In a darkened room, Dr. Farzad Mostashari, national coordinator for health IT, shed some light on HHS' efforts to get physician practices to become meaningful users of electronic health records.
IT chief to docs: Let's get meaningful
Speaking in Las Vegas at the Medical Group Management Association's annual conference last week, Mostashari gave an off-the-cuff speech with no notes and, thankfully, no PowerPoint presentation—although the lights in the room were kept inappropriately dim, maybe just in case the national coordinator felt the need to flash a slide up on the screen.
Mostashari began by noting how, historically, innovation in medicine occurred over a "generational time frame." In contrast, Mostashari said, only a few years ago, just a handful of doctors were using EHRs, but it's possible that half of all practices will be using EHRs by next year.
"It really feels like the ice has broken," he said.
The nature of medical records also has changed, Mostashari said. Originally, the record consisted of a doctor's personal notes and reminders, and then they evolved into something that needed to be kept in order to get paid. Now they are viewed as something to be kept to avoid being sued. But records are starting to be used "to help people stay healthy," he said, adding how "EHRs are the information foundation for what we want to do and what we need to do to provide coordinated care."
He cited a dramatic difference that can be seen when doctor visits end with patients getting a printed summary of the encounter: Patients can now correct doctors about inaccurate information in their records.
Mostashari also took questions from the audience—as well as some heat. In one exchange, a man protested the switch to the ICD-10 diagnostic codes. "We avoided the metric system; let's avoid ICD-10."
The national coordinator didn't back down, however, and noted how delaying implementation by another three years would only delay the benefits he said the new system will bring.
I had the opportunity to interview Mostashari after his talk, and he was still in a bit of a combative mood when I referenced critics of the meaningful-use program who said it may not be working as intended. That's because a large chunk of the initial incentive checks were written for organizations that had well-established EHR installations and not to those that were just starting.
Mostashari said he has to take issue with that assessment, explaining that the intent of the program wasn't to reimburse for expenses incurred after the Health Information Technology for Economic and Clinical Health Act was passed; rather, it was to get practices to become meaningful users of the technology. He said "it's entirely appropriate" to have an incentive payment that defrays costs that early adopters incurred along the way.
Earlier during his talk, Mostashari offered praise to those who had been in the "vanguard" and offered encouragement to those just getting started, saying, "It's never going to be easier than it is now."
Follow Andis Robeznieks on Twitter: @MHARobeznieks.
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