The U.S. Department of Health and Human Services has reversed a major Biden-era reorganization. Effective March 31, HHS officially reinstated the Office of the National Coordinator for Health Information Technology — dropping the dual “ASTP/ONC” title that had been in place since July 2024. This shift marks a notable realignment of federal health IT leadership under the Trump administration.
The change is not merely cosmetic. It moves the CTO, CAIO, and CDO roles back under OCIO and refocuses ONC strictly on health IT policy, standards, and interoperability.
What Changed at HHS on March 31
A Federal Register Notice Signals the Shift
HHS published a formal notice in the Federal Register on March 31, announcing three key changes. First, it ended the dual “ASTP/ONC” title for the office. Second, it moved the roles of the Chief Technology Officer, Chief Artificial Intelligence Officer, and Chief Data Officer back under the HHS Office of the Chief Information Officer. Third, it reassigned specific cybersecurity functions outside the OCIO, transferring the 405(d) Program to the Administration for Strategic Preparedness and Response.
Together, these actions restore a unified, department-wide technology leadership model. Moreover, they sharpen ONC’s mission focus on nationwide health IT interoperability and data liquidity.
The Biden-Era ASTP/ONC Reorganization Explained
How the 2024 Restructuring Came About
In July 2024, the Biden administration restructured HHS’s health IT leadership. The goal was to streamline and consolidate technology, cybersecurity, data, and AI strategy functions. Prior to that change, responsibilities were spread across three offices: ONC, the Assistant Secretary for Administration, and the Administration for Strategic Preparedness and Response.
The 2024 reorganization merged these streams under a single expanded office. It dually titled ONC as the “Office of the Assistant Secretary for Technology Policy / Office of the National Coordinator for Health IT,” or ASTP/ONC. Additionally, it moved the CTO, CDO, and CAIO roles from OCIO into ASTP/ONC. Consequently, the National Coordinator also became the Assistant Secretary for Technology Policy, taking on a broader leadership mandate.
Then-National Coordinator Micky Tripathi defended the move at the time. He argued that treating technology as a strategic mission enabler — rather than just an administrative cost — required a more dedicated leadership structure.
What the New Alignment Means for Tech Leadership
CTO, CAIO, and CDO Return to OCIO
Under the new structure, HHS reorganizes enterprise technology roles under three core functions within OCIO. These are strategic technology leadership and innovation, led by the CTO; responsible, trustworthy artificial intelligence, led by the CAIO; and enterprise data governance and analytics, led by the CDO.
HHS CIO Clark Minor leads OCIO and will oversee all three functions. He outlined the rationale clearly: “This structure allows OCIO to provide an integrated backbone for cloud, cybersecurity, data, and AI that every HHS component can rely on.” Furthermore, he noted that unifying these roles under one roof helps the department move faster on shared platforms and protect systems more effectively.
This integrated model gives every HHS operating division access to consistent, scalable technology services. It also removes the complexity that came with distributing these functions across multiple offices.
ONC Refocuses on Its Core Health IT Mission
Back to Standards, Certification, and Policy
With enterprise technology functions now under OCIO, ONC returns to its foundational purpose. The office will concentrate on health IT policy, standards, and certification. Specifically, it will focus on advancing data liquidity, improving health record interoperability, and reducing friction in sharing patient data.
National Coordinator Dr. Thomas Keane, MD, MBA, emphasized the opportunity this creates. “With this Department-wide 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.”
Moreover, ONC will coordinate more broadly with OCIO, HHS operating divisions, health care providers, health IT developers, and patients. This wider stakeholder engagement reflects ONC’s growing role in shaping the future of digital health — including AI use in clinical care.
What Stays the Same Under ONC
Key Programs Continue Without Interruption
The structural change does not disrupt ONC’s active programs. An ONC spokesperson confirmed this clearly: “Despite the name change, our programs and priorities aren’t changing. ONC will continue to focus on standards, certification and policy that advances key departmental initiatives that improve data liquidity, improve affordability and access, and advance technology.”
Programs such as the Trusted Exchange Framework and Common Agreement, or TEFCA, continue under ONC. Information blocking regulations, the United States Core Data for Interoperability, and other active initiatives also remain intact. Notably, TEFCA reached a significant milestone in February 2026, with half a billion health records exchanged through the framework.
Industry and Leadership Reactions
A Move Toward Leaner Government
This reversal aligns with the broader Trump administration approach to federal government structure. Across agencies, the administration has pursued staff reductions and organizational consolidations aimed at creating a smaller, more efficient government. The HHS realignment fits that pattern — streamlining leadership layers and returning functions to their statutory homes.
The Biden administration had argued that expanding ASTP/ONC’s mandate reflected the growing strategic importance of technology in healthcare delivery. By contrast, the current HHS leadership frames the reversal as a way to improve accountability, speed, and integration across the department. Both perspectives reflect genuine tensions in how large federal agencies should organize technology leadership.
Conclusion: A Leaner, Sharper HHS Health IT Structure
HHS has drawn a clear boundary between enterprise IT operations and health IT policy. OCIO now owns the technology infrastructure. ONC owns the policy, standards, and interoperability work. This division of responsibilities aims to reduce duplication and sharpen focus across both offices.
For health IT stakeholders — providers, developers, payers, and patients — the core message from ONC is clear: the programs and priorities that matter most are not changing. The office’s commitment to advancing interoperability, data access, and responsible AI in clinical care continues under the reinstated ONC banner.
