In the second half of my exit interview with outgoing National Coordinator Farzad Mostashari, MD, of the federal Office of the National Coordinator, we discussed the evolution of electronic health record systems and concerns over quality measures. Part I of the interview is here.
Farzad Mostashari, MD, ScM
National Coordinator for Health Information Technology
HLM: Some argue that HITECH has funded the purchase of EHR software which is really not suited to the emerging value-based care system, that today's EHRs are overwhelmingly designed for fee-for-service and maximization of revenue.
Mostashari: I would say that their views are exactly correct, but a little outdated. When I testified before Congress seven years ago, that's what I said, and I said that EHRs today don't let you make a list. They don't let you measure quality. They don't collect smoking status, or blood pressure, in standardized ways. They don't offer decision support.
One EHR vendor's chief technology officer, during their acquisition process, said, 'we don't believe in decision support.' That's what they were focused on, and that was the whole point of Congress saying, we're not going to just pay for systems. We're going to pay for systems that have what it takes to improve care, and their use of it that way.
So when we see outpatient providers' ability to look at evidence-based guidelines, increasing within a two-year time period from 20-some percent to 50-some percent… that tells you something... That's data.
That's evidence that says that EHRs are changing, and they're use is changing, because of the Meaningful Use incentive program. So I guess I would say EHRs are critical tools… and we can't afford to not use them as tools for population health management and consistent application of guidelines and care coordination and patient engagement.
It would be a tremendous loss if we just view EHRs as data-harvesting machines sitting on top of an army of data slaves, tapping away. That's not the vision that I have for electronic health records.