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Mostashari: 'Pardon our appearance. Transformation underway'

October 12, 2011
by David Raths
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ONC leader says change is messy, but the result will be vast improvements in efficiency, coordination, and quality

In his introductory comments to the Oct. 12 Health IT Policy Committee meeting, Farzad Mostashari, M.D., national coordinator for health information technology, sought to inspire committee members by reminding them that their work is transformational. He described seeing a construction site on his way to the meeting that was messy but had a sign that said, “Pardon our appearance. Transformation underway” and had a picture of what the site would look like when finished to remind people that the effort and inconvenience are going to be worth it. “Sometimes we don’t do enough begging pardon for the appearance and the messiness of change,” he said, “and we don’t put the picture up there of why it’s going to be worth it.”

Mostashari described a recent visit to a one-physician office in the Bay area of California. He sees this practice as a microcosm of the transformation that is taking place. Three years ago it began the transition to electronic health records. In the last year it has received help from the area Regional Extension Center and worked with its independent physician association (IPA) on customization of a hosted solution. “This small 50-person IPA is getting 160 percent of Medicaid payments because they have reduced avoidable hospitalization and they are working with a startup to analyze data to find people with high risk of re-admissions.” They are also looking into how to become an accountable care organization, he added.

With so much public awareness of how healthcare expenses are breaking budgets at the federal, state and individual levels, Mostashari added, largely unnoticed to the world at large three trends are emerging: a transformation in how care is provided, how it is paid for and how patients are engaged in their own health.

“These largely submerged trends will become apparent in a few years,” he said. “If we can work together on those trends so that payment reform takes advantage of IT infrastructure, which also supports patient engagement and performance improvement, we have a chance of vastly exceeding expectations of how much healthcare can improve in efficiency, coordination, and quality. So pardon our appearance. Transformation underway.”

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