Karen DeSalvo and Jacob Reider Leave ONC

UPDATE: It seems that DeSalvo will still be National Coordinator of Healthcare IT along with her new position.

It’s been a tumultuous few months for ONC and it’s just gotten even more tumultuous. We previously reported about the departures of Doug Fridsma MD, ONC’s Chief Science Officer, Joy Pritts, the first Chief Privacy Officer at ONC, and Lygeia Ricciardi, Director of the Office of Consumer eHealth, and Judy Murphy, Chief Nursing Officer (CNO) from ONC. Yesterday, the news dropped that Karen DeSalvo, ONC’s National Coordinator, and Jacob Reider, ONC’s Deputy National Coordinator, are both leaving ONC as well.

Karen DeSalvo has been tapped by HHS Secretary Sylvia Mathews Burwell to replace Wanda K. Jones as assistant secretary of health which oversees the surgeon general’s office and will be working on Ebola and other pressing health issues. I think DeSalvo’s letter to staff describes it well:

As you know, I have deep roots and a belief in public health and its critical value in assuring the health of everyone, not only in crisis, but every day, and I am honored to be asked to step in to serve.

DeSalvo’s always been a major public health advocate and that’s where her passion lies. Her passion isn’t healthcare technology. So, this change isn’t surprising. Although, it is a little surprising that it comes only 10 months into her time at ONC.

The obvious choice as Acting National Coordinator would have been Jacob Reider who was previously Acting National Coordinator when Farzad Mostashari left. However, Reider also announced his decision to leave ONC:

In light of the events that led to Karen’s announcement today–it’s appropriate now to be clear about my plans, as well. With Jon White and Andy Gettinger on board, and a search for a new Deputy National Coordinator well underway, I am pleased that much of this has now fallen into place–with only a few loose ends yet to be completed. I’ll remain at ONC until late November, working closely with Lisa as she assumes her role as Acting National Coordinator.

As Reider mentions, Lisa Lewis who is currently ONC’s COO will be serving as Acting National Coordinator at ONC.

What’s All This Mean?
There’s a lot of speculation as to why all of these departures are happening at ONC. Many people believe that ONC is a sinking ship and people are doing everything they can to get off the ship before it sinks completely. Others have suggested that these people see an opportunity to make a lot more money working for a company. The government certainly doesn’t pay market wages for the skills these people have. Plus, their connections and experience at ONC give them some unique qualifications that many companies are willing to pay to get. Some have suggested that the meaningful use work is mostly done and so these people want to move on to something new.

My guess is that it’s a mix of all of these things. It’s always hard to make broad generalizations about topics like this. For example, I already alluded to the fact that I think Karen DeSalvo saw an opportunity to move to a position that was more in line with her passions. Hard to fault someone for making that move. We’d all do the same.

What is really unclear is the future of ONC. They still have a few years of meaningful use which they’ll have to administer including the EHR penalties which could carry meaningful use forward for even longer than just a few years. I expect ONC will still have money to work on things like interoperability. We’ll see if ONC can put together the patient safety initiative they started or if that will get shut down because it’s outside their jurisdiction.

Beyond those things, what’s the future of ONC?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • It’s hard to underestimate the importance of the ASH position. This is not simply an admin post. It is responsible for almost all of HHS’ health related programs. I would be surprised if DeSalvo went back to ONC. This is a far more important policy post. Just check the various advisory committees: http://www.hhs.gov/ash/advisory_committees/index.html

    In addition to her personal public health background, which is substantial, she also is politically a smart appointment. She has not made any major enemies while at ONC, yet she clearly put her own agenda forward. Finally, she should have an easy time being confirmed. No small advantage these days.

    I do agree, though, that ONC is greatly in need of shoring up. I don’t envy whoever takes over.

  • Hey John,
    Its tough to be a government medical leader. And I’m sure Karen and Jacob both can hear the ever louder roar of EPs and EHs and vendors and HIT industry and groups saying that the very programs they are leading are a disaster that is growing. You cannot be a leader of a failed program(s) and stay on as a leader. This will be pinned on someone, and if you are in the room when this DOES happen, it will be blamed on that person(s) forever. They are smart to get out. MU2 has failed. And miserably. Especially since they have been saying for a year, don’t look at the attestation numbers, they can’t make sense of them or they don’t mean anything, everything is great, etc . Yeah right. Now they HAVE to admit failure. And they are finally hearing from just about every organization that they have overwhelmed EPs and EHs to the point of giving up on this stuff forever. They are going to have to realign PQRS, MU, VBM, ICD-10, HIPAA, ACO, etc. They can keep these things going, but they risk an even worse crisis when EPs retire early, go out of business or go to the self pay model.
    In reality, MU was a flawed program from the start. EPs and EHs were moving to EHR already. The pace would have been better, vendors would have pushed usability and safety and security. Not some back office government idea of meaningful use. The incentives brought together a perfect storm of incapable EPs and IT businesses that know how to get government money. Little did the EPs realize that they would become data entry clerks. Its so obvious now. No one wants to pay someone to enter data, just make the EP do it. Make it a rule, call it CPOE or Med Rec, or VBT or whatever you want. Click here there and everywhere, click OK to the popup 100 times a day.
    Safety, usability, and security were secondary issues. You just have to meet these numerators and denominators, the rest does not matter. Well it does. And its starting to show.
    So I feel these departures mark the end. ONC right now is being run by a grant application attorney. I feel this signals to everyone, like it or not, ONC failed. They can spout that they got everyone on board with EHR, but there is nearly universal dissatisfaction among EPs and EHs and nurses, etc. with what they set up. So as we look back, we will learn again, that artificial government incentives may cause more problems then they solve. Certainly penalties never work and as the penalty phase now comes, they are just going to make the situation even worse. Its going to take a leader to step up and speak the truth, but those are hard to come by in Washington.

  • I generally don’t beat around the bush. Most of the time, people don’t leave positions because they love where they work. #realitycheck

  • @ Mel
    You are correct, though I’d say the adoption rate of EPs was extremely low as an EHR brings no measurable ROI.
    Basically the government created a false demand for something that many didn’t care to have.
    Then, since $$ was being dished out, the gov’t had to create some hoops to jump through…hence meaningful use.
    Having cubicle dwellers create performance metrics just doesn’t work well.

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