Mostashari: Health IT is 'on the march'
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| Farzad Mostashari, MD |
“I think the three-word phrase would be 'on the march.' If we look at every indicator we have, it’s all pointing in the right direction,” he said, noting the EHR adoption rate among primary care providers has risen from 20 percent to nearly 40 percent since 2009, when the HITECH Act was passed.
Meaningful use requirements are helping the Office of the National Coordinator for Health IT (ONC) meet its goal to increase adoption. For example, the ONC is observing a rush to meet an upcoming deadline for electronic prescribing (e-prescribing) meaningful use requirements, Mostashari said.
Mostashari doesn’t want any providers to see a one percent cut in Medicare reimbursements in fiscal year 2012 for failing to meet the June 30 deadline for e-prescribing, and fining providers for failing to meet meaningful use requirements is not what the ONC hopes for. “Our goal is to do whatever we can to see to it that no one gets penalized, not by changing the rules of the game, but by making sure that everyone can get to meaningful use.”
“We’re just starting the program, but we’re getting a huge number of registrations, and I think 2012 is really when it’s going to be kicking in, as providers and hospitals want to maximize their incentive payments,” he added.
Adoption rates are currently the best way to measure the ONC’s success, according to Mostashari, but the presence of health IT isn’t the point; positive outcomes are.
“I think the bigger and better reason, frankly, for adoption and meaningful use is going to be a desire from hospitals and providers to transform the delivery of healthcare using these tools,” he said. “They want to get ready for accountable care, bundled payments and medical homes.”
Brailer, who was the appointed the first national coordinator for health IT when the ONC was created by executive order of President George W. Bush in 2004, wondered how far health IT has come and when it will be ready for the mainstream.
“One of the things I experienced as national coordinator was the incredibly arcane world of how data moves and the standards in format and communication that are involved,” Brailer said. “There is a daunting level of precision needed for this to work, and discussions about this are so jargon-filled that it creates a gulf between that world and the world of practicing doctors who see it but just don’t understand it. Because of this, it is hard to understand where we are with health information exchange (HIE). When will the typical hospital see a HIE that really works?”
These issues are being addressed and improved through the ONC’s standards committee community approach to ensure standards are understandable, easy to implement and information is available across industry sectors in multiple formats, according to Mostashari. Similar efforts are occurring outside of the ONC where an expanded market for health IT products has led to more competition among vendors to develop products that clinicians can use.
While progress has been made, Mostashari said the task at hand is sizable, but he’s enjoying his time as national coordinator for health IT.
“We have been given a big mandate,” he said. “We really set the course on the implementation of HITECH, and the design of the programs and policies, and now it’s time to implement. That’s something that I’m very excited to be a part of and to lead. We are actually now implementing and moving forward on meaningful use of EHRs and information exchange.
“I’m having a lot of fun, and as long as the administration and the secretary want me to serve, and I’m still having fun, I will be here,” he concluded.