Farzad Mostashari, the national coordinator for health I.T., faced a skeptical audience at the Medical Group Management Association meeting in Las Vegas. In a Q&A following his brief, off-the-cuff talk, Mostashari fielded tough questions from the audience--including one call for the postponement of ICD-10 that elicited spontaneous applause from the audience. Others pressed Mostashari on the government's intention for payment policies under ICD-10--an issue he deferred to CMS. Charged with overseeing the government's meaningful use EHR incentive program, Mostashari acknowledged what he called "enormous anxiety" in the industry over the future of the industry. "I wish we could make the regs simpler."

Asked about industry overload from so many regulatory programs at once--such as 5010, meaningful use and ICD-10--Mostashari said, in essence, that EHRs contain the keys to the kingdom of whatever payment systems emerge. Delaying ICD-10 would not accomplish anything, he added. Mostashari defended government regulators, noting that CMS is sincere in its desire to make the various initiatives work. Others pressed the national coordinator on the difficulty of reporting quality measures in different venues and formats. Harmonizing quality reporting--one of the cornerstones of meaningful use--would be "a terrific idea," he said.

The national coordinator then went on to explain why the idea might be long in coming. Each quality program is driven by separate legislation, with different timetables, he noted. "But these problems are workable," he said.

He also cited significant progress in devising data exchange standards. The hard part--making the business case for health information exchanges--is yet to come, however. The national coordinator acknowledged industry concerns over the speed of the meaningful use program, which is being parsed out in three stages. Final criteria for Stage 2 are still under development.


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