David Muntz, principal deputy national coordinator in the federal Office of the National Coordinator for Health Information Technology (ONC), was the opening keynote speaker on Sunday afternoon, May 6, at the Healthcare Informatics Executive Summit, being held at the Marriott Orlando World Center Resort in Orlando, Florida. Just prior to his presentation at the Summit, Muntz, who four months ago was appointed to the second-highest position at ONC, supervises 160 of the 180-ish staff members at that federal agency, and reports directly to Farzad Mostashari, M.D., the national coordinator. Muntz spoke with HCI Editor-in-Chief Mark Hagland about his experiences so far at that agency, and his hopes for the future. Below are excerpts from that interview.
What, if anything, has been surprising to you, now that you’re on the inside at ONC?
The greatest surprise is the sheer intellect [of ONC staff members], and the fact that along with that intellect, are servant hearts beating in everybody who works there. They are smart, they are motivated, and they are all interested in doing the right thing.
People were pleased when you were appointed, to hear that a CIO recognized throughout U.S. healthcare as an industry leader was chosen for the post. Is your perspective different, now that you’re working inside the agency rather than advocating from the outside, as you did on behalf of CHIME [the Ann Arbor, Mich.-based College of Healthcare Information Management Executives, for which Muntz spent several years as a volunteer policy leader, while also working full-time as the senior vice president and CIO at the Baylor Health Care System in Dallas]?
Sure. I think it gives me a little bit better insight into how regulations and policy are crafted. And there is an advantage in having recently implemented the technologies that people are commenting upon. We’ve been working with the stakeholders, and we have both an empathetic and a sympathetic bent when we’re listening and talking. And one of the things that attracted me to the office was that when I had some advocacy responsibility for CHIME, I edited some of the documents going from CHIME to CMS [the Centers for Medicare and Medicaid Services]. And one of the things that impressed me was that in the preambles that accompanied the final rules, I could see the thoughts I had expressed on behalf of my peers being reflected in the documents. The fact that they really listened to us was what most impressed me. And I can say now that I can see how sincere they are in this. We’re focused on value as defined by the stakeholders.
But we also want to make sure that one of the stakeholders represented is the patient; and the patient is represented in everything we do.
What has been the single most challenging thing you’ve experienced so far?
It’s going to sound very funny, but it’s the ability to ‘speak government’—the abbreviations, the acronyms, and the federal mechanisms, are so different from what I’m used to, and it’s taken me a while to develop the skill to listen, and take advantage of the process. Some are more restrictive than what we were used to as a single organization, and the additional scrutiny is not uninvited, but is sometimes challenging, and slows down my speed.
On the other hand, one thing that’s been impressive has been to discover how much the government agencies work together and how much inter-agency activity is necessary to represent the whole. It gives you an appreciation for the complexity of things. I could appreciate the complexity of an electronic health record; I didn’t appreciate how complex policy-making was.
If there’s a single message you’d like CIOs and other healthcare IT leaders around the nation to hear directly from you, what might that be?
I’d like to continue to see us raise the bar together and work collaboratively to help everybody in the community; not just those that are well-represented, but those that are not well-represented as well. And the big institutions, those who have done it, will help those who have yet to do it.