Karen DeSalvo: Interoperability won't come easy

After five years of efforts fueled by the HITECH Act, which mainly served to push providers to use electronic health records, it's time to earn a return on investment, Karen DeSalvo says.

Speaking at the Workgroup for Electronic Data Interchange's annual fall conference in Reston, Virginia, on Tuesday, the National Coordinator for Health IT (pictured right) reiterated the challenges and goals associated with implementing ubiquitous interoperability throughout the healthcare industry.

"When we take a look at where we are today as a country and where we're going, this is our chance to say 'we've built infrastructure for health IT on the front lines, we've built infrastructure around information exchange,'" DeSalvo said. 

"We've shown that you can change culture and get people to work together for the betterment of population health and not just to compete on data. How can we not take what we have learned and use that as a foundation to go forward as quickly as possible to see the value in that data?"

Culture change was a tough task, according to DeSalvo, who talked briefly about national Beacon Community efforts.

The program "brought to the table, typically, competitors for optimum data," she said. "We asked them to consider how [sharing data] would improve population health. That culture change piece of Beacon was so tumultuous. We certainly made a lot of new friends, we argued a lot about things like 'what is the population we're here to serve?' 'How do we define that?' It got heated sometimes, because you're talking about people's lives.

"In the end, what I heard was that people in those communities really learned to work together."

DeSalvo also talked about ONC's next steps, touting the agency's recently unveiled health IT interoperability road map. But she also acknowledged that change won't come easy.

"If this sounds complicated, you are right," she said of the agency's plan to create a learning health system by 2024, which she stressed requires just as much private sector input as public. "We are spending a lot of energy making sure that we avoid throwing the baby out with the bathwater … by relying only on federal processes or rulemaking. … We don't want to end up with a road map in January that doesn't speak to people, that people don't see themselves on."