September 27, 2013


Goodbye Dr. Mostashari

Perhaps because DrFirst is located in the Washington, DC area, and perhaps because we have a strong belief in standards and therefore participate in multiple workgroups tackling national issues, I’ve gotten to know the four individuals who have held the position as National Coordinator of Health Information Technology (ONCHIT) during their tenures–some more than others.
Since the creation of this relatively new federal agency in May 2004, each of the National Coordinators has brought a special flavor to the office. Each of these individuals has left a legacy, whether through setting up the office, bringing in VA healthcare experience, advocating for and receiving a significant budget, or driving Meaningful Use measures (MU) towards the difficult task of being, well, meaningful.
Dr. Farzad Mostashari is a unique individual in his interest and ability to canvas others and listen to their opinions. As such, MU has moved steadily forward. Although the pace of progress toward the Stage II adoption deadline has been controversial, it is due in large part not just to the ONC issues, but to the increasing number of mandatory, competing obligations, rules and deadlines originating from other divisions within HHS, as well as other federal agencies.
Examples include the ICD-10 deadline and the 10+ years of uncertainty and congressional brinkmanship in Medicare payment reform and the Sustainable Growth Rate (SGR). Speaking as a physician, the healthcare industry feels “under siege” resulting from the revolutionary changes coming with the implementation of the ACA law on top of the rapid strides forward in information technology.
Farzad has tried hard to establish a balance between incentivizing positive change more rapidly in health IT, but not at so fast a pace that providers felt they were just hanging on for the ride.  And progression of MU measure adoption through the next phases has been a thoughtful process, with an interest in gaining insight into the early stages before moving on to complete the design of the third stage. Whatever revisions may or may not be made to the ONC deadlines, the loss of Farzad Mostashari will be felt hard by DrFirst, the Physicians EHR Coalition (, and I believe by the many practicing physicians (though not all) who are successfully managing the IT transition and may not yet even realize the impact he has had.
From my personal perspective, in addition to being reasonable and reachable, Farzad is a heck of a nice guy. He always has a smile for a familiar face, and is happy to discuss just about any topic related to healthcare IT.  He will be missed as both a leader and a friend.
The departure of Dr. Mostashari will leave a hole, but certainly not a vacuum. And I’m also sorry to hear about the departure of David Muntz, Principal Deputy National Coordinator.  But ONC is rife with very bright people, including the Acting National Coordinator, Dr. Jacob Reider.  Dr. Reider has a strong interest in usability—if he can help improve that feature in EMR applications, providers will be in a much better position to use those programs happily.

About pkaufman

Schooled at MIT, Dr. Kaufman nurtured a strong interest in medical informatics while a Bowman Gray School of Medicine faculty member. After entering private practice he founded PiNK software in 1996 to produce EMR software, later becoming DrFirst’s chief medical officer upon its founding. He lectures nationally on various healthcare IT topics, and as a board certified gastroenterologist, he continues a limited clinical practice. Dr. Kaufman is a member of the Health IT Standards Committee, Privacy and Security Workgroup for ONC (Office of the National Coordinator for Healthcare Information Technology). Representing the American Gastroenterology Association’s (AGA), Dr. Kaufman is a delegate to the AMA and was the co-chair of the Physicians Electronic Health Record Consortium (PEHRC). He has participated on workgroups at CCHIT (stand-alone e-prescribing), HIMSS (e-prescribing), and NCPDP (e-prescribing).