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Dr. Mostashari's Dramatic CHIME Moment

October 17, 2012
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The National Coordinator for Health IT’s CHIME Fall Forum address deftly blended tones of encouragement, exhortation, and admonishment

Farzad Mostashari, M.D. (r.), responds to audience
questions relayed to him by Randy McCleese,
a CHIME board member, on Oct. 17

Perhaps the thought was inescapable in the context of the current presidential election campaign going on right now; after all, the second presidential debate, in which a very engaged pair of presidential candidates had sparred very intensely over a wide range of topics, had just taken place the night before. But I couldn’t help thinking about Farzad Mostashari, M.D., as speaking like a political leader when he appeared at the CHIME Fall forum on Wednesday, Oct. 17—and I mean that in a good way.

After all, one could easily argue that the most important element in Dr. Mostashari’s role as National Coordinator of Health IT is that of federal persuader-in-chief when it comes to the HITECH Act and its concomitant meaningful use process. Indeed, there were many who predicted just two years ago that the entire meaningful use process might founder on the shoals of provider resistance and the simple difficulties involved in laying a complex, intricate foundation for healthcare IT on a national level.

But, under the leadership of four national coordinators—David Brailer, M.D. (who was the first national coordinator, pre-HITECH, of course), Robert Kolodner, M.D. (our second pre-HITECH national coordinator), David Blumenthal, M.D., and now Dr. Mostashari, a whole lot has happened in our industry in the past several years. And while most providers continue to struggle with at least some aspects of meaningful use, when one looks dispassionately at the process from a meta-level, it is impossible to state that meaningful use and the HITECH Act have been a failure. Indeed, by any objective measure, things are moving forward surprisingly well, even accounting for the inevitable challenges and problems.

And, to be both fair and objective, one must absolutely credit Dr. Mostashari for his highly canny assessment of the constantly evolving collective psychological state of CIOs , CMIOs, and other healthcare IT leaders since he was named National Coordinator in April of 2011. Whereas David Blumenthal, who spent two years as National Coordinator, was widely known to have a rather formal, professorial air about him, Farzad Mostashari has a polar-opposite temperament, and that has largely been a blessing, since he has overseen ONC as meaningful use has ramped up and become progressively more challenging to providers.

So it wasn’t surprising that Dr. Mostashari was passionate in his address to the CHIME Fall Forum audience on Wednesday. Eschewing notes as always, Mostashari  once again offered his healthcare IT executive audience a vision of the new healthcare, one driven by patient-centeredness, broad population health and health information exchange advances, and patient engagement. But the intensity that Dr. Mostashari showed on Wednesday surpassed anything I’ve seen, by a considerable margin. And he made his speech deeply personal as well, recounting, for the first time I’ve ever heard it, the very moving story of how his own mother nearly died because of a lack of readily accessible health information and a lack of good coordination and communication between and among physicians attending to her care.

So what struck me most about his speech Wednesday was this: like a good politician, Dr. Mostashari understands that the greatest power of any speaker lies in persuasion, and that, furthermore, without being able to energize healthcare IT leaders around a broadly unified vision of the new healthcare, the entire meaningful use process could easily falter. So Dr. Mostashari has been ramping up (one might even say, amping up) his energy in recent appearances, to strong effect, and inserting more personal anecdotes in his speeches, as he readily acknowledges how challenging meaningful use is, and how much more challenging it is becoming as we move into Stages 2 and 3, in an industry being hit with three big policy demands at once (MU, healthcare reform, and the ICD-9 transition).

Dr. Mostashari’s repeated exhortations that “We can do better” sounded, in a very good way, to me much like a campaign slogan. And inevitably, he has been and is campaigning—campaigning for provider leaders to recognize how profound the need is for healthcare transformation. And, like a political leader helping to shepherd people forward under his banner, Dr. Mostashari recognizes that the only successful approach is a very carefully calibrated mix of encouragement, exhortation, and admonishment. So each time he speaks to audiences like CHIME’s Fall Forum, he gingerly assembles a slightly new combination of all those elements. But inevitably, with MU pressures intensifying, passion and encouragement must intensify as well.

So in a fall season dominated by a no-holds-barred presidential race, it absolutely takes a politician’s touch to bring the policy message home to the masses. Fortunately, Farzad Mostashari is bringing just the right combination of messaging elements forward at a critical moment on the MU journey of a thousand miles, because there are still hundreds of miles to go, and we’re on the verge of a very steep ascent.

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