WASHINGTON – Farzad Mostashari, the newly appointed and fourth leader of the Office of the National Coordinator for Health Information Technology, is going to face some stiff challenges his predecessor David Blumenthal did not have to face.

 

Blumenthal came to the position just one month after the passage of the HITECH Act and its unprecedented 27 billion dollar infusion of federal funding to spur healthcare IT adoption. The policy-making atmosphere for health IT was mainly optimistic. The health reform law had not passed yet, bringing with it the intense partisan tension that now blankets the healthcare domain in America.

 

The uptake of health IT by physicians has been slow and is still not totally welcome, despite the incentives offered through HITECH. The earliest reports of Stage 1 meaningful use implementation have not yet been tallied, though federal officials say they plan to analyze that information soon. Pressure is mounting on policymakers developing Stage 2 criteria, and many stakeholders are calling for a delay in implementation, which unhindered would begin in 2013.

 

Budget battles are lava-hot on Capitol Hill, and promise to continue to be right through to the 2012 election. Already the GOP is nibbling at ways to cut off the funding stream for health reform, while Republican attorneys general push the new law to the Supreme Court in hopes of abolishing it.

 

The good news is, healthcare IT has always been supported equally by both parties. It should enjoy continued support. But funding will remain the big question. Some of the HITECH funding is already out there, supporting regional extension centers, the Beacon Community program, health IT technology education programs, and more. But some of the funding for Medicare and Medicaid EHR incentives through 2017 is not. Major budget battles could jeopardize that funding, though experts can’t say at this point to what degree.

 

Drafters of the Affordable Care Act intended the law to create new ways to slow healthcare spending, such as through accountable care organizations. The success of ACOs depends heavily on healthcare IT adoption and interoperability. The proposed ACO regulation, out for comment through June 6, so far seems to be facing the same intensity as has healthcare reform. Some people hate it, while some people are embracing it.

 

At the least, Mostashari will need to be a very diplomatic man, because he's walking into a hornet's nest of controversy.