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Q&A: Karen DeSalvo on Meaningful Use, ONC Reorg

Scott Mace, for HealthLeaders Media, June 10, 2014

In an in-depth interview, National Coordinator for Health Information Karen DeSalvo, MD, discusses meaningful use, EHR usability, innovation, and the recently announced restructuring at the Office of National Coordinator. Part one of two.


DeSalvo


Karen B. DeSalvo, MD
National Coordinator for
Health Information Technology

At the annual Health Datapalooza in Washington D.C., last week, I spoke with Karen B. DeSalvo, MD, MPH, MSc, National Coordinator for Health Information Technology, one-on-one for the first time.

DeSalvo, who was appointed to the ONC position in December, has a record of public service. She served as Health Commissioner for the City of New Orleans and as a senior health policy advisor to the mayor. After Hurricane Katrina in 2005, she led the creation of a neighborhood-based primary care and mental health services model for underserved individuals.

In the first part of our conversation, we covered everything from ONC's restructuring to what to do about buggy software that could threaten patient safety.

HLM: The proposed rule on meaningful use Stage 2 – what was the thinking behind that, how do you help large healthcare providers make sense of where Stage 2 is going from here?

DeSalvo: Meaningful use as a program has a large policy goal of advancing adoption of electronic health records in the clinical environment, and seeing that they were not just set up but used in ways that could improve patient care and outcomes.

The reason I start with all that is because we should keep in mind that the goal is to push as many folks forward as possible, and help offset the cost of the installation and use of electronic health records in the clinical environment. That's the incentive payments.

Those who are in the meaningful use program think meaningful use Stage 1 is very successful, [with] huge adoption across the country, incredibly rapidly.

For Stage 2, as you know, we have recently done a couple of things. One is [we've] clarified a hardship exemption that existed in the law, so that if providers, for whatever reason, wanted to claim hardship, it would be clear what those options might be.

But then we just put out a notice of proposed rulemaking that we seek comment on, which gives some flexibility that we think might help providers. [Providers] who, through no fault of their own, have been unable to install a 2014-edition product, and see that it is part of their workflow, so all of the patches— everything's installed.

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