Lobbying gets a bad rep. With billions spent each year by special interest groups and remnants of the Jack Abramoff massacre lingering in peoples' minds, its reputation doesn't come as a big surprise.
However, lobbying is a fact of life, and many experts opine that despite which side of the political aisle you may stand on, lobbying - if you squint really hard - doesn't always appear so nefarious. That's still up for fierce debate, of course, but companies and medical organizations alike advocating on behalf of health information technology are calling their efforts 'bipartisan', 'nonpartisan' and 'necessary' to move out of an antiquated convention into a value-based, technologically competent healthcare system.
Glen Tullman, Jonathan Bush and the EHR Association shared what they'd like to see in Washington and why lobbying for health IT is critical for the future of the healthcare industry.
First and foremost, they explained, it's all about talking with the right people. Having conversations with policymakers and conveying the significance of health IT to those in Washington is imperative, as oftentimes - as Jonathan Bush, CEO of athenahealth, pointed out - policymakers' understanding of the issues can be - how to say - paltry?
"Our experience is that government understanding of cloud-based business services and of the economics of sustainable health information exchange is quite low," Bush said.
For example, it's not all about pouring government money into the industry. "Government funds are not needed to enable the data liquidity that the healthcare market place needs so badly, but some critical adjustment to the anti-kickback law is needed," he continued. "We intend to educate regulators and legislators from both parties on this critical matter."
Part of this education includes emphasizing the importance of innovation in the field. Washington needs to leave room for innovation, said Daniel Orenstein, athenahealth general counsel and senior vice president. The U.S. healthcare system is lagging because more innovation and creative solutions are required to move forward. "We want to make sure that value is also reflected in the regulatory framework."
He cited innovative care delivery models and payment system reform as the two topics that receive the most attention in Washington. Health information technology, however, has not been stressed enough according to Orenstein.
According to Opensecrets.org, in 2011 the company spent $220,000 - a relatively modest amount in the lobbying world - on lobbying for issues pertaining to HIEs and the PPAC. This time around, athenahealth's main focus will be on EHRs and patient communications-related issues.
For Glen Tullman, CEO of Allscripts, it comes down to quantity versus quality. Lobbying efforts for health IT are crucial, he explained, to shift the current payment model based on quantity of care to a model based on quality.
"Our healthcare system will not get better until we can reimburse providers based on the quality of care they deliver and the outcomes realized by their patients, and it takes technology for that to happen," Tullman said. "Healthcare is truly becoming an information business."
Meaningful use also necessitates some tweaking, according to Tullman. Although he agreed that meaningful use was a "transformative step in the right direction," there are other stepping-stones to skip to.
There are still providers who don't qualify for the meaningful use program, and legislation aimed at further expanding meaningful use qualifiers has so far remained stagnant.
Tullman would also like to see something comparable to the Small Business Health IT Financing Act, a bill proposed in 2009 that would have provided loans to small businesses looking to purchase EHR systems and other health IT-related purchases.
Leigh Burchell, vice president of government affairs and public policy at Allscripts, chair, public policy workgroup at the HIMSS Electronic Health Record Association, a network representing 41 EHR vendors, said the group's role in Washington is to be "committed, active advocates for anything that is going to realize and further the value and availability to clinical information."
Advancing interoperability, electronic health records and meaningful use are among the most common conversation topics the EHR Association brings up in Washington, and all of them pertain to the magic word: information.
"We don't currently have access to a lot of information. We don't know what care is being delivered; we don't know entirely how much it costs or what happened afterwards," Burchell said. "And the way to change all of that is to ensure that providers and patients have access to all the information they need about that care. Therefore, the conversations we have, whether they're with Congressional offices or folks at ONC or CMS, we're really talking about how can we pilot additional concepts, how can we expand models that have been successful."
"It is absolutely imperative that the vendors be heard," Tullman concluded. "The development, implementation and rapid evolution of electronic health records is complex, and policymakers must be informed by the subject matter experts who are closest to the process. We can speak to the technical challenges, we can speak to our clients' experiences, and we can speak to our roadmaps, which include innovations in hardware and mobility.
