Health information exchange, patient participation and population management are the three pillars of meaningful use of health information technology going forward, Dr. Farzad Mostashari said in a keynote speech and pep talk.
“Every movement needs its heroes,” said Mostashari, who heads the Office of the National Coordinator for Health Information Technology at HHS, addressing the College of Healthcare Information Management Executives at their 2012 Fall CIO Forum in Indian Wells, Calif. “As best I can tell, you are the best candidates for filling the roles of heroes for this incredible journey that we're on.
“It's the most important thing that we could be possibly doing getting a healthcare system that will get us better healthcare at lower costs,” Mostashari said.
Being able to quickly and conveniently access and exchange information between providers is critical, but systems also need to be configured to help clinicians in real time provide optimum care and not just retrospectively analyze what they missed.
Mostashari recounted a conversation he had with an official at San Francisco-based Dignity Health system, which leverages its IT system to run reports on its patients for compliance with quality reporting metrics while each patient is still in the hospital.
Before, the Dignity official said, the hospital used to pull a sample of charts and perform a quality review, Mostashari reported. “ 'Now, we run the quality reports while they're still in the hospital, on everybody. And if they didn't get everything, we give it to them,' ” Mostashari said. “ 'It goes from retrospective, from sample, to prospective for all of our patients.' ”
“That's a meaningful use,” Mostashari said.
During the question-and-answer session, Mostashari was asked about a movement afoot to afford patient access to providers' notes and whether it would be mandated. Mostashari said he supports the concept of patient access to information to improve patient engagement, but added note-sharing isn't an area the government should rush into and mandate by adding to the meaningful-use criteria of the federal health IT incentive payment program.
Mostashari spoke about a pilot study involving a group of 105 physicians with three healthcare organizations, Geisinger, Group Health and Beth Israel Deaconess Medical Center. The physicians chose the patients with whom they would share access to their notes, he said.
“A lot of the fears that they had, they admitted later, didn't turn out that way,” Mostashari said. “That's a wonderful example of starting it small, and proved it out.
“My fear is, taking something that is a big culture change and regulating that might create a backlash,” Mostashari said. “We agree with the goals, but is regulation and meaningful use the best way to achieving that?”
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