National Health IT Coordinator Mostashari Outlines Challenges - InformationWeek

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National Health IT Coordinator Mostashari Outlines Challenges

Upon assuming Dr. David Blumenthal’s role at the helm of the Office of the National Coordinator for Health IT, Dr. Farzad Mostashari discussed his vision for how IT adoption will transform healthcare, progress made so far, and the road ahead.

Health IT Boosts Patient Care, Safety
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Slideshow: Health IT Boosts Patient Care, Safety
McGee: Related to your number two priority, where it comes to improving health outcomes and quality of care, are electronic health records (EHRs) enough to help make that happen? Or will that require additional investment in technology by healthcare providers?

Mostashari: What's really exciting is that I believe we're moving to a phase where we're getting a virtuous cycle between the goals of delivery system reform, healthcare transformation, and healthcare IT. Obviously the technology on its own is not sufficient. It needs to be part of a system that includes payment that rewards safety, quality, and care coordination. IT enables those payment systems and in turn creates a context in which people invest in those technologies, make use of those technologies, and refine those technologies. I think the stars are aligning with all that's happening out there now.

When people talk about bundled payments, shared savings, accountable care organizations, patient-centered medical homes, IT is the critical foundation for that transformed healthcare. So that's really coming together now.

If you look at what's in meaningful use stage 1, I think that's really the basic building blocks. I think we have to maintain momentum up that escalator of progress, and that it's achievable. We need to keep pushing the boundaries of accomplishing these goals. So, we can't sit still. Stage 1 meaningful use was the right start and we have to keep making progress. Our recommendations from our Health IT Policy Committee [which Mostashari chairs] will be very much in line with that.

McGee: Speaking of progress, how would you assess the progress so far by U.S. healthcare providers in their efforts to comply with the meaningful use stage 1 program? Are there groups of healthcare providers having more difficulties than others?

Mostashari: I think we're making remarkable progress. If you think where we were just a year ago to now, we have 62 regional extension centers working with over 60,000 primary care providers. Our community college program is graduating over 2,000 health IT professions this month and another 3,000 over the summer.

Nearly all of the health information exchange grantees are moving from planning to implementation stages, same with the Beacon Communities. We have over 500 products in the marketplace now that are certified [for meaningful use]. We have attestation for meaningful use that started in April and seems to have gone off without a hitch.

I think it's too early to tell whether there are groups that will have more difficulties than others achieving meaningful use or any particular aspect of meaningful use requirements. I'm heartened by the increased adoption rates of health IT among primary care providers jumping up from 21% to almost 30% in one year. So that's promising and I think the regional extension center program is specially aimed at helping out those organizations that have the least resources, whether it's small practice, critical access hospitals, rural health centers, or others. The centers are helping these providers benefit from technical assistance and make progress to meaningful use.

So we're making progress and we're going to be monitoring it closely to see if a digital divide does begin to emerge and the take steps to redouble our efforts to close any gap that develops. So far we're hitting our milestones, but it's a sprint not a marathon.

McGee: You mentioned the 30% adoption rate for primary care physicians, how about the adoption rate of other groups of providers, such as small rural hospitals?

Mostashari: The particular statistic I cited was from the National Ambulatory Medical Care survey. It doesn't have the specific subgroup you're asking about, but we're developing monitoring capabilities to look at other groups like the one you're asking about, such as rural adoption rates versus urban. We hope to have something on that later this year.

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