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WASHINGTON – At a Bipartisan Policy Center panel discussion on Tuesday, newly-appointed National Coordinator Farzad Mostashari, MD, was optimistic – but also warned of challenges for healthcare IT advancement in the coming few years.
Mostashari said ONC has been working hard over the past two years on programs such as the Medicare/Medicaid EHR incentive program, regional extension centers, HIT community college training programs and others. But now the HITECH programs will be “moving into an intense phase of implementation," he said.
“For some, that seems daunting, but I'm pretty thrilled to be here,” Mostashari said. “We have made great progress in past couple years. We're hitting all our mile markers." But, he added, "it's a marathon.”
Mostashari, who served as Deputy to the National Coordinator prior to his appointment as head of ONC on April 8, hailed many of the programs currently underway.
[See related story: Mostashari takes reins of ONC amid praise.]
Regional extension centers (RECs), designed to assist physicians with EHR adoption, have been established “remarkably quickly,” he said. “Every primary care doctor in America can call a REC and get help,” he added. According to Mostashari, some 60,000 physicians nationwide have already sought help from their REC.
ONC has successfully established meaningful use Stage 1 for the EHR incentive program, he said, which "hit the mark" on balancing stakeholder interests with public interests.
“The wind is at our back," Mostashari said. “What doctors need to do in this new era of healthcare requires health IT.”
Mostashari promised to lead ONC forward “with the principles that got us here.”
“If you don't know what your principles are, you don't know what you can and can't compromise on," he said.
According to Mostashari, ONC’s principles include allowing the marketplace to innovate change, but also including government action when needed to support that change.
“The private marketplace is the biggest driver for innovation,” he said. “We have got to bring innovation more and more to healthcare.”
The healthcare marketplace is not the most efficient, he also warned. That is when it needs some government push. One example would be government support for healthcare providers in adopting electronic health records, and in setting standards for their use.
"We have to do the minimum government action necessary, but no less," he said. “And we have to have humility about what we can and can't do.”
Mostashari said ONC’s use of federal advisory committees has been critical. ONC has held on average a public advisory meeting every other day for the past two years. The advisory committees are comprised of “some of the smartest people in the country,” he said. “That’s what makes us better.”
He said ONC needs to move forward while being pragmatic, practical, incremental, bold and flexible.
And in the end, said Mostashari, “whenever there's any question about what we should do, it’s incredibly grounding to ask ourselves what’s best for the patient.”
[See also: Survey analysis: Mostashari as ONC chief.]



