Mostashari: 'Our healthcare system is in trouble'

By Diana Manos
12:12 PM
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Healthcare IT stakeholders gathered Oct. 14 in Washington for a work meeting, discussing ways IT could help improve transitions in care.

The invitation-only meeting was hosted by the Office of the National Coordinator for Health Information Technology (ONC), the John A. Hartford Foundation, the Gordon and Betty Moore Foundation, and Kaiser Permanente.

Attendees included federal officials, electronic health record vendors, entrepreneurs, grantees, leaders from ONC’s Beacon Communities and foundation funding organizations.

[Related: OHN's 12 health IT best practices, part 2: Collaboration.]

“We basically have all the tribes together today,” said Aaron McKethan, director of ONC’s Beacon Program, as he kicked off the meeting.

“Where we are is between the vision and the reality of seamless care transitions,” he said. “The time has come to address health transitions in a big way. We know now, better than we have before, what will work.”

National Coordinator Farzad Mostashari, MD, was both realistic and optimistic in his charge to attendees.

“Our healthcare system is in trouble," he said. "It doesn’t keep people safe and it’s too costly. But I’m incredibly optimistic that this is the time when we’re going make this better.”

Mostashari said he bases this optimism on three “formidable” changes that are currently taking place “under the surface" – how healthcare is paid for, how healthcare is delivered, and how patients are taking care of themselves.

“Underpinning each of these three is the simple concept that information is power,” he said. “We have an unprecedented opportunity for innovation in all three of these areas, if we keep our eye on the ball.”

[See also: Mostashari mindful of HIT stakeholder tension .]

Mostashari urged stakeholders to work together. “As long as we stay in our silos, we won’t change things enough,” he said. “We are going to make unimaginable progress, on the scale that wasn’t conceivable five years ago.”

He warned, however, that the federal government can only “convene and facilitate.”

“This is not a government endeavor,” he said. “It’s a life and death struggle for payers, providers and purchasers.”

The 200 or so attendees broke into working groups and spent two hours brainstorming, returning to report back to the main group. More than 300 people listened to the session via the Internet, according to meeting hosts.

According to ONC, poor transitions in care causes millions of preventable hospital readmissions a year, costing billions of dollars in healthcare costs.

Attendees of the meeting focused on ways to improve the hospital discharge process, medication reconciliation, information flow and patient and caregiver activation.

[Commentary: Why RECs and HIEs need each other.]

Much of the discussion focused on ways to change the culture of healthcare, from the way things have always been done, to focusing on what would be easier and better for the patient. Many attendees suggested delivering discharge instructions after patients return home, where they would be better able to absorb the information.

Scott Young, MD, co-executive director of the Kaiser Permanente Care Management Institute said patients don’t have information when they need it. “We need to think about information and where it needs to be when. Patients do better when get the information after they leave the hospital,” he said.

“They are not patients, they are people,” said George Bo-Linn, MD, from the Gordon and Betty Moore Foundation. "That’s a hierarchy mentality. If we think of them as people, we can be successfully radical.”

Conclusions of the session can be found in the slides posted on Brian Ahier's Blog here. See slide 24.

Follow Diana Manos on Twitter @DManos_IT_News.