Then in 2005, after DeSalvo left Charity hospital and worked as a professor and researcher at Tulane, Hurricane Katrina hit the city and forced the evacuation of Charity Hospital and other medical centers. “That changed my life and the lives of many,” she said.

The hurricane took the lives of more than 1,800 people, flooded the bayou city for a month and led many people with health conditions experiencing what soon may be considered “never-events” --  on the road, in other states, without access to their treatment or medical records.

“I use the word: it was terrifying as a doctor knowing that my team had patients who were on antiretroviral therapies or had communicable diseases or were on cancer regimens and had to have timely administration with quick follow-ups, and we did not know where they were,” DeSalvo told the panel. “Pieces of paper did not go with them.”

But all of that “led to an unexpected opportunity” to find ways to try to ensure the whole city’s population had a better system for healthcare. “Because all of our institutions were closed, we had a rich period of dialogue and collaboration that led us to a new framework for healthcare in Louisiana," she explained.

Unlike administrators considering an EHR at Charity Hospital in the early 1990s, city health leaders now found that “health information technology was central” to new models of care, especially as an infrastructure that would support focusing more resources on primary care and prevention.

Translating those ideas into policies, DeSalvo ended up leading Louisiana's state-designated health information exchange organization and helped launch patient-centered medical homes and community-based care programs in New Orleans that have garnered national accolades.

Now, DeSalvo is tasked with leading an agency trying to guide American healthcare through complex problems similar to what she worked on in New Orleans, and others — with most providers using EHRs, though not all of them happily,payment policies in upheaval, patients demanding better service, and millions of new Americans entering Medicare, Medicaid and private insurance plans.

“The next major chapter that we must undertake,” she said, “is to see the promise of health information technology in the clinical phase for health systems, the population and the community at large come to fruition.”