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ONC’s First Chief Health Information Officer Says His Number-One Focus Is Interoperability

April 14, 2015
by Mark Hagland
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Michael McCoy, M.D., ONC’s first CHIO, shares his perspectives on interoperability, MU, and the path ahead

In the midst of all the activity at the HIMSS Conference, being held at the McCormick Place Convention Center in Chicago, Michael J. McCoy, M.D. sat down to share his perspectives on a range of topics with HCI Editor-in-Chief Mark Hagland. McCoy joined the Office of the National Coordinator (ONC) on Jan. 26 as that agency’s very first Chief Health Information Officer. Dr. McCoy joins Thomas Mason, M.D., ONC’s new Chief Medical Officer (who came on board on Feb. 23), and Andy Gettinger, M.D., ONC’s Chief Medical Information Officer (who joined in October 2014) as three senior officials who have all practiced medicine (Mason continues to do so part-time), and who bring practicing-physician perspectives to agency leadership—an important attribute to have these days, and to some extent a possible corrective following the departures of Jacob Reider, M.D.  and Judy Murphy, R.N., two senior ONC officials with clinician backgrounds who left last fall.

McCoy in fact has quite a varied background in healthcare. He was health system CMIO for a number of years, most recently serving in that role at the Detroit-based, 20-plus-hospital Catholic Health East, leaving after Catholic Health East was acquired by the Trinity Health integrated system. He has also worked as a consultant, and as a vendor executive, including in stints as vice president and medical director at Eclipsys and executive vice president and chief medical officer at DigiChart, an OB/gyn-specific electronic health record (EHR). He also spent 20 years in practice as an obstetrician/gynecologist.

With that varied background, and his recent experience as a CMIO still fresh in his memory, McCoy says that he wants to bring a strong clinician perspective to the chief health information officer role, which senior officials at ONC crafted for him personally. Below are excerpts from his interview Tuesday with Hagland.

Michael McCoy, M.D.

Given your rich background and varied experiences, what would like to accomplish as ONC’s first chief health information officer?

My primary focus has to be on interoperability, because that’s the foundation for everything else. I would like to see where possible some reduction in the impediments for certification. I think a lot of the challenges are not because people in ONC or CMS [the Centers for Medicare & Medicaid Services] or any of the other federal partners doing this, have mal intent; instead, there are a lot of individual siloed areas [within government agencies]. It’s just that when you pile everything on [providers] all together [including intensifying requirements under the meaningful use program], it becomes… Well, you have to coordinate. And there are opportunities within the constraints of what is legislatively allowed. I’d like to do some things to streamline the certification process, making it more possible for usability to be considered. It’s not that it’s disallowed now, but it becomes more difficult to focus on usability.

Nor are the developers [vendors] the sole culprit. Clinicians, to their detriment, have not as been as engaged as possible in the selection or deployment of certain technologies. So there are many reasons for some of the angst out in the general public. That said, though, we have to get beyond the blame game around [vendor IT] products—we have to optimize the products out there, improving workflows, efficiency, and productivity and most of all focusing on the needs of patients. I personally want a more person-centered approach: health is not just healthcare. We need to help people make more informed decisions in their lives, and we need interoperability to help facilitate everything. And that will help to develop a learning healthcare system as well.

Can you speak to the consternation that some provider leaders are feeling regarding the provision in the proposed change to the Stage 2 MU requirements that would take the requirement that asks providers to get 5 percent of their patients to view, download, and transmit their health information and shrinks it to one patient per provider doing so?

Unfortunately, I’m not allowed to comment on that, because it’s found in an NPRM [notice of proposed rulemaking].

As meaningful use proceeds towards its conclusion, where will that leave us, and where should it leave us, with regard to interoperability?

Ultimately, it should support health system reform. You have to have data liquidity, which requires interoperability, to create that change. As we move towards paying for outcomes, we have to have the data liquid. Think in three buckets of the person, the panel, and the population, and it’s in that panel that the actual dollars will be spent. And the data has to be able to move among all the parties in there so they can optimize the care.

 And life beyond meaningful use is certainly what ONC is trying to position us for, so certainly the optionality in the NPRM for our certification rule is there to show that there is life beyond meaningful use, and that we are trying to position to allow for our certifications to be more meaningful in a broader context. It’s moving beyond the EHR; there are mobile applications and consumer and mobile applications; there’s the Internet of things. Those are all entry points into health, not just healthcare data. How do I perform when I’m exercising? What’s my diet? Those are all elements that inform parts of the system.

Given all that, would you like to accomplish as chief health information officer in the next few years?