Mostashari: 'We are committed to IT'
The day after President Bill Clinton told the HIMSS13 audience that the healthcare system was broken, but could be fixed, ONC chief Farzad Mostashari, MD, offered a personal example of that broken system: his Mom. Mostashari launched his own keynote on Thursday morning by describing what his mother endured when she was admitted to the hospital for routine knee surgery.
[See also: Clinton urges IT pros to help healthcare.]
"Healthcare is broken not just when it comes to costs of healthcare," he said. "Healthcare is broken as a system, as a lack of systems."
Like many patients, Mostashari’s Mom was on an aspirin regimen. The medical protocol called for her to stop taking her aspirin seven days before the surgery. However, she noticed the instructions the day before surgery. The healthcare providers decided to go ahead anyway. As a result she had bleeding complications, infectious complications and cardiac complications.
There had been no alert, no notice, no reminder for the patient. They forgot. They didn’t get around to it,” Mostashari said. “That system is failing everyone in healthcare and everyone we love, he said. "It's the human toll."
How broken is the system? In Cleveland, 24,000 patients with diabetes were delivered the right care, right standards, 7 percent of the time, Mostashari said.
[See also: One-on-one with Mostashari.]
Data and standards of care are critical, he said, but some view standards as cookie-cutter medicine that stifles innovation. The Stanfords, Johns Hopkins, Vanderbilts of the world view it as “something that’s not for us – we are big brains,” Mostashari said.
"But the problem we have today is not too much standards in healthcare," he said, eliciting applause from the audience.
"We are committed to IT," he said, because without it, new care models cannot succeed. "Fee-for-service is not dead yet," he added, "but there are a lot of plans for its demise."
Data will make a difference in the quality of care, he said. "It’s not big data in the sky, it’s little data in the clinic."
Mostashari put up a few slides to drive his point home.
In 2010, 5 percent of healthcare organizations had met the requirements of Stage 1 meaningful use. In 2011, the number rose to 21 percent, and by 2012, it had reached 50 percent.
"This is not easy," he said. "This is not a giveaway. They are earning this. Don’t tell me that healthcare can’t change. It can. There’s a lot of what seems to be resistance,” he said. "It’s just uncertainty. Now we have over 100,000 providers live on EHRs."
"You know what scales?" he said. "Hard work. Grit scales."
On the topic of interoperability, Mostashari put up a slide that showed 24 percent of healthcare organizations had achieved it. "Twenty-four percent is nothing to celebrate, even If it’s triple what it was three years ago," he said. He assured the audience he would “do what it takes to get this to be the top curve.”
"But we need a business case," he said. "We're going to make it more profitable to share than to hoard. No one should make a profit making patient data hostage."