Q & A with the National Coordinator on HIT

Farzad Mostashari, MD, National Coordinator for Health Information Technology, U.S. Dept. of Health and Human Services, and closing keynoter at AMIA 2011, chatted with Symposium News about how he sees the current landscape of informatics and HIT.

SN: Given the current fiscal situation of the U.S. government, can ONC continue to innovate?

Mostashari: We are very fortunate that implementation of HITECH and the health IT agenda in general enjoy bipartisan support. There have been no discussions whatsoever that have targeted the most important part of the program, which is the Meaningful Use and Medicaid Health IT incentive payments. Nor has anything affected the grant programs that we have in the field working every day, from the extension centers and community colleges and health information exchanges. There are providers and hospitals across the country investing in health IT and there’s a broad, bipartisan understanding that the incentive payments are important to support them in making this transformation.

SN: What are ONC’s strategies for continuing the momentum?

Mostashari: We’re helping people who are making the change: doctors and hospitals, and groups like AMIA that are supporting this transformation. We have to do whatever we can to help keep the momentum going. The good news is that this thing has a momentum of its own and there’s a broad, deep movement that is, if anything, accelerating. Once a critical mass is reached, then it really gets its own momentum.

SN: How do you envision interoperability between EHRs to look?

Mostashari:The goal is that critical information needed for exchanged can be exchanged with very little in the way of barriers, and that once exchanged, it can be used for decision support, for quality measurement, for registry functions and patient reminders. This requires that systems be able to communicate with each other to exchange information with each other and also to understand what is communicated. That’s the vision, and I think we’ll get there over time in an incremental and step-wise way. We’ve made very good progress as a country both in terms of terminologies and vocabularies both in terms of messaging standards and in terms of transport.

SN: Which organizations should develop and support standards for EHR interoperability?

Mostashari:The best standards are developed through a broad, inclusive, multi-stakeholder process. We’re fortunate that the HITECH Act gave us the Health IT Standards Committee as an organization that can take the work of development organizations and provide us with recommendations for the maturity standards and their adoptability. Government works best when [it] takes advantage of the intelligence, passion and real life experiences of people in the field. Folks who are interested in new standards and priorities should submit recommendations to the Meaningful Use Work Group.

SN: What new areas will you address going forward?

Mostashari: We are moving with astounding speed toward . . . becoming part of the standard of care throughout rural health clinics and critical active hospitals and store-front doctors’ offices. There’s tons of really interesting research and development to be done, but it’s definitely going to need to look beyond our own academic walls.

We’ve had a lot of focus on doctors and hospitals and EMRs. . . and there is another mass movement out there which is around patients who are more empowered, more informed, and have more tools at their disposal. The federal government is responding to that trend, that river, and thinking about working toward enabling and unlocking and catalizing some of that energy to improve health and healthcare.

Hear Dr. Mostashari deliver the closing keynote at AMIA 2012 on Wednesday, Oct. 26, at 12:15 pm.