ONC Turns 20!

Tomorrow marks the 20th birthday of the Office of the National Coordinator of Health Information Technology.

A few thoughts … 

a) ONC’s work is uniquely bipartisan.  There is little disagreement that information technology – well applied – can (will / must) improve the health of the people of the United States.  While different administrations have managed ONC’s work differently – the common theme remains an optimism about the role of information technology in improving population health, and the need for federal oversight of the tools with which this is done.  The impact of the work of ONC therefore can’t be overstated, despite the single thread with which ONC is sometimes conflated: the 1st five years of HITECH and the meaningful use incentive programs.  While these programs (yes – plural) catapulted ONC into the hearts and minds of most hospitals and clinicians, there was much work done before (and after) the flurry of activity that was HITECH.  Indeed, since ONC has been entrusted to coordinate federal technology work across federal agencies – quite a bit of what ONC has done isn’t visible to the naked eye.

b) I can’t describe ONC’s impact without expressing my gratitude to the team at ONC – past, present and future.  The impact that my 3 years there has had on my life has been extraordinary – and it truly changed the way that I view and understand the work of government.  For those who have not served in this way – I implore you to consider government service of some kind.  The alignment of a dedicated group of people to a shared goal (better health for millions of people) is powerful and exhilarating.  I had the honor of leading ONC for a time between Farzad and Karen, serving as Chief Medical Officer under Farzad – and serving as Deputy National Coordinator under Karen.  These were – in many ways – the best three years of my professional life.  I had planned to stay for “a year or two” – given that my home and my family were in Albany, New York and I was commuting to DC every week – so while the travel was not sustainable – the work was energizing and the team was fantastic – as it remains today.

c) And what’s next for ONC?  While I have some concerns about a few of the regulatory actions over the last few years (Don Rucker’s declaration of success – pulling back on some of the EHR certification requirements was – IMHO – premature) – the future of ONC remains bright – and as generative AI becomes part of day-in-the-life of most clinicians, ONC is well positioned to partner with others (CMS and FDA in particular) to guide the industry toward careful innovations that advance health equity.  It’s an incredibly exciting time – and while we thought (10 years ago) that three stages of “meaningful use” would get us from adoption to interoperability to improved health of populations – we are chipping away at all three.  Three stages?  Five years?  No.  We were too-optimistic.  But change moves at the speed of trust – and through that trust that ONC has now earned – (more) change is coming – for the better.