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MU Final Rules a 'Roadmap' Not a Checklist, Mostashari Says

 |  By Margaret@example.com  
   June 28, 2011

Look for the Office of the National Coordinator to release by next year all of the final rules for Stage 2 of meaningful use.

Farzad Mostashari, MD, the National Coordinator for Health IT, explained Monday that his office is busy reviewing information from the Health IT Policy Committee, which in early June recommended delaying for a year, until 2014, Stage 2 of the meaningful use program for those providers that comply with Stage 1 criteria in 2011.

Mostashari made his comments at the National Health IT and Delivery System Transformation Summit in Washington, D.C.

For providers, meaningful use means using certified electronic health record technology in ways that improve the quality, safety, and effectiveness of patient-centered care.

Without being specific, Mostashari said that while the final rules will pull from the policy committee recommendations, "they will not be identical," although "a lot of deference will be given to the committee."

Mostashari challenged the audience to not think of meaningful use as a random bureaucratic checklist of hoops to jump through, but rather "the roadmap for delivering higher quality healthcare." He said the mindset is shifting from seeing meaningful use as a distraction from providing quality patient care to the "way to get there."

Mostashari clicked off a list of leading IT growth indicators:

  • EHR adoption by primary care physicians. After 20 years the rate of adoption of electronic health records by primary care physicians was 20%. In 2009-2010 it was 30% and the rate of adoption might be 40% by the end of 2011 and at 50% within two years.
  • EHR adoption by hospitals. A couple of years ago 10% of hospitals had a basic EHR system in place. Now surveys indicate that more than 86% of hospital CIOs intend to apply for meaningful use, with 60% expected to apply in the next couple of years.
  • Providers registering for the meaning use program. Five thousand to 10,000 providers each month register for the meaningful use program.
  • Providers registering for regional extension centers. Each month 6,000 small provider practices sign up for help at the extension c enters to learn how they can become meaningful users.

During a question and answer period Mostashari was asked if patient care was headed toward something that "won't work in the end." The questioner noted that "we are basing all of this on the assumption that you can take pieces of information from all these different records, from all these different doctors who have all these different views of the patients and put them together. That might work with an MRI but what about allergies and medications that are patient-specific and can change overtime? It's going to be difficult to weave this all together unless we put it all in the hands of our patients."

Mostashari replied that the questioner's "concern that we going on a path that will be difficult to retreat from is really important. But what are the options? We can do nothing or we can make our best guess at what is the right thing to do. Another option is to make your best guess but recognize that you are probably wrong and try to build in a way that's sensible enough but not overly specific so it can move us forward and yet accommodate a variety of future scenarios."

He offered the health information exchange as an example of something that needs to accommodate what can be done in the future, including personal health records and community health records. "We should take a few steps and see where we are then take a few more steps and re-assess our position. We shouldn't box ourselves into one system."

In closing, Mostashari asked the audience to hold the federal government accountable to make sure it was as "coordinated, as aligned, and as effective as we need to be."

See Also:
ONC Names Mostashari National Coordinator for HIT
Mostashari: We need a better marketplace
Only 13 RHIOs Meet Meaningful Use Criteria
AMA, others advise HHS to clarify meaningful use regs

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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