Mostashari to step down

Farzad Mostashari, MD, ScM, will step down this fall as head of the Office of the National Coordinator for Health IT (ONC) after two years in the position. Mostashari joined ONC in 2009 as deputy national coordinator.

Department of Health & Human Services Secretary Kathleen Sebelius, in a message to staff, praised Mostashari’s accomplishments as ONC chief. “During his tenure, ONC has been at the forefront of designing and implementing a number of initiatives to promote the adoption of health IT among healthcare providers,” her memo said. “Farzad has seen through the successful design and implementation of ONC's HITECH programs, which provide health IT training and guidance to communities and providers; linked the meaningful use of electronic health records to population health goals; and laid a strong foundation for increasing the interoperability of health records—all while ensuring the ultimate focus remains on patients and their families.

“During this time of great accomplishment, Farzad has been an important adviser to me and many of us across the department. His expertise, enthusiasm and commitment to innovation and health IT will surely be missed. In the short term, he will continue to serve in this role while a search is underway for a replacement. Please join me in wishing Farzad all the best in his future endeavors.”

Speaking during the Aug. 7 HIT Policy Committee meeting, Mostashari said he found the response to his announcement humbling. "I think it was largely undeserved but I think it shows an appreciation for the progress made in health IT which symbolizes something larger than my departure. We can still do big things in this country. The way in which we do it truly requires a partnership between government--smart government--as well as the private and nonprofit sectors. That’s how we get big things done."

He said government has a critical but limited role in convening, coordinating policies, engaging with the field and, where necessary, setting standards and establishing a floor. "We’re human. We're not perfect in policymaking but we always considered all the information that we could gather. We always thought it through with the best intentions with no agenda other than to get it right."

Mostashari said it "Just seemed like the right time" to leave his post. Things are going well, he said, and being between rulemaking cycles is good timing. "I will continue to feel passionately about the mission of improving how our system knows its patients, how our healthcare system cares for its patients and the difficult but necessary transition we have to go through to dliever care differently...to engage with patients differently...to pay for care differently. I’m going to be in your camp. I’m going to be continuing to cheer on the efforts here even as I leave this role."

“Farzad was the right man for the right time,” said William Bria, MD, president of the American Medical Directors of Information Systems. “He’s the doctor that helped this country make its first painful steps toward a transformation that most other industries have already gone through. He not only put healthcare on its way, it’s very clear there is no turning back.”

College of Healthcare Information Management Executives CEO Russell P. Branzell and board chairman George T. Hickman added to the praise: “Through Dr. Farzad Mostashari’s leadership, we saw the Office of the National Coordinator lead our nation’s providers through the first gates of measured, meaningful use of electronic health records, and address in reality those initial standards that make our health information portable across the U.S. healthcare system.

“Any CIO will tell you that implementing technology in the face of cultural resistance and process redesign is a monumental challenge. ONC’s task was to help guide such implementations in over 5,000 hospital settings and with nearly 400,000 physicians and clinicians. Today’s health delivery system is fundamentally different than it was five years ago when HITECH was passed, but it’s not because Congress simply passed a law. It’s because ONC and CMS, in partnership with the private sector, designed an implementation strategy that tried to align various stakeholders and make the spirit of HITECH a reality.”

“Each national coordinator has brought the right talent to ONC at just the right time,” said Peter Basch, MD, medical director for ambulatory electronic health record and health IT at MedStar Health, an integrated delivery system based in Baltimore. He said Mostashari's predecessor, David Blumenthal, MD, MPP, was thought at first to be an unusual choice, as he was not a recognized expert in health IT. “And yet what was needed then was someone who could provide a strong policy ‘center’ for health IT.”

Bria agrees about each of the national coordinators and their timing and talent. “[David] Brailer, MD, PhD, was a man of business and vision and power who wasn’t given enough money but started the ball rolling. [Robert] Kolodner, MD, was a brilliant physician-scientist who worked through the strategic plan to get the elements lined up nationally to start to make the transformation of healthcare into the most informatics driven and supported healthcare possible.”

“Farzad stepped up from deputy national coordinator to national coordinator as the best person following Dr. Blumenthal to take what was then a schema supported by regulations, and make it happen,” Basch said. He cited Mostashari’s solid background in EHR implementation and, more importantly, implementation directed towards a goal of better care as further indication of his qualification for the job.

Also, “Farzad had the broad support of colleagues in health IT policy, clinical practice and technology. He made ONC into an organization that could get the work done. When Farzad stepped into the national coordinator role, a minority of doctors and hospitals were using health IT; and now we are not only past the tipping point, it is a majority.  Farzad provided strong and thoughtful leadership during this time of development of the nation's health IT infrastructure and our transition to EHR-enabled care.”

Mostashari has not announced his future plans but Sebelius said he will help with the transition to the next national coordinator.