The Changes at ONC and Next Steps

John D. Halamka

• National Coordinator: Karen DeSalvo (Named Acting Assistant Secretary of Health)
• Deputy National Coordinator: Jacob Reider (Leaving in November)
• Office of Care Transformation: Kelly Cronin
• Office of the Chief Privacy Officer:  Lucia Savage
• Office of the Chief Operating Officer: Lisa Lewis (Named Acting National Coordinator)
• Office of the Chief Scientist: Doug Fridsma, MD, PhD (Became CEO of AMIA)
• Office of Clinical Quality and Safety: Judy Murphy, RN (Joined IBM)
• Office of Planning, Evaluation, and Analysis: Seth Pazinski
• Office of Policy: Jodi Daniel
• Office of Programs: Kim Lynch (Leaving in November)
• Office of Public Affairs and Communications: Peter Ashkenaz
• Office of Standards and Technology: Steve Posnack
• Interoperability Portfolio Manager: Erica Galvez

Although some have voiced concerns about loss of momentum, I believe that in change there is opportunity. ONC has a served as a catalyst, accelerating the adoption of electronic health records by hospitals and eligible professionals. Guided by the certification regulation, EHRs now include robust interoperability for public health reporting, transition of care exchange, lab result incorporation, patient/family engagement and quality data submission.

We’ve achieved a new baseline that did not exist 4 years ago.

Now it’s time for the private sector to step up and lead the charge on the next generation of interoperability - query/response based on FHIR, OAuth2/Open ID, and REST. We need two implementation guides - one for document level exchange and one for data element exchange of the Meaningful Use Common Data Set (see the last page of this document).

A coalition of the willing - vendors, HL7, providers, program management, and champions from the private sector can keep the momentum going as we all drive to a new set of FHIR specifications in 2015 - a second Draft Standard for Trial Use based on lessons learned with the first draft standard.

Over the past few days, I’ve seen new energy and enthusiasm for accelerating interoperability, following the roadmap described by the Jason Task Force.

Rahm Emanuel said “You never let a serious crisis go to waste. And what I mean by that it's an opportunity to do things you think you could not do before.”

The combination of change at ONC, the Jason Task Force report, and new private sector urgency for interoperability is a perfect storm for innovation. I think the weeks ahead will be filled with rich discussion about how all stakeholders can unify to accelerate the efforts already in progress. It’s truly time for a new optimism.