WASHINGTON — Micky Tripathi, PhD, MPP, the new head of the Office of National Coordinator for Health Information Technology (ONC) has the right blend of government and on-the-ground experience needed for the job, according to two of his former colleagues.
Tripathi’s biggest asset is the “breadth of experience he has in the real world as well as the understanding of policy,” said Farzad Mostashari, MD, founder and CEO of Aledade, a company in Bethesda, Maryland that helps primary care doctors start up and run accountable care organizations. “He knows about EHR [electronic health record] adoption, he knows about interfaces — the non-sexy, hard, grinding work — but he also is always among the people pushing the front in terms of ‘We can make the system better.'”
Tripathi, whose appointment does not need to be confirmed by the Senate, comes to the ONC after serving a number of years in various information technology (IT) jobs. He worked in the federal government early in his career, serving as an operations research analyst at the Department of Defense from 1988 to 1992, and then as a project manager at the Center for Naval Analyses, a nonprofit research and analysis firm, from 1992 to 1994. He also did a 1-year stint as president and CEO of the Indiana Health Information Exchange.
From 2005 to 2020, Tripathi was president and CEO of the Massachusetts eHealth Collaborative (MAeHC), a non-profit health IT firm that shut its doors last year and sold its assets to Arcadia, a healthcare data and software company in Burlington, Massachusetts, where Tripathi then served as Chief Alliance Officer. The latter position’s duties are defined by the company on its website as “developing strategic partnerships between Arcadia and other innovative companies to further accelerate the use of advanced technology to improve healthcare.”
Arcadia CEO Sean Carroll told MedPage Today in an email that Tripathi “is bringing to the ONC an in-depth knowledge of what payers and providers need in the current healthcare landscape and a data-driven approach to their mission. He’s the best of the best and I’m glad to have had a chance to work closely with him this year and to watch the impact his team’s policies have on the country.”
Don Rucker, MD, Tripathi’s immediate predecessor at the ONC, called Tripathi “a very strong choice.” “Because he has been involved in the trenches and rolling stuff out, has a very organic sense of how EHRs work, how data flows, when it flows, and when it doesn’t flow,” Rucker said in a phone interview. “He has an intuition about actually getting the data; those are valuable core attributes in this job that underpin all the high-level things.”
Tripathi’s biggest immediate challenge, Rucker said, is “how do you make computing around COVID? How do you get better on the testing, distribution of test results, insights in the disease. How do you facilitate the vaccination process? How do you reach out to people?” Because fighting COVID is a top priority for Biden, and because health IT is an important part of that mission, “Micky was brought in immediately … That’s the reason he was on the job within a day of the Inauguration.”
Mostashari, who served as ONC coordinator under President Obama, said one advantage Tripathi will have is that he’ll know when he can push software developers — and when he can’t. “He can push them because when they say something that isn’t true, he knows it’s not true — they can’t give excuses — but at the same time, he isn’t going to do things that aren’t going to work” because he won’t make unrealistic assumptions about how the market works. One of the first things Mostashari remembered learning about Tripathi was that when Tripathi worked in his job reviewing procurements at the Pentagon, “he tried to kill the V22 Osprey [helicopter]. So he’s no stranger to trying to shut off programs that are overbudget and not delivering.”
Another advantage Tripathi has is that “he really knows the staff at ONC, who are terrific,” and he will value them, Mostashari added. “There’s no question about that with Micky.”
Tripathi will have several good opportunities as head of ONC, Rucker said in a phone interview. “One is the opportunity with state and health health information exchanges to rethink public health reporting,” which for the last 105 years has consisted of mandated reports to public health authorities. “That made total sense when that was the only information and technology around. But we now have so much data in [EHRs] that there is a great opportunity to use the concept of the exchange with these health records.”
The other opportunity, said Rucker, has to do with integrating clinical and financial data. “Right now we have totally separate streams — clinical data goes to information exchanges and the EHR, and financial data flows into claims data, and we wonder, in the search for value … why we have had a hard time getting care that has innate value in it,” he said. “We’re not going to get something that’s a good deal until those data streams are integrated … One thing I think Micky will be good at is thinking about integrating clinical and financial data.”
The nice thing about the ONC job is that political issues are at a minimum, Mostashari said. “We’ve actually had a lot of continuity between national coordinators and between administrations. I’m very grateful to Don [Rucker] for continuing the basic patient-centered agenda, and I absolutely think that while each national coordinator puts their own emphasis on the agenda, that Micky is going to continue to push on the progress that has been made.”