Karen DeSalvo, Former National Coordinator for Health IT, Chapter 2

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

Chapter 2



* Call for “one voice” to represent cybersecurity at HHS

* Action items for CIOs — “Most people don’t even have a baseline.”

* No. 1 issue in HHS Wall of Shame

* Beyond HIPAA risk assessments — “That’s a small piece of the bigger security puzzle”

* Lessons learned from the process

* “Everyone sees the importance of protecting patients.”

* Next steps for HHS



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Bold Statements

I’d go from one end at HHS with the younger innovators, then go to the Office of the Secretary, where we still used paper for clearance. It was a really nice blend. From an operational standpoint, I was able to take some of the more innovative, modern approaches and techniques that were happening in ONC and apply them to OAS, and vice versa.

I just kept going further upstream; the more I learned about the barriers to wellness for my patients, the more I wanted to be a part of public health opportunities to create the conditions in which people could be healthy.

Health is more than healthcare, and if we’re going to really advance health in this country, we’re going to have do that together, and we’re going to have to do it in such a way that we aren’t just fixing people when they arrive in the healthcare system, but doing everything we can to keep them well.

Public Health is at risk of becoming obsolete at the local level if it doesn’t learn to modernize and step out of some of the traditional ways that it’s been practicing.

You cannot make decisions on data that is three years old. You need timely, granular, actionable information to keep everybody in the game and to know that what you’re doing is actually improving the Public Health. That will be a reinforcing cycle, and I think that the Health IT and the healthcare world has such a huge role to play.

Gamble:  You were also Acting Assistant Secretary for Health, so I wanted to ask, did those two roles dovetail pretty well or was it a little tricky in balancing the two?

DeSalvo:  It depended. They’re culturally very different offices and have very different histories and underpinnings. The Office of the National Coordinator was formed in 2004, so it was 10 years old when I got there, and the Office of the Assistant Secretary for Health dates back to 1790s with the beginning of the public health service, and so some of the statutory and other traditions are pretty storied. There’s a lot of history and formality and pomp and circumstance associated, especially with the Commission Corps.

It made for interesting days. If I went from one team to the next team — which I did when my offices were on the same floor — I’d go from one end at HHS with the younger innovators, then go to the Office of the Secretary, where we still used paper for clearance. It was a really nice blend. From an operational standpoint,