Late last month, Jodi Daniel, then-director of the Office of Policy in the Office of the National Coordinator for Health Information Technology (ONC), announced that she would be stepping down from her post at the agency inside the Department of Health and Human Services (HHS). It was then revealed last week that Daniel would be joining Crowell & Moring LLP as a partner in the Washington, D.C.-based firm’s healthcare group.
Daniel served for a decade as the director at the ONC and 15 years at HHS, and according to her ONC bio, she developed the agency’s foundational legal strategies for health IT as the first Senior Counsel for Health Information Technology in the Office of the General Counsel (OGC) of HHS. Daniel was responsible for coordinating all legal advice regarding health IT for HHS and was the lead attorney for ONC, so the move to the law firm should be a natural progression for her.
Nonetheless, Daniel is the longest-tenured senior official at ONC, an agency that has experienced mass departures from its senior-level leadership over the last year. Shortly after announcing her decision to leave ONC and join Crowell & Moring, Daniel spoke with HCI Senior Editor Rajiv Leventhal about: her reason to leave the government; what her and other ONC senior–level leaders’ decisions to move to the private sector might mean for the agency; the government’s proper role in healthcare; how health IT has evolved during her time there; and what’s to be expected in the years ahead. Below are excerpts of that interview.
What was behind your reason to leave ONC at this time?
I have been at HHS for 15 years and at ONC for 10; I helped start the office back in 2005. I felt like it was a fabulous opportunity to have a lasting influence on healthcare systems. I have accomplished a lot, the office has accomplished a lot, but it was just great timing for me. ONC just came out with its [2015 Edition Health IT Certification Criteria] regulations that went along with meaningful use regulations, so for me it was time for a new challenge to see things from another vantage point. The government has done an amazing job of kick starting the movement towards health IT in the healthcare sector. The next decade will bring a lot of interesting activity and innovation happening in the technology sector and the private sector. You have new technology companies entering the market. I really wanted to be a part of leveraging that technology for healthcare and health outcomes, so the transition made sense for me.
What do you hope to accomplish at Crowell & Moring?
I hope to build a health IT policy legal practice where I can focus on issues from many different perspectives. Some of it will be helping providers adapt to changes to technology in the regulatory space, and comply and take advantage of opportunities for improving healthcare particularly as we see more changes with payment and payment reform. I also would like to work with organizations that are developing new technologies and figuring out how to improve how healthcare is delivered and how to improve communication between patients and providers, as well as help patients manage their care outside the doctor’s office and hospital. It’s about trying new things that may not have been contemplated by the current regulatory and policy regime so they understand how they can proceed and do so in a way that’s consistent with the policies from a technology perspective and payment perspective.
How does the federal health IT landscape look today compared to a few years ago? What has changed most?
I think the biggest change is one from spotty adoption of health IT to widespread adoption among providers and hospitals. Going back 10 years, there was a single digit percentage of doctors who had EHRs. Now half of doctors and almost all hospitals are using EHRs to take care of patients. So there is a huge shift in the use of adoption and tools.
There is also improvement in the electronic exchange and interoperability of health information using technology. The goal is that information will follow patients when and where they need. I don’t think we are there yet, but we do see pockets of interoperability in regions or among different healthcare systems, and in some cases nationally through things like The Sequoia Project. And then we have almost universal e-prescribing usage across healthcare providers and the exchange of prescription information between providers and pharmacies. That was a wish when I started, now it’s a reality. We wouldn’t have seen these changes if not for incentives and a push from the federal government.
With adoption, we have hit already hit the tipping point and passed it, so in that space, the real challenges and opportunities are focusing more on usability and the ability of systems to help improve efficiency and effectiveness to help providers care for patients. We are also seeing more adoption of technology outside providers who were eligible for incentives, such as in behavioral health communities. They are so critical to the overall health of patients.
What would you say is the proper role of government in health IT?