LAS VEGAS—“By next year, I predict that the majority of care delivered in this country will be done on EHRs, not paper,” said Farzad Mostashari, MD, national coordinator for health IT, during his keynote address at the 2012 Healthcare Information and Management Systems Society (HIMSS) conference on Feb. 23.
Mostashari reiterated his emphasis on the drivers of the proposed rule for Stage 2 meaningful use: patient engagement, information exchange and clinical decision support.
A fundamental framework is at the heart of meaningful use, he said. Rather than just telling people what to build, the goal is explaining what “we’re trying to do. We’re trying to improve health and the healthcare system in distinct ways” that include more coordination, reduced costs and improved efficiency. He also cited efforts to prevent one million heart attacks and strokes and reduce hospital readmissions by 20 percent in the next three years. “We want to make sure the steps we take are achievable and incremental.”
Mostashari said Former National Coordinator for Health IT, David Blumenthal, MD, asked him to help build the necessary infrastructure for the health IT efforts underway, from which the recovery extension center (REC) program resulted. Over past two years, he said, RECs have worked with 130,000 primary care providers and 70 percent of rural primary care providers “to make sure no one is left behind.”
Policies developed surrounding health IT are “conducive to exchange,” he said, citing Beacon communities and the new competitive EHR certification program. “The results have been breathtaking. We've made more progress on adoption of EHRs in the past two years than we have done as a nation in the past 20.”
The entire health IT ecosystem has shifted, Mostashari said. Nearly 190,000 eligible professionals and over 3,200 hospitals have registered for the EHR incentive program and “the pace of payments is accelerating.” So far, $3.1 billion in payments have been received with $500 million in January alone. He also said that more than 50,000 jobs in health IT have been created, venture capital investments are up and innovative start-up companies are “tapping into opportunities and the mission to help improve healthcare.” However, success requires more, he said. “We need interoperability and exchange.”
There’s a “massive river flowing of [advancements] in health IT and there’s no going back,” Mostashari said. "To be prepared, we need information and information tools. Interventions exist for virtually any specific goal and the meaningful use program serves as the platform. Making meaningful use of meaningful use can be the foundation for providers to help prepare them to not just survive but thrive in the new healthcare economics.”
He cited a “fundamental return to the ethos of medicine,” saying the relationship between patients and providers should be different from that of buyers and sellers. Rather than simply waiting for patients to walk through the door and then provide care, providers should be finding out why some patients aren’t walking through the door at all.
Technology offers “a unique promise that tomorrow is going to be better, cheaper and easier.”
Coordination on all of these issues between programs in the federal government and between public and private sectors and the states is an ongoing opportunity, he said. “Change takes time, innovation and sustained will but we’re on the right track to make meaningful use of meaningful use. The ONC is a very small but dedicated agency. We stand at the intersection of these issues. We have set a course and we will be steadfast partners with you on this voyage. We’re going to listen, engage and partner with you in democratic and transparent processes. We have set ambitious but achievable goals. Keep your eye on the prize but your feet on the ground.”