Healy is the country's runaway record goalscorer with 36 in 94 caps and although he is still in the national set-up, his days as a starter are over. Yet neither O'Neill nor predecessor Nigel Worthington have been able to call on someone who has been able to regularly replicate Healy's eye for goal.
Burnley forward Paterson is likely to get the nod when the campaign gets back under way against Israel on Tuesday night, and he said: "I always think if I do get chances to play regularly up the middle I will score goals, take up David Healy's mantle."
He went on: "To step into his shoes is something very difficult to do but something I would love to do and something I will work very hard to do. I would love to do that."
Paterson, 25, scored his first international goal from the penalty spot in his 14th appearance against Finland last August and has not played since. After struggling with thigh and hamstring problems that were disrupting his club career, he informed O'Neill that he did not wish to be considered for Northern Ireland until he could be confident he was fully fit.
That meant he missed the memorable 1-1 draw in Portugal, as well as four other matches, but he is back and desperate to prove his commitment now.
"It was a tough decision, because every footballer has a young boy in him who just wants to play all the time," he explained. "To make a decision not to play benefited me in terms of staying fit but watching fantastic performances from the sidelines hurt. That hurt can drive you on, though.
"Obviously I am older now, free of injury and this step in my career is the most important.
"I'm 25 years old and fully fit. This campaign and the next year in terms of club football will be the best I have; I am ready to explode. "I definitely have a point to prove and I want to make up for lost time.
"The decision not to play for a couple of (international) games was a decision to play 20 games or more at my club, not struggle through games or come in at 80% fitness. I'm at at 100% now."
- Sports & Recreation