Health IT Czar on Making Meaningful Use 'Meaningful'

Outgoing ONC Chief Farzad Mostashari offers advice to clinicians during an interview with Eric Topol

; Farzad Mostashari, MD


September 04, 2013

In This Article

A Message for Struggling Providers

Dr. Topol: What message do you have for the doctors out there that are struggling? Some are in small practices and want to know where we are going. What do you have to say to them?

Dr. Mostashari: I think that for all of us, what makes us happy is to focus less on the things we can't control and focus more on what we can control. To help our teams, the people who rely on us, and the people who we lead, with what they can do -- create more excellence, -- and to improve, to learn, to make things better and to use the tools that we have, like Accountable Care Organizations, that is a tool. That is something you can grab. It's one-sided risk for 3 years. What other investment vehicle open to you, doctor, gives you one-sided risk for 3 years? Grab that. It is a tool. Help your patients stay healthy and stay out of the hospital, and profit from that. That is okay, right?

Meaningful use, it is a tool. Take that certification, take that decision support, take that quality measurement. Don't have quality measurement done to you or say, "I am going to be paid and judged based on quality. I can't control that." What you can do is make it meaningful; take the tools and make them meaningful. Help your staff make the tools meaningful. That is what I would say. Instead of leaning back -- in kayaking, the worst thing you can do is lean back when you are going into the rapids; you are going to flip -- lean forward and lean into it. Dig the paddle in the water and move forward with your team.

The Next Chapter: Post-ONC

Dr. Topol: It sounds like a good message for the folks out there. Now, what is in the next chapter post-ONC? When do you finish your course?

Dr. Mostashari: End of September, early October.

Dr. Topol: Are you going to take a time-out? What is the plan?

Dr. Mostashari: The plan is to spend some time making a plan. Take a little time off.

Dr. Topol: I can't imagine you being at rest for very long, what with the energy you have had during our interview. What about fast-forwarding to 2020 or even a few years past that? Where will we be in American medicine, and what do you think can be attained in a reasonable timeframe going forward?

Dr. Mostashari: Do you know the Churchill saying that Americans always do the right thing after they have exhausted all other possibilities?

Dr. Topol: Right.

Dr. Mostashari: I think we are there now. I think we are going to fix it. We are going to solve this path that we have been on towards unsustainable cost growth. One out of every $5 spent in this country is being spent on healthcare. It is just amazing, and it is not sustainable. It is not sustainable for people, for families, for businesses, for state governments, for federal governments. It is not sustainable for anybody. We are going to solve that. I think we are going to solve it not by cutting people back, not by saying "You can't get that," but by delivering better care. I really believe that.


Dr. Topol: I love your optimism. I think we all need to have that, especially at times of despair. If you were to look back, what was the most favorite thing that you have had in these 4 years at ONC, particularly the 2 years on your watch? What would you say is the one thing that stands out in the positive category?

Dr. Mostashari: The team. Just to have the privilege of working everyday with people who came into their roles because they wanted to be servants. In a way I think that is underappreciated in America today.

Dr. Topol: Farzad, this has been a really enjoyable and highly energized discussion. I have to say that I haven't really met too many people high up in the government world that have your remarkable ability to communicate and that special charisma, so thanks so much for joining us today and for giving us your views and letting us get to know you. Thanks so much also to our viewers for joining us at Medscape One-on-One.


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