Mostashari rallies stakeholders on meaningful use, urges continued commitment

By Diana Manos
11:10 AM
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WASHINGTON - The U.S. is making strong and fast headway on the adoption of electronic health records, said National Coordinator for Health Information Technology Farzad Mostashari, MD, at a recent event in Washington, D.C.

"There's a lot of work still to be done, but the curve is sloping upward; we're on the steep part of the curve right now," he told attendees of a briefing hosted by the Alliance for Health Reform. The briefing, titled "Health Information Technology: Leveraging Information to Drive Practice," included speakers from all facets of health IT adoption. 

"We've set the adoption in place and clearly that is moving," said Mostashari. "Meaningful use Stage 1 got people on the escalator, but that's not enough. We need to keep constantly moving up."

Mostashari said healthcare IT is crucial, but it's not only about technology. "It's how we use the technology and how we accomplish the goals we set for ourselves." The goals are threefold: driving better care, encouraging better health and lowering healthcare costs. 

"Technology is the enabler, the foundation," he added. "Patients need to care for themselves and become partners in their care." 

Mostashari lauded both the Bush and the Obama Administrations for backing healthcare IT advancement with their leadership and funding requests.

And he praised Congress's wisdom in writing the HITECH Act: "They started with the end in mind, then worked backwards."

The regional extension centers (RECs) established by HITECH have been key to the success in adoption so far, said Mostashari. Some 147,2008 physicians are currently being helped by the RECs, including 70 percent of all rural primary care providers. "We couldn't have dreamed this possible three years ago."

Meaningful use should be considered a building block that continues to build, he said. The ultimate goal is to be able to manage the health of populations. "It's not the whole story, but it's the beginning of the story. If you can't manage information you can't really manage care in a modern healthcare system." 

"We're on really a great path," Mostashari said. "There's a lot of hard work to be done, still, but we can do it. The future of medicine is going to be brighter than its past."

Deanna Okrent, senior health policy associate for the Alliance for Health Reform, said there has been much discussion about ways to transform the healthcare delivery system and slow expenditures through the use of EHRs.

"There may not be a silver bullet that can accomplish all of that instantly, but there have been inroads made," she said. "Adoption is not just a concern, it's the meaningful use that is the long-range objective." 

Anne Marie Audet, vice president for health system quality and efficiency at the Commonwealth Fund said healthcare IT is "absolutely essential" to providing a platform for healthcare reform, payment reform, and to have a positive impact on patients' health.

Andrew Racine, MD, professor of Clinical Pediatrics at the Albert Einstein College of Medicine said healthcare IT alone, isn't enough. A focus on leadership, from the top to the bottom of an institution is needed to make meaningful use of IT a priority. 

In addition, data has to be formatted, aggregated, analyzed and pushed forward for practitioners to use.

"Even when doctors get the information, if it isn't formatted the way they want it, they don't always know what to do with it, particularly while working in teams," said Racine. "It's not simply the physician, it's everyone working with the patient; and this doesn't come naturally for doctors."

He added that incentives for each site are needed in addition to learning collaboratives, for one site to learn from another. "Learning collaboratives are extremely important," he said.