HHS House of Cards Starring DiSalvo, Reider, Burwell, and a Cast of Hundreds

Apparently many positions in government are filled by competent individuals interested in public service. For those who do, it is not about the money, since private enterprise offers much more. 

Many of these appointments are for a relatively short-time and appointees often face the challenges and/or failure of their predecessors..Frequently they must unravel what came before their arrival prior to implementing their new programs.

The appointment process is riddled with politics as they serve as pawns in Congressional debates.  So goes the confirmation of Karen DeSalvo who has already been beaten up in her role in healthcare.gov, which had a  beginning.as a disaster.

ONC Chief DeSalvo Vacates Role, Reider Resigns CMO Post

ONC Chief DeSalvo Faces Resistance to Current HHS Nomination

Leadership changes atop ONC raise questions about the agency’s ability to achieve its long-term plans for interoperability.

Less than a year into her role as the head of the Office of the National Coordinator for Health Information Technology, Karen DeSalvo, MD, MPH, MSc, is moving on, at least in a temporary capacity, to another important position within the Department of Health & Human Services, the federal agency has confirmed.  “In this role she will work with the Secretary on pressing public health issues, including becoming a part of the Department’s team responding to Ebola,” the statement reads. “Dr. DeSalvo has 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.”

House of Cards

These two changes are the latest in a series of departures the ONC has experienced over the past year. Earlier this month, Chief Nursing Officer (CNO) and Director of the Office of Clinical Quality and Safety (OCQS) Judy Murphy announced that she would be leaving the ONC to become the CNO for IBM Healthcare Global Business Services. Prior to that, Chief Science Officer Doug Fridsma, MD, PhD, tendered his resignation to become President and CEO of the American Medical Informatics Association (AMIA) in November. During the preceeding year Farzad Mostashari left the  role of Chief of the Office of the National Coordinator for HIT  at HHS

These more recent departures came after the ONC revealed that Director of Consumer eHealth Program Lygeia Ricciardi, EdM, and Chief Privacy Officer Joy Pritts as former members of the federal agency would be moving on from the federal agency.

The leadership changes at the ONC are likely to raise many questions about the effectiveness of the federal agency to deliver on its goals as well as the level of influence that ONC even has over health IT as a whole