ONC chiefs compare notes

Bipartisanship seen as critical to the work from the get-go
By Tom Sullivan
01:00 AM

When President Bush was running for reelection in 2004, John Kerry’s campaign struck Bush with criticisms about healthcare, and Bush’s people called David J. Brailer, MD, for some talking points.

"I’m sorry David Blumenthal isn’t here because he was advising (ONC), but he was also advising Kerry when he ran against Bush," Brailer said at the gathering of four former national coordinators at HIMSS14 Feb. 26. "We spent the entire night trying to get two teams to back off of each other. We both agreed the next morning we made health IT bipartisan," by keeping it out of the election campaigns. "I don’t think I’ve ever told that story,” said Brailer, who today is CEO of Health Evolution Partners, a healthcare private equity firm he founded in San Francisco after stepping down at ONC.

Bipartisanship was also striking to Robert Kolodner, MD. During his tenure at ONC, the office was "able to take the first step of making certain" it could get the pieces that were needed to advance IT, he said. "We didn’t want anyone to grab and control the core infrastructure. It was important to bring it in the room so that the solution didn't favor one interest or the other,” said Kolodner, who serves as vice president and chief medical officer of telehealth company ViTel.

Then came the HITECH Act, which was passed as part of the American Recovery and Reinvestment Act in 2009 during Blumenthal’s term, while future ONC chief Farzad Mostsashari, MD, served as deputy national coordinator. Today Blumenthal is president of The Commonwealth Fund, and Mostashari is a visiting fellow at the Engelberg Center for Health Care Reform at the Brookings Instittution.

"It took an economic crash to create the opening for something that the groundwork had been laid for," Mostashari said. "The idea that we would get this opportunity was so unbelievable – literally unbelievable –and when the HITECH Act passed, it was a broad movement."

As "exhilarating" as that time was, Mostashari said the low point was clear: the government shutdown in the fall of 2013 – a time in which ONC was gutted down to four employees and some questioned whether the office was even essential.

Brailer’s low point was perhaps equally disconcerting. ONC’s budget got temporarily slashed all the way down to zero and then he was "realizing that there was no political support for this."

Kolodner said he had to perform a political balancing act. "There were times we were accused of being controlled by one side or the other," he said.

The current national coordinator, Karen DeSalvo, MD, was just seven weeks into the post when she jointed the former coordinators at HIMSS14.

"I don't have a low point yet," DeSalvo said. But her high point was the first HIT Policy Committee meeting where she was greeted with a whole host of opinions. "I got very excited about that because this is a community of vendors, purchasers, providers, policy folks, who really … want to get it right."