Hard on the heels of my own departure from the US Centers for Disease Control and Prevention (CDC) on September 30 comes a clean sweep of high-level informatics leaders in the organization.   Sources now confirm that James Buehler, MD the current Director of the Public Health Surveillance and Informatics Program Office (PHSIPO) will depart before year’s end.  His supervisor, PHS Rear Admiral (ret.) Steven Thacker, a long-time advocate for cross-cutting integration, is also slated to leave his post as Director of the Office for Surveillance, Epidemiology and Laboratory Services (OSELS).  These departures follow at least three years of marked funding reductions at CDC’s informatics core.

[Update 12/11/12: We’ve learned Dr. Buehler is departing for family reasons, and Dr. Thacker for health reasons.  Friends and colleagues of Dr. Thacker can connect with him and his family here.]

Few signals indicate the future direction for informatics at the Agency.   Acting leadership for OSELS will be placed in the hands of Denise Cardo, MD, director of the Division of Healthcare Quality Promotion, and Dan Jernigan MD, MPH of the National Center for Immunization and Respiratory Diseases (NCIRD) as her deputy.  While Buehler and I were recruited from outside CDC, both of the new OSELS leads come from powerful National Centers in CDC’s Office of Infectious Disease.  This may (but also may not) indicate a plan to redistribute the OSELS portfolio across the National Centers (sometimes called “Silos of Excellence”). 

The timing for an apparent leadership vacuum and dwindling resources could not be worse.  It comes in the middle of a massive one-time Federal investment of tens of billions of dollars in healthcare information technology and exchange.  Standardization engendered by the “Meaningful Use” electronic health record incentive program could enable major progress in public health programs if two conditions are met.  First, cash-strapped local and state public health agencies must make it a priority to migrate to new, more uniform standards and must have the resources to do so.   Second, critical public health requirements for information exchange must be successfully negotiated with cost-averse healthcare providers and their information system vendors.  Neither can be accomplished without dedicated leadership and resources.  The need for a confident, skillful, flexible and funded approach to public health information exchange with healthcare providers has never been greater.  We anxiously await the announcement of both new a new informatics vision and stable leadership at CDC.