Even doctors who have purchased and successfully implemented electronic health records do not always know what they’re buying until the system is up and running.

ONC director Farzad Mostashari,MD, made that point to a room full of chuckles on Wednesday while giving the closing keynote address at the Government Health IT Conference here in Washington.

The problem: While there are nearly 750 EHR products certified for meaningful use Stage 1, adequate apples-to-apples comparisons of features and prices do not exist today.

[See also: Docs tell government panel EHR tales of woe.]

Competition is a wonderful thing, said Mostashari, but “classic causes of market failure,” in this instance prohibitively high switching costs, vendor or data lock-in, among others, weaken the competitive landscape.

“We need to create a better marketplace,” he said. “We want as little government involvement as possible, but no less.”

[See also from GHIT 2011: The 3 D’s of cloud computing.]

The goal of meaningfully usable, more effective EHRs will help physicians put patients at the center of their own care, said Mostashari, who has been spreading his patient-centric principles since he became national coordinator. On Wednesday, he drilled down into three of the tactics ONC is planning to take.

Building upon his well-established and well-known five principles – good governance, keeping eye on the prize, but with both feet on the ground, using markets to foster innovation, and opening the benefits of health IT to everyone – Mostashari said that the meta principle is putting patients at the center of information flows, literally.

[See also: Mostashari predicts 'tough period ahead'.]

Achieving that means freeing the patient data, empowering patients by raising awareness that they can access their own data and teaching them to learn from it, and creating a platform for innovation, such as the Innovations Initiative (i2), a developer challenge with which ONC hopes to open doors to collaboration and innovation.

[See also: ONC puts its money on health IT innovation.]

“Patients have a right to their records,” Mostashari said. “We need to liberate it from the entities that hold it.”