IT Czar Calls for Clearer Standards

The "meaningful use" standards used by the federal government to measure the quality of electronic health record systems don't necessarily translate into real-world usability, and that needs to change, the nation's health IT czar says.

The health IT community will first have to agree on which aspects of usability are most important and how to reliably measure them, said Dr. Farzad Mostashari, national coordinator for health IT. Yet it's too early to say whether regulation is the way to drive usability improvements, he told Government Health IT magazine editors in an interview published today.

"There are lots of ways once you have the measures that that can be implemented, anything from voluntary testing to challenges," he said in the interview, published online in a Q&A format. "If you have a usability framework, maybe you can have a challenge that will highlight the award winners for usability. That will drive the market to value and compete on the measures of usability."

Additional highlights from the interview:

• Regarding the next stage of health IT innovation, Mostashari says it will come "not (in) the clinical system per se, in terms of transactional clinical system, but all the things you can do once the information is in electronic format and once you have the motivation to do population health management."
• The "key building blocks" needed to make measurable progress this year in moving beyond the "print-fax-scan" transfer of medical records include "the ability of EHRs to ... export summaries of care records in structured format, the ability to send that securely over the Internet using Direct protocols and the ability to incorporate that, either as human-readable or in the future computer-readable" formats.
• On the challenges of meeting multiple new federal mandates for health-care providers, the national coordinator says his "hope for health IT is that we are absolutely the answer for the provider who says, 'What should I do to get ready for delivering accountable seamless care?' The answer should be meaningful use."
• On the imperative to maintain progress, Mostashari says now is not the time to "sit on the sidelines (because) it's possible that there might be a dramatic shift in administration policy in 2012. We have a law, incentive payments in place, and we have a structure in place. And most importantly, we have broad bipartisan support that health IT ... makes sense no matter what your prescription is for getting more value out of health-care dollars across the board."