Farzad Mostashari: Man on a digital mission
March 12, 2012 in Medical Technology
New York hookers spreading HIV. Killer mosquitos. An anthrax-toting terrorist. An urban-scape rife with the sick and poor. These are just some of the challenges tackled by Farzad Mostashari, a Yale-educated physician, epidemiologist and self-confessed computer nerd. His current mission: moving doctors from the Age of Gutenberg into the 21st century. For starters, he’d like them to use e-mail at the office.
It’s a tough nut. The U.S. leads the world in advanced medical technologies, but when it comes to electronic communication, American medicine remains a backward culture. The percentage of private-practice doctors with “fully functional” electronic health record systems was in the low double digits in 2010, according to estimates from the Centers for Disease Control and Prevention. Less than half of solo practitioners keep computer records for anything other than billing. An eBay merchant who sells funny barbecue aprons out of his living room is better equipped for computer communication than many physicians. For real.
American industry learned decades ago that costs could be more efficiently controlled and quality improved with digitized data — information that is gathered electronically, fed into a computer, analyzed, shared and used to offer goods and services at lower cost, better quality and higher margins. Those businesses have joined the Information Age. Not health care, though. Health care costs continue to rise toward the unaffordable, even as quality lags. Meantime, health care’s most essential data — millions of patient health records, trillions of data points — remain isolated on paper stuffed into manila envelopes and stacked on shelves, or locked in proprietary computer systems programmed in incompatible software codes, making them difficult, if not impossible to share.
As head of the federal office charged with leading the digitization effort, Mostashari, 43, aims to change that. “Data is power,” he likes to say. A shaved-head, bow-tied bundle of enthusiasm, he radiates a good-salesman vibe, fist-bumping and high-fiving through conversations. While personality helps, Mostashari’s trump card is money. He is distributing $27 billion in federal stimulus funds as an incentive to doctors and hospitals who install electronic record systems and demonstrate they are meaningfully using them— a bonus that could work out to as much as $64,000 per physician over six years. Eligible hospitals will receive payments in the millions.
‘A Social Change Project’
Mostashari believes the benefits will go well beyond improved individual care. Rich stores of population data could be monitored to warn of disease outbreaks, find evidence for which procedures are most effective and help discover innovative approaches to care. Hospitals, managed care clinics, and even small doctor offices could analyze agglomerated data to carve out unnecessary costs and to help keep a lid on health price inflation.
“He’s trying to change a health care system,” says David Blumenthal, a Harvard professor and Mostashari’s predecessor in the HHS job. “It’s not a technology project, it’s a social change project.”
[See also: Recent Study: Get the Facts Mostashari blog]
A proud nerd in childhood, Mostashari at age 14 moved from Iran to upstate New York to live with an aunt. He made a mistake thinking his prowess in science, math and computers — a trait revered in his native land — would also be considered cool in the U.S. Classmates mocked him, but he persevered.
He graduated as an epidemiologist from the Harvard School of Public Health, then medical school at Yale. His intent: combine on-the-ground medical experience with epidemiology’s more abstract pursuit of pattern recognition. In an early project, he tallied the prevalence of HIV among intravenous drug users, including prostitutes. Hired by the New York City Department of Health and Mental Hygiene, he rose quickly, getting named lead investigator in the West Nile virus outbreak. In 2001, he applied data patterns to develop early terror warning signals in the wake of the anthrax-by-mail attacks that terrorized the nation.
New York City Trial Run
New York Mayor Michael Bloomberg put him on his current path: bringing information technology to a large group of have-nots — desperately poor patients. In 2005, Mostashari headed a city program to help doctors’ offices, community health centers and hospitals set up digital record systems that now cover more than 2 million patients, three quarters of whom are on Medicaid or uninsured.
Now he is attempting to apply those lessons nationally. Remarkably, in an era of partisan government, Mostashari’s program enjoys bipartisan support — or, at least, bipartisan tolerance. While only three Republicans voted for the stimulus bill in 2009, which provided the program’s funding, few have spoken out against it. The fact that the information technology industry is a big supporter — giants such as IBM, Microsoft, General Electric, Hewlett-Packard and a host of smaller health-care specialty technology companies — doesn’t hurt. The $27 billion will flow their way, and plenty of high-priced lobbyists are working hard to keep it flowing.
As of Feb. 17, the government had disbursed $3.1 billion in incentive payments to nearly 2,000 hospitals and more than 41,000 doctors, and Mostashari expects that number will balloon in the coming year.