“We were all learning on the job,” Mostashari said of the EHR project, and there were, “lots of failures and frustrations.” They included bug fixes and version control issues with an EHR the city initiative was using. “We thought quality measures would lead the way,” he said, but they didn't. Health plans wouldn't change their payments because too few doctors would use EHRs.
“We connected the (regional health information organizations) and no one searched,” he said. “We got foundation money to pay docs for outcomes, and it didn't make any difference. But we persevered.” Eventually, 229 out of 230 physicians in the program had successful EHR implementations and, using the system, collectively, he said, they recorded “a 10 percentage point improvement in outcomes.”
Flash forward, and today, the ONC is funding 62 regional health information technology extension centers nationwide to do much the same work as Mostashari did in New York.
Within the last two years, he said, these extension centers have worked with 130,000 primary-care doctors and 70% of rural primary-care providers to make sure they weren't left behind. At last count, 109,000 “eligible professionals” and 3,200 hospitals have registered for EHR incentive payments under the Medicare- and Medicaid-funded programs, he said. Those programs paid out $500 million in incentive payments in January alone.
In the two years since the EHR incentive programs were created under the American Recovery and Reinvestment Act of 2009, “we've made more progress on adoption than we have done as a nation in the past 20,” Mostashari said. “We're on track to see 100,000 meaningful use providers this year,” he said. “I need your help to do it.”
“By next year,” he said, “I predict the majority of care in hospitals and doctors' offices will be done on electronic healthcare records, not on paper.”
“Change takes time,” Mostashari said. “Change takes innovation. It takes sustained will. We're on the right track to make meaningful use of meaningful use. With you, we have set a course and we will be steadfast partners with you.”