During the Thursday morning keynote at HIMSS13, the national coordinator for health IT, Farzad Mostashari, MD focused on the nation's broken healthcare system, while delving into a range of topics.
“The system is failing everyone in healthcare and everyone we love,” Mostashari said. “We don’t know whose life we’re taking when we only control blood pressure in half the population.”
Another example he pointed to is a recent study in Cleveland that found only 7 percent of diabetic patients were receiving the standard of care.
“The problem we have today is not too much standardization in healthcare,” Mostashari said to applause.
So how do we fix it?
Pointing to health information technologies such as EHRs, HIE and to patient data, Mostashari explained that the federal government is raising the bar for providers and vendors.
“The ability to manage information is going to be part of doing business,” Mostashari said. As will driving patient engagement by letting them have their data: “No one should make a profit holding patient data hostage.”
Which is among the reasons that CMS and ONC yesterday posted a joint RFI seeking suggestions on what the federal government should do to ratchet up the exchange of clinical information.
The challenge this year is exchange, which means getting data from here to there, and interoperability, which is not the same, Mostshari said, explaining that interoperability is ensuring that when providers get the data, they can understand and actually use it.
Whereas EHRs are producing clinical benefits for as many as 92 percent of practices, according to data Mostashari presented, HIE “is not where we want it to be." Those statistics are “nothing to celebrate, even if it’s triple what it was three years ago,” he said.
But Mostashari pledged to “do what it takes” – be that with policy, technology or his bully pulpit – to drive exchange, patient engagement and data liberation.
“Technology is democratizing information. It’s an irrevocable process,” he said. “You should not fight it, you should embrace it.”
Heading back into personal experiences, Mostashari touched on the story of signing his parents up for Blue Button and Medicare.gov on Thanksgiving and tapping the power of that information the very next day to make a diagnosis, then book an appointment with an ophthalmologist, saving everyone the time and expense of an emergency room trip.
He also recounted the story of his mother on a daily aspirin regimen leading up to routine hip replacement surgery. Within the paperwork was a requirement to cease taking aspirin seven days prior to the surgery, but she didn’t see it until the day before, at which point the hospital had no process in place to decide whether the surgery should proceed as planned or be rescheduled. There were non-fatal bleeding complications throughout.
The role of data in situations similar to his mother’s is to “make the invisible visible,” he said, because healthcare is broken in more ways than just cost; it's the lack of system that’s worse. “With data we can understand our own behavior and patient’s behavior.”
“It’s the human toll,” he said.