A Market-Driven or Policy-Driven Approach to Health IT Innovation? ONC’s Deputy National Coordinator on the Path Forward

The accelerated pace of innovation in digital health,
record-breaking investments in the sector and even some of the
technology developed to navigate the pandemic wouldn’t have been
possible without groundwork laid by The Office of the National
Coordinator for Health Information Technology (ONC). And there’s
probably no one who understands ONC’s past, present and future
role better than Steve Posnack.

Steve is a fixture at ONC, joining a year after it was formed in
2004 and serving for the past 16 years in various capacities
through four administrations. Since 2019, Steve has served as
Deputy National Coordinator, playing an integral role in policy
development, technology initiatives and investments, budget
prioritization and industry-wide coordination.

In this episode of Healthcare is Hard, Steve gives a background
and history of ONC, explaining how it fits into the Department of
Health and Human Services and the overall role it plays in the
federal government. He shares insights that anyone in the
healthcare innovation ecosystem should understand and his
conversation with Keith Figlioli covers a number of topics
including:



Wins and regrets of ONC. As someone who has been at ONC
for nearly its entire history, Steve has a rare vantagepoint to
reflect on initiatives that have gone smoothly and
lessons-learned for those that haven’t. For example, he
discusses successes and challenges of Meaningful Use,
recognizing its imperfections, but all the innovation that it
made possible as well.


Cybersecurity in healthcare. Steve entered ONC after
earning a dual master’s degree in cybersecurity and health
policy from Johns Hopkins University, giving him a unique
skillset to address the security issues with healthcare IT that
are becoming increasingly more critical. He talks about the
need for better cyber hygiene industry-wide and shares thoughts
about meeting that goal. But he doesn’t predict any federal
mandates for security in the near future.


Improving data quality. According to Steve, poor data
quality is a sore point for public health professionals and an
area where the private sector can help in order to benefit
everyone. He says the people tasked with tracking and
consolidating data spend precious time doing “data detective
work,” and it’s been especially challenging through the
pandemic. This requires looking upstream to know where data is
coming from and where it’s going to figure out how gaps occur
and how to address them.


The future role for ONC. Taking all of ONC’s
accomplishments into account, Keith and Steve discuss if
there’s more work to be done, or if the public sector should
start taking over. From Steve’s perspective, there’s a lot for
the private sector to build on, but he also says there’s a lot
the industry is still asking ONC to push forward. As just two
examples, he talks about how work around the social
determinants of health and the convergence of clinical and
research operations still need broader coordination.



To hear Steve and Keith talk about these topics and more, listen
to this episode of Healthcare is Hard.