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Drs. Brailer and Mostashari in Health Affairs: Two National Coordinators Compare Notes

March 5, 2012
by by Mark Hagland
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The March issue of Health Affairs, whose contents were released online March 2, carried an article in which the first national coordinator of health IT, David Brailer, M.D., interviewed the third, and current, national coordinator, Farzad Mostashari, M.D. In the interview, Dr. Mostashari predicts that 50 percent of physicians will have adopted electronic health records (EHRs) within a couple of years, up from just 20 percent in 2009.

Here are a few brief excerpts:

DAVID BRAILER: “Where are we now with health information technology adoption in general?”

FARZAD MOSTASHARI: “I think the three-word phrase would be ‘on the march.’ If we look at every indicator we have, it’s all pointing in the right direction. As you know, in 2009 about 20 percent of primary care providers had a basic EHR when HITECH was passed, and within a year that jumped to 30 percent. I expect us to be at 40 percent in this year’s statistics, and within a couple of years we’re going to be over 50 percent. That’s real acceleration. We also have seen tremendous attention paid to the need for use of electronic health records, not just basic adoption, but their meaningful use… [W]hat we really want are the outcomes, and I think we’re going to start to see seom demonstrable results from the places like our Beacon demonstration communities…”

BRAILER: “During the Bush administration, we placed the top priority on interoperability and information sharing. We saw the small number of incumbent EHRs in use as an opportunity to push interoperability without facing opposition from legacy systems. The Obama administration has made adoption its top priority, putting the overwhelming share of budget dollars towards. That. Why did you make the shift? And how does health information exchange fit into the adoption agenda?”

MOSTASHARI: That’s a great question, and I guess I would say that it’s really meaningful use of electronic health records that sets the frame here… ‘Meaningful use’ includes electronic prescribing, which is an electronic exchange… It includes public health reporting. And it includes transitions of care, whether it’s for referrals or to hospitals and other settings with electronic transfer of information.”

BRAILER: “…It is hard to understand where we are with health information exchange. When will the typical hospital see a health information exchange that really works? What’s going to be the landmark…?”

MOSTASHARI: “I think it’s already happening. One of the things that our health IT standards committee has really been very vigilant about has been in saying we need standards not only to be well formulated in committee. We also need them to be really very broadly adoptable, and adopted in practice and in industry. That really trends toward, first, simplicity of the standards and protocols, and second, reusing standards that exist in broader electronic contexts—on the Internt—and not just in the health care standards world.”



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