Federal Health IT Office Reorganizes

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The Office of the National Coordinator for Health IT is reorganizing into a flatter, leaner structure as it nears the end of its mandate to promote the use of health information technology using federal stimulus funds.

The new structure announced late last week by ONC Director Karen DeSalvo eliminates a structure in which nine offices reported up through deputy national coordinators; instead, each office is headed by a director reporting directly to DeSalvo and Deputy National Coordinator Jacob Reider, MD.

The 10 office heads in the new structure, all established ONC leaders but many in new or renamed roles, are:

Office of Care Transformation: Kelly Cronin

Office of the Chief Privacy Officer: Joy Pritts

Office of the Chief Operating Officer: Lisa Lewis

Office of the Chief Scientist: Doug Fridsma, MD, PhD

Office of Clinical Quality and Safety: Judy Murphy, RN

Office of Planning, Evaluation, and Analysis: Seth Pazinski

Office of Policy: Jodi Daniel

Office of Programs: Kim Lynch

Office of Public Affairs and Communications: Nora Super

Office of Standards and Technology: Steve Posnack

Lewis was formerly Deputy National Coordinator for Operations, and Murphy was Deputy National Coordinator for Programs and Policy in the old management structure.

The reorganization was announced in an email sent out late Friday, although it refers back to decisions discussed at an all-staff meeting earlier in the week.

"This functional realignment will improve the overall effectiveness and efficiency of ONC by combining similar functions, elevating critical priority functions, and providing a flatter and more accountable reporting structure," DeSalvo wrote in her email. "In addition, this realignment will support our focus on developing and implementing an interoperability roadmap, supporting care transformation, and establishing a framework to support appropriate use of health data to further meaningful consumer engagement, system-level quality and safety of care, improvements in the public’s health, and advancements in science."

Politico had reported earlier in the month that a "major shakeup" was coming, which an unnamed source said would center on the leadership for standards and the Chief Scientist.

The Office of Standards and Technology is new, representing an elevation of the role of standards setting within the organization. Posnack was formerly director of the ONC's Federal Policy Division. According to a description of the new offices, published on the Federal Register website, this office "is responsible for: : (1) leading research activities mandated under the HITECH Act provisions of ARRA; (2) promoting applications of health information technology that support basic and clinical research; (3) collecting and communicating knowledge of health care informatics from and to international audiences; (4) collaborating with other agencies and departments on assessments of new health information technology programs; (5) developing and maintaining educational programs for staff of the Office of the National Coordinator and advising the National Coordinator concerning the educational needs of the field of HIT; and (6) developing the mechanisms for establishing and implementing standards necessary for nationwide health information exchange."

Chief Scientist Doug Fridsma remains in his role, but the office he heads is reverting to its old name, Office of the Chief Scientist, after having been renamed the "Office of Science and Technology" in a previous 2012 reshuffling. This implies he will narrow his focus to science, rather than technology -- defining and evaluating the science underpinning ONC programs and whether they are achieving their intended positive impacts on medical science.

The reorganization also creates a new Office of Care Transformation, "responsible for providing expertise and strategic direction in the domain of transforming and optimizing health care through the leveraged use of health information technology throughout the Department of Health and Human Services, with the private sector, and with other federal partners," according to the Federal Register filing. Its director, Cronin, formerly held the title of Health Care Reform Coordinator.

DeSalvo was appointed ONC Director in December. Formerly New Orleans health commissioner, she attracted attention for her use of health IT (and observations about needed improvements) during the city's recovery from Hurricane Katrina.

The ONC is the unit within the U.S. Department of Health and Human Services that establishes the IT standards for the Meaningful Use program, working with the Centers for Medicare and Medicaid Services (CMS). CMS administers the related system of incentives funded under the HITECH Act, a federal stimulus program that rewards doctors and hospitals for the implementation and effective use of health IT.

Has meeting regulatory requirements gone from high priority to the only priority for healthcare IT? Read Health IT Priorities: No Breathing Room, an InformationWeek Healthcare digital issue.