Mostashari Encourages Open Standards in Health IT Innovation

At the eHealth Collaboration Forum at HIMSS12 on Thursday, Feb. 23, Farzad Mostashari, M.D., the national coordinator for health IT, encouraged the use of open APIs and data platforms to promote the meaningful use process and referenced how the Office of the National Coordinator was doing its part through the Direct Project and code-a-thons to encourage this open collaboration.

Mostashari noted that when Aneesh Chopra stepped down from his position as CTO of the U.S., he released a document called the Government Innovators Toolkit that explained ways that government could go beyond legislating regulations as a means to create change, and instead identify innovators and unleash their creativity, as his colleague Todd Park, CTO, HHS, has advocated.

Mostashari said the ONC has been promoting market transparency to motivate vendors to create and upgrade their clinical information systems to allow providers and hospitals to reach meaningful use.
“We thought of a variety of reasons we could get vendors really motivated around meaningful use, rather than it be the sale of the next install,” he said. “What we finally hit on was why don’t we just publish the data set of everyone who tests meaningful use and link it to the certification, so that any analyst out there can do this analysis and report monthly. It’s a way of having others be more effective through transparency.”

Another way that the ONC has been encouraging open data platforms is through a series of app challenges; the ONC was one of the first of any federal agencies to initiate this program. Mostashari pointed out one innovation, an open source tool that reports human readable quality measurements from standard inputs from CCDs that debuted at HIMSS last year, as being particularly innovative. “We need ground-up systems that take a piece of that and knock the hell out of that and make something beautiful,” he added.
After receiving positive reception at HIMSS, requests for improvements on the tool poured in and another app challenge was initiated. Out of 12 development teams, the winner, a Columbia University informatics team, built an API wrapper out of the application to make a connection between clinical quality measurements and patient engagement. The app allows providers to click on measures, and select any numerator or denominator to tailor e-mails or texts, based on contact information within the system, to remind patients of specific interventions they need like a mammogram or immunization.

He said that compared to a government contract, app challenges, with prizes for instance of $75,000, are much more cost effective to reach the ONC’s goals.

Mostashari mentioned the ONC took a similar tact with the Direct Project, and instead of “throwing money to develop it,” hired Arien Malec instead to lead a group of developers within the community to create the standards for data exchange.

Mostashari concluded his presentation by offering a challenge he gave a couple of vendors exhibiting at the Interoperability Showcase 30 minutes earlier. He asked the vendors to take the next half hour to exchange data with someone they didn’t come in already exchanging data with. “I’m really curious to see what we get, and the day when [it only takes minutes instead of months to do that] is the day we won,” he said.