Q&A: ONC's Jon White, MD
Jon White, MD, acting deputy national coordinator for health IT, has been coming to the HIMSS Annual Conference & Exhibition since 2004. Back then, the Office of the National Coordinator didn't yet exist – it was still a few months away from being founded. President George W. Bush (who will deliver his HIMSS15 keynote address on Wednesday from 4:30-5:30 p.m. in the Skyline Ballroom) had only just made his momentous mention of EHRs in the State of the Union address.
White says he's impressed and gratified by the growth and maturation he's seen in health IT since then.
"What you've really seen is an influx of a lot of larger information technology companies," he says. "They were interested before, but they're really interested now."
Key to that, of course, is the more than $28 billion dollars in incentives made possibly by the HITECH Act and the meaningful use program. On Tuesday morning, White spoke to Healthcare IT News about the recent evolution of both meaningful use and ONC.
Q: Five years ago, meaningful use money was like an injection of rocket fuel for this industry. In the past year or two, however, it seems like the program may be seen as something of a drag by some providers.
A: It's become more part of daily practice, for sure. I started working on health IT with the federal government in 2004. The IOM had just recommended that we start using electronic health records to drive improvement in practice. I was running a research program at that time at AHRQ and it was really about the potential and the excitement ad the promise.
I would say that the past five years have definitely been rubber hitting road. And any time that happens you hear a lot of great stories, and also a lot of challenges that have gone with it. I think that's what we've heard over the past five years.
Q: Were you surprised at all by some of the difficulties with Stage 2?
A: Not necessarily surprised. Stage 2 is ambitious. It hopes to drive a lot of improvements in processes and outcomes. The flip side is that's a pretty heavy lift. It it were easy to make a lot of these changes it would have happened a long time ago. Everyone's been working very hard at it, and even though you hear about a lot of the challenges, I really am impressed by the way the whole health system is digging into it and trying to make it happen.
Q: What do you say to those who say, "We don't need meaningful use anymore. Let the market take over"?
A: I would ask them rhetorically: Is the point to have a box on a desk? Or is the point to have people live longer, suffer less and have better value for their dollars? The obvious answer is the latter. Meaningful use has definitely done its job as far as driving adoption. I think that has been a great success. I think that now the secret sauce is providers grappling with these tools and understanding them at a fundamental level.
My background is as a family doctor. When you do primary care you coordinate across a lot of different folks and coordinate across a lot of different problems. By and large, my stock in trade is information. You come in, I ask what brought you into the office, I ask more pointed questions, I examine you, record data, send you out for labs, get more data. It all goes into the wetware, and I turn that into care and hopefully good outcomes for the patients.
Q: Does it concern you at all that family docs and EPs are having some of the hardest challenges with meaningful use?
A: I always worry about family doctors wherever I go, just being part of the clan. Family doctors have hard jobs. They really do. So it's not unexpected that they'd have some of these challenges. They're engaged, and you certainly hear some strong feedback on some things. But the flip side of that is there seems to be a strong commitment to the use of these tools. I've not heard a (physician) professional society yet say we should go back to paper. It's a hard fight, but I think it's the right fight.