You'd be justified in wondering whether the Office of the National Coordinator might soon see its influence wane, what with EHR adoption having reached critical mass and meaningful use incentive funding dwindling toward the halfway point. But you'd be wrong, says Farzad Mostashari, MD.

Mostashari, the outgoing national coordinator, is adamant the agency’s policy and technical services will continue to be in high demand and continue to work to address the IT challenges and opportunities in healthcare.

The need for the ONC’s work on policy development and coordination with other agencies "is only going to grow, as there’s more and more health information in digital format, and as the flow of that information becomes more important for quality measurement, privacy and security," Mostashari said during an interview this week.

And in the era of accountable care and big data, the ONC is also likely to make technical standards a priority. "Is the need for that going down? Hell no, the need for that is going up."

Especially as health IT moves beyond the basic EHR, the ONC will have a robust role to play guiding technical standards that accountable care, public health and clinical research.

It will be part of an evolution for the agency, but one that stays focused on the goal of enabling the migration from fee-for-service to value-based care, Mostashari said.

"I will grant you, not having a grant-funding relationship with the 52 state health information exchanges, 17 Beacon Communities, 62 regional extension centers, 82 community colleges, is going to change how we interact with the field," Mostashari said.

"But we’re not going to retreat from engagement. We have to continue to inform our policy and standards work with the real world experiences."

Over the past half-decade, as e-prescribing rates rose to greater than 50 percent, among other milestones, the ONC has carried more than its weight in terms of productivity, Mostashari said, with a staff of about 170.

"I think that’s fewer than Canada has in their equivalent office," he said, adding that is exactly why "we have to punch above our weight. We've always punched above our weight for some of this work. We couldn't use the tens of billions of dollars going out as incentives to hire staff, but we have been able to use our staff incredibly strategically to leverage other people’s ability and desire to help."

Mostashari pointed to other health agencies, such as the Centers for Medicare & Medicaid Services, the Substance Abuse and Mental Health Services Administration and the Centers for Disease Control & Prevention, who have offered grants to the ONC to tap their work and expertise.

"The bulk of the funding that spurred this movement will continue to provide the leverage for meaningful use," he said, noting that Medicaid EHR payment adjustments run through 2021. "What will go away is the couple billion dollars that jump-started the initiative."

This story first appeared on Government Health IT.

[See also: Mostashari announces his departure from public service with a message]