Dr. Farzad Mostashari, the newly minted national health IT coordinator, recently offered a snapshot of the near-term direction for the Office of the National Coordinator for Health IT as he saw it, steady on the current path but aware that "nothing stays still, and certainly not in health IT."
As Mostashari takes leadership, ONC is preparing to develop three proposed rules by the end of the year for stage 2 of meaningful use and the accompanying standards and certification criteria for electronic health records (EHRs). ONC will also propose a governance rule to support the expansion of the nationwide health information network (NHIN) to promote sharing of patient data.
ONC is coordinating with the Centers for Medicare and Medicaid Services to develop the regulations for the meaningful use of certified EHRs that healthcare providers must fulfill to qualify for Medicare and Medicaid incentive payments.
"There's a tremendous amount that needs to be done relatively quickly," Mostashari said at the most recent Health IT Standards Committee.
Health and Human Services Secretary Kathleen Sebelius named Mostashari the national coordinator for health IT, effective April 8. Mostashari, who has been the deputy national coordinator for programs and policy at ONC, has taken the reins from Dr. David Blumenthal, who will return to Harvard University.
ONC will stay consistent with the direction it has been heading under Blumenthal towards EHR adoption, health information exchange and assuring privacy and security for patients and their data, Mostashari said.
But he also knows that there will be new challenges and "that nothing stays still, and certainly not in health IT," Mostashari told the standards committee March 29.
Among its principles, ONC will be open and transparent in its processes, “being bold and ambitious and doing what we’ve been striving for to improve health and healthcare and using technology in the service of where we want to go, and always pushing and driving toward that ultimate goal," he said.
At the same time, the goal must be "achievable and having our feet on the ground and knowing what's happening in the real world, monitoring and adapting to conditions to be evidence based," he said.
ONC will foster innovation and use the marketplace and the energy that comes from the market while also watching out for "the little guy" and help guide the context within which the market operates.
"Most importantly, it means putting patients and their interest front and center in everything that we do, including their privacy and security," Mostashari said.
In February, he said ONC plans to offer more support to physicians to help make it easier to adopt EHRs and become meaningful users.
Among those plans, ONC will begin over the next several months to develop guidelines to measure an EHR's usability, in coordination with public and private organizations and the National Institute for Standards and Technology (NIST). Existing systems also need to be tested for usability.
"We've gone too far not to have some guidelines on usability issues on safety, frustrating new user experiences and inconsistencies," he said at the HIMSS annual conference.
ONC will also come up with policies to deal with the cluster of overlapping issues of privacy and security, standards and interoperability, and information exchange and how they fit together, he said.
