Initially Ivor D’Souza ignored the congratulatory emails.

He was on vacation.

When he glanced at his phone, he assumed he was being copied on emails. He would add his good wishes to whoever was being congratulated when he returned to the office.

Then Dr. Francis Collins’ name appeared on the screen.

This email he opened.

That’s how D’Souza, chief information officer at NLM, discovered he was named a FedHealthIT 100 Leader.

D’Souza had no idea that FedHealthIT was even considering him for this honor. Like the other 99 winners, he was nominated by his peers for “driving change and advancement in the federal health information technology market,” according to FedHealthIT.

For this inaugural award, the publication cited common themes among the winners: the desire and willingness to challenge conventional wisdom, to go above and beyond, to drive innovation, and to give back to the larger federal health IT and consulting community.

This description certainly describes D’Souza, but NLM’s top IT leader quickly deflects any praise.

“This is more of a tribute to the team and a tribute to what NLM does. It’s a well-deserved recognition of NLM’s contributions to the health IT space,” he said. “Lots of individuals have contributed to many wonderful things NLM has done, and they have done it for decades—decades before I even got here.”

Indeed, the Library has been a leader in information since it’s founding and is currently one of the largest providers of digital content in the government.

And yet—one person can make valuable contributions.

Performance-oriented

In 1989, when D’Souza was hired as a contractor for the Library, he was involved in network engineering and systems administration. He worked on some notable firsts: setting up the first routers and switches that were used by NLM outside of the Lister Hill Center, connecting NLM’s organizational email system to the Internet for the first time, and setting up the first Unix server in NLM’s Office of Computer and Communications Systems (OCCS).

He said, “Those were good years of experience.”

When D’Souza left NLM in 1993, he discovered just how good that experience was.

As a contractor, he managed projects for many federal agencies.

“I got to learn the culture of a lot of federal agencies,” he said. Without naming the other agencies, D’Souza developed a valid comparison. He concluded, “NLM is a very special place, because our organizational culture very closely matches the private sector. We’re agile in our ways and low on bureaucracy. We’re more performance-oriented and outcome-focused than many parts of the federal government.”

In 2001, he had the chance to come back to NLM and lead a contract. “It was like coming back home,” D’Souza said. “It was an exciting opportunity. No question about it.”

Then in 2004, he became a federal employee. “It was an honor to serve among so many great people.”

Every five to seven years, he was promoted until 2011 when D’Souza became director of information systems and chief information officer of the Library. He oversees a staff of about 180 people, including federal employees and contractors.

Important applications

“Here at the Library, we have some very important applications,” said D’Souza. His organization has developed application platforms for many of NLM’s information resources, which include MedlinePlus, MedlinePlus Connect, DailyMed, the Value Set Authority Center, AccessGUDID, Common Data Elements Repository, the Unified Medical Language System, Medical Subject Headings (MeSH), and RxNorm.

One of D’Souza’s favorite projects was establishing the Value Set Authority Center. “This brought together some of the best and brightest minds at NLM,” he said.

“We had to stand up a platform to support the electronic health records’ incentives program and the measurement of quality in clinical health care,” he said. “To do that, the National Library of Medicine had to build a repository for what we call value sets, which are really sets of numerical values (codes) and human-readable names (terms) from standardized medical vocabularies such as SNOMED CT, ICD10CM, and LOINC. These lists of codes are valuable in measuring the quality of clinical care in Electronic Health Records Incentive Programs sponsored by the Centers for Medicare and Medicaid Services (CMS). We were under a tough timeline to get this done.”

They met the deadlines and delivered a landmark product.

“NLM moved from being an organization that silently did wonderful work in medical terminology to having a prominent role as the ‘source of truth’ of value sets in a very important clinical space,” he explained.

The work continues.

“Over time, we expanded the Value Set Authority Center to provide authoring capabilities so new value sets could be created,” D’Souza explained. “And this past year, we provided innovative collaboration functionality that allows value set authors to collaborate during the process of authoring value sets.”

For D’Souza, working on the Value Set Authority Center was not only among the most satisfying projects of his career, it also highlighted one of the attributes he values most as a manager: teamwork.

The power of teamwork

Training as an engineer, D’Souza focused on the ability to analyze things independently or, as he said, “All I could do was one person’s worth of work.”

When D’Souza became a manager, he realized early on the power of teams.

“Teams can produce so much more than any individual,” he said. “Working together, the value gets even better because of diverse viewpoints, reducing many of the blind spots that individuals have, and the integration of ideas.”

D’Souza takes what he calls a “grassroots approach” to teamwork and generating ideas, making sure everyone gets a chance to chip in.

The opportunity to be part of teams is one of the reasons that D’Souza says NLM isn’t burdened by silos.

“Even though we’re hierarchical like every other organization with branches and divisions, we have many crosscutting projects that give many people an opportunity to work across organizational boundaries,” said D’Souza. “This fuels teamwork beyond the boundaries that hierarchal organizations impose. I feel really good about that.”

As a leader, D’Souza makes it a priority to share his vision with his teams so that everyone benefits.

“They learn something that bolsters their career, they get new positive experiences through their participation, or they get a feeling of self-worth that they are contributing to the mission of the Library,” he explained, “I don’t want anyone feeling like they’re just people in the back office who could have been doing IT for a lawn mowing company and wouldn’t know the difference.”

And the more people understand and feel excited about the mission of NLM, the better for everyone.

Back to the FedHealthIT 100 award

Even though he says he’s “not big on individual awards,” here at NLM, we can’t help but be especially proud of D’Souza and his contributions to NLM and Health IT.

“Congratulations, Ivor!”