Three Communication Lessons from the ONC Leadership Debacle

It’s no secret that government leadership on health IT is in a bit of a shamble. The Office of the National Coordinator for Health IT (ONC) is going through a disconcerting and ill-communicated leadership exodus that has put health IT solutions providers and healthcare leaders on edge nationwide.

The sad part? It didn’t have to be this way. The ONC demonstrated three classic communication fails that, in large part, have driven much of the news coverage and critiques – and could have been avoided.

Lack of Consistency. On October 23rd, the agency announced that Dr. Karen DeSalvo, National Coordinator for Health IT, would step down from her role to serve as Acting Assistant Secretary for Health at HHS, partially to help address the Ebola crisis. Five days later, ONC blogged that Dr. DeSalvo would not in fact leave ONC, but would serve ONC and HHS at the same time. The world of health IT was, to say the least, a little whiplashed by the vacillating statements, leading to significant critique and confusion from press and stakeholders.

A better approach would have been to internally align on a plan, make sure all spokespeople were briefed and in agreement, and communicate it out as part of a broader communications strategy. If in fact this took place, and there was a thoughtful change in the plan after the fact (it happens!), ONC should have been upfront about why they changed their tune, and why it’s the best thing for the country.
Lack of Clarity. To further muddy the waters, ONC went on to state that Lisa Lewis would take on the role as day-to-day leader at the agency, while Dr. DeSalvo conducts her tour of duty at HHS. The obvious question from followers was, how will that work? How involved will Dr. DeSalvo be at ONC while she’s gone? Who’s really running the ship, with this oddly split leadership model?

ONC could have avoided this confusion with a clearer announcement of the change in plan. While the blog did a good job justifying Dr. DeSalvo’s new role at HHS, it did little to clarify how and why she’d stay involved at ONC. Instead, it should have offered an explanation of how roles and responsibilities would be split between Dr. DeSalvo and Lisa Lewis, and quelled stakeholders’ angry questions before they arose.

Failed Stakeholder Engagement. Unfortunately, those angry questions did arise, and in mass. Some important leaders, such as Russell Branzell, President and CEO of the College of Healthcare Information Management Executives (CHIME), saw this as further evidence that the administration doesn’t value health IT. CHIME and the Healthcare Information Management Systems Society (HIMSS) are now questioning Dr. DeSalvo’s ability to juggle two roles, and demanding new full-time leadership at ONC to ensure that important health IT initiatives don’t stall.

While it’s impossible to know exactly how ONC engaged their most important advocates and partners in advance of this news, the outcry implies that it probably wasn’t very successful. As part of any major crisis or leadership change, internal and external stakeholders must be engaged, educated, and involved. ONC should have known that.

This is not to say that smart communications can completely prevent the repercussions of a difficult, controversial organizational change. However, building and executing on a strategic plan in advance of a public announcement, and preparing for anticipated questions and critiques, can go a long way in minimizing disarray and maintaining confidence.

November 13, 2014
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