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Q&A: Blumenthal Talks EHRs, Healthcare Reform

President Obama's former national coordinator for health IT, Dr. David Blumenthal, shares his thoughts on progress with meaningful use of electronic health records, and what's next for healthcare reform.

InformationWeek: What do you miss most and least about the ONC job?

Blumenthal: I don't miss commuting to Washington [from Boston] every week. I don't miss the ethics scrutiny and constant accounting for time and expenses. What I do miss is the sense of being involved with something important where the stakes are high and the impact is great. And the constant flow of information into your environment from the outside. Washington gives you a special perch where you can observe the country and all its diversity. The amount of learning you do just by virtue of people wanting to tell you about themselves and their problems is enormous. It's almost impossible to duplicate anywhere else.

InformationWeek: How do the politics of Washington and the work you were involved with compare to medicine and academia?

Blumenthal: I've always thought that Washington politics are a whole lot easier to navigate. It's not as personal. Everyone understands you're going to make decisions that other people don't like and it's a matter of learning to live with it, and having to manage it and reach compromises that work, and if you can't, you can't, if you do, you do.

In the bipartisan environment of Congress there's less of that civility than there was in my world, which was a relatively professional environment. Republicans were not always supportive, but they were mostly supportive. I certainly didn't take attacks personally. And the interest groups that criticized us clearly weren't making personal attacks, they were representing their constituents.

In academia, people tend to take disagreement extremely personally. There aren't processes and institutions for managing conflict. Sometimes it gets personal in Washington, but in the process of managing substantive issues in Washington, I've found there's greater room for disagreement. In Washington, there's an acknowledged need to agree and disagree. People agree on some issues, and disagree on others without sabotaging the process.

InformationWeek: You were a primary care doctor before taking the job as national coordinator in 2009. Have you gone back to practicing medicine?

Blumenthal: No, I haven't gone back to practicing medicine. I miss it but I don't feel it's responsible for me to start again till I'm quite sure what I want to do. I had a practice before taking the position in Washington. I took my job in Washington on April 20, [2009] and had my last patient session on April 17.

InformationWeek: How did your patients react to you taking the National Coordinator position in Washington?

Blumenthal: Some people thought it was great, and some thought I'd be destroyed by the whole process. I don't think a lot of people understood it. Generally, patients are very supportive of their physicians.

InformationWeek: Were your patients surprised at all with you taking that job--did they see you as the tech-savvy doctor?

Blumenthal: First of all, I wasn't all that tech savvy. But I did have a computer, so I don't think they knew how tech savvy I might be. I think in general, they were sorry--I hope--to see me leave. But physicians move and take new jobs. I think they took it in stride. They all ended up with new physicians. Some ended up not finding a physician they like at Mass General, and moved on to other institutions.

InformationWeek: Now that you're out of ONC, you've been doing a lot of traveling for public speaking. What else are you up to? Are you also teaching at Harvard?

Blumenthal: I'm doing a lot of writing, and teaching as a guest lecturer in lots of courses. I've been at Harvard Medical School, MIT, and I'll be teaching at the [Harvard] Kennedy School of Government and the School Public Health. Harvard has lots of opportunities.

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