Mostashari: 'Virtuous cycle' will bolster healthcare

By Mary Mosquera
04:18 PM

Dr. Farzad Mostashari, the national health IT coordinator, said that the effect of increasingly more physicians and hospitals adopting electronic health records and becoming meaningful users is beginning to produce a “virtuous cycle” of better information to improve healthcare delivery.   

The programs that the Office of the National Coordinator for Health IT has established over the past two years are taking hold as more organizations participate, he said April 26.

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He cited the proportion of providers who use basic EHRs, which had been in a holding pattern at 20 percent for years, jumped to 30 percent within one year. Healthcare providers have invested hundreds of millions of dollars in anticipation of meaningful use incentives.

“I think something bigger is afoot here than just the incentive payments. The wind is at our backs in a very important way. We are approaching the virtuous cycle, where what providers need to do to succeed in the new era of healthcare financing requires better information,” he said.

Those more effective information systems can then help create alternatives for healthcare financing and better payment for quality and not quantity, which did not exist before.

“I think we are about to catch that virtuous cycle,” he said at a presentation at the Bipartisan Policy Center in his first official appearance in his leadership position, aside from his role in chairing public/private health IT advisory committees.

The Bipartisan Policy Center is a think tank established by former Democratic and Republican Senate majority leaders to address tough policy challenges, including health care.

Mostashari explained how health IT was embedded in the recently announced Partnership for Patients, a program sponsored by the Centers for Medicare and Medicaid Services, with public and private organizations coordinating to reduce hospital readmissions for Medicare beneficiaries by 20 percent and hospital associated conditions by 40 percent in the next three years.

“You cannot possibly achieve those goals without having the underpinnings of information technology. Better information is really what it’s about, and technology is the tool to accomplish it,” he said.

ONC will move ahead based on the values that brought it this far. That includes strong support for and reliance on industry innovation, he said. An effective and efficient private marketplace is the biggest driver for innovation.    

“We’re going to use the market. But the market in health care is not the most efficient market,” he said. The costs to go digital or switch EHRs can be high, and that creates an imbalance. Small medical practices also have difficulty understanding complex service level agreements and vendor contracts and enforcing them. “And a lack of transparency is rife throughout the industry,” Mostashari said, adding that it is difficult to compare vendor pricing “apples to apples.”  

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He wants to make sure the market is competitive, that vendors work with smaller customers and that they provide clear information about their health IT products and services. “We have to do the minimum government action necessary but no less,” he said.  


To get it all right, ONC will listen and be transparent. He cited how ONC has held public meetings “on the average of once every other day for the past two years. Our use of the federal advisory committees, and all their work groups, makes us better,” he said.


Mostashari described the coming months as “an intense phase of implementation,” as programs created to help providers become meaningful users of EHRs ramp up.

“We’re hitting our mile markers, but it’s a marathon,” he said.

ONC programs include 62 regional health IT extension centers, which have enrolled 60,000 physicians to offer them technical and project management assistance; curriculum and training courses at 82 community colleges that will graduate the first batch of 2, 228 health IT professionals this month; the EHR certification program with 614 EHR products from 380 vendors; and 50 state health information exchanges that have moved from planning to rollout.