The Era of Paper-Based Medicine is Over: Mostashari

February 23, 2012

National health IT coordinator says most care will be delivered via EHRs by next year.

The government's national health IT coordinator said Thursday that it's almost time to light the funeral pyre for America's paper-based healthcare delivery system, and that Uncle Sam's incentive program for EHR adoption provided the match.

"We've made more progress in the last two years on provider adoption of electronic health records systems than we'd made in the previous 20 years," said Farzad Mostashari, delivering the day's keynote to a packed crowd at HIMSS, health IT conference that drew 37,000 attendees to Las Vegas. "By next year, I predict, the majority of healthcare delivered in this country will be delivered on EHRs, not on paper."

In 2011, 40,000 eligible providers received their first checks after successfully attesting to meaningfully using an EHR system, with tens of thousands more in the pipeline. The results of the meaningful use program, declared Mostashari, "have been breathtaking."

Mostashari also offered further details yesterday about the much-anticipated Stage 2 of the meaningful use regulations. Though the actual regulatory text was still being prepared on Thursday for publication by the federal register, attendees seemed pleased by what they heard. Among the highlights:

* A one-year extension for physicians and groups still struggling to meet the Stage 1 requirements. Under the original regulations, groups that had not yet successfully attested by the end of 2012 would see reductions in the amount of stimulus they could collect, and would receive reduced Medicare payments beginning in 2014. Both dates have been pushed back a year. Moreover, groups will be able to remain in Stage 1 for two full years before being required to meet the Stage 2 requirements, regardless of when they successfully attest to Stage 1.

* New rules that allow certain specialists to participate in the program, particularly radiologists. No regulations concerning access to medical images via an EHR had been included in the Stage 1 rules, meaning radiologists and some other providers that mostly deal with images could not participate. That will change in Stage 2, Mostashari said.

* Provider groups will be required to purchase only the minimum EHR technology necessary to demonstrate meaningful use. It won’t be necessary to acquire modules that are irrelevant to their own practices but that may have previously been considered part of "full" EHR system.

* Groups with multiple eligible providers will be able to attest for all of them simultaneously, Mostashari said, instead of going through the process for each individually.

"Throughout the rule, we've taken every opportunity to reduce the regulatory burden on providers, while keeping our eye on the prize," he said at a press conference following his keynote address.

At the press conference, Mostashari sidestepped a question casting doubt about whether the government would ever actually impose the Medicare payment reductions on those providers that never meaningfully use an EHR. He said that he expected that the vast majority of doctors and virtually every hospital would do so "because it's the right thing to do for their patients."

As for the presidential election this November, Mostashari said he doesn't expect its outcome to affect progress: "We really have broad bipartisan support for health IT."