Karen DeSalvo, Former National Coordinator for Health IT, Chapter 1

When Karen DeSalvo was first asked to interview for the role of National Coordinator for Health IT, she declined, thinking it wasn’t the right fit. After, she lacked the technology expertise that other candidates could offer. What she did have, however, was experience as both a physician and a leader, having spent the prior three years as Commissioner of Health for the City of New Orleans. And so DeSalvo followed her own advice and ran toward the opportunity to make a difference. In this interview, she talks about what she enjoyed most about her role with HHS, why she has become a crusader for public health, what she’s doing now (and hopes to do next), and why it’s critical to “find your true north.”

Chapter 1



* From public official to student

* Turning down HHS: “I didn’t think it was the right job for me.”

* ONC’s “inflexion point”

* Writing the interoperability roadmap — “It’s the currency of today.”

* FHIR’s potential

* Working with Micky Tripathi & Dave McCauley

* Reflecting on her time with HHS  — “You have the opportunity to think big and do big things.”



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Bold Statements

It was a really interesting time of closing out what we had started with grants, helping the team on a pathway of defining what the future would look like, understanding what the value was for taxpayers, and also helping to make sure we didn’t get too far ahead of communities that still had to put the building blocks in place.

Data was going into systems, but it was hard to get out. That was contributing to the frustration of doctors on the frontline who felt like they kept entering data into these EHRs, but when they needed to know somebody’s vaccine history, they couldn’t find it.

Health IT is still pretty much in the adolescent phase. It’s still a little lanky and awkward and tripping over itself, not really always playing nice with others and has some maturing to do.

I don’t think we’re out of the woods on expectations, and I think the industry needs to pay a lot more attention to system usability.

When you’re in public service at the federal level, you have the opportunity to think big and do big things. Certainly you do in the private sector as well and at the state level, but there is something pretty exciting about being able to decide, in partnership with the health IT community, that it was time for APIs to be a part of usual practice.

Gamble:  Hi Karen, thanks so much for taking some time to speak with us today.

DeSalvo:  Hi Kate, I’m happy to be here.

Gamble:  I want to talk about your experience as a national coordinator and acting assistant secretary, as well as some of your work prior to that. But first, can you talk a little bit about what you’re focused on right now?

DeSalvo:  I am officially on hiatus. I’m staying busy with opportunities to speak and participate in conferences, which honestly has been quite nice, because you’re pretty busy when you’re in public service. Sometimes I would speak in a meeting and only be able to stay as long as I was hearing myself speak and not have a chance to listen to others. So I’ve really enjoyed the opportunity in these last few weeks to reflect and listen to what the world has going on and where it’s going. I’m really looking forward to finding more opportunities to be able to keep working at the intersection of healthcare and public health and technology, which is where I spent most of my time at HHS. I think there is some very exciting work and opportunities happen in the US. I’ve been more like a student than anything lately, and it’s just been a delight.

Gamble:  That sounds great. Now, looking at your time as national coordinator for Health IT,