????傳播艾滋病的紐約妓女,、傳播致命病菌的蚊子、身攜炭疽病毒的恐怖份子,、到處是病人和窮人的城市……法扎德?莫斯塔沙瑞需要應(yīng)對(duì)很多挑戰(zhàn),，上面所說(shuō)的這些只是其中一部分,。莫斯塔沙瑞是一名從耶魯大學(xué)畢業(yè)的醫(yī)生、流行病學(xué)家,，另外他還自認(rèn)是一名“電腦怪胎”,。目前他的使命是：將醫(yī)生們從古騰堡時(shí)代帶進(jìn)21世紀(jì)。莫斯塔沙瑞建議剛?cè)腴T的人首先從在辦公室里使用電子郵件開始,。

????不要以為這是件容易的事,。美國(guó)雖然在尖端醫(yī)療技術(shù)領(lǐng)域走在世界前列，但面對(duì)電子通訊,，美國(guó)醫(yī)學(xué)界卻普遍持保守態(tài)度,。根據(jù)美國(guó)疾病控制與預(yù)防中心（Centers for Disease Control and Prevention）的估算，2010年大約只有百分之十出頭的私人診所醫(yī)師擁有“功能完備”的電子病歷系統(tǒng),。除了賬單,，只有不到一半的私人診所醫(yī)生會(huì)使用電腦做記錄。許多醫(yī)生的電腦通訊技能還不如一個(gè)在家里開eBay網(wǎng)店賣燒烤圍裙的人,。這是實(shí)話,。

????今年43歲的莫斯塔沙瑞是聯(lián)邦辦公室的一位主任，負(fù)責(zé)領(lǐng)導(dǎo)醫(yī)療數(shù)字化工作,，他正力圖改變這種狀況,。他總喜歡說(shuō)：“數(shù)據(jù)就是力量”。他的頭發(fā)剃得干干凈凈,，打著領(lǐng)帶,，看起來(lái)熱情四射，身上散發(fā)著一種優(yōu)秀銷售員的氣質(zhì),，談話時(shí)會(huì)碰碰拳頭,，甚至和人擊掌相慶。雖然他的個(gè)性也幫了不小的忙,，但莫斯塔沙瑞最大的王牌還是錢,。他用270億美元的聯(lián)邦刺激資金作為激勵(lì)，分配給那些安裝了電子病歷系統(tǒng),，并證明自己正在有效使用電子病歷系統(tǒng)的醫(yī)生和醫(yī)院,。一個(gè)醫(yī)生在6年的時(shí)間里最多能拿到6.4萬(wàn)美元的獎(jiǎng)金，而醫(yī)院則可能拿到數(shù)以百萬(wàn)美元計(jì)的款項(xiàng),。

????莫斯塔沙瑞相信,，電子病歷系統(tǒng)不僅可以降低成本，提高個(gè)人護(hù)理水平,，還可以帶來(lái)更多的好處?，F(xiàn)在大量的人口數(shù)據(jù)要么被孤立地裝在成千上萬(wàn)的牛皮紙信封里，要么鎖在專用的電腦系統(tǒng)里,。而電子病歷系統(tǒng)的普及可以使這些數(shù)據(jù)得到即時(shí)監(jiān)控,，從而可以警告疾病的爆發(fā),，找到證據(jù)證明哪種療法最有效，也有助于發(fā)現(xiàn)創(chuàng)新性的治療方法,。另外,，無(wú)論是醫(yī)院、保健門診還是小型私人診所,，都可以通過(guò)分析這些整合的數(shù)據(jù)來(lái)削減不必要的成本,，同時(shí)也有助于對(duì)抗醫(yī)療價(jià)格的上漲。

????哈佛大學(xué)（Harvard）教授大衛(wèi)?布魯門薩爾也是莫斯塔沙瑞在美國(guó)衛(wèi)生部（the HHS）的前任,，他說(shuō)：“他正在試圖改變整個(gè)醫(yī)療系統(tǒng),。這不是一個(gè)技術(shù)工程，而是一個(gè)社會(huì)變革工程,?！?/p>

????莫斯塔沙瑞小時(shí)候?qū)W習(xí)刻苦，成績(jī)出眾,，當(dāng)時(shí)他自己也頗以此為傲,。14歲的時(shí)候，莫斯塔沙瑞離開祖國(guó)伊朗,，搬到紐約上州地區(qū),，與姑姑住在一起。伊朗是個(gè)崇拜數(shù)理化的國(guó)家,，莫斯塔沙瑞以為,，憑著自己在科學(xué)、數(shù)學(xué)和電腦上的才智,，他在美國(guó)也會(huì)很受歡迎,。不過(guò)他錯(cuò)了。同學(xué)們都嘲笑他,，但他自己卻一直鍥而不舍。

????莫斯塔沙瑞從哈佛大學(xué)公共衛(wèi)生學(xué)院（Harvard School of Public Health）流行病學(xué)專業(yè)畢業(yè),，后來(lái)又進(jìn)入耶魯大學(xué)（Yale）醫(yī)學(xué)院深造,。他希望把實(shí)際的醫(yī)療經(jīng)驗(yàn)與流行病學(xué)對(duì)模式識(shí)別的抽象追求結(jié)合起來(lái)。在一個(gè)早期的項(xiàng)目上,，他統(tǒng)計(jì)了HIV病毒在靜脈注射藥物人群（包括妓女）中的流行度,。受雇于紐約市健康與心理衛(wèi)生部（New York City Department of Health and Mental Hygiene）后，他被任命為首席調(diào)查官,，負(fù)責(zé)調(diào)查西尼羅病毒爆發(fā)的原因,。2001年，美國(guó)爆發(fā)了令全國(guó)陷入恐慌的炭疽郵件襲擊,。隨后,，他應(yīng)用數(shù)據(jù)模式開發(fā)了早期的恐怖警報(bào)信號(hào),。

????約紐市長(zhǎng)邁克爾?布隆伯格把他放在了目前這個(gè)位子上，現(xiàn)在他的任務(wù)是要把信息技術(shù)帶給一大群極度貧困的病人,。2005年,，莫斯塔沙瑞負(fù)責(zé)了一個(gè)項(xiàng)目，幫助全市的醫(yī)院,、診所和社區(qū)醫(yī)療中心建立數(shù)字病歷系統(tǒng),。這個(gè)系統(tǒng)現(xiàn)在已經(jīng)覆蓋了200多萬(wàn)名病人。

????今天,，莫斯塔沙瑞正在試圖把這些經(jīng)驗(yàn)推廣到全國(guó),。值得注意的是，在這樣一個(gè)黨派政治當(dāng)?shù)赖臅r(shí)代,，莫斯塔沙瑞的計(jì)劃同時(shí)獲得了兩黨的支持——或者說(shuō),，至少是得到了兩黨的容忍。盡管2009年只有三名共和黨議員投票支持刺激法案（正是該法案為莫斯塔沙瑞的計(jì)劃提供了資金）,，但卻很少有人公開反對(duì)這個(gè)計(jì)劃本身,。事實(shí)上，信息技術(shù)產(chǎn)業(yè)本身也是該計(jì)劃的一個(gè)主要支持者,，IBM,、微軟（Microsoft）、通用電氣（General Electric）,、惠普（Hewlett-Packard）等科技巨頭和許多小型的專業(yè)醫(yī)療技術(shù)公司都表示了支持,。

????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 email 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.

????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 works out to as much as $64,000 per physician over six years. Eligible hospitals will receive payments in the millions.

????Mostashari believes the benefits will go well beyond improved individual care at lower cost. Rich stores of population data – now isolated in tens of thousands of manila envelopes, or locked in proprietary computer systems -- 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."

????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 got named lead investigator in the West Nile virus outbreak. In 2001he applied data patterns to develop early terror warning signals in the wake of the anthrax-by-mail attacks that terrorized the nation.

????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 program to help doctors' offices, community health centers and hospitals throughout the city set up digital record systems that now cover more than 2 million patients.

????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 the program. 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.