HHS CIO regains authority in latest reorganization

The Department of Health and Human Services is undoing the technology structure it set up in 2024.

HHS is splitting up its chief information officer’s office and its Office of the National Coordinator for Health IT into two separate and distinct organizations, similar to what existed before the reorganization.

By making this change, HHS says the CIO’s office returns to overseeing and managing departmentwide technology. Meanwhile, ONC, once again, focuses solely on nationwide health IT interoperability and data liquidity.

As part of this change, the chief technology officer, chief artificial intelligence officer and chief data officer come back under the CIO’s office.

“This structure allows OCIO to provide an integrated backbone for cloud, cybersecurity, data and artificial intelligence that every HHS component can rely on,” said HHS Chief Information Officer Clark Minor in a statement. “By bringing the CTO, CAIO and CDO functions together under one roof, we can move faster on shared platforms, protect our systems more effectively and support ONC and the operating divisions with the technology capabilities they need to innovate for patients.”

In 2024, HHS reorganized the ONC and CIO offices around three main areas. First, it renamed the coordinator as the assistant secretary for technology policy. Second, it moved oversight and management of technology, data and artificial intelligence policy and strategy into that new office. This second change included moving the CDO, CAIO and CTO positions into ONC. And third, it transferred the cybersecurity sharing program for the healthcare sector into ONC.

HHS CIO position in constant flux

Reaction to the reorganization was mixed. Some former officials said, at the time, it made sense for several reasons. But over time, current HHS executives said this set up made less and less sense because ONC is an external facing agency and having it run an internal policy shop didn’t work well.

“It was mixing internal operations with an organization that is healthcare-sector facing and it was dumb,” said one HHS source, who requested anonymity in order to talk to the press.

“With this departmentwide alignment, ONC can focus even more on standards, certification and policy, while our close partnership with OCIO ensures that the infrastructure and cybersecurity foundation are in place to support the health care system of tomorrow,” said National Coordinator Dr. Thomas Keane in a statement.

The position of CIO at HHS has been in constant flux over the past decade. Minor, who became CIO in May, is the 10^th CIO in nine years.

The challenge has been HHS leadership never fully supported the CIO authorities provision under the Federal IT Acquisition Reform Act (FITARA). Back in 2014, HHS leadership told the Office of Management and Budget and lawmakers that giving the departmental CIO the authority and management of all IT projects wasn’t going to work.

Bringing the CTO, CAIO and CDO functions, as well as the cybersecurity oversight and management, back under the CIO’s office is a more traditional delegation of duties.

HHS said in its statement that the new structure “reinforces OCIO’s statutory responsibility for enterprise IT, cybersecurity and data operations, while enabling ONC to concentrate on health IT policy, standards, and certification that support better care and lower costs.”

Several components seeking new IT leaders

The challenge for CIOs isn’t just at the headquarters’ level. HHS components are mostly run by acting technology executives.

HHS’s IT leadership directory shows there are acting CIOs at the Food and Drug Administration, the National Institutes of Health, the Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention. Additionally, there are six acting chief information security officers across the department, including at headquarters, CDC and NIH.

NIH posted a job announcement to fill its CIO role in early March. Applications were due by March 23.

The change at headquarters could bode well for a possible reorganization at NIH, which moved its CIO under its Center for Information Technology in 2023. In that change, NIH split up the CIO and director of CIT roles in order for the CIO to focus more on compliance and security standards. At the time, NIH said the two positions would work closely together.

NIH’s last permanent CIO, Adele Merritt, left in August after serving for just nine months.  Maureen Falvella, the associate director for IT, cyberinfrastructure and cybersecurity, is the acting CIO.

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