With the recent appointment of Dr. Vindell Washington as National Coordinator for Health IT, there have been a total of six to hold the post since it was established in April 2004. Although the general public is largely unfamiliar with the position, the National Coordinator holds significant responsibility as the head of federal efforts to improve health IT nationwide. Each individual appointed to the post has aided these efforts in his or her own distinct way.
David Brailer: Before the ONC, there was Dr. Brailer
Dr. David Brailer was appointed as the first National Coordinator on May 6, 2004 after President George W. Bush issued Executive Order 13335 with the goal of establishing a nationwide interoperable health information system.
Before there was an Office of the National Coordinator for Health IT (ONC), Brailer was an unofficial advisor to the Bush administration. He helped significantly with part of the 2014 State of the Union declaring the advancement of health IT a priority for the Bush Administration, according to an April 2014 interview with Modern Healthcare.
He also authored a lengthy Department of Health and Human Services-sponsored white paper regarding policy options for influencing adoption of EHRs. This was published the same month President Bush issued Executive Order 13335 and would become the guide for the development of the Office of the National Coordinator.
Dr. Brailer resigned from the post in April 2006 and went on to found Health Evolution Partners, a private equity firm where he still serves as CEO.
Robert Kolodner: Protector of patient privacy
Shortly after Dr. Brailer left the ONC, Dr. Robert Kolodner began serving as interim National Coordinator until he was officially appointed to the position in April 2007. He quickly set to work as an influential advocate for enhanced patient privacy protections in health IT systems and applications.
“Safeguarding personal health information is essential to our national strategy for health IT,” Kolodner said in a June 2007 statement to the House of Representatives Oversight and Government Reform Committee. “A strategy devoid of measures to ensure privacy and security would neither advance our interests nor those of the American people.”
Throughout his tenure as National Coordinator, Kolodner would address numerous concerns regarding patient privacy protections. From February 2007 to September 2008, the Government Accountability Office issued four separate reports calling for a comprehensive national strategy for protecting patient information. Kolodner and his staff responded with a “Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information,” published in December 2008.
Kolodner left the ONC in September 2009 to join Open Health Tools, a nonprofit organization, as Chief Health Informatics Officer. He is currently Vice President and Chief Medical Officer at ViTel Net.
David Blumenthal: Entering the era of Meaningful Use
Dr. David Blumenthal is probably best known for his role as the architect of CMS' EHR Incentive Program, better known as Meaningful Use. Blumenthal was appointed in April 2009, less than two months after the HITECH Act freed up $19 billion in federal funding to promote health IT adoption.
Despite being put in charge of the unprecedented federal investment in health IT, Blumenthal was not a “techy” kind of guy. “I was never interested in the technological aspects earlier in my career,” he said in a September 2012 interview with Medgadget. “I was actually forced to use an electronic medical record as part of my practice, and I came to the conclusion that this was a very important change in healthcare.”
Dr. Blumenthal’s familiarity with health IT policy would serve him well as he worked to find a balance between legislators’ high expectations for their massive investment and providers’ concerns over aggressive Meaningful Use timelines and stringent requirements.
Dr. Blumenthal left the ONC in April 2011 and currently serves as president of the Commonwealth Fund.
Farzad Mostashari: ONC on the March
Dr. Farzad Mostashari joined the ONC as Deputy National Coordinator in 2009. Over the next two years, he would work with Blumenthal to lay the groundwork for Meaningful Use. Following Blumenthal’s departure, Mostashari was appointed National Coordinator in April 2011.
In an interview, published March 2012 in Health Affairs with former National Coordinator Brailer, Dr. Mostashari was asked, where are we now with health IT? His response: “On the march.” His first year as National Coordinator was also the first year the government began dispersing EHR incentive payments.
By at least one measure, Mostashari’s stint as National Coordinator was a successful one. Meaningful Use made significant progress during Dr. Mostashari’s stint as National Coordinator. Adoption of certified EHRs at hospitals increased to 94% in 2013.
Mostashari resigned as National Coordinator in October 2013. He is currently CEO of Aledade, a company he founded in 2014.
Karen DeSalvo: Introducing Interoperability
Dr. Karen DeSalvo was appointed National Coordinator in January 2014 at a time when the ONC began to shift its focus from EHR adoption to interoperability. Over the course of her tenure as National Coordinator, the ONC made significant progress working with public and private partners to update the Federal Health IT Strategic Plan and to develop a Nationwide Interoperability Roadmap.
“During DeSalvo’s era, the evolution from complex, hard to use standards to simpler, agile standards began and we’re likely to see a much richer ecosystem of healthcare information sharing in the next era,” John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston, told Politico.
DeSalvo won’t be going too far, at least not physically. She resigned as National Coordinator earlier this month to take on the role of acting Assistant Secretary for Health at the Department of Health and Human Services.
Vindell Washington: New Regulator on the Block
It didn’t take long for Dr. Vindell Washington to get a promotion. In January, he was appointed Principal Deputy National Coordinator at ONC. Now, he’s been selected to succeed DeSalvo in the top spot.
Washington first became interested in health IT when he was deployed to Haiti as a Captain in the Army, he wrote in a Health IT Buzz blog post. A fellow soldier presented with strange symptoms, so Washington set up a telecommunications kit in the field to get support from specialists from the Walter Reed Military Medical Center in Washington, D.C. This led to diagnosis and treatment for Dr. Washington’s patient.
Health IT has come a long way since then and Dr. Washington will help to advance it even further. As National Coordinator, he will likely keep the focus on interoperability as he oversees implementation of the Federal Health IT Strategic Plan and the Nationwide Interoperability Roadmap.