Public Health Reporting, Direct Project, and the new ONC

Farzad Mostashari Takes Over ONC

Dr. Farzad Mostashari became the new ONC this week.Secretary Sebilus announced Blumenthal’s replacement after a lot of speculation and blogger’s odds. I for one, was not surprised. Dr. Mostashari has been Blumenthal’s right hand man as the deputy national coordinator for programs and policy since 2009. There has been no slacking in his education, a graduate of Harvard College, the Harvard School of Public Health, and the Yale School of Medicine. After his residency at Mass General he became an EIS Officer at the CDC. The Epidemic Intelligence Service (EIS) is a unique 2-year post-graduate training program of service and on-the-job learning for health professionals interested in the practice of applied epidemiology. Then moving to the big city that if you can “make it there” he established the Bureau of Epidemiology Services at NYC Department of Health (DOHMH) and designed their annual Community Health Survey. He was one of the lead investigators in the outbreaks of West Nile Virus and anthrax in the city and was one of the first developers of real-time electronic disease surveillance systems nationwide. Ending his career in NYC as the Assistant Commissioner at the NYC Department of Health (DOHMH) and Chair of the Primary Care Information Taskforce, he championed and facilitated the adoption of public health-oriented HIT in the under served communities. It is not hard to see what his passions are.

The final and optimal success in EHR adoption will be connecting all the dots or as they like to call it, interoperability. It is hard to connect the dots without any lines. And where to start? Stage 1 core objectives take on what most facilities at least know about with eRx and Labs which exchange health information with pharmacies and laboratories. Stage 1 meaningful use objectives are categorized in 5 priority health outcomes and the fifth priority is improving population and public health. Two Menu Objectives require electronic submissions of health information to health registries. One is to submit electronic data to immunization registries or immunization information systems and the other is to submit electronic syndrome surveillance data to public health agencies.

The Direct Project was launched one year ago in March. The project is based on the initial recommendations from the HIT Policy committee’s Nationwide Health Information Network (NHIN) work group which outlined the policy and technical framework for health information to be exchanged over the Internet. Through Direct Project the authenticated and encrypted exchange is secure, standard-based, and open sourced.To meet stage 1 meaningful use requirements, Direct Project expands on the existing NHIN standards and service descriptions to provide an easy entrance to data exchange for providers and organizations.

The new ONC looks and will be different from both his predecessors even more than his name is not David. In all the history of the ONC the one thing I think they have done right every time is pick the right person for the right time. Brailer laid the foundation and got the big IT players to buy in. Blumenthal was the head cheerleader that got the money and an initial plan that came from all the stakeholders. Mostashari actually might be the guy that can drive this train home. And who better to believe on that than John Halamka (Hail to the New ONC Cheif).

“The wind is, in a sense, at our backs, EHR systems are getting better and better and better. This is not just about getting checks from the government, it’s about professional standards.” Mostashari in an interview last year with CQ HealthBeat.