The National Coordinator at the helm of the Federal Government’s HITECH funded health information technology programs is returning to his roots as planned, having steered a steady and successful course over his tenure. Dr. David Blumenthal left his practice in internal medicine and his position as Director of the Institute of Health Policy at Massachusetts General Hospital to guide the development and implementation of initiatives designed to overcome the barriers to HIT adoption. Not only did all of the mandated programs came to fruition during his time in office, but his leadership in health care policy and in consensus building assures that these programs will successfully grow to meet their goals over time. The HIT Policy Committee, the HIT Standards Committee, and all of their work groups have risen to meet the challenges that he presented and they will continue to carry his legacy of thoughtful dedication to HIT supported health care reform forward into the foreseeable future.
Dr. Blumenthal’s accomplishments and accolades are currently being codified in multiple other settings, so I will not list them here. What I will say is this: Thank you, David. You chose to take on a daunting task and you’ve performed gracefully under pressure to guide us all through a tumultuous time of change and uncertainty. You’ve set a course that we can all follow, albeit at different paces, that aligns the complicated and confusing set of necessary policies and technologies that will assure that every patient’s information is available to the clinician at the time it is needed, to the patient him or herself, and to those who assure the public’s health and safety. As a former member of the ONC team, I know that this has been more difficult than most of our colleagues in the HIT world can imagine. But you’ve done it, and you’ve done it well. So, again, on behalf of CCHIT, I extend our deepest appreciation and wish you continued success as you return to your post at Harvard.
As we look back and then forward to the next phase of ONC’s evolution, we see that there is still much work to be done. ONC was born in April 2004 as the result of an Executive Order signed by then President Bush. Dr. David Brailer, the first National Coordinator quickly developed a Strategic Framework for HIT that included and addressed all of the elements that we are still working with today and created the Office of the National Coordinator. As a poorly funded “start up” within the machinery of the Federal government, the first iteration of ONC was able to create and oversee the first certification process for HIT, the first set of unified interoperability standards, the first set of privacy policies and regulations with respect to HIT, and the first standardized way of measuring EHR adoption nationwide. These initial efforts matured and the National Health Information Network became a major focus of ONC under the leadership of Dr. Robert Kolodner, who had honed his skills in HIT throughout a long career in the Veterans Administration. During his tenure, large federal and private systems healthcare systems developed the ability to exchange health information with each other. Governance efforts also matured through the American Health Information Community, a Federal Advisory Committee conceived and developed under Dr. Brailer. It wasn’t until the ARRA passed, however, that significant funding became available to the point where Dr. Blumenthal and the Office could move forward on all fronts and with the benefit of two collaborating Federal Advisory Committees whose recommendations could be incorporated into the cohesive set of programs with which we are all familiar. The “start up” has evolved into an Office that is integral to national health care policy.
The question now is: what comes next? And who should lead? I would suggest that ONC will now need to focus on Execution and Value.This means that the next National Coordinator will need strong operations experience in addition to being an inspiring physician leader who understands the interplay between policy and technology. Each program will need to be reviewed and retooled to maximize effectiveness and efficiency and its contribution to the overall goal. As health payment reform is more clearly defined, new HIT programs may need to be developed to better support care in new systems. As new technologies become available, ONC will need to accommodate to the changing market place. And there is need to demonstrate, beyond all doubt, that HIT, properly designed, implemented , and used, will mitigate the cost of our rising healthcare bill and provide better, safer care. Our new National Coordinator who can meet these needs is waiting in the wings. In the meantime, let’s continue to be grateful for the guidance and leadership of those who have gone before.
Karen M. Bell, MD, MMS
Chair, Certification Commission
Karen Bell, MD, MMS, is Chair of the Certification Commission for Health Information Technology (CCHIT®. Dr. Bell has wide and varied expertise in health information technology (HIT), quality assurance and clinical practice, in both the private and public sectors. Previously, she served as Senior Vice President, HIT Services, Masspro, the federally-contracted Quality Improvement Organization within Massachusetts, where she oversaw the development, implementation and distribution of products and services to support adoption of electronic health records (EHRs) within the health care system. Between 2005 and 2008, Dr. Bell was Director, Office of Health Information Technology Adoption, Office of the National Coordinator (ONC), U.S. Department of Health and Human Services (HHS), and, in 2006, served as Acting Deputy of ONC. She was ONC’s representative on CCHIT’s Board of Commissioners from 2006 to 2008.
Prior appointments held by Dr. Bell include Division Director, Quality Improvement Group/Office of Standards and Quality for the Centers for Medicare and Medicaid (CMS), and Medical Director of Blue Cross Blue Shield (BCBS) of Rhode Island and of Anthem BCBS of Maine.
She received her medical degree from Tufts University School of Medicine, Boston, and her master of medical science degree from Brown University, Providence, R.I. Dr. Bell has clinical experience as a board certified physician in internal medicine and also was an Associate Professor at the University of Rochester, and Clinical Instructor at Harvard University School of Medicine.