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ONC chief defends federal EHR efforts

By Joseph Conn
Posted: March 7, 2013 - 3:00 pm ET

Dr. Farzad Mostashari, head of the Office of the National Coordinator for Health Information Technology at HHS, spent a portion of his keynote address at the final day of the Healthcare Information and Management Systems Society convention in New Orleans on Thursday pushing back against some bad press about the federal programs to help providers buy and meaningfully use electronic health-record systems.

Mostashari's office has a hand in overseeing the EHR incentive payment programs largely run by the CMS and created in 2009 by the American Recovery and Reinvestment Act of 2009.

In January, for example, the Rand Corp. released a widely publicized study that said the multibillion cost savings projected in a previous Rand estimate in 2005 have yet to pan out.

A more recent newspaper story highlighted an EHR user who called one popular system “mediocre.”

“What they're not good at,” Mostashari said of the media, “is resisting the lure of the counter-intuitive, of the man-bites-dog. If something is counter to the prevailing wisdom, if there is conflict in it, it will be on the front page above the fold.”

The federal government's multibillion investment in health information technology programs—about $11.8 billion through January, according to CMS data—haven't produced changes in outcomes yet, Mostashari said, but “we shouldn't expect to” because it's too early.

Most providers are still busy either installing systems or building up stores of data in them, he said. Only a few are in the data analytics stage that would produce those improved outcomes, and are able to start redesigning care processes for quality and cost improvement.

“Then, as right as rain, then you get the outcomes,” he said.

Meanwhile, Mostashari used a number of charts from data to highlight points of progress so far.

“We're seeing a dramatic increase in adoption” of EHRs, Mostashari said, as well as electronic prescribing and computerized physician order entry, or CPOE.

There were almost no electronic prescribers in 2006, but more than 500,000 by the end of 2012, according to data from the Surescripts e-prescribing network that Mostashari included in a slide presentation.

Just 5% of hospitals were reporting using CPOE in 2010. That number soared to 50% in 2012.

“Don't tell me healthcare can't change,” Mostashari said. “It can.”

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