the nation’s capital. Brailer, then a senior fellow at the Health Technology Center in San Francisco, had recently completed 10 years as chairman and CEO of Philadelphia-based CareScience, the software development company he founded.

“The appointment of Dr. Brailer as the NHIT Coordinator provides vital leadership and crucial visibility for this issue as well as an avenue to achieve the integration of information technology into the everyday lives of Americans," said H. Stephen Lieber, president and CEO of HIMSS.

Brailer left the office on May 19, 2006. Today he continues to head Health Evolution Partners, the private equity firm he founded in San Francisco after he left office.

 “I completed what brought me to DC, and I’m eager to come home, “ he said, in announcing his departure.

In an interview with Brailer on the day he resigned, he said he was most proud that he had created a middle ground between a laissez-faire approach to healthcare IT adoption and a path that would have the government paying for it and mandating it.

“We’ve shown that there is a way to do this other than ignoring the market failures of healthcare or leaving it to the government,” he said.