As Dr. Farzad Mostashari, the national coordinator for health IT, prepares to leave his post this fall, the Obama administration is left without a champion for electronic health record (EHR) adoption.
"We will lose a valuable cheerleader that actually understood the various market forces affecting the industry," Shahid Shah, CEO of IT consulting firm Netspective Communications and author of The Healthcare IT Guy blog, told eWEEK in an email. "It's a loss that will be felt from a leadership perspective."
Mostashari announced his resignation Aug. 6 in an email to staff at the Department of Health and Human Services (HHS). Prior to his stint in the Office of the National Coordinator (ONC), Mostashari worked at the New York City Department of Health and Mental Hygiene, where he "set a benchmark for how EHRs should be leveraged for public health and population health management," according to a statement by the Healthcare Information and Management Systems Society (HIMSS).
He replaced Dr. David Blumenthal, who stepped down in February 2011.
The ONC chief is responsible for encouraging health care organizations to adopt EHRs and satisfy the meaningful-use objectives to qualify for federal incentives.
"[Mostashari] has seen through the successful design and implementation of ONC's HITECH [Health Information Technology for Economic and Clinical Health Act] programs, which provide health IT training and guidance to communities and providers; linked the meaningful use of electronic health records to population health goals; and laid a strong foundation for increasing the interoperability of health records—all while ensuring the ultimate focus remains on patients and their families," HHS Secretary Kathleen Sebelius told HHS colleagues in an Aug. 6 email.
A change in leadership at ONC will not likely affect existing initiatives on EHR adoption, according to Shah.
"In general there will be little or no effect on any existing initiatives because MU [meaningful use] Stages 1 and 2 are already in place," as are similar regulations, Shah said.
"[Mostashari] stepping down was not surprising as basically all [funds] have now been allocated and those physicians that would adopt an EHR for incentive payments have done so," added John Moore, managing partner at Chilmark Research.
A director with a background in medical devices could help move forward integration of medical device data, Shah noted.
Potential successors could include several officials at ONC, according to PhysBizTech.
They include Deputy National Coordinator David Muntz and Judy Murphy, who serves as deputy national coordinator for programs and policy. Other candidates include Dr. Doug Fridsma, chief science officer and director of ONC's Office of Science & Technology, and Dr. Jacob Reider, director of ONC's Office of the Chief Medical Officer.
Another potential successor who has been mentioned in reports is Dr. John Halamka, CIO at Beth Israel Deaconness Medical Center, who recently discussed with eWEEK his plans to launch a Google Glass pilot in the hospital's emergency room later this year.
Simple fatigue may have played a role in Mostashari's exit, according to insiders.
"Burnout is hard to avoid when you've cleaned the Augean Stables and your only feedback is that you missed a spot," Halamka wrote in his Life as a Healthcare CIO blog.
"I think he's just tired and wants to do something different," Shah added.
A successor will need to have the influence to accelerate EHR timelines, according to Jennifer Kent, a senior analyst at Parks Associates.
"Technology providers and investors in the connected health space will be looking for Mostashari's position to be filled quickly with someone who can similarly push this market forward," Kent told eWEEK in an email. "The ONC will want to provide the market, and especially health care providers, with a confirmation that EHR requirements and timelines will not be changing (or if so how) in Mostashari's absence."