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New Orleans Health Commissioner Named HHS Health IT Coordinator

By John Reichard, CQ HealthBeat Editor

December 18, 2013 -- New Orleans Health Commissioner Karen DeSalvo will start Jan. 13 as the new national coordinator for health information technology at the Department of Health and Human Services (HHS).

"DeSalvo has been at the forefront of efforts to modernize the New Orleans health care system," HHS Secretary Kathleen Sebelius said in an email to staff announcing the appointment.

DeSalvo made health IT a "foundational element" of efforts to redesign the city's health care system after it was devastated by Hurricane Katrina, Sebelius said. "Further, she has led the planning and construction of the city's newest public hospital, which will have a fully-integrated HIT network."

DeSalvo also serves as senior health policy adviser to Mayor Mitch Landrieu, the brother of Sen. Mary L. Landrieu, D-La.

While DeSalvo is viewed as an expert on information technology, her career has focused more broadly on developing efficient systems of care to treat the medically underserved and to improve the health of local populations.

She won national recognition for her work after Katrina in 2005 to create a new system of primary care in the city. The flood forced doctors to practice out of makeshift clinics around the city, according to a profile in Governing magazine that named her one of nine top public officials in 2013. DeSalvo was chief of internal medicine at the Tulane School of Medicine at the time, where she had earned both a medical degree and a public health degree. She also has a master's degree in clinical epidemiology from the Harvard School of Public Health.

"DeSalvo was instrumental in developing a network of more than 100 neighborhood-based 'medical homes' providing health care access for uninsured, underinsured and low-income patients," the profile said.

Mayor Landrieu hired her in 2011 to overhaul the city's approach to public health. She sought to "transform the health department from a reactionary agency focused on clinical care into a comprehensive resource aimed at making New Orleans a healthier place to live," the magazine said. She worked with an estimated 100 or so organizations in leading the development of "Fit NOLA" to address obesity, diabetes and high blood pressure, including by adding bike lanes and building parks and by bringing supermarkets to underserved areas, the magazine said.

The announcement by Mitch Landrieu's office also noted that DeSalvo "has been instrumental in implementing the Mayor's comprehensive murder reduction strategy."

HHS and New Orleans city officials declined requests to interview DeSalvo.

The network of neighborhood clinics developed in New Orleans focused on delivering comprehensive primary care through the medical home model, DeSalvo said in a presentation earlier this year to a national health IT conference. She defined a medical home as "not just a place to get health care, but a place where you are understood." The medical homes are linked together into an information network in which doctors use electronic health records to follow a patient as they move through the city's health system.

As national health IT coordinator, DeSalvo will be closely involved in the implementation of Medicare and Medicaid payment incentives to make increasingly "meaningful use" of health IT to improve the safety and efficiency of care. But her career in New Orleans suggests she could focus more broadly on using the technology to improve primary care and reduce spending growth. In her presentation at the IT conference, DeSalvo said widespread adoption of primary care could save the U.S. up to $175 billion over 10 years.

Sebelius said DeSalvo also has been a leader in local efforts to set up a computerized network among providers for exchanging health data, and has been involved in setting up regional centers that assist doctors and hospitals in adopting health information technology.
"She served as President of the Louisiana Health Care Quality Forum, the Louisiana lead for their health information exchange and regional extension center grants," Sebelius said.

Salvo succeeds Farzad Mostashari, who stepped down Oct. 4 after two years in the position. Mostashari is now with the Brookings Institution.

Jacob Reider, the acting national coordinator, will serve as chief medical officer in the national coordinator's office. "Every minute has been inspiring, educational, and energizing," Reider said in an email welcoming DeSalvo's appointment.

"She has deep knowledge and experience in health policy, medical education, and public health," Reider said of his new boss.

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