National Coordinator Mostashari Announces Resignation

 

 

 

Farzad Mostashari, MD, ScM, announced on August 8 that he will step down from his position as national coordinator for health information technology in the fall. Mostashari first joined the Office of the National Coordinator (ONC) as deputy for programs and policy in 2009 and succeeded David Blumenthal, MD, as national coordinator in April 2011. Although the previous national coordinators have also served approximately two years in the position, Mostashari’s announcement caught the health IT community by surprise and prompted many accolades for his national leadership for health IT and its role in patient safety and quality improvement.

 

Many reports of Mostashari’s resignation mention his personal commitment to patient safety; his own letter to the ONC staff announcing his decision is among the most compelling:

On a pre-dawn morning in June 2009, I paced helplessly outside my Mom’s hospital room as alarms beeped and the monitor showed the most recent run of life-threatening heart arrhythmia. I had screwed up my courage to ask to see the paper chart, but I couldn’t even read the cardiology consult’s name. After her discharge it was also very difficult to get her records; she didn’t get needed follow-up and required emergency surgery. The complications, which weren’t supposed to happen, indecently increased the hospital’s revenue.

I joined ONC a week later. This office had a daunting task ahead of it. Working backwards from the outcomes we hoped to enable, we had to define ’Meaningful Use’ of electronic health records, establish a new certification program, endorse national standards, design and set up a slew of new grant programs to assist in health IT adoption, exchange, workforce, research, and privacy.

 

The full text of Mostashari’s email and Secretary Kathleen Sebelius’s letter to staff members at the Dept. of Health and Human Services are available at MedCity News.

 

Mostashari’s passion for improvement was also evident in his keynote to the HIMSS conference last March in New Orleans. As I described in the March/April issue of PSQH, “Mostashari described why providers must demonstrate “meaningful use” of electronic records before they may collect incentive payments and included a convincing argument for engaging with patients proactively, not just in episodic office visits. He argued that what physicians learn about their practices from electronic records may reveal gaps in care, allowing them to correct safety problems that would remain hidden in paper-based systems. With paper, there is no practical way to know who didn’t return for follow-up care, who didn’t receive critical lab results, who is suffering from an error of omission.

 

Whether or not you have your blood pressure or lipids controlled is a coin toss in America. That is symptomatic of a broken system just as much as the errors of commission around safety.

With electronic records, it’s possible to catch people who would otherwise fall between the cracks. The information makes “the invisible [patient] visible and makes those people count.” Like a true epidemiologist, he’s excited that, at last, physicians can see the denominators—the whole patient population—and engage with them proactively to provide better healthcare.”

Farzad, as he’s universally known, has not announced what he plans to do next, and there is of course much speculation about who next will lead the ONC. Twitter will be the best place to monitor developments in the ONC leadership, as it is for health IT in general. Among his accomplishments, Farzad uses Twitter effectively, where he maintains two accounts; for the next few month at least, you’ll find him at @Farzad_ONC and, for slightly more whimsical moments, @FarzadsBowtie.

Of course, we’ll report here when there is news about a new appointment to the ONC.