Farzad Mostashari talks interoperability, usability, sequester, more

In a wide-ranging discussion, Farzad Mostashari, M.D., talks patient data interoperability, improving usability and fallout from the budget sequester.

The usability of health IT software applications is improving, and initiatives around privacy and security are ramping up, according to the national coordinator for HIT.

Farzad Mostashari, M.D., discussed federal efforts during his annual HIMSS media sit-down, as he fielded questions on a wide range of topics.

Soon after HIMSS 2012 last year, Mostashari bemoaned the state of health IT software interfaces. Specifically, he said that he walked the aisles of the exhibit hall and chastised software companies for making it harder on physicians to attest for meaningful use because of difficult-to-use applications.

What a difference a year makes, even though some vendors have not yet gotten the message. Browsing exhibits at HIMSS 2013, Mostashari said it appears to him that physician demand for usability is driving some market innovation without -- for now -- his agency having to step in and regulate the usability aspects of EHRs.

"I am seeing progress. I'm seeing some products that continue to have user interfaces that are circa 2005, and I just can't imagine those vendors doing well, now that there are real choices in the marketplace around usability," Mostashari said. "Compared to when I was in the market for an electronic health record [2007], the interfaces are night and day in terms of how sleek they are, how intuitive they are and how consonant they are with the visual vocabulary of the Internet. It doesn't look like Microsoft Access anymore, it looks more like Amazon. That really helps."

Security takes center stage as HIE ramps up

Mostashari also added detail to his comments on the evolution of health information exchange (HIE). One of the big announcements in that arena was the CommonWell Health Alliance, about which he first spoke to SearchHealthIT earlier in the week. Privacy and security will take center stage as care coordination becomes a major component of healthcare reform and providers increasingly share patient data across locations and platforms, he said.

We have baked both security and privacy issues into all of the activities we have around information exchange.

Farzad Mostashari, national coordinator for health IT

He added that Joy Pritts, chief privacy officer at the ONC, constantly reminds policy leaders that it's not "HIE," but "secure HIE," keeping that piece of the health IT puzzle front-of-mind in their various initiatives.

"We have baked both security and privacy issues into all of the activities we have around information exchange," Mostashari said, citing requirements in the 2014 EHR certification standards. Those call for secure exchange of health information that is encrypted and requires authentication of users on both ends of the transaction. The standards also require other practices, such as leaving all patient identifiers out of file metadata.

The sequester is 'going to hurt'

Finally, Mostashari addressed the effects of the budget sequester, which calls for across-the-board cuts to many federal agencies and programs. While ONC employees would not be required to take furloughs at this time, his agency's budget will be cut by $3 million from its annual $60 million budget. Instead, ONC will have to tap the brakes on certain future contracts in the works.

"This sequester's going to hurt," Mostashari said. "There's going to be things the industry expects us to do, that providers and patients expect us to do, that we simply will not be able to do. It may be issues around security. Issues around improving testing for quality measurement. It may be issues around interoperability, devices or long-term care. These are all critical, limited, finite, smart-government leveraged investments that can have enormous returns, and yet we have zero flexibility in terms of how the sequester cuts are taken. We're under an account, and the account is going to be cut."

Let us know what you think about the story; email Don Fluckinger, News Director, or contact @DonFluckinger on Twitter.

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