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Mostashari Named Health IT Czar

By John Reichard, CQ HealthBeat Editor

April 8, 2011 -- Farzad Mostashari, who led an effort in New York City to foster the adoption of health information technology (IT) by primary care doctors serving low-income populations, has been named the new national coordinator for health IT. Mostashari succeeds David Blumenthal.

A graduate of Harvard College, the Harvard School of Public Health, and the Yale School of Medicine, Mostashari started the job last week. Since July 2009, he had been working under Blumenthal as deputy national coordinator for programs and policy.

"I look forward to continuing to work with him in this new capacity as he builds on the incredible progress made in the adoption and meaningful use of health information technology during David Blumenthal's tenure," Health and Human Services Secretary Kathleen Sebelius said in an e-mail to senior staff.

Although many providers are moving to adopt health information technology, they face a number of challenges in order to qualify as "meaningful users." That's the status required under HHS rulemaking to get Medicare bonus payments. Mostashari will have to navigate demands from providers for greater flexibility in striving for meaningful use.

"We are hopeful that as the future stages of the incentive program are developed, the government will take into account the difficulties medical groups currently face in meeting the meaningful use requirements," Medical Group Management Association President William F. Jessee said this week.

Doctors' offices have struggled to absorb use of the new technology in their work routines. Initially, many physicians struggle to record data on computers and often find themselves putting in extra hours to input patient information. Over time, however, practices that stick with it show gains in productivity and lower costs. But the transition can be daunting.

"It is difficult; there is no question about it," Mostashari said in an interview with CQ HealthBeat last year. The process does not simply entail learning to use the technology but also involves redesigning the way tasks are performed in the medical office, he noted.

But "the wind is, in a sense, at our backs," he said. "EHR systems are getting better and better and better." Along with rising Medicare and Medicaid payments to encourage IT use, he added, expectations are building within the medical profession that the technology should be used. "This is not just about getting checks from the government, it's about professional standards," he said.

David Brailer, a Bush administration appointee who served as the first national coordinator for health information technology, said Mostashari "really blossomed" in his role as Blumenthal's deputy. While Blumenthal served more in the role of a visionary pulling together the policy elements of the federal health IT effort, Mostashari has "a real street feel" for the challenges of implementing the technology.

Owing to his experience in New York City spurring some 1,500 primary care providers to adopt IT to deliver better preventive care, Mostashari has "a street level view of the immensity of the problem and of the power of the solution," said Brailer.

Brailer also credits Mostashari with having a gift for compromise, saying that rulemaking over what constitutes meaningful use of health IT has pitted those who wanted few demands on doctors against those who saw a rare opportunity to really push the medical profession hard to exploit its potential. Mostashari "was one of the key people that talked dreamers back into reality," Brailer said.

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