In one of his first media interviews since taking over as head of the Office of the National Coordinator for Health IT on April 8, Mostashari stresses that a critical goal of the HITECH Act's electronic health record incentive program , which his office administers, is to "make sure we do what steps are necessary ... to protect the privacy and security of information." Incorporating such protections in future EHR "meaningful use" incentive requirements for participating hospitals and physicians, as well as in the criteria for EHR software eligible for the incentive program, is "certainly going to be something that's a priority for us," he says.
Among the many technical issues that ONC, a unit of the Department of Health and Human Services, needs to address, Mostashari says, are to "find ways to give patients more granular consent over what information is disclosed and to whom ... look at the EHR certification requirements and the opportunities there, and [address] governance over trusted intermediaries. There's going to be rulemaking coming out later to identify what are some of the conditions of trust and interoperability for intermediaries [like health information exchanges] that move information between covered entities [like hospitals and clinics]."
Other Privacy, Security IssuesAlso in the interview, Mostashari notes:
- An interagency task force on privacy and security, including representatives of ONC, the HHS Office for Civil Rights and several other agencies, is continuing to work on ensuring a consistent approach to health information privacy and security.
- ONC will test components of a new health information exchange architecture recommended by the President's Council of Advisors on Science and Technology (See: Tests of New HIE Architecture Slated). The council endorsed using metadata tags tied to individual data elements within electronic health records. The tags would contain descriptive information, such as the source of the data as well as patient consent for access and exchange. ONC is studying whether to include any elements of the architecture in future requirements for the EHR incentive program. "I think there are some very exciting possibilities for technology that really permits more granular policies around sharing of information and choice," he says.
- His goal as head of ONC is "to help create the world that we wish to see, where we see improved health and healthcare, and trust in information systems on the part of the patients."
Asked whether he plans to serve a two-year term as national coordinator, following in the path of his predecessor, David Blumenthal, M.D., Mostashari says, "I plan on serving until they kick me out."
Before assuming his current role, Mostashari had served as deputy national coordinator for programs and policy at ONC. Previously, he served at the New York City Department of Health and Mental Hygiene as assistant commissioner for the Primary Care Information Project, where he helped facilitate the adoption of prevention-oriented health information technology by more than 1,500 providers in underserved communities.
Mostashari also formerly led the NYC Center of Excellence in Public Health Informatics and an Agency for Healthcare Research and Quality funded project focused on quality measurement at the point of care. He established the Bureau of Epidemiology Services at the NYC Department of Health, which provides epidemiologic and statistical expertise and data for decision making to the health department.
The physician did his graduate training at the Harvard School of Public Health and Yale Medical School and completed his internal medicine residency at Massachusetts General Hospital. He was one of the lead investigators in the outbreaks of West Nile Virus and anthrax in New York City, and was among the first developers of real-time electronic disease surveillance systems nationwide.