The federal government’s health information technology leader Farzad Mostashari made his final comments before a key policy committee, as the Office of the National Coordinator carries on the still evolving task of meaningful use.
Mostashari, the fourth person to lead the Department of Health and Human Services’ health IT office since 2004, said he had a “great appreciation” for the work of the federal Health IT Policy committee, for working out consensus among diverse technology, provider, insurance and consumer interests and producing a “roadmap that has proved remarkably robust.”
Mostashari said his departure, along with conversations he’s had with healthcare groups, made him “look anew at the progress we’ve made” nationally in meeting the goals of the the HITECH Act, and in starting to provide a foundation for Affordable Care Act reforms. At the same time, he said, “We have to be true spirit and intent of these terms when we talk about patient registries or decision support or quality improvement, or interoperability and transitions of care.”
For doctors and other clinicians, “it’s still too hard for them to use the EHRs in the ways that they want to do,” Mostashari said — for instance using data for third party applications or querying other providers.
A lot of the challenge nationally for bringing healthcare into the digital age, he said, will be “getting to a common base of capabilities around the country, so that these providers...have some common assumption of what the capabilities of the systems will be around interoperability and patient health management and patient engagement.”
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The HITECH Act along with the ACA’s accountable care programs are offering ambitious providers a way to leave the problematic fee-for-service business model, he said.
“New capabilities we’ve been laying the track for are exactly what you need for these new delivery models,” said Mostashari, an Iranian-born, upstate New York-raised physician who led an EMR program for New York City’s community providers in the early 2000s.
“The first thing they all talked about was being able to understand the full history of the patient, to have it be retrievable and analyzed, as opposed to it being on paper and scattered among many other sites,” Mostashari said of recent conversations he had with leaders at several hospitals, health systems and physicians groups participating in Medicare accountable care programs.
As those providers stake out new healthcare models and others remain undecided, they’re all facing a cascade of regulatory compliance initiatives that Mostashari suggested taking into consideration for designing meaningful use stage 3.
“I think the focus of meaningful use stage 3 shifting to outcomes is the right one. But I also heard from these groups how many things they’re trying to work on simultaneously...And perhaps we know ourselves of some measures for which the burden of just reporting it maybe exceeds the benefit of the measure itself.”
Although he hasn’t said what he’ll be working on next, Mostashari did praise the Health IT Policy Committee and its subgroups for representing healthcare and IT industries, along with consumers, privacy advocates, public health agencies and state legislatures.
“I thank you for your service, and I will be listening from now on with rapt attention.”
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