There are many eligible candidates who come to mind when thinking about who could fill the shoes of David Blumenthal, MD, national coordinator for health information technology. Experts cite meaningful use and electronic health record implementation experience as important criteria, but one consultant puts particular emphasis on finding a new leader who possesses a care team approach to health IT.
[See also: Blumenthal to leave ONC.]
Consultant Ann Farrell, principal at Farrell Associates and a former RN, believes that William Bria, MD, CMIO, Shriners Hospital for Children, Tampa, Fla., would be the ideal replacement for Blumenthal. She wrote a letter detailing why she thought Bria was the best candidate, which first appeared on HISTALK on Feb. 9.
Farrell says that Bria's credentials and breadth of EHR experience in diverse organizations, his leadership role at the Association of Medical Directors of Information Systems (AMDIS), and his temperament and character "position him to achieve the next set of challenges."
She adds the key characteristic that sets Bria apart from his peers is his career-long team based approach to healthcare.
"We need to usher in huge culture change," she said. "It's key that the new leader recognizes that emerging care models – accountable care organizations (ACOs) and medical homes – are patient centric, highly collaborative and team based. EHRs must support new delivery and reimbursement models."
Unless nursing, in particular, and other clinicians have roles to play in meeting the mandates of HITECH, Farrell says, "I don't think we will achieve the ultimate national goals, nor will physicians be well served."
Each of three prior ONC leaders brought unique strengths she said: David Brailer, MD, brought entrepreneurship; Robert Kolodner, MD, brought VA Vista experience; Blumenthal had impeccable academic credentials.
[See also: Blumenthal credited with building solid base for health IT.]
"In considering the many talented candidates against my list of critical success factors, it became clear to me that he [Bria] could best lead us to the promised land."
While Farrell has known Bria for many decades, he was not aware of her campaign. When she contacted him for a heads-up about her letter, he said he was flattered to be considered. Bria declined to comment to Healthcare IT News on the letter at this time.
Other experts predict Blumenthal's successor may come from within the ONC.
"My guess is most likely Sachin Jain, who has been deputy ONC director in support of Blumenthal," said Robert Rowley, MD, chief medical officer, Practice Fusion. "It will most likely be from within the ranks of the ONC, rather than from outside (though there has been a tendency to select candidates from academia)."
Another choice might be Farzad Mostashari, MD, MPH, currently a deputy director under Blumenthal, said David C. Kibbe, MD, senior advisor, American Academy of Family Physicians, chair, ASTM International E31Technical Committee on Healthcare Informatics and principal at the Kibbe Group LLC.
Kibbe calls Mostashari, "very competent, very effective, a good listener."
A popular candidate to replace Blumenthal is John Halamaka, MD, chief information officer at Harvard Medical School and the Beth Israel Deaconess Medical Center in Boston.
Jim Tate, founder of EMRAdvocate and a nationally recognized expert on the American Rehabilitation and Recovery Act and its HITECH provisions, calls him "a missionary for meaningful use."
"John Halamka embodies the optimism and knowledge to motivate the industry to continue to move forward with EMR and NHIN," said independent healthcare consultant and entrepreneur Renee Lin, who blogs regularly at Health Plan Geek.
Click on the next page to read Farrell's letter.
Ann Farrell's letter:
Greetings,
I am a career-long champion of EMRs as end-user at first US commercial implementation, EHR vendor VP and now Principal of Strategic HIT consulting firm. The news of Dr. Blumenthal's departure while not totally surprising is nonetheless of concern with now third hand off of leadership in high impact initiative that is advantaged by continuity. Nevertheless, this is an opportunity to look carefully at the character, characteristics and capabilities of the new leader so we can align the next set of challenges to the appropriate candidate and perhaps overcome flaws with current approach.
We recognize value of the next leader having directly supported ONC in HITECH initiatives. We also appreciate value of someone who has successfully supported change management with "hands on" experience in implementing EHRs in several diverse organizations who've achieved goals of HITECH in real world settings. The person ideally would be universally respected by vendors, hospitals, colleagues and the market – without political baggage and not part of "old boy network".
In this regard, we think Dr. Bill Bria would make an exceptional candidate. His knowledge, passion and track record well position him for success. Perhaps most importantly, Dr. Bria recognizes that healthcare does not equal "MDs" alone but requires a care team who execute MD orders as well as plans of care that together drive efficiencies and outcomes. All caregivers contribute to EHRs and patient care. Till this time, a clear MD-centric bias is reflected in Meaningful Use content, phasing of criteria and messaging. Ironically, this approach has had unexpected negative consequence for MDs as well as the program.
Dr. Bria has played a critical role in the "visioning" and design of several lead EMR/EHRs since the early days and played key leadership roles at diverse prestigious healthcare organizations and AMDIS. Bill is a hero to those of us who worked with him. Dr. Blumenthal's departure provides a chance to "reboot" HITECH – Dr. Bria could bring a new more realistic and a-political, patient-centric, interdisciplinary approach needed to optimize this once on a lifetime opportunity for HIT.
Regards,
Ann
Ann Farrell
Principal, Farrell Associates
San Francisco , CA 94114
Farrell is a longtime expert in the healthcare IT field. She was a nurse at El Camino Hospital in California, the first commercial implementation of an EMR worldwide. She subsequently was an executive for the EMR vendor when Bria was at Baystate Medical Center which served as the beta site for the vendor's "birth to death" electronic medical record in the 1980s. Since then, she's followed Bria's work at University of Michigan, and now Shriners Childrens Hospital and AMDIS.
