ONC's Mostashari wants to be remembered for getting things done

“Excellence in execution” is how Dr. Farzad Mostashari would want his tenure to be described at the Office of the National Coordinator for Health Information Technology.

“I'm kind of a practical, implementation-minded guy,” Mostashari said in an interview for a series of articles about the ONC on its 10th anniversary this month.

Not surprisingly, executing on a long task list set out for the ONC by the American Recovery and Reinvestment Act of 2009 was his top priority during more than four years at the federal agency, Mostashari said.

Mostashari came to the office in July 2009 as a deputy national coordinator for programs and policy under then-ONC chief Dr. David Blumenthal. He succeeded Blumenthal two years later, serving as ONC chief from April 2011 until October 2013, making him the longest serving ONC leader to date.

Second on his list of achievements, Mostashari said, was continuing the entrepreneurial and innovative spirit of the ONC first set by Dr. David Brailer, its founding national coordinator. The office sponsored contests for developers; put its public-private standards and interoperability development work, called the S&I Framework, on a wiki; and otherwise “kept within government an activist feel to the office,” Mostashari said. A side benefit of all this, he said, was: “It helped us to recruit and retain really amazing people.”

Mostashari also said he used the bully pulpit afforded by the office, “continually trying to raise people's eyes from what we're doing as a regulation to why we're doing this.”

For example, under Mostashari's watch, the ONC offered a $100,000 first prize to a developer that could create a mobile app to identify people at risk of a heart attack and help them develop a prevention plan.

Mostashari's ONC also backed the federal Blue Button initiative to enable patients to obtain electronic copies of their medical records, a program first launched by the Veterans Affairs Department. Blue Button has since expanded to include participation by other federal agencies, including Medicare and the Social Security Administration, and by private-sector record handlers such as pharmacy chains and insurance companies.

Mostashari said he foresees a long-term role for the ONC in monitoring safety and privacy protections, as both patients and individuals who are well—and want to stay that way—become creators and users of their own healthcare data.

“The one regret that I have, and I don't know if there would have been a way for us to do it or not, was around APIs, (application programming interfaces) making it really easy for third-party applications to plug into EHRs,” Mostashari said. “We tried to propose it and had lots of discussions about it with the Health IT Standards Committee … but I wonder if we couldn't have pushed harder.”

Follow Joseph Conn on Twitter: @MHJConn