Q&A: Mostashari Reflects as He Prepares to Exit ONC

Scott Mace, for HealthLeaders Media , October 1, 2013

Unfortunately, it only accounted for three percent of medication errors that led elderly patients to the emergency room. What accounted for 40 percent was Cumadin, Warfarin, and keeping people in the right therapeutic range for Cumadin, so they don't bleed out.

Was there a measure for that? Not until Stage 2 Meaningful Use, where we worked with CMS to develop one for that. So I guess I would say it's a little more complicated than that. We need measures that matter. We need to make measures in which the data for it from… routine care provisions, so we reduce the burden of it. And [we need to make measures] that are meaningful, that are longitudinal outcome-based measures that make use of the strength of electronic health records, and we are very much making progress on doing that.

What I think we need now is for big employers like GE to demand of their health plans that they all use the same damn measures, instead of providers getting 12 different signals from 12 different health plans, so that I think is another area we highlight in the paper as needed focus for quality measurements.

HLM: Touché. Is any of the pause in healthcare spending growth attributable to the role of technology?

Mostashari: We don't know, and I don't think that the role of technology in reducing the growth in healthcare spending is going to be something neatly attributable. It's going to be part of a broader system of changes in how we pay for and deliver care, for which health IT is an essential component, but not by itself able to be attributed to some portion of it.

So some portion of this is due to readmission adjustments, and the decline that we're seeing in readmissions. Has health IT contributed to that? Probably. I think it probably has contributed to that.

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